Public Health Commons^™

The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers To Chronic Pain Management In Primary Care In Three Steps, Laura Ellen Ashcraft, Megan E Hamm, Serwaa S Omowale, Valerie Hruschak, Elizabeth Miller, Shaun M Eack, Jessica S Merlin

Faculty, Staff and Student Publications

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence. The objectives for this study were to (1) explore determinants of evidence-based chronic pain management and (2) develop a novel approach to using implementation science to address the evidence-practice gap.

Method: A convenience sample of twenty-one Pennsylvania PCPs participated in one-time semi-structured telephone interviews. Interviews were transcribed verbatim and both …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Prozone Masks Elevated Sars-Cov-2 Antibody Level Measurements, Micaela N Sandoval, Samuel P Mcclellan, Stephen J Pont, Jessica A Ross, Michael D Swartz, Mark A Silberman, Eric Boerwinkle

Faculty, Staff and Student Publications

We report a prozone effect in measurement of SARS-CoV-2 spike protein antibody levels from an antibody surveillance program. Briefly, the prozone effect occurs in immunoassays when excessively high antibody concentration disrupts the immune complex formation, resulting in a spuriously low reported result. Following participant inquiries, we observed anomalously low measurement of SARS-CoV-2 spike protein antibody levels using the Roche Elecsys® Anti-SARS-CoV-2 S immunoassay from participants in the Texas Coronavirus Antibody Research survey (Texas CARES), an ongoing prospective, longitudinal antibody surveillance program. In July, 2022, samples were collected from ten participants with anomalously low results for serial dilution studies, and a …

Colonial Drivers And Cultural Protectors Of Brain Health Among Indigenous Peoples Internationally, Rita Henderson, Joyla A Furlano, Shayla Scott Claringbold, Ashley Cornect-Benoit, Anh Ly, Jennifer Walker, Lisa Zaretsky, Pamela Roach

Faculty, Staff and Student Publications

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This …

Higher Baseline Serum Bilirubin Levels Are Associated With Increased Risk Of Early Neurological Deterioration In Women With Acute Ischemic Stroke, Meng Sun, Yingfeng Weng, Jiwei Cheng, Guoyi Li, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Early neurological deterioration (END) occurs in up to one-third of patients with acute ischemic stroke (AIS) and associated with poor outcome. The role of serum bilirubin in END remains controversial. This study aims to investigate the association of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) with END.

METHODS: This study was a cross-sectional retrospective study with 344 AIS patients enrolled. We retrospectively reviewed consecutive AIS patients with END through a medical record retrieval system and enrolled patients as control randomly from the AIS patients without END at the same period. The bilirubin levels were …

Health Policies Within The Poverty Agendas Of Lula And Rousseff, Welington Lazarini, Francis Sodré, Carlos Eduardo Siqueira

Gastón Institute Publications

The anti-poverty agenda has been at the heart of the World Bank’s discourse in recent decades. Social policies started to be identified as strategic for combating poverty and promoting development in poor countries. We analyzed the health policy recommendations made by the World Bank to Brazil in the Lula da Silva and Rousseff administrations from 2003 to 2014. Document analysis was used to explore the partnership contracts between the World Bank and Brazil, projects financed by the World Bank in Brazil, and the document “20 Years of Construction of the Health System in Brazil: An Analysis of the Unified Health …

The Lived Experience Of The Covid-19 Pandemic Among Mandate-Resistant Adults In Washington State, Amber N. Peterson

Antioch University Dissertations & Theses

This study examined the lived experience of self-identified, mandate-resistant adults in Washington state. This study explored participants’ experience of the COVID-19 pandemic, from a retrospective framework by uncovering challenges, silver linings, decision-making, and self-reported mental health. Remote interviews were conducted with nine participants. Participants were between 23–31 years old, mostly male, and over half identified as Black. Through semi structured interviews, data was collected and analyzed using Interpretive Phenomenological Analysis (IPA). Participants described their experiences during the COVID-19 pandemic and highlighted significant changes in the way they lived their lives. Most notably, participants described ways in which they defied COVID-19 …

Inhaling The Unseen: Exploring The Presence Of Microplastics In The Human Respiratory Tract, Kara Coffman-Rea

Graduate Research Theses & Dissertations

Microplastics (plastic pieces less than 5 mm) have emerged as a pervasive form of pollution acknowledged as a universal threat to both environmental and human health. Their small size and widespread distribution pose significant risks to marine life, terrestrial ecosystems, and ultimately human health. Microplastics have been reported in food and drink items designated for human consumption, in cosmetics and consumer goods designed for human use, and within the air we breathe, each providing an entry route for microplastics to enter the human body. Recently, microplastic particles have been detected in a variety of human tissue samples (e.g., lung tissue). …

Implementing A Nurse-Driven Clostridium Difficile Screening Protocol, Sandrela Magnuson

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: Clostridium difficile infection (CDI) is a prevalent infection often contracted in hospitals. CDI is also increasingly originating from community settings. In addition to the health risks associated with CDI, diagnosis of a hospital-acquired CDI can have a significant financial impact on hospital systems. When hospital acquired, hospital systems are no longer reimbursed by payers. Secondary to the increasing prevalence of community-acquired CDI, mechanisms for early detection and isolation are warranted.

Local Problem: J.W. Ruby Memorial Hospital has an integrated Clostridium difficile (C. difficile) electronic health record (EHR) screening questionnaire that requires updating to align with current guidelines.

Purpose: …

Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi

All ETDs from UAB

Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …

Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee

All ETDs from UAB

There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …

Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair

All ETDs from UAB

In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …

State Of The Science Of Scale-Up Of Cancer Prevention And Early Detection Interventions In Low- And Middle-Income Countries: A Scoping Review, Tara M Friebel-Klingner, Gloria Guevara Alvarez, Hope Lappen, Lydia E Pace, Keng-Yen Huang, Maria E Fernández, Donna Shelley, Anne F Rositch

Faculty, Staff and Student Publications

Purpose: Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings.

Methods: We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention …

Using Focus Groups To Explore Older Black Men's Perception Of Dietary Interventions., Ashley R Shaw, Eric D Vidoni, Mickeal N Key, Brandon A Yates, Roland Thorpe

Faculty, Staff and Student Publications

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer’s disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted …

An Exploration Of Anxiety And Depressive Symptoms Among Sexual And Gender Minority Young Adults Visiting A Drop-In Center For Youth Experiencing Homelessness, Lourence Misedah-Robinson, Laura Witte, Elizabeth Henneke, Madonna Land, Vanessa Schick

Faculty, Staff and Student Publications

Background: Research suggests that marginalized young adults, particularly sexual and gender minorities (SGM), face distinctive healthcare transition challenges. SGM often navigate a complex intersection of identities, experiences, and stressors that can contribute to mental health disparities. However, they often lack access to appropriate support and resources tailored to their needs, which can result in increased psychological distress. Drop-in centers are effective mental health interventions for marginalized communities. Therefore, we conducted a study to explore the healthcare access experiences and mental health outcomes of young adult SGM compared to their non-SGM counterparts.

Methods: We surveyed 151 young adults aged 18-25 who …

Association Of Cancer Diagnosis With Disability Status Among Older Survivors Of Colorectal Cancer: A Population-Based Retrospective Cohort Study, Shiming Zhang, Lin-Na Chou, Michael D Swartz, Hemalkumar B Mehta, James S Goodwin, Yong-Fang Kuo, Sharon Hermes Giordano, Carole A Tucker, Karen M Basen-Engquist, Elizabeth J Lyons, Brian Downer, Susan K Peterson, Tru Cao, Maria C Swartz

Faculty, Staff and Student Publications

BACKGROUND: Older cancer survivors likely experience physical function limitations due to cancer and its treatments, leading to disability and early mortality. Existing studies have focused on factors associated with surgical complications and mortality risk rather than factors associated with the development of poor disability status (DS), a proxy measure of poor performance status, in cancer survivors. We aimed to identify factors associated with the development of poor DS among older survivors of colorectal cancer (CRC) and compare poor DS rates to an age-sex-matched, non-cancer cohort.

METHODS: This retrospective cohort study utilized administrative data from the Texas Cancer Registry Medicare-linked database. …

Racial And Ethnic Differences In Infant Survival For Hydrocephaly-Texas, 1999–2017, Munir Ahmed, Charles Shumate, Heidi Bojes, Ketki Patel, A J Agopian, Mark Canfield

Faculty, Staff and Student Publications

Background: Congenital hydrocephaly, an abnormal accumulation of fluid within the ventricular spaces at birth, can cause disability or death if untreated. Limited information is available about survival of infants born with hydrocephaly in Texas. Therefore, the purpose of the study was to calculate survival estimates among infants born with hydrocephaly without spina bifida in Texas.

Methods: A cohort of live-born infants delivered during 1999-2017 with congenital hydrocephaly without spina bifida was identified from the Texas Birth Defects Registry. Deaths within 1 year of delivery were identified using vital and medical records. One-year infant survival estimates were generated for multiple descriptive …

Factors Associated With Infant Sex And Preterm Birth Status For Selected Birth Defects From The National Birth Defects Prevention Study, 1997–2011, Eva M Williford, Wei Yang, Meredith M Howley, Chen Ma, Ronnie T Collins, Kari A Weber, Dominique Heinke, Julie M Petersen, A J Agopian, Natalie P Archer, Andrew F Olshan, Lindsay A Williams, Marilyn L Browne, Gary M Shaw

Faculty, Staff and Student Publications

Background: Birth defects and preterm birth co-occur, with some overlapping risk factors. Many birth defects and preterm births tend to have a male preponderance. We explored potential risk factors impacting sex and preterm (< 37 weeks of gestation) birth differences among infants with selected birth defects delivered from 1997 to 2011 using data from the National Birth Defects Prevention Study (NBDPS).

Methods: The NBDPS was a large multisite, population-based case-control study. Using random forests, we identified important predictors of male preterm, female preterm, and male term, each compared with female term births for each birth defect. Using logistic regression, we estimated odds ratios for associations between important predictors and sex-preterm birth status by birth defect.

Results: We examined 11,379 infants with nine specific birth defects. The top …

Traditional Chinese Medicine And The Argument For Future Application In The United States, Kylie Nicole Frohlich

Graduate Student Theses, Dissertations, & Professional Papers

No abstract provided.

An Endemic Issue: Malawi's Struggle To Prevent Childhood Malaria, Hailey A. Smalley

Graduate Student Theses, Dissertations, & Professional Papers

Malaria is one of the most prolific diseases in the world, generating hundreds of millions of cases and hundreds of thousands of deaths a year. In 2021, the World Health Organization initiated preliminary trials for the first malaria vaccine in three countries, including Malawi. This project explores the impact of the malaria vaccine on community perspectives and health outcomes related to malaria , describes ongoing challenges that health workers face when disseminating the vaccine, and explains how Malawi’s experience implementing the malaria vaccine reflects larger trends in international aid.

Developing A National Implementation Strategy To Accelerate Uptake Of Evidence-Based Family Caregiver Support In Us Cancer Centers, J Nicholas Odom, Heather M Young, Katherine Sterba, Timothy S Sannes, Susan Reinhard, Chandylen L Nightingale, Diane Meier, Tamryn F Gray, Betty Ferrell, Maria E Fernandez, Heidi Donovan, Kayleigh Curry, Erin R Currie, Tara Bryant, Marie A Bakitas, Allison J Applebaum

Faculty, Staff and Student Publications

OBJECTIVE: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services.

METHODS: Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed …

Risk Of Depression In Persons With Alzheimer's Disease: A National Cohort Study, Casey Crump, Weiva Sieh, Barbara G Vickrey, Alexis C Edwards, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

INTRODUCTION: Depression is a risk factor and possible prodromal symptom of Alzheimer's disease (AD), but little is known about subsequent risk of developing depression in persons with AD.

METHODS: National matched cohort study was conducted of all 129,410 persons diagnosed with AD and 390,088 with all-cause dementia during 1998-2017 in Sweden, and 3,900,880 age- and sex-matched controls without dementia, who had no prior depression. Cox regression was used to compute hazard ratios (HRs) for major depression through 2018.

RESULTS: Cumulative incidence of major depression was 13% in persons with AD and 3% in controls. Adjusting for sociodemographic factors and comorbidities, …

Feri: A Multitask-Based Fairness Achieving Algorithm With Applications To Fair Organ Transplantation, Can Li, Dejian Lai, Xiaoqian Jiang, Kai Zhang

Faculty, Staff and Student Publications

Liver transplantation often faces fairness challenges across subgroups defined by sensitive attributes such as age group, gender, and race/ethnicity. Machine learning models for outcome prediction can introduce additional biases. Therefore, we introduce Fairness through the Equitable Rate of Improvement in Multitask Learning (FERI) algorithm for fair predictions of graft failure risk in liver transplant patients. FERI constrains subgroup loss by balancing learning rates and preventing subgroup dominance in the training process. Our results show that FERI maintained high predictive accuracy with AUROC and AUPRC comparable to baseline models. More importantly, FERI demonstrated an ability to improve fairness without sacrificing accuracy. …

Acceptability Of Anal Human Papillomavirus Home Self-Sampling And Clinician Sampling Among Sexual And Gender Minority Individuals In Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study, Jenna Nitkowski, Anna R Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

Purpose: Anal cancer has disproportionately high incidence among sexual minority men. We compared acceptability of home versus clinic human papillomavirus (HPV) anal swabbing.

Methods: The Prevent Anal Cancer Self-Swab Study recruited sexual and gender minority individuals in Milwaukee, Wisconsin. Eligible participants were randomized to a home or clinic arm. Home participants received a mailed anal HPV self-sampling kit. Clinic participants attended a clinic appointment where a clinician collected an anal HPV swab. We examined acceptability (overall thoughts, comfort with method, pain, and future willingness to swab) of home versus clinic swabbing using postswab survey responses.

Results: A total of 191 …

Characteristics And Quality Of Life Of People Living With Comorbid Disorders In Substance Use Recovery Residences, Elizabeth O Obekpa, Sheryl A Mccurdy, Kathryn R Gallardo, Serena A Rodriguez, Cecilia Ganduglia Cazaban, H Shelton Brown, James J Yang, J Michael Wilkerson

Faculty, Staff and Student Publications

BACKGROUND: Opioid use disorder (OUD) is associated with significant morbidity and mortality; however, research on physical and mental health comorbidities and health-related quality of life (HRQoL) among people taking medication for OUD (MOUD) and living in recovery residences is sparse. We investigated the prevalence of comorbidities and examined which EQ-5D-5L HRQoL dimensions are most affected by these comorbidities.

METHODS: Data were collected from 358 residents living in 14 Texas-based recovery residences from April 2021 to June 2023. The EQ-5D-5L descriptive system comprises five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Each dimension has five levels of perceived problems, dichotomized into …

Human Papillomavirus (Hpv) Vaccination In Males: Associations Of Hpv-Related Knowledge And Perceptions With Hpv Vaccination Intention Among Korean Mothers Of Boys, Jihye Choi, Paula Cuccaro, Christine Markham, Sooyoun Kim, Irene Tamí-Maury

Faculty, Staff and Student Publications

OBJECTIVES: Human papillomavirus (HPV) vaccination rates among males are suboptimal worldwide. In South Korea, little is known about parents' intention to vaccinate boys against HPV. Therefore, we examined the associations of HPV-related knowledge and perceptions with vaccination intention among Korean mothers of boys.

METHODS: From August to December 2021, eligible mothers were surveyed about HPV-related knowledge, perceptions, and intention to vaccinate their sons against HPV. Mothers were categorized into no intention, contemplating, and intention to vaccinate groups. Using analysis of variance, we compared the groups' scores on the scales measuring HPV-related knowledge, attitudes, and beliefs. We conducted a multinomial logistic …

A Randomized Controlled Study Of Auricular Point Acupressure To Manage Chemotherapy-Induced Neuropathy: Study Protocol, Nada Lukkahatai, Michael V Nguyen, Jingyu Zhang, Yu-Min Cho, Chitchanok Benjasirisan, Heijingzi Monica Jia, Claudia M Campbell, Jennifer Kawi, Hulin Wu, Hongyu Wang, Rupsikha Bora, Johannes Thrul, Constance M Johnson, Thomas J Smith

Faculty, Staff and Student Publications

Objective: Chemotherapy-induced neuropathy (CIN) significantly impacts cancer patients, leading to functional disability, diminished quality of life, and increased healthcare costs amid the ongoing opioid crisis. Auricular point acupressure (APA), a non-invasive and non-pharmacological alternative, has shown potential for alleviating the pain, numbness, and tingling associated with CIN. This study aims to assess the efficacy of APA for CIN symptoms and physical function and to examine the mechanisms underlying APA's effects on CIN.

Methods: This is a three-arm randomized controlled clinical trial protocol. Patients aged 18 and older who are experiencing CIN are randomly assigned to one of the three groups: …

A Comparative Study Of Venezuelan Immigrants’ Pre- And Post-Migration Concerns For Their Children In The United States And Colombia, Aigerim Alpysbekova, Pablo Montero-Zamora, Mary H Soares, Carolina Scaramutti, Sumeyra Sahbaz, Maria Duque, Tara Bautista, Maria Fernanda Garcia, Christopher P Salas-Wright, Mildred M Maldonado-Molina, Melissa M Bates, Augusto Pérez-Gómez, Juliana Mejía Trujillo, Eric C Brown, Seth J Schwartz

Faculty, Staff and Student Publications

Research suggests that forced migration may lead to cultural stress and psychological distress. However, little is known about immigrant parents' pre- and post-migration concerns for their children's welfare. The present study examined the concerns of Venezuelan parents who migrated to the United States versus those who migrated to Colombia, and whether post-migration concerns were related to cultural stressors, mental health, and cultural identity. A sample of 609 Venezuelan immigrants completed surveys and responded to an open-ended prompt asking about pre- and post-migration concerns for children's welfare. Lack of safety was the most common pre-migration concern for Venezuelans in the U.S., …

Joint Problem-Solving Orientation, Mutual Value Recognition, And Performance In Fluid Teamwork Environments, Michaela Kerrissey, Zhanna Novikov

Faculty, Staff and Student Publications

INTRODUCTION: Joint problem-solving orientation (JPS) has been identified as a factor that promotes performance in fluid teamwork, but research on this factor remains nascent. This study pushes the frontier of understanding about JPS in fluid teamwork environments by applying the concept to within-organization work and exploring its relationships with performance, mutual value recognition (MVR), and expertise variety (EV).

METHODS: This is a longitudinal, survey-based field study within a large United States healthcare organization

RESULTS: Our results affirm a moderated mediation model wherein JPS enhances performance, both directly and through MVR; EV serves as a moderator in the JPS-MVR relationship. JPS …

Mda Foundation: 2024 Promises Great Things From The Mda Foundation, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation is making significant strides in supporting dental and hygiene students and the community. In a recent announcement, 12 scholarships totaling $31,000 were awarded, thanks to donor generosity. The Foundation's upcoming Sparkling Smiles Celebration will provide an opportunity to meet scholarship recipients and acknowledge donors. The primary focus in June will be the Mission of Mercy event in Flint, aiming to offer essential dental care to up to 2,000 individuals. Volunteers are encouraged to participate, and financial support can be pledged online. Ongoing efforts include fundraising for the Karen Burgess Scholarship Endowment and the upcoming MDA Foundation golf …