Duke Research Blog

Following the people and events that make up the research community at Duke.

Category: Medicine (Page 2 of 17)

Bass Connections and GHANDI – Understanding Disability from a Global Perspective

Duke prides itself on being a research institution that is not only intellectually curious, but also extremely interdisciplinary. Through Duke’s Bass Connections initiative, students and faculty come together in project teams that tackle complex issues using multiple disciplines and approaches. The program held its annual fair last week to showcase its work and to get new students connected with these exciting projects.

How does it work?

Graduate students, undergraduates, and faculty members apply for a research project in any of these five areas: Brain and Society, Information Society & Culture, Global Health, Education & Development, and Energy. Once accepted, group members work on a year-long research project, that often includes a field work component. One project in particular that combines many disciplines and interests to address an issue of global importance GANDHI, a Global Health project that studies disability from multiple cultural perspectives.

What is GANDHI?

GANDHI team members meet with Dr. Rune Simeonsson at UNC to discuss the WHO ICF-CY (International Classification of Functioning – Children and Youth), a document he helped co-write that provides a framework for diagnosing and addressing disability.

The Global Alliance on Disease and Health Innovation (GANDHI) was created in 2016 to support disabled individuals by providing them with the community reintegration tools necessary to live a healthy, comfortable life. Yukhai Lin, a Duke undergrad and GANDHI team member, shared that many hospital systems are not good at helping those the disabled reintegrate themselves in their community, and often forget about their patients after they are released. The research team recognized this flaw, and began a thorough data collection process to understand the reason for this lack of care. In the fall of 2016, team members took a seminar course, “Living with Disability Around the Globe”, in which they were paired with global partners in ten different countries to examine disability from a more specific context. In this interdisciplinary class, team members not only strengthened their knowledge of disability and its implications on global societies, but they were also able to develop strong research skills, for they ultimately synthesized their findings by creating a thorough comparison of disability in each of the countries studied.

The team also attended a conference in New Orleans to network with organizations that were conducting similar research. Lin said she interviewed doctors from The Netherlands, as well as leaders of influential health organizations to holistically understand the issues that come with helping the disabled. The team hopes to present their findings at a forum this spring, and, like many other Bass Connection projects, will continue throughout the 2017-2018 academic year. They encourage all to apply, and hope to broaden the scope of their research by adding countries in Southeast Asia and creating new opportunities for fieldwork. Some eager students have already showed interest in going to China to interview families with disabled members, says Lin.

Other Bass Connections projects at the fair spread across all disciplines, ranging from the development of effective chemotherapy drugs to the study of urban development in cities across the globe. But, what all projects share in common is a strong emphasis on research that is hands-on, collaborative, and relevant to society.

 

Post by Lola Sanchez-Carrion

Using the Statistics of Disorder to Unravel Real-World Chaos

What do election polls, hospital records, and the Syrian conflict have in common? How can a hospital use a patient’s vital signs to calculate their risk of cardiac arrest in real time?

Duke statistical science professor Rebecca Steorts

Duke statistical science professor Rebecca Steorts

Statistician Rebecca Steorts is developing advanced data analysis methods to answer these questions and other pressing real-world problems. Her research has taken her from computer science to biostatistics and hospital care to human rights.

One major focus of Steorts’ research has been estimating death counts in the Syrian civil war. She is working with her research group at Duke and the Human Rights Data Analysis Group (https://hrdag.org/) on combining databases of death records into a single master list of deaths in the conflict, a task known as record linkage.

“The key problem of record linkage is this: you have this duplicated information, how do you remove it?” explained Steorts. For example, journalists from different organizations might independently record the same death in their databases. Those duplicates have to be removed before an accurate death toll can be determined.

At first glance, this might seem like an easy task. But typographic errors, missing information, and inconsistent record-keeping make hunting for duplicates a complex and time consuming problem; a simple algorithm would require days to sort through all the records. So Steorts and her collaborators designed software to sift through the different databases using powerful machine learning techniques. In 2015, she was named one of MIT Technology Review’s 35 Innovators Under 35 for her work on the Syrian conflict. She credits a number of colleagues and students for their contributions to the project, including Anshumali Shrivastava (Rice University), Megan Price (HRDAG), Brenda Betancourt and Abbas Zaid (Duke University), Jeff Miller (Harvard Biostatistics, formerly Duke University), Hanna Wallach (Microsoft Research), and Giacomo Zanella (University of Bocconi and Visitor of Duke University in 2016).

Steorts’ work towards estimating death counts in the Syrian conflict is still ongoing, but human rights isn’t the only field that she plans to study. “I think of my work as very interdisciplinary,” she said. “For me, it’s all about the applications.”

Recently, Steorts, colleague Ben Goldstein, and students Reuben McCreanor and Angie Shen have been applying statistical methods to medical data from the Duke healthcare system. Her ultimate goal is to find techniques that can be used for many different applications and data sets.

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Guest post by Angela Deng, North Carolina School of Science and Math, Class of 2017

Starting Your Own Business in Social Entrepreneurship? Lessons from Four Founders

Interested in starting your own jazz festival? Or creating hydrogen-rich water to boost your circulation and improve muscle recovery?

These are the accomplishments of Cicely Mitchell and Gail Levy, who were among four inspiring leaders at the evening panel discussion in the Fuqua School of Business this past Wednesday. Excited students and faculty gathered in the Kirby Reading room to learn about the leaders’ unique perspectives as founders of non-profit and for-profit solutions to various social impact and sustainability issues.

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Students and faculty gathered for dinner and networking before the panel discussion.

Organized by the Duke Innovation & Entrepreneurship Initiative and the Center for the Advancement of Social Entrepreneurship (CASE), the panel served to enlighten the audience about the challenges the women have faced and the lessons they learned in starting and scaling their social ventures. Panel moderator Erin Worsham, the Executive Director of CASE, opened the discussion with a few statistics.

In the non-profit sector, women make up 75% of the workforce, but in leadership positions, this ratio drops to 45%. As of 2013 in the for-profit sector, only 2.7% of venture capital investments went to fund companies with a female CEO. While black women own 1.5 million businesses in the U.S., they receive only 0.2% of venture funding. Undoubtedly, Worsham concluded, there is a lot of work to do in terms of women getting funded and represented as leaders.

Erin Worsham opened up the panel with statistics about women in the workforce. Worsham is the Executive Director of the award-winning CASE based at Duke University’s Fuqua School of Business

To commence the discussion, Worsham asked the panelists to speak about the gender discrimination they faced while starting their own companies. Gail Levy, founder of H Factor Water, a health-focused company producing hydrogen-infused water in environmentally friendly packaging, answered with a time she was challenged to a drinking match in order to close a deal. “The lesson I learned is to not go and drink your way into making a deal,” Levy joked. “But more importantly, you need to have grit and tenacity. Let our presence be known, because eventually we will be heard.”

Gail

Gail Levy was the founder of the White House Millennium Green Committee under the Clinton Administration in 1999. She is passionate about advocating for women worldwide and is also the founder of H Factor Water.

Founder of The Art of Cool, a Durham nonprofit promoting music education to Durham-area youth, Cecily Mitchell remarked that she would be charged significantly more money than a male counterpart to work with the same artist.

Cicely Mitchell is co-founder of The Art of Cool, a Durham nonprofit promoting music education to Durham-area youth

Cicely Mitchell is co-founder of The Art of Cool, a Durham nonprofit promoting music education to Durham-area youth

Rebecca Ballard, lawyer and founder of Maven Women, a sustainability-focused fashion company dedicated to making professional wear for women, noted that “we live in a visual world, but we need to start looking at a person’s character rather than solely focusing on how they look.” Based on her experience with her medical real estate development company ACCESS Medical Development, angel investor Stephanie Wilson expanded on the comment, adding that the best thing to do about the prejudice against women is to know that it’s there and fight for it.

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Rebecca Ballard told the audience, “The most challenging thing about being a working woman is that appearance is considered ‘relevant.’” She started her career as a public interest lawyer and was previously the Executive Director of Social Impact 360.

I asked the founders to share their experiences in building a successful customer base. Wilson noted that to institute her company, she “determined who was the top real estate agent in our area and sought them out. I discussed my idea with them and asked for their advice on segueing into the market.” She suggested sending handwritten thank you notes to build relationships with your customers.

Stephanie Wilson founded ACCESS Medical Development and is also the co-founder of MillennialsMovingMillions.org.

Stephanie Wilson founded ACCESS Medical Development and is also the co-founder of MillennialsMovingMillions.org.

Mitchell added that The Art of Cool held the first few concerts for relatives and friends, and later partnered up with other small entrepreneurs. “Make sure what you do connects with people enough that they want to go and tell other people about what you’re doing,” she advised.

Cecily Mitchell talked about her experience with The Art of Cool. She handles the booking, contracts, networking, pitching for sponsorships and assisting in writing grants for the company.

Maven Woman founder Rebecca Ballard commented on the importance getting support from women in other sustainable industries, since “you are all driven by the same mission in the social entrepreneurship space.”

Rebecca

Rebecca Ballard is the founder of Maven Women, a sustainability-focused fashion company dedicated on making professional wear for women.

Worsham’s final question for the panel asked for any last pieces of advice. Ballard concluded the conversation with a reason why she started her company: “Social entrepreneurship exists because the status quo is not okay. There are externalities happening and people being treated badly; the status quo doesn’t have to be the way it is.”

From left to right:

Posing with the panelists! From left to right: Anika Radiya-Dixit (author), Gail Levy, Cecily Mitchell, Rebecca Ballard, and Stephanie Wilson.

By Anika Radiya-Dixit

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Depression Screening Questions Seem to Miss Men

Women may be more likely to be diagnosed and treated for anxiety and depression not because they are, but because they’re more willing than men to honestly answer the questions used to diagnose mental health problems, a new Duke study finds.

man drinking - Wellcome Images

Asking men about their drinking might identify more cases of the blues like this guy. (Blauwe Week 1936 advertisement against alcohol. From Wellcome Images via Wikimedia Commons)

Jen’nan Read, a Duke sociologist and lead-author of the study, said men seem to adhere to a societal stigma to remain “macho” and are less likely to open up about their feelings. Her findings appear in Sociological Forum available online now and will appear in print in December.

Read’s study examines connections between mental and physical health in both men and women and suggests that the criteria used to examine mental health should be expanded beyond depression to include questions on substance abuse, which is another form of expressing mental distress, and more common among men.

The study finds that while depression is often how women express problems with mental health, men do so by drinking alcohol. The Duke study found that questioning men about alcohol use is a better way to diagnose both mental and physical health problems.

“Depression gives a lopsided picture,” Read said. “It makes mental health look like a women’s issue.”

A common set of questions include asking how often people have trouble getting to sleep or staying asleep, felt sad, lonely or like ‘you couldn’t shake the blues.’

Jen'nan Read is a Duke sociologist

Jen’nan Read is a Duke sociologist

“It’s more acceptable for women to answer affirmatively to these questions,” Read said. “Men are less likely to say they have feelings of anxiety. Issues of masculinity lead many to mask their problems.”

The result is often missed diagnoses of mental health problems in men.

The study crunches data from the Aging Status and Sense of Control Survey, in which people answer questions about their mental and physical health, diet, family situation, access and use of health care and other life factors. The average of women surveyed is about 54, and the average age of men was about 51.

Read’s study found that both men and women suffering from poor mental health are likely to suffer physical problems as well, like high blood pressure, diabetes and other issues.

The study was conducted by Read, Jeremy R. Porter, a sociologist with the City University of New York – Brooklyn College, and Bridget K. Gorman, a sociologist at Rice University.

Eric FerreriGuest Post by Eric Ferreri, Duke News and Communications

Does Digital Healthcare Work?

Wearable technologies like Fitbit have been shown to provide a short-term increase in physical activity, but long-term benefits are still unclear, even if recent studies on corporate wellness programs highlight the potential healthcare savings.

Headshot of Luca Foschini

Luca Foschini, PhD is a co-founder and head of data science at Evidation Health, and a visiting research scientist at UCSB. Source: Network Science IGERT at UCSB.

To figure out the effects of these technologies on our health, we need ways to efficiently mine through the vast amounts of data and feedback that wearable devices constantly record.

As someone who has recently jumped on the Fitbit “band” wagon, I have often wondered about what happens with all the data collected from my wrist day after day, week after week.

Luca Foschini, a co-founder and head of data science at Evidation Health, recently spoke at Duke’s Genomic and Precision Medicine Forum where he explained how his company uses these massive datasets to analyze and predict how digital health interventions — Fitbits and beyond — can result in better health outcomes.

California-based Evidation health uses real-life data collected upon authorization from 500,000-plus users of mobile health applications and devices. This mobile health or “mHealth” data is quickly becoming a focus of intense research interest because of its ability to provide such a wealth of information about an individual’s behavior.

Foschini and Evidation Health have taken the initiative to design and run clinical studies to show the healthcare field that digital technologies can be used for assessing patient health, behavioral habits, and medication adherence, just to name a few.

Foschini said that the benefits of mobile technologies could go far beyond answering questions about daily behavior and lifestyle to formulate predictions about health outcomes. This opens the door for “wearables and apps” to be used in the realm of behavior change intervention and preventative care.

Foschini speaks at Duke’s Genomic and Precision Medicine Forum

Foschini explains how data collected from thousands of individuals wearing digital health trackers was used to find a associations between activity tracking patterns and weight loss.

Evidation Health is not only exploring data based on wearable technologies, but data within all aspects of digital health. For example, an interesting concept to consider is whether devices create an opportunity for faster clinical trials. So-called “virtual recruiting” of participants for clinical studies might use social media, email campaigns and online advertising, rather than traditional ads and fliers. Foschini said a study by his firm found this type of recruitment is up to twelve times faster than normal recruitment methods for clinical trials (Kumar et al 2016). 

While Foschini and others in his field are excited about the possibilities that mHealth provides for the betterment of healthcare, he acknowledges the hurdles standing in the way of this new approach. There is no standardization in how this type of data is gathered, and greater scrutiny is needed to ensure the reliability and accuracy of some of the apps and devices that supply the data.

amanda_cox_100 Post by Amanda Cox

Diabetes — and Privacy — Meet ‘Big Data’

“Click here to consent forever.”

If consent to participate in medical research were that simple, Joanna Radin of Yale University would have to find a new focus for her research, and I would never have found the Trent Center for Bioethics, Humanities & History of Medicine.

Luckily for us both, this is not the case. Medical consent is a very complex issue that can, as Radin’s research attests, traverse generations.

joanna-radin-headshot

Joanna Radin’s reserach focuses on the intersection of medical history, anthropology and ethics at Yale University. Source: Yale School of Medicine

Radin is an Associate Professor of Medical History at Yale, the perfect fit for the Humanities in Medicine Lecture Series taking place this month at the Trent Center. Her research nails the narrow intersection of medical history, anthropology, bioethics and data analytics. In fact, Radin’s appeal is so broad that her visit to Duke was sponsored by no less than six Duke departments, including the Departments of Computer Science, History, Electrical and Computer Engineering, Cultural Anthropology and Statistical Science.

Radin’s lecture honed in on a well-known case in the realm of bioethics and medical history: the Pima Native American tribe in Arizona, which is known for unusually high rates of diabetes and obesity. The Pima were the first Native American tribe to be granted a reservation in Arizona—30,000 acres—at the beginning of the California Gold Rush. In 1963, following nearly half a century of mass famine among the Pima, the National Institute of Health (NIH) conducted a survey for rheumatoid arthritis in the Pima tribe, instead discovering a frighteningly high frequency of diabetes.

In 1965, the NIH initiated a long-term observational study of the Pima that continued for about 40 years, though it was meant to last no more than 10. The goal of the study was to learn about diabetes in the “natural laboratory” of sorts that the Pima reservation unwittingly provided. The data collected in this study came to be known as the Pima Indian Diabetes Data set (PIDD).

Machine learning enters the story around 1987, when David Aha and colleagues at the University of California, Irvine (UCI) created the UCI Machine Learning Repository, an archive containing thousands of data sets, databases and data generators. The repository is still active today, virtually a gold mine for researchers in machine learning to test their algorithms. The PIDD is one of the oldest data sets on file in the UCI archive, “a standard for testing data mining algorithms for accuracy in predicting diabetes,” according to Radin.

pima_indian_man_miguel_a_farmer_pima_arizona_ca-1900_chs-3625

A Pima farmer in Pima, Arizona, circa 1900. Source: Wikimedia Commons

Generations’ worth of data on the Pima tribe have been publicly accessible in the UCI archive for over two decades, creating ethical controversy around the accessibility of information as personal as blood pressure, body mass index (BMI) and number of pregnancies of Pima Native Americans. Though the PIDD can help refine machine learning algorithms that could accurately predict—and prevent—diabetes, the privacy issues provoked by the publicness of the data are impossible to ignore.

This is where “eternal” medical consent enters the equation: no researcher can realistically inform a study participant of what their medical data will be used for 40 years in the future.

These are the interdisciplinary questions that Radin brought forth in her lecture, weaving together seemingly opposite fields of study in an engaging, thought-provoking presentation. No one who left that room will look at the Apple Terms & Conditions the same way again.

 

Post by Maya Iskandarani iskandarani_maya_100hed

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