Public Health Commons^™

The Shared Ethical Framework To Allocate Scarce Medical Resources: A Lesson From Covid-19, Ezekiel J. Emanuel, Govind C. Persad

Sturm College of Law: Faculty Scholarship

The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair disadvantage, equal moral concern, reciprocity, and instrumental value. These values are universal. None of the values are sufficient alone, …

Improvement Of Community Health Worker Counseling Skills Through Early Childhood Development (Ecd) Videos, Supervision And Mentorship: A Mixed Methods Pre-Post Evaluation From Tanzania, Josephine Pascal Ferla, Michelle M. Gill, Teopista Komba, Amina Abubakar, Pieter Remes, Ola Jahanpour, Gretchen Antelman

Institute for Human Development, East Africa

Background: Community health workers (CHWs) play significant roles in improving health practices in under- resourced communities. This study evaluated an early childhood development (ECD) project in Tanzania assessing the effect of mobile video use, supervision and mentorship to improve quality of CHW counseling skills.

Methods: CHWs participating in the Malezi Project in Tabora Region were enrolled in a mixed methods pre-post evaluation. CHWs previously trained in UNICEF’s Care for Child Development package were further trained in counselling caregivers on nurturing care and father engagement using videos. Health providers were trained to provide ECD-focused supervision/mentorship of CHWs in facilities and …

Navigating Life With Hiv As An Older Adult On The Kenyan Coast: Perceived Health Challenges Seen Through The Biopsychosocial Model, Patrick Mwangala, Ryan G. Wagner, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Objectives: This study explores the perceptions of adults living with HIV aged ≥50 years (recognized as older adults living with HIV—OALWH), primary caregivers and healthcare providers on the health challenges of ageing with HIV at Kilifi, a low literacy setting on the coast of Kenya.

Methods: We utilized the biopsychosocial model to explore views from 34 OALWH and 22 stakeholders on the physical, mental, and psychosocial health challenges of ageing with HIV in Kilifi in 2019. Data were drawn from semi-structured in-depth interviews, which were audio-recorded and transcribed. A framework approach was used to synthesize the data.

Results: Symptoms of …

Unilateral Agenesis Of Adnexa, Srinidhi Govindarajan, Poornima M Associate Professor, Rashmi H.S., Aishwarya Bhat

Digital Journal of Clinical Medicine

No abstract provided.

A Pandemics Treaty: A Boon For Africa, Kafumu Kalyalya

Southern African Journal of Policy and Development

This article illustrates the weaknesses of the current global health framework. It highlights two pillars a new treaty regime ought to be built upon. The analysis seeks to establish how these pillars could have helped Africa during the pandemic and can indeed help Africa in future pandemics. The analysis suggests the need for a unified global health regime or pandemics’ treaty that promotes a level legal and political playing field regarding future pandemics. The treaty could focus on coordination of research and development; build a stronger global framework that reinforces legal obligations and norms; provide for universal access to medicines, …

Psychometric Properties Of The Suicide Behaviors Questionnaire-Revised (Sbq-R) In American Sign Language, Jared A. Embree, Amanda M. Hinson-Enslin, Kathy Taylor, Josephine Wilson

JADARA

Limited research has focused on the risk of suicide within the deaf community, and no published studies to date report SBQ-R scores in deaf populations. The purpose of this study was to adapt the Suicide Behaviors Questionnaire-Revised into American Sign Language (SBQ-R-ASL). After the translation protocol was completed, the SBQ-R-ASL was field-tested with 340 deaf individuals in a national sample. Data analysis indicated satisfactory validity and internal consistency, and a Principal Components Analysis resulted in one factor. Field-test data revealed a mean SBQ-R-ASL score of 8.76, which is above published cutoff scores for suicide risk. These findings demonstrate a crucial …

Prenatal And Childhood Exposure To Organophosphate Pesticides And Behavior Problems In Adolescents And Young Adults In The Chamacos Study, Sharon K. Sagiv, Ana M. Mora, Stephen Rauch, Katherine R. Kogut, Carly Hyland, Robert B. Gunier, Asa Bradman, Julianna Deardorff, Brenda Eskenazi

Public and Population Health Faculty Publications and Presentations

Background: We previously reported associations of prenatal exposure to organophosphate (OP) pesticides with poorer neurodevelopment in early childhood and at school age, including poorer cognitive function and more behavioral problems, in the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a birth cohort study in an agriculture community.

Objective: We investigated the extent to which early-life exposure to OP pesticides is associated with behavioral problems, including mental health, in youth during adolescence and early adulthood.

Methods: We measured urinary dialkylphosphates (DAPs), nonspecific OP metabolites, in urine samples collected from mothers twice during pregnancy (13 and 26 …

Summary Of: Why Did Some Rural Mainers Accept Novel Covid-19 Vaccines When Rolled Out In 2021, While Others Did Not?, Michael Kohut Phd, Liz Scharnetzki, Joseph Pajka, Elizabeth Jacobs, Kathleen Fairfield

Northern New England Clinical & Translational Research

Many people, especially in rural areas of the United States, choose not to receive novel COVID-19 vaccinations despite public health recommendations.

Understanding how people describe decisions to get vaccinated or not may help to address hesitancy.

Study @ "Decisions about adopting novel COVID-19 vaccines among White adults in" by Michael Kohut PhD, Liz Scharnetzki et al.

Mothers' Experiences Of A New Early Collaborative Intervention, The Eaci, In The Neonatal Period: A Qualitative Study, Charlotte Sahlén Helmer, Ulrika Birberg Thornberg, Thomas Abrahamsson, Evalotte Mörelius

Research outputs 2022 to 2026

Aim: To explore mothers' experiences of the EArly Collaborative Intervention. Background: Preterm birth puts a considerable emotional and psychological burden on parents and families. Parents to moderate and late premature infants have shorter stays at the neonatal intensive care unit and have described a need for support. The EArly Collaborative Intervention was developed to support parents with preterm infants born between gestational Weeks 30 to 36. In this study, mothers' experiences of the new intervention were explored. Design: A qualitative design guided by a reflexive thematic analysis according to Braun and Clarke. Interviews were individually performed with 23 mothers experienced …

Diabetes Prevalence And Monitoring In Nonmetropolitan And Metropolitan Areas Within A Commercially Insured U.S. Population, Lindsey R. Hammerslag, Jeffery Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Enrollees living in nonmetropolitan areas had 22% higher likelihood of having diabetes, even after controlling for factors like age and region.
• The prevalence of diabetes in 2019-2020 was 7.9% in nonmetropolitan areas and 6.2% in metropolitan areas.
• Annual hemoglobin A1c (HbA1c) testing occurred for 85.1% of nonmetropolitan and 85.7% of metropolitan enrollees with diabetes. After controlling for other factors, we found significantly lower testing for those in nonmetropolitan areas.
• For diabetic enrollees, having an HbA1c test in 2019 was associated with an 8% decrease in the likelihood of non-cardiovascular complications related to diabetes and a 6% …

Food Insecurity Among Deaf And Hard Of Hearing: A Scoping Review, Rylea Saunders, Laportia Jackson, Julia Vandermolen

JADARA

The authors employed a scoping review to examine peer-reviewed journal articles published between 2017 and 2020 focusing on the relationship between food insecurity among deaf and hard of hearing (DHOH) populations and language barriers using American Sign Language (ASL). Four databases yielded 257 peer-reviewed articles during the initial search. Four peer-reviewed articles were included in the review to explore the relationship between food insecurity among DHOH populations and language barriers using ASL. Multiple contributing factors create a food-insecure individual. Results indicate that income level, mental health status, and caregiver communication are all predictors of food security for DHOH. One of …

Assessing Boil Water Notices As Health-Risk Communication: Risk Perceptions, Efficacy, And Compliance During Winter Storm Uri, Ashleigh M. Day, Sydney O'Shay, Khairul Islam, Matthew W. Seeger, Shawn P. Mcelmurry

Open Data at Wayne State

Winter Storm Uri was an extreme disaster that impacted much of the United States during February of 2021. Texas and Oklahoma were generally not prepared for such an event and experienced massive power grid failures. This led to cascading risks including water system disruptions and many boil water notices (BWNs). The breakdown of some communication channels and the inability to enact protective actions due to power outages, as well as travel limitations on public roads, complicated both dissemination and implementation. Under these conditions, a non-representative, cross-sectional, survey was collected to assess individuals experience BWNs and how perceived efficacy impacts compliance. …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Commencement Program 2023, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2023 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

25 | The Program, The School Honorees, and The Speakers

• School of Medicine, 26
• School of Pharmacy, 52
• School of Dentistry, 69
• School of Public Health, 93
• San Manuel Gateway College, 108
• School of Allied Health Professions—Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication …

(R2032) Modeling The Effect Of Sanitation Effort On The Spread Of Carrier-Dependent Infectious Diseases Due To Environmental Degradation, Ram Naresh, Sandhya Rani Verma, J. B. Shukla, Manju Agarwal

Applications and Applied Mathematics: An International Journal (AAM)

In this present study, an SIS model is proposed and analyzed to study the effect of sanitation effort in controlling the spread of carrier-dependent infectious disease in a human habitat due to environmental degradation. The dynamics of the model consist of six dependent variables, the susceptible population density, infective population density, carrier population density, cumulative density of environmental degradation and the density of sanitation effort applied on carrier population and degraded environment. In the modeling process, the carrier population density and sanitation effort are modeled logistically and the degradation of the environment is assumed to be directly proportional to the …

Trends Of Ovarian Cancer Incidence And Mortality In Mississippi Between 2003 And 2020, Angel Walker

Honors Theses

Ovarian cancer is the fifth leading cause of cancer deaths in women, accounting for more deaths than any other gynecologic cancer (Arora et al., 2023). Over the past few decades, there have been several advancements in treating the disease. However, improvements in survival rates for ovarian cancer are not seen equally among women. For White women, the five-year survival rate for ovarian cancer has improved, while for Black women, it has worsened (Karanth et al., 2019). To further understand how ovarian cancer affects women, we aim to describe the trends of ovarian cancer incidence and mortality for White and Black …

The Development Of Sexual Health Educational Canvas Modules For Cal Poly Students, Alexa J. Asson, Dillan Chiewpanich, Amanda Hodges, Tanya Patil

Biological Sciences

Purpose: Sexual health education continues to be a taboo topic underrepresented in young adult health education. Many high school students do not receive the sexual health education they need. One study found that 34% of girls and 42% of boys left high school without education on birth control methods (Wong et al., 2019). Furthermore, students entering college have varying, often inadequate, levels of sexual health knowledge. After examining sexual health data at California Polytechnic State University (Cal Poly), the Cal Poly Sexual and Reproductive Health (SRH) Lab found that students engage in risky sexual behaviors. For example, nearly one quarter …

The Development Of Sexual Health Educational Canvas Modules For Cal Poly Students, Alexa Jordan Asson, Dillan Isabella Chiewpanich, Amanda Hodges, Tanya Patil

Kinesiology and Public Health

Purpose: Sexual health education continues to be a taboo topic underrepresented in young adult health education. Many high school students do not receive the sexual health education they need. One study found that 34% of girls and 42% of boys left high school without education on birth control methods (Wong et al., 2019). Furthermore, students entering college have varying, often inadequate, levels of sexual health knowledge. After examining sexual health data at California Polytechnic State University (Cal Poly), the Cal Poly Sexual and Reproductive Health (SRH) Lab found that students engage in risky sexual behaviors. For example, nearly one quarter …

Evidence-Based Practices And Self-Efficacy: A Quantitative Study Of Mental Health Counselors Treating Clients With Substance Use Disorder, Carl Bastien

Dissertations

Substance use disorder affects a substantial number of individuals in the United States. The specific problem of this research is that it was not known to what extent their use of evidence-based practices is driven by their sense of self-efficacy. The purpose of this quantitative correlational research was to examine to what extent the use of evidence-based practices covary with a sense of self-efficacy for mental health counselors treating individuals diagnosed with a substance use disorder. The study population was 121 mental health counselors who specialized in substance use disorder treatment who completed a digital survey. The study findings did …

Phase Ii Trial Of Nelipepimut-S Peptide Vaccine In Women With Ductal Carcinoma In Situ, Anne E O'Shea, Guy T Clifton, Na Qiao, Brandy M Heckman-Stoddard, Malgorzata Wojtowicz, Eileen Dimond, Isabelle Bedrosian, Diane Weber, Judy E Garber, Alexander Husband, Ricardo Pastorello, J Jack Lee, Mike Hernandez, Diane D Liu, Lana A Vornik, Powel H Brown, Gheath Alatrash, George E Peoples, Elizabeth A Mittendorf

Faculty, Staff and Student Publications

UNLABELLED: NeuVax is a vaccine comprised of the HER2-derived MHC class I peptide E75 (nelipepimut-S, NPS) combined with GM-CSF. We completed a randomized trial of preoperative vaccination with NeuVax versus GM-CSF alone in patients with ductal carcinoma in situ (DCIS). The primary objective was to evaluate for NPS-specific cytotoxic T lymphocyte (CTL) responses. Patients with human leukocyte antigen (HLA)-A2-positive DCIS were enrolled and randomized 2:1 to NeuVax versus GM-CSF alone and received two inoculations prior to surgery. The number of NPS-specific CTL was measured pre-vaccination, at surgery, and 1 and 3 to 6 months post-operation by dextramer assay. Differences in …

Piloting The Sexual And Gender Minority Cancer Curricular Advances For Research And Education (Sgm Cancer Care) Workshop: Research Training In The Service Of Sgm Cancer Health Equity, Miria Kano, Irene Tamí-Maury, Mandi L Pratt-Chapman, Shine Chang, Mikaela Kosich, Gwendolyn P Quinn, Tonia Poteat, Peter A Kanetsky, Ronit Elk, Ulrike Boehmer, Julian Sanchez, Charles Kamen, Nelson F Sanchez

Faculty, Staff and Student Publications

The purpose of this study is to describe the context, curriculum design, and pilot evaluation of the educational program "Sexual and Gender Minority Cancer Curricular Advances for Research and Education" (SGM Cancer CARE), a workshop for early-career researchers and healthcare providers interested in gaining knowledge and skills in sexual and gender minority (SGM) cancer research and healthcare advocacy. A needs assessment of a sample of clinicians and researchers (n = 104) and feedback from an Advisory Board informed the curriculum design of the SGM Cancer CARE workshop. Four SGM-tailored modules, focusing on epidemiology, clinical research, behavioral science and interventions, and …

Neuroaffective Reactivity Profiles Are Associated With Vulnerability To E-Cigarette Use, Francesco Versace, George Kypriotakis, Dustin Pluta

Faculty, Staff and Student Publications

BACKGROUND: We tested whether neuroaffective responses to motivationally salient stimuli are associated with vulnerability to cue-induced e-cigarette use in e-cigarette naïve adults who smoke daily. We hypothesized that individuals with stronger neuroaffective responses to nicotine-related cues than to pleasant stimuli (the C>P reactivity profile) would be more vulnerable to cue-induced nicotine self-administration than individuals with stronger neuroaffective responses to pleasant stimuli than to nicotine-related cues (the P>C reactivity profile).

METHODS: We used event-related potentials (ERPs, a direct measure of cortical activity) to measure neuroaffective reactivity to pleasant, unpleasant, neutral, and nicotine-related cues indicating the opportunity to use an …

Exploring The Potential Of Hearing Screening Smartphone Applications To Enhance Access To Hearing Healthcare: A Literature Review, Adam Sulaiman

Dissertations, Theses, and Capstone Projects

In 2016, the National Academies of Sciences (NAS) published a landmark consensus report with several recommendations to enhance the availability and affordability of hearing healthcare in the United States. Among the most notable of the recommendations was the creation of a new category of FDA-approved Over-the-Counter (OTC) hearing aids. Unlike the traditional hearing aid model, which requires a comprehensive hearing test by a hearing health professional prior to purchase, OTC hearing aids would be directly available for sale to any American adult with a self-perceived mild-to-moderate degree of hearing loss. This proposal has now become reality with the passage of …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

A Case For Accelerating Standards To Achieve The Fair Principles Of Environmental Health Research Experimental Data, Rance Nault, Matthew C. Cave, Gabriele Ludewig, Hunter N. B. Moseley, Kelly G. Pennell, Tim Zacharewski

Markey Cancer Center Faculty Publications

BACKGROUND: Funding agencies, publishers, and other stakeholders are pushing environmental health science investigators to improve data sharing; to promote the findable, accessible, interoperable, and reusable (FAIR) principles; and to increase the rigor and reproducibility of the data collected. Accomplishing these goals will require significant cultural shifts surrounding data management and strategies to develop robust and reliable resources that bridge the technical challenges and gaps in expertise.

OBJECTIVE : In this commentary, we examine the current state of managing data and metadata—referred to collectively as (meta)data—in the experimental environmental health sciences. We introduce new tools and resources based on in vivo …

Incidence Of Chronic Kidney Disease Following Acute Coronavirus Disease 2019 Based On South Carolina Statewide Data, Roy O. Mathew, Jiajia Zhang Ph.D., Xueying Yang, Shujie Chen, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: Coronavirus disease 2019 (COVID-19) was associated with severe acute illness including multiple organ failure. Acute kidney injury (AKI) was a common finding, often requiring dialysis support.

Objective: Define the incidence of new clinically identified chronic kidney disease (CKD) among patients with COVID-19 and no pre-existing kidney disease.

Design Participants: The South Carolina (SC) Department of Health and Environmental Control (DHEC) COVID-19 mandatory reporting registry of SC residents testing for COVID-19 between March 2020 and October 2021 was included.

Design Main Measures: The primary outcome was a new incidence of a CKD diagnosis (N18.x) in those without a pre-existing diagnosis …

Mda Foundation: Mission Of Mercy Moves To Flint In June 2024; Save The Date And Participate, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation is organizing its fifth Mission of Mercy (MOM) in Flint in June 2024. The event aims to provide dental care to those in need, especially those who are uninsured and unable to afford dental services. The MOM will take place at the Dort Financial Center in Flint from June 13 to 17, offering dental care from 6 a.m. to 6 p.m. on June 14 and 15. This initiative has been critical in delivering dental services and improving the lives of those who lack access to proper oral healthcare.

President’S Address: Dr. Vince Benivegna, Vince Benivegna Dds

The Journal of the Michigan Dental Association

Dr. Vince Benivegna, the outgoing President of the Michigan Dental Association, addressed the House of Delegates, emphasizing the significant progress in enhancing Adult Dental Medicaid coverage and reimbursement in Michigan. He thanked the dedicated individuals who supported him during his tenure and shared his journey. Dr. Benivegna lauded Michigan's accomplishments in reducing opioid prescribing and highlighted the MDA's role as a model state society in advocacy, leadership, mentorship, continuing education, diversity, equity, and inclusion. He praised Michigan's achievements in improving Adult Dental Medicaid, encouraging Michigan dentists to participate and help address oral health disparities. Dr. Benivegna underscored how this aligns …

Mosquito Bed Net Use And Associated Factors Among Pregnant Women In Rwanda: A Nationwide Survey, Joseph Kawuki, Elorm Donkor, Lilian Nuwabaine, Ghislaine Gatasi

School of Nursing & Midwifery, East Africa

Background

In malaria-endemic countries such as Rwanda, the appropriate use of mosquito bed nets is an effective intervention for malaria prevention. Despite being one of the demographics most impacted by malaria, there is a dearth of literature on the usage of mosquito bed nets by pregnant women in Rwanda. The study aimed to assess the prevalence and associated factors for mosquito bed net use among pregnant women in Rwanda

Methods

We used weighted data from the 2020 Rwanda Demographic and Health Survey of 870 pregnant women, and multistage stratified sampling was used to select participants. Multivariable logistic regression was conducted …