Global vaccination coverage remains profoundly uneven, especially across the Global South. Varying levels of vaccine uptake in these countries are not shaped by access alone but can be influenced by deeper forms of institutional mistrust rooted in historical, economic, and political relationships between citizens, healthcare systems, and the government. We investigated whether COVID-19 vaccine decisions in Africa are rooted in negative healthcare experiences or in deeper epistemic mistrust of authority and the government. Using the Afrobarometer Round 9 Dataset, through Principal Component Analysis (PCA) and Bayesian multilevel cumulative hurdle models, we modeled drivers of COVID-19 vaccine interest and status, as well as reasons for not receiving the COVID-19 vaccine, and assessed these data against varying degrees of institutional mistrust and differing healthcare experiences. Our study reveals that lower trust shifts vaccination refusal away from pragmatic considerations like medical safety and concern, and towards institutional skepticism or illegitimacy. Additionally, while healthcare experience initially showed weak associations with vaccination outcomes, these associations diminished once measures of institutional mistrust were introduced in our findings, and institutional mistrust serves as a stronger independent predictor for vaccine decision-making. Understanding such complex drivers of vaccination coverage can provide a platform for public health programs aimed at promoting vaccination in the Global South.

Neurological diseases such as Alzheimer’s severely impairs one’s memory, cognition, and behavior which can significantly impact the quality of life for both patients and caregivers. This project explores the benefits of music therapy as a nonpharmacological and noninvasive intervention which addresses the emotional and mental well-being of various communities. Furthermore, the feasibility of music therapy as an effective public health intervention is also investigated. Throughout this project, the research question regarding how music therapy can be integrated as a form of care for individuals living with neurological disorders in the clinical setting is expanded upon. To examine these findings, a comprehensive literature review was conducted alongside peer-reviewed articles, interviews, and case-based observations. The research conducted by Myrah, a digital health startup exploring the intersections of music therapy, caregiving, and public health, was taken into consideration as well. Centering music as both a holistic and accessible approach, there are a multitude of ways music can be integrated into one’s day-to-day life. Music therapy serves as a valuable tool in promoting health and preserves humanity in a community. Even in the state of cognitive decline, music provides a temporary respite, reminding everyone that they are deeply human. This project aims to promote the importance of exploring music as a public health intervention and raise awareness for individuals living with neurological diseases such as Alzheimer's.

Background Long Ambulance Patient Offload Time (APOT) limits emergency medical service (EMS) availability for calls, increasing critical response times. In October 2024, the UCLA ED implemented the “Physician Optimizer,” an additional attending physician from 1-9 pm, to perform roles including rapid assessment of ambulance arrivals. This study aims to understand the impact of an optimizer program on APOT, and other operational metrics. Methods We conducted a pre-post study at the UCLA RRH ED with the pre-intervention, Phase 1 (10/1/24 - 3/31/25) and intervention period, Phase 2 (4/1/25 - 11/1/25). We examined APOT across phases, as well as between Optimizer and non-Optimizer hours within Phase 2. Secondary outcomes include medical screening exam time (MSE), door to doc time (D2D), Initial Patient Contact (IPC). Results There were 9833 total ED visits brought in by ambulance (BIBA). 4490 visits during Phase 1 and 5343 visits during Phase 2. During Phase 1, median APOT was 14.57 minutes. 27.5% of Phase 2 visits were BIBA during optimizer hours, 72.5% during non-optimizer hours. During Phase 2 median (IQR) APOT was 7.52 minutes during optimizer hours, 13.04 minutes during non-optimizer hours. Median MSE, D2D, and IPC among all ED visits BIBA were also analyzed. Conclusion Observed decreases in median APOT during optimizer hours suggest a dedicated physician improves ED operational metrics. Future studies may assess cost-benefit of an optimizer physician, staff cohesiveness, and EMS response times to subsequent calls.

Empathic communication skills are essential to high-quality and equitable patient care, yet traditional simulations using actors are often resource-intensive, leaving many learners feeling unprepared for difficult conversations. To address this gap, we developed an Artificial Intelligence (AI) driven communication skills training module that simulates challenging patient phone call conversations meant to trigger evolved mechanisms that predispose clinicians to feel negatively about patients who appear aggressive, exploitative, or otherwise risky. Trainees are tasked with following the Humanism Pocket Tool, a set of techniques clinicians can use to counteract biases and stay humanistic during three scenarios. We developed the simulation using the generative AI audio platform ElevenLabs and refined it through iterative prompt testing. We also implemented an AI coaching agent to provide customized performance evaluations to learners, enabling improvement of empathic communication skills through feedback and repeated deliberate practice. Next steps include a pilot study with clinicians and trainees to assess usability and impact. Our goal is to scale up AI-powered simulations to equip future healthcare professionals with hands-on opportunities to rehearse compassionate communication skills that could improve patient-physician interactions and ultimately patient health outcomes.