Health Policy Commons^™

Surveillance Systems In Western Kenya: Methods, Perceptions, And Effectiveness, Marissa Duffy

Independent Study Project (ISP) Collection

Surveillance is an important tool in monitoring and evaluating infectious disease patterns and trends. Surveillance is vital because it aids public health officials and medical professionals in creating better prevention methods and efficiently managing outbreaks. Kenya is home to many noncommunicable diseases making it an important location to conduct disease surveillance. Within Kenya, each county has its own surveillance unit which tracks and controls outbreaks. In addition, government run surveillance systems were established to determine disease burden, incidence, and patterns in specific at-risk communities around Kenya. One of these major surveillance systems is Population-Based Infectious Disease Surveillance (PBIDS) which has …

Climate Change, Malnutrition, And Hiv: The Impact Of Food Insecurity On Hiv Response In Sub-Saharan Africa, Olivia Walshak

Independent Study Project (ISP) Collection

Climate change is a key driver of an unprecedented global food crisis, exacerbated by rising temperatures and the vulnerability of crop yields. Sub-Saharan Africa is particularly susceptible, and case studies demonstrate the fragility of food systems in the region, leading to severe food insecurity and famine in the face of climate shocks.

There are a variety of health implications, particularly the syndemic relationship between malnutrition and HIV. HIV interacts bidirectionally with malnutrition, creating a vicious cycle of poor clinical outcomes. Expanding access to antiretroviral therapy in Sub-Saharan Africa is hindered by rampant food insecurity, including inadequate food intake, reduced dietary …

Universal Health Coverage: A Basis For Pandemic Preparedness?, Merline Feero

Independent Study Project (ISP) Collection

Amid extensive research and reporting on the effects of COVID-19 on Universal Health Coverage (UHC) progress, this study explores an often neglected topic: the potential of UHC to contribute to the foundations of pandemic preparedness. Herein, quantitative analysis reveals that countries with higher UHC coverage tend to exhibit greater pandemic preparedness (as determined by the UHC Service Coverage Index and the Global Health Security Index). Complementary qualitative analysis is used to further illustrate and explain the correlation between UHC and pandemic preparedness using four case study countries, integrating literature reviews and relevant expert interviews. Through these methods, a clear tie …

Hidden Hurdles: Evaluating Informal Barriers To Primary Healthcare Access Among Undocumented Migrants In Switzerland, Arantxa Bonifaz Rosas

Independent Study Project (ISP) Collection

Undocumented migrants face heightened difficulties in accessing healthcare due to a combination of legal, financial, and social challenges. Informal barriers to accessing healthcare further exacerbate poor health outcomes among undocumented migrants. In Switzerland, where undocumented migrants have the right to health insurance, barriers to receiving healthcare continue to restrict their access to essential services, such as primary healthcare (PHC). Employing a meta-analysis approach, this qualitative study aimed to broaden existing research on informal barriers hindering access to PHC for undocumented migrants, with a particular focus on the Swiss context. The identified informal barriers centered around health insurance, fear of deportation, …

The Implications Of Politicizing Global Health Diplomacy In A Multipolar World, Haley Stock

Independent Study Project (ISP) Collection

This research paper is the result of an independent study project that details the implications of politicizing global health diplomacy. With a mixture of interviews, primary sources, and secondary sources, this project aims to explain how and why global health has become entrenched in politics in the world today. This paper explores the intersection between global health and foreign policy and analyzes the extent to which countries use medical interventions to achieve political and economic success. Medical interventions, like vaccines, have become increasingly significant, especially looking back at the recent pandemic. Therefore, this paper will also explore the complex nature …

A Special Message To You From Your Mda Dental Pac Chair, Elizabeth Ralstrom Dds, Ms

The Journal of the Michigan Dental Association

This article is a message from the chair of the Michigan Dental Association’s political action committee thanking members for their contributions and encouraging them to make a contribution with their 2024 dues statement. It includes a listing of all contributors to the PAC over the past year.

Mda Advocacy Report: 2023 To Date, And What’S Next, Jason Mashni Dds

The Journal of the Michigan Dental Association

This article is a recap of MDA legislative advocacy accomplishments and what is on the horizon for the remainder of 2023, written by the chair of the MDA Committee on Governmental and Insurance Affairs.

J Mich Dent Assoc October 2023

The Journal of the Michigan Dental Association

The October 2023 issue of the Journal of the Michigan Dental Association provides: A message from the chair of the Michigan Dental Association political action committee with a listing of donors and a report on MDA advocacy during 2023, which are this month’s cover stories. Also included is a Q&A feature on dealing with dental benefits companies. This month’s clinical article is a discussion of the management of a failing implant using guided bone regeneration and esthetic crown lengthening. Other features include a listing of 2023 MDA life members and a President’s Message on the dental workforce crisis in Michigan. …

Professional Virtue Of Civility And The Responsibilities Of Medical Educators And Academic Leaders, Laurence B Mccullough, John Coverdale, Frank A Chervenak

Center for Medical Ethics and Health Policy Staff Publications

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical …

Spanish-Language Communication Of Covid-19 Information Across Us Local Health Department Websites, Isabelle S Kusters, Amanda M Gutierrez, Julianna M Dean, Mark Sommer, Anna Klyueva

Center for Medical Ethics and Health Policy Staff Publications

The COVID-19 pandemic has brought new urgency to a longstanding problem: the US health system is not well-equipped to accommodate the country's large limited English proficient (LEP) population in times of national emergency. We examined the landscape of Spanish-language COVID-19 website information compared to information in English provided by health departments of the top 10 cities by population in the USA. For each city, coders evaluated three score measures (amount of information, presentation quality, and ease of navigation) for six content types (general information, symptoms, testing, prevention, vaccines, and live statistics) across six delivery modes (print resources, website text, videos, …

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Rural-Urban Disparities In Video Telehealth Use During Rapid Mental Health Care Virtualization Among American Indian/Alaska Native Veterans, Isabelle S Kusters, Amber B Amspoker, Kristen Frosio, Stephanie C Day, Giselle Day, Anthony Ecker, Julianna Hogan, Jan A Lindsay, Jay Shore

Center for Medical Ethics and Health Policy Staff Publications

Importance: American Indian/Alaska Native veterans experience a high risk for health inequities, including mental health (MH) care access. Rapid virtualization of MH care in response to the COVID-19 pandemic facilitated care continuity across the Veterans Health Administration (VHA), but the association between virtualization of care and health inequities among American Indian/Alaska Native veterans is unknown.

Objective: To examine differences in video telehealth (VTH) use for MH care between American Indian/Alaska Native and non-American Indian/Alaska Native veterans by rurality and urbanicity.

Design, setting, and participants: In this cohort study, VHA administrative data on VTH use among a veteran cohort that received …

Factors Associated With Internalizing And Externalizing Symptoms In A Clinical Sample Of Youth With Misophonia, Gabrielle M Armstrong, Rebecca L Greenberg, Orri Smárason, Renee M Frederick, Andrew G Guzick, Sophie C Schneider, Samuel D Spencer, Matti Cervin, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia …

Clinician Perspectives On Levels Of Evidence And Oversight For Deep Brain Stimulation For Treatment-Resistant Childhood Ocd, Michelle T Pham, Tiffany A Campbell, Natalie Dorfman, Laura Torgerson, Kristin Kostick-Quenet, Jennifer Blumenthal-Barby, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Approximately 10-20% of children with obsessive-compulsive disorder (OCD) have treatment-resistant presentations, and there is likely interest in developing interventions for this patient group, which may include deep brain stimulation (DBS). The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful randomized controlled trials should be available before DBS treatment for a psychiatric disorder is considered "established." The FDA approved DBS for adults with treatment-resistant OCD under a humanitarian device exemption (HDE) in 2009, which requires that a device be used to manage or treat a condition impacting 8,000 or fewer patients annually in the United …

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Ethics Education For Healthcare Professionals In The Era Of Chatgpt And Other Large Language Models: Do We Still Need It?, Vasiliki Rahimzadeh, Kristin Kostick-Quenet, Jennifer Blumenthal Barby, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

In this paper, we contend with whether we still need traditional ethics education as part of healthcare professional training given the abilities of chatGPT (generative pre-trained transformer) and other large language models (LLM). We reflect on common programmatic goals to assess the current strengths and limitations of LLMs in helping to build ethics competencies among future clinicians. Through an actual case analysis, we highlight areas in which chatGPT and other LLMs are conducive to common bioethics education goals. We also comment on where such technologies remain an imperfect substitute for human-led ethics teaching and learning. Finally, we conclude that the …

Feminization Of Sri Lankan Doctors And Key Specialties: 2000 To 2020, Dileep De Silva, Pamila Adikari, Mihiri S. Rubasinghe, Udeni L. Seneviratne

Journal of Indonesian Health Policy and Administration

The study focused on the feminization of Sri Lankan generalist doctors in all major and selected minor specialties between 2000 and 2020. The study analyzed all relevant documents by exploring Sri Lanka's male-to-female doctor and specialist ratio over 20 years. This was determined by analyzing state medical faculty records from 1990 to 2020. For better clarity, the researchers analyzed the gender ratio changes in every five-year block from 1990 to 2020. Focus groups filled PGIM's gender data fields. Five-year medical students surged from 43% to 63% between 1990 and 2020. Linear trend analysis predicts 68% of female medical students by …

Sensitive Intervention Policy Recommendations To Reduce Stunting Rates Based On Spatial Analysis Of Sanitary Factors In Dki Jakarta Province 2021, Septiria Irawati, Ema Hermawati

Journal of Indonesian Health Policy and Administration

The purpose of this study was to describe the prevalence of stunting in children under five and the percentage of proper sanitation, as well as recommendations for priority areas for stunting control interventions in the Province of the Special Capital Region of Jakarta in 2021. This study used a descriptive approach to present an overview of the percentage of sanitation and prevalence of stunting in children under five by sub-district in 38 districts in DKI Jakarta. Data is displayed as a map to show distribution areas based on high, medium, and low categories. An overlay was made between the distribution …

Health Policy Reform Through Strengthening Indonesia's Health Resilience System, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

The National Health System in Indonesia is developing and being discussed more seriously after entering the COVID-19 pandemic. With a national health system and several existing tools, Indonesia needed more time to be ready to face the challenges of that time. Upstream health policies should be optimized to mobilize resources and increase the nation's efforts to build a national resilience system. This paper was built using selected policy documents up-to-date and reliable literature. By reviewing empirical evidence, the author believes and shows the role of strengthening health policies in building a robust national health resilience system. Indonesia has several policies …

The Effects Of Vaccination Against Covid-19 Incidence: Is The Current Age-Priorities Appropriate?, Dian Ip Nugrahari, Nurhanifah Hamdah

Journal of Indonesian Health Policy and Administration

Age is an independent risk factor for COVID-19. Thus, the government of Indonesia prioritizes the elderly and adults with significant comorbidities for COVID-19 vaccination. To discover whether this policy is still appropriate, we evaluated the effects of vaccination against the COVID-19 incidence and infection risk.It was a retrospective cohort study of the NAR COVID-19 and Dashboard KPCPEN COVID-19 of the Depok City Health Department. The tests used to analyze the data were the chi-square and logistic regression tests. We discovered that there was a 92.7% total reduction in the COVID-19 infection rate with vaccination. The infection risk for COVID-19 in …

Policy Implementation Analysis Of Spm Health Sector For Hypertension Sufferers In South Kalimantan Province, Indonesia In 2022, Anggi Asri Rusliana Dewi, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

Hypertension is a major cardiovascular risk factor that causes disability throughout the world and among those who are not aware of their health condition, it is often referred to as the silent killer . The prevalence rate of hypertension in Indonesia is quite high. Based on Riskesdas (2018), South Kalimantan Province shows the highest prevalence of hypertension, but the percentage of hypertension sufferers who receive health services is still low. Banjarbaru City has the lowest percentage, namely 11.3% of the target of 100%. Health services for hypertension sufferers are included in the Minimum Service Standards (SPM) for the Health Sector …

Building On The Health Policy Analysis Triangle: Elucidation Of The Elements, Aysha Zahidie, Saima Asif, Meesha Iqbal

Community Health Sciences

The health policy triangle first presented in the 20th century by Walt and Gilson has been extensively used at local, national, regional, and international levels to assess health policies related to communicable and non-communicable diseases, physical and mental health, antenatal and postnatal care, and human resources, services, and systems. However, the framework lacks intricate details for the four pillars in the triangle viz: 'content,' 'context', 'actors', and 'processes. We propose a checklist of elements to be considered for each pillar; to ease and enhance the process of policy analyses for researchers and policymakers across the globe, including low- and middle-income …

Researching The Future: Scenarios To Explore The Future Of Human Genome Editing, Cynthia Selin, Lauren Lambert, Stephanie Morain, John P Nelson, Dorit Barlevy, Mahmud Farooque, Haley Manley, Christopher T Scott

Center for Medical Ethics and Health Policy Staff Publications

Background: Forward-looking, democratically oriented governance is needed to ensure that human genome editing serves rather than undercuts public values. Scientific, policy, and ethics communities have recognized this necessity but have demonstrated limited understanding of how to fulfill it. The field of bioethics has long attempted to grapple with the unintended consequences of emerging technologies, but too often such foresight has lacked adequate scientific grounding, overemphasized regulation to the exclusion of examining underlying values, and failed to adequately engage the public.

Methods: This research investigates the application of scenario planning, a tool developed in the high-stakes, uncertainty-ridden world of corporate strategy, …

Progress Reimagined: A Generation Z Perspective On Belfast In Relation To The Unsdgs., Lucy Love Haman, Rebecca F. Macleod, Emilee E. Ernster, Camryn Moore, Erin Miller, Daron Baltazar, Ricardo Jackson

[Archive] Belmont University Research Symposium (BURS)

This research explores a contemporary outsider view of Belfast, through the eyes of Generation Z visiting college students, in relation to how three United Nations Sustainable Development Goals are carried out (Good Health and Well-Being, Climate Action, and Peace, Justice, and Strong Institutions). To learn through firsthand accounts, the researchers utilized ethnographic and phenomenological methods, as interacting with locals to gather community inputs, surveying different groups in the city, Abstract: recording quotes said by citizens and displayed at billboards, and For Peer Review applying personal sensory experiences. It was found that a political deadlock plays a major role in the …

Nevada Medical Residencies, 2023, Annie J. Vong, Emily J. Daclan, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023 graduating classes of the Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) and the University of Nevada, Reno (UNR) School of Medicine. This fact sheet presents the number of residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine and reveals where Nevada medical school students pursue their residencies, and updates findings from a 2022 fact sheet exploring 2021 and 2022 graduating class data.

Poverty And Commercial Surrogacy In India: An Intersectional Analytical Approach, Sheela Suryanarayanan

Dignity: A Journal of Analysis of Exploitation and Violence

The destination and source countries for commercial surrogacy match world patterns of inequality. India, Nepal, Thailand, Mexico, and Cambodia banned commercial surrogacy, moving the market to other less-developed countries in South Africa and South America. India had a commercial surrogacy boom until exploitative factors led to the passage of the Surrogacy (Regulation) Bill in 2019, which banned the practice. This paper examines surrogacy's monetary, health, and emotional effects on 45 surrogate mothers in Gujarat State, India. The study revealed that a majority (63%) of the very poor women remained very poor post-surgery. Surrogate mothers in poor households had to do …

Integrating Social Determinants Of Health Into Ethical Digital Simulations, Kristin Kostick-Quenet, Vasiliki Rahimzadeh, Sharmila Anandasabapathy, Meghan Hurley, Anika Sonig, Amy Mcguire

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

International Society For Cell & Gene Therapy Position Paper: Key Considerations To Support Evidence-Based Cell And Gene Therapies And Oppose Marketing Of Unproven Products, Laertis Ikonomou, Natividad Cuende, Miguel Forte, Bambi J Grilley, Aaron D Levine, Megan Munsie, John E J Rasko, Leigh Turner, Hamid R Bidkhori, Rachele Ciccocioppo, Felix Grignon, Alok Srivastava, Daniel J Weiss, Patricia Zettler, Bruce L Levine

Center for Medical Ethics and Health Policy Staff Publications

The field of regenerative medicine, including cellular immunotherapies, is on a remarkable growth trajectory. Dozens of cell-, tissue- and gene-based products have received marketing authorization worldwide while hundreds-to-thousands are either in preclinical development or under clinical investigation in phased clinical trials. However, the promise of regenerative therapies has also given rise to a global industry of direct-to-consumer offerings of prematurely commercialized cell and cell-based products with unknown safety and efficacy profiles. Since its inception, the International Society for Cell & Gene Therapy Committee on the Ethics of Cell and Gene Therapy has opposed the premature commercialization of unproven cell- and …

Cell-Based Noninvasive Prenatal Testing (Cbnipt)-A Review On The Current Developments And Future Prospects, Mohamad Ali Maktabi, Liesbeth Vossaert, Ignatia B Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Considering the diagnostic limitations of cfDNA-based noninvasive prenatal testing (NIPT), scientists have long been interested in isolating and analyzing rare intact fetal and trophoblast cells from maternal blood or endocervical samples to diagnose fetal genetic conditions. These cells may be scarce and difficult to isolate, but they are a direct source of pure fetal genetic material. In this review, we summarize the history of cell-based NIPT, present an updated review on its current developments, evaluate its genetic diagnostic potential, and discuss its future prospects for clinical use.

Childhood Exposure To Parental Threatening Behaviors And Anxiety In Emerging Adulthood: Indirect Effects Of Perceived Stress, Erika S Trent, Andres G Viana, Elizabeth M Raines, Haley E Conroy Busch, Karina Silva, Eric A Storch, Michael J Zvolensky

Center for Medical Ethics and Health Policy Staff Publications

Background: Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults.

Methods: Participants (N = 855; Mage = 18.75 years, SD = 1.05, range 18-24; 70.8% female) were recruited from a …