This thesis/creative project involved writing a collection of creative nonfiction essays and building a website to reflect on my experiences traveling through Spain in the summer of 2023, for both a study abroad program and on my own. There are a total of nine essays in this current collection, along with a tenth introductory essay. They reflect the chronological order of my travels to Madrid, Sevilla, Granada, Valencia, Barcelona, and Lisbon, concluding with an essay written about my return to Phoenix, Arizona. The goal of this project was to not only personally reflect on what I learned while in these various places, but also to share these experiences with a wider audience in the digital world. I plan to continue adding essays to this website, using it as a "living document" for my future travels, and as a place for further reflection.

Oral health encompasses a wide variety of conditions with two of the primary conditions being enamel degradation and periodontal disease. These ailments are intertwined and are known to be prevented by a combination of good oral hygiene and a balanced diet. Despite this, incidence rates of oral health conditions in both high and low-and-middle income countries remain high. Periodontal disease prevention is of particular relevance due to its correlation with cardiovascular disease. One highly popular diet that could serve as an alternative strategy in combatting these oral health conditions is intermittent fasting. Intermittent fasting has shown promise in decreasing systemic inflammation and blood glucose levels, both of which are correlated with periodontal disease and enamel degradation. To explore this relationship between intermittent fasting and oral health a 9-week experimental protocol with 4 randomly established groups was completed. These groups included ad libitum high and low-fat groups, and time restricted feeding high and low-fat groups. After the 9-week protocol the mice were sacrificed, and their intact jaws and gingiva tissue were isolated. Three primary methods were used to quantify the effects of intermittent fasting on oral health: comparing the enamel density between groups, comparing the alveolar bone recession between groups, and comparing the gene expression of periodontal disease markers between groups. Body composition and fasting blood glucose levels of the mice were also quantified. We found that the fasting groups had lower average fasting blood glucose levels and maintained a more physiologically ideal body composition. Despite this, the oral health analyses did not have any consistent significant results. The results of this study suggest that despite intermittent fasting’s role in blood glucose levels and body composition regulation, it has minimal effects on enamel degradation and periodontal disease development.

In 2019, 20.4 million people in the United States were diagnosed with SUDs, and only 10.3 percent of those diagnosed received SUD treatment [1]. Addiction Consult Services in the inpatient setting provide an opportunity for diagnosis and treatment. An ACS is a multidisciplinary team which offers specialized care for those with SUDs, often including initiation of medication treatment, linkage to outpatient clinics and resources, and patient counseling [2]. We sought to conduct a systematic review and partial meta-analysis on the impact of Addiction Medicine Consult services in the inpatient setting on patients with SUDs.

Dementia is a disease affecting many individuals worldwide resulting in neurological deficits. The most common form of dementia known as Alzheimer’s Disease (AD) is the 6th leading cause of death in the United States. The disease is defined by neuron loss, the presence of intracellular tau protein (tubulin associated unit) neurofibrillary tangles (NFT), and extracellular amyloid- (Aβ) plaques. For this study, our aim was to understand the staging system used based off of the disease progression, called Braak Staging. Our hypothesis is that as disease progresses, marked by Braak stages, different brain regions will begin to show differential expressions of various biological dysregulations. Molecular dysfunctions of early disease will be precursors to later disease dysfunctions. The outcomes of our study indicated there were several molecular dysfunctions in early disease with tau pathology not present in the region yet.

Families that are discharged from the Neonatal Intensive Care Unit (NICU) oftentimes need additional support which is provided by NICU follow-up home visitation programs. The emergence of the COVID-19 pandemic caused numerous programs to shift to telehealth visitation. Following the pandemic, many of those home visitation programs continue to offer telehealth support while transitioning back to in-person care. This qualitative study aims to analyze parent attitudes toward telehealth and in-person care delivery. Through analysis, 6 main themes were generated: staff support, telehealth challenges, telehealth convenience, telehealth engagement, in-person engagement, and family preferences. The hybrid participants preferred in-person visitation due to better learning and interactions, while the telehealth group leaned toward telehealth visitation for its convenience. Nevertheless, most parents desired a hybrid mode of service delivery. Both groups shared similar thoughts about the effectiveness and convenience of telehealth. Hence, telehealth is an effective method of service delivery for home visitation programs from a parent perspective. However, depending on the family and their needs, in-person services could be encouraged to further develop the learning experience and the parent-provider rapport. For a majority of families, hybrid support provides the most suitable combination of both care models.

Background: Eosinophilic esophagitis (EoE) is an increasingly prevalent allergic disease characterized by eosinophilic inflammation and symptoms of esophageal dysfunction. Diagnosis and monitoring require repeated, invasive endoscopic esophageal biopsies to assess levels of eosinophilic inflammation. Recently, the minimally invasive esophageal string test (EST) has been used collect protein in mucosal secretions as a surrogate for tissue biopsies in monitoring disease activity. From the string, assessment of the eosinophil-associated proteins major basic protein-1 (MBP-1) and eotaxin-3 (Eot3) is used to assess disease activity; however, this requires measurement in a reference laboratory, for which the turnaround time for results exceeds the time required for histopathologic assessment of endoscopic biopsies. In addition, MBP-1 and Eot3 are not markers unique to eosinophils. These obstacles can be overcome by targeting eosinophil peroxidase (EPX), an eosinophil-specific protein, using a rapid point-of-care test. Currently, EPX is measured by a labor-intensive enzyme-linked immunosorbent assay (ELISA), but we sought to optimize a rapid point-of-care test to measure EPX in EST segments. Methods: We extracted protein from residual EST segments and measured EPX levels by ELISA and a lateral flow assay (LFA). Results: EPX levels measured by LFA strongly correlated with those quantified by ELISA (rs = 0.90 {95% CI: 0.8283, 0.9466}). The EPX LFA is comparable to ELISA for measuring EPX levels in ESTs. Conclusions: The EPX LFA can provide a way to rapidly test EPX levels in ESTs in clinical settings and may serve as a valuable tool to facilitate diagnosis and monitoring of EoE.