Sabbatical Leave Final Report

My plan for sabbatical leave is to renew my commitment to personal counseling by: 1) Reacquainting myself with the current manual used to diagnose psychiatric disorders - DSM-IV-TR, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; 2) Reading the latest professional journals and texts; 3) Attending several professional workshops, either live, on line, or through audio recordings; and 4) Immersing myself in the study, diagnosis, and treatment of students with Asperger\u27s Syndrome, an autistic spectrum disorder

PUBH 3231 - Epidemiology and Biostatistics

This course introduces the student to the principles and practice of epidemiology and vital statistics. Students will be exposed to the historical development of epidemiology, concepts of causality, definitions of health and disease, and sources of community health data. Current principles and practices in the cause, prevention and control of diseases in various community settings will be emphasized

Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?

Context: Health disparities are among the critical public health challenges. Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement. Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities. Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four activities. LHD characteristics significantly associated (p≤0.05) with the increased likelihood of performing activities to address health disparities were: recent completion of community health assessment, community health improvement plan and agency wide strategic plan. Other significant positive impacts on such activities included per capita expenditures, local governance, having one or more local boards of health, larger population size and metropolitan status of the LHD jurisdiction. Conclusions: Reduced infrastructural capacity of LHDs has resulted in fewer LHDs addressing health disparities in their jurisdictions. LHD characteristics associated with higher performance of activities for health disparity reduction identified by this research have important policy implications

Investigating factors that improve golf scores by comparing statistics of amateur golfers in repeat scramble strokes and one-ball conditions

This study investigated how scores and statistics of amateur golfers changed when self-scramble (SC) was compared to normal play. Participants took two (SC2) to three (SC3) golf strokes each. Scores under these conditions were compared with those from normal round (NR) play to determine to what extent the scores and statistics would improve. Means, standard deviations, repeated measures one-way ANOVA, and a forward stepwise multiple regression analysis were performed for data analysis. The mean total score over nine holes by NR plays was 46.6 strokes, with a significant reduction of 7.7 strokes and 10.6 strokes under SC2 and SC3 conditions, respectively. Even when the three play conditions’ total scores decreased significantly for all subjects, the putt rate was around 38%, suggesting that the ratio of the number of putts per score did not change when play conditions changed. Stepwise multiple regression analysis for NR and SC2 using total score as the dependent variable and each statistic as the independent variables showed that greens in regulation (GIR) predicted 51.2% of the total score for NR; GIR and the One-Putt rate predicted 87.3% of the total score for SC2. These findings indicate that GIR is the most important factor for reducing non-professional golfers’ total scores. This study suggests that players gain experience in reducing their golf scores in a format that is similar to an actual game of golf

Principal leadership qualities needed for the twenty-first century: A reflective essay

According to Heck (1991), Socrates once defined an ideal leader as a philosopher-king. This person would be secluded from society so as to be unaffected by the behaviors of politicians. He claimed that being surrounded by these types of people could lead to such undesirable traits as greed, dishonesty or illogical thinking. After a period of years, this person would emerge having been tutored by the wisest teachers and well-prepared to rule the rest of society

Tracing sources of natural organic matter, trihalomethanes and metals in groundwater from a karst region

Groundwater offers an important source for drinking water around the world; however, groundwater quality is under increasing pressure and is particularly vulnerable in karst areas. Total organic carbon (TOC) is significantly related to groundwater quality and when not removed by water treatment processes can give rise to the formation of disinfection by-products trihalomethanes (THMs) above the level of compliance. This study investigated the source of organic matter giving rise to the THM exceedances in a groundwater supply in a karst area. Results highlighted that source water for this groundwater supply was prone to surface water infiltration linked to rainfall events; was not accurately captured in the zone of contribution (ZoC); had inadequate treatment of natural organic matter (NOM) and suffered THM exceedances in 45% of sampling events. THMs were mostly represented by chloroform and caused by terrestrial delivered reprocessed organic matter. This work will support water managers tasked with decision-making

Diverse populations of T cells with NK cell receptors accumulate in the human intestine in health and in colorectal cancer

T cells expressing NK cell receptors (NKR) display rapid MHC-unrestricted cytotoxicity and potent cytokine secretion and are thought to play roles in immunity against tumors. We have quantified and characterized NKR+ T cells freshly isolated from epithelial and lamina propria layers of duodenum and colon from 16 individuals with no evidence of gastrointestinal disease and from tumor and uninvolved tissue from 19 patients with colorectal cancer. NKR+ T cell subpopulations were differentially distributed in different intestinal compartments, and CD161+ T cells accounted for over one half of T cells at all locations tested. Most intestinal CD161+ T cells expressed § g TCR and either CD4 or CD8. Significant proportions expressed HLA-DR, CD69 and Fas ligand. Upon stimulation in vitro, CD161+ T cells produced IFN- + and TNF- § but not IL-4. NKT cells expressing the V § 24V g 11 TCR, which recognizes CD1d, were virtually absent from the intestine, but colonic cells produced IFN- + in response to the NKT cell agonist ligand § -galactosylceramide. NKR+ T cells were not expanded in colonic tumors compared to adjacent uninvolved tissue. The predominance, heterogeneity and differential distribution of NKR+ T cells at different intestinal locations suggests that they are central to ntestinal immunity

Influence of family planning and immunization services integration on contraceptive use and family planning information and knowledge among clients: A cross-sectional analysis in urban Nigeria

Reproductive autonomy necessitates that women have access to high quality family planning information and services. Additionally, closely spaced pregnancies increase maternal and infant morbidity and mortality. Although integrating family planning into child immunization services may increase access to information and services and postpartum contraceptive use, evidence on how integration affects service delivery and health outcomes is scarce. One limitation of previous studies is the use of binary integration measures. To address this limitation, this study applied Provider and Facility Integration Index scores to estimate associations between integration and contraceptive use, receipt of family planning information, and knowledge of family planning services availability. This study leveraged pooled cross-sectional health facility client exit interview data collected from 2,535 women in Nigeria. Provider and Facility Integration Index scores were calculated (0–10, 0 = low, 10 = high) for each facility (N = 94). The Provider Integration Index score measures provider skills and practices that support integrated service delivery; the Facility Integration Index score measures facility norms that support integrated service delivery. Logistic regression models identified associations between Provider and Facility Integration Index scores and (a) contraceptive use among postpartum women, (b) receipt of family planning information during immunization visits, and (c) correct identification of family planning service availability. Overall, 46% of women were using any method of contraception, 51% received family planning information during the immunization appointment, and 83% correctly identified family planning service availability at the facility. Mean Provider and Facility Integration Index scores were 6.46 (SD = 0.21) and 7.27 (SD = 0.18), respectively. Provider and Facility Integration Index scores were not significantly associated with postpartum contraceptive use. Facility Integration Index scores were negatively associated with receipt of family planning information. Provider Integration Index scores were positively associated with correct identification of family planning service availability. Our results challenge the position that integration provides a clear path to improved outcomes. The presence of facility and provider attributes that support integration may not result in the delivery of integrated care

Fine-tuning language models to find agreement among humans with diverse preferences

Recent work in large language modeling (LLMs) has used fine-tuning to align outputs with the preferences of a prototypical user. This work assumes that human preferences are static and homogeneous across individuals, so that aligning to a a single "generic" user will confer more general alignment. Here, we embrace the heterogeneity of human preferences to consider a different challenge: how might a machine help people with diverse views find agreement? We fine-tune a 70 billion parameter LLM to generate statements that maximize the expected approval for a group of people with potentially diverse opinions. Human participants provide written opinions on thousands of questions touching on moral and political issues (e.g., "should we raise taxes on the rich?"), and rate the LLM's generated candidate consensus statements for agreement and quality. A reward model is then trained to predict individual preferences, enabling it to quantify and rank consensus statements in terms of their appeal to the overall group, defined according to different aggregation (social welfare) functions. The model produces consensus statements that are preferred by human users over those from prompted LLMs (>70%) and significantly outperforms a tight fine-tuned baseline that lacks the final ranking step. Further, our best model's consensus statements are preferred over the best human-generated opinions (>65%). We find that when we silently constructed consensus statements from only a subset of group members, those who were excluded were more likely to dissent, revealing the sensitivity of the consensus to individual contributions. These results highlight the potential to use LLMs to help groups of humans align their values with one another