PHRM 485 Intercultural and global health issues sp23

Spring 2023 Intercultural and Global Health Issues

www.b360nc.com

Created by the students in PHRM 48500 Compiled by Cynthia P Koh-Knox Sharp, PharmD, RPh Purdue University College of Pharmacy

Intercultural and Global Health Issues Table of contents Topic (authors)

Page

Antibiotic resistance Porter Boroski, Nina Hawkins, Miranda Milzarek, Sydney Szymanski....................................2 Complementary and alternative medicine Maggie Dong, Aran Kim, Josiah Probst, Matt Wolter ........................................................................... 7

Environment Erin Burke, Hyeonjeong Noh, Erin Tobin, D’Eric Whitt ..................................................................... 13

Ethical dilemmas Jordenn Call, Nick Hull, Sophia Palant, Trevor Tran ........................................................................... 18

Family planning Liying Che, Amy Jo, Anastasia Pinopoulos, Ruoyu Wan .................................................................... 24

Health disparities Elexus Goodpaster, Perri Macoit, Elena Madren, Keagan Smith ......................................................... 30

Health education Anu Cherukara, Anna Kendrick, Pasha Pourian, Alvin Wang ................................................35 Immunizations Mitchell Briggs, Grace Huang, Ethan Miyake, Giovani Teran ............................................................ 41

Infectious diseases Faith Eriks, YoonSeo Ko, Vedang Revankar, Zachary Rust, Zilin Xianyu ......................................... 47

Media (Can you trust modern media?)

Tyler Fritsch, Maureen Ma, Timothy Samuel, Gracie Zhu .................................................................. 54

Mental Health Jordan Beatrice, Jackson Gum, Kathleen Massa, Carter Stobierski ........................................59 Nutrition Ashlyn Felton, Brian Li, James Rooney, Samantha Zhou .................................................................... 65

Pharmacognosy Ian Chen, Alexandra Kasch, Dalton Polley, Rose Wang ...................................................................... 71

Substance use and abuse Celine Huo, Lauren Payne, Meghan Valentine .................................................................................... 77

Group 2 Spring 2023 Nina Hawkins, BSPS Candidate Sydney Szymanski, BSPS Candidate Miranda Milzarek, BSPS Candidate Porter Boroski, BSPS Candidate

Nina Hawkins, BSPS Candidate Why is this an issue?

When pathogens mutate and become resistant against antibiotics, new methods must be used to target those microbes. One way that superbugs can be stopped is with the development of new generations of antibiotics that can target the bacteria in ways that it is not already resistant to. However there is not enough new development to effectively combat the growing issue of antibiotic resistance. Proof of this limited development can be shown in that only 12 new antibiotics have been approved for marketing in the last six years. Even worse than that, 10 of these 12 drugs employ targeting mechanism that resistance has already emerged from.

Lynn L. Silver, “Challenges of Antibacterial Discovery,” Clinical Microbiology Reviews 24, no. 1 (2011): 71–109, doi: 10.1128/CMR.00030-10.

What is my personal opinion?

Since the main barrier to entry of new development is lack of money, I believe that there needs to be a greater financial incentive for large pharmaceutical companies to dedicate the time and money into this risky development. This can be done by governments directly or other federal agencies. With more people learning about antibiotic resistance, there is a greater chance of important discoveries. ~N. Hawkins

Who is affected by this issue?

Anyone can be susceptible to a bacterial infection at any time, making the issue of limited new development a global issue.

https://www.ebrd.com/news/2018/how-to-stop-the-rise-and-rise-of-drugresistant-superbugs.html

What can be done/is being done to combat this?

To fight this shortage of new development, the World Health Organization (WHO) has urged pharmaceutical companies and governments to put more focus and money into research and development of new antibiotics. The main deterrent for research interest in this area is the high cost that is required for the low success of developing a new class of antibiotic. Many of the original generations of antibiotics were derived from natural compounds. Unfortunately, high throughput screening of natural compounds has been unsuccessful for the last 20 years. The most promising of the new methods that researchers are currently attempting is combining multiple different drugs into one formulation, with the goal that the bacteria will be susceptible to at least one of the antimicrobials. More innovative ideas include development of monoclonal antibodies, bacteriophages, and vaccines against the pathogen are also being explored, however with less success.

References: 1.

2.

3.

Stop the spread of Superbugs. National Institutes of Health. https://newsinhealth.nih.gov/2014/02/stop-spread-superbugs. Published October 28, 2019. Accessed April 11, 2023.

Cook MA, Wright GD. The past, present, and future of antibiotics. Science Translational Medicine. 2022;14(657). doi:10.1126/scitranslmed.abo7793 Lack of innovation set to undermine antibiotic performance and health gains. World Health Organization. https://www.who.int/news/item/22-06-2022-22-06-2022-lack-of-innovation-set-to-undermine-antibiotic-performance-and-health-g ains. Accessed April 11, 2023.

Antibiotic Shortages

Sydney Szymanski, BSPS Candidate Background Information There has been a shortage of antibiotics that has mostly been affecting the oral suspensions. There is currently growth in the lack of availability of some of the older more common antibiotics and this can be seen in countries that range regarding income level. The shortage of antibiotics correlates back to the overall issue which is antibiotic resistance since the lack of these older common antibiotics can cause there to be a need for substitutions which can be difficult to come across for many. The lack of treating these illnesses that would originally require treatment can lead to mutating diseases as well as patients that develop drug resistances.

Why is this an issue?

In some of these older antibiotics, there were known issues with the API (active pharmaceutical ingredient) which halted the production of these antibiotics, such as penicillin in 2015. This halt in production caused penicillin to be unavailable in at least 40 different countries. Some of the factors that are causing this shortage include the complexity of development, not being able to anticipate new respiratory diseases and supply chain issues. An issue that results from these antibiotic shortages is that when these occur it can be very costly to attempt to find substitutions or alternatives which can be very difficult for lower income countries seeing as though it is more difficult for these lower income countries to come up with the funds as well as the resources to find these alternatives for antibiotics that have been around for years. If these lower income countries are unable to afford these shortages, morbidity rates increase as a result of not receiving treatment as well as patients developing drug resistances.

Who is affected?

This would be regarded as a global issue rather than an intercultural health issue seeing as that it does not only occur in some places; it is an issue that is seen among the entire world and many countries are affected.

What is currently being done?

Currently there is a platform that operates out of Sweden, Platinea, that is proactively working on reducing these antibiotic shortages by a three step program: transparency increase within supply chains, improvement of the profitability for antibiotic providers and investments to have newer, more developed factories

Personal Opinion In my professional opinion, I feel as though that this shortage is not solely based on unavailable funds to keep these antibiotics stocked, but it is also regarding the inability for scientists as well as antibiotic providers to predict when there is going to be a spike in illnesses or when a new respiratory disease is going to require treatment that has not been developed as of yet. ~S Szymanski

References Baraldi E. Causes of antibiotic shortages and the solutions to address them. REVIVE. Feb 10,2021. https://revive.gardp.org/causes-of-antibiotic-shorta ges-and-the-solutions-to-address-them/

Noncompliance To Antibiotics Miranda Milzarek, BSPS Candidate – Noncompliance is when the patient is not taking the correct dose at the proper time or times each day for the prescribed duration of treatment.

https://www.foodsafetynews.com/2022/04/eu-figures-show-high-levelsof-antibiotic-resistance-in-foodborne-bacteria/

What Does It Look Like?

Why Might It Happen?

– Noncompliance with antibiotics appears to have a direct relation to the increase in antibiotic resistance occurrence. Noncompliance to antibiotics leads to less effective treatments, and increases the chances that the infecting organism will survive. The surviving organism can then adapt or evolve in ways that block or combat an antibiotics effect inside the body.

– The consequence of bacterial resistance emerging due to noncompliance can occur within a single individual or it can expand to affect an entire population (1). Recent literature states that approximately 40% of patients around the world do not adhere to prescribed antibiotic treatment, with noncompliance more prevalent among males and younger patients (2). Several European countries have made note of an issue with self medication because of citizens utilizing "leftover" antibiotics from previous prescriptions or obtaining questionable antibiotics from variable third parties (3).

How do we fix it?

The World Alliance Against Antibiotic Resistance was formed in France to help address and combat this overall issue. The main objective of the alliance is to protect the efficacy of antibiotic therapy and promote patient education and awareness for every citizen on a global scale (4).

The proposed solutions for patient noncompliance to antibiotics are: – A surveillance of antibiotic resistance and use, with regular feedback to healthcare professionals and the general public, – Implementation of education and training programs for both healthcare professionals and consumers, and – Big information campaigns targeted at children/teenagers (5).

“Personally speaking, strict compliance to antibiotics is the ideal goal, but it is a very unrealistic one. In my opinion, the general public needs more education on antibiotics and proper use of medicine, along with better communication within healthcare, overall. Noncompliance is an issue to be handled by each person, individually. I think working to establish a more informed public and a more involved patient are crucial in order for the world to have its best chance against antibiotic resistance.” -M. Milzarek 1. Kardas, Przemyslaw MD, PhD. Noncompliance in Current Antibiotic Practice. Infectious Diseases in Clinical Practice 14(4):p S11-S14, July 2006. | DOI: 10.1097/01.idc.0000230544.11499.8b 2. Jake L. Cotton, Tarig Ali-Dinar, Aledie Navas-Nazario, "Cavitary Pneumonia: A Complication of Antibiotic Noncompliance", Case Reports in Pulmonology, vol. 2020, Article ID 5971348, 5 pages, 2020. https://doi.org/10.1155/2020/5971348 3. Grigoryan L, Monnet D, Haaijer-Ruskamp F, Bonten M, Lundborg S, Verheij T. Self-Medication with Antibiotics in Europe: A Case for Action. Current Drug Safety. 2010;5(4):329-332. doi:https://doi.org/10.2174/157488610792246046 4.WAAAR | ACdeBMR - World Alliance Against Antibiotic Resistance. WAAAR | ACdeBMR. https://waaar.org/en/. Accessed on 03/21/2023.

5.Carlet J, Rambaud C, Pulcini C. Save Antibiotics: a call for action of the World Alliance Against Antibiotic Resistance (WAAAR). BMC Infectious Diseases. 2014;14(1). doi:https://doi.org/10.1186/1471-2334-14-436

Porter Boroski, BSPS Candidate What is Overprescription?

Overprescription of antibiotics is a global issue.

It occurs when patients are prescribed antibiotics for a condition that is not caused by a bacterial infection. As a result the condition cannot be treated by antibiotics, making them ineffective. Additionally, overprescription also occurs when antibiotics are prescribed for conditions in which they are not recommended and/or required. (4.1) How/Where does Overprescription happen?

Overprescription occurs at nearly all types of healthcare facilities. However, studies show that some facilities are more likely to unnecessarily prescribe antibiotics for similar conditions that don’t respond to antibiotics.

Urgent care centers (red) are the largest culprits of this, in which 46% of patients diagnosed with an acute respiratory condition for which antibiotics are neither recommended or effective receive antibiotics anyways. (4.1) This most often happens as a result of patient actions or due to general practitioner (GP) negligence. 90% of GPs reported feeling pressured by a patient to prescribe antibiotics, 70% of GPs prescribe antibiotics when unsure if they are treating a viral or bacterial infection, and 49% of GPs prescribe antibiotics once a week without knowing whether they are medically necessary or not. (4.3) What is my personal opinion?

I believe that combating overprescription is one of the first steps to be taken in handling antibiotic resistance in a serious capacity. Because it is reliant on purely human factors, it should be in our power to change the negligence and laziness in both GP and patients that is primarily responsible for this issue. -PBoroski

How does it relate to Antimicrobial Resistance?

Even if your condition is not caused by bacteria, it still exists in your body.. These often helpful bacteria are still attacked by antibiotic treatments, and their potential survival can lead to resistance being passed down and later passed on to other harmful species of bacteria. As a result, harmful bacteria now possess antibiotic resistance despite never having been treated with the antibiotic themselves. (4.2).

Overprescription by Location

Key: Office-based clinics-Dark Blue, Emergency departments-Light Blue, Urgent care centers-Red, Retail health clinics-Pink.

Danielle Palms et al., Opportunity to Improve Antibiotic Prescribing Across Outpatient Settings pewtrusts (4.1)

What can be done/is being done to combat this?

The CDC found in 2016 that around 30% of antibiotics prescriptions in the US were unnecessary. As part of the national plan to combat antibiotic-resistant bacteria they aimed to reduce this number by focusing on prescribing habits, antibiotic stewardship, and patient responsibility through public awareness. (4.4)

(4.1) Hyun D, Zetts R. Antibiotics are overprescribed in urgent care. The Pew Charitable Trusts. Published July 16, 2018. Accessed March 28, 2023.

(4.2) Mayo Clinic Staff. Antibiotics: Are you misusing them? Mayo Clinic. Published March 11, 2022. Accessed March 28, 2023.

(4.3) Leonard R. In the balance: GPS, patient care and antibiotics. Longitude Prize. Published March 8, 2021. Accessed March 28, 2023.

(4.4) CDC. CDC: 1 in 3 antibiotic prescriptions unnecessary. Centers for Disease Control and Prevention. Published January 1, 2016. Accessed March 28, 2023.

CAM

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COMPLEMENTARY AND ALTERNATIVE MEDICINE

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PHRM 48500: INTERCULTURAL AND GLOBAL HEALTH ISSUES; SPRING 2023 Aran Kim, BSPS Student Maggie Dong, BSPS Student Josiah Probst, BSPS Candidate Matthew Wolter, BSPS Student

WHAT IS CAM? The FDA defines CAM as "a wide array of health care practices, products, and therapies that are distinct from practices, products, and therapies used in 'conventional' or 'allopathic' medicine."

These include but aren't limited to traditional medicines, psychedelics, vitamins/supplements, and faith healing. They range in effectiveness but are largely nonregulated.

Source: https://www.drweil.com/health-wellness/balanced-living/meet-dr-weil/what-is-integrative-medicine/

ARAN KIM BSPS STUDENT

Traditional Medicines BACKGROUND AND DEFINITION It is the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures. There is a lot of traditional medicine in Korea, China, Japan, Europe, Africa, etc. It is often used as an alternative or complementary treatment to Western medicine. Many people turn to traditional medicine when Western medicine fails to provide relief or when they cannot afford or access Western medical treatments. In some cases, traditional medicine may also be preferred due to

https://rb.gy/ixq4c

cultural or religious beliefs.

THE GLOBAL ISSUE Traditional medicine is a global issue because it has been practiced for thousands of years in many parts of the world and continues to play an important role in healthcare in many countries. While traditional medicine may not always have a scientific explanation for how it works, there is growing evidence that many traditional remedies and practices can be effective in treating a wide range of health conditions.

FOCUSING ON KTM Fugl-Meyer Assessment (FMA) for Stroke Functional Recovery Assessment

KTM, or Korean Traditional Medicine, is based on the thought that the human body is another universe, so it believes that there are

Traditional medicine Placebo

flows between organs that seem to have no relationship between them and they think this is an important factor in treating disease.

For treating disease, they use Hanyak which is herb medicine, acupuncture, cupping therapy, Moxibustion, etc. In fact, Korean traditional medicine, unlike Modern (Western) medicine, does not clearly prove why the disease can be cured. It is just performed because it really works and can treat a lot of people. That's why it can be used as complementary or alternative medicine.

PERSONAL OPINION

0 Week Placebo

4 Week

8 Week

12 Week

https://www.haneumnetwork.co.kr/m/basic/aft ereffect.php

Traditional medicine is a complex and diverse field that includes various practices that have been used for centuries in many parts of the world. While there might not be hard scientific evidence for traditional medicine, people stand by it and use it to aid in diseases that previous medications have been unable to treat.

So while traditional medicine should not be seen as a replacement for modern medicine, the integration of traditional and modern medicine can lead to improved healthcare outcomes. Further research and investigation into the safety, efficacy, and potential interactions of traditional medicine with modern medicine are needed.

~ A. Kim

MAGGIE DONG BSPS STUDENT

Psychedelics as Treatment BACKGROUND INFORMATION Psychedelics are a class of drugs that have a hallucinogenic quality that brings about an altered mind state. They have been in use since pre-medieval times in Europe with plants such as belladonna, henbane, and mandrake. Their popularity and cultural perception have waned in and out of positivity depending on the cultural climate. In the current Western cultural consciousness, psychedelics have been thought of as strictly recreational use. But recently, this CAM has gained popularity in recent years as a verifiable and effective medication, particularly for mental disorders. Studies have shown the effectiveness of psychedelics in helping people overcome mental illnesses by sublimating a more proactive mindset.

Source: https://adf.org.au/drug-facts/psychedelics/

CULTURAL ATTITUDE In America, the use of psychedelics has been seen as shameful and used to insight racial stereotypes.

SCIENTIFIC BASIS

Even now, the use of psychedelics or recreational

The effectiveness of psychedelics largely hinges on how

minority groups. The “War on Drugs” in the 1970s

psychedelics help in neuroplasticity. These drugs include but aren’t limited to LSD, mescaline, psilocybin (magic mushrooms), etc. When administered appropriately, These drugs can induce a calm sensation and a relaxed environment for the healing of the mind. They allow for better changes in mood, cognition, perception, and remodeling to allow for a better environment for healing.

drugs has been used to instigate witch hunts on was largely targeted toward low-income Black and Hispanic communities, and that link still stands despite those communities having some of the lowest rates of use. Psychedelics also have a large significance in Indigenous medicine, but due to negative preconceptions, these communities have been moved to eliminate their practices and history.

By using psychedelics, someone who might be against talking about or working through their trauma or disorder might be more open and introspective.

PERSONAL OPINION I believe the biggest obstacle to wider acceptance of psychedelics is more cultural than scientific.

Depending on the lawmaker’s perception of psychedelics, this will influence the use of psychedelics in the future or shunned still. So it is important to examine, not only the scientific basis for medicine but also the cultural history and modern preconceptions to fully realize psychedelics as an effective tool for healing.

-M. Dong

Source: https://doi.org/10.7759%2Fcureus.29167

JOSIAH PROBST BSPS CANDIDATE

Unregulated Medicines POPULARITY

REGULATION

While the public’s faith in the drug discovery and

Unlike medicines and therapeutic treatments,

therapeutic regulation process has remained relatively

supplements popular in alternative medicines are

unchanged, a small subset of patients continues to grow

lightly regulated. The U.K., Japan, and E.U.'s follow

in popularity. Alternative medicine sources, such as

similar supplement regulation protocols to the

dietary supplements, vitamins, and other herbal

U.S.'s Dietary Supplement Health & Education Act

remedies have reentered the public consciousness as a

(DSHEA) of 1994. Under DSHEA’s legislation, dietary

viable means of treatment. Seen as a more “natural”

supplements are considered a subcategory of food,

product used by our predecessors compared to the

and do not have to be regulated as a drug product,

heavily modified scientific approach, the usage of these

as long as the supplement passes food checks. As

unregulated medicines has exploded in recent years, to a

such, supplements are not regulated to the same

variety of different results.

state as medical products, with even some products completely forgoing regulation.

https://doi.org/10.1016/j.cgh.2018.01.018

CONCERN While some manufacturers attempt to mitigate the lack of regulation via the purchase of high-quality

Source: https://doi.org/10.1016%2Fj.jsps.2018.11.005

ingredients or verifications, many manufacturers may

PERSONAL OPINION

choose to use lesser quality or potentially dangerous

While the usage of alternative medicine is up to

materials in production to save costs. Additionally,

patient preference, patients should at least know that

since drug regulation is more stringent than food,

the product they are taking has been verified for

bacterial loads and unknown drug side effect are more

efficacy & quality. As such, the supplemental markets

often to occur, with the potential that a patient may

should be regulated as medicinal drug products

overdose or worse. Finally, while some supplemental

instead of food subsidiaries. While regulation may be

drugs may give out a therapeutic response, there lies a

more time-consuming and expensive, ensure high

chance that some patients may forgo treatments and

product standards instills strength in the regulatory

replace them with supplements, for reasons ranging

system while forcing faulty products to either

from cost savings to a more “natural” recovery.

conform or be removed from shelves. - J Probst

MATTHEW WOLTER BSPS STUDENT

Faith-Based Healing DEFINITIONS Faith-based healing is the use of prayer or other beliefbased actions or rituals in the healing process. Just like all other forms of alternative medicine faith-based healing can be used in conjunction with more traditional or modern approaches to health care or entirely on its own.

The use of faith-based healing in tandem with modern health care is extremely common across all religions and cultures.

TYPES OF FAITH-BASED HEALING

Source: https://indiana.pbslearningmedia.org/resource/sj14-socreligmap/world-religions-map/

Faith based healing are broken down into two main types biased mostly on belief systems.

Religion-Based Healing

Energy-Based Healing

Prayer

Contact Healing

Rituals

Biofield energy

Sacrifices/Offerings

Spiritual healing

THE PROBLEM

https://aashirwadayurveda.com/blog/f/conceptof-spiritual-healing

While faith-based healing can be dangerous to patients when used as an alternative to any other form of medication. Those who forego medicine often cause easily treatable diseases to progress into permanent disabilities and even death. This often leads to deal of children and infants due to children’s weaker immune systems and greater susceptibility to illnesses.

PERSONAL OPINION The combination of faith and medicine can be a beneficial partnership. Religious connections for patients can be a point of comfort and confidence often absent from the healing process.

However, the abandonment of modern medicine in the use of faith-based healing methods is dangerous and should be avoided when at all possible.

-Matthew Wolter

References Traditional Medicine 1. About Korean Medicine. https://nikom.or.kr/kmp/board/index.do?menu_idx=29&manage_idx=89.

Published February 17, 2017. Accessed February 21, 2023.

2. World Health Organization (WHO). Traditional Medicine. World Health Organization. https://www.afro.who.int/health-topics/traditional-medicine 3. Villines Z. What to know about hanyak. Medical News Today. https://www.medicalnewstoday.com/articles/hanyak

Psychedelic as Treatment 1. Ens A. Silencing indigenous pasts: Critical indigenous theory and the history of psychedelics.

International Journal of Qualitative Studies in Education. 2021;34(10):904-914. doi:10.1080/09518398.2021.1942297 2. Jahn ZW, Lopez J, de la Salle S, Faber S, Williams MT. Racial/ethnic differences in prevalence of hallucinogen use by age cohort: Findings from the 2018 national survey on drug use and health.

Journal of Psychedelic Studies. 2021;5(2):69-82. doi:10.1556/2054.2021.00166 3. Reiff CM, Richman EE, Nemeroff CB, et al. Psychedelics and psychedelic-assisted psychotherapy.

FOCUS. 2021;19(1):95-115. doi:10.1176/appi.focus.19104 4. Sessa B. The history of psychedelics in medicine. Handbuch Psychoaktive Substanzen. November 2016:1-26. doi:10.1007/978-3-642-55214-4_96-1

Unregulated Medicines 1. Cohen, M. H. Complementary and integrative medical therapies, the FDA, and the NIH: definitions and regulation. Dermatologic Therapy. 2003. Volume 16 (Issue 2). Pages 77 - 84. https://doi.org/10.1046/j.1529-8019.2003.01614.x 2. Simone, C. D. The Unregulated Probiotic Market. Clinical Gastroenterology and Hepatology. 2019.

Volume 17 (Issue 5). Pages 809–817. https://doi.org/10.1016/j.cgh.2018.01.018

Faith Based Healing 1. Faith Healing and the Law. Pew Research Center. 2009. https://www.pewresearch.org/religion/2009/08/31/faith-healing-and-the-law/ 2. Levin J. Energy healers: who they are and what they do. Explore (NY). 2011;7(1):13-26. doi:10.1016/j.explore.2010.10.005 3. Shinall, M. C. The Separation of Church and Medicine. Virtual Mentor. 2009. Volume 11 Pages 747-749. https://doi.org/10.1001/virtualmentor.2009.11.10.fred1-0910.

Environment Spring 2023

Introduction

Due to the growing environmental crisis, health relating to the environment is currently a problem and will grow to be more of a problem in the future. The environment is central to many different aspects of our well-being. With these central ties, it is important to manage the environment so as to ensure our future health will not be negatively impacted.

Air Pollution

By: Erin Burke BSPS Student

Air pollution can cause many health issues such as heart disease, diabetes, and respiratory illnesses. The inflammation in the lungs and other parts of the body induced by air pollutants leads to the degradation of cells or other tissues that causes these illnesses. Outdoor air pollutants have the ability to enhance underlying conditions or irritate both the upper and lower respiratory tract.

There is a correlation between particulate matter (PM when measuring ambient air quality) and cardiorespiratory morbidity and mortality. PMs are defined as being 2.510 micrometers in diameter. There is not a lot of information on ultra-fine particles and their health risks even though they are far more abundant than what is measured with particulate matter.

Air pollution disproportionately impacts low and middle class income communities (LMICs). Some levels of air pollution reach the point where outdoor physical activity is less beneficial to health due to the exposure to air pollutants.

Hodges L. A doctor near east palestine, Ohio, details the main thing he's watching for now. NPR. https://www.npr.org/2023/02/22/1158827319/east-palestine-ohiotrain-norfolk-southern-health-doctor-chemicals. Published February 22, 2023.

Accessed March 21, 2023.

Combatting Air Pollution

The biggest contributors of air pollution are large corporations burning fossil fuel. In recent studies, it has shown that energy companies are “responsible for 71% of all industrial emissions since human-driven climate change was officially recognized” (Axelrod). With this statistic, it is important to note that the main way to combat climate change is to support policies that can hold these large corporations accountable for the emissions they release into the atmosphere. These policies can then prevent corporations from continuing poor practices. This impacts a large portion of the world population, and this problem will continue to grow in the future as air pollution continues to worsen.

Personal Opinion Discussing climate change can be overwhelming. However, it is important that we continue to discuss ways that we can combat climate change. I believe that it is important to recognize that, although small personal lifestyle changes can help, the most productive way to combat climate change is recognizing that it is not an individual problem, but a societal problem that needs societal solutions. ~E. Burke

Deforestation

D'Eric Whitt : BSPS Student

Deforestation involves humans permanently clearing a forest without replanting the trees. The downstream effects on the environment can be irreversible by the time we realize there was an issue.

Impacts of deforestation Loss of biodiversity Insects that pollinate fruit and vegetable plants will die which affects food supply Animal habitat destruction. source Climate change impact Increased global temperatures Rising sea levels would submerge many coastal areas and islands.

https://pixabay.com/photos/river-forest-polandjungle-nature-6838322/

Trees protect the river banks and shade fish Trees (riparian buffers) reduce the rate river banks erode.

Warmer water dissolves less oxygen.

Large pieces of wood that fall into water are used as habitat for fish

https://pixabay.com/photos/forest-sunrisedeforestation-goats-7794461/

Soil erosion and Land degradation Dangerous landslides Loss of nutrients in the soil that are necessary for agriculture.

Loss of future medical resources We could lose access to discovered and undiscovered drug compounds in natural plants Ocean Acidification CO2 that the trees convert to O2 will now be released to the atmosphere then forced into the oceans.

Marine species may not be able to tolerate the pH differences

Personal Opinion

Finding sustainable ways to extract resources from the forest is obligatory if we are going to maintain healthy ecosystems and preserve habitable planet for future generations. The US needs to honor the COP26 agreement to do our part. ~D. Whitt

Water Pollution

Hyeonjeong Noh BSPS student

Water is getting polluted day by day due to fuel spillages, rubbish and toxic waste

dumping, and the continuous use of chemical and biological properties. Water pollution is one of the most critical issues that every country is facing globally today.

Causes of Water Pollution Global warming Deforestation Industry, agriculture and livestock farming Rubbish and faecal water dumping Maritime traffic Fuel spillages Radioactive waste dumping

https://www.sciencenews.org/article/manta-rays-haveunusual-mouth-filter-resists-clogging

Impacts of Water Pollution Contaminate the food chain Cause differnt types of disease leads to Diarrhea, cholera, Hepatitis A, cancer, etc Genetic variation Radioactive substances waste dumping may lead to genetically induced diseases like hereditary defects.

Lack of potable water Infant mortality

WHAT HAPPENS IN THE OCEAN? As dead algae decompose, oxygen is consumed in the process, resulting in a depletion of oxygen in the water.

AEROBIC MICROORGANISMS AEROBIC MICROORGANISMS Certain anaerobic microorganisms produce toxins such as sulfides and ammonia.

485,000 diarrhearelated deaths According to the Unicef, “every year, 85,700 children under the age of 15 die from diarrhea linked to unsafe water.”

Also, contaminated water can lead to many types of diseases such as diarrhea, cholera, hepatitis A, cancer, etc. https://www.flickr.com/photos/usaidwater/26479216227

PROFESSIONAL OPINION

We won’t survive without water. It is our ~ H. Noh responsibility to make some extreme changes in our lifestyles to spare the water on earth.

Currently, people are trying to replace plastic with paper. To prevent water pollution, we can reduce plastic consumption, minimize the use of pesticides and chemical fertilizers, and not dispose of chemicals but instead reuse them.

https://pixabay.com/v ectors/cartoontornado-weatherwind-1296854/

https://pixabay.com/photos/key-westflorida-hurricane-dennis-81664

With natural disasters being so unpredictable it is critical that we are prepared for their global effects and impacts on both humanity and the environment.

Potential Impacts: Limited healthcare capabilities due to power outages, limited water and oxygen supply, and damaged medical supplies.¹ Increased communicable disease spread in temporary shelters.¹ Physical injuries from disaster Delays in continued treatment for those with long-term illnesses, for example, cancer.² Infrastructure damage, like water contamination or limited transportation capabilities.

Food shortages, as agriculture absorbs 22% of economic burden from natural disasters.³ Negative mental health impacts https://pixabay.com/vector s/brain-human-anatomyorgan-body-7822205/

Fast Facts: There is a 13.8% increase in suicide and depression rates in a 4-year period following earthquakes, hurricanes, and floods.¹ The annual global death rate from natural disasters has been steadily declining.⁴ The number of global natural disasters per year is on the rise.⁵ Solutions: There are many free online planning tools, like on FEMA's website, that can be used to prepare a plan for these types of events.

Ritchie H, Rosado P, Roser M. Natural disasters. Our World in Data. https://ourworldindata.org/natural-disasters#citation. Published December 7, 2022. Accessed March 22, 2023.

Dlewis. Increase in natural disasters on a global scale by ten times. Vision of Humanity. https://www.visionofhumanity.org/global-number-of-naturaldisasters-increases-ten-times/. Published September 18, 2021. Accessed March 22, 2023.

There is also an emphasis on evacuations and limiting human exposure since technology has advanced in its predication capabilities. Lastly, drills and warning system testing is crucial to ensure proper functionality in the event it is needed.

Professional Opinion: Natural disasters seem distant and unimportant until they impact you. It is essential to realize the ripple effect they can have on our global economy and ecosystem. While increased tracking has helped limit annual deaths, individual planning can help to lower the number further. I believe it will be necessary to also address disparities that exist in accessing up to date weather information and in accessing temporary relocation housing. ~E.Tobin

References Natural Disasters: ¹Jones J. Mother nature's disasters and their health effects: a literature review. Nurs Forum.

2006;41(2):78-87. doi:10.1111/j.1744-6198.2006.00041.x ²De Guzman R, Malik M. Global Cancer Burden and Natural Disasters: A Focus on Asia's Vulnerability, Resilience Building, and Impact on Cancer Care. J Glob Oncol. 2019;5:1-8. doi:10.1200/JGO.19.00037 ³Food and Agriculture Organization. Home | Food and Agriculture Organization of the United Nations. https://www.fao.org/3/i4434e/i4434e.pdf. Accessed February 14, 2023. ⁴Ritchie H, Rosado P, Roser M. Natural disasters. Our World in Data. https://ourworldindata.org/natural-disasters#citation. Published December 7, 2022. Accessed March 22, 2023. ⁵Dlewis. Increase in natural disasters on a global scale by ten times. Vision of Humanity. https://www.visionofhumanity.org/global-number-of-natural-disasters-increases-ten-times/.

Published September 18, 2021. Accessed March 22, 2023.

Air Pollution: Mon C, Art: Romualdo Faura. Sources: IPCC; U.S. National Climate Assessment; World Health Organization. 5 ways climate change will affect you: Health risks. 5 Ways Climate Change Will Affect You: Health Risks | National Geographic. https://www.nationalgeographic.com/climatechange/how-to-live-with-it/health.html. Accessed March 21, 2023.

Protecting Yourself from Poor Air Quality. The National Council on Aging. https://www.ncoa.org/article/protecting-yourself-from-poor-air-quality. Accessed February 14, 2023.

Laumbach, Robert, et al. What can individuals do to reduce health risks from air pollution.

Journal of Thoracic Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311076/.

Published January 7, 2015. Accessed February 12, 2023.

Bernstein, Jonathan A., et al. “Health Effects of Air Pollution.” Journal of Allergy and Clinical Immunology, vol. 114, no. 5, 2004, pp. 1116–1123., https://doi.org/10.1016/j.jaci.2004.08.030.

Water Pollution: 10 solutions to Combat Water Pollution. Atlas Scientific. https://atlas-scientific.com/blog/waterpollution-solutions/. Published November 3, 2022. Accessed February 14, 2023.

More Children Killed by Unsafe Water, than Bullets, Says UNICEF Chief | UN News. United Nations, United Nations, https://news.un.org/en/story/2019/03/1035171.

Deforestation:

Moas A, Schwartz J, Beliveau M-J. Solutions to deforestation. Greenpeace USA. https://www.greenpeace.org/usa/forests/solutions-to-deforestation/. Published May 19, 2020.

Accessed February 14, 2023.

Evette, A., Labonne, S., Rey, F. et al. History of Bioengineering Techniques for Erosion Control in Rivers in Western Europe. Environmental Management 43, 972–984 (2009). https://doi.org/10.1007/s00267-009-9275-y Cardinal K. How can trees help the seas? The Nature Conservancy. https://www.nature.org/enus/about-us/where-we-work/united-states/washington/stories-in-washington/forests-reduceocean-acidification/. Published 2023. Accessed February 14, 2023.

What are ecosystem services? Earthwise Aware. https://www.earthwiseaware.org/what-areecosystem-services/. Published 2021. Accessed February 14, 2023.

Tesfahunegn GB, Ayuk ET, Adiku SGK (2021) Farmers’ perception on soil erosion in Ghana: Implication for developing sustainable soil management strategy. PLoS ONE 16(3): e0242444. https://doi.org/10.1371/journal.pone.0242444

Ethical Dilemmas Jordenn Call, Sophia Palant, Nicholas Hull, Trevor Tran Spring 2023 Introduction: Ethical dilemmas can be defined as choices or decisions for which there is no definite answer, and is simply based on one's moral principles. This is a global health issue that can be applied to any area of healthcare. The following monograph explores topics such as artificial wombs, CRISPR, The Inflation Reduction Act, and distribution of medical resources to better understand how healthcare systems in various countries develop novel therapeutics and decide on regulations.

Surrogacy with Artificial Wombs Trevor Tran, BSPS Candidate

Background Is it ethically okay to remove an embryo from a consenting mother’s womb to be put into an artificial womb in a laboratory? There are many debates about growing a fetus in a laboratory. Is the fetus well taken care of when it is in a laboratory setting without the warmth and affection of the mother? Will there be drawbacks on the fetus being developed in the laboratory? With all these difficult questions it is very clear that currently there is a difficult line to where to put this topic on in our laws with ethical dilemmas such as abortion rights. As of now we have Figure 1. Shows a recent upcoming artificial womb experimented with this topic such as creating the first made in the Netherlands that claim to start In Vitro fertilization baby in the 1970s which is done officially doing this in 10 years by collecting the donor sperm & egg and fertilizing it https://www.bbc.com/news/av/health-50056405 in a lab for up to 14 days then to be put back into the mother’s womb. And the first baby born from this is still thankfully alive today at the time this monograph Global Issue is written. This 14 day rule is implemented to secure People against this topic debate that the fetus the safety of the embryo because after the 14th day, has human rights and deserves a loving mother’s the embryo is now individualized and begins womb to take care of them. Rather than the fetus gastrulation. This 14 day In vitro is a standard used being used as a subject in their labs for the around the world, there are laws in many 1st world purpose to attain the goals of others. They’re also countries that prevent going further than 14 days afraid of other complications such as the such as the United Kingdom, but in the USA it’s a nutrients and signals that a mother would give to suggestion. We have also successfully grown an nurture the fetus compared to an artificial womb. extreme premature lamb for four weeks with no People for this topic find it to be beneficial to issues from its 107th day of gestation. human society without having the stress of carrying the baby for nine months and have a People Affected higher chance of giving birth to the baby without The people who are affected by this issue is of course defects and lowering the chance of failing the the babies in these artificial womb and everyone birth of the baby when done naturally. Lowering around the world who are going to interact with them the risk of pregnant mothers not dying during which will be everyone in the future besides the childbirth and other complications. people who isolate themselves from others.

What Efforts are made and What should be done?

Opinion Efforts that are done from people against this In my humblest opinion on this issue is that sooner or issue are active protesting either in person or later there will be a line to be put in the middle with social media. While the efforts for this issue is these differentiating ideas. It’s going to be different companies & people funding this idea to progress all around the world and to a lot of people it is going this change to happen faster. What should be to be a while until people come to be okay with a tiny done is that in this world of misinformation, degree of this idea. Since it seems dystopian, we people should be more educated in this topic so a would have to wait for at least a generation of these people can make a definite decision. This will help babies born from artificial wombs and see how they the progress in determining how we want to move develop in real life to really solidify this idea since I forward with this idea so there can be less feel this is going to inevitably happen in the future. conflict with the masses. ~TTran

CRISPR

Sophia Palant, BSPS Candidate

Clustered Regularly Interspaced Short Palindromic Repeats, or CRISPR, is a gene editing technology that can be applied to diagnostics and therapeutics in cancer, genetic disorders, neurodegenerative disorders, genetically modified babies, and various other therapeutic areas. Ethics comes into play when deciding the limitations of this technology.

Figure 2. Mechanism of Action of CRISPR-Cas9

Rainha J, Rodrigues JL, Rodrigues LR. CRISPR-Cas9: A Powerful Tool to Efficiently Engineer Saccharomyces cerevisiae. Life. 2021; 11(1):13. https://doi.org/10.3390/life11010013

Examples of CRISPR Use

Figure 3. Microplate containing edited embryo's. https://www.nytimes .com/2018/11/26/he alth/gene-editingbabies-china.html

Various countries have begun using this Geographic Politics technology at different levels. In China, A 2021 European Commission study displayed that Biophysicist, He Jiankui, used CRISPR to alter the the US and Japan will not regulate gene edited DNA sequence of two human embryo's in 2018. crops and the EU will have a less "rigid stance" on Plant biologist, Li Jiayang, uses CRISPR to this issue but is worried about "potential impacts manipulate plant DNA and has been very on biodiversity." (Europe). As seen in previously successful specifically with rice. These examples discussed examples, CRISPR is a very powerful tool lie on opposite ends of the spectrum of what and anyone in the world can be affected by its individuals are usually more willing to accept when uses. A Frontiers article argues that by allowing it comes to the power of this technology. Gene public input rather than simply relying on scientific editing has become a popular area of research in governance, the technology may become more the US since the FDA approved CAR-T cell therapy accepted. in 2017. Many researchers believe that CRISPR will only improve this type of therapy. An important use for this technology is creating allogeneic CART cells, which would allow for "off-the-shelf" CAR-T treatment.

Figure 4. Manufacturing process for autologous and allogeneic therapeutic CAR-T cells https://innovativegenomics.org/news/crispr-clinical-trials-2023/

Opinions

In 2020, a study was run using BERT and statistical methods to analyze the population's opinions on CRISPR, with data being pulled from tweets published since the first publication of gene editing application was released in 2013. The results showed that the majority of tweets discussed the novel technology in a positive light, but since 2017 there was a rapid decline in sentiment which seemed to be associated with genetically modified babies, the side effects, and malware. Personally I believe that CRISPR can be very beneficial to increasing crop and providing life-saving treatment to patients who have exhausted all other treatment options, but a limitation exists when physical characteristics are altered. ~S. Palant

References

Müller M, Schneider M, Salathé M, Vayena E. Assessing Public Opinion on CRISPR-Cas9: Combining Crowdsourcing and Deep Learning. J Med Internet Res. 2020;22(8):e17830.

Published 2020 Aug 31. doi:10.2196/17830 Meyer M and Vergnaud F (2021) The Geographies and Politics of Gene Editing: Framing Debates Across Seven Countries. Front. Polit. Sci. 3:731496. doi: 10.3389/fpos.2021.731496 What is CRISPR? The Jackson Laboratory. https://www.jax.org/personalized-medicine/precision-medicine-and-you/what-is-crispr. Accessed February 20, 2023.

Kolata G, Wee S-lee, Belluck P. Chinese scientist claims to use CRISPR to make first genetically edited babies. The New York Times. https://www.nytimes.com/2018/11/26/health/gene-editing-babies-china.html. Published November 26, 2018. Accessed March 28, 2023.

Europe is reviewing its stance on CRISPR crops. Alliance for Science. https://allianceforscience.org/blog/2021/04/europe-is-reviewing-its-stance-on-crispr-crops/. Accessed March 28, 2023.

Regulations + Laws:

The Inflation Reduction Act Jordenn Call, BSPS Candidate

What is the Inflation Reduction Act?

The Inflation Reduction act is the nation's new prescription drug law. For the first time, drug companies will pay rebates to Medicare when their prescription drug prices increase faster than the rate of inflation for certain drugs dispensed to people with Medicare. Ethics comes into play with this act due to the fact that it raises the question is it ethical to only be available to a certain group of people.

Efforts and Solutions This act will require the federal government to negotiate prices for certain high-cost drugs covered under medicare.

Require drug manufacturers to pay rebates to Medicare if they increase prices faster than inflation for drugs used by Medicare beneficiaries.

Limit the cost of insulin to $35 per month.

Expands eligibility for full Part D low income subsidies.

Figure 1. details the potential impact of the provisions in the Inflation Reduction Act for Medicare beneficiareis both nationally and by state. https://www.kff.org/medicare/issue-brief/explaining-the-prescription-drug-provisions-in-theinflation-reduction-act/

People affected?

Individuals on the federal health insurance Medicare. Medicare is for people 65 or older, some people with disabilities and people with end-stage renal disease.

Opinions In my personal opinion, the Inflation Reduction Act is a very much-needed piece of the United States' health care system. The cost of medications oftentimes makes it so people who need medications have to go without them. One flaw I do recognize with this act is the fact that it is only available to those who are on Medicare.

Although the elderly are often retired and have a tougher time paying for prescriptions how is it fair to individuals who can not afford insurance or have a hard time paying for the co-pay? ~JCall

Distribution of Medical Resources as it relates to the COVID vaccine

https://www.phila.gov

Nick Hull BSPS Candidate

Possibe options and solutions

Background information Do weather countries have a moral obligation to provide medical resources to poorer countries? If so to what extent are they obligated to provide to these countries. For this question I will be examining the COVID-19 vaccine development cost and how the United States distributed it to its people then how it distributed it to other countries around the world.

People affected The main people that are affected by this dilemma are the citizens of third world countries that may not have the resources to develop and produce their own vaccines and the citizens of first world countries that do have the means to develop and produce their own vaccines.

One possible line of thinking is wealthier countries should provide COVID-19 vaccines to less fortunate countries before providing them to their own citizens because wealthier countries are more readily able to handle the strain on the healthcare system than less wealthy nations. which is shown by less wealthy nations having a higher case mortality rate relative to wealthier ones One other line of thinking is that since the wealthier nation is the one investing, developing and producing the vaccines, their people should be rewarded for their investment by being able to be the first to get access to the vaccines.

A third line of thinking could be that wealthier nations have no obligation to provide for less wealthy nations since they are the ones that are doing all investing and work to solve the problem so other countries that did not contribute should not get a claim on the vaccines.

Opinion In my personal opinion, I think that wealthier countries should adopt a policy that is a mixture between the first and second lines of thinking that tilts more towards the second. I think this because I believe that wealthier nations do have an obligation to provide aid to less fortunate countries when they are able to, but I also think that since the wealthier countries are doing the work and the investment into the development of these resources, they should be a higher priority. So, while the vaccines were being made, I think the initial majority should remain domestic while giving a minority of them away. Then as time goes on and the crisis is managed in the United States then vaccines distribution to the rest of the world should become the priority. ~ N. Hull

Citations Explaining the prescription drug provisions in the Inflation Reduction Act. KFF. https://www.kff.org/medicare/issuebrief/explaining-the-prescription-drug-provisions-in-the-inflation-reduction-act/. Published January 24, 2023. Accessed February 19, 2023.

Driscoll S. How the inflation reduction act impacts health policy. FSI. https://fsi.stanford.edu/news/inflation-reductionact-significant-health-policy-bill. Accessed February 19, 2023.

Bosworth A. Price increases for prescription drugs, 2016-2022. ASPE. https://aspe.hhs.gov/reports/prescription-drug-priceincreases#:~:text=This%20report%20tracks%20drug%20price,these%20drugs%20was%2031.6%20percent. Accessed February 19, 2023.

Assistant Secretary for Public Affairs (ASPA). New HHS reports illustrate potential positive impact of inflation reduction act on prescription drug prices.

HHS.gov. https://www.hhs.gov/about/news/2022/09/30/new-hhs-reports-illustrate-potential-positive-impact-inflationreduction-act-prescription-drug-prices.html. Published September 30, 2022. Accessed February 19, 2023.

Fact sheet: The inflation reduction act supports workers and Families. The White House. https://www.whitehouse.gov/briefingroom/statements-releases/2022/08/19/fact-sheet-the-inflation-reduction-act-supports-workers-and-families/. Published September 20, 2022. Accessed February 19, 2023.

Rainha J, Rodrigues JL, Rodrigues LR. CRISPR-Cas9: A powerful tool to efficiently engineer saccharomyces cerevisiae.

MDPI. https://www.mdpi.com/2075-1729/11/1/13. Published December 26, 2020. Accessed March 28, 2023.

Henderson H. CRISPR clinical trials: A 2023 update. Innovative Genomics Institute (IGI). https://innovativegenomics.org/news/crispr-clinical-trials-2023/. Published March 18, 2023. Accessed March 28, 2023.

An extra-uterine system to physiologically support the extreme premature lamb | Nature Communications. https://www.nature.com/articles/ncomms15112 Accessed February 17, 2023.

Artificial womb. In: Wikipedia. ; 2023. https://en.wikipedia.org/w/index.php? title=Artificial_womb&oldid=1137601884 Accessed February 17, 2023.

IVF - NHS. https://www.nhs.uk/conditions/ivf/ Accessed February 17, 2023.

Should We Study Human Embryos Beyond 14 Days? | NOVA | PBS. https://www.pbs.org/wgbh/nova/article/14-day-rule/ Accessed February 17, 2023.

Powell K. What’s next for lab-grown human embryos? Nature. 2021;597(7874):22-24. doi:10.1038/d41586-021-02343-7 Accessed February 17, 2023.

Kellner H. City announces phased schedule of priority populations for covid-19 vaccine: Department of Public Health. City of Philadelphia. https://www.phila.gov/2021-01-12-city-announces-schedule-of-priority-populations-for-covid-19-vaccine/.

Published January 12, 2021. Accessed March 28, 2023.

Mortality analyses. Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/data/mortality. Accessed March 28, 2023.

Family Planning Spring 2023

Amy Jo, BSPS Candidate Ruoyu Wan, BSPS Candidate Liying Che, BSPS Student Anastasia Pinopoulos, BSPS Candidate

Background When a couple is ready to expand their family, they are practicing family planning. There are a lot of factors that impact when individuals feel like they are ready for children and these factors are different for every individual. When looking at individuals around the world, a difference in culture and beliefs can impact how a couple pursues family planning. In order for individuals to make this monumental decision, they need to be more knowledgeable in the areas of birth control methods, sex education, surrogacy, and access to postpartum care. With more knowledge on these topics, people can make a more informed decision.

So what is so important about family planning? Family planning makes it more likely for people to have their desired number of children and helps them determine the spacing between pregnancies. It also helps people prevent unwanted pregnancy through a variety of contraceptive methods and services.

Family. Default. https://www.judiciary.gov.sg/family. Published March 1, 2023. Accessed March 28, 2023.

Birth Control Methods

By Amy Sungeun Jo Background

Contraceptive methods and services are fundamental to the health and human rights of all individuals. The prevention of unintended pregnancies aid in reducing unsafe (illegal) abortion, pregnancy-related deaths, and any health complications that might arise from childbearing. On top of this, various birth control methods can be used to reduce HIV/STD transmissions, ovarian cyst, and other hormonerelated problems.

http://www.paragard..com

Who is affected? Why is it a problem?

Despite its advantages, about 214 million women of reproductive age have an unmet need for contraception due to reasons such as: limited access and choice, experience of side-effects (or fear), cultural and/or religious opposition, poor quality of services, and gender-based barriers.

Moreover, a lot of people are not well informed of the different types of contraception, which have varying rates of effectiveness depending on the usage.

Types of Contaceptives: Hormonal- usually oral pills, implants, patches, or vaginal rings which secrete small doses of one or more hormones to prevent ovulation.

Intrauterine device-also known as IUDs, they are inserted into the uterus where they release hormone (levonorgesterol) or copper component.

Emergency contraception- usually oral pills, which are intended to prevent pregnancy after unprotected sex.

Condoms-have the female and male kind. Both are intended to block sperm meeting the egg by creating a barrier.

Lactational amenorrhea- temporary form of contraception for mothers whose monthly bleeding hasn't returned after giving birth.

Current efforts and author's opinion (A.J.)

There are currently more efforts to spread awareness/information and access, as schools are starting to incorporate birth control methods as part of the sex education curriculum. There are also some institutions that provide certain types of contraceptives (ex. male condoms) to provide more resources to students. Lastly, birth control methods are offered over the counter and/or covered by insurance in some countries. In my opinion, I think every school should require including information about birth control methods in their curriculum (for subjects like health class), to reduce unfamiliarity regardless of gender.

Also, birth control should be made available to both men and women equally.

Amy Jo, BSPS Candidate

Why is it important Receiving adequate sex education and knowledge about it ensures that young children learn and think about what is right and safe for them, or how to avoid coercion, sexually transmitted infections diseases, including HIV, and early and unintended pregnancies.

It helps to keep our children safe from abuse by teaching them about their bodies. Some studies have shown that having adequate comprehensive sexuality education programs reduce the rates of sexual activity, sexual risk behaviors (eg, number of partners and unprotected intercourse), sexually transmitted infections, and adolescent pregnancy.

https://www.kff.org/womens-health-policy/fact-sheet/sexual-hea lth-of-adolescents-and-young-adults-in-the-united-states/

As we can see from the figure, compared to older adults, sexually active teens and young adults are at higher risk for acquiring sexually transmitted infections, including chlamydia, gonorrhea, and HIV listed above, due to a combination of behavioral, biological and cultural factors.

Though they make up 25% of the sexually active population, they account for nearly half of new STI cases. Young students getting enough education thus are more aware of HIV and other STIs. They are more inclined to take protective Some people, parents and measures such as using condoms, getting tested and religious groups, take issue with discussing HIV/AIDS with their partners. comprehensive sex education because they believe it goes against their cultural or religious values, and think that it can have a corrupting influence on kids.

Why is it an issue

https://www.kff.org/womens-health-policy/fact-sheet/sexual-health-of-adolescents-and-young-adults-in-the-united-states/

Some Stats about it

Personal Opinion

by LChe

As stated above, there are more advantages for young children to receive sex education during school, which could also contribute to family planning as a whole. I believe that sex https://www.kff.org/womens-health-policy/fact-sheet/sexual-hea education provides young kids lth-of-adolescents-and-young-adults-in-the-united-states/ with the knowledge and skills The teen birth rate has decreased significantly over the past they need for a lifetime of good decades, falling to 27 births per 1,000 females ages 15 to 19 in sexual health.

2013 from 62 births per 1,000 females in 1991. Researches https://www.plannedparenthood.org/learn/foreducators/what-are-goals-sex-education-youth have been showing that comprehensive sex education is https://www.unaids.org/en/resources/presscentr e/featurestories/2021/december/20211207_educ associated with lower pregnancy risks, a later age at first sex, ation#:~:text=It%20ensures%20that%20our%20 and an increased probability of contraceptive use.

Sex Education

children,teaching%20them%20about%20their% 20bodies.

Liying Che, BSPS Student

Surrogacy Background

Surrogacy is illegal in most countries because some people consider surrogacy as baby-selling. Only nine counties legalize surrogacy and the US is one of the nine (not all states). The cost ranges from $110, 000 to $170, 000 and the average base pay for surrogacy is $45,000. According to public data, there are around 4,000 surrogacy cases every year. Although surrogacy offers new reproductive opportunities, many moral dilemmas have arisen.

People affected those who have struggled with infertility LGBT couples those with medical conditions that makes pregnancy unsafe

https://surrogacy.institute/surrogate-motherhood/?cn-reloaded=1

Efforts/Solutions screen parents in need of surrogacy set health (physical/mental) requirements for surrogate mothers determine the number of times a woman could be a surrogate mother

Personal Opinion

https://www.shecares.com/pregnancy/surrogacy-traditional-and-gestational

R Wan

Surrogacy remains a controversial issue where some feminists and I believe it’s very unethical for women to sell their bodies and compare it on some level with prostitution. In underground markets, some women would be hostaged illegally and forced to be surrogates. There is a long, hard road for surrogacy to be “completely” legalized.

Ruoyu Wan, BSPS Candidate

Access to Postpartum Healthcare By: Anastasia Pinopoulos, BSPS Candidate

After bringing a baby into the world, both parents experience a big change in their lives. This big change is often accompanied by stress, changes in mental health, and changes in physical health. The period after a baby is born, postpartum, is a crucial time in a woman’s life. It is important that women all around the world have access to any necessary mental and physical health resources in order to preserve her health and that of the baby’s.

Mental Health

https://www.societyforscience.org/blog/regeneron -isef-finalists-are-making-mental-health-a-priority/

Physical Health

The postpartum period is accompanied with a huge shift in hormones putting women at risk for changes in their mental health. What society has coined as the “baby blues'', occurs in the first couple weeks after birth and is seen in over half of the mothers. They often experience heightened anxiety, tearfulness, and irritability that typically resolves on its own. If these symptoms progress and last longer than two weeks, then the mother is said to have postpartum depression. Roughly 1 in 7 mothers experience postpartum depression. Mental health issues can disrupt a person’s day to day life and in severe cases mothers will not care for their newborn.

Postpartum complications can put the mother at risk for serious health problems. Some conditions include heavy bleeding, gestational diabetes, and preeclampsia. Severe cases can lead to death. Maternal mortality rates have decreased by 34% between 2000 and 2020.

The World Health Organization found that in high income countries 12 per 100,000 live births resulted in maternal death while in low income countries it was 430 maternal deaths per 100,000 live births. Some of these complications could have been prevented if the mother had access to routine check ups.

Current Recommendations Physical health: 6 week appointment with OBGYN maintain contact with OBGYN within 3 weeks of having baby

Proposed Follow Up by ACOG American College of Gynecology 3-10 days: blood pressure check 1-3 weeks: high risk follow up 1st 3 weeks: recommended check up with provider 3+ weeks: check up as needed

https://ourworldindata.org/maternal-mortality

Opinion More mental health resources need to be provided to new mothers More postpartum mental health screening is needed More work needs to be done in order to ensure all women are receiving adequate healthcare before, during, and after pregnancy in order to decrease the risk of postpartum complications.

Adopt the proposed follow up by ACOG ~ A. Pinopoulos

References Comprehensive sexuality education. ACOG. https://www.acog.org/clinical/clinical-guidance/committeeopinion/articles/2016/11/comprehensive-sexualityeducation#:~:text=Studies%20have%20demonstrated%20that%20comprehensive,transmitted%20infe ctions%2C%20and%20adolescent%20pregnancy. Accessed March 30, 2023.

Published: Aug 20 2014. Sexual health of adolescents and young adults in the United States. KFF. https://www.kff.org/womens-health-policy/fact-sheet/sexual-health-of-adolescents-and-young-adultsin-the-united-states/. Published August 20, 2014. Accessed March 30, 2023.

Cheng C-Y, Fowles ER, Walker LO. Continuing education module: Postpartum maternal health care in the United States: A critical review. The Journal of perinatal education. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595301/. Published 2006. Accessed February 21, 2023.

Postpartum psychiatric disorders. MGH Center for Women's Mental Health. https://womensmentalhealth.org/specialty-clinics-2/postpartum-psychiatric-disorders-2/. Published August 22, 2022. Accessed February 21, 2023.

Author: William Houghton Bill Houghton is the founder of Sensible Surrogacy, Bill Houghton is the founder of Sensible Surrogacy. Average surrogacy costs: The Total Guide to an affordable journey.

SENSIBLE Surrogacy Agency. https://www.sensiblesurrogacy.com/surrogacy-costs/. Published December 14, 2022. Accessed February 21, 2023.

Contraception. World Health Organization. https://www.who.int/health-topics/contraception. Accessed February 21, 2023.

Surrogacy. Yale Medicine. https://www.yalemedicine.org/conditions/gestationalsurrogacy#:~:text=%E2%80%A2A%20process%20in%20which,%E2%80%A2Involves%20fertility%20cent er. Published August 15, 2022. Accessed February 21, 2023.

Dr. Phipps is from the Departments of Obstetrics & Gynecology and Community Health. Consequences of inadequate sex education in the United... : Obstetrics & Gynecology. LWW. https://journals.lww.com/greenjournal/Citation/2008/02000/Consequences_of_Inadequate_Sex_Educa tion_in_the.2.aspx#:~:text=There%20are%20consequences%20associated%20with,unintended%20preg nancy%2C%20and%20sexual%20violence. Accessed February 23, 2023.

Mark NDE, Wu LL. More comprehensive sex education reduced teen births: Quasi-experimental evidence. Proceedings of the National Academy of Sciences of the United States of America. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8872707/#:~:text=A%20consistent%20finding%20from %20observational,use%20(29%E2%80%9331). Published February 22, 2022. Accessed March 30, 2023.

Family Planning Workgroup. Family Planning Workgroup - Healthy People 2030. https://health.gov/healthypeople/about/workgroups/family-planningworkgroup#:~:text=Family%20planning%20makes%20it%20more,of%20contraceptive%20methods%20 and%20services. Accessed March 30, 2023.

The American College of Obstetricians and Gynecologists. Optimizing Postpartum Care. www.acog.org.

Published May 2018. https://www.acog.org/clinical/clinical-guidance/committeeopinion/articles/2018/05/optimizing-postpartum-care

HEALTH DISPARITIES Spring 2023

The CDC identifies health disparities as, “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by [social, economic, and/or environmentally] disadvantaged populations.”

Our team will focus on rural versus urban health disparities, access to healthcare, patient education, and socioeconomic status.

Rural Vs. Urban Health Elexus Goodpaster | BSPS Candidate

Access to Healthcare Perri Macoit | BSPS Student

Education Status Keagan Smith | PharmD Student

Socioeconomic Status Eleana Madren | PharmD Student & BSPS Candidate

Group 14

Rural vs. Urban Health Disparities Elexus Goodpaster | BSPS Candidate Figure 1: Age-adjusted death rates, by urbanrural classification: United States, 1999-2019

Centers for Disease Control and Prevention (CDC). (2021). National Center for Health Statistics.

Since 1999, Rural areas have led the United States in deaths per 100,000 standard population. With the age-adjusted death rate, rural areas had a 20% higher death rate than urban in 2019.1 Figure 2: Age-adjusted death rates for the 10 leading causes of death, by urban-rural classification: United States, 2019

Background Information There are 6 classifications of counties in the united states, large central metropolitan, large fringe metropolitan, medium metropolitan, small metropolitan, micropolitan, and noncore, which would be considered rural. Noncore, or rural, communities have a higher chance of mortality for a variety of diseases.

2% more rural respondents reported their health status as fair or poor compared to respondents in small 5 metropolitans. Rural health status is generally poorer than in more populated areas and can be attributed to socioeconomic factors, access to places for physical activity, and disease prevention efforts.6

Potential Solutions Several agencies and organizations are working to help alleviate these differences by researching and investigating healthcare outcomes, increasing health education, and engaging policymakers to establish a plan.4

Centers for Disease Control and Prevention (CDC). (2021). National Center for Health Statistics.

Rural areas lead the United States in all of the top 10 leading causes of death, leading most in heart disease.1 Rural areas have a higher percentage of uninsured inhabitants, a shortage of workers in healthcare, a shortage of specialty healthcare services,2 and the services that are available are often underfunded.

This lack of support can lead to those living in rural areas engaging in more poor health-related behaviors such as smoking or drinking as well as not being checked for or treated for heart disease or cancer.

Professional Opinion An increase of just 10 primary care physicians per 100,000 population can equate to lower mortality rates.3 Therefore increasing the number of primary care and specialty physicians, healthcare services, including hospitals, emergency care, and reliable transportation can help alleviate the issues that rural populations are facing. ~ E. Goodpaster

ACCESS TO HEALTHCARE Perri Macoit | BSPS Student

Background Information Access to healthcare is the ability a patient has to receive health services within a reasonable timeframe with the best outcome. The unfortunate truth is most people lack the proper access which leads them not receive the best care if care at all.

There are five main barriers that are characterized as the five A's of access to care: affordability, availability, accessibility, accommodation, and acceptability.

The Five A's

Statistics

Affordability: How much a provider charges related to the patient's ability to pay for services Availability: The resources, staff, and technology needed to meet the needs of a patient Accessibility: How easily a patient can physically get to a provider Accommodation: How well a provider's operation can meet the constraints and requirements of a patient Acceptability: How comfortable a patient is with the characteristics of the provider and vice versa

According to the World Health Organization, at least half of the world's population cannot obtain essential health services.

800 million people spend at least 10% of their household budgets on health expenses 100 million people are pushed into extreme poverty because of this expense 28 million people do not have health insurance at any point during the year

Vulnerable Populations

Source: KFF analysis of 2021 National Interview Survey

Possible Solutions

Expand Insurance: 35 states in January 2020 expended Medicaid resulting in adults ages 18 to 64 years old being more likely to be insured Extend Telehealth Services: Telehealth can be used to provide remote access to physicians to patients that are in small or rural communities Invest in Mobile Clinic: Alternative treatment sites would combat the geographic barriers patients may face Educate about Health Care Sites: Educating patients on the different types of care provided by primary care, urgent care, and emergency rooms Improve Cultural Responsiveness: Training staff to reduce implicit bias and educating them on cultural competency will help all patients feel so comfortable in healthcare settings

Chronically Ill and Disabled: Patients who suffer from chronic diseases are at more risk for poor health outcomes compared to healthy individuals. They also have a higher expense Low Income/Homeless: Patients who have a low income are less likely to have coverage and have interaction with proper healthcare Certain Geographical Communities: Patients living in rural areas have less access to healthcare LGBTQ+ Community: 1 in 5 members of the LGBTQ reported avoiding seeking medical care because of fear of discrimination Very Young and Very Old: This is a lack of adequate pediatric research and older adults don't always get the best healthcare recommended for them

Professional Opinion The ultimate goal is to not only provide everyone with healthcare but the most cost-efficient, high-quality, ad culturally proficient care. In order to achieve this I think the first step would be to lower costs by expanding insurance. Then investing in additional mobile clinics and encouraging healthcare facilities to provide telehealth.

Finally, educating providers on how they can be culturally compliant and patients on where and how to receive the best care.

-P Macoit

Health Education Keagan Smith, PharmD student and BSPS candidate

Overview Health education isn't just about what people learn growing up about their health, it also includes the education recieved throughout life including higher education such as college. This side of health disparities is often not thought of when discussing my topic but, is arguably the most important to discuss.

Statistics and Facts Adults with higher educational attainment live healthier and longer lives compared to their less educated peers.As seen on the chart, health disparites affect those with less education more.

Overall, increasing health education in class rooms is an effective way to increase health and life span according to the CDC.

Conclusion Someone with less education will be in poorer health than someone with higher education. Health education should be the first subject taught in schools, this will lead to a healthier nation and world. ~ K. Smith

Eleana Madren | PharmD Student & BSPS Candidate

Socioeconomic Status A person's position in the social hierarchy, as defined by a combination of social and economic elements, is referred to as their socioeconomic status (SES).¹

Categories SES Is normally broken down Into 3 categories:

Low generally associated with lower-class

Medium generally associated with middle-class

High generally associated with upper-class

Contributing Factors Financial Security Education Attainment Occupation Community Safety Social Support

Why Do We Care?

There is more than enough evidence to show that SES is a global issue connected to a number of risk factors for illness and death. When compared to people with greater socioeconomic status, those with lower socioeconomic status usually have limited access to financial, educational, social, and health resources. Smoking, a sedentary lifestyle, a bad diet, and obesity have all been linked to cancer, heart disease, stroke, and diabetes, as well as mental health Issues such as anxiety, depression, and schizophrenia Those with low SES have been found to have more of these risk factors than people with higher SES.²

3

Potential Solutions The key to overcome the effects of socioeconomic deprivation is to reduce poverty, improve education, and provide safe conditions at home, at school, and at work.²

Professional Opinion: SES has an impact on many aspects of our functioning, such as our physical and mental health. Our society is ultimately impacted by low SES and its implications, including reduced educational achievement, poverty, and poor health. The first step In solving the problem Is recognition of the factors contributing to the Issue. When we can fully address the individual contributing factors head-on and provide solutions, I think that the population as a whole will be much happier and healthier.

-E.Madren

References Access to Healthcare: 1. Kimmel, A. D., & Arnett, D. K. (2020). Five Vulnerable Populations in Healthcare. The American Journal of Managed Care, 26(1), e20-e22. doi: 10.37765/ajmc.2020.42790 2. nsigths.omnia-health.com. (2021). The Importance of Accessible and Sustainable Healthcare. Retrieved from https://insights.omnia-health.com/management/importance-accessible-and-sustainablehealthcare 3. Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical care, 19(2), 127-140. doi: 10.1097/00005650-198102000-00001 4. Kaiser Family Foundation. (2021). Key Facts about the Uninsured Population. Retrieved from https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/ Rural Vs Urban Populations: 1. Centers for Disease Control and Prevention (CDC). (2021). National Center for Health Statistics.

Retrieved from https://www.cdc.gov/nchs/data/databriefs/db417.pdf 2. University of Minnesota Rural Health Research Center. (2019). Access to Specialty Care in Rural and Urban Community Health Centers. Retrieved from https://rhrc.umn.edu/wpcontent/uploads/2019/12/UMN-Access-to-Specialty-Care_12.4.pdf 3. Basu S, Berkowitz SA, Phillips RL, Bitton A, Landon BE, Phillips RS. (2019). Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015. JAMA Intern Med. 179(4), 506-514. doi: 10.1001/jamainternmed.2018.7624. PMID: 30776056; PMCID: PMC6450307.

4. Rural Public Health - NRHA. www.ruralhealth.us. https://www.ruralhealth.us/NRHA/media/Emerge_NRHA/Advocacy/Policy%20documents/NRHARural-Public-Health-Policy-Brief-2022.pdf 5. Flaskerud JH, DeLilly CR. Social determinants of health status. Issues Ment Health Nurs. 2012 Jul;33(7):494-7. doi: 10.3109/01612840.2012.662581. PMID: 22757603; PMCID: PMC3710744.

6. ‌Summary Health Statistics. Published 2018. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2018_SHS_Table_P-1.pdf Health Education 1. Centers for Disease Control and Prevention (CDC).(2023). Health Education. Retrieved from https://www.cdc.gov/healthyyouth/health-education/index.htm.

2. Science Direct. (2021). Health Education and Health Promotion. Retrieved from https://www.sciencedirect.com/science/article/pii/B9780123739605000095.

Socioeconomic Status: 1. American Psychological Association. Socioeconomic status (no date). Available at: https://www.apa.org/topics/socioeconomic-status/ (Accessed: April 4, 2023).

2. National Cancer Institute. NCI Dictionary of Cancer terms (no date). Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/socioeconomic-status (Accessed: April 4, 2023).

3. Kim, S.Y. et al. (2019) 'Stratified analysis of disease complexity by socioeconomic status', BMC Public Health, 19(1), p. 386. doi: 10.1186/s12889-019-6718-5. Available at: https://www.researchgate.net/figure/Stratified-analysis-of-disease-complexity-by-socioeconomicstatus-N-1619-SES_fig1_358507496 (Accessed: April 4, 2023).

Health Education SPRING 2023

How health education is taught is essential for societal development. According to the CDC, school-based health education help adolescents acquire functional health knowledge, strengthen attitudes and beliefs, and practice the skills needed to adopt and maintain healthy behaviors. 1 Insufficient health education can result in poorer mental, physical, and emotional health, reinforcing that health education is critical for individuals to live a healthy lifestyle. Benefits of a proper health education include preventing sickness/disease, developing critical thinking and problem-solving skills, and making informed decisions.

WHAT IS HEALTH EDUCATION? Health education is a social science that draws from the biological, environmental, psychological, physical sciences to promote health. The goal is to prevent disease, disability and premature death through education-driven voluntary behavior change activities. 2

https://www.ucsfhealth.org/education/diabetes-in-pregnancy

Sexual Health Education Pasha Pourian | BSPS Candidate Background While we can all agree that being educated on sex education is important, it's often an uncomfortable topic to teach. Therefore, not a lot of institutions emphasize it. Various social stigmas and curriculums determine the length and depth of sex education covered, which usually isn't adequate. Therefore, individuals around the world should be equally and sufficiently educated about sexual health in this intercultural and global issue.

Who needs sex education?

Ideally, everyone should be taught about all forms of sexual education from adolescence to adulthood. Understanding not only your own sex but how everyone's bodies work can be beneficial in the long run, especially if health complications occur later on in life, regardless of the differences between environments and societal norms.

What's the best age to teach sex education?

Most Western classes teach sex education for only a couple class periods, which isn't enough time for students to learn and absorb that information.

According to Sex Ed Solutions, potential solutions have been to increase policies regarding teaching various sexual education topics, but not all states 3 have the same level of standards.

What has society done with sex education?

There are many countries that skip over sex education because it's a taboo or difficult subject to teach. However, this can lead to more unsafe sex practices, confusion, and increase the rate of getting sexually transmitted diseases.

4

40%

Individuals who are taught about sex education have a 40% higher chance 5 of getting tested for an STI.

51%

Individuals who are taught about sex education have a 51% lower chance of 5 getting an STI.

Professional Opinion In my personal and professional opinion, sex education should be taught at least once a year in school, with additional education being required in college. Additionally, various schools should consider having outside or online resources for students so they can learn about the topic more critically. ~Pasha Pourian https://www.statista.com/chart/18825/state-laws-sex-ed-in-the-us/

Nutrition Education

ANNA KENDRICK BSPS CANDIDATE Triple Burden of Malnutrition According to Beaudreault, there are...

About Nutrtition Education Nutrition education is defined as a set of learning opportunities designed to motivate people to freely 6 adopt healthy eating practices and other behaviors.

Traditionally, nutrition education courses have been taught to children and teens in school or via social Topics: media. Programs tend to Diet focus on eating guidelines, Physical Activity menu approaches, tracking Sleep Habits methods.

Behavioral habits Challenges with Teaching Nutrition Differences of genetic background, environment, and dietary patterns between cultures Lack of research on the correlation between nutritional courses and health statistics around the world Despite required nutritional courses, some countries still suffer high rates of malnutrition Example Below are examples of food triangles from multiple countries. Each country prioritizes different foods groups. There is little data available on how nutrition education in countries impact their health statisitcs.

BELGIUM

CHINA

821 Million people who are underweight

1.9 Billion people who are overweight

2 Billion people who are

micronutrient deficienct

SOLUTIONS Policies that are accessible to those with less access to traditional education Online nutritional classes Focus on data collection and analysis PERSONAL OPINION While each country should develop its own nutrition courses, there is a need for a global standard to provide information and statistics to everyone. Suggested diets should include variations based on cultural background. ~ A Kendrick UNITED STATES

https://www.treehugger.com/what-food-pyramids-around-world-4868722

Anu Cherukara BSPS Candidate

Health Education

Healthcare Professional Training ABOUT HEALTHCARE PROFESSIONAL TRAINING (HPT) HPT education refers to any mix of learning opportunities standardized to instruct healthcare professionals, intended to help individuals and societies better their health, whether it be increasing awareness or changing attitudes.

8 at a compound annual growth rate of The global healthcare education market is forecasted to grow 9.8% from 2022 to 2027 and worth 140.2 billion USD by 2027.

HPT plays a role in shaping several aspects of health education because the way healthcare professionals (HPs) provide care to their patients influences HPs patients' decision-making, choices, and perception of their health that also impacts how they share the knowledge they obtain towards their loved ones or others, which ultimately affects overall public health.

WHO OR WHAT GLOBAL/INTERCULTURAL IS AFFECTED? 9 CHALLENGES Current/future HPs Shortage/Lack of trainers Lack of talent development within healthcare systems Limited resources and/or guidelines Insufficient human resources Poor workforce management and leadership Differences in training programs

Patients and their families Workplace/Employers Communities and societies

SOLUTIONS Emphasis on self-awareness Incorporating health literacy in training programs Implement standard educational content such as case studies, simulations, etc.

Proper training in intercultural competence Assessments during training

https://sph.umich.edu/news/2022posts/images/bo a-health-equity-illustration-family-doctor-01.png

PROFESSIONAL/PERSONAL OPINION DISCUSSION The current prediction of the global healthcare education solutions market is expected to account for 14870.44 million USD. 10Based on this, I believe current global challenges can be addressed by standardizing various learning opportunities to form general guidelines for healthcare professional trainers that can be practiced globally. ~ A Cherukara https://www.databridgemarketresearch.com/reports/global-healthcare-educationsolutions-market

Alvin Wang BSPS Candidate

Health Education DRUG ABUSE

Background Information Drug abuse is a growing issue across the United States, as well as internationally. Drug/substance abuse programs such as D.A.R.E. are only present in developed countries, and substance abuse education varies significantly across the globe. More measures must be taken to properly educate the public on the dangers of drug and substance abuse.

Discussion + Personal Opinion Who is affected by drug abuse?

How is this a global/intercultural problem?

In America, over 20 million over age 12 have an addiction.

100 people die of an overdose everyday. This rate has tripled in the past 20 years, indicating a progressively worsening issue.

Drug use is responsible for 11.8 million deaths each year, with 350,000 dying from overdose. More than half of those who die from overdose are younger than 11 50. Over 2% of the world population has a drug addiction, and the number continues to increase.

What are some solutions?

Personal Opinion

Continued development of drug abuse rehabilitation programs such as NIDA can help contribute to a solution. Programs such as D.A.R.E. continue to educate the youth on the dangers of drug and substance abuse, and plan to 12 expand internationally.

We should continue to advance drug abuse education programs with a focus on educating the youth to stop early addiction and potentially prevent a life-long issue. - A. Wang

References 1. Profiles results. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/data/profiles/results.htm. Published August 22, 2022. Accessed February 21, 2023.

2. Health Education and promotion. Kent State University. https://www.kent.edu/ehhs/hs/hedp#:~:text=Health%20education%20is%20a%20social,driven%20voluntary %20behavior%20change%20activities. Accessed March 26, 2023.

3. Sex Ed Solutions. https://www.sexedsolutions.org/. Accessed March 28, 2023.

4. What’s the State of Sex Education In the U.S.? Planned Parenthood. https://www.plannedparenthood.org/learn/for-educators/whats-state-sex-education-us. Accessed February 21, 2023.

5. Craig-Kuhn MC, Schmidt N, Lederer A, et al. Sex education and STI fatalism, testing and infection among young African American men who have sex with women. Sex education. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411927/#:~:text=Those%20who%20received%20sex%20ed ucation,Chlamydia%20screening%20(44.1%25%20vs. Published September 9, 2020. Accessed March 28, 2023.

6. Nutrition education. DSHS. https://www.dshs.wa.gov/altsa/program-services/nutritioneducation#:~:text=Nutrition%20education%20can%20be%20defined,nutrition%20services%20to%20older %20persons. Accessed February 21, 2023.

7. Beaudreault AR. Nutrition + prosperity. CSIS. https://www.csis.org/analysis/nutrition-prosperity. Accessed March 28, 2023.

8. ltd MDF. Global Healthcare Education Market Size, trends, growth: 2022 to 2027. Market Data Forecast. https://www.marketdataforecast.com/market-reports/global-healthcare-education-market Published January 2022. Accessed February 21, 2023.

9. Evans T, Araujo EC, Herbst CH, Pannenborg O. Wish health professional education report interprofessional.global. Addressing the Challenges of Health Professional Education. https://interprofessional.global/wp-content/uploads/2019/11/WISH-2016-Health-Professional-EducationReport-ADDRESSING-THE-CHALLENGES-OF-HEALTH-PROFESSIONAL-EDUCATION-OPPORTUNITIES-TOACCELERATE-PROGRESS-TOWARDS-UNIVERSAL-HEALTH-COVERAGE.pdf. Published 2016. Accessed February 21, 2023.

10. Data Bridge Market Research. Healthcare Education Solutions Market to surge USD 14870.44 million by 2029, share, size, key growth drivers, future trends, industry value and applications overview.

GlobeNewswire News Room. https://www.globenewswire.com/en/newsrelease/2022/09/21/2520529/0/en/Healthcare-Education-Solutions-Market-to-Surge-USD-14870-44-Millionby-2029-Share-Size-Key-Growth-Drivers-Future-Trends-Industry-Value-and-Applications-Overview.html.

Published September 21, 2022. Accessed April 5, 2023.

11.BM; CRRCAMJ. The effectiveness of Drug Abuse Resistance Education (project dare): 5-year follow-up results. Preventive medicine. https://pubmed.ncbi.nlm.nih.gov/8781009/. Accessed March 28, 2023.

12. National Institute on Drug Abuse (NIDA). National Institutes of Health. https://www.nih.gov/aboutnih/what-we-do/nih-almanac/national-institute-drug-abuse-nida. Published March 3, 2022. Accessed March 28, 2023.

Immunizations Spring 2023 Mitchell Briggs BSPS Candidate

Ethan Miyake BSPS Student

Grace Huang BSPS Student

Giovani Teran BSPS Student

Immunizations are an important aspect of healthcare! They help lower the incidence of preventable diseases and keep communities safe from potentially disastrous outbreaks and epidemics!

Tetsekela Anyiam-Osigwe. Vaccines Work. https://www.gavi.org/vaccineswork/covid-19-vaccines-are-now-approved-some-countries-what-willit-take-approve-them. February 2 2021. March 22 2023.

Topics discussed in this monograph include: ● Types of immunizations and how they work ● Selection process for immunizations, specifically with the flu vaccine ● Discourse on how to handle immunization of the population ● Disparities in access to immunizations

Types of Vaccines: Transportation and Storage Grace, BSPS Student Several types of vaccines are said to be used for immunization. According to the Centers for Disease Control and Prevention (CDC, 2022), these comprise non-live vaccines, attenuated and live vaccines, subunit vaccines, conjugate vaccines, and toxoid vaccines. Attenuated, live vaccines contain weakened pathogens and target bacteria and viruses (CDC, 2022). Non-live vaccines have the same purpose but contain a killed or inactive pathogen (CDC, 2022). Toxoid vaccines contained weakened toxins to combat the harmful compounds produced by bacteria in the host (CDC, 2022). Subunit vaccines contain a part of the pathogen while conjugate vaccines target bacteria with antigens (CDC, 2022).

Additionally, as per the Department of Health and Human Services (HHS, 2022), other types of vaccines that can be used are messenger RNA (mRNA) vaccines and viral vector vaccines. mRNA vaccines facilitate protein production to trigger immune responses while viral vector vaccines rely on modified viruses or vectors to combat diseases such as flu (HHS, 2022).

Vaccines must be stored with a closed lid and with their original packaging. They must be refrigerated, at a temperature of 2 to 8℃, while some vaccines such as the MMR and varicella vaccines need -15 to -50℃ storage. They must also be kept away from light and must be transported using portable refrigerators along with devices for temperature measurement (CDC, 2021; Pambudi et al., 2022).

Professional Opinion: I feel that storage and transportation of vaccines can be a major concern for areas with limited infrastructure, resources, and staff. This can especially be the case in hospitals located in rural or remote areas or in developing nations, which lack the funds or facilities required to store and transport vaccines. I thus feel that governments should identify such organizations and support them accordingly. I also feel that some individuals may be an intolerance or allergic to vaccines. In such cases, medical researchers and practitioners must develop and inject alternative vaccine preparations. ~ G Huang

References: CDC. (2021). Vaccine Storage and Handling. Centers for Disease Control and Prevention. Retrieved March 28, 2023, from https://www.cdc.gov/vaccines/pubs/pinkbook/vac-storage.html CDC. (2022). Understanding How Vaccines Work. Centers for Disease Control and Prevention. Retrieved 28 March, 2023, from https://www.cdc.gov/vaccines/hcp/conversations/understanding-vacc-work.html HHS. (2022). Vaccine Types. U.S. Department of Health and Human Services. Retrieved 28 March, 2023, from https://www.hhs.gov/immunization/basics/types/index.html Pambudi, N. A., Sarifudin, A., Gandidi, I. M., & Romadhon, R. (2022). Vaccine cold chain management and cold storage technology to address the challenges of vaccination programs. Energy Reports, 8, 955-972. https://doi.org/10.1016/j.egyr.2021.12.039.

Seasonal Flu Vaccine Mitchell Briggs BSPS Candidate

Flu: A Global Pandemic The flu virus is a constant threat to public health and the lives of at risk populations that transcends borders. The Global Influenza Surveillance and Response System (GISRS) is a multinational effort that has participants in all 125 of the World Health Organization member states that contribute to the final immunization product, showing the global burden of the flu.

Blue Cross Blue Shield. Why Flu Shots Matter.https://www.bcbs.com/the-health-of-america/articles/why-flu-shots-matter.

Published December 3, 2018. Accessed March 22 2023.

Background The flu is a family of viruses that are constantly mutating with many new strains coming out every year. One only need look at the devastation caused by the particularly virulent outbreaks such as the swine flu or the spanish flu to see how impactful these viruses can be to our society if not effectively managed. Thus the manufacture and distribution of the seasonal flu vaccine is an essential component of modern healthcare.

Influenza.

American Lung Association. https://www.l ung.org/lunghealth-disea ses/lung-dise ase-lookup/i nfluenza.

Unknown publication date.

Accessed March 22 2023

Who is at risk?

The flu is a virus that anyone could contract, but the National Foundation for Infectious Diseases has identified certain risk factors that make you more susceptible to contracting the disease and having more serious periods of illness. Essentially any stressor on your body will make you more susceptible. The young, the old (greater than 65), pregnant or recently pregnant, those with chronic health conditions, and certain racial groups are all at increased risk for flu (They did not make a distinction for why certain racial groups are at more risk, as it is somewhat messy to unravel. So it is unclear if this is due to sociological or biological factors).

Current Efforts A yearly conference held by the GISRS decides on the final form that the seasonal flu vaccine will take using data collected by many centers internationally. The vaccine includes 4 strains: H1, H3, B/yamagata, and B VIctoria. These are selected based on many factors including infectivity, viral resistance, and lethality. These are then produced over the course of months to create a large enough stock for the season.

Professional opinion: I feel that the flu vaccine is an oft overlooked aspect of healthcare globally due to the frequency of the various epidemics, but there are still a staggering number of deaths each year that implicate the flu and I feel that we should not become complacent both in preventing flu and in perfecting our policies and technology to minimize the impact that this has on the public. ~ M. Briggs

Regulation of Vaccines Giovani Teran BSPS Student

Background: Covid-19 not only brought lockdowns across many countries, it incited a fierce debate regarding whether a vaccine should be something which is mandated or not. Making this an intercultural issue which can extend further than Covid itself. The two sides to this debate revolved around not trusting a new vaccine, while the other looked at a method of fighting the pandemic. This debate can be applied to not only the COVID-19 vaccine but all other types of vaccine. https://www.fda.gov/food/food-safety-during-emergencies/f ood-safety-and-coronavirus-disease-2019-covid-19

What efforts have been made: As of now, most vaccines regulation is left to state legislation. These vaccines are all taken by children K-12 and even young adults in universities. It is important to also note that there are exemptions individuals can exercise which allow them to not take these vaccines. These exemptions vary from state to state but are mainly focused around medical and religious matters with few allowing personal reasons.

Once an individual gets older vaccines tend to lean more towards a recommendation format rather than a requirement. https://www.vdh.virginia.gov/coronavirus/get-the-latest-g uidance/k-12-education-and-child-care/

Who it affects: This current method of regulation is one which focuses heavily on the youth. But clearly the rise of a pandemic required the need for a new vaccine to combat this new disease, which affected people of all ages and not only the youth.

Thus, this type of issue is one which affects everyone of all ages. It is also important to mention that this type of regulations in place also affects older individuals simply by having a system which recommends rather than requires vaccines.

Personal Opinion: I personally think that some things should stay the way they are and some things should change. When it comes to the regulation of vaccines focused around children it is key to keep this the way it is as it helps prevent serious diseases from being spread and harming the youth. Although, when it comes to a new disease that has as great as an impact as COVID-19 did, regulation should be set in place where a vaccine, which is safe and which the is to combat the pandemic/outbreak of such disease. This regulation should be aimed at aiding the general population, with certain exemptions which are centered around medical or religious needs. ~ G. Teran

Vaccine Equity Ethan Miyake - BSPS Stuent

Vaccine equity refers to the ensural of universal access to vaccinations/immunizations. Anyone who wants a vaccine should be able to receive it, despite outside factors which may get in the way. These factors, including societal, economical, and geographical, affect whether communities have equal access.

Access to vaccines is important because they provide immunity towards vaccine-preventable diseases, such as measles, the flu, chickenpox, etc. According to the CDC, 4 million deaths are prevented each year because of childhood vaccination.

Equal access to vaccines is not a reality for many people. It is a prominent global health issue, as many countries/communities do not have the same accessibility as others. A large portion of people who experience inequity are in the countries of Central Africa. With weaker health care systems comes less means for vaccine storage/transportation, less vaccine coverage, and vaccine hesitancy. The World Health Organization states that 1 in 5 African children do not receive the necessary/basic vaccines. This leads to over half a million children deaths which could have been prevented with adequate vaccination.

https://www.path.org/articles/lining-up-fo r-hopeand-a-meningitis-vaccine/

https://oecd-development-matte rs.org/2021/04/12/for-greater-va ccine-equity-first-fix-these-misco nceptions/

Efforts to mitigate inequity include non-profit organizations and importantly vaccination campaigns. An example of a notable campaign is the MenAfriVac campaign. In the late 1900’s, a meningitis outbreak occurred in Central Africa every 5-10 years, where it would reach more than 250,000 cases and 25,000 deaths. The MenAfriVac vaccine was developed as a response and costs less than $0.50. Once the campaigns started, it was administered enough to nearly eliminate the disease and prevent more than 1 million meningitis cases. What once was a deadly disease killing tens of thousands at a time. is now nearly completely eradicated. This vaccination campaign shows how beneficial campaigns can be and how many lives they save.

Professional opinion: Everyone deserves to be immunized against a harmful disease, so vaccine inequity is very important to address and deserves the efforts which combat it. It is satisfying to see efforts and campaigns starting and actually having a positive impact. However, many people choose not to receive certain vaccinations. Vaccine equity is about access for only those who are looking for them, individuals who do not want a vaccine should have their opinions E. Miyake respected. -

Citations Are you at risk for serious flu-related complications? National Foundation for Infectious Diseases. https://www.nfid.org/infectious-diseases/are-you-at-risk-for-flu-and-related-complications/#:~:text=Anyone%20can%20get%20sick%2 0with,up%20to%20two%20weeks%20postpartum). Published September 15, 2022. Accessed March 22, 2023.

CDC's World Health Organization (WHO) collaborating center for surveillance, Epidemiology and control of influenza. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/weekly/who-collaboration.htm?web=1&wdLOR=cC8533F22-6481-4D31-9C65-4A67142D8063. Published November 17, 2021. Accessed March 22, 2023.

Commissioner Oof the. FDA is working on developing new technologies for making flu vaccines. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/fdas-critical-role-ensuring-supply-influenza-vaccine. Accessed March 22, 2023.

Covid-19 vaccines are now approved in some countries. what will it take to approve them for the rest of the world? Gavi, the Vaccine Alliance. https://www.gavi.org/vaccineswork/covid-19-vaccines-are-now-approved-some-countries-what-will-it-take-approve-them.

Published June 21, 2021. Accessed March 22, 2023.

Disease burden of flu. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/burden/index.html#:~:text=CDC%20estimates%20that%20flu%20has,annually%20between%202010 %20and%202020. Published October 4, 2022. Accessed March 22, 2023.

Estimating disease burden of influenza. World Health Organization. https://www.who.int/europe/activities/estimating-disease-burden-of-influenza. Accessed March 22, 2023.

Global Influenza Surveillance and Response System (GISRS). World Health Organization. https://www.who.int/initiatives/global-influenza-surveillance-and-response-system. Accessed March 22, 2023.

How influenza (flu) vaccines are made. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/prevent/how-fluvaccine-made.htm. Published November 3, 2022. Accessed March 22, 2023.

Influenza vaccine production and design. National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/influenza-vaccine-production-and-design. Accessed March 22, 2023.

National Influenza Centres. World Health Organization. https://www.who.int/initiatives/global-influenza-surveillance-and-response-system/national-influenza-centres. Accessed March 22, 2023.

Selecting viruses for the seasonal influenza vaccine. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/prevent/vaccine-selection.htm. Published November 3, 2022. Accessed March 22, 2023.

WHO collaboration centers. World Health Organization. https://www.who.int/initiatives/global-influenza-surveillance-and-response-system/who-collaboration-center-erl?CxitPEOtTWx0xUd5T JdODSXcnyJqzYd7FZeivpn7xcI=. Accessed March 22, 2023. influenza. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/influenza. Unknown publication date. Accessed March 22 2023 Blue Cross Blue Shield. Why Flu Shots Matter.https://www.bcbs.com/the-health-of-america/articles/why-flu-shots-matter. Published December 3, 2018. Accessed March 22 2023.

Viviani S. Efficacy and effectiveness of the Meningococcal Conjugate Group A vaccine Menafrivac® in preventing recurrent meningitis epidemics in Sub-Saharan africa. Vaccines. 2022;10(4):617. doi:10.3390/vaccines10040617 Eliminating meningitis across Africa's meningitis belt. Eliminating Meningitis Across Africa's Meningitis Belt. http://millionssaved.cgdev.org/case-studies/eliminating-meningitis-across-africas-meningitis-belt. Accessed March 27, 2023.

Developer. Lessons from one of the world's most successful, yet unusual, covid-19 vaccination campaigns. O'Neill. https://oneill.law.georgetown.edu/lessons-from-one-of-the-worlds-most-successful-yet-unusual-covid-19-vaccination-campaigns/.

Published June 2, 2022. Accessed March 27, 2023.

Immunization. World Health Organization. https://www.afro.who.int/health-topics/immunization. Accessed March 27, 2023.

Infectious Diseases Spring 2023

Infectious diseases are illnesses caused by pathogens that enter the body including bacteria, viruses, fungi or parasites. These diseases are not limited to a certain group of people and can affect anyone and everyone. It is a global health concern as new diseases emerge and drug resistance continues to increase. Infectious diseases can be passed person to person, from animals or insects, or even from environmental factors like water and soil. Each disease requires individualized prevention/treatment methods and requires worldwide intervention to minimize the impact of these disease. In this monograph the infectious diseases covered are Ebola, HIV/AIDS, flu/common cold, and Malaria. Ebola is transmitted from bodily fluids most commonly found in West Africa. HIV/AIDS is sexually transmitted and affects nearly 40 million people worldwide each year. The flu/common cold is a respiratory illness caused by viruses that affects people of all ages, genders and backgrounds. Malaria is transmitted by infected mosquitos and affects people in tropical and subtropical climates.

Ebola Yoonseo Ko - BSPS student

Background Ebola is a rare and deadly disease that is transmitted through direct contact with the bodily fluids of an infected person or animal. Some of the symptoms are fever, muscle pain, sore throat, vomiting, diarrhea, and rashes. Ebola has a high death rate that varies from 25 percent to 90 percent.

Ebola as global health issue : West African Ebola Virus Epidemic Currently, over 36000 reported cases and more than 15000 deaths in the world. From 2014 to 2016, there was an Ebola outbreak in West Africa. A total of 28,616 cases and 11,310 deaths were reported in guinea, Liberia, and Sierra Leone. The outbreak was challenging due to their weak healthcare systems, limited resources, and poor infrastructure.

2014 ebola outbreak in west africa epidemic curves. Centers for Disease Control and Prevention. https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/cumulative-cases-graphs.html. Published April 3, 2019.

Global response to 2014-2016 Ebola outbreaks The Ebola virus outbreak in West Africa in 20142016 highlighted the urgent need for a global response to infectious disease outbreak.

Effective surveillance system Trained healthcare workers in West Africa Contact tracing Interviewing people who may have been in contact with Ebola patients to see if they have symptoms Research and development of new treatment

Western African ebola virus epidemic. Wikipedia. https://en.wikipedia.org/wiki/Western_African_Ebola_virus_epidemic.

Prevention and Treatment Some of the prevention methods are avoiding contact with the blood and body fluids of people who are infected with Ebola. Two monoclonal antibodies,Inmazeb and Ebanga,were approved for the treatment of Ebolavirus infection in adults and children by the US Food and Drug Administration in late 2020.

Vaccines The Ervebo vaccine had been developed and administrated to more than 350,000 people in Guinea in the 2018-2020

Professional opinion Since researchers have developed a vaccine and monoclonal antibodies that increases survival rate for Ebola, I believe there have been significant improvements in treating Ebola virus compared to the past outbreak. -Y Ko

Background HIV is a deadly disease HIV/AIDS that is sexually Vedang Revankar BSPS Student transmitted. It is caused by a virus that attacks the body's immune system. This can cause the person to be more susceptible to bacterial and viral infections like tuberculosis or the common cold. AIDS is a more deadlier version since the immune system is even more badly damaged. It has a higher viral load and can easily transmit to others. https://www.statista.com/chart/18713/estimated-

Who is affected The disease is transmitted sexually so many sex workers and people who take injectable drugs are mostly affected by this.

There is also an increase in infection with homosexual and transgender men.

number-of-aids-related-deaths-worldwide/.

Global Health Issue: In 2021, 38.4 million people have HIV globally (UNAIDS). Although overall HIV infections have been reduced, there are still 1-2 million people per year contracting this disease. AIDS have also reduced but around 650,000 people die each year.

Efforts/ Solutions: In the 1990s-early 2000s, HIV/AIDS was a big issue but there have been advancements to prevent the spread of it. People have been advised to practice safe intercourse by using condoms or setting boundaries with your partner about the disease. People that use injectable needles need to also clean the needle before using it. There have also been drugs that combat HIV. Preexposure Prophylaxis (PrEP) is used to reduce the risk of transmission of HIV. Professional Opinion I think that this disease has been successfully treated since the number of people being exposed to it have decreased. There has been a lot of research to create drugs and preventative measures to decrease transmission. There have also been less deaths compared to the past from this disease. I think there needs to be more programs that bring awareness to the disease which could inform the public on how to handle it safely. -V Revankar

1. CDC. About HIV/AIDS. Centers for Disease Control and Prevention. Published June 1, 2021. https://www.cdc.gov/hiv/basics/whatishiv.html 2. Mayo clinic. HIV/AIDS - Symptoms and causes. Mayo Clinic. Published July 29, 2022 https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524 9..“Global HIV & AIDS Statistics - Fact Sheet.” UNAIDS, https://www.unaids.org/en/resources/fact-sheet.

10. .Zandt, Florian, and Felix Richter. “Infographic: HIV/AIDS Deaths Continue to Decline.” Statista Infographics, 30 Nov. 2021, https://www.statista.com/chart/18713/estimated-number-of-aids-relateddeaths-worldwide/.

Influenza, commonly known as the flu, and the common cold are both respiratory illnesses caused by viruses. The flu is caused by the influenza virus, while the common cold can be caused by multiple viruses, such as rhinoviruses and coronaviruses. Both illness are spread through respiratory droplets when an infected person coughs or sneezes, and they are most commonly contracted during the winter months. Vaccines are available to prevent the flu, but there is no cure for either illness, and treatment focuses on relieving symptoms.

The flu and the common cold are global health issues that affect millions of people each year. Both illnesses are highly contagious and can spread rapidly, making them a significant public health concern. Influenza is responsible for causing seasonal epidemics around the world, with an estimated 290,000 to 650,000 deaths annually. The common cold is a https://www.cdc.gov/flu/symptoms/coldflu.htm long term cause of doctor's visits and missed days of work or school, resulting in a significant economic impact. Effective prevention and control measures, such as vaccination, hand hygiene, and social distancing, are essential in reducing the spread of these illnesses and mitigating their impact on global health.

Both the flu and the common cold can affect people of all ages, genders, and backgrounds. However, certain populations may be at higher risk of complications from these illnesses. For instance, young children, the elderly, pregnant women, and individuals with underlying health conditions such as asthma, diabetes, or heart disease are more susceptible to severe illness from the flu and the common cold. In addition, healthcare workers and individuals who live or work in crowded settings, such as schools or nursing homes, may be at higher risk of contracting and spreading these viruses.

Efforts have been made to prevent and treat the flu and the common cold, including the development of vaccines, antiviral medications, and supportive care. Vaccines are available for the flu and can help prevent illness and reduce the severity of symptoms. Antiviral medications, such as Tamiflu, can be used to treat the flu and shorten its duration. Supportive care, such as getting plenty of rest, staying hydrated, and using over-thecounter medications to relieve symptoms, can also help manage the flu and the common cold.

https://www.cdc.gov/handwashing/index.html

Professional/Personal Opinion: To further prevent and treat these illnesses, it is important to continue developing new vaccines and medications that target multiple strains of the viruses, including emerging strains. In addition, public health measures such as promoting hand hygiene and social distancing, can help reduce the spread of these illnesses. Finally, education campaigns to raise awareness about the importance of vaccination and early treatment can help encourage individuals to protect themselves and others from these common respiratory infections. - Z Xianyu How to wash hands properly?

Malaria Faith Eriks BSPS Student Background: A disease transmitted by infected mosquitos. It is commonly found in tropical and subtropical areas of the world where there is a high mosquito population. It can be transmitted person to person as well as through contaminated blood transfusions and needles.

Who Is Affected: Malaria is not a tropical disease, but a disease that has been eradicated everywhere except the tropics. Due to less social and economic developments, these low income tropical areas are disproportionately affected. Nearly 96% of all deaths related to malaria were found on the African continent and the group with nearly half the deaths coming from children five and under.

Global Health Issue: Historically malaria affected people all across the globe, but in the last few generations it has successfully been eradicated from many regions in the world. Unfortunately a quarter of the world's surface area are still at risk for this infectious disease. In 2019 it was estimated that there were 229 million cases of malaria and 409,000 deaths from malaria.

Malaria incidence, 2020 Number of New Cases per 1000 Population at Risk

Number of Deaths from Malaria, 2019

https://ourworldindata.org/malaria.

https://ourworldindata.org/malaria.

Efforts/Solutions: The current efforts for malaria revolve around disease control. The goal is to block the transmission and treat the disease soon after it has been diagnosed. The single most effective prevention method was insecticide-treated bed nets, which kills the mosquitos. So not only does it protect the people sleeping under them, it can also protect entire communities if there is enough nets used.

Professional/Personal Opinion: I think there is a lot of good progress to help control the disease, but I think more resources should be allocated to prevent and treat this infectious disease. We have seen that this disease can be eradicated with proper funding and public health measures. Regardless of the area affected, this is a global health problem. These poorer tropical areas need support from the well developed countries who have the resources and the experience to eliminate malaria. ~F Eriks

Malaria. Our World in Data. https://ourworldindata.org/malaria. Published November 12, 2019. Accessed February 14, 2023.

References 1. CDC. About HIV/AIDS. Centers for Disease Control and Prevention. Published June 1, 2021. https://www.cdc.gov/hiv/basics/whatishiv.html

2. Mayo clinic. HIV/AIDS - Symptoms and causes. Mayo Clinic. Published July 29, 2022 https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524

3. Ebola virus disease. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease . Accessed February 14, 2023.

5. Eccles R. Understanding the symptoms of the common cold and influenza. Lancet Infect Dis. 2005;5(11):718-725. doi:10.1016/S1473-3099(05)70270-X

6. Home - PMC - NCBI. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/.

Accessed February 23, 2023.

7.Reasons for the increase in emerging and re-emerging viral infectious diseases. Microbes and infection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7110580/#:~:text=These%20factors%20are%20complex%20but, systematically%20reviewed%20in%20this%20article. Published March 2006. Accessed February 23, 2023.

8.Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands.external icon Int J Environ Res Public Health. 2011;8(1):97-104.

9..“Global HIV & AIDS Statistics - Fact Sheet.” UNAIDS, https://www.unaids.org/en/resources/fact-sheet.

10. .Zandt, Florian, and Felix Richter. “Infographic: HIV/AIDS Deaths Continue to Decline.” Statista Infographics, 30 Nov. 2021, https://www.statista.com/chart/18713/estimated-number-of-aids-related-deaths-worldwide/.

Infec&ous diseases: plague

Zachary Rust, BSPS candidate Spring 2023 Yersinia pes*s is a type of bacteria that causes the infec&ous disease referred to as plague.1 The bacteria associated with plague are par&cularly of interest due to its high levels of virulence.2 Plague comes in several forms such as pneumonic plague (infec&on involving the lungs), bubonic plague (infec&on caused by a break in skin and also the most common form), or sep&cemic plague (infec&on involving a person’s blood).1 Plague is a vector-born disease, arising from fleas and these fleas commonly are found on rodent hosts.2 Recent outbreaks of plague make it a modern infec&ous disease to be aware of once again, ci&ng 2017 and 2021 outbreaks of plague in Madagascar as examples.3 Plague has been a recurring issue throughout history with several global pandemics occurring in three dis&nct &me periods.4 Considering the current state of interna&onal trade and the known virulence of the disease, another pandemic of plague could occur at any given &me without warning (as modeled by the Covid-19 pandemic). In addi&on to this, Yersinia pes*s is an adaptable pathogen, able to infect different species of rodents rela&vely quickly in comparison to other pathogenic bacteria.2 Hinnebusch says that the disease has been ac&vely reported in Vietnam, India, Madagascar, Tanzania, and the Democra&c Republic of the Congo, but the extent of the disease’s prevalence should not be limited to these countries.2 The reservoirs of plague, as stated by Hinnebusch, are “poorly defined”, but are thought to be in rodent popula&ons worldwide.2 In other words, the disease could be of concern to anyone anywhere rod ents are found as the disease arises from the flea vector found on various species of rodents.

As these outbreaks become more common, it is important that the treatments that are proven to be effec&ve to cure the disease are readily available as early treatment (within the first 24 hours of the onset of symptoms) is crucial to preven&ng death.1 An&bio&c regimens that are currently used to treat plague are: streptomycin, gentamicin, tetracyclines, andchloramphenicol.1 Vaccines, a poten&al proac&ve approach for highly suscep&ble communi&es, do not currently exist.1 Personal opinion: Since popula&ons of rodents are generally conceived to be hand in hand with human popula&on, especially in urban communi&es, I believe that the threat of plague outbreaks is more common than most people perceive it to be. Thinking about the threat of the disease in a proac&ve sense, it is my opinion that vaccines could and should be developed against this pathogen given its high l evel of virulence. These vaccines could be deployed to the affected countries when reports arise of a new outbreak to therefore stop the outbreak in its tracks before the disease progresses from epidemic to pandemic. Although a vaccine would be of great value, it is understandable that this would take a large investment and may not be en&rely prac&cal. A more prac&cal approach would be to make sure that there is always a reserve of the medica&ons (streptomycin, gentamicin, tetracyclines, and/or chloramphenicol) used to treat plague set aside. In the hands of an interna&onally- governing health body, quick and effec&ve distribu&on of these medica&ons could get to the necessary loca&ons in prompt order to prevent the spread of this highly virulent disease once reported. ~ Z. Rust

References 1. CDC | Facts About Plague. emergency.cdc.gov. Published February 21, 2019. h`ps://emergency.cdc.gov/agent/plague/factsheet.asp#:~:text=Plague%20is%20an%20infec&o us%20disease 2. Hinnebusch BJ. Plague in the 21st Century: Global Public Health Challenges and Goals. Natl Inst All Infect Dis. NIH. Published online 2010:87-94. doi:h`ps://doi.org/10.1007/978-1-60761-512-5_9 3. Plague - Madagascar. www.who.int. Published October 1, 2021. h`ps://www.who.int/emergencies/diseas e-outbreak-news/item/plague---madagascar 4. Barbieri R, Signoli M, Chevé D, et al. Yersinia pes&s: the Natural History of Plague. Clin Microbiol Rev. 2020;34(1). doi:h`ps://doi.org/10.1128/cmr.00044-19

can you

rust T modern media?

SPRING 2023

Gracie Zhu (BSPS Candidate) Maureen Ma (BSPS Candidate) Timothy Samuel (BSPS Candidate) Tyler Fritsch (BSPS Candidate)

Modern media encompasses things such as social media and other information sharing sources and their impact on people’s understanding of health. Massive steps have been taken within technology that enable new methods of opinion sharing which allows medical information to be more easily available to the public, right or wrong. Staying well informed about the pros and cons will allow you to benefit most from the advantages of the media and guarantee that you don’t fall victim to the many issues that develop from it.

Celebrity & Influencer Impact -Tyler Fritsch, BSPS Candidate

Background With the rise in social media, celebrities and social influencers have more impact on the public than ever before. Their "followers" will blindly listen to them on many different topics no matter what backing the influencer claims to have.

Whether it pertains to supplement usage, fad diets, or even their viewpoints on vaccination, these personalities share their opinions and lead to the potential harm of the people that listen. Celebrities will promote unstudied supplements that can have either no effect or even be harmful to the user, partake in FAD diets that are unhealthy without the proper management (physician care), and share very biased opinions about medical topics that have no real scientific backing. This all can lead to high-risk activities being performed by their followers, and false viewpoints being made about usually safe medical treatments.

Efforts/Solutions Overall, there have been minimal efforts in order to alter the effect of celebrity biased, but this could be due in part to a lack of awareness for the issue. There have been some investigations done to determine the true impact of media perspectives on things such as vaccination, but there have not been great attempts at countering the issue. When it comes to supplements, the main issue is a lack of an FDA approval process and solely the need for safety evidence provided by the company. Increasing the control of the FDA on supplements could begin to fix the harmful effects and only allow beneficial products to be on the market, and therefore promoted by celebrities.

Finally, when it comes to FAD diets, the easiest correction to this would be to increase awareness on the risks that come with them and try to provide safer alternatives for people to use.

Who is Affected?

This issue can affect anyone within any different demographic or region. There are celebrities all across the globe that have followers from almost anywhere you can think of. Each culture has their own influencers who can each have a different impact on the general public.

https://www.searchenginejournal.com/why-social-media-isimportant/285809/#close

References

Opinion

1. Roberts S. 5 Fad Diets and the Foods You Aren’t Getting Enough Of. Accessed February 21, 2023. https://www.hopkinsallchildrens.org/ACH-News/General-News/5-FadDiets-and-the-Foods-You-Aren-t-Getting-Enoug 2 2. Office of Dietary Supplements - Dietary Supplements: What You Need to Know. Accessed February 21, 2023. https://ods.od.nih.gov/factsheets/WYNTK-Consumer/ 3. Cascini F, Pantovic A, Al-Ajlouni YA, et al. Social media and attitudes towards a COVID-19 vaccination: A systematic review of the literature. eClinicalMedicine. 2022;48:101454. doi:10.1016/j.eclinm.2022.101454

With the reach that celebrities have today, I think efforts need to be made to educate the population on how to properly listen to someone's opinion. Too many people blindly follow their favorite influencer's opinions and we need to create a new habit of people creating their own instead. - T Fritsch

Misinformation

-Timothy Samuel, BSPS Candidate

Modern means of mass communication have proven to have a significant impact on the quality of health-related and lifestyle information that is widely spread and accessible to the public.

According to a research article from Cambridge, An individual’s partisan identity affects the information they collect, process, and respond to and the actions they take — including how and whether they choose to receive health care.

Impact Misinformation in media has become a global and cultural health issue as it can spread rapidly through various platforms, leading to confusion and harm to both individuals and communities.

Inaccurate information can negatively impact public health by promoting false cures or treatments, causing panic and fear, and hindering the efforts of healthcare professionals.

Efforts It is also important to address measures that some key players in social media and information distribution have taken to control the issues associated with misinformation (Youtube includes health source information panels that help viewers identify videos from authoritative sources and health content shelves that highlight videos from these sources when you search for health topics, so people can more easily navigate and evaluate health information online. Elon Musk also made some changes to Twitter making it known that the platform is strictly for opinion sharing due to diversity of users).

One of the most important things to understand regarding this issue of misinformation is that every individual needs to try as much as possible to draw the line between facts and opinions/constructs.

References

-T. Samuel

PatientEngagementHIT. Navigating Social Media's public health, medical misinformation problem. PatientEngagementHIT. https://patientengagementhit.com/features/navigating-social-medias-public-health-medical-misinformation-problem. Published September 16, 2022. Accessed February 21, 2023.

Havey NF. Partisan public health: How does political ideology influence support for covid-19 related misinformation? Journal of computational social science. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604541/. Published 2020. Accessed February 21, 2023.

Infodemics and misinformation negatively affect people's health behaviours, new who review finds. World Health Organization. https://www.who.int/europe/news/item/01-09-2022-infodemics-and-misinformation-negatively-affect-people-s-health-behaviours--new-who-review-finds. Accessed February 21, 2023.

Self-Diagnosis

-Gracie Zhu, BSPS Candidate

Self diagnosis is the process of diagnosing or identifying a medical condition in yourself.

Findings from Primary Research

community malpractice mistreatment convenience

Above is a New York Times article published in 2022 which points out how some young people choose to believe TikTok over trained therapiests for mental health issues.

References

Caron, Christina. “Teens Turn to TikTok in Search of a Mental Health Diagnosis.” The New York Times, The New York Times, 29 Oct. 2022, https://www.nytimes.com/2022/10/29/well/mind/tiktok-mentalillness-diagnosis.html.

‘It’s like having a physician in your pocket!’ A critical analysis of selfdiagnosis smartphone apps. (2015, April 3). ‘It’s Like Having a Physician in Your Pocket!’ a Critical Analysis of Self-diagnosis Smartphone Apps - ScienceDirect. https://doi.org/10.1016/j.socscimed.2015.04.004

A primary literature called “a critical analysis of self-diagnosis smartphone apps” contains in-depth analysis of the origin, development and social impacts of self-diagnosis apps.

One fifth of smartphone users have used their phone to download a medical or health-related app.

Words such as ‘medical’, ‘clinic’ and ‘triage’ in app titles and medical symbols such as stethoscopes and red crosses were frequently used to further establish authority.

How can the general public determine what commercial interests lie behind the apps' creation and how their health data may be used?

Opinion: Posting and sharing stories are ways for people to advocate for themselves and to even find a community.

However, it is important to find credible sources and seek professional help.

-Gracie Zhu

Spreading Awareness -- Maureen Ma, BSPS Candidate

Background Recent developments on social media have allowed the fast spreading of health-related information all around the world. Currently, more people are able to access that information and carry out actions for disease prevention and treatment. With social media, people can hear what is prevalent in the world, and government and healthcare professionals may post important information for citizens as well [1]. For example, the National Institutes of Health (NIH) and Centers of Disease Control and Prevention (CDC) websites are two good sources for health-related information in the US.

Efforts In The Area International campaigns Collaborations of health organizations around the world Online doctor's appointments

Opinion With the convenience of social media, both benefits and detriments exist. People need to learn how to find authentic health information in order to improve the quality of care both for themselves and for others. -- M Ma

https://www.nfid.org/toolkits/measles-awareness-toolkit/

Impact Research has shown that social media is promoting healthy behavior changes. In a review paper published in 2016, 151 out of 170 studies showed the positive impact of information technology, while 141 studies reported great improvement in patient engagement [2]. Also, with the help of technology, now patients can seek help online through virtual appointments with physicians.

In addition, the connections people have on social media can provide a community for people with similar health concerns.

Previously, without social media, people may not know about some rare diseases or other neglected health information. Besides, people may not be willing to discuss some health conditions. However, with the spread of information on social media, people now are paying more attention to their health and more aware of some diseases and health conditions.

References 1. Al-Dmour H, Masa’deh R, Salman A, Abuhashesh M, Al-Dmour R. Influence of Social Media Platforms on Public Health Protection Against the COVID-19 Pandemic via the Mediating Effects of Public Health Awareness and Behavioral Changes: Integrated Model. J Med Internet Res. 2020;22(8):e19996. doi:10.2196/19996 2. Sawesi S, Rashrash M, Phalakornkule K, Carpenter JS, Jones JF. The Impact of Information Technology on Patient Engagement and Health Behavior Change: A Systematic Review of the Literature. JMIR Med Inform. 2016;4(1):e1. doi:10.2196/medinform.4514

Spring 2023

TABLE OF CONTENTS Undiagnosed Illness....2 Suicide...........................3 Environment................4 Stigmas.........................5

Mental health becoming more widespread and accepted, it is important now more than ever to discuss these issues. Our subtopics include: undiagnosed mental health illness, suicide awareness/prevention, how environmental factors influence mental health, and global mental health stigmas. Each of our subtopics are meant to tie back to the theme of mental health issues and to one another. The way your environment can shape how you think. How stigmas make talking about this with others especially in other countries. These stigmas and even your environment leads to underdiagnosed diseases. Underdiagnosed diseases make these conditions worse and can affect you physically. Lastly, these worsening conditions can eventually lead to suicide.

We want to present this in a manner to put power back into the people's hands. With this presentation we are hoping people will be able to learn the signs to help people around them and realize their own risk. Mental health can be a very tricky topic to discuss but that is why it is so important to start the conversations.

CREATED BY Jordan Beatrice (BSPS Student) Jackson Gum (BSPS Student) Kathleen Massa (BSPS Candidate) Carter Stobierski (BSPS Candidate)

G. Rifai. Mental Health Concept. Via Canva

Mental Health

Undiagnosed Mental Illness Jordan Beatrice (BSPS Student) Undiagnosed and misdiagnosed mental illness can be described as a silent issue. Many individuals go unseen and unheard from due to a hesitancy (or negative stigma) towards treatment and a lack of available resources. This can create an avalanche of consequences in situations like dealing with police involvement, and lead to the development of sociopathic and psychopathic behaviors. ADHD, Autism, Bipolar disorder, PTSD, eating disorders, and borderline personality disorder are examples of commonly undiagnosed/misdiagnosed mental illnesses. ~ J. Beatrice Undiagnosed Mental Health in the Emergency Department (1) Chicago, IL

The Economic Burden of Mental Illness (2) Canada

Irritable Bowel Disease and Undiagnosed Mental Illness Comorbidity (4) Rome, Italy

Average Medical Cost per Capita 3,000$

Major Depression 25% 2,000$

Negative 57.3%

General Anxiety 9.4%

1,000$

Drug Abuse 8.3%

Only 2% of those diagnosed were diagnosed by the ED attending. All others were diagnosed via the MiniInternational Neuropsychiatric Interview (MINI).

0$

Diagnosed

UnDiagnosed

NonMentally Ill

Individuals in Canda that are undiagnosed for mental illness are spending on average, double in medical expenses, then a nonmentally ill individual.

~50% of patients in this study done at the University of Rome, were found to have at least on symptom of undiagnosed mental illness, 5% of them displaying two or more.

What is the impact of having a diagnosis? (theawarenesscentre.com)

Having a diagnosis helps patients to better understand themselves and the feelings and emotions they are dealing with. A diagnosis can help a patient to shift away from blaming themselves. It can also encourage individuals to find the correct help in a more efficient manner. Individuals with a diagnosis are better able to identify their needs for medication and apply for health care coverage. Having a diagnosis can not only help individuals to interact with others but help others to better understand how to interact with the patient.

Suicide Prevention Carter Stobierski (BSPS Candidate) Suicide is a top ten leading cause of death globally in ages 11-65. Some groups are more inclined to commit suicide due to how they are perceived in modern society(gender, age, sexuality, race, etc).

Uncomfortable issue to talk about because you do not want to step on any toes or bring it up to bring burden on others. Failure to resolve mental health could lead to suicide which is why more people need to become educated in resolutions like QPR training and therapy to reduce the risk of suicide.

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Step-by-Step Prevention: Identifying people who are at risk of suicide from past behavior/tendencies, reach out to them and ask if they need help, make sure they5have access to mental health/inpatient care, decrease ways that someone could commit suicide, and finally, make sure that they have necessary support systems and people around them that can benefit their lives. (5) A study was done that showed that when primary care doctors were informed that their patient has had suicidal thoughts or a mental health disorder; patients were less inclined to commit suicide or have suicidal tendencies in the future.(7) In terms of a future outlook for suicide prevention,, society needs to make this issue more comfortable to talk about even though it is so morbid. However, this is a necessary step that we need to take so that suicide prevention can have the biggest platform it can. (6)

Suicide is now more prevalent than ever before due to the rise of mental health issues over the last few decades. I personally believe the most important step we can take in suicide prevention is making this issue something we can talk about in normal conversation and making access to therapy more available to those who less fortunate. ~ C. Stobierski

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How Your Environment Affects Your Mental Health Jackson Gum (BSPS Student) Your environment can consist of many different things. This subtopic is an intercultural issue because it depends on the area that you live. It can expand globally but each area will have slightly different issues. This includes where you live, how you were raised, and who you are surrounded by. Different mental health issues stem from how you live your life. Not every mental health issue is caused by one's environment but it can worsen preexisting conditions or contribute to new ones.

Divorce (8) (11) Substance Abuse (8) (11) Alcoholism Drug abuse Broken Homes (8)

Canvas BarleyDevi. Liquor Bottles. Via

Common Contributors

Parents with Mental Health Issues (8)

Common Associated Mental Health Issues Depression (9) (11) Anxiety (8) (10) (12) Anger Issues (11) Antisocial Disorder (8) (9)

Relationship with family members (8) Man hugging knees Anxious. Via Canva

Poverty (8) (9) Physical Disorders (8) (9) Such as Obesity Schooling (10) Low Quality Classrooms Social Hierarchy (9) (10) Exclusion (9) (10) Urban Areas (12) (11) Neighbor Noise Over Crowding Lack of Nature Crime Rates Pollutants Wynne B. Animated City Buildings. Via Canva Lack of access (9) (12)

Ways to Improve Building relationship with those in your life. This produces stress relieving hormones. (09) Improving Design of Cities including social features. Include more Nature (12) Seek Professional Help Identify stressors in life and try to fix or cut it out of your life when applicable.

Most people cannot control every aspect of their environment. By recognizing some areas that affect your mental health, you can understand some factors that contribute to poor mental health. A better understanding of yourself should help others improve and become content with some of their mental health issues. I also feel that seeing the roots of problems can help one improve their current situation by reinforcing the positive environment in their life while reducing the negative. ~J Gum

Mental Health Stigmas Around the Globe Kathleen Massa (BSPS Candidate) The final subtopic related to mental health is the global issue of opposing stigmas of mental health in different areas of the world. The different areas of the globe explored include Asia, Latin America, and Australia. The subtopic is stigmas relates to mental health because others opinions does affect how patients seek and respond to care.

Latin American cultures’ opinion on mental health illnesses and stigmas were identified via a systematic review. The results showed that patients suffering from schizophrenia were associated with bizarre, inadequate, and aggressive behavior in both Argentina and Mexico. This review also had a very interesting finding in that mental health professionals were viewed negatively in these Latin American cultures, so one could assume that seeing a mental health professional is also viewed negatively. Another negative stigma surrounding these illnesses is that the illnesses that are linked to a biological component have an increased perception of danger. There were no methods of intervention discussed in this review of Latin America.(14)

Another systematic review was completed in Asian countries to learn more about the stigmas and attitudes that are present. Overall, people with mental illnesses were considered dangerous, aggressive, and weak. These stigmas were especially present in patients that suffered from schizophrenia and bipolar disorder. Asian communities also stigmatized an entire family when addressing these illnesses. There are also increasing initiatives designed to treat patients within communities that have these stigmas.

Studies show that supernatural and religious approaches are not as effective for treatment. (13) The Content of Asia. Via Canva Layouts

A telephone survey allowed researchers to come to conclusions about stigmas and attitudes the Australian population has towards patients suffering from mental illnesses. The opinions that presented themselves during the survey showed that schizophrenia is closely associated with danger, unpredictability, and avoidance.

These opinions about patients with schizophrenia are more prevalent for male patients than females. Patients South America. Via Canva Layouts that suffered from social phobia/anxiety were also perceived as weak individuals. This research article also Overall, I think a lot of cultures are taking included different ideas on interventions that can be great steps to address mental illness, completed. These interventions included dehowever, more can be done in a lot of these stigmatizing individual disorders, addressing why situations. For example, to reduce the weakness and dangerousness are associated with stigmas around mental health they could be mental illness, and aligning public opinions with discussed in school in these countries in individual's personal beliefs. (15) order to introduce the topic at a younger Australia. Via Canva age. I also believe that every country can learn more about how stigmatized patients feel in order to further address what changes can be a made. ~K Massa

References Undiagnosed Mental Illness 1. Downey LV, Zun LS, Burke T. Undiagnosed mental illness in the emergency department. J Emerg Med. 2012;43(5):876-882. doi:10.1016/j.jemermed.2011.06.055 2. Lim KL, Jacobs P, Ohinmaa A, Schopflocher D, Dewa CS. A new population-based measure of the economic burden of mental illness in Canada. Chronic Dis Can. 2008;28(3):92-98. PMID: 18341763.

3. Downey VA, Zun LS. Identifying Undiagnosed Pediatric Mental Illness in the Emergency Department. Pediatr Emerg Care.

2018;34(2):e21-e23. doi:10.1097/PEC.0000000000001151 4. Lewis K, Marrie RA, Bernstein CN, et al. The Prevalence and Risk Factors of Undiagnosed Depression and Anxiety Disorders Among Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis. 2019;25(10):1674-1680. doi:10.1093/ibd/izz045 Suicide 5. CDC. Prevention strategies. Centers for Disease Control and Prevention. https://www.cdc.gov/suicide/prevention/index.html. Published October 11, 2022. Accessed March 28, 2023.

6. QPR Institute . QPR Institute: Practical and proven suicide prevention training. QPR Institute | Practical and Proven Suicide Prevention Training QPR Institute (en-US). https://qprinstitute.com/about-qpr. Published 2023. Accessed March 28, 2023.

7. Mann JJ, Michel CA, Auerbach RP. Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review. American Journal of Psychiatry. 2021;178(7):appi.ajp.2020.2. doi:10.1176/appi.ajp.2020.20060864 How your Environment Affects Mental Health 8. Rutter M. How the environment affects mental health. British Journal of Psychiatry. 2005;186(1):4-6. dot:10.1192/bjp.186.1.4 9. Tosh H, Champagne F, Meyer-Lindenberg A, Environmental influence in the brain, human welfare, and mental health.

Nature Neuroscience. 2015;18(10):1421-1431. doi:10.1038/nn.4108 10. Milkie M, Warner C. Classroom Learning Environments and the Mental Health of First Grade Children. Journal of Health and Social Behavior. 2011;52(1):4-22. doi:10.1177/0022146510394952.

11. Stiffman A, Hadley-Ives E, Elze D, Johnson S, Doré P. Impact of Environment on Adolescent Mental Health and Behavior: Structural Equation Modeling. American Journal of Orthopsychiatry. 1999;69(1):73-86. doi:10.1037/h0080383 12. Guite H, Cark C, Ackrill G. The impact of physical and urban environment on mental well-being. Public Health.

2006;120(12):1117-1126. doi:10.1016/j.puhe.2006.10.005 Mental Health Stigmas Around the Globe 13. Zhang Z, Sun K, Jatchavala C, et al. Overview of stigma against psychiatric illnesses and advancements of anti-stigma activities in six Asian societies. International Journal of Environmental Research and Public Health. 2019;17(1):280. doi:10.3390/ijerph17010280 14. Mascayano F, Tapia T, Schilling S, et al. Stigma toward mental illness in Latin America and the Caribbean: A systematic review. Revista Brasileira de Psiquiatria. 2016;38(1):73-85. doi:10.1590/1516-4446-2015-1652 15. Reavley NJ, Jorm AF. Stigmatizing attitudes towards people with mental disorders: Findings from an Australian National Survey of Mental Health Literacy and Stigma. Australian & New Zealand Journal of Psychiatry. 2011;45(12):1086-1093. doi:10.3109/00048674.2011.621061

Nutrition Spring 2023

Supported by a well-balanced diet.

A biochemical process by which an organism uses food to obtain nutrients, produce energy, and support its life.

Quality standards set by governmental agencies and health organizations.

Affects both physical and mental health.

Neglection can lead to issues such as cardiovascular disease and obesity.

DIET

JAMES ROONEY BSPS STUDENT

Over the last century in the US...

Despite citizens spending among the least amount of time eating each day, the US still has the greatest obesity rate by far https://www.theatlantic.com/business/archive/2009/07/this-is-why-youre-fat/21684/

Best Diets for Healthy Eating Daily Caloric Intake Increased by 18%

Mediterranen Fruits, vegetables, whole grains, and nuts Some lean meat and fish Prevent cardiovascular disease, increase lifespan, promote healthy aging https://www.prevention.com/f ood-nutrition/healthy-

DASH

eating/g39113108/bestmediterranean-dietcookbook/

Fruits, vegetables, low-fat dairy, whole grains, lean meats, and nuts Treat and prevent high blood pressure

Flexitarian

Daily Fat Intake Increased by 60% https://doi.org/10.3389/fnut.2021.748847

https://www.225batonrouge.com/fooddrink/dash-diet-ranked-one-best-diets-everdeveloped-sponsored-pennington-biomedicalresearch-center

Semi-Vegetarian Minimal meat consumption Reduce caloric intake and saturated fats Weight loss, diabetes prevention https://health.clevelandclinic.org/ what-is-the-flexitarian-diet/

Personal Opinion: Everyone should strive to eat a healthy, wellbalance to support their overall health and longevity.

- J. Rooney

Obesity

Did you know?

In 2016, more than 1.9 billion adult were determine as overweigh. Over 650 milion were obese.

In 2019 more than 40 % of adult population are classified as obesity

obese

https://www.niddk.nih.gov/health-information/healthstatistics/overweight-obesity

overweight

Zhibo Li BSPS student obese

obese

healthy weight https://www.dhss.delaware.gov/dhss/dph/dpc/obesity preventionupdate.html

In United State,over 40% of Americans being classified as obese The obesity population growth 12.4% in 17 years.

Estimated 300,000 deaths may cause by obesity each year.

What is Body Mass Index (BMI)?

A value to show if your weight is healthy, which can be calculated by dividing a person's weigh in kg by the square of the body height in meters.

This value is used by world Health Organization(WHO) and Centers for Disease Control (CDC) for weight categories: 18.5< BMI < 24.9 (healthy); BMI ≥ 30 (obese).

However, factors such as age, sex, muscle mass can affect and mislead the relationship between BMI and body fat. There are other methods that has more accuracy than BMI. For example, waist-to-hip ratio.

Personal Tips

Wegovy, a drug mimic body hormone call glucagon-like peptide(GLP-1) to regulate appetite, food intake and glucose uptake on GI area.

Disease cause by obesity

https://drlogy.com/health/obesity-symptoms

To prevent obesity: Reduce uptake of carbohydrates and fat in food Increase physical exercise Regular diet Good sleep https://www.erxpharmaceuticals.com/metabolic -disease-focus/obesity/

New treatment

-Zhibo Li

First used to treat type-2 diabetes and get approved

by CDC as a treatment for weight management in 2021.

Shows high efficiency on weight lost compare to diet and physical exercise method.

However, the side effects include diarrhea, vomiting, nausea and abdominal pain and etcYour paragraph text

Eating Disorders Samantha(Shuyi) Zhou| BSPS student Eating disorders are serious conditions related to persistent eating behaviors that negatively impact people’s health/emotions & ability to function in important areas of life.

At least 9% of the population worldwide are affected by eating disorder.

Overlaps With Other Mental Diseases Depression

Anxiety

Substance abuse

Each year, there is about 10,000 deaths are the direct result of an eating disorder and about 26% of people with eating disorders attempt suicide.

Genetic heritability

Anorexia Characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape.

Bulimia Characterized by episodes of binge-eating and feelings of a lack of control over eating.

People may feel guilty, shameful and fearful of gaining weight, and thus want to try to get rid of the extra calories in an unhealthy way like forced vomiting or exercise too much.

Binge- eating C

People regularly eat too much food but without compensating for the behavior with exercise like people with bulimia do.

Many people with eating disorders may not think they need treatment. If you're worried about a loved one, urge him or her to talk to a doctor.

The Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment

1-800-662-HELP (4357) or 911

About 28-74% of risk for eating disorders is through genetic heritability.

The Eating Disorders Genetics Initiative (EDGI) is an international investigation designed to identify hundreds of genes that potentially influence a person’s risk of developing three major eating disorders.

Study Highlights In some individuals with eating disorders, certain identified chemicals in the brain that control hunger, appetite, and digestion have been found to be unbalanced.

Genetics alone don’t cause an eating disorder. Eating disorders are caused by a combination of genetic, environmental, and psychological factors.

Personal opinion We hope to see more attention from the public, more studies conducted in this field, and more patient sample involved to help researchers understand the mechanisms behind. S. Zhou

US vs Europe Ashlyn Felton BSPS Student

Food Quality Standards How are they determined?

Figure 1: https://www.focusforhealth.org/the-americanfood-supply-not-fit-for-european-consumption/

The criteria for acceptable ingredients differs in various parts of the world.

The FDA creates a list of ingredients that are safe to use in the US called GRAS (Generally Recognized As Safe).

However, products with a new substance do not need to be on this list. The company can make an independent conclusion that the substance is safe on their own.

Companies can release their product on the market immediately after they have reached a conclusion. Without FDA approval, which may lead to biased results.

Food additives maintain freshness, taste, texture, and appearance.

Preservatives are evaluated byC the Food and Agricultural Organization (FAO) and World Health Organization (WHO).

Based on acceptable daily intake (ADI), which is the estimated amount of a substance in a food or drink that can safely be consumed daily over a lifetime without adverse health effects.

Efforts Other parts of the world, such as Europe, have chosen to take a more cautious approach regarding food quality standards, and will not allow a product to be sold if there is any possibility the product causes harm.

On the other hand, the US takes an "innocent until proven guilty" approach.

Ultimately, this affects citizens of areas of the world that do not have strict food standards, such as the US.

Personal Opinion

Until institutional changes are made, we cannot do much to avoid unhealthy ingredients. The biggest thing we can do is read food labels and try to opt for fresh, whole products rather than processed food, but this is difficult when you are on a budget. Overall, in the future food quality standards should be set by an unbiased organization and the rules should be stricter so that companies cannot find loopholes described previously. -A. Felton

References

Bulik CM, Coleman JR, Hardaway JA, et al. Genetics and neurobiology of eating disorders. Nature Neuroscience.

2022;25(5):543-554. doi:10.1038/s41593-022-01071-z Eating disorders. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/eating-disorders/symptoms-causes/syc20353603. Published February 22, 2018. Accessed February 16, 2023.

Thompson D. This is why you're fat. The Atlantic. https://www.theatlantic.com/business/archive/2009/07/this-is-why-yourefat/21684/. Published July 21, 2009. Accessed March 28, 2023.

Lee JH, Duster M, Roberts T, Devinsky O. United States dietary trends since 1800: Lack of association between saturated fatty acid consumption and non-communicable diseases. Frontiers. https://www.frontiersin.org/articles/10.3389/fnut.2021.748847/full. Published December 20, 2021. Accessed March 28, 2023.

Migala J. U.S. News & World Report's Best and Worst Diets for 2023. EverydayHealth.com. https://www.everydayhealth.com/diet-and-nutrition/diet/us-news-best-diet-plans-mediterranean-dash-more/. Published January 3, 2023. Accessed February 16, 2023.

“Overweight & Obesity Statistics - Niddk.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, https://www.niddk.nih.gov/health-information/health-statistics/overweightobesity.

Delaware TSof. One in three Delaware adults reports being obese. Obesity Prevention Update - Delaware Health and Social Services - State of Delaware. https://www.dhss.delaware.gov/dhss/dph/dpc/obesitypreventionupdate.html. Accessed April 4, 2023.

Obesity. ERX Pharmaceuticals. https://www.erxpharmaceuticals.com/metabolic-disease-focus/obesity/. Accessed March 28, 2023.

7 obesity symptoms you must know. drlogy. https://drlogy.com/health/obesity-symptoms. Accessed March 28, 2023.

Food Additives. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/food-additives. Published January 31, 2018.

Food ingredient gras conclusions: What you should know. Food Ingredient GRAS Conclusions: What You Should Know. https://www.foodmanufacturing.com/ingredients/article/21271894/food-ingredient-gras-conclusions-what-youshould-know. Published February 12, 2021.

Shore J, Director E, Daniel November 10th, et al. The American food supply: Not fit for European consumption. Focus for Health. https://www.focusforhealth.org/the-american-food-supply-not-fit-for-european-consumption/. Published November 14, 2019.

Pharmacognosy Spring 2023 Ian Chen (BSPS Student), Rose Wang (BSPS candidate) Dalton Polly (BSPS candidate), Alexandra Kasch (BSPS candidate)

Pharmacognosy is a pharmaceutical discipline that studies the science behind drugs and the natural origins in which they receive a chemical substance from. This branches most commonly from natural sources, such as living organisms, microorganisms, and the use of traditional medicine. The importance of pharmacognosy has dated back to early medicine and still serves as a useful resource as 80% of world populations from developing countries still use traditional medicine and 25% of prescription drugs dispensed in the US have at least one chemical substance that was obtained by plants. The use of treatments under pharmacognosy are debated still by many cultures for the possible negative side effects that may come with these naturally derived chemical substances [1].

Hallucinogens: Subcategory of diverse drugs work to distort a person's awareness of self and surrounding.

Debates on their clinical/recreational use remain a current conversation as they still hold a negative public view.

Cannabinoids: Any chemical originating from the marjuana plant that has drug-like effects or therapeutic benefits. Debates relate to medical and recreational usage as well as legalization.

Traditional Chinese Herbal Medicine: Centuries-old practice that uses natural sources to prevent or treat health conditions. Controversial debates about its safety and efficacy still remain despite the recognition

by WHO.

Psychological Disorders: Mood disease and cognitive diseases has been a major issue for decades. The research on pharmacognosy has shown that many herbal medication is efficient on psychological diseases, yet high tolerance by patients.

Pharmacognosy Treatment of Psychological Disorders Rose Wang (BSPS Candidate)

Background: Psychological disease includes a wide range of disorders, thousands of people suffers from it. Majority of Psychological and mood diseases have interaction with neurological functions, improving the complexity of treatment. For decades, psychological disorder has always been a popular topic to research, there are multiple sources discovered as potential treatment of psychological disorders, including pharmacognosy treatment. Even though pharmacognosy is not the mainstream of treatment, but pharmacognosy medication has been used for hundreds of years, its efficiency should not be ignored.

Saint John’s Wort:

Saint John’s Wort: hypericum perforatum https://ww w.rebeccas herbs.com/ pages/herb -article-brst-johns-w ort

Also known as hypericum perforatum. It is a pharmacognosy medication used for a variety of conditions, including kidney and lung ailments, insomnia, and depression, and to aid wound healing.

St. John’s wort is a plant with yellow flowers that has been used in traditional European medicine centuries ago. The name St. John’s wort refers to John the Baptist, as the plant blooms around the time of the feast of St. John the Baptist in late June. St. John’s wort appears to be more effective than a placebo and as effective as standard antidepressant medications for mild and moderate depression. It’s uncertain whether this is true for severe depression and for time periods longer than 12 weeks. Under the recent data, St. John’s wort isn’t consistently effective for depression, and should be taken as a supplement instead of actual treatment.

Representative Pharmacognosy Medications: ● ● ●

Saint John’s Wort Bacopa Monnieri Ginkgo Biloba

Ginkgo Leaf https://www.vectorst ock.com/royalty-freevector/ginkgo-leavesvector-4650093

Bacopa Monnieri:

Bacopa monnieri (L.) Pennel has been used for centuries in Ayurvedic medicine, either alone or in combination with other herbs, as a memory and learning enhancer, sedative, and anti-epileptic. It grows in wet tropical environments, and, under its common English name of water hyssop, is a popular aquarium plant.

Study have shown that the Standardized extract of B monnieri was found to be effective in alternating the symptoms of ADHD and was well-tolerated by the children. Furthermore, bacopa brings the levels of major neurotransmitters — serotonin, dopamine, GABA, and acetylcholine — into balance. Proving that bacopa can be an effective treatment/supplement for mood disorder/ ADHD.

Bacopa Monnieri: https://www.mayernikkitchen.com/medicinal-plants/brah mi

Ginkgo Biloba: Ginkgo biloba is one of the oldest living tree species.Most research on ginkgo focuses on its effect on dementia, memory and pain caused by too little blood flow. the extract from ginkgo leaves is promoted as a dietary supplement for many conditions, including anxiety, allergies, dementia, eye problems, and peripheral artery disease. Various preclinical and clinical studies have shown a positive effect of Ginkgo biloba to improve cognitive abilities in impaired individuals and reducing anxiety under pathological conditions. However, more advanced experiments need to be performed, from the current study, Ginkgo is efficient as a supplement to help reduce anxiety symptoms, but cannot be taken as the main medication.

k

Hallucinogens Alexandra Kasch (BSPS candidate)

Background This subcategory of diverse drugs work to distort a person's awareness of self and surrounding. Discovery from indigenous cultures by western and European countries in the 20th century sparked popularity with medicinal and recreational use. In the 60’s, hallucinogens began to receive a controversial reputation for their dangerous side effects that caused many countries to place restrictions. Most notably in the United States, the war on drugs placed all hallucinogens on a schedule I status and halted all research. Decades later, a second wave of research began showing significant improvement in the reduction of psychotherapy, but the topic of hallucinogens place in society is still debated. [3]

Future of Hallucinogens in Research A resurgence of research in the 90’s opened. Several of the hallucinogens under the schedule I ban have supporting data to their effectiveness in a psychotherapy environment with issues such as mental health and substance abuse.

LSD (Psychedelic) LSD has potential to treat Anxiety, depression, OCD, and substance abuse 2014 study investigated LSD treatment for anxiety associated with a life-threatening illnesses was conducted ● 77.8% post study said they had reduced levels of anxiety ● 66.7% reported increased quality of life since the study was conducted [2]

Associated Risks Short-term effects: Paranoia, psychosis, nausea, increased heart rate, and intense feelings of sensory experiences.

Long term effects: persistent psychosis, hallucinogen persisting perception disorder, speech problems, memory loss, suicidal thoughts, over dose, and highly addictive mechanisms of action [4]

Author's Note Continuing research for hallucinogens should be supported and considered further as treatment alternatives given the current data that supports their potential for a psychotherapy setting. Removing their use from society entirely effects the research and the ability to gain more knowledge on these substances as well as those suffering from the mentioned conditions.

With secure measures and proper education programs in place, associated risks can be reduced and can give patients a safe alternative when administering hallucinogens. ~AKasch

Cumming P, Scheidegger M, Dornbierer D, Palner M, Quednow BB, Martin-Soelch C. Molecular and functional imaging studies of psychedelic drug action in animals and humans. Molecules.

2021;26(9):2451. doi:10.3390/molecules26092451

Psilocybin (Psychedelic) Properties to treat anxiety, OCD, treatment-resistant depression, smoking addiction, and alcoholism.

Clinical studies completed have results showing - Patients with cancer diagnosis have reduced anxiety, depression for up to 6 months post treatment - MRI scans show psilocybin decreases activity of medial prefrontal cortex, known contributor for patients with depression [2]

Traditional Chinese Herbal Medicine Ian Chen (BSPS Student)

Background

TCM Common Herbs

Traditional Chinese Medicine (TCM) is a form of medicine that has been practiced for over centuries to balance the body and adjust pathological conditions.

TCM is based on the concept of Qi, the vital energy that flows through the body's meridians and energy channels. Herbal medicine is a common approach in TCM to address patients' problems. These TCM herbs are in fact common in our diet, for example, mulberry and honey. During the Ming Dynasty of China, the development of the Compendium of Materia Medica became one of the most important TCM texts today.

TCM herbal medicine has continued to evolve over times, with new herbs and formulations being discovered and developed. In 2019, the WHO has recognized TCM for its potential to contribute to global health.

[6],[9]

Ginseng : ● TCM: Therapeutic effect such as retroactive, tonic, nootropic, and antiaging. ● Modern Research: improve general indices of stress and mood disturbance, has improvements in performance measures Golgi Berry(Wolfberry)[5],[7]: ● TCM: Enhance immune system function, improve eyesight, protect liver, improve sperm production, and improve circulation among other effects ● Modern Research: Improves immune response, promotes vision-protective effect, and lipid-lowering effect Dried goji berries wolfberry: Lycium Barbarum. Agora Market. https://agoramarket.shop/produ ct/dried-goji-berries-wolfberry-l ycium-barbarum. Published February 26, 2023. Accessed March 27, 2023.

Concern and Public Perspective Concern: Quality control and regulation Adverse reactions and drug-drug interactions Affected population: - Patients (currently taking or might be treated with TCM herbs) Public Perspective: “Some European doctors think Chinese medicine should come with a health warning” - CNN - “Ancient Chinese Medicine Unlocks New Possibilities for cancer Treatment” – Yale School of Medicine

TCM Herbal medicine NMRICM101 (Chingguan Yihau)[8]: ● A combination of TCM herbs to treat COVID-19 in Taiwan ● Studies have shown the effectiveness of this medicine by achieving consecutive negative reports from COVID-19 patients with high risks and severe symptom. The therapeutic effect is coming from interactions with spike proteins on virus.

Personal Opinion - I.Chen While TCM has faced critics and skepticism in some quarters, its increasing acceptance and recognition by organizations such as WHO suggest that it has a crucial role in the future medical system. TCM provides a unique perspective on pathological conditions of our body, and some studies have supported its practical usage as treatment. However, despite the therapeutic effect of some herbs provided by science, studies still need to be conducted for the safety and efficacy of most herbs and settling regulation standards for manufacture. It is important to note that TCM currently cannot replace Western medicine. The doctor’s perspective is another factor that prevents the public from accessing TCM due to its concerns. With more research being conducted, doctors might eventually recognize the potential of TCM. Overall, TCM seems to continue to grow as more people seek alternative healthcare approaches. However, it is important for practitioners, scientists, and policymakers to continue investigating and evaluating its role in modern health care.

Cannabinoids Dalton Polley (BSPS Candidate) Background: So what exactly is a “cannabinoid”? A cannabinoid is a chemical in the marijuana plant that causes drug-like effects all throughout the body, including the CNS and immune system. The primary active metabolite in cannabis is delta-9-tetrahydrocannabinol, which is the drug responsible for making you feel “high”. THC is not the only cannabinoid and not all cannabinoids produce a high. For example, CBD is a cannabinoid with therapeutic effects and it produces no high. Currently, marijuana or cannabis is considered to be a Schedule 1 substance with no therapeutic benefit in the United States. However, it is not illegal in every country and some cultures use and accept it as medicine.

Cannabis Use as an Intercultural Issue: Cannabis use is typically associated with cultural rituals such as birth, death, healing, protection and purification. It was often used as medicine (as seizure medication for example) in ancient cultures such as ancient India and Egypt. Over time, this culture became international leading to the formation of “cannabis culture”.

https://www.researchgate.net/figure/Chemical-str uctures-of-major-cannabinoids-Phytocannabinoi ds-are-natural-cannabinoids_fig1_328592871

Special Populations that Benefit: 1. Cancer - Some inhibition of tumor cell growth and induction of cancer cell apoptosis.

2. Epilepsy - The endocannabinoid system is strongly activated by seizures.

3. Dementia - Some evidence for interruption of the pathological process in Alzheimer's disease.

4. Glaucoma - Glaucoma is the primary cause of irreversible blindness. The smoking or ingestion of cannabis has shown evidence to reduce intraocular pressure associated with glaucoma.

5. PTSD - Cannabinoids have shown evidence to decrease PTSD symptomology, more specifically sleep issues and nightmares.

Legal Efforts: In the United States, there has been continual effort to legalize cannabis for medical and recreational usage in support of therapeutic research findings. Some states have legalized it already while others have not.

Other countries, such as China and Russia have made it completely illegal.

Professional/Personal Opinion: ~ D. Polley In my opinion, cannabis should be legalized. Edible consumption has shown little evidence of being harmful. With proper substance abuse education, it could possibly become the societal replacement for alcohol. Rather than bringing out impulsivity like alcohol does, cannabis causes introspective thoughts and feelings. It also helps anxiety, rather than worsen it like alcohol does. I am in full support of medical and recreational usage.

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Orhan IE. Pharmacognosy: Science of natural products in drug discovery. Bioimpacts. 2014;4(3):109-110. doi:10.15171/bi.2014.001 Garcia-Romeu A, Kersgaard B, Addy PH. Clinical applications of hallucinogens: A review. Exp Clin Psychopharmacol. 2016;24(4):229-268. doi:10.1037/pha0000084 A history of the Drug War. Drug Policy Alliance. https://drugpolicy.org/issues/brief-history-drug-war.

Accessed March 27, 2023.

NIDA. Hallucinogens DrugFacts. National Institute on Drug Abuse website. http://nida.nih.gov/publications/drugfacts/hallucinogens. April 22, 2019 Accessed March 27, 2023 Cheng J, Zhou ZW, Sheng HP, et al. An evidence-based update on the pharmacological activities and possible molecular targets of Lycium barbarum polysaccharides. Drug Des Devel Ther. 2014;9:33-78. Published 2014 Dec 17. doi:10.2147/DDDT.S72892.

Ginseng: The root of improving athletic performance? PodiumRunner. https://www.podiumrunner.com/nutrition/health/ginseng-the-root-of-improving-athletic-performance/.

Published December 17, 2020. Accessed March 28, 2023.

Ma ZF, Zhang H, Teh SS, et al. Goji Berries as a Potential Natural Antioxidant Medicine: An Insight into Their Molecular Mechanisms of Action. Oxid Med Cell Longev. 2019;2019:2437397. Published 2019 Jan 9. doi:10.1155/2019/2437397.

Tsai KC, Huang YC, Liaw CC, et al. A traditional Chinese medicine formula NRICM101 to target COVID-19 through multiple pathways: A bedside-to-bench study. Biomed Pharmacother. 2021;133:111037. doi:10.1016/j.biopha.2020.111037 Xiang Y-Z, Shang H-C, Gao X-M, Zhang B-L. A comparison of the ancient use of ginseng in traditional Chinese medicine with modern pharmacological experiments and clinical trials. Phytotherapy Research.

2008;22(7):851-858. doi:10.1002/ptr.2384 Sami Sarfaraz, Vaqar M. Adhami, Deeba N. Syed, Farrukh Afaq, Hasan Mukhtar. Cannabinoids for Cancer Treatment: Progress and Promise. Cancer Res 15. https://doi.org/10.1158/0008-5472.CAN-07-2785.

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Friedman Daniel, Orrin Devinsky. Cannabinoids in the Treatment of Epilepsy. New England Journal of Medicine 2015. https://doi.org/10.1056/NEJMra1407304. Published September 10, 2015. Accessed February 21, 2023.

Krishnan S, Cairns R, Howard R. Cannabinoids for the treatment of dementia. Cochrane Database of Systematic Reviews 2009. https://doi.org/10.1002/14651858.CD007204.pub2. Published April 15, 2009.

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Tomi Järvinen, David W Pate, Krista Laine. Cannabinoids in the treatment of glaucoma. Pharmacology & Therapeutics. https://doi.org/10.1016/S0163-7258(02)00259-0. Published August 2002. Accessed February 21, 2023.

C. Hindocha, J. Cousijn, M. Rall & M. A. P. Bloomfield. The Effectiveness of Cannabinoids in the Treatment of Posttraumatic Stress Disorder (PTSD): A Systematic Review. Journal of Dual Diagnosis. https://doi.org/10.1080/15504263.2019.1652380. Published September 3, 2019. Accessed February 21, 2023.

Spring 2023 PURDUE UNIVERSITY

Substance Use and Abuse

Prescription Drug Abuse

Needle and Syringe Exchange

More Potent Fentanyl

Megan Valentine (BSPS Candidate)

Celine Huo (BSPS Candidate)

Laura Payne (BSPS Candidate)

One of the main issues today with the use of pharmaceuticals is the addictive potential that they have. There is a wealth of issues surrounding the use of numerous substances that negatively impact the health of those using them. Issues surrounding the problem can range from the actual substances being introduced to the body, to the equipment used, to the mental health of individuals using. Our monograph is going to focus on 3 different subtopics that correspond with our main issue on substance use and abuse.

The first issue we will focus Finally, we'll talk about Then, we are going to on is prescription drug new issues surrounding introduce Needle/Syringe abuse. This can be fentanyl that stem from Exchange. Sharing needles extremely dangerous the presence of has caused many serious leading to overdose and problems and induced disease tranquilizers in fentanyl, even death. This is an causing extended transmission. Reused needles ongoing problem, however, were the second-highest risk catatonic states in users there have been many rules immediately. This has led factor for HIV infection, and regulations put into to numerous problems according to the study. place for prescribers and for addicts ranging from Therefore, avoiding needle pharmacists to follow for robbery to increased exchange can efficiently the patient's safety. overdose rates. reduce virus infection.

Prescription Drug Abuse The misuse of prescription drugs means taking a medication in a way or a dose other than prescribed; taking someone else’s prescription, even if for a legitimate medical complaint such as pain; or taking a medication to have a more intense effect. The most misused prescription drugs are opioids. They cause a slowed breathing rate and the By: Meghan Valentine, BSPS Candidate potential for breathing to stop. Another abused prescription is anti-anxiety medicines and sedatives, which help you feel calm or less anxious but stopping medication will lead to withdrawals such as an overactive nervous system and seizures. Lastly, stimulants are commonly misused, which can increase body temperature, cause heart problems, high blood pressure, and paranoia. This abuse continues to become an increasing problem that is affecting all age groups starting as young as the age of 12 globally.

Early identification of prescription drug abuse and early intervention may prevent the problem from turning into an addiction. There are many laws and regulations put into place to protect the abuse of prescription drugs such as the prescription drug monitoring programs which is an electronic database that tracks controlled substance prescriptions in a state for each patient. Also the patient should always follow directions carefully and use your medicine the way it was prescribed. Never use another person's prescription because dosing is specific to the patient it is prescribed. Prescription drug abuse can have serious medical consequences. Prescription drug misuse over the past two decades has led to a significant increase in overdose deaths involving prescription drugs.

As you can see in this line plot the systems developed to protect patients from abusing prescription medication have helped. We can see a decrease in Americans misusing Rxdrugs over the past 5 years. The resources and tools that states and the federal government have implemented are working to protect individuals from addiction and even a fatal overdose.

https://drugabusestatistics.org/prescription-drug-abuse-statistics/

A Decline in the Abuse of Rx Drugs

Prescription drug abuse. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/ prescription-drug-abuse/symptoms-causes/sy 20376813.

Published October 25, 2022.

Rise in prescription drug misuse and abuse impacting teens. SAMHSA. https://www.samhsa.gov/homelessness-programs-resources/hprresources/rise-prescripti on-drug-misuse-abuse-impacting-teens.Published April 13, 2022.

Needle & Syringe Exchange

Celine Huo, BSPS Candidate

Intercultural/Global Issue

Background Since the beginning of the AIDS epidemic, needle exchange programs have been established in several developed countries and have proven effective in reducing AIDS transmission. Many papers have presented data that shows the correlation between sharing needles and the increase in HIV infection.

HIV and Hepatitis C are the two common diseases that are transmitted by shared needles in the community. According to the CDC, HIV can survive in a used syringe for up to 42 days, which makes sharing syringes the second riskiest behavior for getting HIV. People who inject drugs might develop other major health issues such as skin infections and heart infections in addition to being at risk for HIV and viral hepatitis.

Solution Society has established rules to prevent needle reusing: Only licensed pharmacists may sell hypodermic needles and syringes to adults aged 18 and older without a prescription.

Moreover, syringe services programs (SSPs) are tested and reliable community-based preventive initiatives that can offer various services, such as access to and disposal of sterile syringes and injection supplies, immunization, testing, and connections to caring for infectious diseases and drug abuse.

SSPs have effectively lowered disease transmission.

"Syringe services programs (SSPs) reduce the disease transition and improve community health."

--Celine Huo

HIV and injection drug use. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/hiv-transmission/injection-druguse.html#:~:text=Sharing%20needles%2C%20syringes%2C%20or%20other,transmitting%20HIV%20and%20other%20infections. Published April 21, 2021.

Summary of information on the safety and effectiveness of Syringe Services Programs (ssps). Centers for Disease Control and Prevention. https://www.cdc.gov/ssp/syringe-services-programs-summary.html. Published January 11, 2023. Accessed March 27, 2023.

Fentanyl Crisis MORE PREVELENT AND POTENT

Laura Payne, BSPS Candidate

To the general US public, fentanyl usually comes up along with death. This is largely due to the recent boom in the US of drugs being made with traces, or greater, of fentanyl in them. Fentanyl is one of the strongest opiates available, and due to this paints a pretty picture for those suffering from opiate addiction. For those not yet suffering, fentanyl cause deadly overdoses in a very rapid amount of time.

This has led to a recent public surge in concern over the drug and its use on the streets, especially in drugs that would not normally contain the substance. Outside of the US, there seems to be a spike in opiate abuse, which indicates that this problem could be spreading to have a more global impact.

Benzo-Dope

substance.uvic.ca/blog/xylazine/

When it comes to those who are already suffering from specifically fentanyl addiction, the problem is getting much worse.

Recently on the streets the presence of fentanyl cut with tranquilizers, such as benzodiazepines, have been popping up When fentanyl is combined with benzodiazepines, which can't be everywhere. The term counteracted by naloxone, the results are terrifying. The benzo-dope results used for these drugs is in a catatonic state for users that can last for hours. In this state, users have “benzo-dope”. been subjected to a whole host of problems including rape, robbery, and the loss of limbs due to gangrene forming.

"This is an issue likely to go onto the back burner" -L Payne

Many fatal overdoses have also been the result of benzo presence in fentanyl, as illustrated in the figures above. These drugs are most likely coming from overseas, specifically China, making this an intercultural issue. It does however currently hit the US the hardest.

How can the US government combat this problem? Programs for addicts must be set p and overprescription must be reduced.

However, due to the stigma around those affected and the already deep effects of previous overprescription, this will take time.

Han, Y., Yan, W., Zheng, Y. et al. The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies. Transl Psychiatry 9, 282 (2019). https://doi.org/10.1038/s41398-019-0625-0 https://www.vice.com/en/article/4awv3d/rise-of-benzo-laced-fentanyl. Published November 18, 2021. Accessed February 7, 2023.

Pardo B. Insights Into Mixing Fentanyl and Benzodiazepines From Canadian Drug Seizures. JAMA Psychiatry. 2022;79(1):81–83. doi:10.1001/jamapsychiatry.2021.3292