Public Health Commons^™

Examination Of Traffic Safety In Neighborhoods Associated With Active Commuting To School In Austin, Texas, Kathryn G Burford, Deborah Salvo, Harold W Kohl, Leigh Ann Ganzar, Cici X Bauer, Eugen Resendiz, Yuzi Zhang, Deanna M Hoelscher

Faculty, Staff and Student Publications

Background: Only 10% of US children participate in active commuting (walking and bicycling) to school (ACS). Parental concerns related to traffic are a primary barrier to ACS, yet no studies have assessed these concerns together with neighborhood traffic safety-related features. This study examined the associations between traffic safety-related features in neighborhoods and ACS among school-age children in Austin, Texas.

Methods: This cross-sectional analysis utilized pre-COVID-19 baseline data (2019-2020) of parent-child dyads enrolled in the Safe TRavel Environment Evaluation in Texas Schools study. ACS, traffic safety-related features in the neighborhood (sidewalk availability, safe road crossings, traffic safety, traffic speed, and safety …

Cellstaar: Incorporating Single-Cell-Sequencing-Based Functional Data To Boost Power In Rare Variant Association Testing Of Noncoding Regions, Eric Van Buren, Yi Zhang, Xihao Li, Margaret Sunitha Selvaraj, Zilin Li, Hufeng Zhou, Nicholette D Palmer, Donna K Arnett, John Blangero, Eric Boerwinkle, Brian E Cade, Jenna C Carlson, April P Carson, Yii-Der Ida Chen, Joanne Curran, Ravindranath Duggirala, Myriam Fornage, Nora Franceschini, Misa Graff, Charles Gu, Xiuqing Guo, Jiang He, Nancy Heard-Cosa, Lifang Hou, Yi-Jen Hung, Rita R Kalyani, Sharon L R Kardia, Eimear Kenny, Charles Kooperberg, Brian G Kral, Leslie Lange, Dan Levy, Changwei Li, Simin Liu, Donald Lloyd-Jones, Ruth J F Loos, Ani W Manichaikul, Lisa Warsinger Martin, Rasika Mathias, Ryan L Minster, Braxton D Mitchell, Josyf C Mychaleckyj, Take Naseri, Kari North, Jeff O'Connell, James A Perry, Patricia A Peyser, Bruce M Psaty, Laura M Raffield, Ramachandran S Vasan, Susan Redline, Alex P Reiner, Stephen S Rich, Jennifer A Smith, Brian Spitzer, Hua Tang, Kent D Taylor, Russell Tracy, Satupa'itea Viali, Lisa Yanek, Wei Zhao, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium, Jerome I Rotter, Gina M Peloso, Pradeep Natarajan, Xihong Lin

Faculty, Staff and Student Publications

Understanding how rare genetic variants influence complex traits remains a major challenge, particularly when these variants lie in noncoding regions of the genome. The effects of variants within candidate cis-regulatory elements (cCREs) often depend on the cell type, making interpretation difficult. Here we introduce cellSTAAR, which integrates whole-genome sequencing data with single-cell assay for transposase-accessible chromatin using sequencing data to capture variability in chromatin accessibility across cell types via the construction of cell-type-specific functional annotations and regulatory elements. To reflect the uncertainty in cCRE-gene linking, cellSTAAR uses a comprehensive strategy to link cCREs to their target genes. We applied cellSTAAR …

Mapping Social Determinants Of Health Data In Sub-Saharan Africa: A Scoping Review Protocol, Felix Anyiam, Jessica Gjonaj, Ngeresa Osango, Richard Mugo, Peace Aber, Jasmit Shah, Judith Mangeni, Rajesh Vedanthan, Joseph Hogan, Ann Mwangi

Internal Medicine, East Africa

Introduction Research has increasingly underscored the impact of factors such as socioeconomic status, education, healthcare access, housing and environmental conditions in shaping population health outcomes. These factors, collectively called social determinants of health (SDOH), provide crucial context for understanding drivers of health outcomes. In sub-Saharan Africa (SSA), the study of SDOH is critical due to the region’s unique sociocultural and economic conditions. Understanding how SDOH interacts with health systems and capturing SDOH in data is crucial for informing modelling efforts and policies improving population health more effectively. This scoping review aims to map the types of data used to capture …

Real-World Prevalence Of Pd-L1 Positivity In Early-Stage/Metastatic Triple-Negative Breast Cancer: Primary Results And Pathology Insights From The Global Retrospective Observational Vanessa Study, Corrado D'Arrigo, Sitki Tuzlali, Romualdo Barroso-Sousa, Nagi El Saghir, Rebecca Dent, Nataša Medić-Milijić, Gyungyub Gong, Shahin Sayed, Tu Anh, Alisan Zirtiloglu

Pathology, East Africa

Aim To understand whether the worldwide implementation of PD-L1 testing in triple-negative breast cancer (TNBC) can be achieved in routine clinical practice.

Methods and results The multicentre retrospective observational VANESSA study consecutively and uniformly enrolled patients treated with systemic therapy for early or metastatic (e/m)TNBC diagnosed between 2014 and 2017. PD-L1 status was retrospectively assessed locally and centrally using the VENTANA PD-L1 (SP142) Assay (PD-L1 expression on tumour-infiltrating immune cells covering ≥1% of the tumour area). The primary objective was to determine the prevalence of PD-L1 positivity assessed locally on primary and/or metastatic tumour tissue. Concordance between local and central …

Purpuric Pityriasis Rosea In A 7-Year-Old Girl: A Rare Variant With Generalized Involvement, Ying-Ying Qian, Ya-Fen Wu, Ting Zhang, Ji-Bing Li, Si-Yuan Song, Wei Li

Faculty, Staff and Students Publications

A 7-year-old girl presented with a 10-day history of generalized purpura and petechiae. The eruption began with a solitary violaceous macule on the trunk and progressed within 1 week to multiple oval and round dark-red to violaceous purpuric macules, ecchymoses, and petechiae affecting the face, trunk, and extremities. Lesions were distributed parallel to skin cleavage lines with a characteristic “Christmas-tree” pattern on the back (Fig 1). No oropharyngeal lesions were noted on examination, and the patient denied sore throat or oral discomfort. She reported no pruritus, pain, fever, or systemic symptoms.

Evaluation Of Host-Immune Biomarker Signatures As Multiplex Qpcr Diagnostic Assays: A Pilot Study Toward Meeting Who Target Product Profiles For Tb Diagnosis In India, Harriet N. Garlant, Kalaiarasan Ellappan, Noyal Mariya Joseph, Carrie Turner, Vishnukanth Govindaraj, Saka Vinod Kumar, Sanjeev Kumar, Seshadri S. Vasan, Karen Elizabeth Kempsell

Research outputs 2022 to 2026

Background: Tuberculosis (TB) remains the leading cause of death from a single infectious agent. Current diagnostic tools are limited, especially in low-resource settings. The World Health Organization's (WHO) Target Product Profiles (TPPs) call for rapid, non-sputum-based diagnostics with high sensitivity and specificity. This study evaluates our previously published TB-associated host-immune biomarkers alongside small-size signatures from other studies, in our previously published non-human primate (NHP) TB infection study dataset (GSE76703) and two previously published human datasets (GSE144127, GSE42834), which include other disease group comparators, including sarcoidosis. These were also evaluated in a small-scale, exploratory qPCR pilot study to assess the feasibility …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

An Impact Assessment Of The Effectiveness Of Utilizing Informal Health Communication Interventions To Spread Health Recommendations And Change Public Perception, Lina Mohamed Ezzat Ahmed Abdel Mawgoud

Theses and Dissertations

Brain health is an increasingly urgent but critically under-addressed public health priority in Egypt and the wider MENA region. Despite its centrality to aging, productivity, and overall quality of life, public understanding of brain health remains limited, and stigma continues to shape responses to dementia and cognitive decline. This study evaluates the effectiveness of informal, culturally adapted health communication as a tool to shift perception, increase awareness, and promote behavior change among non-medically trained adults in Egypt.

Grounded in global evidence on cognitive reserve, neuroplasticity, and the life-course approach to brain health, the intervention translated expert-informed brain health recommendations into …

Investigating The Risk Factors Affecting The Control Of Diabetes And Hypertension In The Refugees Living In Egypt, Noura Seada

Theses and Dissertations

Introduction: Non-Communicable Diseases (NCDs) account for 74% of global deaths, with high prevalence of Diabetes and Hypertension worldwide. Egypt hosts over 1 million registered refugees and asylum seekers, often lacking inclusion in social protection or insurance schemes. This study aimed to assess the factors affecting the control of Type 2 Diabetes (T2D) and Hypertension (HTN) among Syrian and Sudanese refugees in Egypt, focusing on healthcare access, sociodemographic characteristics, lifestyle, and health behaviours.

Methods: This study employed a cross-sectional design using a self-administered questionnaire and BMI measurement. Data were collected from 246 refugees diagnosed with type T2D and/or HTN in the …

Harmonization And Ambiguity In Regulations For Physicians With Family Medicine Competence Post-Law No. 17 Of 2023, Danar Wahyu Giwang Katon, Dumilah Ayuningtyas, Purnawan Junadi, Wahyu Sulistiadi, Roberth J. Pattiselanno, Fitria Fitria, Ika Fitri Alfiani

Journal of Indonesian Health Policy and Administration

Strengthening primary care services in Indonesia requires that community health centers, namely Pusat Kesehatan Masyarakat (Puskesmas), involve medical personnel with family medicine competence. However, the fulfillment of physicians with this competence, especially Primary Care Family Medicine Specialists or Spesialis Kedokteran Keluarga Layanan Primer (Sp.KKLP), still face significant obstacles. This qualitative research uses the integrated Easton's System Model and Buse's Policy Framework to analyze the dynamics of this policy. The findings reveal a gap between the strong legal foundation and weak implementation mechanisms on the ground. First, there is ambiguity in terminology and lack of harmonization among regulations, especially concerning the …

The Relationship Between Accessibility Factors And Post-Inpatient Control Visits Among Non-Jkn Participants At Hospital X, Putri Candaika, Desy Kartika Ningsih, Risky Kusuma Hartono

Journal of Indonesian Health Policy and Administration

The rate of post-inpatient control visits remains relatively low due to various factors, including accessibility. At Hospital X, 220 of non-Jaminan Kesehatan Nasional (JKN) participants scheduled for post-inpatient control visits between January and March 2025, 71.82% attended, and 28.18% did not. Patients who did not attend control visits were twice as likely to be readmitted. This study aimed to determine the relationship between accessibility and post-inpatient control visits for non-JKN participants at Hospital X. This quantitative study employed an analytical cross-sectional design, with a population of 220 patients and a sample of 142 patients selected using probability sampling. Bivariate …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

More Than A Healthcare Issue: Understanding The Breadth Of Occupational Burnout In Our Patients, Aliza Anderson*, Julia Maniccia*, Marc Moss

Marshall Journal of Medicine

Burnout is an occupation-related condition resulting from chronic workplace stress and is associated with significant psychological and physical morbidity. This commentary recognizes burnout as a public health concern across both healthcare and non-healthcare professions, illuminates key occupational risk and protective factors, reviews the biopsychosocial impacts of burnout, and argues for the integration of occupational health screening into clinical practice. A synthesis of the literature highlighted that existing research has focused primarily on healthcare occupations; however, emerging evidence demonstrates an elevated burnout risk in numerous non-healthcare occupations. Characterized by high job demands, limited autonomy, inadequate social support, and physically demanding labor, …

Symposium Day Reflection Paper - Burnout In Medicine: Understanding The Student & Resident Experience, Souraha Longo

Introduction to Public Health

A brief summary & reflection of a Symposium Day presentation (from a public health perspective).

Youth Violence, Cyberbullying, And Mental Health Among Adolescence: A Public Health Analysis Of Netflix’S “Adolescence”, Natepy Vann

Introduction to Public Health

It is a summary of a Netflix's series about British psychological crime thriller.

Reflection On ‘Adolescence’ And Mental Health, Souraha Longo

Introduction to Public Health

A brief summary & reflection of the Netflix Drama Adolescence (from a Public Health perspective).

Comparing Educational Pathways For Denturists To Become Maxillofacial Prosthetic Specialists In The Us And The Uk, Minseok Kim

Oral Health

Abstract

In the absence of formal training, licensure, and professionalism, this scientific literature review will seek to include denturists in the American maxillofacial prosthetics industry. Denturists are oral health professionals who perform oral examination, design, manufacture, and place removable oral prostheses. In other regions of the world, they are also known as clinical dental technologists and dental prosthetists. This practice is not widespread in the US. The review can also be assessed on the model mediated by PRISMA, which is concentrated on the experiences of international education in the United Kingdom, Canada, and Australia, where the concentration further revolves around …

Partial Versus Full Revision In Cementless Single-Stage Exchange For Hip Periprosthetic Joint Infection: A Multicenter Comparative Study With 10-Year Survivorship Analysis, Wenbo Mu, Atthakorn Jarusriwanna, Boyong Xu, Scot A. Brown, Xiaogang Zhang, Alexander Dawes, Javad Parvizi Md, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty (THA). Traditional management typically involves full revision to ensure comprehensive infection eradication. However, for patients with well-fixed implants, partial revision in a single-stage cementless approach may provide a viable alternative, potentially preserving bone stock and reducing operative time. The relative efficacy of this approach compared with full revision remains to be fully explored. This multicenter study aims to determine whether partial revision in cementless single-stage exchange surgery offers comparable infection control outcomes to full revision for select patients with well-fixed implants.

METHODS: We conducted …

Leveraging Informatics To Manage Lifelong Monitoring In Childhood Cancer Survivors, Kimberly Davidow, Renee Gresh, E. Anders Kolb, Ellen Guarnieri, Mary R. Cooper

College of Population Health Faculty Papers

Background: Electronic health records (EHR) have long held promise for sharing information efficiently, but this remains challenging. This quality improvement initiative sought to improve the accurate documentation of anthracycline and radiation therapy exposures in pediatric oncology patients who were treated at different institutions through a quality improvement methodology and EHR tools. Methods: A custom-built EHR smartform was previously created. Modifications were made to the smartform, and quality improvement methods were utilized to improve receipt of radiation summaries from other institutions and documentation of chemotherapeutic doses. Results: Three months after interventions, including clinician education and smartform updates, accurate anthracycline documentation improved …

Structural Empowerment And The Work Environment Of Nursing Home Care Workers In China, Yawen Ou

Lingnan Theses (MPhil & PhD)

China is experiencing a profound demographic transformation as its population ages rapidly, driven by declining fertility, increased longevity, and long-term effects of the One- Child policy. Traditional family-based elderly care has become increasingly unsustainable due to the pressures of the “4-2-1” family structure and the rising prevalence of empty-nest households. In this context, there is an increasing trend in institutionalized elderly care, accompanied by a growing demand for Nursing Home Care Workers (NHCWs). In spite of their vital importance, NHCWs often face heavy workloads, poor compensation, low recognition, and limited professional autonomy. This study explores the work environment and structural …

Mental Health First Aid Training In K-12 Schools, Jenna L. Workman, Brianna L. Schierberg, Grace H. Sullivan, Erin Robinson

Posters-at-the-Capitol

The increasing prevalence of mental health challenges among school-aged children has become a rising public health concern. Recent data indicates that nearly 70% of schools report heightened mental health problems among students, with anxiety and depression being most common (National Center for Education Statistics, 2024). The purpose of this capstone project is to raise awareness of mental health issues in K–12 public schools and to increase faculty and staff confidence in recognizing and assisting students experiencing mental health difficulties through nurse-led Mental Health First Aid (MHFA) training. Using Peplau’s Interpersonal Relations Theory as a guiding framework, this project emphasizes the …

Pemodelan Regresi Logistik Spasial Pada Kejadian Demam Berdarah Dengue (Dbd) Di Provinsi Jawa Barat Tahun 2023, Valida Ulfa Septiana, Sutanto Priyo Hastono

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Demam Berdarah Dengue (DBD) merupakan salah satu penyakit menular yang masih menjadi masalah kesehatan masyarakat di Indonesia, termasuk Provinsi Jawa Barat, dengan rata-rata kejadian yang lebih tinggi dari rata-rata nasional. Analisis spasial diperlukan untuk memahami pola penyebaran DBD, mengingat adanya kemungkinan pengaruh antar wilayah. Penelitian ini bertujuan untuk menganalisis pengaruh faktor sosio-demografi, faktor perilaku, serta efek spasial kedekatan geografis antar wilayah terhadap kejadian DBD di Provinsi Jawa Barat tahun 2023. Penelitian ini menggunakan desain potong lintang dengan unit analisis 27 kabupaten/kota di Jawa Barat tahun 2023. Data sekunder diperoleh dari Survei Kesehatan Indonesia 2023 dan Jawa Barat dalam Angka 2024. …

Psychological Resilience In The Covid-19 Response: A Systematic Review For Future Public Health Preparedness, Atena Pasha, Abdul-Hanan Saani Inusah, Jannatun Nayem, Xiaoming Li, Shan Qiao

Faculty Publications

Objective: The COVID-19 pandemic has highlighted the importance of psychological resilience for well-being. While several reviews have addressed resilience in specific populations or contexts, few have synthesized global literature across diverse populations. This review examines psychological resilience across diverse populations, focusing on measurement, associated factors, and future public health preparedness strategies. Method: Guided by the PRISMA, a thorough search of PsycINFO, PubMed, ScienceDirect, and Web of Science was conducted in February 2024, including quantitative studies considering psychological resilience during the COVID-19 pandemic published in peer-reviewed English journals from 2020 to 2024, using search terms relevant to psychological resilience and COVID-19. …

Surviving Staten Island: Black Women’S Narratives Of Resilience, Motherwork, And Embodied Trauma, Jazmin Rivera

Student Theses

This oral history dissertation centers the experiences of six Black women who had formative experiences navigating hostile school and community-based settings on Staten Island during the 1970s, 1980s, and early 1990s. Guided by a conceptual framework that draws on Black orality, Black feminist thought, and endarkened feminist epistemology, this study demonstrates how Black women were required to cross geographic and social boundaries to survive hostile conditions in Staten Island communities and schools. Findings from this study highlight Black women’s use of community cultural wealth to inform their survival strategies and resilience. At the same time, their experiences indicate the potential …

Pandemic Mask Mandates And Closures Were Linked To Increased Gun Violence, Douglas A. Wolf, Emily W. Wiemers, Iliya Gutin, Jennifer Karas Montez, Shannon M. Monnat

Population Health Research Brief Series

Gun violence worsened substantially during the COVID-19 pandemic. This brief summarizes findings from a study using weekly gun violence casualty data from 2016-2021 for 304 U.S. counties from the Gun Violence Archive and COVID-19 policy data from county-level measures of activity restrictions and masking requirements. The authors find that policies requiring masking and activity restrictions were associated with significant increases in gun violence. Indoor masking requirements were linked to a 28% increase in gun violence, while activity restrictions were associated with a 4.2% increase.

Expanding Access To Live Donation Opportunities: Implementing Telehealth Solutions To Enhance The Living Donor Navigator Program, Alexis Carter

ETDs from 2020-2029

Living donor kidney transplantation (LDKT) is the most effective treatment for patients with end-stage kidney disease; however, living donation rates have remained suboptimal over the past two decades. As a result, many interventions have been developed and tailored to increase living donation. The Living Donor Navigator (LDN) Program is one effort designed to help transplant candidates identify potential living donors and guide them through the donation process, using a combination of advocacy and systems training. The LDN Program is a lay-navigator-based intervention that equips participants with the knowledge, communication skills, and confidence needed to identify and engage potential living donors. …

Development And Validation Of A Theoretically Informed Instrument To Measure The Antecedents Of Microbreaking Intentions (I-Mami) Of Procedural Healthcare Workers, Robin Riddle

ETDs from 2020-2029

ABSTRACT Work-related musculoskeletal disorders (WMSD) affect 77% of nurses and 60% of surgeons, exceeding rates in other occupational sectors and threatening healthcare workforce sustainability. Microbreaking is brief, strategic pause of 20 seconds to five minutes performed every 20 to 40 minutes during medical procedures. It has demonstrated effectiveness in reducing fatigue, improving accuracy, and lowering physiological stress markers without extending medical procedure duration. Despite this evidence, adoption remains limited, and no theoretically informed instruments exist to measure the behavioral determinants of microbreaking intentions among procedural healthcare workers. Investigators of this three-manuscript dissertation developed and established content and construct validity as …

Handling Missing Data In Copd Research, Chia-Ying Chiu

ETDs from 2020-2029

Chronic Obstructive Pulmonary Disease (COPD) remains a major global health concern and one of the leading causes of death in the United States, affecting approximately 4.6% of adults and reaching a prevalence of 9.4% in Alabama according to 2024 National Health Interview Survey. The disease imposes a substantial burden on quality of life and healthcare costs and contributes to increased disability-adjusted life years and years of life lost, as highlighted by the 2022 Lancet Commission report. Despite its im-pact, COPD is frequently diagnosed only after irreversible lung damage has occurred, largely due to under-recognized symptoms and limited diagnostic tools. Early …