There is a growing body of scientific evidence that the health of the microbiome (the trillions of microbes that inhabit the human host) plays an important role in maintaining the health of the host and that disruptions in the microbiome may play a role in certain disease processes. An increasing number of research studies have provided evidence that the composition of the gut (enteric) microbiome (GM) in at least a subset of individuals with autism spectrum disorder (ASD) deviates from what is usually observed in typically developing individuals. There are several lines of research that suggest that specific changes in the GM could be causative or highly associated with driving core and associated ASD symptoms, pathology, and comorbidities which include gastrointestinal symptoms, although it is also a possibility that these changes, in whole or in part, could be a consequence of underlying pathophysiological features associated with ASD. However, if the GM truly plays a causative role in ASD, then the manipulation of the GM could potentially be leveraged as a therapeutic approach to improve ASD symptoms and/or comorbidities, including gastrointestinal symptoms.

One approach to investigating this possibility in greater detail includes a highly controlled clinical trial in which the GM is systematically manipulated to determine its significance in individuals with ASD. To outline the important issues that would be required to design such a study, a group of clinicians, research scientists, and parents of children with ASD participated in an interdisciplinary daylong workshop as an extension of the 1st International Symposium on the Microbiome in Health and Disease with a Special Focus on Autism (www.microbiome-autism.com). The group considered several aspects of designing clinical studies, including clinical trial design, treatments that could potentially be used in a clinical trial, appropriate ASD participants for the clinical trial, behavioral and cognitive assessments, important biomarkers, safety concerns, and ethical considerations. Overall, the group not only felt that this was a promising area of research for the ASD population and a promising avenue for potential treatment but also felt that further basic and translational research was needed to clarify the clinical utility of such treatments and to elucidate possible mechanisms responsible for a clinical response, so that new treatments and approaches may be discovered and/or fostered in the future.

Background: Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey.

Methods: Announcements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects.

Results: Responses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors. For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments. The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments.

Conclusion: Although this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD.

With the recent rise in opioid overdose and death1<br/><br/>, chronic opioid therapy (COT) programs using<br/>Center of Disease Control (CDC) guidelines have been implemented across the United States8<br/>.<br/>Primary care clinicians at Mayo Clinic initiated a COT program in September of 2017, during the<br/>use of Cerner Electronic Health Record (EHR) system. Study metrics included provider<br/>satisfaction and perceptions regarding opioid prescription. Mayo Clinic transitioned its EHR<br/>system from Cerner to Epic in October 2018. This study aims to understand if provider perceptions<br/>about COT changed after the EHR transition and the reasons underlying those perceptions.

Natural gas development in the Northern Appalachian region has skyrocketed dramatically over the past decade. Correspondingly to the unprecedented growth rate of the natural gas industry, population health risks have shifted dramatically in response to both aerial and water pollution. With energy as a key input in all sectors of Appalachian life, the Pennsylvania region serves as a fascinating case study where clusters of unconventional gas drilling wells intersect varying population densities and governing laws to create different levels of health risks. Studies have found that horizontal hydraulic fracking corresponds to an increased risk of upper respiratory symptoms (URS), low birth weights, premature births, and certain cancers (White et al., 2009). Also, zoning and local planning laws are policy tools local governments can use to directly influence community wellbeing (Diez-Roux, 2011). This study will focus on the spatial relationship between upper respiratory symptoms (URS), a key volatile health benchmark, and the zoning/planning laws that the Oil and Natural Gas Industry must adhere to. Our project seeks to provide a preliminary understanding of the interplay between different natural gas zoning laws and the resulting health implication risks that appear in the Marcellus shale region of Pennsylvania. This is necessary to appropriately regulate and monitor hydraulic fracking. To get a better understanding of this phenomenon, spatial autocorrelation and analysis of variance statistics are integrated to generate a surface-level understanding of areas impacted by natural gas development. To guide the creation of our models, we geographically process the unconventional well locations, upper respiratory symptom health utilization, and zoning law data to develop insights that policymakers can take into consideration. Regionally, natural gas has become an integrated part of the energy sector and a driver of local economic development. The patterns drawn from this assessment provide a novel way of understanding the population health risks posed by different zoning ordinance models.

The influence of exercise on cognitive function is an important topic. This study examines the effects of different interventions on executive functioning, specifically on cognitive planning, which is a sub-category of executive function, in adults with Down syndrome. Research has shown that an acute bout of Assisted Cycle Therapy improved manual motor functioning, cognitive planning, and information processing in adolescents with Down syndrome but there is a lack of research when it comes to resistance training. Fourteen adults with Down syndrome completed acute sessions of Assisted Cycle Therapy, Resistance Training, and No Training. Cognitive planning was measured by the Tower of London test. The results show that cognitive planning can be improved following Assisted Cycle Therapy. An increase in cognitive planning was also present in the No Training group which may be a result of cognitive stimulating games that were played. In conclusion, this study suggests that teachers, therapists, etc. that work with adults with DS, should be sure to include a cognitive component in all activities.

Social media is rapidly changing the way we view the world and live our lives, serving as an online space for connection, creative expression, and inspiration. However, the ever-evolving world of photo editing apps combined with popular health and fitness content on social media sites can be a dangerous combination for young women’s self esteem and body image. This thesis defense explores the ways in which young women are influenced by content that they interact with online. The goal of this project was to provide a general analysis of how fitness and diet-promoting culture on Instagram is affecting young women’s behaviors and perceptions of themselves with an emphasis on the local ASU community. A literature review was conducted as well as an informal survey in order to collect data on the topic and formulate suggestions for alleviating these issues.

Agenesis of the corpus callosum is the lack of the development of the corpus callosum. This condition can lead to impairments in language processing, epilepsy, and emotion and social functioning, but many individuals with this condition do not show any of these impairments. The present study investigated the connectivity of language and sensorimotor networks within an individual with agenesis of the corpus callosum using resting-state fMRI. The individual’s results were compared to those of neurotypical control subjects. It was hypothesized that the overall interhemispheric functional connectivity would be less than that of a control group in bilateral language networks, but the intrahemispheric connectivity, particularly within the sensorimotor network, would show greater functional connectivity. The results revealed significantly weaker functional connectivity in the individual with agenesis of the corpus callosum within the right ventral stream compared to the control group. There were no other significant inter or intrahemispheric differences in the functional connectivity of the language and sensorimotor networks. These findings lead us to conclude that the right hemisphere’s ventral stream perhaps relies upon connections with the left hemisphere’s language networks to maintain its typical functionality. The results of this study support the idea that, in the case of corpus callosum agenesis, the right language network may contribute differently to language processes than in neurotypical controls.

The purpose of this project is to explore the historical context and current state of prison hospice programs in the US. This objective was accomplished through an extensive review and synthesis of the relevant literature pertaining to prison hospice programs in the US. The historical increase of the incarceration rate beginning in America during the 1980’s has led to the development of more elderly prisoners than ever before in the US. As prisoners age in the US correctional system, they experience faster-than-average health decline. Mass incarceration has placed incredible strain on the correctional system to provide healthcare to the medically complex elderly inmate population. This project proposes that some of this systematic strain may be alleviated through the action of prison hospice programs. Prison hospices replace unnecessary industrial medical interventions with personalized comfort care measures and the unique service of inmate volunteers. This approach to medical care at the end of life has become the standard of care for the free population but is slower to emerge in the prison context. This project asserts that the dying US inmate population should be offered the right to a dignified death through equitable access to hospice services.