Digital Commons Network^™

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 …

Covid And The Great Retrenchment, Samuel R. Bagenstos

Articles

The past six years have seen two dramatic shifts in federal health and benefits policy. First, during the COVID pandemic, the government dramatically expanded public benefits. These expansions had incredibly positive effects, and recipients were largely satisfied with them. But after a relatively short time, Congress rolled back nearly all of the expansion. Worse, the immediate pullback set the stage for even more significant retrenchments in the second Trump Administration. Where in 2023 the United States came closest to universal health care in its history—with a record low uninsured rate of 7.7%—the Trump Administration’s Medicaid cuts and failure to extend …

Factors That Impede Women's Contraceptive Care Needs During And Immediately After Incarceration In New South Wales, Australian. Qualitative Perspectives Of Professional Staff Working With Incarcerated Women, Helene Smith, Mandy Wilson, Basil Donovan, Jocelyn Jones, Tony Butler, Paul Simpson

Research outputs 2022 to 2026

Introduction: Women with a history of incarceration report higher rates of pregnancy and abortion, lower contraception use and poorer birth outcomes compared to other women in the community. This suggests family-planning and reproductive-health needs that are not well served by current models of care. Despite this, little is known about how contraception is provided within Australian carceral settings, or the structural barriers experienced by professional staff working in these environments. We report findings from a qualitative study conducted in New South Wales (NSW), Australia, describing professional staff's views of factors that support or impede women's contraceptive care needs both during …

Governing Professional Mobility: An Llm-Assisted Framework And Empirical Taxonomy Of Health-Professional Mobility Agreements, David C. Benton, Andrew D. Benton

Research outputs 2022 to 2026

Background: Health-professional mobility agreements (eg, compacts, mutual recognition arrangements, memoranda of understanding) are increasingly used to address workforce shortages, support crossborder practice, and enable new technology-mediated modes of service delivery. Regulators need rapid, reproducible ways to assess whether such instruments protect the public while facilitating proportionate professional mobility.

Purpose: To develop and internally test a 10-dimension, 41-subdimension assessment framework for health-professional mobility agreements; examine whether large language model (LLM)–assisted coding can approximate expert legal regulatory assessment; and derive an empirical taxonomy of mobility and other similar instruments.

Methods: A focused documentary synthesis of legal instruments, academic literature, and intergovernmental guidance …

Knowledge, Intentions And Attitudes Towards Osteoporosis And Other Health Conditions Among Older Australians, Phuong Dung Lam, Satvinder S. Dhaliwal, Christina M. Pollard, Jonine M. Jancey, Richard L. Prince, Deborah A. Kerr

Research outputs 2022 to 2026

Background: Osteoporosis burden is underdiagnosed and undertreated. While increasing community awareness and education are recognised priorities, research on how older adults view osteoporosis is limited. The aim was to assess osteoporosis-related knowledge, intentions and attitudes in relation to other health conditions in Australian adults aged 50 years and older.

Methods: A validated online questionnaire, developed with an expert panel, was administered to 1432 healthy volunteers, (64.3 ± 9.5 years). The questionnaire assessed knowledge of osteoporosis risk factors, attitudes and intentions. Multivariable logistic regression identified factors associated with low knowledge.

Results: Knowledge score across six topics was 29.5 ± 14.5 (100 …

Restricting Outdoor Advertising Of Unhealthy Food: Feasibility Of Using A Nutrition Classification System In Australia, Claire E. Pulker, Frith Klug, Georgina S.A. Trapp, Ainslie Sartori, Michelle Mcintosh, Alexia Bivoltsis, Catrina Mcstay, Clare Whitton

Research outputs 2022 to 2026

Objective: Exposure to food advertising is associated with consumption. Globally, most outdoor food advertisements feature unhealthy foods or beverages. As Australian local government areas (LGAs) begin developing restriction policies, the feasibility of applying nutrient-based Nutrition Classification Systems to outdoor advertising requires evaluation.

Design: Observational study on 1) types of food business advertisements outdoors and 2) availability of quantitative nutrition and/or ingredient information for featured products. 178 outdoor advertisements were analysed, from a 500m audit around schools in 16 stratified LGAs (2019), along with bus shelter audits in four LGAs (2022). Advertisements were categorised as featuring ‘branded packaged products’, ‘food service …

Multi-Omics Integration Reveals Vaccine-Specific Molecular Signatures And Temporal Dynamics Of Covid-19 Immune Responses, Anne H. Klein, David J. Beale, Thao V. Nquyen, Jian-Wei Liu, Petrus Jansen Van Vuren, Nagendrakumar B. Singanallur, Carol Lee, Andrew C. Boomer, Jennifer A. Juno, Stephen J. Kent, Adam K. Wheatley, Gough G. Au, Seshadri S. Vasan, Laurence Wilson, Alexander J. Mcauley

Research outputs 2022 to 2026

Vaccination elicits systemic immune responses that extend beyond antibody and lymphocyte activation, engaging coordinated metabolic and lipid pathways that modulate immune function. Nevertheless, how systemic molecular responses differ across COVID-19 vaccine platforms, including closely related mRNA platforms, remains poorly understood. Here, we performed integrated plasma proteomic, lipidomic, and metabolomic profiling of 53 SARS-CoV-2–naïve adults vaccinated with Pfizer-BioNTech, Moderna, or AstraZeneca COVID-19 vaccines. Samples were analysed across multiple timepoints using differential analysis and DIABLO-based multi-omics integration. Our findings reveal distinct platform-associated multi-omic molecular signatures not captured by unsupervised analyses alone. Pfizer-BioNTech vaccination was associated with widespread increases in immunoglobulin and complement …

Promoting The Concept Healthy Ageing For Use In Gerontological Health And Social Care Policy And Practice, Claire Donnellan

Research outputs 2022 to 2026

Aims: The concept of healthy or successful ageing dates back to the 1960s, where its goal is more realistic in today's ageing society as a result of effective interventions to control and reduce disability and health risks. The aim of this paper is to outline the importance of defining ageing, the semantics and indicators used, and to identify common challenges for health professionals' understanding and application of a healthy ageing approach in their everyday clinical practice. Design and Methods: This discursive paper demonstrates how realistic ageing indicators are for highlighting the variation and impact of challenges associated with ageing. It …

Sugar Consumption In Aboriginal Children Explored From A Social Practice Perspective, Amy Budrikis, Angela Durey, Dan Mcaullay, Paul Ward, Hanny Calache, Thierry Ng, Roma Winmar, Linda Slack-Smith

Research outputs 2022 to 2026

Australian Aboriginal children have higher sugar intake and are disproportionately affected by sugar-related diseases such as obesity, diabetes and dental caries than non-Aboriginal children. The intention of this paper was to highlight the need for approaches that can capture the complexity of health practices without reducing them to either individual choice or structural determination. We explore sugar consumption in Aboriginal children from a social practice perspective. Here, the unit of analysis is the practice, not the individual, where the elements of a social practice (competence, materials and meanings) are integrated into its performance. We conducted qualitative research using elements of …

Participatory Development Of Innovation And Implementation Strategy: An Action-Oriented Approach, Miae Lee, Lesley A. Anderson, Emilia Piltonen, Abha Maheshwari, Julian Griffin, Seshadri S. Vasan

Research outputs 2022 to 2026

Background: Healthcare and academic institutions face growing challenges in strategic planning due to rapid advances in medicine and technology, alongside fiscal and workforce constraints that limit traditional consultation. Participatory approaches offer a way to integrate diverse stakeholder perspectives under these constraints, generating contextually relevant strategies that can indicate whether current directions are appropriate or whether priorities have been overlooked.

Methods: A structured, time-limited participatory workshop was conducted at the 10th Grampian Research Conference (June 2025), that brought together National Health Service (NHS) staff, academia, industry and patients and public communities. Participants engaged in 14 parallel roundtable discussions, with contributions captured …

Thorium Lung Burdens Of Norm Workers Revisited, Gregory S. Hewson, Martin I. Ralph, Marcus Cattani

Research outputs 2022 to 2026

Historical thorium bioassay data collected from Australian mine workers in the 1990s, including in vivo lung counting and thoron-in-breath (TIB) measurements, were re-evaluated using current dosimetric and biokinetic models. Revised daily thorium intakes from bioassay were compared with previous estimates to assess changes in the dose profile and potential implications for contemporary operations. Reanalysis revealed lower estimates of annual dose, including the number of workers assessed as exceeding 20 mSv. However, it was found that intakes derived from industry personal air sampling (PAS) underestimated intake by up to three-fold. This study determined that sensitive bioassay techniques, such as TIB using …

Forced Oscillation Technique In Pneumothorax (Pneumofot) Study, Niranjan Ananda Setty, Carolyn J. Mcintyre, John Blakey, Yun Chor Gary Lee

Research outputs 2022 to 2026

Forced Oscillation Technique in Pneumothorax (PneumoFOT) study A single-centre prospective pilot feasibility study designed to assess the feasibility of performing FOT measurements in patients with pneumothorax. STATISTICAL ANALYSIS PLAN Version 24.05.2026

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

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 …

Hyphema Associated With Water Bead Projectile Toys: A Retrospective Comparative Study, Aashri I. Aggarwal, Priya K. Singh, Diego E. Arias, Peter A. Netland

Department of Ophthalmology Faculty Publications

Purpose: Superabsorbent water beads can be used in projectile toy guns. We aimed to characterize water bead-related hyphema and compare the prevalence with other causes of traumatic hyphema.

Methods: In this 10-month retrospective review, we identified 35 consecutive patients with traumatic hyphema presenting to the emergency department. Cases were grouped by injury mechanism, water bead-related compared with all other causes. Clinical data on initial presentation and subsequent visits were compared.

Results: In the patients with traumatic hyphema, 8 (23%) cases were due to water bead trauma. Bead-related cases involved significantly younger patients (16 ± 9 years) compared with other cases …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

The Dual-Factor Model (Dfm) Of Mental Among Appalachian Youth, Mawyah Adel Bashatah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background. Adolescent mental health is a critical public health concern, particularly in rural Appalachian communities where rates of depression, anxiety, and substance use exceed national averages and access to mental health resources remain severely limited. Traditional mental health frameworks rely predominantly on the identification and reduction of psychopathological symptoms, neglecting the independent contributions of positive well-being to adolescent risk and resilience. The Dual-Factor Model (DFM) of mental health offers a more comprehensive alternative by simultaneously assessing subjective well-being (SWB) and psychopathology, classifying individuals into four distinct groups: Complete mental health, Vulnerable, Symptomatic but content, and Troubled. Despite the DFM’s growing …

Behavioral Economic Factors Implicated In Young Adult Drinking In The Natural Environment: An Ema Study, Tatiana Magri

Graduate Studies Theses and Dissertations 2026

Background: Young adult (YA) alcohol use remains a prominent public health concern. Despite research efforts aimed at mitigating harms related to drinking, rates of alcohol use and adverse outcomes related to use, remain high among YAs. Previous research has identified alcohol demand, craving, and delay discounting as risk factors for problematic drinking among YAs. However, few studies have concurrently examined these constructs using methodologies that maximize ecological and contextual validity. Method: YA individuals (N=104) completed an ecological momentary assessment (EMA) protocol assessing three demand indices (i.e., intensity, Omax, and breakpoint), delay discounting, craving, and alcohol use and problems. Participants received …

Examining Attrition In Rtms For Smoking Cessation: The Roles Of Perceived Research Burden And Delay Discounting, Miranda Proctor

Graduate Studies Theses and Dissertations 2026

This secondary analysis examined predictors of attrition in a randomized clinical trial conducted by Roswell Park Comprehensive Cancer Center evaluating repetitive transcranial magnetic stimulation (rTMS) for cigarette smoking cessation. Smoking cessation reduces cancer risk and mortality and improves mental health outcomes. Although rTMS shows promise for supporting sustained abstinence by targeting neurobiological mechanisms underlying nicotine dependence, participant attrition threatens statistical validity, reduces power, and limits generalizability. Identifying predictors of attrition is therefore critical for optimizing trial design and retention.

Research examining predictors of attrition in smoking cessation trials remains limited. Prior work in other clinical populations suggests that higher perceived …

Teledentistry: A Path To Minimize Emergency Department Dependency For Dental Issues, Aishwarya Joshi

Graduate Studies Theses and Dissertations 2026

Teledentistry has been promoted as a strategy to minimize emergency department (ED) visits for non-traumatic dental conditions (NTDCs). However, it remains unclear whether structural readiness or temporary policy expansion drives sustained reductions in reliance on the ED. This study integrates Andersen’s Behavioral Model of Health Services Use and Diffusion of Innovation (DOI) theory to examine determinants of Medicaid NTDC ED utilization and Tele-dentistry adoption.

Andersen’s model posits that utilization is shaped by predisposing, enabling, and need factors, whereas DOI theory emphasizes structural attributes that influence adoption, including relative advantage, compatibility, complexity, trialability, and observability. Combining these frameworks allows for a …

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

Children With Cystic Fibrosis Can Lead Normal Lives; It All Started With The Nih, The Center For Integration Of Science And Industry

CISI Publication

Cystic fibrosis is a model of what can be accomplished with sustained support from the government, public, and biotechnology industry.

Our research shows that the NIH funded research underlying >99% of all drugs approved 2010-2024 with an average spending of $1.4 billion/drug approval.1-4 This research creates the foundational knowledge required for successful drug development by industry.

Health Insurance As A Mediator Of Neighborhood Deprivation And Pediatric Cancer Survival: An Analysis Of State Cancer Registry Data, Emma Hymel, Cheng Zheng, Jenna Allison, Kendra L. Ratnapradipa, Edward S. Peters, Sarah H. Nash, Mei-Chin Hsieh, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

INTRODUCTION: To develop interventions to reduce neighborhood-level disparities in pediatric cancer outcomes, it is necessary to understand their underlying mechanisms. It has been suggested that individual-level health insurance is a mediator of neighborhood deprivation and pediatric cancer survival.

METHODS: This study was a population-based longitudinal study of children with cancer from 2000 to 2020 in the Iowa Cancer Registry and Louisiana Tumor Registry. Neighborhood deprivation was measured using the Area Deprivation Index. Log-binomial regression models were used to identify predictors of health insurance status at diagnosis. Cox regression models were used to assess the association between health insurance status at …

Outbreak Preparedness And Response In A Globalized World: Are We Ready?, Francesca F. Norman, David Brett-Major, Chiara Sepulcri, Emmanuel Bottieau, Theresa Sepulveda, Federica Toscanini, Laura A. Nicolini, Jesse J. Waggoner, Sami Alcedo, Davidson H. Hamer, Ralph Huits, Michael Libman, Geosentinel Network, Tropnet Network, Kevin O'Laughlin

Journal Articles: Epidemiology

BACKGROUND: Recent global epidemics and pandemics have highlighted the need for adequate diagnostic capacities to respond to emerging threats. Strengthening operational capacities can lead to improved preparation; investing in emergency response infrastructure may diminish progression of outbreaks and prevent escalation.

METHODS: An email-linked survey was sent January-March-2025 to two global infectious disease surveillance networks' (GeoSentinel and TropNet) participating clinics assessing capacity for Oropouche virus (OROV) diagnostic testing. Data on testing capacity for other arboviruses was also requested.

RESULTS: Responses were obtained for 58 GeoSentinel/TropNet sites (58/104, 55.8%): 50% responding sites (29/58) had OROV diagnostic testing available at a public reference …

Climate And Other Environmental Factors Predict Tick Abundance And Lyme Cases In Minnesota One And Two Years In Advance, Kathleen E. Angell, Janet Jarnefeld, Elizabeth K. Schiffman, M. Jana Broadhurst, Jianghu James Dong, Abraham Degarege, Roberto Cortinas, David Brett-Major

Journal Articles: Epidemiology

BACKGROUND: Environmental factors, like weather and host abundance influence tick populations which in turn affect tickborne disease in endemic regions. It is important to understand how these factors are associated with tick abundance, and whether they can predict disease. We assessed associations between environmental factors, tick abundance, and human Lyme disease cases in the same year and with one- and two-year lags in Minnesota. In parallel, we compare conventional analytical methods with a novel machine learning approach to evaluate their relative strengths and potential for integration.

METHODS: Environmental and tick abundance relationships were examined using generalized linear mixed-effects models (GLMM), …

When Clades Collide: Genomic Admixture In Blacklegged Ticks (Ixodes Scapularis) From The Great Plains, Kaylee S. Herzog, Zach Pella, Halie Smith, Dayna Mccormick, Lily Nuss, Amanda Brinkworth, Sujata S. Chaudhari, Kathryn Duncan, Kellee Sundstrom, Sydney Stein, Holly Black, Jose E. Pietri, Ryan C. Smith, Jeff Hamik, Roberto Cortiñas, Joseph R. Fauver

Journal Articles: Epidemiology

Ixodes scapularis ticks transmit a number of pathogens important to human health, including Borrelia burgdorferi sensu stricto, the causative agent of Lyme disease. While I. scapularis is found across the Eastern United States, Lyme disease transmission is largely limited to the Northeast and Upper Midwest and is nearly absent in the South. This indicates that differences in northern versus southern clades of I. scapularis are associated with differences in Lyme disease transmission risk. Ixodes scapularis is undergoing range expansion, including into the Great Plains region of the United States. Determining where I. scapularis populations in the Great Plains originated can …

Prevalence Of Grip And Leg Strength Asymmetries In U.S. Youth, Elyse M. Deschryver

Theses and Dissertations

Early-life physical activity is important for building muscular strength, supporting healthy growth and disease prevention, and for establishing physical activity and strength habits that often track into adulthood. Although grip strength asymmetry is a well-documented risk factor in older adults, evidence in children and adolescents is limited and largely based on small, sport-specific samples. PURPOSE: To describe grip and leg extension strength asymmetries in a nationally representative sample of U.S. youth aged 6–15 years using the National Youth Fitness Survey (NNYFS). METHODS: The analysis included 1,214 participants (606 boys, 608 girls) with valid grip or leg extension data. Age, sex, …

On Burden Of Diseases, Prevention, Medical Research And Health Service Delivery: Grampian Case Study, Seshadri S. Vasan, Sudarshan Anand, Miae Lee, Nicholas C. Fluck

Research outputs 2022 to 2026

Burden of diseases measured as disability-adjusted life years (DALYs) per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions, and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified that selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias …

Reflecting On Themes From Telehealth Consultations Early In The Pandemic: An Opportunity To Learn From Multiprofessional Colleagues, Maggie Meeks, Laura R. Joyce, John Dean, Lorna Davies, Tika Ormond, Philippa Seaton, Dale Sheehan, Dean Sutherland, Melanie Welfare, Arindam Basu

Research outputs 2022 to 2026

Aims: This study is aimed at documenting the reflections of New Zealand healthcare professionals on the use of synchronous telehealth consultations. Methods: A qualitative narrative inquiry was conducted to explore the practice of telehealth in New Zealand. Purposive sampling was used to identify clinicians from multiple professions who used telehealth during the initial phase of the COVID-19 pandemic. Fifteen semistructured interviews were conducted between October 2020 and May 2021 with clinicians from primary and secondary care, including multiple professional backgrounds. Interview transcripts were analysed thematically. Results: Six themes were identified: (1) equitable access: There were concerns regarding equitable access to …