Public Health Commons^™

Covid-19 And Health Equity: Lessons Learned From The Pandemic, Sumaya Ali, Lakell Archer, Erica L. Jensen

Journal of Nonprofit Innovation

Health inequities refer to avoidable, unjust differences in health outcomes caused by systemic disadvantages rooted in social, economic, and environmental contexts (Braveman, 2014). Health disparities refer to differences in health outcomes between groups, often measured by prevalence, morbidity, or mortality (Centers for Disease Control and Prevention [CDC], 2020). Health inequalities are measurable differences in health status that may arise from biological, social, or environmental factors (World Health Organization [WHO], 2019). Health inequities, however, are specifically preventable and unjust differences.

The COVID-19 pandemic highlighted these inequities, intensifying pre-existing structural disparities within healthcare and societal systems. The pandemic underscored the urgency of …

A Framework For Human Evaluation Of Large Language Models In Healthcare Derived From Literature Review, Thomas Yu Chow Tam, Sonish Sivarajkumar, Sumit Kapoor, Alisa V Stolyar, Katelyn Polanska, Karleigh R Mccarthy, Hunter Osterhoudt, Xizhi Wu, Shyam Visweswaran, Sunyang Fu, Piyush Mathur, Giovanni E Cacciamani, Cong Sun, Yifan Peng, Yanshan Wang

Faculty, Staff and Student Publications

With generative artificial intelligence (GenAI), particularly large language models (LLMs), continuing to make inroads in healthcare, assessing LLMs with human evaluations is essential to assuring safety and effectiveness. This study reviews existing literature on human evaluation methodologies for LLMs in healthcare across various medical specialties and addresses factors such as evaluation dimensions, sample types and sizes, selection, and recruitment of evaluators, frameworks and metrics, evaluation process, and statistical analysis type. Our literature review of 142 studies shows gaps in reliability, generalizability, and applicability of current human evaluation practices. To overcome such significant obstacles to healthcare LLM developments and deployments, we …

Molecular Targets For Breast Cancer Therapy, Hamidreza Montazeri Aliabadi

Pharmacy Faculty Articles and Research

"Breast cancer is by far the most common cancer in women, and for a while, it surpassed lung cancer as the most diagnosed cancer, regardless of gender, in 2020 [1]. Chemotherapy and hormone therapy are still the first line of treatment, despite extensive research in molecularly targeted drugs. Therefore, triple negative breast cancer (TNBC) is still known as the most challenging type for treatment due to the limited identified targets. Inherent and acquired resistance are still major hurdles in breast cancer therapy, which further highlights the importance of identifying new molecular targets in this battle. The inherent resistance of unresponsive …

Genomic And Socioeconomic Determinants Of Racial Disparities In Breast Cancer Survival: Insights From The All Of Us Program, Nubaira Rizvi, Hui Lyu, Leah Vaidya, Xiao Cheng Wu, Lucio Miele, Qingzhao Yu

School of Public Health Faculty Publications

Background: Breast cancer outcomes are worse among Black women in the U.S. compared to White women. While extensive research has focused on risk factors contributing to breast cancer; the role of genomic elements in health disparities between these racial groups remains unclear. This study aims to identify genomic variants and socioeconomic status (SES) determinants influencing racial disparities in breast cancer survival through multiple mediation analyses. Methods: Our investigation is based on the NIH-supported All of Us (AoU) program and analyzes 7452 female participants with malignant tumors of breast, including 5073 with genomic data. A log-rank test reveals significant racial differences …

Noninvasive Multi-Cancer Detection Using Blood-Based Cell-Free Micrornas, Jason Zhang, Hallgeir Rui, Hai Hu

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Patients diagnosed with early-stage cancers have a substantially higher chance of survival than those with late-stage diseases. However, the option for early cancer screening is limited, with most cancer types lacking an effective screening tool. Here we report a miRNA-based blood test for multi-cancer early detection based on examination of serum microRNA microarray data from cancer patients and controls. First, a large multi-cancer training set that included 1,408 patients across 7 cancer types and 1,408 age- and gender-matched non-cancer controls was used to develop a 4-microRNA diagnostic model using 10-fold cross-validation. In three independent validation sets comprising a total of …

Sequencing-Based Detection Of Avian Influenza A(H5n1) Virus In Wastewater In Ten Cities, Michael J Tisza, Blake M Hanson, Justin R Clark, Li Wang, Katelyn Payne, Matthew C Ross, Kristina D Mena, Anna Gitter, Sara J Javornik Cregeen, Juwan Cormier, Vasanthi Avadhanula, Austen Terwilliger, John Balliew, Fuqing Wu, Janelle Rios, Jennifer Deegan, Pedro A Piedra, Joseph F Petrosino, Eric Boerwinkle, Anthony W Maresso

Faculty, Staff and Student Publications

No abstract provided.

Sequencing-Based Detection Of Avian Influenza A(H5n1) Virus In Wastewater In Ten Cities, Michael J Tisza, Blake M Hanson, Justin R Clark, Li Wang, Katelyn Payne, Matthew C Ross, Kristina D Mena, Anna Gitter, Sara J Javornik Cregeen, Juwan Cormier, Vasanthi Avadhanula, Austen Terwilliger, John Balliew, Fuqing Wu, Janelle Rios, Jennifer Deegan, Pedro A Piedra, Joseph F Petrosino, Eric Boerwinkle, Anthony W Maresso

Faculty, Staff and Students Publications

No abstract provided.

Economic Factors Affecting Patients Who Use Safety Net Clinics And Food Insecurity In Rio Grande Valley, Michael Machiorlatti, Cliff Clark, Deepu George

Research Colloquium

Food insecurity (FI) is a pervasive problem. It is linked to education and parental SES. The burden is not distributed equally. Younger and older groups are at greater risk along with those who identify with marginalized groups. The purpose of this study was examine how self-reported social determinants are associated with FI in the lower Rio Grande Valley.

The study was conducted at safety net clinics (14) in the RGV from April 1, 2021, to Dec 1, 2021. A common instrument was developed used across the clinics. Goals were to identify what social determinants of health are clients of each …

Gathering And Using Demographic Data For The Rio Grande Valley, Jennifer Cahn, Aniella N. Perez

Research Colloquium

Background: “Statistics are people with the tears wiped away.” Dr. Irving J. Selikoff Statistics, as the quote above suggests, often seem very removed from the lived experience of individuals, particularly in regard to their health concerns. Yet used well, demographic statistics can paint a clear, objective picture of the population being studied, significantly strengthening the validity of research as well as justifying requests for resources such as grant funding.

Method: As a tool for UTRGV researchers, research administrative staff in the School of Medicine have created a demographic table of key data on basic population characteristics including economics, education and …

Bodyweight Changes During Covid-19 For Patients Diagnosed With Depression: A Retrospective Cohort Study, Elias Arellano Villanueva, Kimberly Fulda

Research Colloquium

Background: The effects of the COVID-19 pandemic on mental health and body weight have been well documented, however a possible direction of the causality of the relationship between depression and weight as affected by lockdown measures has not been studied. This study examined if depression was associated with changes in BMI during the COVID-19 lockdown. We hypothesized that depressed adults (DEP) would have a greater increase in BMI than non-depressed adults (NDEP), and that greater pre-post changes in BMI would be observed among younger DEP compared to middle-aged and older DEP and NDEP.

Methods: Retrospective cohort study design using EHR …

Review Of The Heumann Perspective Podcast, Jennifer Woody Collins

Feminist Pedagogy

This media review of the Heumann Perspective podcast encourages educators to use it as a way to discuss and teach disability justice and activism.

Emotional Overeating And Eating Motives During Covid-19 In Polish Women: Intergroup Comparison Among Participants In Various Body Mass Index Categories, Adriana Modrzejewska, Justyna Modrzejewska, Kamila Czepczor-Bernat, Julia Wyszomirska

Baltic Journal of Health and Physical Activity

Introduction: Taking into account the situation of the COVID-19 pandemic and the ac-companying lockdown resulting in increased negative emotions, it is interesting to learn about eating motives and behaviors and check their intensity. The aim of this study was to investigate the differences between Polish women in various body mass index categories in terms of eating motives and emotional overeating during the COVID-19 pandemic. Material and methods: This study sample comprised 1,447 women (M_age = 31.34 ± 11.05; M_BMI = 23.79 ± 4.59). The research used the following tools: the Eating Motivation Survey, the Emotional Overeating Questionnaire, and …

The Relationship Between The Clinical Scales Of The Personality Assessment Inventory And Bmi Reduction In Bariatric Surgery Patients, Douglas Lytz

Doctor of Psychology (PsyD)

Since the National Institute of Health recommendation in 1991, most bariatric clinics and insurance companies across the United States now require psychological evaluations for patients before receiving bariatric surgery (Marek & Heinberg, 2016). Clinicians are now using various objective personality measures and other assessment tools during comprehensive evaluations to help make recommendations to surgeons and clinical staff about patient suitability for weight loss surgery. Previous studies suggest that specific demographics and clinical elevations on objective personality assessments may predict the reduction of body mass index (BMI) in patients after bariatric surgery (Oltmanns et al., 2020; Hoyt & Walter, 2022a). This …

How Family Communication Emerges In Hpv Vaccine Parent Narratives, Samantha Garcia, Suellen Hopfer, Michelle Miller-Day, Jamie Mccain, Michael L. Hecht

Communication Faculty Articles and Research

Family communication surrounding HPV vaccination can support or hinder HPV cancer prevention strategies. We used narrative communication theory to elicit HPV vaccine decision narratives in the context of family communication from a purposive sample of 29 parents of adolescents. Parent narratives indicated that family negotiations occur throughout the decision-making process, topic avoidance was common among parents of unvaccinated and undervaccinated children, parents had concerns that vaccination is a sign of approving sexual permissiveness, and family communication was often prompted by encounters in the exam room. Understanding complex family dynamics in the context of vaccination decision-making, the role of family communication …

Relationship Between Household Water Sanitation And Hygiene Behaviors And Diarrhea Between 2010-2020 In Rwanda, Amans Ntakarutimana Dr., Patrick A. Tschida Dr.

Journal of Social, Behavioral, and Health Sciences

Rwanda has made considerable progressive policy efforts to significantly reduce diarrhea among children under 5 years old, especially since 2010. This cross-sectional study aimed to assess the relationship between household water sanitation and hygiene (WASH) behaviors and diarrhea among children under 5 years old between 2010 and 2020. We used secondary data from the 2010, 2015, and 2020 Rwanda Demographic Health Surveys. We used descriptive statistics, pairwise comparisons, and linear regression designs to assess (a) the prevalence of household WASH behaviors across districts, regions, urban areas, and rural areas, (b) the variation of household WASH behaviors over time, and (c) …

The Impact Of Digital Inequities On Salivary Gland Cancer Disparities In The United States, David M. Bruss, David J. Fei-Zhang, Helena Kim, Daniel C. Chelius, Anthony M. Sheyn, John P. Maddalozzo, Jeffrey C. Rastatter, Jill N. D'Souza

School of Medicine Faculty Publications

Introduction: Technology and internet access have become increasingly integrated into healthcare as the primary platform for health-related information and provider-patient communication. Disparities in access to digital resources exist in the United States and have been shown to impact health outcomes in various head and neck malignancies. Our objective is to evaluate the associations of digital inequity on health outcomes in patients with salivary gland cancer (SGC). Methods: The Digital Inequity Index (DII) was developed using 17 census-tract level variables obtained from the American Community Survey and Federal Communications Commission. Variables were categorized as digital infrastructure or sociodemographic (e.g., non-digital) and …

Health Risk Factors Of Female African American Informal Caregivers For Alzheimer’S Disease Patients In Low-Income Communities, Rosaline Elaine Elliott

Walden Dissertations and Doctoral Studies

By 2050, 152 million people worldwide, primarily low-income populations, will have Alzheimer's disease (AD). African American (AA) women informal caregivers are primary caregivers in low-income neighborhoods, and they suffer from burnout and poor health, including physical and mental fatigue, despair, anxiety, hypertension, and stressors that can lead to heart attacks, strokes, or premature mortality. The Informal Caregiver Integrative Model (ICIM) theoretical framework was used to survey 120 participants using SurveyMonkey was administered to collect data for this cross-sectional quantitative study. The multiple hierarchical regression analyses revealed caregiving appraisal had no significant impact on burnout. A higher quality of the caregiver-care …

Burden Of Diabetes Mellitus In The Medically Underserved Rio Grande Valley, John M. Gaddis, Elias Arellano, Kassandra Pulido, Tyler Torres, Dominic Chau-Zanetti, Natasha N. Quailes, Andres Suarez Parraga

School of Medicine Publications

Introduction

Diabetes mellitus (DM) encompasses metabolic disorders characterized by elevated blood sugar. This study aimed to evaluate the prevalence and associated metrics of DM in the Rio Grande Valley (RGV), a low-income and medically underserved region in the United States, and compare these metrics to the national averages from 2012 to 2022.

Methods

A retrospective cross-sectional analysis was conducted using publicly accessible data from the Centers for Medicare and Medicaid Services (CMS). Metrics analyzed included DM prevalence, average principal cost, rates of emergency department visits, hospitalizations, screenings, and prevalence of obesity. Data from the RGV counties were compared to national …

Secular Trends In Underweight, Overweight, And Physical Fitness Of Girls And Boys Aged 16–18 In Eastern Poland From 2006 To 2016–2021, Agnieszka Wasiluk, Jerzy Saczuk

Baltic Journal of Health and Physical Activity

Introduction: Significant changes in the nutrition and physical fitness of children and adolescents have been observed in many countries around the world. The purpose of this study is to determine the changes in the prevalence of underweight, normal BMI, and overweight, as well as in the physical fitness of girls and boys from eastern Poland. Materials and methods: The study was conducted over the years 2006–2021. BMI was calculated, and physical fitness was assessed using the EUROFIT test. The results were statistically analyzed. Results: Minor changes in underweight were observed, and even a re-duction in its prevalence among girls was …

Examining Daily-Self Weighing As A Stand-Alone Intervention For Obesity Management, Ashley Parish

All ETDs from UAB

Obesity is an epidemic that has substantial implications for both individuals with the disease as well as the healthcare system in the United States. Individuals with obesity are at increased risk for developing associated co-morbid conditions such as cardiovascular disease, type 2 diabetes, and some forms of cancer, which can affect quality of life and lead to mortality. There are many health behavior interventions which target weight loss, maintenance of weight loss, or weight gain prevention in those with obesity; however, interventions have unique barriers that can vary based on personal, environmental, and social factors. Primary care (PC) settings, which …

Examining Management And Employees' Perceptions Of Occupational Heat Exposure And The Effectiveness Of A Heat Stress Prevention Intervention On Safety And Well-Being Among Natural Gas Construction Workers: A Qualitative Field-Based Study, Muinat Abolore Idris, Christine Markham, Kristina D Mena, William B Perkison

Faculty, Staff and Student Publications

BACKGROUND: Numerous risk factors have been identified as significantly influencing outdoor workers' risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers' safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative.

OBJECTIVE: To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention.

METHODS: In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Implementation Of Healthy Heart Ambassador To Improve Blood Pressure Control At Community Health Centers In Texas, Natalia I Heredia, Ella R Garza, Fernanda Velasco-Huerta, Tracy L Swoboda, Pierre Fwelo, Patenne D Mathews, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Hypertension is one of the most prevalent chronic diseases in the United States and can increase a person's risk of stroke and other cardiovascular complications. Yet only 1 in 4 people with high blood pressure in the United States have their blood pressure managed. To improve hypertension control, we supported 9 health centers in Texas with the implementation of the Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA) Program.

METHODS: We provided health center training using the HHA Program Facilitation Training Guide, recorded barriers to implementing the HHA program, and employed strategies to overcome those barriers.

RESULTS: There were 68 …

Physical Activity: A Comparison Of Rural And Urban Older Adults' Needs And Preferences, Annette Contrady, Sarah L. Francis, Elgloria Harrison, Doris Montgomery, Catherine Rudolph, Lillie Monroe-Lord, Phd, Rdn, Ld, Elmira Asongwed, Anne Marie Jean Baptiste, Tiffany Johnson-Largent Phd Rdn Ld, B. Michelle Harris, Tia D. Jeffery, Pier Broadnax

Journal of Extension

Physical activity (PA) rates among older adults are low. We examined and compared the PA needs, preferences, and practices of 118 rural- and urban-residing older adults through focus groups and surveys. The sample was diverse (White = 42.4%, Black = 37.3%), mostly female, food-secure, and not meeting PA recommendations (38.1%). PA rates were lower for rural-residing older adults (p < 0.05). PA motivators were health benefits and socialization, while barriers were cost, pain, low motivation, and health limitations. Preferred PA programs were described as age-appropriate, expert-led, and group-based. These findings provide insight regarding what to consider when planning PA programming for community-residing older adults.

Optimization Of Cellular Transduction By The Hiv-Based Pseudovirus Platform With Pan-Coronavirus Spike Proteins, Syamala Rani Thimmiraju, Maria Jose Villar, Jason T Kimata, Ulrich Strych, Maria Elena Bottazzi, Peter J Hotez, Jeroen Pollet

Faculty, Staff and Students Publications

Over the past three years, new SARS-CoV-2 variants have continuously emerged, evolving to a point where an immune response against the original vaccine no longer provided optimal protection against these new strains. During this time, high-throughput neutralization assays based on pseudoviruses have become a valuable tool for assessing the efficacy of new vaccines, screening updated vaccine candidates against emerging variants, and testing the efficacy of new therapeutics such as monoclonal antibodies. Lentiviral vectors derived from HIV-1 are popular for developing pseudo and chimeric viruses due to their ease of use, stability, and long-term transgene expression. However, the HIV-based platform has …

A Call For Better Understanding Household Complexity In Environmental Social Science, Rebecca Nixon, Brooke Mcwherter, Anna Erwin, Jonathan Bauchet, Zhao Ma

School of Earth, Environmental, & Marine Sciences Faculty Publications

No abstract provided.

Case Title: Uncovering The Truth: The Unexpected Incidental Discovery Of Metastatic Carcinoid Tumor In An Elderly Patient., Kavitha Chittaragi Dr, Shwetha R. Poojary Dr

Radiology Teaching Files

Carcinoid tumors are rare neuroendocrine neoplasms with varied clinical presentations. We report a case of a 70-year-old female patient who presented with history of loose stools, vomiting, and abdominal pain. Imaging revealed a small hyper-enhancing nodule in the small bowel, multiple liver lesions, and a mesenteric mass, all suggestive of metastatic carcinoid disease. Biopsy confirmed a neuroendocrine tumor. As these tumors can remain indolent for years, early detection and treatment are critical for effective management and better prognosis.

The Association Between Race And Obesity After Controlling For Dietary Behaviors Among Adolescents, Jasmine Nicole Williams

Walden Dissertations and Doctoral Studies

Childhood obesity has become a critical global public health concern due to its significant, long-term impact on overall quality of life and physical health. Despite efforts, there is a lack of information that includes all races and ages to combat childhood obesity. This study addressed the association between race and obesity after controlling for dietary behaviors among adolescents in Georgia, using quantitative cross-sectional data from the 2021 Youth Risk Behavior Surveillance System (YRBSS). Guided by the social ecological model, the research investigated how demographic factors and dietary behaviors influence obesity rates. Specifically, the study explored the association between age, race, …

Ret Mutated Non-Small Cell Lung Cancer (Nsclc) In Association With Patients From Central America, Lily Z. Chen, William J. Gibson, Brian C. Boulmay

School of Medicine Faculty Publications

The rearranged during transfection (RET) gene is on chromosome 10 (10q11.2) and normally encodes a receptor tyrosine kinase that plays a role in the development of the kidney, nervous, and respiratory systems. Aberrant RET gene activation can occur through gene mutations, gene fusions, or over expression leading to uncontrolled cell growth and the development of malignancy. The RET gene was first identified in 1985 as a protooncogene playing a role in the pathogenesis of lymphoma, and mutations are now associated with numerous cancers including lung, thyroid, breast, colon, prostate, and kidney. Activating RET mutations are estimated to occur in 1-2% …