Medical Student Research Forum Posters

In 2022, San Joaquin County had approximately 2,319 unhoused/unsheltered individuals, with 66% residing in Stockton. Studies have found that approximately 75% of unhoused individuals reported drug use of any kind and 12% reported opioid use. Additionally, drug overdosedeaths increased in the United States by more than 30% from 2019 to 2020. Transmission rates of infections associated with injection drug use have also been increasing. Harm reduction services, including syringe exchange and naloxone distribution, have been shown toreduce the rates of disease transmission and drug overdose death within communities.

In 2016, the rate of drug-induced deaths was 56% higher in San Joaquin County than the California state average. Developed in July 2020, The Stockton Harm ReductionProgram (SHRP) provides sterile syringes and injection equipment, condoms, naloxone, hygiene products, and referrals for health and housing services to people in San Joaquin County. The purpose of this study is to determine the impact of a mobile harm reduction program on usage of sterilesyringes and naloxone by program participants.

To evaluate the consistency of contraceptionplan identified at delivery hospitalization withreported contraception use over 6 monthspostpartum.

Determine which elements of a lactating patient’s clinical presentation, including breast pump use and symptoms, are associated with a diagnosis of nipple thrush.

The primary aim was to examining abortion-trained physician perspectives on barriers toabortion access and their views on physicians'roles in the legislative regulation of abortion.

The secondary aim was to elicit theperspectives and experiences of abortion-trained physicians to understand the effectsof legislation on their ability to providepatients with comprehensive reproductivecare.

Neurofibromatosis type 1 (NF1) is an inherited tumor syndrome caused by heterozygous germline mutations in the NF1 gene, occurring in approximately 1/2600 individuals. A subset of patients with neurofibromatosis type 1 (NF1) develop juvenile xanthogranulomas (JXGs), a non-Langerhans cell histiocytosis, and some of these patients also develop juvenile myelomonocytic leukemia (JMML).Yet, these associations are poorly delineated.JXG is a benign proliferation of non-Langerhans cells histiocytes characterized by small yellow/brown papulonodules ranging from 1-20 mm in size. JMML is a mixed myeloproliferative-myelodysplastic disorder that affects children, most often before age 6.4. The first and only systematic review on this described therisk of developing JMML 20 to 30 times higher in patients with NF1 with JXG lesions compared to those without JXG. Since then, mostly isolated case reports have either refuted or confirmed this triple association.

Racial inequities in medicine have impacted health outcomes in various communities. These inequities have been documented in journals to highlight racial inequities in health status, racial inequities in clinical algorithms, and racial identity and health. We conducted a review of literature and selected 95 articles to analyze and summarize in an annotated bibliography. The annotated bibliography was sorted into four categories: racial inequality in health status, racial inequality in clinical algorithms, racial identity and health (ex. mental health, development, schooling, etc.) including biracial and multiracial individuals, and the impact of racism on health. These articles highlight a theme of racial inequities in policy making, racial perceptions which influence clinical decision making, and the use of race as a sole indicator for diagnosis and treatment options in clinical algorithms. Racist perceptions against non-white patients were found to negatively influence clinical decision making in emergency settings.

Objective: This study conducted in Sacramento, California seeks to explore the challenges of women living outside during the COVID pandemic between May and August 2020.

1. To provide background demographics of women living outdoors in Sacramento during the COVID pandemic from May and August 2020.

2. To describe sources of information about COVID and what sources these unhoused women considered to be reliable.

3. To describe the lived experiences of unhoused women living during the COVID pandemic.

4. To offer recommendations for future advocacy, education and resource priorities for this vulnerable population

Method: Mixed method study of convergent design where data was collected both via a quantitative paper survey and in-depth qualitative person to person interviews. 90 women completed the paper survey and of those 21 women completed an interview.

Results: Of the 200 adult survey participants 90 (45%) identified as female and 21 (23%) of those women completed qualitative interviews that were fully transcribed. The average age was 50 years old (Range 19-73), and 39 (43%) identified as white, black/African American 29 (32%), Hispanic/Latinx 5 (5.5%), mixed 13 (14%), and other 18 (20%). 99% of study participants spoke English as their primary language. 62% (56/90) identified as having a primary care provider, while 90% (81/90) said they had insurance, with Medicaid (MediCal) being the most common type of health insurance. Theme content was analyzed and organized into three main thematic categories: information/communication about COVID 19, access to basic necessities, and power/fear. Women’s knowledge of COVD varied dramatically with many having a sense that it’s a contagious respiratory illness, others denying its existence, and others believing the virus to be man-made. Access to resources also varied with the more urban located women having improved access compared to women living closer to the Sacramento River. The dynamics between members of power in the community and the unhoused women changed depending on the women – for example, some felt amicably about the police while others were triggered and easily intimidated. Our results suggest that homeless women have unique challenges and have had varied experiences in managing during the COVID pandemic. Many feel their access to health care resources improved during the pandemic, while others continued to struggled to find basic necessities.

Conclusion: The outcomes of this study can contribute to development of appropriate programs and interventions for this marginalized population. Seeing which resources were most valued by the community and which resources were misallocated can lead to more effective responses by community and government groups when addressed homeless women’s needs during public health crises.

The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in an unprecedented global “lockdown,” which has confined millions to mandatory isolation or self-quarantining in an effort to limit virus transmission. This has led to major socioeconomic disruptions, including travel restrictions and the closure of schools and businesses. Quarantine measures and the closure of gymnasiums, public pools, and exercise facilities have disrupted the exercise/physical activity (EPA) routines of millions of people. Primary care physicians (PCPs) serve as frontline health workers as patients continue to visit them for COVID-19 and non-COVID-19 healthcare needs. Because regular EPA has proven health benefits, it is essential that PCPs are prepared to adequately counsel and offer EPA recommendations to their patients during the COVID-19 pandemic. In 2015, the World Health Organization (WHO) recommended that adults aged 18-64 should perform at least 150 minutes/week of moderate-intensity aerobic activity or 75 minutes/week of vigorous-intensity aerobic activity. EPA has been shown to have wide-ranging positive effects on physical and mental health. Regular EPA is associated with decreased rates of major chronic diseases, such as hypertension, diabetes, and coronary heart disease. Regular EPA also has been shown to have favorable effects on immune function and mental health. More recently, it also has been suggested that regular EPA can reduce the risk of acute respiratory distress syndrome, a leading cause of mortality in COVID-19 patients. Given the many potential health benefits of regular EPA, PCPs should counsel their patients about regular EPA and recommend it to them during the COVID-19 pandemic. The fluid nature of the evolving COVID-19 outbreak has resulted in unique quarantine and social distancing guidelines in different countries, states, and locales. In consideration of the EPA recommendations from the American College of Sports Medicine and the WHO, and in consideration of the ongoing need for some albeit varying quarantine and social distancing guidelines, we propose PCPs offer their patients the following EPA counseling and recommendations during the COVID-19 pandemic.