Public Health Commons^™

Implicit Bias Training Standards In Health Care: Did Michigan Get It Right? A Policy And Ethical Framework Analysis, Megan Gailliard, Kieran Fogarty, Mary Lagerwey

The Open Journal of Occupational Therapy

In 2022, Michigan joined a handful of states requiring implicit bias training for its health care professionals. In its ideal application, implicit bias training of health care professionals will result in a reduction of the implicit biases held by health care providers. This bias reduction will, in theory, contribute to improved equity in the delivery of health care services. Ultimately, the less biased health professional, now delivering health care services with a more equitable hand, will help reduce health disparities in the State of Michigan.

This analysis of Mich. Admin. Code R.338.7004 - Implicit bias training standards for licensed and …

Managing User Conflicts In A Water Aerobics Program On Behalf Of A Veteran’S Group: A Short Case Study, Hadley Blankenship, Steven N. Waller Ph.D., Jason L. Scott

International Journal of Aquatic Research and Education

This article captures an experience in conflict management that happened during the summer of 2024 as a recreational therapy intern with an adaptive sport and recreation organization located in the Southeastern United States. The backdrop to the case is that a recreational therapy intern worked with various special needs populations – mainly with paraplegic (adult and youth) athletes and veterans. In many organizations, user conflicts and poor communication regarding service provision and scheduling hinder the implementation of programs for special populations, such as veteran groups. In this case, a problem occurred with the scheduling of a water aerobics program for …

Curbing Fatal And Non-Fatal Drowning Deaths: An Effort To Reach Under-Resourced Children In Baltimore, Maryland, Ashton P. Christo, William D. Ramos

International Journal of Aquatic Research and Education

Drowning remains a significant public health problem in the United States, with The Centers for Disease Control and Prevention (CDC) reporting approximately 4,000 drowning deaths annually. Children aged 1-4 face the highest risk, and African American children are disproportionately affected–7.6 times more likely to drown than white children (CDC, 2024). In a city on the East Coast that is predominantly African American, limited access to swimming lessons heightens the risk. To reduce drowning rates, a collaborative swimming program was established between a city high school and a public school enrichment program. The initiative provided essential water safety and swimming skills …

Diversity In Aquatics:4th Special Issue, Tiffany M. Quash Ph.D., Angela K. Beale-Tawfeeq, Steven N. Waller Ph.D.

International Journal of Aquatic Research and Education

The theme of this special issue is “Building a Community of Champions.” The purpose of this theme is to highlight and promote a civic engagement perspective that engages, advocates, and supports communities of Black, Indigenous, People of Color (BIPOC) in addressing the national, regional, and local evolving health-related issue of drowning. Aquatic Settings have been a pivotal focal point of social justice, water safety, and public health, not only in the past but also in our present day (Beale-Tawfeeq, Quash, et al, 2023 and Waller and Bemiller, 2023). Diversity In Aquatics (DIA) strives to positively impact the field of aquatics …

Teaching Swimming To Children With Disabilities: A Qualitative Analysis Of Swim Instructorstea, Stephanie S. Garcia-Hidalgo, Martin E. Block

International Journal of Aquatic Research and Education

When teaching children with disabilities, swim instructors need to be able to assess the unique strengths and needs of each child to determine modifications needed to instruction, equipment, and the setting and then be flexible enough to make changes in real-time to ensure success for the child. Unfortunately, many swim instructors only work seasonally and have the occasional child with a disability, and as a result are likely to have limited training and experiences with children with disabilities. The purpose of this pilot qualitative study is to examine backgrounds, training, and experiences of six swim instructors who work with children …

Promising Practices For Increasing The Number Of Equity-Owed Lifeguards In Canada And The United States Of America, Sofia Pantano, Audrey R. Giles

International Journal of Aquatic Research and Education

Currently a shortage of lifeguards exists in Canada and the United States (US) (Frommer, 2023; Santucci, 2024), and those who are working as lifeguards often do not reflect the diversity of the communities they serve (Martinez, 2020). Increasing the number of lifeguards from equity-owed groups is a potential way of increasing the lifeguard workforce and decreasing the shortage of workers in these important roles, as well as a moral imperative. In this paper I explore challenges to and promising practices aimed at increasing the representation of members equity-owed groups in lifeguarding. I begin with an overview of lifeguarding in Canada …

Adopting Stuart Hall’S “Race, The Floating Signifier” As A Conceptual Framework Within Aquatic Research And Education, Kurt J. Cordice

International Journal of Aquatic Research and Education

During his 1997 lecture at Goldsmiths College in London, Stuart Hall, renowned for his contributions to sociology and cultural studies, offered his argument that the concept of race functions as a Floating Signifier. In this essay, Stuart Hall’s Race, the Floating Signifier is presented as a strong conceptual framework to support more accurate and effective positioning of race as an important consideration within aquatic research and education. Evidence from a range of disciplines, including historical research, is presented to establish both the importance and challenge of race within aquatic research and education. This evidence is also used to demonstrate …

Building Swimming Skills In A Community Based Program For Black Youth: An Evaluation, Tyler Lennon Md, Mph, Ashley Hayes Mph, Leonardo Barrera Mph, Amy Hill Ms, Mph, Andy Miner, Michelle Macy Md, Ms

International Journal of Aquatic Research and Education

Black youth in the United States disproportionately experience fatal drowning at rates up to five times higher than their white peers. Eliminating these inequities requires new approaches that address historical and structural barriers of learning to swim. The objective of this study was to evaluate the three-week long swimming component of a community-based discovery program to empower Black youth in Evanston, IL. Participants were Black youth ages 8-10 years enrolled in summer 2023 and 2024. Swim skills were assessed by instructors using the Pictorial Scale of Perceived Water Competence (PSPWC). Caregiver surveys, collected post-intervention, also assessed perceived changes in swim …

An Innovative Approach Addressing Childhood Drowning: Making Use Of Collegiate Aquatic Facilities And Expertise, Gennette Cordova, Natasha Lloyd, Chezik Tsunoda

International Journal of Aquatic Research and Education

The silent epidemic of childhood drowning, and the racial disparities associated with it require scalable and innovative approaches that both break cycles of exclusion and circumvent our societal tendency to overlook drowning as a matter in need of urgent resolution. No More Under, a Seattle-based water safety organization whose mission is to eradicate childhood drowning, has launched the Swim Safely Series. The series is a national program uniquely poised to overcome the various barriers associated with racial and socioeconomic drowning disparities by tapping into underutilized collegiate aquatic spaces and merging water safety with mentorship and social intervention.

Large Language Models As Information Providers For Appropriate Antimicrobial Use: Computational Text Analysis And Expert-Rated Comparison Of Chatgpt, Claude And Gemini, Marcello Di Pumpo, Maria Rosaria Gualano, Danilo Buonsenso, Francesca Raffaelli, Daniele Donà, Vittorio Maio, Patrizia Laurenti, Walter Ricciardi, Leonardo Villani

College of Population Health Faculty Papers

OBJECTIVES: Antimicrobial resistance is a critical public health threat. Large language models (LLMs) show great capability for providing health information. This study evaluates the effectiveness of LLMs in providing information on antibiotic use and infection management.

METHODS: Using a mixed-method approach, responses to healthcare expert-designed scenarios from ChatGPT 3.5, ChatGPT 4.0, Claude 2.0 and Gemini 1.0, in both Italian and English, were analysed. Computational text analysis assessed readability, lexical diversity and sentiment, while content quality was assessed by three experts via DISCERN tool.

RESULTS: 16 scenarios were developed. A total of 101 outputs and 5454 Likert-scale (1-5) scores were obtained …

Eye On The Prize: Expanding Student Awareness Of Optometry As A Profession, Lorena Flores-Hernandez

MedEd Teaching Certificate Program

The proposed Doctor of Optometry program at UTRGV has the potential to positively enhance the ocular health of our communities. Implementing an outreach program highlighting a career path in optometry will be essential for the future of eyecare in the Rio Grande Valley.

According to data from the US Bureau of Labor Statistics, the optometric workforce is projected to grow over the next decade. The increased demand for optometrists is related to multiple factors including an aging population with chronic diseases and a nationwide shortage of ophthalmology practitioners.

Nationally, the Optometry Gives Me Life campaign, launched by the Association of …

Strategies For Addressing Covid-19 Vaccine Equity With Intermediaries, Prevention Research Centers, And The Vaccine Confidence Network, Kelianne K Hara-Hubbard, Allison Beaulieu, Anais Mendiola, Pooja Gandhi, Nicole Kuiper, Richard Quartarone, Jinni Tang, Olivia Dominguez, Maritza Bond, Dorothy Cohen, Margaret Goetz, Nasra Mohamed, Paula Cuccaro, Peggy A Hannon, Maria E Fernandez, Jackson Higginbottom, Rafael Pérez-Escamilla, Bárbara Baquero

Faculty, Staff and Student Publications

In April 2021, the CDC provided supplemental funding to all 26 Prevention Research Centers (PRCs) to create the PRC Vaccine Confidence Network (VCN) to increase COVID-19 vaccine confidence and uptake in communities disparately impacted by COVID-19 and/or in vaccine hesitant populations. A key strategy to building vaccine confidence was engaging with intermediaries (i.e., mutually trusted community and practice-based organizations conducting community outreach and intervention activities) to address barriers for our shared communities of focus. These intermediaries were key in building community trust, addressing community needs and concerns, and in turn, building vaccine confidence and demand in areas and communities disproportionately …

Resilience And Vulnerabilities Of Tumor Cells Under Purine Shortage Stress, Jianpeng Yu, Chen Jin, Cheng Su, David Moon, Michael A Sun, Hong Zhang, Xue Jiang, Fan Zhang, Nomi Tserentsoodol, Michelle L Bowie, Christopher J Pirozzi, Daniel J George, Robert Wild, Xia Gao, David M Ashley, Yiping He, Jiaoti Huang

Faculty, Staff and Students Publications

Purpose: Purine metabolism is a promising therapeutic target in cancer; however, how cancer cells respond to purine shortage, particularly their adaptation and vulnerabilities, remains unclear.

Experimental design: Using the recently developed purine shortage-inducing prodrug DRP-104 and genetic approaches, we investigated the responses in prostate, lung, and glioma cancer models.

Results: We demonstrate that when de novo purine biosynthesis is compromised, cancer cells employ microtubules to assemble purinosomes, multiprotein complexes of de novo purine biosynthesis enzymes that enhance purine biosynthesis efficiency. Although this process enables tumor cells to adapt to purine shortage stress, it also renders them more susceptible to the …

Stereoelectroencephalography Reveals Neural Signatures Of Multisensory Integration In The Human Superior Temporal Sulcus During Audiovisual Speech Perception, Yue Zhang, John F Magnotti, Xiang Zhang, Zhengjia Wang, Yingjia Yu, Kathryn A Davis, Sameer A Sheth, H Isaac Chen, Daniel Yoshor, Michael S Beauchamp

Faculty, Staff and Students Publications

Human speech perception is multisensory, integrating auditory information from the talker's voice with visual information from the talker's face. BOLD fMRI studies have implicated the superior temporal gyrus (STG) in processing auditory speech and the superior temporal sulcus (STS) in integrating auditory and visual speech, but as an indirect hemodynamic measure, fMRI is limited in its ability to track the rapid neural computations underlying speech perception. Using stereoelectroencephalography (sEEG) electrodes, we directly recorded from the STG and STS in 42 epilepsy patients (25F, 17M). Participants identified single words presented in auditory, visual, and audiovisual formats with and without added auditory …

Silent Signals: Human Trafficking And The Dental Professional’S Duty To Act, Pamela Zarkowski

Journal of the American College of Dentists

Human trafficking is a global public health and human rights crisis that includes forced labor and commercial sexual exploitation. Dental professionals are uniquely positioned to recognize signs of trafficking, as many victims encounter healthcare settings, including dental offices, during their exploitation. This article introduces the types and prevalence of trafficking, outlines legal and ethical responsibilities, and provides clinical red flags, case scenarios, and actionable strategies for screening and reporting. Myths that hinder detection are also addressed. By recognizing their ethical duty to protect vulnerable patients, dental professionals can become vital allies in the identification and support of trafficking survivors.

21st-Century Dental Public Health: Revisiting The Role Of Community Water Fluoridation, Larry Williams, Preetha Kanjirath

Journal of the American College of Dentists

Community water fluoridation (CWF) has been celebrated as a major public health achievement, significantly reducing dental caries and narrowing oral health disparities. While historically effective, today’s fluoride exposure landscape has shifted, with multiple sources contributing to cumulative intake. This article reviews the scientific foundation, mechanisms of action, public health benefits, and ethical considerations surrounding CWF, alongside real-world outcomes from policy reversals. It examines contemporary concerns, including potential neurodevelopmental risks and vulnerable populations, and calls for recalibrated policies that maintain caries prevention benefits while monitoring total fluoride exposure to ensure safety in modern contexts.

Ethical Dilemmas Surrounding Community Water Fluoridation, Roopwant Kaur, Herminio Perez, Mark Moss

Journal of the American College of Dentists

Since the 1950s, community water fluoridation (CWF) has stood as a cornerstone of dental public health. However, a growing amount of public scrutiny necessitates reflection on the ethical basis for coming to a firm position on the topic. Aside from CWF, fluoride in the form of ingestible supplements has recently been identified as a concern by the US Food and Drug Administration. Indeed, it is challenging to wade through the facts, opinions, misinformation, and policy shifts. This article examines the ethical dilemmas that surround CWF through the lens of the American Dental Association (ADA) Principles of Ethics and Code of …

J Am Coll Dent 2025 92 1

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

Housing Insecurity Is Associated With Higher Utilization Of Acute Care Services Among Oregon Health Plan Members With Behavioral Health Conditions, Megan Holtorf, Cat Livingston

Articles, Abstracts, and Reports

No abstract provided.

Addressing Housing As A Health-Related Social Need: Insights And Impacts From Health Share’S Housing Benefit Pilot Program, Monique Gill, Benjamin Gronowski, Megan Holtorf

Articles, Abstracts, and Reports

No abstract provided.

A Social Media Campaign And Web-Based Survey About Prostate Cancer Genetics: Mixed Methods Study, Amy Leader, Stacy Loeb, Preethi Selvan, Ashley Hunter, Rebecca Hartman, Scott Keith, Veda Giri

Department of Medical Oncology Faculty Papers

BACKGROUND: Germline genetic variants are important for prostate cancer (PCa) management and hereditary cancer risk assessment, but testing is underused. Furthermore, patients are often unaware of the genetic connections to PCa. Social media is increasingly serving as a source of awareness for health information and a method to gather data from a large population.

OBJECTIVE: There were three objectives: to (1) create and test social media messages related to PCa genetics and genetic testing, (2) determine which social media message was most engaging, and (3) assess knowledge of and attitudes toward PCa genetic testing through an online survey using the …

Predictors Of Parental Behavior And Child Weight Status, Fidelia Senayah, Heba M. Athar, Allison G. Litton

Journal of Social, Behavioral, and Health Sciences

Childhood obesity is a major health issue globally. The prevalence rate remains high in Ohio, with associated complications among affected children and adolescents. The current study examined the association among obesity risk knowledge, risk perception, feeding behavior, and child weight outcome while controlling for race, gender, income, and education. We collected quantitative data through an online survey of parents in Northwest Ohio (n = 71) using the obesity risk knowledge scale and factors from the Child Feeding Questionnaire. We analyzed data using multiple linear regression. The primary outcome measures were feeding behavior and child weight status. Parental obesity risk …

Learning From Covid-19: Clinical Trials, Health Information Technology, And Patient Mortality, Christos Nicolaides, Avinash Collis, Seth Benzell, Indranil Bardhan

Economics Faculty Articles and Research

During the COVID-19 pandemic, deaths per case in the United States decreased from 7.46% in April 2020 to 1.76% in April 2021. One mechanism that could explain this decline is a learning effect associated with testing of new treatments by hospitals. Hospitals that participated in clinical trials developed better organizational capabilities to diagnose and treat COVID-19 patients. Simultaneously, hospitals used health information technologies (IT) that integrated health information across healthcare providers to facilitate greater learning and sharing of best practices. Using US county-level data on clinical trial participation, use of health IT, and COVID-19 cases and deaths, we show that …

Risk Factors And Clinical Significance Of Urologic Injury In Cesarean Hysterectomy For Placenta Accreta Spectrum, J Connor Mulhall, Kayla E Ireland, John J Byrne, Patrick S Ramsey, Georgia A Mccann, Jessian L Munoz

Faculty, Staff and Students Publications

Background/Objectives: Placenta accreta spectrum (PAS) is an obstetric condition with placental adherence to the underling myometrium characterized by significant surgical morbidity at time of delivery. PAS delivery is most commonly performed by cesarean hysterectomy. The most common morbidities associated with PAS cesarean hysterectomy are blood transfusion, intensive care unit admission and urinary tract injuries. This requires interdisciplinary team management including obstetricians and urologists. Our objective was to identify pre- and intra-operative risk factors for urologic injury in this high-risk condition.

Methods: A retrospective cohort study was performed at a single tertiary center with the Center for the Management …

A Safety-Ii Approach To Learn From Practice Variation In The Diagnostic Process In The Emergency Department: An Action Research Study, Rick Roos, Laura Zwaan, Myrthe Maranus, Iwan A Meynaar, Vanessa J Valk, Cees Van Nieuwkoop, Gert-Jan Kamps, Hardeep Singh, Maarten O Van Aken

Faculty, Staff and Students Publications

Objectives: The focus on improving patient safety has mainly been by learning from errors and near misses (Safety-I). We applied a novel Safety-II approach to identify and learn from practice variations in the diagnostic process in the emergency department (ED), and subsequently design and implement practice changes.

Methods: In this single-center study, we used action research (cycles of micro-experiments to study and improve processes with active stakeholder involvement) in the diagnostic process. We used three subsequent observation cycles of the following six steps: observations, gathering of follow-up data, analyses, a co-creation session with involved stakeholders, sharing of best practices, and …

Vision 2050: India’S Path To Becoming A Global Player, Balasubramanian Mahadevan Dr

Journal Of Indian Physician Associates

This study examines India’s strategic plan to become one of the top three global economies by 2050 through data-driven analysis and comparisons of economic indicators from 2024 to 2050, utilizing data from trusted sources such as the Reserve Bank of India and NITI Aayog. We analyze India’s economic growth in relation to other major emerging economies, focusing on technology, manufacturing, and service sectors. Findings suggest that with strategic policy reforms, investment in innovation, and enhanced infrastructure, India can achieve significant GDP and productivity growth. This article concludes with actionable policy recommendations for local and global stakeholders.

Revolutionizing Digital Health In Rwanda: Progress Toward Universal Health Coverage, Roméo Bananeza Mr

Journal Of Indian Physician Associates

Rwanda is an African country that is making rapid progress in all sectors, including digital health. This review explores Rwanda’s transformative journey in digital health, highlighting key achievements, ongoing challenges, community involvement, and future prospects. Rwanda’s commitment is evident in using electronic health records, telemedicine, and mobile health applications. Rwandan institutions, including Rwanda Biomedical Center, Rwanda Ministry of Health, Rwanda Health Information Exchange, Rwanda Development Board, Partners in Health, universities, and several nongovernmental organizations, have made significant contributions to revolutionize digital health in Rwanda. However, the country continues to face barriers, including limited digital infrastructure, financial constraints, and disparities in …

Assessment Of Microbial Contamination On High-Touch Public Surfaces And Its Implications For Community Health: A Cross-Sectional Study From Urban South India, Muhammed Suhail S

Journal Of Indian Physician Associates

Objectives High-contact public surfaces, such as bus seatbacks, mall escalator belts, and theater armrests, may act as reservoirs of opportunistic and antimicrobial-resistant microorganisms, posing a significant but underreported risk to community health. In urban environments like Coimbatore, Tamil Nadu, surface-level microbial surveillance remains poorly characterized. This study aimed to assess the magnitude, composition, and density of microbial contaminants on commonly touched surfaces across transit and commercial hubs.

Methods A total of 30 surface swab samples were collected from five public locations, including intra-city TNSTC buses, inter-state SETC coaches, Brookfields Mall escalator handrails, multiplex theaters and local bus seat-grips. Standardized 25 …

Assessing The Impact: Cerebral Palsy On Domains Of Quality Of Life, Sheetal Malhan

Journal Of Indian Physician Associates

Introduction Cerebral palsy (CP) is characterized by a group of permanent movement and posture disorders resulting from nonprogressive disturbances in the developing fetal or infant brain. CP is a chronic condition affecting approximately 1.2–2.5 per 1000 school-aged children, often accompanied by comorbidities such as visual, auditory, and feeding impairments, delayed language development, and epilepsy. These related challenges can markedly reduce a child’s quality of life (QoL), particularly when compounded by social and environmental limitations. Despite the importance of understanding QoL outcomes in this population, limited region-specific data exist. Understanding domain-specific QoL can guide targeted rehabilitation planning.

Methods A cross-sectional survey …

Ligand-Receptor Interactions Induce And Mediate Regulatory Functions Of Batf3+ B Cells, Hui Yan, Rui Wang, Suryavathi Viswanadhapalli, Christian Cervantes, Funan He, Shuai Wu, Azad Khosh, Weiwei Luo, Jingwei Wang, Maria J Fernandez, Uday P Pratap, Mustafa Khan, Karli Hinton, Sai Eashan Vankamamidi, Dariela Perez, Carlos E Rivera, Harshita B Gupta, Fushun Zhang, Zhenqing Ye, Yidong Chen, Xiao-Dong Li, Gangadhara R Sareddy, Hong Zan, Yue Li, Exing Wang, Evelien M Bunnik, Guangming Zhong, Christopher A Hunter, Ross M Kedl, Zhinan Yin, Booki Min, Diako Ebrahimi, Siyuan Zheng, Tyler J Curiel, Yan Xiang, Ratna K Vadlamudi, Paolo Casali, Zhenming Xu

Faculty, Staff and Student Publications

B cells express many protein ligands, yet their regulatory functions are incompletely understood. We profiled ligand expression across murine B sublineage cells, including those activated by defined receptor signals, and assessed their regulatory capacities and specificities through in silico analysis of ligand-receptor interactions. Consequently, we identified a B cell subset that expressed cytokine interleukin-27 (IL-27) and chemokine CXCL10. Through the IL-27–IL-27 receptor interaction, these IL-27/CXCL10-producing B cells targeted CD40-activated B cells in vitro and, upon induction by immunization and viral infection, optimized antibody responses and antiviral immunity in vivo. Also present in breast cancer tumors and retained there through CXCL10-CXCR3 …