Health Policy Commons^™

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

Blood Biomarkers In Down Syndrome: Facilitating Alzheimer’S Disease Detection And Monitoring, Melissa E. Petersen, Lisi Flores-Aguilar, Elizabeth Head, Laia Montoliu-Gaya, Andre Strydom, Sarah E. Pape, Juan Fortea, Nicholas J. Ashton, Chinedu Udeh-Momoh, Sid E. O’Bryant, Dwight German, Florin Despa, Mark Mapstone, Henrik Zetterberg

Neurology Faculty Publications

Blood-based biomarkers continue to be explored for disease detection, monitoring of progression, and therapeutic outcomes as the diagnostic determination of Alzheimer’s Disease in Down Syndrome (DS-AD) remains challenging in clinical settings. This perspective highlights the current status of this effort. Overall, amyloid (A), tau (T), and neurodegeneration (AT[N]) blood-based biomarkers have been shown to increase with disease pathology for individuals with DS. Phosphorylated tau biomarkers (p-tau217, p-tau181) have been consistently shown to track disease progression for DS-AD and are likely good candidates for use in clinical settings. Biomarkers of inflammation (glial fibrillary acidic protein) also show promise; however, additional work …

Challenges Associated With Pfas Detection Method In Africa, Abdullahi Tunde Aborode, Ridwan Olamilekan Adesola, Ibrahim Idris, Waheed Sakariyau Adio, Segun Olapade, Gladys Oluwafisayo, Israel Ayobami Onifade, Sodiq Fakorede, Taiwo Bakare-Abidola, Jelil Olaoye, Adedeji Daniel Ogunyemi, Oluwaseun Adeolu Ogundijo, Olamilekan Gabriel Banwo, Adetolase Azizat Bakre, Peter Oladoye, Grace Adegoye, Noimat Abeni Jinadu

Chemistry & Biochemistry Faculty Publications

Per- and polyfluoroalkyl substances (PFAS) are a group of man-made chemicals that are widely present in many industries. Monitoring and analyzing PFAS in Africa is challenging due to the limited availability of mass spectrometry (MS), which is an essential technique for detecting PFAS. This review assesses the scope and impact of the shortage of mass spectrometry instruments in Africa, emphasizing the resulting limitations in monitoring environmental and public health threats. The review analyzes the existing PFAS monitoring, the accessibility of MS instruments, and the technical capabilities within the continent. This study suggests that fewer African countries have sufficient MS instruments, …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

The Affordable Care Act And The For-Profit Congregate Care Industry: How Good Policy Intent Turned A Fringe Industry Into A Taxpayer-Funded Multi Billion Dollar Industry, Erin Viehmann

College of Graduate Studies: Theses & Dissertations

The Affordable Care Act significantly transformed the for-profit congregate care (FPCC) industry, which provides residential treatment for adolescents with behavioral and mental health issues. This study analyzes financial records from Universal Health Services (UHS), the largest provider in the industry, to examine how healthcare policy changes and economic conditions affected the industry's growth and funding structure. Through analysis of SEC Form 10-K filings from 2006-2016, the research documents how the ACA's mental health coverage mandates created new revenue streams that enabled dramatic industry expansion. Findings show that following ACA passage in 2010, UHS more than doubled its behavioral health capacity …

Examining Drug Policy In Portugal And Greece, Collin Fernandes

Dissertations and Theses

This thesis examines the divergent drug policies implemented in Portugal and Greece, analyzing why Portugal's comprehensive decriminalization model has been more successful than Greece's partial approach. Since 2001, Portugal has pioneered a drug policy that decriminalizes all drugs for personal use while investing in harm reduction services, rehabilitation, and social reintegration. In contrast, Greece maintained criminalization while implementing more limited harm reduction measures, particularly through OKANA (the Organization Against Drugs). The research highlights how economic factors, particularly the 2008 financial crisis and austerity measures, negatively affected both countries' programs but hit Greece's initiatives with greater severity. Portugal's programs have remained …

Faltered States: The Rise, Fall, And Containment Of Psychedelic Science In The United States, Baxter Brew

CMC Senior Theses

This thesis traces the history of psychedelic science in the United States and its implications for policymaking. In the postwar period, psychedelic researchers were enabled by a unique convergence of optimism in medical science and structural flexibility. But their hope blinded them to the deeper tensions of their field. As institutions grew increasingly rigid and risk-averse, the space for psychedelics began to close. Some scientists responded by fortifying the walls around them, developing socially and professionally acceptable research methods. Others tried to escape these walls entirely. But neither approach could prevent psychedelics from being squeezed out of formal inquiry. Yet …

Analyzing The Centers For Disease Control And Prevention Mortality Data Using Weekly Exceedance In Mortality Count And Weekly Change In Mortality Indicator: A Time Series Study, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Cause-specific mortality (CSM) count prediction plays a vital role in the context of public health policy. In this study, we introduce a new analytical approach, which is divided into three phases to answer specific questions regarding CSM due to 14 specific causes by computing different simple, compound, and conditional probabilities.

Methods

A multivariate time series forecasting model was developed using the CDC weekly mortality count data. A binary data matrix was constructed for 14 causes of death (COD) as a function of weeks by combining the observed and forecasted mortalities. We introduced two new concepts: Weekly Exceedance …

A Learning History Of A State Physical Activity Plan, Jessica Nicole Riffee

Graduate Theses, Dissertations, and Problem Reports (ETD)

Physical inactivity remains a persistent public health concern in the United States, disproportionately affecting rural populations like West Virginia. To address statewide physical activity challenges, West Virginia developed one of the nation’s first state level physical activity plans, ActiveWV: 2015, that was revised to ActiveWV: 2030. Limited research has investigated how statewide physical activity plans unfold over time or how stakeholder learning can drive improvement.

This dissertation employed a learning history action research methodology to construct a collective narrative of the development, dissemination, implementation, and evaluation activities across both iterations of the West Virginia Physical Activity Plan. Reflective interviews with …

Effect Of Universal Health Coverage On Neonatal Mortality Rate In Sub-Saharan Africa: Addressing Missing Data In Health Indicators, Elizabeth Nalule Arihoona

Graduate Research Theses & Dissertations

This study utilizes two mixed-effects models to examine the effect of Universal Health Coverage on Neonatal Mortality Rate (NMR) in 30 countries of Sub-Saharan Africa from 2000-2019 while addressing the missing data in health indicators. Using natural cubic spline interpolation, I impute the missing values in the health coverage indices to preserve the location- specific trends of the data. Findings indicate that among the health Coverage indices, only Index1, which directly relates to coverage of maternal, newborn and child health services is significantly associated with reduced NMR. While higher Current Health Expenditure is associated with reduced NMR, a higher share …

A Qualitative Analysis Of College Students' Interest In Mhealth Solutions, Leslie Hoglund, Craig M. Becker, Cara Tonn

Health Behavior, Policy & Management Faculty Publications

This study explores college students' perceptions of an AI-driven mHealth application designed to promote well-being. With rising mental health challenges in academic settings, students increasingly seek digital tools that provide holistic support for physical, mental, and financial health. Through focus groups, this qualitative study examines students' preferences for personalized health tracking, educational content, and flexible reminders within a private, supportive community. Key findings emphasize students' desire for a balanced, all-in-one app that integrates health and wellness tools without overwhelming them with notifications. Students also highlighted the importance of social media integration for outreach, though concerns were raised about potential stress …

Impact Of Volume-Based Procurement Policy On Coronary Stent Use In Tianjin: Interrupted Time Series Analysis, Zhao Yang, Liangyu Ni, Wei Zhao, Yuxi Li, Yongyi Wu, Qiyun Zhu, Linlin Da, Weijia Liu, Qi Zhang, Jianping Li, Bin Jiang

Health Behavior, Policy & Management Faculty Publications

Objectives

This study aimed to analyze the impact of China’s centralized volume-based procurement policy on the procurement and utilization of coronary stents in Tianjin from 2019 to 2021.

Methods

An interrupted time-series design was used to assess monthly procurement data of coronary stents and balloons in Tianjin from January 2019 to December 2021.

Results

The volume-based procurement policy significantly reduced coronary stents prices, with an average price reduction of 92.67% for ten selected stents, and the lowest price dropped to 469 CNY. Following policy implementation, annual procurement in Tianjin increased by 59.55%, and tertiary hospitals demonstrated a significant monthly level …

Examining Low-Income Caregivers' Knowledge And Comprehension Of The Dental Caries Process, Melissa Sullivan, Denise C. Mckinney, Deanne Shuman, Qi Zhang

Dental Hygiene Faculty Publications

Purpose Dental caries among young children remains a public health concern in the United States (US). Children of caregivers with low oral health literacy (OHL) tend to have greater unmet dental needs and poorer oral health status. The purpose of this study was to examine the understanding of pediatric dental terms associated with the dental caries process among low-income caregivers.

Methods This study included 14 caregivers with children enrolled in a Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the Southeastern US. Through structured phone interviews, the validated Oral Health Literacy Inventory for Parents (OH-LIP) was used …

Association Between Neighborhood-Level Social Vulnerability And Hypertension Outcomes, John E. Brush Jr., Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Iris J. Lundy, Jordan R. Asher, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, Yuan Lu

Department of Medicine Faculty Publications

Background

Neighborhood-level social vulnerability is associated with hypertension prevalence and severity and with cardiovascular complications in conditions other than hypertension, but its association with cardiovascular complications in patients with hypertension is understudied.

Objectives

The aim of the study was to examine how the neighborhood-level social vulnerability index (SVI) influences cardiovascular outcomes in a large, diverse cohort of patients with hypertension.

Methods

We used electronic health data to examine the association between census tract-level rankings for the SVI with a composite endpoint of incident myocardial infarction, congestive heart failure, or stroke.

Results

In a longitudinal cohort of 330,972 patients with hypertension …

A Worker's Struggle, Sakan Binte Imran, Shadman Mahmood Khan Pathan

Electrical & Computer Engineering Faculty Publications

[Introduction] The casualty department at Sir Salimullah Medical College Mitford Hospital was crowded, as it always was. The air smelled of antiseptics, and hurried footsteps echoed through the narrow corridors. It was another day of internship, and I had just finished checking on a patient when a nurse called me over.

“There’s a new case in Trauma. Factory worker. Severe hand injury.”

I hurried over and found a man sitting on the examination table. His face was pale, and his forehead was glistening with sweat. His right hand was wrapped in a blood-soaked cloth. His left hand trembled as he …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Disparities In Cardiovascular Disease Outcomes And Economic Burdens Among Minorities In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf Alddin, Michael Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Cardiovascular diseases are the leading cause of mortality in the United States, presenting significant public health challenges and financial burdens, particularly in Southeastern Virginia, where African American and Hispanic (AA&H) populations are disproportionately affected.

Methods

This retrospective observational study analyzed data from 30,855 hospital discharges of AA&H patients across Southeastern Virginia from 2016 to 2020, focusing on individuals aged 18 to 85 with cardiovascular diseases. Utilizing the Virginia Health Information database, we examined demographic information, clinical data, and healthcare utilization patterns through hypothesis tests and regression models to explore associations between these variables and the economic impacts of cardiovascular …

Association Of Maternity Care Deserts With Maternal And Pregnancy-Related Mortality, Rula Atwani, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between the level of maternity care access and maternal and pregnancy-related mortality.

METHODS:

This was a cross-sectional analysis of county-level data in the United States from January 2018 to December 2021. Using the level of maternity care access, we categorized counties into desert, low access, moderate access, and full access. The primary outcome of interest was maternal mortality rate per 100,000 live births. A secondary outcome was pregnancy-related mortality rate per 100,000 live births. Absolute risk differences and adjusted incidence rate ratios were calculated for maternal mortality and pregnancy-related mortality with multivariable negative binomial mixed-effects …

The Influence Of Gender Identity And Healthcare Delivery Experience On Hiv Screening, Delton Harris

Theses and Dissertations

This dissertation examines the roles of gender identity, healthcare experience, and practitioners' scope of healthcare services in the uptake of annual HIV screening among the understudied population of transgender individuals. Transgender individuals are about half as likely to have an annual HIV screening despite having similar risk profiles to men who have sex with men (MSM). The current HIV guidelines for MSM recommend annual HIV screening because of the risky sexual practice, anal sex with other men. Similar to MSM, transgender individuals who have anal sex with men are at higher risk than the general population for HIV acquisition because …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …