Exploring public health education's integration of critical race theories: A scoping review.

Introduction: Public health has declared a commitment toward diversity as a whole, with a commitment toward addressing and dismantling racism being at the forefront. Although public health has admirably taken on this mission, and the foundational principles of public health align with social justice and health equity, public health as a discipline is vastly behind other fields in integrating and utilizing critical race theorizations. Of particular concern is the lack of critical race theorization within public health education materials. Public health education serves as a precursor to public health practice and situates topics and competencies that are essential to one's foundational public health knowledge and skillset, thus the use of strong theoretical groundings is critical in public health education. Objectives: Therefore, to explore the current landscape of public health educational research that employs critical race theories, this study sought to conduct a scoping review investigating the current literature of public health pedagogical, instructional, and curricular efforts that utilize race and antiracist theorization principles as a means to administer public health education. More specifically, we sought to investigate how have faculty and instructors published their integration of race theorization in public health curriculum/instruction within the United States since 2011. Results: We found 18 examples from peer-reviewed literature of curricular, pedagogical, or instructional practices and strategies that integrate critical theories of race, including contemplative pedagogy (n = 1), antiracism (n = 3), Public Health Critical Race praxis (n = 4), Critical Race (n = 5), critical service-learning/community engagement (n = 2), ethnic studies (n = 1), and intersectionality (n = 2). Conclusion: These articles present a wide breadth of innovative approaches to infusing critical race studies within public health higher education, ranging from individual assignments to course design and implementation to institutional culture change, thus demonstrating the multifaceted nature of critical race studies within micro-learning communities and macro-discipline practices. Identifying theoretically grounded, exemplary models and scholarly recommendations of pedagogical, instructional, and curricular practices provides readers the opportunity to borrow from successful practices and implement concepts of race, racism, antiracism, intersectionality, and more into their classrooms.

Global health-based virtual exchange to improve intercultural competency in students: Long-lasting impacts and areas for improvement.

Introduction: As public health expands its role in global settings, the need to develop intercultural competency for public health students also grows. One initiative being applied to promote global awareness is the use of virtual exchange (VE) programs. VE programs promote collaborative online international learning (COIL) and allow students from different countries to connect and work together on projects related to their field of study; however, there is little research around the long-term impacts of these programs. Methods: Undergraduate pre-health students from the United States who participated in a VE program a year prior were interviewed about their experiences engaging with undergraduate medical students in Egypt. They were asked if the experience impacted their current behaviors, skills, or knowledge, and what improvements could be made to the program. Mezirow's Transformative Learning Theory (TLT) served as the theoretical framework, grounding interview instrument development and directed content analysis procedures. Researchers also engaged in inductive analysis to capture other salient themes. Results: Ten students were interviewed with a majority engaging in either of the two final stages of Mezirow's TLT: "building of self-confidence and self-competence" (60%) and "reintegration" (50%). Other salient themes found were intercultural interactions, VE appreciation, and VE improvements. When describing their experience in one word, students overwhelmingly provided words with positive connotations (80%), with the negative responses being explained by the structure and presentation of the VE. Discussion: Students were able to apply lessons they learned during the VE within a 1-year follow-up period. This is beneficial, as health professionals require intercultural competency to promote and provide improved health outcomes. Results from this study indicate the need for structure when conducting a VE, addressing the need to increase the number of direct interactions and thereby promoting more intercultural exchanges. Likewise, the interviews demonstrated that changes in course instruction need to be implemented gradually to allow for students to adjust to unfamiliar teaching methods.

Transforming Perspectives Through Virtual Exchange: A US-Egypt Partnership Part 2.

Collaborative online international learning programs, such as virtual exchange, that utilize telecollaborative activities have been integrated into more classrooms within the higher education setting. These programs provide students exposure to international cultures, perspectives, and ideas is no longer considered "value added", but a prerequisite to entering many workforces. These programmatic objectives compliment Mezirow's Transformative Learning Theory, that substantiates two major elements of transformative learning are critical reflection and dialectical discourse. This study presents the second half of a qualitative inquiry into the prominent themes that arose during a virtual exchange that was conducted in March 2021 between students in the United States (US) enrolled in a global public health course and Egyptian microbiology students. This study sought to expand upon the Transformative Learning Theory through inductive analysis procedures to offer a modernized adaptation of the theoretical framework within international learning environments. Student responses enrolled in an undergraduate global public health course were collected and analyzed by two coders using inductive/open coding to identify salient codes. These codes were then summarized into categories and subsequently defined. Resulting themes include Connectedness, Openness, Acquisition of Knowledge and Skills, Communication, Cultural Identity, Anticipation of Options for New Roles, Relationships, and Actions, and Absence of Change. Several themes have corresponding categories and subcategories. Adult learning environments such as the modern college classroom have changed with the introduction and reliance upon online learning domains, as well as the diversification of higher education student demographics, accentuating the need to inductively analyze student learning processes and outcomes. In doing so, our findings provide a modernized adaptation of the Transformative Learning Theory that allows for adult learning theorists, researchers, and scholars to integrate tenets of transformative learning more appropriately. As such, this provides an opportunity for educators to coalesce the identified mechanisms (e.g., openness, cultural background, anticipation of roles and relationships) to bolster student's willingness and ability to engage in transformative critical reflections. By capitalizing on students' innate characteristics, such as open-mindedness predispositions and cultural background, educators are able to augment transformative learning strategies through tailored assignments and course activities.

Transforming Perspectives Through Virtual Exchange: A US-Egypt Partnership Part 1.

With more classrooms within higher education mobilizing strategies for internationalization, collaborative online international learning (COIL), also referred to as virtual exchange, is an effective approach at offering intercultural competence through experiential learning. This strategy provides students who face barriers to international travel the opportunity to engage with students from other countries in meaningful ways, while enhancing and reinforcing course content. Grounded in the transformative learning theory, this study evaluates the effectiveness of a virtual exchange that was implemented within an undergraduate global public health course. The virtual exchange connected students from the University of Florida (within the US) with medical students in a microbiology course at Ain Shams University in Cairo, Egypt. Using adapted reflection prompts, we assessed the students' knowledge and learning before, during, and after the virtual exchange. This was coupled with a final paper to capture how personal backgrounds and experiences may contribute to their perception of the virtual exchange, as well as if they felt their global perspective had changed or shifted during the experience. Using directed content analysis for each of the measurements, two researchers coded the data independently to then present agreed upon salient themes to the larger group. Of the 28 randomly sampled students who participated in the virtual exchange, seven major themes emerged from the data: Connectedness; Openness; Acquisition of Knowledge and Skills; Communication; Cultural Identity; Anticipation of Options for New Roles, Relationships, and Actions; and Absence of Change. Through this evaluation it was clear there was a variance of different perspectives with many sampled students having diverse lived experiences that influenced their worldview prior to the virtual exchange. Despite course-related barriers, students acknowledged several facilitating factors that improved their intercultural competence and knowledge of course content. The integration of a virtual exchange within the classroom, with careful design and implementation, can provide a unique experience for students and an inclusive approach to learning.

What does community resilience mean in the context of trauma-informed communities? A scoping review.

Several communities are implementing trauma-informed, community-level approaches focused on addressing/preventing adverse childhood experiences (ACEs), yet most community resilience definitions from published articles are based on acute traumas. This scoping review aims to determine how community resilience is defined and operationalized within the context of chronic/complex traumas. METHODS: We performed a rigorous, comprehensive literature search using multiple databases. RESULTS: The 38 included articles addressed multiple types of chronic traumas, including historical trauma, poverty, minority stress, mass incarceration, and ACEs. A variety of definitions of community resilience were cited, several of which stressed the ability to thrive despite risk factors and the safety and wellbeing of residents. Few articles operationalized community resilience within the context of ACEs, suggesting significant gaps in the literature. CONCLUSION: This review can serve as an important building block to develop expanded definitions of community resilience for chronic traumas and assist communities in promoting community-wide responses to ACEs.

DISOLV: A Python Package for the Interpretation of Borehole Dilution Tests.

Single borehole dilution tests (SBDTs) are an inexpensive but effective technique for hydrogeological characterization of hard-rock aquifers. We present a freely available, easy-to-use, open-source Python package, DISOLV, for plotting, analyzing, and modeling SBDT data. DISOLV can significantly reduce the time spent interpreting field data by helping to identify flowing fractures intersecting the borehole and estimate the corresponding flow rates. DISOLV is successfully benchmarked against two analytical solutions. We also present an example application to real data collected in a borehole in a crystalline basement aquifer in southern India.

Protective Factors Using the Life Course Perspective in Maternal and Child Health.

The life course perspective (LCP), a valuable theoretical framework for investigating racial disparities in birth outcomes, examines the cumulative exposure of risk and protective factors throughout the life span. Although risk and protective exposures are equally vital to health, most studies have focused solely on the risk factor exposures faced by vulnerable populations. In clear contrast to the traditional public health approach, which emphasizes a deficit model, strengths-based approaches focus on protective factors and fostering resilience. These approaches view communities as valuable assets that have the capacity to fully engage themselves and their residents to achieve optimal health. Participatory action research methods are well suited to apply a strengths-based approach to understand health disparities. Our study aimed to explore maternal and child health protective factors from community residents' perspective. A group of researchers, including active members in the community with a long history of grassroots development work, conducted ten community-based participatory focus groups with community residents in Tampa, FL, using the LCP framework. A total of 78 residents participated in ten focus groups. Perceived protective factors during pregnancy included self-esteem, spirituality, pregnancy support, good nutrition, prenatal care, and community resources. Protective factors for non-pregnant women were self-esteem, spirituality, social support, health literacy, community support and community resources, and societal factors. For children and adolescents, relevant protective factors were self-esteem, positive role models, nutrition and physical activity, and community support. The identified factors are community assets or strengths that mitigate or eliminate maternal and child health risks in families and communities residing in low-income neighborhoods, which must be considered in developing effective maternal and child health interventions.

Hypoxia-Activated, Small-Molecule-Induced Gene Expression.

Hypoxia, a condition of reduced oxygen, occurs in a wide variety of biological contexts, including solid tumors and bacterial biofilms, which are relevant to human health. Consequently, the development of chemical tools to study hypoxia is vital. Here we report a hypoxia-activated, small-molecule-mediated gene expression system using a bioreductive prodrug of the inducer isopropyl 1-thio-ß-d-galactopyranoside. As a proof-of-concept we have placed the production of a green fluorescent protein under the control of hypoxia. Our system has the potential to be extended to regulate the production of any given protein of choice.

CYP450 Enzymes Effect Oxygen-Dependent Reduction of Azide-Based Fluorogenic Dyes.

Azide-containing compounds have broad utility in organic synthesis and chemical biology. Their use as powerful tools for the labeling of biological systems in vitro has enabled insights into complex cellular functions. To date, fluorogenic azide-containing compounds have primarily been employed in the context of click chemistry and as sensitive functionalities for hydrogen sulfide detection. Here, we report an alternative use of this functionality: as fluorogenic probes for the detection of depleted oxygen levels (hypoxia). Oxygen is imperative to all life forms, and probes that enable quantification of oxygen tension are of high utility in many areas of biology. Here we demonstrate the ability of an azide-based dye to image hypoxia in a range of human cancer cell lines. We have found that cytochrome P450 enzymes are able to reduce these probes in an oxygen-dependent manner, while hydrogen sulfide does not play an important role in their reduction. These data indicate that the azide group is a new bioreductive functionality that can be employed in prodrugs and dyes. We have uncovered a novel mechanism for the cellular reduction of azides, which has implications for the use of click chemistry in hypoxia.