Digital Commons Network^™

Directional Association Between Irritable Bowel Syndrome And Dermatological Disease: A Large-Scale Retrospective Study, Alex Y. Liu, Naomi T. Matsuno, Houston Nelson, David Johnson, David Pariser

Department of Medicine Faculty Publications

Background/Objectives: Microbial dysbiosis is implicated with a pathogenic role in both irritable bowel syndrome (IBS) and several dermatological conditions. Yet, few studies have assessed a potential overlapping epidemiologic association. We aimed to assess the 1-year prevalence of common dermatologic conditions following an initial IBS diagnosis and to evaluate the reverse association using reciprocal analyses. Methods: We conducted a retrospective study using TriNetX. Patients aged 18–50 with no history of inflammatory bowel disease, celiac disease, or infectious intestinal disease were matched 1:1 to healthy controls by demographics and comorbidities. The primary outcome was the prevalence of acne vulgaris, psoriasis, …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Trends In Hypertension Prevalance And Control In The United States Over 25 Years, Omar Saleh, Neda Rehan, Saleh Mostafa, Rehan Qayyum

Department of Medicine Faculty Publications

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear …

A Fishy Situation: Hand Infection Due To Mycobacterium Marinum Mistaken For Giant Cell Tumor, Alynna Knaub, Dylan Baker, Jennifer Hanrahan

Department of Medicine Faculty Publications

Mycobacterium marinum is an acid-fast bacterium (AFB) associated with exposure to water and aquatic species. When inoculated, infection can result in nodular cutaneous lesions. In the absence of detailed history or culture data, these nodular skin lesions can be mistaken for noninfectious orthopedic conditions. We present a case of M. marinum mistaken for a giant cell tumor. This case illustrates the overlap in these conditions, as well as the utility of QuantiFERON Gold testing to provide supportive evidence for the diagnosis of Mycobacterium marinum.

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Ultra-Processed Foods And The Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, And Translational Evidence, Saiful Singar, Amirhossein Ataei Kachouei, Leandro Lantigua-Somoano, David Manley, Anthony Cardinale, Muhammad Zulfiqah Sadikan, Saurabh Kadyan, Donya Shahamati, Lorena Dias, Amber Wood, Cinthia Chavarria, Sara K. Rosenkranz, Neda S. Akhavan

Department of Medicine Faculty Publications

Cardiovascular-kidney-metabolic (CKM) syndrome integrates excess adiposity, metabolic dysfunction, kidney impairment, subclinical cardiovascular diseases, and clinical events along a staged continuum that invites unified prevention and treatment. Ultra-processed foods (UPFs) are a complex, high-prevalence exposure that may influence risk across CKM stages through nutrient profiles, additives, processing-induced compounds, and packaging-related contaminants. This review synthesizes epidemiologic, mechanistic, and translational evidence with attention to exposure definition and analytic rigor. We summarize NOVA-based UPF operationalization across dietary assessment tools, highlighting misclassification of mixed dishes, brand heterogeneity, and energy under-reporting, and we propose further examination of energy-adjusted models, calibration, and harmonized metrics. Observational studies consistently …

Micro- And Nanoplastics: A Paradigm Shift In The Pathogenesis Of Inflammatory Bowel Disease, Michael Saadeh, Priyata Dutta, Gordon Hong, Edward Oldfield, David A. Johnson

Department of Medicine Faculty Publications

Micro- and nanoplastics (MNPs) are pervasive environmental contaminants with growing recognition as potential contributors to human disease. Widespread human exposure occurs primarily through ingestion of contaminated food and water, and MNPs have been detected in multiple human tissues, including the gastrointestinal tract. Experimental evidence provides a plausible biological basis for disease associations, including impairment of intestinal barrier integrity, activation of mucosal immune pathways, and alteration of gut microbial communities caused by MNP exposure. Although human data remain limited, early studies demonstrate MNP detection in stool and suggest potential correlations with inflammatory biomarkers such as fecal calprotectin. These findings, together with …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

Glucagon-Like Peptide Receptor Agonists (Glp-1ras) As Cardiovascular Risk Modifiers In Obstructive Sleep Apnea And Obesity: A Real-World Study, Jaeun Ahn, Junmin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Nathaniel T. Gordon, Joshua M. Sill

Department of Medicine Faculty Publications

Introduction

Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients.

Methods

We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching …

Association Of Valvular Disease Progression Using Echocardiographic Findings In A Large U.S. Cohort, Abes A. Bautista Neughebauer, Amin Yehya, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Background

The prevalence of valvular disease in the US is approximately 2.5%. Given that over 5 million Americans are affected, it is crucial to find those at higher risk of progression. The goal of this paper is to uncover which patients are more likely to have valvular disease progression using demographic factors, EKG and echocardiogram (ECHO) findings.

Methods

This paper utilized the EchoNext Database, which pairs 100,000 electrocardiograms and echocardiograms based on specific structural heart disease labels. Univariate and multivariate logistic regression were used to find risk factors for progression for aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), …

Nirmatrelvir-Ritonavir Targeting Viral Persistence In Post-Covid-19 Condition (Long Covid) In The Usa (Recover-Vital): A Randomized, Double-Blind, Placebo Controlled, Phase 2 Trial, Lindsey R. Baden, Nirav S. Shah, Sean T. H. Liu, Jonathan Cohen, James May, Andre Kumar, Grace A. Mccomsey, Peter Chen, Michelle Floris-Moore, Nora G. Singer, Inti Fernandez, Alex J. Slandzicki, Zanthia Wiley, Alexandra Kadl, David A. Kaminsky, Harvey Hsu, Tiffany A. Walker, Aluko A. Hope, Luis Ostrosky-Zeichner, Jason D. Goldman, Michael J. Peluso, Thomas F. Patterson, Sairam Parthasarathy, Janet M. Mullington, Paul Bolin Jr., Sarah E. Jolley, Jerry A. Krishnan, Mario Castro, Sally L. Hodder, Priscilla Pemu, Helen Y. Chu, Michael G. Risbano, Maya R. Jerath, Eleftherios Mylonakis, Ryan T. Hurt, Radica Alicic, Nabila S. Azad, Marc A. Sala, Michelle S. Harkins, Jeffrey Parsonnet, Neil Stafford, Philip Robinson, Sabiha Hussain, Xian Qiao, Sophie Two Hawk, Michael Lillestol, Nathan Erdmann, Kelly A. Gebo, Praveen Sudhindra, Joseph Sassine, Gailen D. Marshall, Tulika Chatterjee, Caryn G. Morse, Eyal Kedar, William W. Stringer, Jennifer A. Frontera, Michael Jordon, Caitlin Blaskewicz, Jorge L. Santana, Rachel A. Foot, Cherry Wongtrakool, Matthew William Mccarthy, Alem Mehari, Arch Amon, Alison K. Cohen, Nita Jain, Christine Maughan, Doug Lindsay, Rachel Olson, Samuel Broderick, Pearl Rowe, Sean M. O'Brien, David R. Walt, Bruce D. Levy, Leonard A. Jason, Phillip A. Low, Cyndya A. Shibao, Barry Make, Lucinda Bateman, Susan Redline, David Knopman, Adrian F. Hernandez, Tracy L. Nolen, Craig Reist, Lisa Berdan, Richard Whitley, Kanecia O. Zimmerman, For The Recover-Vital Clinical Trial Group

Department of Medicine Faculty Publications

Background

Post-acute sequelae of SARS-CoV-2 infection, more commonly known as long COVID, has emerged as a major health problem. The pathogenesis of long COVID is unknown, but among the leading hypotheses is viral persistence. We aimed to investigate whether the use of the SARS-CoV-2 antiviral nirmatrelvir-ritonavir improved long COVID symptoms.

Methods

We conducted a double-blind, placebo-controlled, randomised trial involving adults who had developed persistent symptoms (≥12 weeks) associated with three major symptom phenotypes (cognitive, autonomic, or exercise) after acute SARS-CoV-2 infection at 69 US sites. Participants were eligible if they were 18 years or older and had a previous suspected, …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

Spectral Frequency And Broadband Noise Analysis Of The Firefighter Environment: Potential Implications For Cardiac Health, James Blando, Catherine Reed, Amya Turner

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Firefighters are well known to have elevated risk of adverse health outcomes across a wide range of diseases and injuries, including cancer, hearing loss, fatal cardiac events, post-traumatic stress disorder (PTSD), sleep disorders, and many other adverse outcomes. It has been speculated that the noise environment is a significant risk factor for several of these diseases. In particular, the impact of noise on cardiac outcomes has recently been identified. An environmental survey of noise that included spectral and broadband analysis was conducted across all 14 firehouses in a southeastern city in the United States as a first step to investigate …

Paneugenesis: A Regenerative Systems Hypothesis For Advancing Health Promotion, Craig M. Becker, Leslie Hoglund, Beth Chaney, Joseph G. L. Lee, Michael Stellefson, Alex Davis

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Despite major advances in health promotion science, dominant approaches remain largely prevention-and risk-reduction-oriented. The prevailing orientation creates a substantial opportunity to advance generative, system-design strategies that intentionally produce well-being rather than merely prevent disease. This article proposes paneugenesis as a regenerative systems framework and a testable theoretical model for the intentional creation of net-positive outcomes, thereby extending health promotion beyond its traditional pathogenic emphasis. Paneugenesis integrates systems science, salutogenesis, behavioral science, complexity theory, and quality management principles into a unified four-function process: operationalizing idealized outcomes, identifying key precursors, optimizing processes, and continually plotting progress through feedback mechanisms. The central hypothesis …

Examining The Association Of Maternal Oral Health Experiences With Adverse Birth Outcomes: Findings From Virginia's Prams Survey, May Salama, Abdullah Al-Taiar, Denise C. Mckinney, Li-Wu Chen, Anwar T. Merchant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Preterm birth (PTB) and low birth weight (LBW) are significant public health challenges globally, contributing to neonatal morbidity, mortality, and long-term complications. Maternal oral health has been increasingly recognized as a potential contributor to PTB and LBW, yet there is inconclusive evidence about the effectiveness of dental cleaning in preventing PTB and LBW. This study examined the association between dental cleaning during pregnancy and the prevalence of PTB and LBW using data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods

We analyzed data from Virginia PRAMS Phases 7 and 8, spanning a 10-year period from 2012 to …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …

Systematic Review And Meta‑Analysis Of United States Childhood Obesity Public Policy Interventions, Marilyn Frenn, Maharaj Singh, Julia A. Snethen, Leigh Small, Nancy Browne, Cindy Smith Greenberg, Emily Horner, Sharon Y. Irving, Eric A. Hodges

College of Nursing Data

No abstract provided.

Meta-Analysis Of The Health Effects Of Gas Cooking In Homes, P. Jacob Bueno De Mesquita, Núria Casquero-Modrego, Erik Pontes

Arts & Sciences Faculty Publications

Background: Given existing evidence linking indoor gas combustion with potential health effects, we aimed to quantify from epidemiologic field studies the health impacts associated with residential gas cooking and unvented heating.

Methods: We evaluated and synthesized results from peer-reviewed epidemiologic studies that isolated associations between exposure to residential gas cooking and/or unvented heating and an unrestricted range of health outcomes. We focused on studies conducted since 2000 that cited at least one of five, well-regarded studies. We evaluated relevant studies and computed pooled effect estimates, where at least three studies contributed data, using random effect meta-analysis models with inverse-variance weighting. …

Combined Effects Of Cumulative Triglyceride-Glucose And Blood Pressure On Stroke In Middle-Aged And Older Chinese Adults: A Longitudinal Analysis, Xinyue Wang, Wen Zheng, Xiangqian Jin, Hongzhi Liu, Jiheng Hao, Liyong Zhang, Yuanyuan Gu, Haifeng Hou, Wei Wang

Research outputs 2022 to 2026

Background: The triglyceride-glucose (TyG) index has increasingly been recognised an indicator for stroke risk. We aimed to explore the relationship between TyG and blood pressure (BP) and the combined effects of cumulative TyG (CumTyG) and cumulative BP (CumBP) on stroke risk in a cohort of Chinese middle-aged and older adults. Methods: We enrolled 5138 participants from the 2011–2018 waves of the China Health and Retirement Longitudinal Study. Cumulative TyG and BP exposures were recorded between 2011 and 2015, and stroke incidence was then followed up until 2018. We conducted a cross-lagged panel analysis to address the temporal and directional relationships …

Implementation Of Risk Prediction And Stratification Approaches For Ageing Populations In Australian Healthcare: A Systematic Review, Leanne Greene, Jacob Brain, Belinda Brown, Claire V. Burley, Elissa Burton, Zhongyang Guan, Bronwyn Myers, Katherine Ride, Serena Sabatini, Mario Siervo, Abay Woday Tadesse, Eugene Yee Hing Tang, Blossom C.L. Stephan, Jennifer Dunne

Research outputs 2022 to 2026

Despite widespread development of prognostic risk stratification tools, their implementation in Australian healthcare remains poorly characterised. This review identified tools implemented for adults aged ≥40 years and examined their real-world use. Following PRISMA and SWiM guidelines, MEDLINE, EMBASE, Web of Science, PsycINFO, and CINAHL Plus were searched from inception to 20th February 2026. Eligible studies reported implementation of a risk stratification tool in Australian healthcare and health, functional, or implementation outcomes. The Mixed Methods Appraisal Tool assessed study quality. Of 7115 records screened, 21 studies were included across primary care, hospitals, residential aged care, and community services. Interventions included electronic …

Machine Learning Derived Abdominal Aortic Calcification Is Associated With Physical Frailty In Community-Dwelling Adults: The Uk Biobank Imaging Study, Abadi K. Gebre, Marion Mundt, Elsa Dent, James Webster, Afsah Saleem, Syed Zulqarnain Gilani, Yuandan Zhang, Cassandra Smith, Parminder Raina, John P. Kemp, William D. Leslie, John T. Schousboe, Nicholas C. Harvey, Joshua R. Lewis, Marc Sim

Research outputs 2022 to 2026

Clinical cardiovascular disease (CVD) is often present in frail individuals. However, it remains unclear whether subclinical CVD, e.g., abdominal aortic calcification (AAC), is associated with frailty. This study investigated the cross-sectional relationship between AAC scored using a validated machine learning model (ML-AAC24) and physical frailty. 49,081 participants from the UK Biobank Imaging Study without atherosclerotic CVD (ASCVD) diagnosis were included. ML-AAC24 extent was categorised as low, moderate and high, based on established severity categories. Physical frailty was based on a modified Fried’s frailty phenotype comprising weak hand grip strength, slow walking speed, weight loss, exhaustion, and physical inactivity. Individuals with …

Reduced Physical Activity During Submarine Deployment: Health And Performance Consequences And Feasible Countermeasures—A Narrative Review, Benjamin J.C. Kirk, Georgios Mavropalias, Anthony J. Blazevich, Jodie L. Cochrane Wilkie, Aus Molan, Kazunori Nosaka

Research outputs 2022 to 2026

Objectives: Submarine environments pose unique challenges to maintaining physical activity due to space constraints, operational demands, and prolonged confinement. This review aims to synthesize existing literature on the health and performance consequences of reduced physical activity in submarine personnel and to examine feasible strategies to mitigate these effects during deployment. Methods: A narrative overview methodology was adopted, with peer-reviewed studies identified from PubMed, Scopus, and Google Scholar. Articles examining physical activity patterns, health outcomes, and exercise or movement-based interventions in submarine environments and comparable confined operational settings were included. Results: Submarine deployments are consistently associated with reduced physical activity, low …

Under-Five Mortality Estimation Methods: A Methodological Systematic Review, Bereket Kefale, Jonine Jancey, Amanuel T. Gebremedhin, Daniel Gashaneh Belay, Gavin Pereira, Gizachew A. Tessema

Research outputs 2022 to 2026

Purpose This methodological systematic review aimed to identify and synthesise the existing under-five mortality (U5M) estimation methods globally. Methods We searched seven databases including Medline, Embase, Scopus, Web of Science, CINAHL, Global Health, and ProQuest Central, as well as grey literature sources from inception to September 25, 2025. The review protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023465476). Results Fifty-six studies were included in this review. The most frequently employed child mortality estimation method was the indirect method (n = 16), followed by the Global Burden of Disease (GBD) study method (n = 12) …

Alcohol Advertising At The Beach: Insights From Young People In Western Australia, Renee N. Carey, Gemma Crawford, Nicola D'Orazio, Gina S.A. Trapp, Lauren Nimmo, Tina Lam, Jonine Jancey, Justine E. Leavy

Research outputs 2022 to 2026

Background: Advertising and marketing by the alcohol industry serve to normalise alcohol use, with exposure to alcohol advertising linked to earlier and riskier drinking among young people. Advertising that portrays alcohol use in and around waterways is of particular concern, with one in five fatal drownings being associated with alcohol. Objective: This study aimed to explore the types of alcohol advertising that young people were exposed to, and to determine whether exposure to alcohol advertising was related to their alcohol use in aquatic environments. Methods: We surveyed 102 young people aged 18 to 25 years attending a free event at …

Predictors Of Quality Of Family Planning Counselling In Ethiopia: Multilevel Analysis Of The Spa Survey 2021/22, Kalayu Brhane Mruts, Tesfay Brhane Gebremariam, Amanuel Tesfay Gebremedhin

Research outputs 2022 to 2026

Background: High-quality family planning (FP) counselling is essential for informed contraceptive choice, reducing discontinuation, and improving reproductive health. However, many women in sub-Saharan Africa continue to face barriers. This study examined client-, provider-, and facility-level determinants of FP counselling quality in Ethiopia using nationally representative, multi-source data. Methods: We analysed data from the 2021/22 Ethiopia Service Provision Assessment, including 2,224 women who received or were prescribed injectables, pills, or implants. Counselling quality was assessed using a 15-item checklist derived from direct observations and client exit interviews. Multilevel ordinal logistic regression was applied to identify predictors at the client-, provider-, and …

Global, Regional, And National Burden Of Epilepsy, 1990–2021: A Global Burden Of Disease Study, Jinqing Zhao, Qiannan Chen, Jiahan Dong, Meng Gao, Siqi Ge, Anxin Wang

Research outputs 2022 to 2026

Background: Epilepsy is a common neurological disorder characterised by spontaneous seizures without an identifiable cause, leading to high morbidity and a significant public health burden. Understanding trends in its incidence, prevalence, mortality, and disability-adjusted life years (DALYs) is essential for developing effective prevention and treatment strategies. We aim to describe global trends in epilepsy over the past 32 years and explore the impact of sociodemographic index (SDI) levels on disease burden using the Global Burden of Disease 2021 data. Methods: We analysed the global burden of epilepsy (1990–2019) using age-standardised rates (ASRs) and their 95% uncertainty intervals (UI). We assessed …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 6: Quality, Leadership And Governance (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Alexiou, Peter D’Cress, Kasie Jackson, Karen Hunter, Stacey Mckenzie, Avalon O’Dowd, Asha Rojahn, Blake Stewart, Henry Tan

Research outputs 2022 to 2026

Quality, Leadership and Governance are central pillars in the role early learning settings play in children’s growth, development and wellbeing. By meeting regulatory requirements and quality standards through stringent business procedures and continuous improvement practices, services can provide high-quality food environments for all children – shaping their thoughts, feelings, and practices around food and eating.

This Quality, Leadership and Governance (QLG) module aims to:

- Provide critical context for how the Early Childhood Education and Care (ECEC) food environment is intertwined with National Law and Regulations.

- Support services to meet regulatory requirements, through specific resources and guidance.

- Provide …