Voting is Healthcare: Talking Politics With Patients Can Improve Health Outcomes

Introduction: Many healthcare policy-related issues were hot topics during this unprecedented election year. Healthcare workers took it upon themselves to play a major role in the election by introducing voting as a topic of discussion within the patient encounter. At Wayne State University School of Medicine (WSUSOM), the Voting is Healthcare (VIH) Taskforce was created in order for students, residents and faculty to assist patients with voter registration. The Taskforce’s major partner was VotER, a non-profit, non-partisan organization dedicated to helping patients register to vote through a user-friendly and easily-accessible online platform. Methods: The VIH Taskforce distributed badge-backers with QR codes that patients could scan with their phones to learn more information regarding voter registration, polling location, and absentee voting. Codes were utilized in in-patient settings, clinics, and through tele-health encounters. The VIH Taskforce spearheaded a training session for the WSUSOM community where VotER representatives and local community partners across Michigan spoke. Results: Per VotER records, the VIH Taskforce and WSUSOM community helped 84 patients vote. Of those patients, 34 were previously unregistered and 50 cast absentee ballots. Conclusions: In order to increase voter turnout, the VIH Taskforce opened up the patient encounter to include the topic of political advocacy. This is an unprecedented accomplishment, but it is a necessary addition to the social history portion of the visit. Future studies aim to make the link between civic engagement and positive health outcomes explicit

Transepithelial Anti-Neuroblastoma Response to Kale among Four Vegetable Juices Using In Vitro Model Co-Culture System

Juicing vegetables is thought to be an anticancer treatment. Support exists for a rank order of anticancer greens (kale \u3e dandelion \u3e lettuce \u3e spinach) based on degrees of bioavailability of different phytochemicals, also offset by some noxious molecules (i.e., calcium-oxalate). We developed a new in vitro transepithelial anti-neuroblastoma model system. The juices were diluted as predicted once in the small intestine. They were applied to apical Caco-2Bbe1 cells atop dividing SH-SY5Y neuroblastoma cells, and changes in transepithelial electrical resistance (TEER) and cell growth were considered with juice spectroscopies. Studied first in monoculture, kale and dandelion were the most cytostatic juices on SH-SY5Ys, lettuce showed no effect, and high (4.2%) spinach was cytotoxic. In co-culture, high (4.2%) kale was quickest (three days) to inhibit neuroblastoma growth. By five days, dandelion and kale were equally robust. Lettuce showed small anti-proliferative effects at five days and spinach remained cytotoxic. Spinach’s cytotoxicity corresponded with major infrared bands indicative of oxalate. Kale juice uniquely induced reactive oxygen species and S-phase cell cycle arrest in SH-SY5Y. The superiority of kale and dandelion was also apparent on the epithelium, because raising TEER levels is considered healthy. Kale’s unique features corresponded with a major fluorescent peak that co-eluted with kaempferol during high performance liquid chromatography. Because the anticancer rank order was upheld, the model appears validated for screening anticancer juices

Association of Social Determinants with Patient-Reported Outcomes in Patients with Cancer

Patient-reported outcome (PRO) scores have been utilized more frequently, but the relationship of PRO scores to determinants of health and social inequities has not been widely studied. Our goal was to determine the association of PRO scores with social determinants. All patients with a new cancer diagnosis who completed a PRO survey from 2020 to 2022 were included. The PRO survey recorded scores for depression, fatigue, pain interference and physical function. Higher depression, fatigue and pain scores indicated more distress. Higher physical condition scores indicated improved functionality. A total of 1090 patients were included. Married patients had significantly better individual PRO scores for each domain. Patients who were able to use the online portal to complete their survey also had better individual scores. Male patients and non-White patients had worse pain scores than female and White patients, respectively. Patients with prostate cancer had the best scores while patients with head and neck and lung cancer had the worst scores. PRO scores varied by cancer disease site and stage. Social support may act in combination with specific patient/tumor factors to influence PRO scores. These findings present opportunities to address patient support at institutional levels