Medicine and Health Sciences Commons^™

Incorporating An Analytical Approach To Ethical Reasoning Into An Ethics Case Conference For Residents, Holland Kaplan, Alyssa Kahl, Jonathan Lim

Center for Medical Ethics and Health Policy Staff Publications

Educating residents to apply ethical principles in clinical practice is critical in achieving standards in professionalism. We implemented biweekly ethics morning report case conferences incorporating a validated analytical tool in medical ethics, the Four-Box Method, from July 2022 to June 2023 in our internal medicine residency program. In 24 ethics morning reports, over 73% of participants reported that the intervention helped them achieve each of three learning objectives in ethics education. Ninety-two percent of cases addressed > 1 ethical issue. Our intervention may be easily integrated into the morning report conference structure as an educational tool in medical ethics across internal …

Faktor Kontributor Prevalensi Stunting: Studi Kasus Jawa Timur Tahun 2022, Sofiyulloh Sofiyulloh, Martya Rahmaniati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Malnutrisi, termasuk stunting, masih menjadi masalah kesehatan yang mempengaruhi kemajuan pembangunan berkelanjutan. Stunting, akibat kekurangan gizi berkepanjangan dan infeksi berulang, menghambat pertumbuhan anak. Di Indonesia, prevalensi stunting pada tahun 2022 adalah 21,6% dan masih belum mencapai target. Dan Jawa timur, angka stunting di 2022 adalah 19,2%, mendekati angka nasional pun masih belum mencapai target. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berkontribusi terhadap stunting di Jawa Timur, dengan fokus pada faktor soial ekonomi dan kesehatan. Data sekunder dari Kementerian Kesehatan, dan Dinas Kesehatan Jawa Timur dianalisis menggunakan uji korelasi. Hasil menunjukkan bahwa Indeks Pembangunan Manusia (IPM) dan rata-rata lama sekolah memiliki …

Economic Growth, Poverty Gap, And Health Inequality: Implications Based On Panel Analysis Of Organization For Economic Cooperation And Development Data, Sangik Han

Kesmas

This study investigated the impact of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). Employing a panel analysis, this study amalgamated 21 years of data (spanning from 2000 to 2020) from 37 OECD countries. The dependent variables (life expectancy and avoidable mortality) were scrutinized against independent variables (gross domestic product and poverty gap). Control variables encompassed body mass index, consumption patterns, smoking rates, health workers availability, number of beds in health facilities, national medical expenses, and unemployment rates. This study revealed significant associations between economic growth, poverty gap, and …

Social Determinants Of Neonatal Health Outcomes In Indonesia: A Multilevel Regression Analysis, Rooswanti Soeharno, Amal Chalik Sjaaf

Kesmas

Indonesia’s neonatal mortality rate remains alarmingly high. This study addressed the determinants of neonatal outcomes in Indonesia, including the effects of a decentralized health system, socioeconomic disparities, and geographic variations. The analysis used 2018 national survey data across 34 provinces, 513 cities/districts, and 300,000 households, with a sample of 73,864 women aged 10-54 years who have given birth in the preceding five years. The multilevel regression was used to assess the impact of social determinants and systemic inequalities on neonatal health. Key findings revealed a neonatal mortality rate that, despite being preventable in many cases, remained high with significant disparities. …

Telemedicine Adoption In Developing Economies: A Systematic Review On The Enablers And Barriers, Zaidbren Macabato, Lemuel Clark Velasco, Art Brian Escabarte, Mae-Lanie Ong Poblete, Armando Isla Jr., Rentor Cafino, Sarah Lizette Aquino-Cafino, Frevy Teofilo-Orencia

Kesmas

Telemedicine’s adoption has been effective in certain contexts despite being controversial in certain settings because of its tendency to cause misdiagnosis and concerns about data privacy. This study aimed to synthesize the research findings on the factors leading to the adoption of telemedicine among developing economies. The study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology to analyze 27 related literature and the Unified Theory of Acceptance and Use of Technology to map out the factors considered enablers and barriers in adopting telemedicine. Results showed that performance expectancy, effort expectancy, social influence, and facilitating conditions were significant predictors. …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

The Meatpacking Industry Needs Stronger Worker Protections And Enhanced Oversight, India Luxton, Laura-Anne Minkoff-Zern

Center for Policy Research

Meatpacking plants are hazardous workplaces with high injury rates and poor working conditions, negatively impacting the health of the industry’s predominately immigrant and refugee workforce. The COVID-19 pandemic illuminated ongoing concerns in the industry, including the problems associated with consolidation and concentration, worker safety, and poor public health outcomes. This brief summarizes findings from a study that used data from 39 interviews with local, state, and federal officials and bureaucrats, worker advocates, and workers to analyze meatpacking policymaking and oversight during COVID-19. The authors find that a lack of industry oversight and decreased regulation contribute to unsafe environments, and injustices …

Study Abroad Angst: A Literature Review On The Mental Health Of International Students During Covid-19, Daisuke Akiba, Michael Perrone, Caterina Almendral

Publications and Research

Background: The COVID-19 pandemic presented unique and unprecedented challenges for international students, those studying at institutions of higher education outside of their home countries, due to their distinct circumstances and vulnerabilities. This literature review examines the multifaceted mental health burdens they experienced and highlights the need for targeted support and interventions. Methods: A rigorous search across three databases (i.e., PubMed, PsycINFO, and ERIC) yielded 50 empirical studies for inclusion in this literature review. A six-phase thematic analysis framework was employed to identify and synthesize key themes. Results: Seven prominent themes emerged: (1) academic and professional disruptions; (2) challenges navigating international …

Social Media As Health Educator: An Assessment Of The Understandability And Accuracy Of Tiktok Content About Contraception, Julianna Coleman, Maetal Haas-Kogan, Andrea Pelletier, Rachel Stoddard, Natasha Johnson, Julia Beatini, Nora Sun, Alex Keuroghlian, Deborah Bartz

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Contraception knowledge and attitudes are largely formed from conversations within one's social network. More recently, this network has expanded to include social media. As the fastest growing social media platform, we aimed to assess popular contraception videos on TikTok for content understandability, actionability and accuracy.

METHODS: This is a secondary analysis of the most viewed, contraception-specific TikTok videos that were previously coded as containing educational messaging in a content-analysis study. We assessed videos for understandability (ability to explain a key message) and actionability (identify what they can do to act on that message) using the Patient Education Materials Assessment …

Narratives Of Resilience: The Power Of Creative Expression And Community Support During Familial Incarceration, Alana Alexander

USF Tampa Graduate Theses and Dissertations

Existing literature stresses that the far-reaching effects of mass incarceration extend beyond prison walls, profoundly shaping familial experiences. Despite this, families remain consistently overlooked in criminal justice discourse, leading to heightened stress and diminished resilience. This thesis is a program review of a community-based program, referred to here as the Storytelling, Creativity, and Care (SCC) program, to protect the confidentiality of its participants and activities. The SCC program integrates neuroscience and narrative theory to explore how storytelling influences cultural perceptions, shapes lived experiences, and supports psychological and physiological healing. Additionally, this work investigates the socio-political narratives that perpetuate stigma and …

An Analysis Of The Environmental Account Of Obesity As A Form Of Financial Neo-Imperialism, Zahara Alzubaidi

The Cardinal Edge

Socioeconomic developments of the past half-century have created mass social concern over an “obesity epidemic.” This concern is given a sense of legitimacy by studies that warn of a totally obese America in only a few decades, and children being more likely than ever to be diagnosed with Type 2 Diabetes. The “environmentalist account” of obesity asserts that factors like genetics, food availability, and social or political climate are the major determinants of an “obesogenic environment” – that is, an environment of obese adults likely to raise obese children. Some feminist thinkers argue that the environmentalist account is necessary to …

The Effect Of A Virtual Covid-19 Interprofessional Educational Module On Knowledge, Confidence, Attitude, And Practice Among Health And Allied Health Professions Students, Tsu-Yin Wu, Jenni L. Hoffman, Grigoris Argeros, Sarah Lally, Andrea Gossett Zakrajsek, Jillian Graves, Alice Jo Rainville, Olivia Ford, Angela Lukomski, Renuka Roche, John Sonnega, Joan E. Cowdery Phd

Journal of Interprofessional Practice and Collaboration

Purpose: The purpose of this research study was to examine the effect of an innovative, online COVID-19 interprofessional educational module among health and allied health professions students.

Methods: This study utilized a pre- and posttest design with quantitative and qualitative data collected winter 2023 and spring/summer 2023 semesters, and consisted of health and allied health professions students (N=143) from three Midwestern, urban, public universities. Participants completed a pretest, then an IPE module on COVID-19, and a posttest immediately after the educational intervention, and another (the same) posttest one month later. Quantitative and qualitative data were subject to statistical …

Understanding A College Of Health And Human Service’S Needs Around Interprofessional Education, Research, And Practice: A Needs Assessment, Jenni L. Hoffman, Jillian Graves, Andrea Gossett Zakrajsek

Journal of Interprofessional Practice and Collaboration

Introduction: A needs assessment can demonstrate when improvement is needed for an organization to function more optimally.

Methods: A college’s emerging interprofessional education center provided the impetus for the needs assessment in an effort to identify and respond effectively to faculty interprofessional education needs.

Results: Twenty-four health professions faculty from the college completed the needs assessment survey, which indicated their experiences with interprofessional education as well as their needs to enhance interprofessional education support at the university.

Discussion: The results of this needs assessment will drive the center’s strategic activities and indicate areas of future research in understanding faculty needs. …

Evaluating Trauma-Informed Design In A Mental Health Setting: A Community-Based Research Case Study, Marie Spence

Electronic Theses and Dissertations

This case study utilized a community-based research framework to explore how the Trauma-Informed Design framework can be implemented in a mental health setting. This study focused on the site of Empower Therapy Practice, a private mental health practice in the Denver Metro Area, to engage clients and staff to participate in advisory boards and inform the interior design of a new office space. To explore the application of Trauma-Informed Design, participants engaged in a variety of research activities, including an evaluative questionnaire, Photovoice, and focus group. Advisory board members identified various aspects of Trauma-Informed Design which meaningfully translate to therapeutic …

The Impact Of Cumulative And Acute Loading On Achilles Tendon Health, Performance, And Reported Pain In Collegiate Gymnasts, Julio Serrano Samayoa

Electronic Theses and Dissertations

Gymnasts are at a high risk of Achilles tendon (AT) injuries due to intense loads during takeoffs and landings. To better understand better the relationship between impact loading and its effects on tendon adaptation and athletic performance, this study uses Inertial Measurement Units (IMUs) to track AT loading across a collegiate gymnastics season. This data were compared against physiological and athletic performance metrics, obtained through force plates and ultrasound imaging, to explore how mechanical load influences reported pain and athletic performance. Results varied, with cumulative impacts being correlated with improved jump height (Spearman 0.362, Pearson 0.348), while peak power and …

Factors Related To Racial Trauma Distress Among Bipoc College Students, Miguel Castano, Richard Chang, Giezel Guevarra

Undergraduate Research Symposium Posters

Racial trauma distress is when post-traumatic stress disorder symptoms occur due to repeated and cumulative experiences of racism and can negatively impacted Black, Indigenous, and people of color (BIPOC). Consensus in research findings strongly suggest that BIPOC students are more likely to experience racism on university campuses than non-BIPOC students. To mitigate some of these negative outcomes, existing research has shown that psychological safety, resilience, and intraminority solidarity are protective factors for BIPOC students experiencing race-related distress. However, little is known about the frequency of racial trauma distress among BIPOC college students and how these variables may protect against racial …

Alternatives To Screen Time Given In Parenting Advice, Emma Romeo

Undergraduate Research Symposium Lightning Talks

Screen time within the last decade is an area of rising interest, especially in a "Post-Covid" world. Despite a diversity of opinions being written and research being done on screen time, what is being presented as an alternative is lesser known. In this research, the aim is to identify types of activities that are presented to parents as alternatives' to screen time in parenting websites and blogs. This study uses qualitative content analysis of over 240 articles from 2019-2023 mentioning media use or screen time from two regularly consumed and popular parenting websites, Sheknows.com and Parents.com. The data so far …

Exploring Mental Health Providers' Willingness To Integrate Digital Applications For Gen-Z Students, Chanlinee Karawek

Undergraduate Research Symposium Lightning Talks

Mental health services have expanded significantly throughout recent years, alongside the virtualization of said services since the COVID-19 pandemic. As a result, digital mental health applications (DMHAs) are now widely available. Generation-Z college students are a demographic that both grew up with this technology and is associated with a high risk of mental illness development during their time in higher education. Integration of familiar technology and necessary mental health services could potentially help address their unique psychological needs. This study explores mental healthcare providers’ perspectives on incorporating DMHAs into their therapy services to Gen-Z college students. An anonymous survey was …

The Impact Of Intimate Partner Violence On Young Mother's Mental Health, Claudia Chavez, Clariana Vitória Ramos De Oliveira

Undergraduate Research Symposium Posters

Intimate partner violence (IPV) rates are notably higher among adolescents who are pregnant or have experienced a pregnancy, with physical IPV reaching up to 62%, and psychological abuse being even more common. IPV has serious mental health consequences for adolescent mothers, leading to increased rates of depression and anxiety which can impair caregiving. IPV negatively affects children, increasing the risks of poor maternal bonding, and low birth weight. This study investigates how IPV contributes to adverse mental health outcomes in Brazilian adolescent mothers. A cross-sectional approach was used with data collected between August 2023 to 2024. The study participants were …

The Role Of Uncertainty In Illness: Insights Into Psychological Adjustment In Systemic Lupus Erythematosus, Theresa A. Skojec

MUSC Theses and Dissertations

There are currently few studies that directly explore the relationship between uncertainty in illness and psychological adjustment to Systemic Lupus Erythematosus (SLE), highlighting a critical gap in understanding how patients cope with and adjust to the emotional and mental challenges posed by this chronic condition. This dissertation comprises three manuscripts focused on filling this knowledge gap. The first is an integrative review guided by Mishel’s Uncertainty in Illness Theory, which examines how uncertainty affects patients' psychological and emotional well-being during illness and explores strategies to manage or reduce this uncertainty. The integrative review included 27 publications that examined uncertainty in …

Initiation Of Hearing Aids Use And Incident Dementia Among Mid-To-Late Life Adults: The Health And Retirement Study 2010-2018, Jingkai Wei, Kun Li, Youngran Kim, Rahul Ghosal, Donglan Zhang, Anwar T Merchant, Casey Crump

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Hearing aids may reduce the risk of dementia among individuals with hearing loss. However, no evidence is available from randomized controlled trials (RCTs) on the effectiveness of hearing aids use in reducing incident dementia. Using target trial emulation, we leveraged an existing longitudinal cohort study to estimate the association between hearing aids initiation and risk of dementia.

RESEARCH DESIGN AND METHODS: The Health and Retirement Study was used to emulate target trials among non-institutionalized participants aged ≥50 years with self-reported hearing loss, without dementia at baseline, and without use of hearing aids in the previous 2 years. …

Lengthening Atlantic Hurricane Seasons With Earlier Storm Formation Dates Including Implications From 2020, Barry D. Keim, L. C. Hamilton, V. M. Brown, P. J. Klotzbach, A. B. Lewis, D. T. Thompson

School of Public Health Faculty Publications

This paper analyzes the formation dates of the nth storm in a sequence for all named North Atlantic tropical cyclones (TCs) and assesses whether the intraseasonal length of the Atlantic hurricane season has changed temporally. The record-breaking 2020 season, with 30 named storms, set records for the earliest third TC formation (Cristobal) and from the sixth TC (Fay) onward. Analysis of season length from 1851 to 2022 identifies only one statistically significant breakpoint detected in the early 1970s, roughly coinciding with the introduction of satellite observations. Since 1970, we also find a trend toward longer North Atlantic hurricane seasons. The …

Small Beef-Packer Resilience During The Covid-19 Pandemic: Evidence And Policy Implications, Azzeddine Azzam, Sunil P. Dhoubadel, Binod Khanal

Cornhusker Economics

As part of a larger research project on the economics of beef supply chain resilience to natural disasters, financed in part by a grant from the USDA National Institute of Food and Agriculture, we obtained information from 289 processing plants across the United States about their operations during the peak COVID-19 period of March to June 2020 via a telephone survey. We collected data on plant type (slaughter, processing, both), the dominant livestock processed by the plant (predominantly beef, pork, poultry, and sheep/goat), plant capacity (maximum and typical capacity in slaughter head/day), age of establishment, and, whether the plant ceased, …

Moving From Traits To The Dynamic Process: The Next Steps In Research On Human Resilience, Yannick Hill, Michael L. Dolezal, Patric C. Nordbeck, Ruud J. R. Den Hartigh, David Pincus, Adam W. Kiefer, Bernard P. Ricca

Psychology Faculty Articles and Research

The current literature on resilience shows a trend toward a dynamic process conceptualization, moving away from the previous trait-approach. However, the term “dynamic” is increasingly treated as a buzzword and is thereby oversimplified in the literature. The aim of this article is to develop a unified language pertaining to resilience as a dynamic process, so as to ensure progress in this field. First, we briefly introduce the traditional trait approach alongside the implicit assumption on which it is built. Next, we contrast this approach by discussing what dynamics entail and how this approach differs from mainstream psychological approaches. Specifically, dynamics …

Evolution Of International Collaboration In China’S Biomedical Technology And Policy Implications, Xinyu Liu, Fang Wang, Liang Xi

Bulletin of Chinese Academy of Sciences (Chinese Version)

In light of the rapid advancement of biomedical technologies and intensifying geopolitical competition over technological dominance, international cooperation in this field has garnered significant attention among scholars, policymakers, and industry leaders. This study employs comprehensive patent data spanning from 2002 to 2023 across the global biomedical landscape to systematically investigate the characteristics and evolution patterns of both global and Chinese biomedical inventions. Employing econometric analysis of patents and social network analysis, the research examines three key dimensions: patent output, technological pathways, and collaboration networks. Three research findings are derived. Firstly, China has transitioned from a “catch-up collaborator” to a critical …

The Southern Nevada Care Economy: Addressing Child Care And Elder Care Challenges, The Lincy Institute

Lincy Institute Events

This community forum examines the economic and societal impact of the “care economy” in Southern Nevada in collaboration with Tripp Umbach, a nationally recognized consulting firm that provides comprehensive services including research and strategic plans to further the operations and activities of healthcare services.

Central to the care economy is elder care and child care. Having access to elder care and child care services is essential to working age adults, many of whom need one or both types of services to continue participating in the workforce. The delivery of child care and elder care services have far-reaching implications for our …

Political Polarization Harms Public Health, Shana Kushner Gadarian, Jay Van Bavel, Kai Ruggeri, Eric Knowles

Population Health Research Brief Series

Political polarization poses considerable risks to well-being. Both ideological polarization (“extremification” of policy positions and ideological orientations) and affective polarization (out-party hate) have increased over the past several decades with detrimental effects on public health. This brief summarizes the impacts of political polarization on public health in the U.S., highlighting the COVID-19 pandemic as a case study on the health risks of polarization. The authors show that, in the United States, one of the strongest predictors of COVID-19 prevention behaviors, such as social distancing and vaccination, was political partisanship. Gaps in these behaviors between Republicans and Democrats increased over the …

Ethical Issues In Implementation Science: Perspectives From A National Heart, Lung, And Blood Institute Workshop, Neal W Dickert, Donna Spiegelman, Jennifer S Blumenthal-Barby, Garth Graham, Steven Joffe, Jeremy M Kahn, Nancy E Kass, Scott Y H Kim, Meeta P Kerlin, Aisha T Langford, James V Lavery, Daniel D Matlock, Kathleen N Fenton, George A Mensah

Center for Medical Ethics and Health Policy Staff Publications

Ethical issues arise in the context of implementation science that may differ from those encountered in other research settings. This report, developed out of a workshop convened by the Center for Translation Research and Implementation Science within the United States National Heart, Lung, and Blood Institute, identifies six key themes that are important to the assessment of ethical dimensions of implementation science. First, addressing ethical challenges in implementation science does not require new ethical principles, commitments, or regulations. However, it does require understanding of the specific contexts arising in implementation research related to both study design and the intervention being …

Fgf21 Acts In The Brain To Drive Macronutrient-Specific Changes In Behavioral Motivation And Brain Reward Signaling, Md Shahjalal H. Khan, Sora Q. Kim, Robert C. Ross, Florina Corpodean, Redin A. Spann, Diana A. Albarado, Sun O. Fernandez-Kim, Blaise Clarke, Hans Rudolf Berthoud, Heike Münzberg, David H. Mcdougal, Yanlin He, Sangho Yu, Vance L. Albaugh, Paul L. Soto, Christopher D. Morrison

School of Medicine Faculty Publications

Objective: Dietary protein restriction induces adaptive changes in food preference, increasing protein consumption over carbohydrates or fat. We investigated whether motivation and reward signaling underpin these preferences. Methods and Results: In an operant task, protein-restricted male mice responded more for liquid protein rewards, but not carbohydrate, fat, or sweet rewards compared to non-restricted mice. When the number of responses required to access protein reward varied, protein-restricted mice exhibited higher operant responses at moderate to high response requirements. The protein restriction-induced increase in operant responding for protein was absent in Fgf21-KO mice and mice with neuron-specific deletion of the FGF21 co-receptor …

Nevada’S Care Workforce: Obstacles And Opportunities For Policymakers, David Damore, Caitlin J. Saladino, William E. Brown Jr., Fatma Nasoz

Policy Briefs and Reports

The care economy includes “the paid and unpaid labor and services that support caregiving in all its forms.” This work includes caring for children, the elderly, and those who are ill or have disabilities. Care work is often undervalued, underpaid, and without a fair system of work benefits in place (e.g. contracts, paid leave, workers’ rights) that in many cases falls disproportionately on women and communities of color. In this policy brief, we examine the care economy in Nevada by focusing on three areas of care: (1) child care; (2) elder care; and (3) mental and behavioral health care. In …