Young Epidemiology Scholars Competition

"As an athlete, I was shocked to read about healthy high school athletes who died from the superbug infection, MRSA."

Reports of superbug infection MRSA are increasing among high school athletes and young adults, yet outpatient skin testing is neither routine nor mandatory. In some states, MRSA infection is not considered a reportable disease. Since MRSA infections do not respond to the standard treatment for skin infection, accurate and early detection and treatment are crucial. Michelle Lee sought to determine whether it is cost- effective to require testing of all high school athletes with skin infections for MRSA. She developed a computer simulation model and found that routine testing becomes cost-effective when the prevalence of MRSA is greater than 10 percent.

"Since the prevalence rate of this superbug infection varies among young athletes according to factors such as close skin-to-skin contact, cuts and contaminated surfaces, my findings could be useful in determining when routine outpatient testing should occur," states Michelle. In addition to her research on MRSA, Michelle is active in educating athletes about methods of prevention, signs of infection and treatment.

A member of the public health computational and operations research team at the University of Pittsburgh, Michelle will receive a U.S. Congressional Award gold medal this year in recognition of 400 hours of volunteer work. This 17-year-old junior is an international award-winning pianist who has performed solo six times at Carnegie Hall and once at the United Nations, having won a Grand Prize at the World Piano Competition. She also enjoys playing the harp and rowing. Michelle plans to major in bioengineering or biology and chemistry, and aspires to have a career that combines medical research, medical engineering and public health.

Routine Outpatient Testing of Skin Infections for Methicillin-Resistant Staphylococcus Aureus (MRSA) in High School Athletes

Abstract

Reports of methicillin-resistant staphylococcus aureus (MRSA) skin infection are increasing among high school athletes and young adults. Since MRSA infections do not respond to the usual standard treatment for skin infection (cefalexin), accurate and early detection followed by an appropriate treatment is important to minimize potential complications and prevent further spread to others. Currently, outpatient skin testing for MRSA skin infection is neither routine nor mandatory. I developed a stochastic computer simulation model to determine whether it is cost-effective to require testing of all high school athletes with skin infection for MRSA. The model examines how the cost-effectiveness changes with the changing prevalence of MRSA in this population. With this computer model, one million person simulations were performed. Using a widely accepted standard for cost-effectiveness, it was found that routine testing becomes cost-effective when MRSA prevalence is ≥ 10 percent. Although the current estimates for MRSA prevalence are lower than this threshold if, as expected, MRSA prevalence continues to increase especially in subgroups, such as athletes involved in contact sports, routine testing may be beneficial. This study demonstrates the potential utility of routine testing for MRSA as well as the importance of accurately determining the prevalence of MRSA in specific populations.

"My project determines if the popular trend of barefoot running may actually be detrimental to long-distance runners."

After running cross-country for four years and dealing with various injuries and footwear issues, Rebecca Leong became interested in studying running-related injuries. According to studies, 60 percent of distance runners will suffer a running-related injury that not only temporarily affects their training, but can also have long-term psychological and physical effects. Rebecca's study examines how footwear habit (barefoot, transitioning or shod) affects the injury rates of long-distance runners, specifically those running more than 10 miles a week.

Barefoot running has gained attention for its claim to reduce running-related injury and promote a natural running stride. Rebecca's study tells a different story, "Despite recent speculation, barefoot running in industrialized countries does not appear to reduce running-related injury." Her study also supports that shod running presents the lowest risk of injury for distance runners; barefoot runners are 1.35 times as likely to suffer an injury as shod runners.

An 18-year-old senior in high school, Rebecca has received honors in math from the American Association of University Women and placed in the top 15 at the Washington Junior Science and Humanities Symposium. She plans to pursue a career as a doctor or biomedical engineer.

The Effect of Footwear Habits of Long-Distance Runners on Running-Related Injury: A Prospective Cohort

Abstract

Every year, approximately 60 percent of long-distance runners will suffer a running-related injury that not only temporarily affects their training, but can also have long-term psychological and physical effects. Following recent publications, barefoot running has gained attention for its claim to reduce running-related injury and promote a natural running stride. This study directly compares injury rates between barefoot and shod runners, and for the first time quantitatively evaluates the risk present in transitioning from shod to barefoot running. The following question will be examined: How does footwear habit (barefoot, transitioning or shod) affect the injury rates of long-distance runners? A series of surveys were e-mailed to participants to record running habits and injuries suffered over a course of 12 weeks. The data supported that runners transitioning from shod to barefoot running had the highest prevalence, with an average of 32 percent of its runners in an injured state each week. Shod runners had the lowest prevalence, with 21 percent and barefoot runners (prevalence of 29 percent) were in the middle. Furthermore, relative risk calculations, which are based on a ratio of prevalence, showed that barefoot runners are 1.35 times as likely to suffer an injury as shod runners. Transitioning runners are 1.48 times as likely as shod runners to suffer an injury. This study supports that shod running presents the lowest risk of injury for distance runners. Despite recent speculation, barefoot running in industrialized countries does not appear to reduce running-related injury. Thus it is not recommended that healthy runners transition to barefoot running for the sole purpose of reducing injury risk.

"The prevalence of depressive symptoms within the average adolescent population surprised me."

Sarah Hardtke was drawn to her research because of the high prevalence of depression among adolescents. Almost one out of eight adolescents will experience a major depressive episode and approximately 50 percent experience mildly depressive (subsynrdomal) symptoms. Most depression research has taken a singular approach, looking only through the biological, genetic or environmental lens. In her investigation, Sarah sought a more integrative perspective, assessing the interactions between cognitions and environmental stressors.

Sarah was surprised to find that nearly 10 percent of adolescents in her study experienced enough symptoms to cross the threshold to a major depressive episode. Her results also identified peer victimization and perceived incompetence as precursors of depressive symptoms. Based on her findings, Sarah believes interventions at the school level should focus more attention on reputational and relational, rather than physical, victimization; her results indicate that rumor-and-gossip-based victimization elicited greater consequences.

Sarah plans to major in English or psychology and hopes to become a magazine writer or editor. A tutor and volunteer with the New York City food bank, she is a member of the National Honor Society and writes for her school magazine. This 16-year-old senior enjoys reading, writing and jogging.

A Sociocognitive Model of Adolescent Depression: Underlying Mechanisms of Competency

Abstract

Depression is the most prevalent affective disorder within the adolescent population, with approximately 50 percent of adolescents experiencing subsyndromal symptoms. This study provided the foundation for a sociocognitive model of adolescent depression through explicating interactions between peer stressors and perceived competence. Adolescents ranging from 14-18 years of age were recruited from a high school within Westchester County, New York. Participants completed a demographic questionnaire, as well as the Self-Perception Profile for Adolescents, the Social Support Scale for Children and Adolescents, the Revised Peer Experiences Questionnaire, and the Center for Epidemiologic Studies Depression Scale. Results indicated that both perceived competence (p<.001; r= -.54), specifically self-worth, and reputational victimization (p=.001; r=.33) contributed unique variance to adolescent depression. Moderate support was found for a moderation model of perceived competence (r2 adj =.11). Social support was also expressed as a partial mediator of the interaction between reputational victimization and depressive symptoms. In specifying the underlying processes between cognitions and stressors, this study further elucidates the etiology of depression, thus providing a basis for preventative and treatment measures. Implications for the clinical setting are fostered through the targeting of at-risk adolescents and the identification of thought processes requiring attention.

"I was inspired to study procrastination due to my observation that many of my peers procrastinate, and that I, too, am sometimes guilty of this habit."

Procrastination may seem a mild affliction, but previous research has related procrastination to increased stress, anxiety and depression. Seeing procrastination's impact on her own life and that of her peers, Caroline Trezza set out to gain insight into how to reduce its prevalence and adverse health effects in students.

Caroline conducted two studies investigating factors that predict academic procrastination in high school students. In the first, 79 high school students completed a 45-question survey about procrastination, the fear of failure, and positive and negative self-oriented perfectionism (SOP). Self-efficacy was added to the model in a follow-up study of 89 students. Both self-efficacy and the fear of failure were significant predictors of procrastination. Positive SOP was also correlated with self-efficacy. The findings suggest that fears of being ashamed may relate to students' tendencies to self-handicap and procrastinate.

"If parents or teachers can help students become more positive self-oriented perfectionists, they may be able to increase students' self-efficacies, in turn lessening their procrastination habits. Additionally, if students are taught that the work they produce is not a measure of their worth as a person, they may be less inclined to self-handicap and procrastinate," explains Caroline.

Caroline was named an Intel Science Talent Search Finalist in January for this project. She plans to continue researching students' motivation and work habits in college. The 17-year-old senior is considering psychology, English and economics as potential college majors. Caroline has her eye on possible careers as a scientific journalist or behavioral economist. She enjoys photography, sailing and writing.

The Relationships Between Academic Procrastination and Beliefs About Effort and Capability in High School Students

Abstract

Procrastination is a huge mental health problem. This two-part study was conducted to investigate factors that predict academic procrastination. In the first study, high school students (N = 79) completed a 45-question survey about procrastination, the fear of failure, and positive and negative self-oriented perfectionism (SOP). A multiple regression analysis showed that these factors accounted for 18.5 percent of the variance in the procrastination scores. Positive SOP was the only significant predictor of procrastination (p<.01). Self-efficacy was added to the model in a follow-up study conducted on a new sample of students from the same high school (N=89). This new model accounted for 25.7 percent of the variance in procrastination. Self-efficacy was a significant negative predictor of procrastination. Additionally, bivariate correlations showed that positive SOP had a positive correlation with self-efficacy, which also had a negative correlation with procrastination. Thus, it appears that self-efficacy may mediate the relationship between positive SOP and procrastination. The second study also found the fear of failure to be a predictor of adjusted procrastination, suggesting that students' conceptions of self-worth are linked to procrastination habits. Understanding these relationships may help teachers and other educators identify ways to reduce academic procrastination tendencies in students.

"My findings regarding the dichotomy of beliefs regarding raw milk among students with farm exposure and without farm exposure were very interesting. I found that students considered farm exposed were nearly sevenfold more likely to consume raw milk than those with no farm exposure."

Carly Barker's inspiration for her research came from a piece of Wisconsin state legislation. The bill in question concerned legalizing the commercial sale of raw milk, which is known to contain disease-causing pathogens. "I thought it would be interesting to survey students in my community to assess their attitudes regarding the risks and benefits of raw milk consumption," she points out.

To estimate the prevalence of consumption and factors influencing support for raw milk, Carly conducted a survey of high school students in a rural dairy farming area of Wisconsin. "The general conclusion from my study was that students with farm exposure were more likely to drink raw milk and were more likely to have favorable attitudes towards raw milk than students without farm exposure," explains Carly. She believes her study could be utilized by politicians debating the retail sale of raw milk in Wisconsin.

Carly is an 18-year-old senior who plans on studying environmental science and political science in college. She enjoyed collaborating with researchers and learning about how her research could lead to developing public health policies. Carly gives back to her community by volunteering as a tutor for the Big Brothers Big Sisters School Buddy Program. In her free time she enjoys cooking and swimming, and was voted Most Valuable Swimmer on her varsity swim team.

High School Students' Attitudes and Beliefs Toward the Risks and Benefits of Raw Milk Consumption

Abstract

Although raw milk is known to contain disease-causing pathogens, legislation has recently been proposed in Wisconsin to legalize its the commercial sale. To estimate the prevalence of raw milk consumption and factors influencing support for raw milk, I conducted a survey of high school students in a rural dairy farming area of Wisconsin. The survey was distributed to students, in November 2010, in order to identify high school students' perceived risks and benefits of raw milk. Attitudes and beliefs of raw milk consumption were compared among those who did and did not consume raw milk in the past year, and among those with and without farm exposure. Analyzable surveys were completed by 1,035 (82 percent) of 1,259 students enrolled at the high school. Of the 1,035 surveys analyzed, 120 (12 percent) reported consuming raw milk in the past year, with 53 out of 119 students (45 percent) consuming raw milk at least once a month. Overall, those who consumed raw milk had more favorable views towards it than non raw milk drinkers; raw milk consumers were more likely to agree with statements such as, "Raw milk has more nutritional value than pasteurized milk" and "Raw milk is safe to drink." Those who lived on a farm with dairy cows, had at least one parent that worked on a farm with dairy cows, or owned dairy cows were considered "farm exposed" and were nearly seven times more likely to consume raw milk than those who were not farm exposed. Raw milk consumption in this rural Wisconsin community is associated with exposure to dairy farms. The results from this study could be used to inform health care officials and politicians involved in the debate regarding the retail sale of raw milk in Wisconsin.

"I want teenagers to know they should not take their ears for granted. It's not cool to have your ears ring so much you can't sleep."

When the ringing in her ears would not stop and her sensitivity to loud noises grew increasingly worse, Gita Bhattacharya decided that for the sake of her hearing she must quit marching band. Her personal predicament prompted her to survey 290 of her peers. Did they experience music-induced tinnitus or ringing in the ears too? At what volume level did they listen to their MP3 players? Did they play a musical instrument?

Through her research, she learned that those who sometimes listen to their MP3 players at unsafe levels are 1.97 times more likely to experience tinnitus. The likelihood that they would experience the ringing sensation jumped even higher if they also played a loud instrument. She hopes to continue researching the issue using a more sophisticated statistical analysis.

A member of the American Tinnitus Association and the Tinnitus Support Group for Teenagers, Gita continues to play the piano and guitar, occassionally performing at assisted-living centers. Fluent in Japanese, the 17-year-old junior is one of a group of 27 who will travel to Japan this summer as part of the Japan America Watershed Stewardship (JAWS), a project funded by the U.S. State Department. An avid writer, Gita finished in the top 10 in the JFK Profiles in Courage Essay Contest and is the founder and president of the BLAST! Into Bioinformatics club. She plans to study genetics or bioinformatics in college so she can eventually earn a Ph.D. and work for the Department of Health.

Wake Up When Your Ears Ring! The Implications of MP3 Use for Tinnitus

Abstract

The author conducted a survey of 290 youth during November 2010 through January 2011 to examine the effect of MP3 player/iPod listening patterns on ringing in the ear, or tinnitus. Simple univariate tests associating ringing with each causal variable one at a time fail to reject linear independence. However, when a multivariate logit model is estimated with the response variable "ringing" or "no ringing," results indicate that relative to the safe listening level of 50 percent of the volume, those who "sometimes" listen at unsafe volume-stretch combinations are about 1.97 times (p = 0.05) more likely to experience tinnitus, controlling for whether the person plays a loud musical instrument or not and for the type of headphone used. Those who play a loud instrument are 2.22 times (p = 0.02) more likely to experience tinnitus (from MP3 use) than those who do not, controlling for the unsafe volume-stretch combinations and headphone type.

This study is the first, to the best of the author's knowledge that uses a multivariate logit model to predict the incidence of noise-induced tinnitus. Lately, it has been questioned whether some measurements of noise-induced hearing loss have been overestimated. In a survey context, self-reports of the ear ringing are likely to be more accurate than self-reports on hearing loss that may not be discernible to the respondent. Most importantly, this study serves as a prototype for establishing empirically based guidelines for safe listening estimated from a large population that can control for several variables, unlike a lab-based study with its inherent limitations on size.

"There are racial disparities in the health care system. It is imperative to address this gap in order to provide equal opportunities to health care for all."

For eighth-grader Jazmin Branch it was a one-two punch: First, a close relative died of cancer; then a school official was diagnosed with the same disease. Her interest in cancer continued into high school, leading to her involvement in the YES Competition. Using data from a survey conducted by the Chicago REACH Out Program, Jazmin was able to determine that knowledge, level of education and insurance impacts the likelihood of African-American women getting screened for breast and cervical cancer. However, she was surprised to learn that, with the exception of insurance, these factors did not have a significant impact on screening for Latina women.

Even though the 17-year-old senior devoted 280 hours to her research, she says it's not enough, "While the biological aspects of cancer are interesting and informative, I enjoy looking at the impact of the disease on society." She hopes to major in biomedical engineering in college and continue her cancer research.

Jazmin was recently named valedictorian of her high school graduating class. Other academic honors include being named an Illinois State Scholar and a member of the National Honor Society. A member of the public health club, she is also involved in the American Cancer Society's high school summer research programs. Jazmin is the captain of the varsity cheerleading squad and enjoys dancing, singing and bird watching.

Analysis of Existing Disparities in Breast and Cervical Cancer Among African American and Latina Women

Abstract

Background: There is an existing disparity between minorities and whites receiving proper health care. Adhering to screening guidelines is an important aspect of closing these gaps between mortality among the different racial groups. Several factors contribute to seeking screening. Purpose: This analysis focuses on African American and Latina women to find how the two racial groups differ on factors that contribute to adhering to screening guidelines. Hypothesis: Knowledge, education and insurance will all impact adherence to screening recommendations between African American and Latina women. Methods: Data sets from a faith-based community intervention program were used to determine the significance of the factors on screening. Statistical analysis was performed to test the importance of the three factors individually. Conclusions: All three factors had a major impact on the African Americans in the sample seeking breast and cervical cancer screening. However, with the exception of insurance, these factors did not have a significant impact on screening for Latina women. More research should be done to focus on factors that may affect screening adherence for Latina women.

"Poor sleep is an emerging risk factor for suicide attempt among teenagers."

Inspiration sometimes stems from tragedy and for 18-year-old Neel Koyawala, this was the case. Puzzled by the suicide of a family friend, he decided to explore the third leading cause of death among adolescents. In his project, Neel examined the association between sleep disturbances and suicide attempt among adolescents, comparing 40 adolescents who attempted suicide in the past year with 40 adolescents who had no history of suicidal thinking or behavior.

His study suggests that adolescents who have recently attempted suicide are approximately four times more likely to wake up a lot at night than nonsuicidal youth. He comments, "I was surprised that parent-reported child-waking-up-a-lot at night did not remain statistically significantly linked with adolescent suicide attempt after controlling for depression, antidepressant use and being bullied, while self-reported waking-up-a-lot at night remained significant. This finding suggests parents are underestimating the amount of waking-up-a-lot at night for their adolescents."

Adolescents may be reluctant to tell their doctors about feeling depressed or contemplating taking their lives. Neel hopes future research can develop his findings and help clinicians better prevent suicidal behavior by recognizing which specific sleep disturbances most associate with adolescent suicidal behavior.

A senior, Neel is a National AP® Scholar and a recipient of the Frank P.R. Van Syckel award and Cornell Cup. He was a youth counselor at a summer Hindu temple camp for kids and is co-president of Gender Relations in Our World, which facilitates a Boys Bridges mentor program between middle school and upper school boys, as well as other activities.

Sleep Problems and Suicide Attempts Among Adolescents: A Case-Control Study

Abstract

Objective: This study examines the association between sleep disturbances and suicide attempt among adolescents, after controlling for major confounders such as depression, antidepressant medication use and being a victim of bullying. Methods: A case-control design was used to compare 40 adolescents who attempted suicide in the past year with 40 adolescents who had no history of suicidal thinking or behavior (controls). Adolescents and parents answered detailed questionnaires about potential risk factors for suicide attempts. Results: For both parents' reports and self-reports, the suicide attempters differed from the controls with regard to waking up multiple times at night. According to parents' reports, 30 percent of attempters versus 10 percent of controls woke up multiple times at night ( x²=4.2, p=.04). Parents' reports of sleep problems tended to underestimate the disparity between attempters and controls, in comparison to self-reports, which revealed that 54 percent of attempters versus 22 percent of controls awoke multiple times during the night ( x²=8.4, p=.004). Logistic regression analyses showed suicide attempters were four times more likely than nonsuicidal adolescents to wake up multiple times at night after controlling for antidepressant use, depression and being bullied (95% confidence interval [CI] = (1.29, 12.21); p=.02). Conclusion: Poor sleep is an emerging risk factor for suicide attempts among teenagers. Clinicians should be aware of sleep problems, such as waking up a lot at night, as potential risk factors for suicide attempts. Future research should determine which specific sleep disturbances are most strongly associated with adolescent suicidal behavior.

"I started to question why most people I knew who were depressed in school were girls and that led me to do research on depression statistics by gender."

Depression is not a foreign illness to Mary Sun, who has seen both friends and family fight this psychiatric disorder that affects 19 million Americans. When she noticed a gender disparity with depression in her own high school, Mary was compelled to make sense of it and the course for her research was set. "When I discovered the enormous gender gap and learned about the gender shift that occurs during adolescence, I knew I wanted to find out more about it," she explains.

Mary completed a cross-sectional study analyzing data from a population-based sample of 2,202 adolescent twins to assess the effects of alcohol-related risk factors on depression by gender. The results in the male model showed increased age decreased the probability of depression by 26 percent. In the female model, high levels of peer alcohol use indicated a 20 percent higher probability of depression. For Mary, this suggested that the prevention and treatment of adolescent depression should be targeted by gender.

Mary is a 17-year-old junior who plans on studying bioengineering and public policy in college. This summer, she will start an internship with the National Institute of Bioimaging and Bioengineering. Next year, she will continue her research, analyzing the genetic influences of gender on depression. Mary won first place in the health and medicine category of her high school's science fair and competes on her school's varsity swim team.

Assessing the Role of Alcohol to Address Gender Differences in Adolescent Depression

Abstract

Depression affects nearly 19 million Americans each year and is the most globally prevalent psychiatric disorder. The average age of depression onset, currently at 14.5 years, has steadily decreased over the past three decades. In order to effectively prevent, diagnose and treat depression, researchers must first understand adolescent depression; early-onset depression causes depressive recurrence in adulthood and later life. It is during this phase of depression that a phenomenon known as the "gender shift," the doubling of female susceptibility to depression as compared to males by ages 13-15 occurs, and continues throughout adulthood. This cross-sectional study analyzed data from a population-based sample of 2,202 adolescent twins to assess the effects of alcohol-related risk factors on depression by gender. Analyses were taken to be representative as the prevalence of depression and alcohol problems mirrored figures reported by large-scale health studies. Alcohol problems, age, cigarette use and peer alcohol use were determined to be the major risk factors for depressive symptoms. Partial correlation tests confirmed that a significant relationship existed between depression and alcohol problems, after controlling for smoking and age. In the male model, increased age decreased the probability of depression by 26 percent. In females, high levels of peer alcohol use indicated a 20 percent higher probability of depression. The results suggest that the prevention and treatment of adolescent depression should be targeted by gender. Recommendations for future study include replicating and testing model analyses in longitudinal and increased sample-size studies, as well as utilizing the twin data to perform research on the influence of genetic associations.

"With the reemergence of several dangerous infectious diseases, new and more accurate methods for modeling them are necessary for public health services to protect us."

While following the Commonwealth Games in India, Udayan Vaidya was interested not only in the games but in health officials' concerns about a potential outbreak of dengue fever, arguably the disease that has the most global impact. For his YES project, Udayan developed a simulator model to more accurately predict the spread and infection rates of the disease, utilizing several new parameters not included in previous models. These included rainfall and crossover immunities acquired when an individual has previously contracted dengue. He also used his model to assess dengue prevention techniques, analyzing the effectiveness of each method as well as their estimated cost.

Udayan was surprised by the effectiveness of prevention techniques he studied. He points out, "Interestingly, the most efficient method to prevent the spread is to simply have the population actively turn over all objects left outside their homes each day, destroying any potential breeding grounds,"

The 17-year-old senior is continuing to develop his simulator to include an interactive tool that public health officials can use to visually see and analyze dengue outbreaks. Udayan plans to study mathematics or computer science in college. His career interests include becoming a professor of mathematics, a computer engineer or working at the National Institutes of Health. Udayan is the president of the mathematics club and a violist in the Greater Dallas Youth Orchestra. He was the first-place team captain at the National Ing Go Tournament and twice ranked in the top 10 at the Texas A & M Math Contest. His free time is spent reading and playing Go.

A Novel Computational Framework for Modeling the Outbreak, Spread and Containment of Dengue Fever

Abstract

With the reemergence of several dangerous infectious diseases in today's world, few would disagree that new, more accurate methods for modeling are necessary in order for public health services to protect us from these diseases. Arguably the disease that has the most global impact, dengue fever has slowly been growing out of its endemic state in several tropical countries and is threatening to grow into a full-scale pandemic. The purpose of this research project is to develop a computational model for dengue fever, utilizing several new parameters that have not been included in previous models. This current framework is stochastic and can include discrete events, such as rainfall or pesticide spraying to kill mosquito population at certain frequencies. Additionally, an extension from temporal to spatial domain is easily created and numerically tractable as compared to earlier mathematical models. The computational model presented uses a contacts-based approach to predicting a dengue outbreak, and incorporates the amount and periodicity of the rainfall — as well as any crossover immunities individuals have gained from previous dengue infections. Furthermore, various dengue-prevention techniques have been studied; this model has analyzed the effectiveness of each method as well as their estimated cost. The model and its extensions can be used by public health services to forecast dengue outbreaks as well as assess their outbreak-prevention strategies.

"After completing the diabetes research project and realizing the monumental importance of the findings I collected, I began to search for ways to aid in this detrimental disease in my area."

Diabetes affects approximately 9 percent of the population in Sarah Yazji's community of South Texas; higher than the 8 percent affected nationally. This, combined with her father's involvement in fighting the disease, inspired Sarah to further understand the factors behind this illness. She researched the relationship between family history of diabetes, diabetes risk perception and preventative lifestyle habits in a population of 287 South Texas college students.

Based on her results, a significant relationship exists between family history and risk perception; those who have a family history of the disease understand they are at a greater risk. However, no significant relationship was found between risk perception and preventative lifestyle habits. "This indicates the need for further research in the subject of practicing preventative lifestyle habits," Sarah explains. She now works with the Rio Grande Valley Diabetes Association to advocate for the preventative practices that should be undertaken against diabetes.

A 16-year-old junior, Sarah plans to study sciences, English or philosophy in college. She hopes to become a cardiovascular surgeon or medical researcher and is pursuing a medical research internship this summer. Sarah is a Business Professionals of America National Qualifier and enjoys painting, reading and writing.

Family History, Diabetes Risk Perception and Health Behaviors: Findings from College Students in South Texas

Abstract

Diabetes is a metabolic disorder affecting the lives of more than eight percent of the U.S. population. The disease is most often caused by a combination of hereditary and lifestyle factors. This study investigates the relationship between family history of diabetes, diabetes risk perception, and preventive lifestyle practices in the areas of diet and exercise, among college students in South Texas. A survey instrument, containing questions from the Behavioral Risk Factor Surveillance System Questionnaire distributed by the Centers for Disease Prevention and Control, was used to collect data from 287 college students. The statistical analyses used included descriptive statistics (frequencies and means), chi-square tests, and analysis of variance (ANOVA). A highly significant relationship was found between family history of diabetes and diabetes risk perception (p<0.001). However, no significant relationship was found between diabetes risk perception and lifestyle behaviors (physical activity, and fruit and vegetable consumption). These results indicate that family history of diabetes plays a large role in an individual's risk perception for developing the disease. The results also imply the possibility of variables other than risk perception that may instigate the practice of healthy lifestyle behaviors. This implication and the lack of relationship between risk perception and lifestyle habits necessitates further research into what promotes preventive practices in order to reduce diabetes risk among the general population.

"Having a friend with severe food allergies, I realized how difficult it is to have to watch what you eat at all times and the impact it has on the family."

Zizi Yu's curiosity was piqued when she noticed that unlike a friend who suffers from severe food allergies, this health problem was unheard of in her family. From there she questioned whether early exposure to common food allergens might be beneficial instead of harmful, as many U.S. health officials believe. Zizi surveyed 258 high school students between the ages of 14 and 18 to determine whether teenagers with and without food allergies differ in their age of first exposure to six common food allergens.

She learned, "My research findings actually confirmed my hypothesis that early exposure to food allergens may be beneficial rather than detrimental." Zizi found that exposure to dairy, eggs and wheat/gluten before 12 months of age, peanuts/tree nuts and seeds before 24 months, and shellfish before 36 months may actually be protective factors against the development of food allergies. "The results from this study may be valuable in improving the recommendations of health care professionals for future prevention of food allergies in children and young adults," she states,

Zizi is a 16-year-old junior who plans to study sciences or biomedical engineering in college. She hopes to become a dermatologist or oncologist and will spend her summer conducting research at Yale University School of Medicine. Zizi participates in the global warming club and her local Woodbridge Clean Energy Task Force. She has performed as a violin soloist with the Greater New Haven Youth Orchestra and won a gold medal in the National Spanish Exam. She enjoys volunteering, violin, tennis and figure skating.

Investigating the Hygiene Hypothesis: A Case-Control Study of Food Allergies and Age of Food Allergen Exposure in High School Teenagers

Abstract

A food allergy is an immune system disorder that affects six percent of U.S. children and four percent of the overall U.S. population. In the past, health officials have recommended food allergen avoidance in infants as a way to prevent food allergies, but according to the Hygiene Hypothesis proposed by David P. Strachan in 1989, exposure to allergens and pathogenic substances is necessary to develop a healthy, effective immune system. The purpose of this case-control study was to determine whether teenagers with and without food allergies differ in their age of first exposure to common food allergens. It was hypothesized that teenagers without food allergies were exposed to common food allergens early — in the first few years of life — while teenagers with food allergies were exposed to the allergens relatively late. There were 258 high school teenagers (67 cases and 191 controls) between the ages of 14-18 surveyed to gather data about allergy and diet history for six common food allergens. Within the cases and controls, the participants were then divided based on their exposure before or after a particular age that was determined for each food. Then two-by-two contingency tables were constructed and odds of exposure were calculated. The odds ratio for all six foods was less than one, indicating that exposure before a particular age may be a protective factor against food allergies. Results demonstrate that exposure to dairy, eggs and wheat/gluten before 12 months of age; peanuts/tree nuts and seeds before 24 months; and shellfish before 36 months may be beneficial. Chi-square tests yielded p-values far less than 0.05 for all six foods, confirming statistical significance. The results from this study may be valuable in improving the recommendations of health care professionals for future prevention of food allergies in children and young adults.