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"Hood, Michelle"
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Equivalence of using a desktop virtual reality science simulation at home and in class
The use of virtual laboratories is growing as companies and educational institutions try to expand their reach, cut costs, increase student understanding, and provide more accessible hands on training for future scientists. Many new higher education initiatives outsource lab activities so students now perform them online in a virtual environment rather than in a classroom setting, thereby saving time and money while increasing accessibility. In this paper we explored whether the learning and motivational outcomes of interacting with a desktop virtual reality (VR) science lab simulation on the internet at home are equivalent to interacting with the same simulation in class with teacher supervision. A sample of 112 (76 female) university biology students participated in a between-subjects experimental design, in which participants learned at home or in class from the same virtual laboratory simulation on the topic of microbiology. The home and classroom groups did not differ significantly on post-test learning outcome scores, or on self-report measures of intrinsic motivation or self-efficacy. Furthermore, these conclusions remained after accounting for prior knowledge or goal orientation. In conclusion, the results indicate that virtual simulations are learning activities that students can engage in just as effectively outside of the classroom environment.
Journal Article
Per- and Polyfluoroalkyl Substances and Hormone Levels During the Menopausal Transition
Abstract
Context
Per- and polyfluoroalkyl substances (PFAS) are widespread chemicals that may affect sex hormones and accelerate reproductive aging in midlife women.
Objective
To examine associations between serum PFAS concentrations at baseline (1999-2000) and longitudinal serum concentrations of follicle-stimulating hormone (FSH), estradiol, testosterone, and sex hormone-binding globulin (SHBG) at baseline and through 2015-2016.
Design
Prospective cohort.
Setting
General community.
Participants
1371 midlife women 45 to 56 years of age at baseline in the Study of Women’s Health Across the Nation (SWAN).
Main Outcome Measure(s)
FSH, estradiol, testosterone, SHBG.
Results
In linear mixed models fitted with log-transformed hormones and log-transformed PFAS adjusting for age, site, race/ethnicity, smoking status, menopausal status, parity, and body mass index, FSH was positively associated with linear perfluorooctanoate [n-PFOA; 3.12% (95% CI 0.37%, 5.95%) increase for a doubling in serum concentration), linear perfluorooctane sulfonate [PFOS; 2.88% (0.21%, 5.63%)], branched perfluorooctane sulfonate [2.25% (0.02%, 4.54%)], total PFOS (3.03% (0.37%, 5.76%)), and 2-(N-ethyl-perfluorooctane sulfonamido) acetate [EtFOSAA; 1.70% (0.01%, 3.42%)]. Estradiol was inversely associated with perfluorononanoate [PFNA; −2.47% (−4.82%, −0.05%)) and n-PFOA (−2.43% (−4.97%, 0.18%)]. Significant linear trends were observed in the associations between PFOS and EtFOSAA with SHBG across parity (Ps trend ≤ 0.01), with generally inverse associations among nulliparous women but positive associations among women with 3+ births. No significant associations were observed between PFAS and testosterone.
Conclusions
This study observed positive associations of PFOA and PFOS with FSH and inverse associations of PFNA and PFOA with estradiol in midlife women during the menopausal transition, consistent with findings that PFAS affect reproductive aging.
Journal Article
Hepatic steatosis in postmenopausal women is characterized by distinct serum extracellular vesicle proteomic signatures
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is common among midlife women. Circulating extracellular vesicles (EVs) carry bioactive cargo that may mediate or reflect disease processes, but their role in hepatic steatosis in postmenopausal women remains unexplored.
Methods
We conducted liquid chromatography data-independent acquisition–mass spectrometry on serum-derived EVs from 275 postmenopausal women enrolled in the Michigan site of the Study of Women’s Health Across the Nation (MI-SWAN). Participants were grouped by hepatic steatosis status (
n
= 75), assessed via standardized ultrasound at the 2010 follow-up visit. Fasting serum samples were processed using size exclusion chromatography to isolate EVs. Differential EV protein abundance was evaluated by ANCOVA, adjusting for ethnicity and diabetes status, and applying Benjamini–Hochberg correction. Gene Set Enrichment Analysis (GSEA) was performed to identify enriched biological pathways.
Results
Among 469 detected EV proteins, 60 differed by hepatic steatosis status (
p
< 0.05), with two proteins remaining significant after multiple testing correction: complement C4A (C4A) and afamin (AFM). GSEA indicated enrichment in lipid metabolism and innate immune activation pathways. Subgroup analyses revealed racial and disease severity-specific differences in EV protein profiles. In Black women (
n
= 172), AFM, C4A, and APOA1 were significantly elevated, while in White participants (
n
= 103), no proteins reached significance, although AFM displayed a nonsignificant trend toward higher abundance. In participants with severe hepatic steatosis (
n
= 43), subgroup analysis showed increased COL18A1, AFM, PRG4, and INHBE and decreased C4A and APOA1. INHBE was the only protein consistently elevated across all three subgroups, whereas others showed subgroup-specific enrichment, such as immunoglobulins in Black women and complement or coagulation proteins in White participants and those with severe steatosis. Analysis of hepatic transcriptomic datasets demonstrated consistently higher
INHBE
expression across the MASLD spectrum, including metabolic dysfunction-associated steatohepatitis (MASH), while
AFM
expression was significantly higher in the MASH vs. steatosis comparison.
Conclusions
This study demonstrates that circulating EV proteomes differ by hepatic steatosis status in postmenopausal women. While exploratory, candidate EV proteins such as INHBE and AFM merit validation as biomarkers and potential contributors to MASLD in this high-risk population.
Journal Article
Impact of a music therapy program on mental health and school attendance among female adolescents in Kasai-Central province, Democratic Republic of Congo
This study assessed whether a music therapy program improved mental health and school attendance among girls in the Democratic Republic of Congo (DRC) following economic and conflict-related insecurity. It included 483 girls aged 10–14 who participated in the Healing in Harmony (HiH) program, implemented by World Vision and Make Music Matter in Kasai-Central province. Participants completed surveys before and after the program, and up to two follow-up interviews assessing depression, anxiety, self-esteem, and school attendance. Before the program, 36.0% (95% CI 31.7%–40.3%) and 60.5% (95% CI 56.1%–64.8%) screened positive for depression and anxiety, respectively. After participation, the risk of screening positive declined by 75% for depression (RR = 0.27, 95% CI 0.22–0.32) and by about half for anxiety (RR = 0.46, 95% CI 0.41–0.53), with improvements sustained up to 17 months. Self-esteem scores increased by 3.93 points (95% CI 3.22–4.64, p<0.001). School absenteeism decreased from 10% (95% CI 7.2%–12.6%) to 5.4% (RR = 0.54, 95% CI 0.40–0.73). Participation in HiH was associated with sustained improvements in mental health and school attendance. These findings support integrating psychosocial care into humanitarian responses to improve both mental health and educational outcomes for crisis-affected children.
Journal Article
Associations between sleep and cognitive performance in a racially/ethnically diverse cohort: the Study of Women’s Health Across the Nation
Abstract
Study Objectives
To determine whether actigraphy-assessed indices of sleep are associated with cognitive performance in women, and explore whether these associations vary by race/ethnicity.
Methods
Participants were 1,126 postmenopausal community-dwelling females (mean age 65 years) from the observational Study of Women’s Health Across the Nation (SWAN); 25% were black, 46% white, 13% Chinese, 11% Japanese, and 5% Hispanic. Actigraphy-assessed sleep measures included total sleep time, wake after sleep onset (WASO), and fragmentation. Cognitive measures included immediate and delayed verbal memory, working memory, and information processing speed. All measures were assessed in conjunction with SWAN annual visit 15.
Results
Across the sample, after covariate adjustment, greater WASO and fragmentation were concurrently associated with slower information processing speed. Black participants had significantly worse sleep relative to other race/ethnic groups. Significant race/sleep interactions were observed; in black, but not white, participants, greater fragmentation was concurrently associated with worse verbal memory and slower information processing speed, and greater WASO was concurrently associated with slower information processing speed. Sleep-cognitive performance associations were not different in Chinese and Japanese participants relative to white participants.
Conclusions
Greater wakefulness and fragmentation during sleep are concurrently associated with slower information processing. Sleep continuity impacted concurrent cognitive performance in black, but not white, women. This effect may not have been detected in white women because their sleep was largely within the normal range. Future longitudinal studies in diverse samples are critical to further understand whether race/ethnicity moderates the influence of sleep on cognitive performance.
Journal Article
Simulation based virtual learning environment in medical genetics counseling: an example of bridging the gap between theory and practice in medical education
Background
Simulation based learning environments are designed to improve the quality of medical education by allowing students to interact with patients, diagnostic laboratory procedures, and patient data in a virtual environment. However, few studies have evaluated whether simulation based learning environments increase students’ knowledge, intrinsic motivation, and self-efficacy, and help them generalize from laboratory analyses to clinical practice and health decision-making.
Methods
An entire class of 300 University of Copenhagen first-year undergraduate students, most with a major in medicine, received a 2-h training session in a simulation based learning environment. The main outcomes were pre- to post- changes in knowledge, intrinsic motivation, and self-efficacy, together with post-intervention evaluation of the effect of the simulation on student understanding of everyday clinical practice were demonstrated.
Results
Knowledge (Cohen’s
d
= 0.73), intrinsic motivation (
d
= 0.24), and self-efficacy (
d
= 0.46) significantly increased from the pre- to post-test. Low knowledge students showed the greatest increases in knowledge (
d
= 3.35) and self-efficacy (
d
= 0.61), but a non-significant increase in intrinsic motivation (
d
= 0.22). The medium and high knowledge students showed significant increases in knowledge (
d
= 1.45 and 0.36, respectively), motivation (
d
= 0.22 and 0.31), and self-efficacy (
d
= 0.36 and 0.52, respectively). Additionally, 90 % of students reported a greater understanding of medical genetics, 82 % thought that medical genetics was more interesting, 93 % indicated that they were more interested and motivated, and had gained confidence by having experienced working on a case story that resembled the real working situation of a doctor, and 78 % indicated that they would feel more confident counseling a patient after the simulation.
Conclusions
The simulation based learning environment increased students’ learning, intrinsic motivation, and self-efficacy (although the strength of these effects differed depending on their pre-test knowledge), and increased the perceived relevance of medical educational activities. The results suggest that simulations can help future generations of doctors transfer new understanding of disease mechanisms gained in virtual laboratory settings into everyday clinical practice.
Journal Article
Addressing Selection Bias When Estimating Associations Between Physical and Cognitive Functioning in Older Adult Women
Background Physical functioning is positively associated with cognitive performance but estimates of this association from longitudinal studies may be subject to selection bias due to differential loss‐to‐follow‐up via poor physical function, death, or comorbidities. We estimated the potential impact and drivers of differential selection on this association among a cohort of older women. Method The Study of Women's Health Across the Nation (SWAN) is a community‐based, longitudinal study of women. From the initial cohort (n = 3,302), only 59.4% (n = 1345) participants completed gait speed and cognitive functioning tests at study visit 15 (V15, 2015‐16). To address potential selection bias for each of the reasons above, inverse probability weighting was used to upweight participants at V15 who resembled those lost to follow‐up. A global cognitive z‐score was derived by averaging z‐scores from processing speed, verbal memory, and working memory tests; higher z‐score indicates better overall cognitive functioning. Linear regression models (with and without weights) estimated the relationship between gait speed and global cognitive z‐score. Models were stratified by financial strain and education. Result Our sample included 1345 women with a mean age of 65.5 (± 2.6 SD) years. The unweighted, unstratified model estimated a faster gait speed was associated with a 0.82‐unit increase in global z‐score (95% CI:0.66,0.98). The weighted model estimate was 17% higher (β:0.96, 95%CI:0.77,1.15). Among women who reported any financial strain, the unweighted model found that a faster gait speed was associated with a 1.08‐unit increase in global z‐score (β:1.08, 95%CI:0.74,1.42), whereas the weighted model estimated this association to be 13.9% higher (β:1.23, 95%CI: 0.86,1.60). Comparatively, among women who reported no financial strain, the weighted model estimate was 6.8% higher than the unweighted model (weighted β:0.63, 95%CI:0.44,0.83; unweighted β:0.59, 95%CI:0.42,0.77). Similar results were observed in models stratified by education. Conclusion Results indicate that loss to follow‐up in SWAN leads to underestimation of the relationship between gait speed and cognitive performance. The association is strongest among the most disadvantaged, who are also more likely to drop out. Accounting for differential loss‐to‐follow‐up is critical for a more accurate characterization of the association between gait speed and cognitive performance.
Journal Article
Bidrectional associations between gait speed and cognitive performance in older adult women: the Study of Women's Health Across the Nation
Background Many women experience declines in physical function across and beyond menopause. While there is an established bidirectional association between gait speed and cognition, longitudinal studies are needed to quantify the magnitude of these relationships. Additionally, prospective studies, particularly among older adults, are prone to selection bias due to differential loss‐to‐follow‐up. We leveraged data from the Study of Women's Health Across the Nation (SWAN) to quantify the associations between gait speed and cognitive function, accounting for loss‐to‐follow‐up. Methods SWAN is a multi‐ethnic, community‐based cohort of women followed through menopause into older adulthood. At study visits in 2012‐13 (V13) and 2015‐16 (V15), participants completed a timed four‐meter walk to assess gait speed and tests of working memory, processing speed, and verbal memory. A summary measure of cognition, the cognitive z‐score, averaged z‐scores across cognitive tests. Linear regressions were employed to predict V15 cognitive z‐score from V13 gait speed and vice versa, adjusting for demographic and socioeconomic characteristics. Inverse probability weights for missingness due to death, stroke, poor physical function, and other reasons adjusted for differential loss‐to‐follow‐up from baseline. Results The sample included 1,258 women who completed gait speed and cognitive tests at visits 13 and 15, with a mean age of 65.5 years (SD=2.7) at V15. Half the sample was White, 23.5% Black, 12.2% Chinese, 10.8% Japanese, and 3.5% Hispanic. Adjusting for race, education, age, and financial strain, faster gait speeds at V13 were associated with higher global cognitive z‐scores at V15 (β=0.20, 95%CI:0.05,0.35) but higher global cognitive z‐scores at V13 were not significantly associated with faster gait speeds at V15 (β=0.017, 95%CI:‐0.002,0.036). Adjusting for covariates and loss‐to‐follow‐up, weighted models indicated gait speeds at V13 were positively associated with global cognitive z‐score (β=0.22, 95%CI:0.06,0.37) and global cognitive z‐scores at V13 were positively associated with gait speeds at V15 (β=0.022, 95%CI: 0.000,0.044). Conclusions This SWAN sample exhibited a bidirectional relationship between gait speed and cognitive performance across time. Weighted estimates exceeded unweighted estimates, suggesting that models not accounting for selection bias underestimate associations. Future research will examine the longitudinal associations between specific domains of cognition and other measures of physical functioning among SWAN women.
Journal Article
Horse talk : Equine based learning programs and their engagement with individuals
Studies about equine therapies or equine experiential learning recommend that significantly more research, specifically longitudinal research, across age groups, genders, contexts and client cohorts needs to occur in diverse contexts. There exists diverse equine-related programs which engage with a range of cohorts, specifically; young children who have experienced abuse; adolescents who have experienced abuse and family violence and adults who have experienced family violence, psychiatric disorders, social anxiety and social isolation. The most common outcomes from the equine learning program studied for this article, from the case-studies and the thematic analysis includes; behavioural changes, stress relief, mind and body awareness and control, forming a relationship with an intuitive practitioner, guided meditations as a means of creating independent meditation techniques and re-engagement with education, work, friendships and family relationships. The mind - body awareness that is gained by participants of the program provides skills and techniques for individuals (and families) to utilise in every-day, with lifelong learning a crucial aspect of the program. [Author abstract]
Journal Article