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Nevada's Healthcare And Education Workforce Pipelines, David Damore, Caitlin J. Saladino, William E. Brown Jr.

Policy Briefs and Reports

With ongoing workforce shortages in K-12 education, healthcare, and mental and behavioral health—occupations central to the HEAL (health, education, administration, and literacy) economy—this brief utilizes the Nevada P-20 to Workforce Research Data System (NPWR) and data from the U.S. Bureau of Labor Statistics to explore the current and projected landscape for these workforces in Nevada. Examining the demographic characteristics of those participating in focused career and technical education training and those earning relevant postsecondary credentials illuminates gender disparities in Nevada’s healthcare and education workforce pipelines. After reviewing the current state of these workforces and assessing the available NPWR data, we …

Venezuelan Migrants In Prostitution: A Personal Decision?, Yazmin Maria Lucila Cadena Camargo, Izara Maite Mondragon Moreno, Isabela Osorio Jaramillo, Paula Angélica Suárez Álvarez, Andrés Duarte Osorio, Carlos Gómez-Restrepo

Dignity: A Journal of Analysis of Exploitation and Violence

This paper explores the multifaceted experiences of Venezuelan migrant women engaged in prostitution, framed through three critical moments: the “decision to enter in prostitution,” the unique abuses faced, and the resultant consequences on mental, physical, and social health. The study highlights how socioeconomic vulnerabilities—exacerbated by migration and poverty—significantly influence the likelihood of entering prostitution. It also shows how traumatic experiences, particularly in childhood and adolescence, coupled with a lack of support networks, contribute to a heightened risk of exploitation. Eleven life stories were collected through a phenomenological approach, revealing a common narrative of abuse, poverty, and the search for survival …

Diabetes-Related Foot Complications And Socioeconomic Influences Among Hispanic Males In South Texas: A Scoping Review, Mariana J. Rodriguez, Demian Rodriguez, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: Diabetes mellitus is the 7^th leading cause of death in the United States and is 6^th in the state of Texas. Counties from South Texas are primarily affected with higher rates of diabetes than both the state and national average. Diabetes mellitus is a complex and progressive disease which can affect multiple systems of the body, leading to serious complications if untreated, especially in the lower extremities. Uncontrolled diabetes is often associated with diabetic foot ulcers (DFU), foot infections, and lower extremity amputations (LEA). South Texas is a region predominantly populated by Hispanic Americans who are disproportionally …

Hungry Minds: Analyzing The Impact Of Food Insecurity And Food Assistance Programs On Neurocognitive Development And Childhood Mental Health, Kayla A. Davenport

Senior Theses

Introduction: Food insecurity affects millions of children in the United States and is increasingly recognized as a significant risk factor for poor nutritional intake and adverse health outcomes. However, less is known about how the experience of food insecurity disrupts healthy development and well-being, particularly among American youth. This thesis had two aims: (1) to examine the relationship between household food insecurity and children’s neurocognitive and mental health outcomes and (2) to evaluate how major food assistance programs address, or fail to address, these developmental risks.

Methods: This thesis uses a mixed-methods approach, integrating a narrative literature review, a cross-sectional …

Real-World Use Of Classic And Non-Classic Psychedelics In Hispanic/Latino Adults With Obsessive-Compulsive Disorder: International Findings From The Latino Study, David S Mathai, Jill O Robinson, Kevin Wagner, Logan Neitzke-Spruill, Dayan Berrones, Jacey L Anderberg, Renee M Frederick, Vanessa Zavala Cruz, Josselyn S Muñoz, Latin American Trans-Ancestry Initiative For Ocd Genomics, Brazilian Obsessive-Compulsive Spectrum Disorder Working Group;, Carolyn I Rodriguez, Lynnette A Averill, James J Crowley, Eric A Storch, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Objective: Despite growing research on the potential mental health benefits of psychedelics, there has been limited study of these drugs in populations with obsessive-compulsive disorder (OCD) and with Hispanic and Latin American (H/L) ancestry.

Methods: Demographic and clinical assessments were conducted as part of the Latin American Trans-ancestry Initiative for OCD genomics (LATINO) Study in H/L participants with OCD living throughout the Americas. Self-reported data on the prevalence of naturalistic psychedelic use and associated outcomes on OCD symptoms were collected in a subsample of 2,639 adults. Descriptive statistics and regression analyses were used to assess psychedelic use, predictors of use, …

A Qualitative Exploration Of Child, Caregiver, And Clinician Perspectives On Mental Health In Children With Osteogenesis Imperfecta, Justin H Qian, Andrew D Wiese, Clarissa Gonzalez, Whitney S Shepherd, Hannah Cho, Gianna M Colombo, Julia M Morales, Selena Guo, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Kara Ayers, Members Of The Bbdc, Marie-Eve Robinson, Chaya N Murali, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Osteogenesis imperfecta (OI) is a heritable connective disorder with clinical manifestations including bone fragility and short stature. Previous research identified psychosocial themes related to mental health among children with OI and their caregivers, such as independence, social isolation, depression, and anxiety. Several studies have also examined clinicians of individuals with OI for their perspectives on mental health among their patients. However, no known studies have compared psychosocial themes among all three participant groups concurrently. This qualitative study examined mood and anxiety, along with risk and protective factors, from perspectives of youths, parents, and clinicians. Semi-structured interviews were conducted, which were …

The Cost Of Malnutrition In Older Adults In The Mountain West, 2020, Taylor Volk, Anirudh Polagani, Olivia K. Cheche, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents 2020 data on the annual costs of disease-associated malnutrition for adults aged 65 years and older across the five Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The data are sourced from “Advancing Policies for Quality Malnutrition Care in Older Adults: A Toolkit for State Legislators,” a report published by Defeat Malnutrition Today and Women in Government.

African Swine Fever In Indonesia: Insights From Southeast Asia’S Policy Response Through The One Health Approach, Niken Salindri, Wachyu Sulistiadi

Journal of Indonesian Health Policy and Administration

African Swine Fever (ASF) seriously threatens pig production systems, food security, and rural livelihoods across Southeast Asia. This study employs an analysis of secondary national data from Indonesia using a quantitative descriptive analysis approach, complemented by regional policy responses to ASF from 2019 to 2024. To contextualize regional findings, this study also integrates official statistics from Statistics Indonesia (BPS) covering provincial pork production trends (2021–2023), the number of ASF-affected pigs per province (2020–2024), and per capita pork consumption by district. Quantitative data show that ASF outbreaks have been disproportionately concentrated in specific provinces such as East Nusa Tenggara and North …

The Effects Of Input And Characteristic Factors On Contact Rate Achievement Among Puskesmas In Indonesia, Iqbal Andri Makarim, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The contact rate is the lowest-performing indicator in the Performance-Based Capitation Payment system initiated by BPJS Kesehatan. Analysis of the 2019 National Health Facility Research (Rifaskes) data showed that less than half of Puskesmas in Indonesia achieved the target. This cross-sectional study analyzed 5,384 Puskesmas from the 2019 Rifaskes to examine the effect of input and characteristic factors on achieving the contact rate. Independent variables included health worker ratios (doctors, nurses, midwives per 5,000 participants), completeness of essential medical equipment, communication facilities, P-Care application use, and Puskesmas characteristics. Multivariate logistic regression identified four significant factors: doctor ratio (OR=1.06; p<0.0001), midwife ratio (OR=1.01; p=0.033), completeness of essential medical equipment (OR=1.16; p=0.029), and BLUD-based financial management (OR=1.13; p=0.029). These factors explained only 2.6% of the variance (Nagelkerke R²=0.026), suggesting other unmeasured influences. Policy implications include equitable distribution of health personnel, targeted procurement of essential equipment, strengthening financial autonomy through BLUD, and optimizing P-Care data utilization to improve service accessibility and performance.

Overview Of A Hospital Management Information System Using The Hot-Fit Method In Medan Hospitals In 2025, Grace Putri Laia, Hotmarina Lumban Gaol, Jev Boris

Journal of Indonesian Health Policy and Administration

Hospital Management Information System (SIMRS/HMIS) is crucial in ensuring efficiency and quality in hospital services by integrating clinical and administrative functions. This study aims to evaluate the implementation of HMIS at Medan Adventist Hospital in 2025 using the Human-Organization-Technology Fit (HOT-Fit) framework. A descriptive design with total sampling was employed, involving 70 respondents comprising medical records staff, inpatient and outpatient registration staff, and ward officers. Data were collected through a structured questionnaire adapted from a validated instrument (validity 0.690–0.900; reliability 0.841–0.911) and analyzed using descriptive statistics. The results showed a high level of implementation in all HOT-Fit domains: system use …

The Ethics Of Clinical Ethics, Matthew Shea

Center for Medical Ethics and Health Policy Staff Publications

The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional …

Towards A New Health Politics In Kenya: Labor Organizing And Strikes By Health Workers In The Public Health Sector, Michael Scanlon

Graduate Doctoral Dissertations

There has been insufficient attention by global health scholars to labor organizing by health workers, including when and why organizing occurs, what forms and strategies it takes and its implications for governance and policy. These questions are critical but largely absent in research on what has been called the “global health workforce crisis.” Kenya represents an important case study. A new constitution in 2010 expanded institutional spaces for labor organizing and decentralized governance of the health system. Both reforms had significant implications for the health workforce and strikes by health workers have been pervasive. In 2017, nationwide strikes by public …

Has Regional Hospital Autonomy Achieved Its Goals? Lessons Learned From Indonesia: A Systematic Review, Masyitoh Basabih, Indriaswari Widhakuswara

Kesmas

This study examined the impact of hospital autonomy implementation on the performance of regional public hospitals in Indonesia, particularly in terms of efficiency, effectiveness, and governance. A systematic review of 32 peer-reviewed studies published between June 12 and September 6, 2023, was conducted using Garba Rujukan Digital and Google Scholar, following PRISMA guidelines. Studies addressing financial performance, service outcomes, and challenges related to implementing autonomy were included. The findings indicated that while autonomy led to improvements in infrastructure, service types, visit volumes, and hospital revenues, it had only a marginal impact on improving key health performance outcomes, such as service …

Government Health Spending And Life Expectancy: Evidence From Cities And Districts In Indonesia, Kurnia Sari, Budi Hidayat, Amal Chalik Sjaaf, Mardiati Nadjib

Kesmas

Life expectancy is widely recognized as a fundamental indicator of population health, and its improvement is often linked to government health spending, particularly in decentralized health systems. This study aimed to investigate the relationship between local government health expenditures and life expectancy in decentralized Indonesia. Data from 492 cities and districts, spanning from 2015 to 2019, were analyzed using a two-way fixed effects regression model to control for time-invariant district characteristics and common temporal shocks. The findings indicated that a 10% increase per capita in government health expenditure was associated with a 0.01% increase in life expectancy. This association was …

Barriers To Implementing Comprehensive Sexuality Education As A Strategy To Prevent Adolescent Pregnancy In Indramayu District, Indonesia, Een Kurnaesih, Chahya Kharin Herbawani, Nelly Febriani

Kesmas

The implementation of comprehensive sexuality education (CSE) is not optimal. This qualitative study aimed to identify and contextualize barriers to CSE implementation, specifically in Indramayu District, Indonesia. Conventional content analysis procedures were used. Seven participants, consisting of relevant authorities, were interviewed. A purposive sampling technique was employed to select participants. Data were collected through in-depth, semi-structured interviews. All interviews were recorded and transcribed verbatim. Data were analyzed using conventional qualitative content analysis. The barriers to CSE implementation in Indramayu District were identified across five themes: advocacy, technical considerations, coordination and collaboration, integration with other sexual and reproductive health projects, and …

Governance Of Polygenic Embryo Screening: A Qualitative Study On The Perspectives Of Clinicians And Patients, Jason Bach, Jonathan Frumovitz, Dorit Barlevy, Rémy A Furrer, Abigail Martinez, Ana Battaglino, Shai Carmi, Todd Lencz, Gabriel Lázaro-Muñoz, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Objective: To investigate the perspectives of stakeholders on their attitudes toward potential regulation of polygenic embryo screening (PES), a new form of preimplantation genetic testing that is used to screen embryos for the genetic chances of developing medical conditions and nonmedical traits involving hundreds or thousands of genes.

Design: We conducted individual, semistructured interviews and analyzed transcripts using thematic analysis.

Subjects: Twenty-seven US-based reproductive endocrinology and infertility specialists and 26 patients who were currently undergoing in vitro fertilization or had within the past five years.

Main outcome measures: Repeating ideas and patterned responses were organized into themes and subthemes.

Results: …

Experiences Of Elderly Living With Noncommunicable Diseases In Utilizing Health Services In Myanmar During The Covid-19 Pandemic, Nway Eint Chei, Kwanjai Amnatsatsue, Natkamol Chansatitporn, Ariya Bunngamchairat

Kesmas

The COVID-19 pandemic and armed conflicts in Myanmar have intensified the challenges in accessing and utilizing health services, particularly for noncommunicable diseases (NCDs) among older adults. This qualitative study explored the experiences of the elderly with NCDs regarding health service accessibility and utilization in secure areas with fully operational health facilities by conducting in-depth interviews with 20 eligible older adults in Myanmar; data were analyzed using content analysis. Four key themes emerged: NCD service utilization patterns; unmet needs; preferences and hesitancy toward NCD services; and disparities, barriers, and opportunities. The findings revealed widespread underutilization of NCD services due to several …

Time Ticks Slowly For Kidney Transplant Reform: Eskd Patient Challenges And Opportunities, Gregory P. Hess

College of Population Health Faculty Papers

No abstract provided.

Factors Associated With Adolescents' Self-Efficacy To Meet With Their Health Care Provider Alone, Albert C Hergenroeder, Blanca Sanchez-Fournier, Cassandra Enzler, Mary Majumder, Beth H Garland, Constance M Wiemann

Center for Medical Ethics and Health Policy Staff Publications

Adolescents with special health care needs (ASHCNs) must develop self-management skills to effectively transition into adult-based care. This requires having the self-efficacy to meet with their health care provider independent of caregivers. This study aims to identify the factors associated with self-efficacy in meeting with a provider alone among ASHCN preparing for this transition.Eighty-three English-speaking 18-year olds with renal, gastrointestinal, neurologic, or rheumatologic diseases, and their English- or Spanish-speaking caregivers were recruited at a large children's hospital, and completed a one-time assessment as the historical control group for a larger intervention study. The main outcome measure was self-efficacy to meet …

Nevada Medical Residencies, 2025, Olivia K. Cheche, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet highlights medical residency data for the 2021, 2022, 2023, 2024, and 2025 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 data on residency program matches at the Kirk Kerkorian School of Medicine at UNLV and the UNR School of Medicine, shows where Nevada medical school graduates pursue their residencies, and updates findings from a 2024 fact sheet exploring 2021, 2022, 2023, and 2024 graduating class data.

Readiness Of Universitas Indonesia To Be An Inclusive Campus For People With Disabilities, Dumilah Ayuningtyas, Tri Auri Putri Ayuningtyas, Anita Pebrina Lubis, Anindya Naila Sabahat, Ratih Oktarina, Afaf Jauhar

Masyarakat: Jurnal Sosiologi

Ensuring equal education rights remains a challenge in Indonesia, despite constitutional mandates and the global commitment to “no one left behind.” The Disability Participation Rate remains low; in 2023, only 21.03% of individuals aged 19–23 were included. This reflects, among other factors, the limited preparedness of educational institutions. This study evaluates Universitas Indonesia’s readiness to develop inclusive education for persons with physical, sensory, mental, and intellectual disabilities. Using the capability approach, it assesses whether institutional resources can be translated into capability-enhancing conditions for students with disabilities. The study draws on literature review, targeted document searches, SWOT analysis, IFE-EFE matrices, and …

Resilience Of Interdependent Transportation And Healthcare Systems: A Simulation-Driven Framework Incorporating Social Equity And Facility Optimization, S. Yasaman Ahmadi

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The overarching goal of this dissertation is to develop an integrated, simulation-driven framework to assess and enhance the resilience of interdependent transportation and healthcare systems before, during, and after natural hazards. By examining how spatial disruptions, social vulnerability, operational constraints, and infrastructure interdependencies affect access to and functionality of hospitals, this research offers a multifaceted evaluation of system performance under stress. This dissertation examines the impact of natural hazards, particularly floods, on the interdependent transportation and healthcare systems. The proposed approach combines and advances GIS-based network analysis, graph-theoretical modeling, and discrete-event simulation to evaluate system performance under different scenarios. The …

Contribution Of National Health Insurance Patient Revenue To Financial Performance Of Private-Profit Hospitals From 2017 To 2022, Fadlul Imansyah, Amal Chalik Sjaaf, Mardiati Nadjib, Rina Hartini

Kesmas

This study investigated the relationship between National Health Insurance (NHI) patient revenue and profit-private hospital financial performance in Indonesia. As the NHI provider, Badan Penyelenggara Jaminan Sosial (BPJS) Healthcare Security’s influence on hospital revenues has raised concerns about its impact on financial sustainability. This study used financial performance indicators to develop a financial performance index—Return on Assets (ROA), Return on Equity (ROE), Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA) Margin, Current Ratio, and Net Profit Margin (NPM)—to assess the financial impact of BPJS Healthcare Security revenue. A partial model approach of multiple linear regression was employed using secondary data …

Direct Medical Costs Of Diabetes Mellitus Treatment For Patients With Cardiovascular And Renal Complications, Rizki Fadila, Ayu Tyas Purnamasari, A.A. Istri Citra Dewiyani

Kesmas

Type 2 Diabetes Mellitus (T2DM) represents a growing global health challenge with significant clinical and economic implications, notably in Indonesia. The burden is intensified by renal and cardiovascular complications, especially among National Health Insurance beneficiaries. This retrospective study evaluated the direct medical costs of hospitalized T2DM patients with such complications at a type B hospital from 2019 to 2022. Costs were analyzed from both healthcare provider and payer perspectives, covering medical services, medical support services, pharmaceuticals, and other support services. Of the 192 patients reviewed, most were male (57.8%), aged 45–64 years (72.4%), with hospital stays of 1–5 days (90,1%) …

Factors Of Anxiety Symptoms Due To Large-Scale Social Restriction Policy During The Covid-19 Pandemic In Indonesia, Indri Hapsari Susilowati, Sudibyo Alimoeso, Susiana Nugraha, Bonardo Prayogo Hasiholan, Magda Sabrina Theofany Simanjuntak, Nur Rachmat Satria

Kesmas

The Indonesian Government took some preventive measures to slow the spread of the COVID-19 virus, including social restrictions and encouraging individuals to stay at home and avoid needless gatherings. This study aimed to identify factors related to anxiety symptoms during large-scale social restrictions. This study employed a cross-sectional design using the snowball technique in an online survey. A total of 788 respondents comprised the target population to detect the smallest effect size (Cohen's dz = .2), with the level of power of 0.8 using G*Power 3.1, specifically targeting adults aged over 18 years. Out of 1,194 people who took part …

Associated Factors In Willingness To Shift Tobacco Expenditure Into National Health Insurance Premium Among Subsidized Members, Mugi Wahidin, Muhammad Agus Mikrajab, Rozana Ika Agustiya, Veza Azteria

Kesmas

In Indonesia, subsidized members are the largest group in the National Health Insurance program. Hence, it is essential to understand their ability to pay (ATP) based on tobacco expenditure. This study aimed to determine the ATP of subsidized members based on tobacco expenditure and factors associated with their willingness to pay (WTP). This cross-sectional study used secondary data from the National Institute of Health Research and Development. The population included all subsidized members; 19,918 were sampled for ATP, and 14,560 were WTP. The independent t-test, ANOVA, and logistic regression were performed. Results showed that ATP from tobacco expenditure ranged from …

The Healthcare Workforce In Nevada, 2024, Olivia K. Cheche, William E. Brown Jr., Caitlin J. Saladino

Health

This fact sheet presents data on the healthcare workforce in Nevada. The U.S. Bureau of Labor Statistics’ Occupational Employment and Wage Statistics Query System provides data on the amount of employment in all job sectors at the state and metropolitan statistical area (MSA) levels. This fact sheet focuses on employment and wage data for the State of Nevada, the Las Vegas-Henderson-Paradise, NV MSA, and the Reno, NV MSA as of May 2024.

The Mental Health Workforce In Nevada, 2024, Olivia K. Cheche, William E. Brown Jr., Caitlin J. Saladino

Health

This fact sheet presents data on the share of workers in the mental health workforce in Nevada. The U.S. Bureau of Labor Statistics’ Occupational Employment and Wage Statistics Query System provides data on the amount of employment in all job sectors at the state and metropolitan statistical area (MSA) levels. This fact sheet focuses on employment and wage data for the State of Nevada, the Las Vegas-Henderson-Paradise, NV MSA, and the Reno, NV MSA as of May 2024.

Osteogenesis Imperfecta And The Family: A Qualitative Analysis Of The Experiences Of Family And Caregivers, Gianna M Colombo, Andrew D Wiese, Amelia E Mercado, Whitney S Shepherd, Michelle Fynan, Kara Ayers, W Conor Rork, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Julia M Morales, Saniah I Kazimi, Hannah E Cho, Members Of The Bbdc, Chaya N Murali, Marie-Eve Robinson, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Osteogenesis imperfecta (OI) describes a group of rare, heritable bone disorders causing bone fragility, tendency to fracture with minimal trauma, and chronic pain due to abnormal collagen synthesis. Limited research exists on the psychosocial impact of OI during childhood on caregivers and families.

Purpose: This study aimed to understand caregiver experiences, existing social support provided for families affected by OI, and the impact of OI on family life.

Method: Thirteen caregivers of individuals with OI participated in semistructured interviews. Researchers coded, abstracted, and analyzed qualitative data to develop themes on the psychosocial impact of OI on the family unit. …