Public Health Commons^™

The Epidemiology Of Catastrophic Head And Neck Injuries In High School And College Non-Football Sports: A 4-Decade Review, Courtney M. Meyer, Kristen L. Kucera, Samantha E. Scarneo-Miller, Zachary K. Winkelmann, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Background:

Catastrophic head and neck injuries (CHNIs) in sport are rare but can have disabling or fatal outcomes. Prior studies have focused on football, equipment-laden sports, or different injury severities, not CHNI in nonfootball sports.

Purpose:

To describe the epidemiology of CHNI across levels (high school vs collegiate) in nonfootball sports and evaluate differences in injury rates (IRs) by sport, sex, and decade.

Study Design

Descriptive epidemiological study.

Methods:

This study utilized 40 academic years (1982-1983 to 2021-2022) of surveillance data from the National Center for Catastrophic Sports Injury Research. Descriptive statistics summarized athlete, event, and injury characteristics. IRs were …

Development Of A Semi-Mechanistic Population Pharmacokinetic Model For Predicting Tenofovir Disoproxil Fumarate And Tenofovir Alafenamide Exposure In Plasma And Cellular Matrices During Pregnancy And Postpartum, Yifan Yu, Kristina M. Brooks, Gustavo F. Doncel, Brookie M. Best, Mark A. Marzinke, Mark Mirochnick, Peter Anderson, Landon Myer, Connie Celum, Renee Heffron, Jenell Coleman, Dvora Joseph Davey, Craig W. Hendrix, Jeremiah D. Momper, Robert Bies, Rachel K. Scott

CONRAD Publications

Background and Objective

Tenofovir (TFV)-based regimens are backbones of both HIV treatment and pre-exposure prophylaxis during pregnancy. Multiple studies have shown up to one-third decreases in dried blood spot tenofovir-diphosphate concentrations during pregnancy among participants taking tenofovir disoproxil fumarate (TDF). Currently, there are no mechanism-based models describing the pharmacokinetics of tenofovir diphosphate (the active anabolite) in peripheral blood mononuclear cells (PBMCs) of pregnant individuals receiving TDF or tenofovir alafenamide (TAF), and the mechanisms behind observed differences between dried blood spots and PBMCs remain unclear.

Methods

To address this gap, we developed a semi-mechanistic model to simultaneously describe the pharmacokinetics of …

Artificial Intelligence And Machine Learning In Smart Vaginal Formulation Development, Deborah A. Ogundemuren, Vivek Agrahari, Andrew P. Wong, Carolina Herrera, Margaret O. Ilomuanya, Gustavo F. Doncel

CONRAD Publications

Vaginal drug delivery in women's health remains underutilized and insufficiently studied, largely due to the complexity and dynamic nature of the vaginal microenvironment. Variations in vaginal pH, hormonal levels, and microbiota composition introduce significant biological variability, complicating formulation design and contributing to inconsistent therapeutic outcomes and poor patient adherence. Conventional vaginal formulations often fail to account for these individual differences, highlighting the need for more adaptive and predictive approaches. Emerging advances in artificial intelligence (AI) and machine learning (ML) offer promising strategies to address these challenges by enabling multi-parameter, data-driven formulation development that explicitly considers biological variability. Despite their transformative …

Micrornas Regulated By Pregnancy Target Antiviral And Cancer Immunity Overlapping With The Hiv Interactome, Paula F. T. Cezar-De-Mello, Jonathan M. Dreyfuss, Pai-Lien Chen, Hidemi Yamamoto, Xiaoming Gao, Hui Pan, Charles Morrison, Gustavo F. Doncel, Robert L. Barbieri, Raina N. Fichorova

CONRAD Publications

Innate immunity predictors of HIV-1 risk and pathogenesis vary with reproductive hormones, pregnancy, and lactation, yet the underlying mechanisms remain unclear. We hypothesized that pregnancy-associated physiological adaptations alter systemic microRNA (miRNA) expression, thereby regulating immunity, pathogenesis and susceptibility to infection. We analyzed 174 serum samples from 88 participants in a longitudinal cohort from Uganda and Zimbabwe across pre-pregnancy (PP), pregnancy (P), and postpartum breastfeeding (BF). Cell-free peripheral blood miRNAs (n = 2083) were profiled using HTG EdgeSeq. Pregnancy-specific miRNAs were identified by intersecting differentially expressed (DE) miRNAs from P vs. PP and P vs. BF comparisons. miRNA targets and pathways …

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

A Scoping Review To Conceptualize Social Privilege For Studying Patients' Health Outcomes And Health Disparities, Elizabeth A. Brown, Priyanka Patel, Esther May B. Sarino, Vladimir Markovic, Carles Muntaner

Health Behavior, Policy & Management Faculty Publications

Background

The continued reliance on single-category self-reported demographic data (e.g., race/ethnicity) reflects conceptual limitations that hinder the study and understanding of health outcomes research. There is a pressing need for more precise measures of social privilege that conceptualize privilege and oppression while enabling the examination of their effects on health outcomes in the United States (US) healthcare system.

Objective

The purpose of this scoping review was to review the literature, determine how researchers have measured aspects of privilege and oppression, and develop a conceptual framework to study patients' social privilege in the US healthcare system and public health research.

Methods …

Large Language Model-Assisted Research Question Development In Public Health: A Case Study In The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic), Qi Zhang, Bidusha Neupane, Priyanka Patel, Futun N. Alkhalifah, Yi He, Leslie Hodges

Health Behavior, Policy & Management Faculty Publications

Objective:

To assess the feasibility of using large language models (LLMs) to develop research questions about changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages.

Design:

We conducted a controlled experiment using ChatGPT-4 and its plugin, MixerBox Scholarly, to generate research questions based on a section of the USDA summary of the final public comments on the WIC revision. Five questions weekly for three weeks were generated using LLMs under two conditions: fed with or without relevant literature. The experiment generated 90 questions, which were evaluated using the FINER criteria (Feasibility, Innovation, Novelty, Ethics, …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …

Facilitating Shared Reading Exposure To Promote Health Outcomes In A Rural Pediatric Primary Care Clinic, Meredith L. Longino

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to address a gap in early literacy promotion for rural children by incorporating the Reach Out and Read program. This program bolsters foundational literacy by providing a book and anticipatory guidance at every well-child visit from birth through age 5. This project was expected to decrease no-show well-child attendance rates and improve provider morale.

Background

The project was implemented in an established rural pediatric primary care clinic in Northeast Texas. 

Methodology

Process implementation was measured through books distributed and EHR documentation of the intervention. Process objectives were measured by no-show rates for …

Higher Nurse-To-Patient Staffing Ratios Affect Patient Safety Outcomes: An Integrative Research Review (Irr), Kimberly Everard Martinez

Covenant Nurses Week 2026

No abstract provided.

No Pass Culture Lowers Patient Fall Incidence, Marie Camille Austria

Covenant Nurses Week 2026

No abstract provided.

Improving Patient Outcomes Through Structured Nursing Safety Huddles In Acute Care Settings: An Integrative Research Review (Irr), Brandon Everard Thomas

Covenant Nurses Week 2026

No abstract provided.

Hapi Heroes Initiative: Innovating Patient Turn Strategies Utilizine The Braden Scale To Prevent Hospital Acquired Pressure Injuries (Hapi) In The Cardiac Telemetry Unit-A Reposition Disposition Quality Improvement Project, Kenn Everard Lachenal, Kimberlea Gale Hiett-Gonzales, Charmaine Capili, Jelly Jacob, Melissa Fallorina, Dillon Mckee

Covenant Nurses Week 2026

No abstract provided.

Improving Patient Outcomes Through Structured Nursing Surveillance In Acute Stroke And Transient Ischemic Attack (Tia): An Integrative Research Review (Irr), Sheeba Everard Matthew

Covenant Nurses Week 2026

No abstract provided.

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …

Health Behavior Profiles In Early Pregnancy Are Associated With Adverse Pregnancy Outcomes And Maternal Blood Pressure 2-7 Years After Delivery, Andrea C. Kozai, Bethany Barone Gibbs, Lisa D. Levine, Abbi D. Lane, Mitali Ray, William Grobman, Philip Greenland, Matthew K. Hoffman, C. Noel Bairey Merz, Phyllis C. Zee, Lisa Mims, Natalie A. Cameron, George Saade, Robert M. Silver, Natalie A. Bello, Eliza C. Miller, Uma M. Reddy, Judith H. Chung, Kara M. Whitaker, Janet M. Catov

Department of Obstetrics & Gynecology Faculty Publications

Background

The joint effects of individual health behaviors on pregnancy health are rarely considered. We examined associations between combinations of first trimester health behaviors with adverse pregnancy outcomes (APOs) and blood pressure (BP) 2-7 years after delivery, and estimated the proportion of associations with later BP mediated by APOs.

Methods

Participants in the nuMoM2b Heart Health Study prospective cohort were included. Physical activity, diet, sleep duration, and smoking were scored using the Life's Essential 8 framework. APOs included hypertensive disorders of pregnancy, preterm birth, gestational diabetes, small-for-gestational-age birth, or stillbirth. We constructed latent profiles of health behaviors using the Life's …

Assessment Of Major Adverse Cardiovascular Event Across Diverse Racial Groups Of Psoriasis Patients On Biologic Therapy: A Retrospective Cohort Study, Chunghwan Ro, Ana Ormaza Vera, Waleed Adawi, Clinton W. Enos

Department Dermatology Faculty Publications

Psoriasis is associated with an increased risk of major adverse cardiovascular events (MACE), and biologic therapy may reduce this risk by targeting systemic inflammation. However, limited data exist on whether long term MACE risk differs by biologic class or across racial groups. We conducted a retrospective cohort study to assess the risk of primary MACE in psoriasis patients receiving biological therapies, stratified by biological class, compared with biologic-naïve psoriasis patients. Whether MACE risk among biologic-treated patients varied by race was further examined. After 1:1 propensity score matching, 36 330 biologic-treated patients were compared with 36 330 non-biologic-treated patients. Incident MACE …

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 …

Advancing Interoperability Through Governance And Sustainability: A Qualitative Comparative Case Study Of State Health Information Exchanges In The United States, Karterria Finkley

College of Graduate Studies: Theses & Dissertations

This study presents a comprehensive comparative analysis of state-level Health Information Exchanges (HIEs) across all 50 U.S. states and the District of Columbia, examining how governance structures, consent frameworks, funding models, and technical infrastructure influence interoperability maturity, sustainability, and adoption. Guided by Systems Theory and Donabedian’s Structure Process Outcome framework, the research employs a mixed-methods comparative case design integrating systematic documentary review, qualitative thematic analysis, and a policy-anchored analytic scoring methodology. Structural and policy characteristics were operationalized through standardized ordinal (1-5) metrics and aggregated into composite indices representing governance capacity, consent inclusivity, financial sustainability, and technical readiness. This approach enabled …

From Screens To Stress: Public Health Implications Of Cancer Worry In A Digitally Connected World, Shreya Mathur, Ethan Burns, Michael Pokojovy, Tzu-Liang Bill Tseng, Sunil Mathur

Mathematics & Statistics Faculty Publications

Aims:

This study examines how digital information environments, genetic testing experiences, health behaviors, and psychological distress influence cancer-related worry among adults in the United States. It further considers the public health implications of elevated or reduced cancer worry for prevention and risk communication.

Methods:

Data were drawn from a nationally representative survey of 6,252 U.S. adults. Measures included reliance on social media for health decision-making, smoking status, history of genetic testing, and psychological distress. Multivariable analyses assessed associations between these factors and levels of cancer worry.

Results/Findings:

Reliance on social media for health decisions was associated with greater cancer worry, …

Associations Between Accelerometer-Measured Physical Activity And Sleep Duration And Health Indicators In Children And Adolescents With Attention-Deficit Hyperactivity Disorder: A Systematic Review And Meta-Analysis, Xiao Liang, Hui Qiu, Justin A. Haegele, Xiao Li, Minghui Li, Jiayue Li, Shirley Xin Li

Human Movement Studies & Special Education Faculty Publications

Objective

This systematic review and meta-analysis synthesized available studies to explore relationships between accelerometer-measured physical activity (PA) levels or sleep duration and health-related outcomes in children and adolescents with attention-deficit hyperactivity disorder (ADHD).

Methods

Following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, the six databases APA PsychInfo, CINAHL Ultimate, Embase, MEDLINE, SPORTDiscus with Full Text and Web of Science were searched from inception through July 2024. The correlation coefficient (r) was employed to determine the effect size in the meta-analysis. A random-effects model was utilised to estimate the potentially heterogeneously distributed effect sizes with a 95 % …

Ensuring Rich Rigor Of Qualitative Methodologies In Behavior Analytic Research, Daria K. Lorio-Barsten, Selena J. Layden

Human Movement Studies & Special Education Faculty Publications

Quantitative methods remain the hallmark of research in applied behavior analysis. Yet, such methods frequently fail to capture the nuances of context where behavior analysis is practiced. Therefore, qualitative methods can provide complementary means to gain deeper insight into changes in socially significant behavior. We believe that researchers within the field of behavior analysis have much to gain from embracing qualitative methodologies. We propose that more researchers can and should consider conducting rigorous qualitative research to elevate the voices of the participants and relate the depth and complexities of their nuanced experiences. This article discusses Tracy’s “big tent” quality criteria …

Accelerometer-Measured Physical Activity Among Children And Adolescents With And Without Neurodevelopmental Disorders: A Systematic Review And Meta-Analysis, Xiao Liang, Raffy C.F. Chan, Justin A. Haegele, Sean Healy, Richard H. Xu, Chang Liu, Ming Chen, Minghui Li, Hui Zhang, Cindy H.P. Sit, David H.K. Shum

Human Movement Studies & Special Education Faculty Publications

Purpose

Physical inactivity is a health concern for children and adolescents with neurodevelopmental disorders (NDDs) as it directly increases their risk of developing various health problems. Evidence on differences in accelerometer-assessed physical activity between children and adolescents with and without NDDs is inconclusive. And age- and body mass index (BMI)-related effects on physical activity remain unclear.

Methods

The systematic literature searches were performed in 6 databases up to March 2025. Methodological quality was evaluated by the Newcastle-Ottawa Scales. Data were pooled using a random-effects model. Hedges' g was used to express the effect size index with 95 % confidence interval …

The Effects Of Physical Activity Timing And Adherence To Physical Activity Guidelines On Sleep In Children With Adhd, Xiao Liang, Mengping Zhao, Li Su, Justin A. Haegele, Richard H. Xu, Jingjing Li, Andy Choi-Yeung Tse, Shirley X. Li

Human Movement Studies & Special Education Faculty Publications

Regular physical activity (PA) has been shown to benefit sleep. However, the effects of PA timing and adherence to the WHO's recommended 60-min moderate-to-vigorous physical activity (MVPA) guideline on sleep are unclear, especially for children with ADHD who often experience sleep problems. This study examined whether timing of MVPA influenced objectively measured sleep, including sleep latency (SL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO), among children with ADHD. This cross-sectional study involved 253 children with ADHD (Mage = 8.60 ± 1.31 years, 81% boys). MVPA timing was categorized as more than 8 h before …

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

Investigating The Association Between Polycystic Ovary Syndrome (Pcos) And Idiopathic Intracranial Hypertension (Iih): A Cross-Sectional Analysis, Savannah L. Adams

Graduate Studies Theses and Dissertations 2026

Polycystic ovary syndrome (PCOS) and idiopathic intracranial hypertension (IIH) are chronic conditions that disproportionately affect women of reproductive age and share several metabolic risk factors, including obesity, insulin resistance, and hormonal dysregulation. Despite growing clinical interest in a potential relationship between these conditions, limited research has examined awareness, knowledge, symptom presentation, and barriers to healthcare among young adult populations. The purpose of this study was to investigate awareness, knowledge, perceived healthcare barriers, and potential associations between PCOS and IIH among college-aged individuals. A cross-sectional survey was administered to students aged 18-25 at the University of Central Florida through classroom recruitment …

Do Fair Schedules Matter? Work-Home Conflict And Justice In Emergency Medicine, Maresca J. Brand

Graduate Studies Theses and Dissertations 2026

Emergency physicians work in a high-demand environment requiring irregular, around-the-clock schedules, which can contribute to elevated work-home conflict and burnout. While previous research has focused on objective schedule characteristics such as length of shift or time of day worked, less attention has been given to how emergency physicians perceive the fairness of the scheduling process itself. Drawing on Work-Home Resources Theory and Personal Resource Allocation Theory, this study examines whether perceptions of schedule justice influence work-home conflict via schedule satisfaction. I propose that perceived fairness in schedule creation functions as a contextual resource that shapes whether a schedule is experienced …

Physical Activity And Health Outcomes In Children With Dyslexia During Summer Versus School Months, Tina J. Glatz

Graduate Studies Theses and Dissertations 2026

Children in the United States continue to experience rising rates of overweight and obesity. Children with learning disabilities are twice as likely to have obesity than typically developing peers, partly due to difficulties with motor skills and behavior regulation. The purpose of this study was to examine and compare differences in health outcomes and physical activity (PA) during summer versus school months in children with dyslexia, using a within- subject study design.

At three timepoints (May, August, December 2025), children’s height, weight, and fitness were measured via a portable stadiometer, dual-frequency foot-to-foot bioelectric impedance device, and Progressive Aerobic Cardiovascular Endurance …

Social Support As An Effect Modifier Of The Assocation Between Drug-Use Related Stigma And History Of Substance Use During Pregnancy Among Women Who Use Unprescribed Opioids In New York City: A Cross-Sectional Study, Isabelle C. Lynch

Graduate Studies Theses and Dissertations 2026

Substance use and misuse among women who are pregnant is a growing public health concern in the United States. Overdose deaths are now a leading cause of death among pregnant and postpartum women, and neonatal abstinence syndrome rates have increased to 23 per 1000 births. A barrier addressing substance use among these women is social stigma, which in part is driven by punitive drug policies that criminalize substance use during pregnancy and societal gender roles and norms surrounding women’s substance use. Social support, including emotional, instrumental, and informational support, can serve to mitigate the negative impacts of stigma on health …