Digital Commons Network^™

Social Determinants Of Health And How They Affect A Small Rural Community (Case Study) Eastern Shore Of Maryland, Kristopher S. Durham, Lindsay Gietzen

Pacific Journal of Health

The Eastern Shore of Maryland is rural and is characterized by prevalent poverty, housing instability, lack of access to healthcare, chronic diseases, substance abuse, and issues with transportation to access healthcare services. The same problems exist for the population in Maryland and the United States. Understanding the challenges experienced by rural communities in Maryland is critical to addressing the vulnerable population. This study is an explanatory case study that examines the social determinants of health and how those affect small rural communities on the Eastern Shore of Maryland by examining literature published between 2016 and 2024. The literature reviewed resulted …

Lived Experiences Of Low-Income African American Burn Survivors In Greater Washington, Dc, Angela White

Walden Dissertations and Doctoral Studies

Burn injuries are wounds that affect the skin and other organic tissue, categorized according to the mechanism of injury and brought on by heat, electricity, chemicals, fire, or flames. In the United States, researchers have shown that race and other healthcare inequalities lead to increased burn injuries among African Americans but have yet to explore their lived experiences after sustaining these injuries. This phenomenological study explored perceptions and understanding of the manifestation of burn injuries of seven African American burn survivors. Participants were recruited in health services public waiting areas, community storefronts, mailers, and on Facebook. Data were collected via …

A Phenotypic Characterization Of Staphylococcus Aureus Bacteremia Clinical Isolates, Sara Dj Daniels

USF Tampa Graduate Theses and Dissertations

Staphylococcus aureus is a human pathogen of serious concern because of its ability to cause serious and wide-ranging disease. Of particular concern is the ability of S. aureus to cause bacteremia (SAB), allowing the bacteria to disseminate and spread to various organs. This study addressed this issue through the phenotypic characterization of two methicillin-resistant S. aureus (MRSA) clinical isolates taken from patients with sustained complicated bacteremia at Tampa General Hospital, referred to as SA1097 and SA1098. A battery of phenotypic tests was conducted on these strains, including a growth curve, hemolysis and proteolysis screenings, cytotoxicity assays using human neutrophils, blood …

Professional Development: A Mixed Methods Study Of Masters Of Public Health Alumni, Orna Baron-Epel, Yana Douvdevany, Dana Ivancovsky-Wajcman, Paul Barach, Osnat Bashkin, Katarzyna Czabanowska, Keren Dopelt, Nadav Davidovitch, Szczepan Jakubowski, Fiona Macleod, Maureen Malowany, Leah Okenwa-Emegwa, Maya Peled-Raz, Shira Zelber-Sagi

College of Population Health Faculty Papers

INTRODUCTION: We examined the perceptions of the Master of Public Health (MPH) degree graduates regarding their personal competencies, job performance and professional development using a mixed method, explanatory sequential design.

METHODS: A cross-sectional, self-administered questionnaire of the Haifa School of Public Health alumni who graduated between 2005 and 2022 was disseminated to 849 graduates between March and June 2022, from which 127 responded (response rate: 14.90%). This was followed by 24 in-depth interviews with alumni from the same sample (conducted between November 2022 and March 2023).

RESULTS: The sample included 74.8% of females with a mean age of 40.7 years, …

Environmental House Calls Can Reduce Symptoms Of Chemical Intolerance: A Demonstration Of Personalized Exposure Medicine, Rudolfo Rincón, Roger Perales, Raymond F. Palmer, Jackie F. Forster, Jessica F. Hernandez, Bryan Bayles, Carl Grimes, Carlson R. Jaén, Claudia S. Miller

Public Health (Archived)

Aim: The goals of this investigation were to 1) identify and measure exposures inside homes of individuals with chemical intolerance (CI), 2) provide guidance for reducing these exposures, and 3) determine whether our environmental house calls (EHCs) intervention could reduce both symptoms and measured levels of indoor air contaminants.

Background: CI is an international public health and clinical concern, but few resources are available to address patients’ often disabling symptoms. Numerous studies show that levels of indoor air pollutants can be two to five (or more) times higher than outdoor levels. Fragranced consumer products, including cleaning supplies, air fresheners, and …

Open Access In The Age Of Ai: The Journal Of Appalachian Health And Hurricane Helene Recovery, Noah Wren, Bradley Firchow

Journal of Appalachian Health

The recent destruction brought upon the Appalachian region by Hurricane Helene has emphasized the importance of the Journal of Appalachian Health. As an open-access peer-reviewed source of information, the Journal plays a critical role in not only facilitating public health research about Hurricane Helene, but also combating misinformation regarding the event. In the days following Hurricane Helene, misinformation about the federal government’s response, along AI generated images, have left many in the region confused and misled about what had happened. Going forward, the Journal will play an necessary part in making sure accurate information is shared to understand how …

Credentialing Care: Covid-19 And The Bureaucratization Of Doulas, Ellen Block, Julie Johnson Searcy, Angela N. Castañeda

Sociology Faculty Publications

Doulas in the United States offer embodied, informational, and continuous one-on-one care to birthing people. Doulas have historically sought certification to gain knowledge through training and to gain legitimacy for healthcare providers and clients. During the COVID-19 pandemic, hospitals required doulas to provide proof of certification. The COVID-19 pandemic, and the proliferation of state-sponsored doula programs, has sparked a shift in how doulas are viewed and regulated, enabling new forms of bureaucratic oversight and control. Based on participant observation, surveys, and semi-structured interviews, we examine the connection between certification and care including motivations doulas have for certification, the perceived value …

Analisis Aktivitas Fisik Pekerja Mal Pelayanan Publik Kota Cilegon, Muhammad Syifa Abdy Mulya, Indri Hapsari Hapsari Susilowati

National Journal of Occupational Health and Safety

Physical activity is important because it has so many benefits. Even so, there are still many workers who are exposed to the risk of lack of physical activity. For this reason, it is necessary to know what affects the implementation of physical activity in workers. Quantitative design was used with a cross sectional study on 58 Cilegon Public Service Mall workers who met the criteria. As a result, 65.5% of workers are classified as active, 34.5% of workers are inactive and 12% of workers do not carry out any physical activity at all. Level of education (p value = 0.005), …

Psychosocial Factors, Stress And Sleep Among Rural Appalachian Kentucky Residents With Type 2 Diabetes Mellitus, Blake Dipaola, Zoe Taylor, Eric Hennemann, Brittany L. Smalls, Philip M. Westgate, Nancy Schoenberg

Journal of Appalachian Health

Introduction: Rural Appalachian residents experience higher rates of most chronic diseases, including type 2 diabetes mellitus (T2DM). Stress and sleep deficiency also are common in the region.

Purpose: To better understand these associated health burdens, the relationship among these conditions and psychosocial factors—such as depressive symptoms, distress, empowerment, and social support—was examined among Appalachian residents with T2DM.

Methods: Using data collected from a community-based sample of Appalachian adults with T2DM, the study examined whether psychosocial factors were associated with perceived stress (Cohen Perceived Stress Scale) and self-reported sleep deficiency (Epworth Sleepiness Scale). Multilevel linear mixed effects regression modeling was used …

Black Women’S Perceptions Of Perinatal Healthcare In New York City Community Health Centers, Asiyah Franklin

Walden Dissertations and Doctoral Studies

The purpose of this qualitative study was to explore the experiences of Black women who have received perinatal care in New York City (NYC) community health centers and the perceived impact on their maternal health behaviors and outcomes. Although maternal health care delivery and outcomes among Black women have been explored in research, socially and economically disenfranchised Black women in NYC who rely on community health centers for perinatal care have not been included in this research. This study involved addressing the lack of knowledge of Black women’s experiences with perinatal care in NYC’s community health system and consisted of …

The Lived Experiences Of Work Related Violence Against Public Health Professionals During Covid-19 Pandemic, Cynthia Howell

Walden Dissertations and Doctoral Studies

Work-related violence (WRV) against public health professionals is increasingly prevalent worldwide but received much greater attention during the COVID-19 pandemic. This qualitative study addressed a gap in the literature by exploring public health professionals' experiences with WRV threats, what factors contributed to their vulnerability, and the severity of these threats during the COVID-19 pandemic from 2020 to 2023. Rogers' (1975) Protection Motivation Theory was the conceptual framework for phenomenological study. Twelve public health professionals, both male and female, including epidemiologists, nurses, physicians, researchers/scientists, and community health workers, who actively worked during the COVID-19 pandemic and were residents of New York …

Examining The Relationship Between Employment And Health Status Among Adults With Autism Spectrum Disorder (Asd) In The United States, Winifred Beckles

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD), characterized by challenges in social communication and repetitive behaviors, is a developmental disability that impacts over five million adults in the United States. Despite the significant amount of research literature on the association between health and employment in the general population, there remains a gap in research on the relationship between health and employment in adults with autism. Utilizing the Social Ecological Model (SEM) framework, this study examined whether there is a relationship between employment, current living status, non-paid activities, United States Census regions, type of health insurance, and health status when controlling for age, race, …

Social Isolation And Loneliness Prevention Among Rural Older Adults Aging-In-Place: A Needs Assessment, Jodi L. Southerland, Shimin Zheng, Kayla Dodson, Erin Mauck, Juanita-Dawne R. Bacsu, Monique J. Brown Ph.D., Mph, Jeremy Holloway, Steffi M. Kim, Ayse Malatyali, Matthew Lee Smith

Faculty Publications

Introduction: The adverse effects of social isolation and loneliness (SI/L) have been documented among older adults in rural communities and contribute to poor health outcomes, premature disability and mortality, and increased burden on the healthcare system. The identification of factors contributing to SI/L among older adults can build the foundation for rural policymakers and leaders to allocate resources and develop tailored strategies more efficiently. The purpose of this article is to describe findings from a needs assessment designed to understand local factors that contribute to SI/L among rural older adults in a county in Northeast Tennessee. Findings from the needs …

Assessing The Climate Readiness Of Physician Education Leaders In Graduate Medical Education, Deborah Simpson, Anne Getzin, Aaron A. Levy, Victoria Gillet

Journal of Patient-Centered Research and Reviews

Climate change affects patient health through an array of exposures, including increasing heatwaves, extreme weather events, poor air quality, and expanding vector-borne illnesses. Physicians are at the forefront of addressing the health consequences of these exposures with patients, and environmental sustainability has become a priority for health care organizations. Accordingly, climate change and health is becoming a critical area for graduate medical education (GME). As GME leaders design and drive education in residency and fellowship programs, understanding those leaders’ baseline knowledge on this topic and its alignment with their organizations’ priorities is an essential step in the development of climate …

The Price Of Prevention: Spain And Italy's Approach To National Prep, Jon Burkart

Claremont-UC Undergraduate Research Conference on the European Union

While recent advancements in antiretroviral therapy (ART) continue to improve the outlook for people living with HIV (PLHIV), new infections remain a concern for health authorities around the world. A clinically proven intervention holds the potential to dramatically reduce new infections: Pre-exposure prophylaxis (PrEP) is a once-daily pill for high-risk populations, including men who have sex with men (MSM), that substantially reduces HIV infection risk. However—much like rates of new infection—public provision of PrEP varies considerably among OECD countries. This case study thus seeks to answer the question: What might explain the disparate timeline of adopting public reimbursement for PrEP …

Factors Affecting The Quality Of Reporting Dispensing Errors Among Pharmacists, Kelley Latrece Lavallais

Walden Dissertations and Doctoral Studies

Medication dispensing errors, which are the inconsistency between the dispensing of medication to the patient against the prescribed medication, continue to be a public health challenge. Many studies have been conducted to examine their causes, including burnout, illegible handwriting, workload, and interruptions. There have also been studies on the types of medication dispensing errors. This study focused on the reporting of errors. The purpose of this quantitative study involving secondary data analysis was to examine the factors affecting the quality of reporting dispensing errors among pharmacists and the seriousness of the adverse events. The social-ecological model served as the theoretical …

An Epiq Mass Shelter Training For Public Health Nurses In Georgia To Improve Core Competencies In Disaster Preparedness: A Pilot Study, Ashlie L. Pullen, Sonya Shinhoster

Journal of the Georgia Public Health Association

Background: Research shows that nurses are often ill-prepared for disaster response. A survey conducted by the Georgia Department of Public Health Office of Nursing in April of 2021, demonstrated that 45% of the public health nurses surveyed had never deployed to a mass congregate shelter, and 43% reported they had no formal training related to emergency preparedness or mass sheltering. The purpose of this pilot study was to measure public health nurses’ improvement in familiarity with emergency preparedness and disaster response core competencies as defined by the Emergency Preparedness Information Questionnaire (EPIQ) after a focused educational program and tabletop workshop. …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …

Development Of Prediction Models Of Covid-19 Vaccine Uptake Among Lebanese And Syrians In A District Of Beirut, Lebanon: A Population-Based Study, Marie-Elizabeth Ragi, Hala Ghattas Ph.D., Hazar Shamas, Jocelyn Dejong, Nada M. Melhem, Stephen J. Mccall, The Caep Study Group

Faculty Publications

Introduction Vaccines are essential to prevent infection and reduce the morbidity of infectious diseases. Previous evidence has shown that migrants and refugees are particularly vulnerable to exclusion and discrimination, and low COVID-19 vaccine intention and uptake were observed among refugees globally. This study aimed to develop and internally validate prediction models of COVID-19 vaccine uptake by nationality.

Methods This is a nested prognostic population-based cross-sectional analysis. Data were collected between June and October 2022 in Sin-El-Fil, a district of Beirut, Lebanon. The study population included a random sample of Lebanese adults and all Syrian adults residing in areas of low …

Rare Variant Contribution To The Heritability Of Coronary Artery Disease, Ghislain Rocheleau, Shoa L Clarke, Gaëlle Auguste, Natalie R Hasbani, Alanna C Morrison, Adam S Heath, Lawrence F Bielak, Kruthika R Iyer, Erica P Young, Nathan O Stitziel, Goo Jun, Cecelia Laurie, Jai G Broome, Alyna T Khan, Donna K Arnett, Lewis C Becker, Joshua C Bis, Eric Boerwinkle, Donald W Bowden, April P Carson, Patrick T Ellinor, Myriam Fornage, Nora Franceschini, Barry I Freedman, Nancy L Heard-Costa, Lifang Hou, Yii-Der Ida Chen, Eimear E Kenny, Charles Kooperberg, Brian G Kral, Ruth J F Loos, Sharon M Lutz, Joann E Manson, Lisa W Martin, Braxton D Mitchell, Rami Nassir, Nicholette D Palmer, Wendy S Post, Michael H Preuss, Bruce M Psaty, Laura M Raffield, Elizabeth A Regan, Stephen S Rich, Jennifer A Smith, Kent D Taylor, Lisa R Yanek, Kendra A Young, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium, Austin T Hilliard, Catherine Tcheandjieu, Patricia A Peyser, Ramachandran S Vasan, Jerome I Rotter, Clint L Miller, Themistocles L Assimes, Paul S De Vries, Ron Do

Faculty, Staff and Student Publications

Whole genome sequences (WGS) enable discovery of rare variants which may contribute to missing heritability of coronary artery disease (CAD). To measure their contribution, we apply the GREML-LDMS-I approach to WGS of 4949 cases and 17,494 controls of European ancestry from the NHLBI TOPMed program. We estimate CAD heritability at 34.3% assuming a prevalence of 8.2%. Ultra-rare (minor allele frequency ≤ 0.1%) variants with low linkage disequilibrium (LD) score contribute ~50% of the heritability. We also investigate CAD heritability enrichment using a diverse set of functional annotations: i) constraint; ii) predicted protein-altering impact; iii) cis-regulatory elements from a cell-specific chromatin …

Understanding Long Covid: Navigating The Journey To Recovery, Heather H. Kelley, Rachel Byers, Ty Aller, Timothy Keady

All Current Publications

This fact sheet provides very basic facts on what long COVID is and information on how to navigate the healthcare system and cope with long COVID.

Association Between Particulate Matter And Copd Among Adults In Alaska, Adeyemi Samuel Alimi

Walden Dissertations and Doctoral Studies

Exposure to high levels of fine particulate matter (PM2.5) is emerging as a crucial risk factor for chronic obstructive pulmonary disease (COPD), a deadly lung disease with a significant public health burden. The Fairbanks North Star Borough (FNSB) in Alaska has one of the worst PM2.5 issues in the United States. The PM2.5 issues in the area are associated with increased wood-burning and temperature inversions in the winter and wildfires in the summer. Given these prevailing PM2.5 issues, this quantitative study was conducted using Alaska BRFSS datasets and a chi-square test to compare the COPD prevalence in the FNSB with …

Sources Of Information That Introduced Undergraduate Students To Their Allied Health Major, Erin Vanderbunt

Internet Journal of Allied Health Sciences and Practice

Purpose: Selecting a college major can be overwhelming for undergraduate students. The factors influencing major selection not only impact student success and degree completion time but also affect university recruitment and retention strategies. Therefore, the purpose of this study was to identify the most influential sources of information that first introduced undergraduate students to their current major of nutrition, public health, or speech pathology and sought to determine if any differences existed between the academic majors or by the demographic variables of gender or racial/ethnic backgrounds. Methods: A total of 121 undergraduate students from a regional, midwest institution participated in …

Primary Prevention And Motivational Interviewing: Patterns In Athletic Training, Mark C. West, Justin P. Young, Matthew J. Rivera, Kenneth E. Games

Internet Journal of Allied Health Sciences and Practice

Background: The BOC practice analysis defines the first domain as Risk Reduction, Wellness and Health Literacy including, “Promoting healthy lifestyle behaviors with effective education and communication.” There is limited evidence on primary prevention measures athletic trainers (ATs) use to address health-related behaviors. Motivational interviewing is an evidence-based patient-centered style of communication used to help patients modify detrimental health behaviors to improve health outcomes. The purpose of this study was to explore knowledge and practice patterns of primary prevention and motivational interviewing in athletic training. Methods: We used a cross-sectional, web-based survey (Qualtrics, Provo, UT). The survey contained demographic questions, …

How Have Occupational Therapy Services Been Delivered During The Covid-19 Pandemic?, Hulya Yucel, Selen Aydoner

Internet Journal of Allied Health Sciences and Practice

The provision of traditional healthcare services has encountered obstacles due to the Coronavirus Disease-2019 (COVID-19) pandemic. The inability of healthcare professionals and clients to survive the pandemic and the inadequacy of personal protective equipment have created uncertainties regarding the appropriate practices for addressing individuals' health conditions. Furthermore, the field of rehabilitation, including occupational therapy, has experienced changes in the delivery of traditional practices. Therefore, this review aimed to examine occupational therapy services delivered during the COVID-19 pandemic. As a result of the literature review, the most commonly provided services by occupational therapists during COVID-19 were discussed and a total of …

Stigma Experience Of Men With Eating Disorders: A Scoping Review, Rachael Maloney, Louise Lunney, Olivia-Mari Lennox, Elena Vaughan, Colette Kelly

Journal of Social Care

This scoping review aimed to synthesise the literature concerning the stigma experiences of men with eating disorders. Seven databases were searched using relevant keywords and subject headings. Following deduplication, articles published since 2000 were screened against eligibility criteria. Key information was charted and analysed using descriptive statistics and deductive content analysis. The final sample (n=9) was synthesised under four categories of stigma experiences within the Health Stigma and Discrimination Framework. Internalised stigma was the most prevalent stigma experience across the included studies. This review suggests that men with eating disorders experience stigma in many forms and across various contexts, including …

Whole-Genome Sequencing In 333,100 Individuals Reveals Rare Non-Coding Single Variant And Aggregate Associations With Height, Gareth Hawkes, Robin N Beaumont, Zilin Li, Ravi Mandla, Xihao Li, Christine M Albert, Donna K Arnett, Allison E Ashley-Koch, Aneel A Ashrani, Kathleen C Barnes, Eric Boerwinkle, Jennifer A Brody, April P Carson, Nathalie Chami, Yii-Der Ida Chen, Mina K Chung, Joanne E Curran, Dawood Darbar, Patrick T Ellinor, Myrian Fornage, Victor R Gordeuk, Xiuqing Guo, Jiang He, Chii-Min Hwu, Rita R Kalyani, Robert Kaplan, Sharon L R Kardia, Charles Kooperberg, Ruth J F Loos, Steven A Lubitz, Ryan L Minster, Take Naseri, Satupa'itea Viali, Braxton D Mitchell, Joanne M Murabito, Nicholette D Palmer, Bruce M Psaty, Susan Redline, M Benjamin Shoemaker, Edwin K Silverman, Marilyn J Telen, Scott T Weiss, Lisa R Yanek, Hufeng Zhou, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium, Ching-Ti Liu, Kari E North, Anne E Justice, Jonathan M Locke, Nick Owens, Anna Murray, Kashyap Patel, Timothy M Frayling, Caroline F Wright, Andrew R Wood, Xihong Lin, Alisa Manning, Michael N Weedon

Faculty, Staff and Student Publications

The role of rare non-coding variation in complex human phenotypes is still largely unknown. To elucidate the impact of rare variants in regulatory elements, we performed a whole-genome sequencing association analysis for height using 333,100 individuals from three datasets: UK Biobank (N = 200,003), TOPMed (N = 87,652) and All of Us (N = 45,445). We performed rare ( < 0.1% minor-allele-frequency) single-variant and aggregate testing of non-coding variants in regulatory regions based on proximal-regulatory, intergenic-regulatory and deep-intronic annotation. We observed 29 independent variants associated with height at P < 6×10-10" role="presentation" style="box-sizing: inherit; display: inline-block; line-height: 0; font-size: 18.08px; font-size-adjust: none; overflow-wrap: normal; text-wrap-mode: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; margin: 0px; padding: 1px 0px; color: rgb(33, 33, 33); font-family: BlinkMacSystemFont, -apple-system, "Segoe UI", Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", sans-serif; position: relative;">6×10−106×10-10 after conditioning on previously reported variants, with effect sizes ranging from -7cm to +4.7 cm. We also identified and replicated non-coding aggregate-based associations proximal to HMGA1 containing variants associated with a 5 cm taller height and of highly-conserved variants in …

Beyond Assistance: Amplifying The Lived Experiences Of Marginalized Communities Navigating Support Service Systems In Mississippi, Karla Mccullough, Rodney Washington, Angela A. Omondi

Journal of Public Health in the Deep South

Background

Perceived dehumanizing experiences when interacting with social assistance caseworkers and providers can contribute to negative perceptions of the service system that may impede enrollment and retention of families in need thereby contributing to health disparities.

Purpose

This study aimed to use secondary analysis of qualitative data to explore the interaction between social services workers/providers and recipients from the perspectives of families seeking social support services in Mississippi.

Methods

This study analyzed secondary qualitative data from a sample of (n=15) representatives in Mississippi. Data was analyzed using a thematic analysis approach.

Results

Participants reported perceived dehumanized experiences such …

The Psychological Impacts Of Algorithmic And Ai-Driven Social Media On Teenagers: A Call To Action, Sunil Arora, Sahil Arora, John Hastings

Research & Publications

This study investigates the meta-issues surrounding social media, which, while theoretically designed to enhance social interactions and improve our social lives by facilitating the sharing of personal experiences and life events, often results in adverse psychological impacts. Our investigation reveals a paradoxical outcome: rather than fostering closer relationships and improving social lives, the algorithms and structures that underlie social media platforms inadvertently contribute to a profound psychological impact on individuals, influencing them in unforeseen ways. This phenomenon is particularly pronounced among teenagers, who are disproportionately affected by curated online personas, peer pressure to present a perfect digital image, and the …

Advances In Biomedical Research And Treatments: What Is Acceptable?, Michael L. Clancy, Khalid M. Iskandarani, Mitchell C. Mccrea

Journal of Health Ethics

This study investigated the technology acceptance (TA) of twenty-first century biomedical treatments by adults in the United States. A new TA instrument was created, using five distinct levels: (1) Healing and Prevention, (2) Replacement Organs, (3) Enhancements-Medical, (4) Enhancements-Discretionary, and (5) Transhumans. An on-line survey produced 353 usable responses, which showed distinct patterns for each of five biomedical treatment levels. There was clear support for Levels 1–3, but very strong opposition to Levels 4–5. The TA finding draws the line between which human interventions are acceptable versus others that should be prohibited through public policies and medical guidelines.