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Faltered States: The Rise, Fall, And Containment Of Psychedelic Science In The United States, Baxter Brew

CMC Senior Theses

This thesis traces the history of psychedelic science in the United States and its implications for policymaking. In the postwar period, psychedelic researchers were enabled by a unique convergence of optimism in medical science and structural flexibility. But their hope blinded them to the deeper tensions of their field. As institutions grew increasingly rigid and risk-averse, the space for psychedelics began to close. Some scientists responded by fortifying the walls around them, developing socially and professionally acceptable research methods. Others tried to escape these walls entirely. But neither approach could prevent psychedelics from being squeezed out of formal inquiry. Yet …

Social Determinants Of Health And Aging In Africa: Structural Inequality, Vulnerability, And The Future Of Care, Aremu Umor Lukman, Sunkanmi Folorunsho, Abdulrauf Olaitan Taofeeq

Department of Sociology: Faculty Publications

Population aging is accelerating across Africa yet remains underrepresented in research, policy, and public health planning. This review critically examines how social determinants shape aging experiences across the continent, focusing on health, care systems, and structural inequalities. While traditional African societies have historically valued older adults, modernization, migration, and economic hardship have eroded support systems, leaving many to face old age with limited resources. Older Africans, particularly women and rural residents, contend with lifelong disadvantages including low education, informal labor, poverty, and gendered caregiving roles that contribute to poor health and social vulnerability. Health systems remain poorly equipped to address …

Antibiotic Resistance: The Growing Threats And Potential Solutions, Olisaemeka Zikora Akunne, Blessing Nkechi Emmanuel, Umar Faruk Saidu, Ayobami Sunday Akinnawo, Nasiru Ademola Adeyemi, Livia Chinaza Egoh, Malami Aishatu Muhammad, Olusegun Ayo Ade-Adekunle, Deborah Ahuoyiza Peter, Anne Amina Freitas

Department of Biomedical and Translational Sciences Faculty Publications

Antibiotic resistance (AR) has become a critical global health crisis, threatening the efficacy of antibiotics and increasing healthcare costs, morbidity, and mortality. The One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health, is increasingly recognized as an essential framework for addressing the complex drivers of AR. This review explores the mechanisms of resistance, such as genetic mutations, horizontal gene transfer, and biofilm formation, along with contributing factors such as the overuse of antibiotics in healthcare and agriculture. We assess both traditional and emerging strategies to combat AR, including antimicrobial stewardship, the development of new antibiotics, and …

Examining Drug Policy In Portugal And Greece, Collin Fernandes

Dissertations and Theses

This thesis examines the divergent drug policies implemented in Portugal and Greece, analyzing why Portugal's comprehensive decriminalization model has been more successful than Greece's partial approach. Since 2001, Portugal has pioneered a drug policy that decriminalizes all drugs for personal use while investing in harm reduction services, rehabilitation, and social reintegration. In contrast, Greece maintained criminalization while implementing more limited harm reduction measures, particularly through OKANA (the Organization Against Drugs). The research highlights how economic factors, particularly the 2008 financial crisis and austerity measures, negatively affected both countries' programs but hit Greece's initiatives with greater severity. Portugal's programs have remained …

Effect Of Universal Health Coverage On Neonatal Mortality Rate In Sub-Saharan Africa: Addressing Missing Data In Health Indicators, Elizabeth Nalule Arihoona

Graduate Research Theses & Dissertations

This study utilizes two mixed-effects models to examine the effect of Universal Health Coverage on Neonatal Mortality Rate (NMR) in 30 countries of Sub-Saharan Africa from 2000-2019 while addressing the missing data in health indicators. Using natural cubic spline interpolation, I impute the missing values in the health coverage indices to preserve the location- specific trends of the data. Findings indicate that among the health Coverage indices, only Index1, which directly relates to coverage of maternal, newborn and child health services is significantly associated with reduced NMR. While higher Current Health Expenditure is associated with reduced NMR, a higher share …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

A Study Of Regulatory Compliance In U.S. Nursing Homes, Patrick Schumacher

Electronic Theses & Dissertations (2024 - present)

The federal government is responsible for ensuring that nursing homes comply with regulations designed to protect residents from abuse, neglect, and substandard care. To this end, the Centers for Medicare and Medicaid Services (CMS) partners with states to conduct onsite inspections of nursing homes, during which regulators may identify violations. The agency can take one or more actions in response to violations, including imposing civil money penalties (fines), appointing a state monitor, or mandating remedial education for staff. Despite this regulatory framework, the quality of care in nursing homes remains poor, with many facilities failing to protect the well-being of …

Assessing How Patients With Spinal Cord Injury Are Affected By Climate Change And Extreme Weather: A Scoping Review, Lien-Chieh Lin, Hung-Chou Chen, Tsan-Hon Liou

Rehabilitation Practice and Science

Climate change and the rising frequency of extreme weather events (EWEs) pose significant challenges to vulnerable populations, particularly individuals with spinal cord injury (SCI). These patients are at greater risk due to impaired thermoregulation, limited mobility, poor sensation, and dependence on caregivers or adaptive equipment, increasing their exposure to climate-related hazards and disrupting healthcare access during disasters. Although climate change impacts on the general population are well-documented, research on specific disability groups like SCI patients remains limited. This scoping review investigates how SCI patients perceive and experience health risks from climate change and EWEs, as well as factors influencing their …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Different Responses Involving Tfh Cells Delay Parasite-Specific Antibody Production In Trypanosoma Cruzi Acute Experimental Models, Ana Carolina Leão, Maria Jose Villar, Rakesh Adhikari, Cristina Poveda, Leroy Versteeg, Gregório Almeida, Peter J Hotez, Maria Elena Bottazzi, Kathryn M Jones

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects millions globally. Despite treatment options in the acute phase, most infections progress to a chronic indeterminate form or develop severe cardiac/gastrointestinal complications. Understanding the immune response is crucial for the development of vaccines and more efficient drugs for the disease control.

Methods: This work investigates the immune response to T. cruzi H1 K68 strain infection in female BALB/c and C57BL/6 mice to characterize differences in Tfh and B cell responses that may be involved in the poor parasite-specific antibody production during acute infection. For this, mice were euthanized …

Advancing Medical Applications Of Cancer Nanotechnology: Highlighting Two Decades Of The Nci's Nanotechnology Characterization Laboratory Service To The Research Community, Rachael M Crist, Yechezkel Barenholz, Ahuva Cern, Kate N Clark, Pieter R Cullis, Cheryl Dean, Neil Desai, Mauro Ferrari, Matthieu Germain, Carmen A Giacomantonio, Emma Grabarnik, Piotr Grodzinski, Atara Hod, Barry E Kennedy, Ruvanthi N Kularatne, Glen S Kwon, Emmanuel Loeb, Erin B Noftall, Len Pagliaro, Morteza Rasoulianboroujeni, Alexander Roth, Darren Rowles, Kulbir Singh, Nicole F Steinmetz, Zhanna Yehtina, Yao Zhang, Daniel Zilbersheid, Jeffrey D Clogston, Stephan T Stern, Marina A Dobrovolskaia

Center for Medical Ethics and Health Policy Staff Publications

The Nanotechnology Characterization Laboratory (NCL) is a US federally funded resource providing characterization and expertise to the cancer nanomedicine research community. Founded as a formal partnership among the US National Cancer Institute (NCI), the US Food and Drug Administration (FDA), and the US National Institute of Standards and Technology (NIST), the NCL has spent two decades developing a one-of-a-kind service with broad multidisciplinary expertise to meet the needs of a rapidly evolving drug development field. To mark the 20th anniversary of the lab's founding, the NCL hosted a symposium to highlight the achievements of the cancer nanomedicine field, showcase novel, …

Smallpox Outbreaks And Immunization Policies In Tanzania From The Late Nineteenth Century To The First World War, Lorne Larson

Zamani: A Journal of African Historical Studies

An estimated 300 million people died globally from smallpox in the 20th century alone. There was very much a North/South divide in the existence of the disease in that period, with countries across South America, Africa and Asia recording the majority of cases. In 1966 the World Health Organization launched an intensive effort to finally eliminate the disease. The last known endemic case of smallpox was reported in Somalia in 1977, and that outbreak was promptly contained. In 1980 smallpox was declared eradicated – the only infectious disease affecting humans to achieve this distinction. This remains among the most notable …

‘Prevention Is Better Than Cure’: Smallpox Vaccination In Postcolonial Tanzania, 1961–1980, Musa Sadock

Zamani: A Journal of African Historical Studies

This article examines the smallpox vaccination programme in postcolonial Tanzania from the 1960s to the early 1980s as part of the postcolonial future making in preventive medicine. The article departs from extant scholarship on smallpox vaccination in postcolonial Tanzania, which depicts the intervention as a success, while relegating to the background challenges associated with the intervention. The article argues that the smallpox vaccination programme registered challenges and successes that offer lessons for combating of future epidemics. The achievements of the programme were due to the adoption of specific public health policies, namely mass vaccination and public health education as well …

Excess Mortality In Persons With Concurrent Hiv And Cancer Diagnoses: A Retrospective Cohort Study, Kamaria L Lee, Varada Sarovar, Jennifer O Lam, Wendy A Leyden, Stacey E Alexeeff, Alexandra N Lea, Rulin C Hechter, Haihong Hu, Julia L Marcus, Qing Yuan, Jennifer R Kramer, Lilie L Lin, Elizabeth Y Chiao, William J Towner, Michael A Horberg, Michael J Silverberg

Center for Medical Ethics and Health Policy Staff Publications

Background: With extended lifespans for people with human immunodeficiency virus (PWH), there is a corresponding increased burden of chronic illnesses, including cancer. Our objective was to estimate the excess mortality among PWH with cancer compared with people without HIV (PWoH), accounting for the higher background mortality in the general PWH population.

Methods: We identified 39,000 PWH and 387,767 demographically matched PWoH in three integrated healthcare systems from 2000 to 2016. We estimated excess mortality among PWH with cancer, computed as the cancer mortality rate difference-in-difference comparing PWH and PWoH. We evaluated five cancer groups: any cancer; virus-, human papillomavirus-, and …

Downeast Community Opioid Response Program: Final Summary Report, Tyler Egeland Ba, Gordon Mcintire Ba, Evelyn Ali, Mary Lindsey Smith Phd, Katie Rosingana Ba

Substance Use Research & Evaluation

The Downeast Substance Treatment Network is a group of diverse organizations working to improve integration and access to treatments and services for people with substance use disorder. The consortium’s Rural Communities Opioid Response Program grant project aims to: (1) expand the reach of their treatment network, (2) increase awareness and practice of harm reduction, and (3) facilitate transitions of care to improve partner efficacy. This project included a mixed-methods evaluation led by Catherine E. Cutler Institute’s Substance Use Research and Evaluation Team (SURE). This year 3 final summary presentation includes feedback from program partners and key informants, in addition to …

The Impact Of The Coronavirus Disease 2019 Pandemic On Urban Nonprofit Organizations In A Southeastern City, Yvette Michelle Brown

Doctoral Dissertations and Projects

This qualitative study examined the impact of the coronavirus disease 2019 pandemic on human services nonprofit organizations in an urban setting and the strategic measures implemented by the leaders to remain focused on their mission. The logic of inference was that the pandemic significantly impacted these nonprofit organizations, forcing the public administration leaders to implement new innovative strategies that should be documented. The study data was collected and analyzed through three streams of data: interviews with nonprofit or public administration leaders, surveys of nonprofit employees, and document analysis of organizational financial reports over four years. The results from the interviews …

Tumor-Associated Edema In Children With Kaposi Sarcoma: 14 Years' Experience At Kamuzu Central Hospital, Lilongwe, Malawi, Fatsani Rose Manase, Allison Silverstein, William Kamiyango, Jimmy Villiera, Clement Dziwe, Claudia Wallrauch, Tom Heller, Mark Zobeck, Tamiwe Tomoka, Michael E Scheurer, Carl E Allen, Nmazuo Ozuah, Rizine Mzikamanda, Nader Kim El-Mallawany, Casey L Mcatee

Center for Medical Ethics and Health Policy Staff Publications

Background/objectives: Kaposi sarcoma (KS) is a common lymphatic endothelial cancer among children with and without HIV in central and eastern Africa. Despite its clinical heterogeneity, its various clinical phenotypes are often grouped together in staging and treatment algorithms. Patients with KS tumor-associated edema, referring to hard, non-pitting lesions which often lead to chronic disability, represent a unique, understudied subgroup of children with KS. To continue our work defining the distinct phenotypes of pediatric KS, this study aimed to assess the clinical progression and outcomes of KS edema in children.

Methods: A retrospective cohort study was conducted at Kamuzu Central Hospital …

Community Quarantines And Social Protection Programs: Philippine Pandemic Response Viewed Through The Human Security Framework, Leslie Advincula-Lopez, Jessica Sandra R. Claudio, Haraya Marikit C. Mendoza

Development Studies Faculty Publications

No abstract provided.

Improving Socioeconomic Conditions For Ghanaian Fishers On Flagged Vessels : Policy Recommendations For The Fishing Industry, Robert Nyarkoh

World Maritime University Dissertations

No abstract provided.

Solid Waste Management Practices And The Role Of Public Perception In West Point, Monrovia, Liberia, Lucy Garmai Varnie

World Maritime University Dissertations

No abstract provided.

Automated Electronic Health Record Data Extraction And Curation Using Extractehr, Tamara P Miller, Kelly D Getz, Edward Krause, Yun Gun Jo, Sandhya Charapala, M Monica Gramatages, Karen Rabin, Michael E Scheurer, Jennifer J Wilkes, Brian T Fisher, Richard Aplenc

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Although the potential transformative effect of electronic health record (EHR) data on clinical research in adult patient populations has been very extensively discussed, the effect on pediatric oncology research has been limited. Multiple factors contribute to this more limited effect, including the paucity of pediatric cancer cases in commercial EHR-derived cancer data sets and phenotypic case identification challenges in pediatric federated EHR data.

Methods: The ExtractEHR software package was initially developed as a tool to improve clinical trial adverse event reporting but has expanded its use cases to include the development of multisite EHR data sets and the support …

Empowering Modernization Of National Emergency Management With New Generation Of Information Technology: Technology Foresight And Policy Recommendations Based On Typical Scenarios, Haibo Zhang, Xinyu Dai, Yi Peng, Yi Liu, Xue Lin, Yongjian Zhu, Wu Chen, Zhen Wu, Xinyue Qin, Depei Qian, Jian Lv

Bulletin of Chinese Academy of Sciences (Chinese Version)

In the context of the new round of scientific and technological revolution, how to grasp the historical opportunity of supporting the development of the “overall safety and emergency response framework” with the NGIT, and promoting the transformation of the public safety governance to emphasis on prevention, is a pressing issue to be studied. This study focuses on five typical scenarios in emergency management, drawing on multiple rounds of expert interviews and questionnaire surveys to identify a list of critical technologies, analyze future development trends and constraints, and provide references for advancing relevant technological research and development. The study further emphasizes …

The Implications Of The New Security Environment On The National Health Systems Enterprise, Martin Charles Bricknell, Derek Licina

Joint Force Quarterly

This article argues that the changing global security environment requires the United States to treat the military health system and the broader national health systems enterprise as strategic national capabilities rather than primarily as peacetime healthcare services. Drawing on lessons from the COVID-19 pandemic, the war in Ukraine, and growing risks of large-scale conflict, the authors contend that future crises could produce military and civilian casualty levels that exceed the capacity of existing military medical systems. They emphasize the need for military health services to operate as part of an integrated civil-military health system capable of supporting deployed forces, receiving …

Improving Volunteers' Safety During The Covid-19 Pandemic, Dr. Laquetta Postell

Walden Dissertations and Doctoral Studies

The onset of COVID-19 presented multiple challenges to both governmental and nongovernmental organizations. The selected study site is a nonprofit organization located in a major Southern US City. This organization shelters homeless men. The organization depended on volunteers' assistance in offering short-term and long-term solutions to provide clothing, cleaning, and shelter for homeless men. The organization was facing new challenges due to the onset of the COVID-19 pandemic. In this study, the complexities of the social, political, and economic challenges for volunteers during the pandemic were well explored. The nonprofit organization’s challenges were examined and recommendations to help the organization …

Racial Residential Segregation And Covid-19 Health Outcomes: Evidence From The State Of Georgia, Palak Patel, Simon Medcalfe, Catherine P. Slade

Journal of the Georgia Public Health Association

ABSTRACT

Background:

According to the Georgia Department of Public Health (GDPH), the state of Georgia reported 563,658 cumulative COVID-19 cases and 9,845 total deaths in 2020. Decades of research on racial disparities in health outcomes suggest we should not be surprised with the disproportionate number of cases, hospital visits, and deaths of non-white and Black Georgia residents. Racial disparities in health are often defined by a Social Determinants of Health (SDOH) model. One understudied SDOH is racial residential segregation. In this study we explore the relationship between racial residential segregation and COVID-19 health outcomes. Our paper addresses critical challenges for …

Negara Hukum Kesejahteraan Di Batas Pantai: Paradoks Perlindungan Negara Terhadap Masyarakat Pesisir Di Tengah Perubahan Iklim, Aji Baskoro

Jurnal Ilmu Kesejahteraan Sosial

Climate change poses significant challenges to vulnerable coastal communities in Indonesia. As a welfare state, the Indonesian government is expected to safeguard these vulnerable groups through policies that promote their welfare and sustainable livelihoods. However, current policies create a paradox. This article explores this paradox: on the one hand, Indonesia adheres to the welfare state principle, which demands that all government actions be grounded in law, ensuring public safety and welfare. On the other hand, the policies focus on exploiting natural resources, exacerbating the vulnerabilities of coastal communities, particularly in the face of climate change. The article employs a normative …

Developing A Stand-Alone Children’S Hospital In Southern Nevada: Needs, Opportunities, And Economic Development Considerations, Tripp Umbach

Policy Briefs and Reports

This independent study developed by Tripp Umbach demonstrates how an independent, research-intensive, stand-alone children’s teaching hospital can significantly enhance the health status of Southern Nevada’s children, reduce outmigration, attract children from neighboring states, and stimulate the healthcare economy. Tripp Umbach evaluated the need for a children’s hospital, the barriers to overcoming its absence, and the advantages of establishing a stand-alone children’s hospital in Southern Nevada for diverse audiences throughout Nevada and nationally.

Current And Emerging Trends In The Management Of International Disasters, Laura M. Phipps, David A. Mcentire

Mavs Open Press Open Educational Resources - Archive

This edited book examines major problems facing the international disaster community as well as innovative solutions to global emergency management, focusing on the current and emerging trends in disaster management that cross geographic, social, and political borders.

What Is The Economic Benefit Of Annual Covid-19 Vaccination From The Adult Individual Perspective?, Sarah M Bartsch, Kelly J O'Shea, Colleen Weatherwax, Ulrich Strych, Kavya Velmurugan, Danielle C John, Maria Elena Bottazzi, Mustafa Hussein, Marie F Martinez, Kevin L Chin, Allan Ciciriello, Jessie Heneghan, Alexis Dibbs, Sheryl A Scannell, Peter J Hotez, Bruce Y Lee

Center for Medical Ethics and Health Policy Staff Publications

Background: With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward.

Methods: We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine.

Results: For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe …

Driving Green Investments To Address Climate Change, Baptiste Gibrat

Dartmouth College Master’s Theses

The climate crisis is no longer news, and society needs to accelerate the transition to net zero emissions. Otherwise, the consequences of climate change will become increasingly catastrophic.

This thesis develops a framework to drive green investments, which reduce society’s dependance on fossil fuels. Initially, the research provides a comprehensive examination of these investments, followed by an exploration of three strategies to enhance their adoption: leveraging financial instruments and capital markets, implementing regulatory frameworks, and harnessing the power of technologies. To integrate these elements within a comprehensive framework, the study employs market research, reviews relevant literature, and includes interviews with …