Public Health Commons^™

Analyzing The Global Happiness Index, Victoria Hernandez, Christy W. Wachira

SMU Data Science Review

This study explores the Global Happiness Index using data compiled from the OECD and Our World in Data to identify key factors contributing to societal well-being. Six primary predictors were analyzed: GDP per capita, social support, healthy life expectancy, freedom to make life choices, generosity, and perceptions of corruption. Regression and clustering techniques were employed to uncover patterns among countries. By expanding the analytical scope beyond conventional economic and social indicators, this study helps identify new pathways for improving well-being across diverse cultural and economic landscapes. Additional variables such as perceived safety, political engagement, and values related to family and …

Characterization Of Antiretroviral Therapy (Art) Adherence Phenotypes And Psychosocial Symptom Clusters Among Black/African American (Aa) And Hispanic/Latine Adolescents And Young Adults (Ayas) With Hiv In The Adherence Connection For Counseling, Education, And Support (Access-Ii) Trial, Ann-Margaret Navarra, Taehoon Ha, Eva Liang, Maurade Gormley, David R. Garcia, Jason Fletcher, Lloyd A. Goldsamt, Michael G. Rosenberg, Karin Hasegawa, Jie Yang

School of Nursing Faculty Publications

Antiretroviral therapy (ART) adherence behavior is heterogeneous among adolescents and young adults (AYAs) with HIV and influenced by individual and interpersonal psychosocial factors. The primary objective of this study is to characterize ART adherence phenotypes and psychosocial symptom clusters, as related to ART adherence and HIV viral load suppression. This analysis included 60 AYAs with HIV enrolled in an ART adherence support clinical trial. Self-reported ART adherence at baseline, 12-weeks, and 24-weeks was used to define four ART adherence phenotypes: consistently high adherence (YY), early-only adherence (YN), late-only adherence (NY), and consistently low adherence (NN). Symptom clusters were empirically derived …

Geographic And Socioeconomic Predictors Of Early Follow-Up Loss In Patients Undergoing Pituitary Neuroendocrine Tumors (Pitnets) Resection: A Retrospective Review Of 1143 Cases, Daniel Quintana, Rithvik Ramesh, Robert C. Osorio, Wesley Shoap, Paul Mcmillan Villalobos, Philip V. Theodosopoulos, Sandeep Kunwar, Jose Gurrola, Ivan H. El Sayed, Manish K. Aghi, Ezequiel Goldschmidt

School of Medicine Faculty Publications

OBJECTIVE: Postoperative follow-up after PitNET resection is essential for monitoring tumor recurrence and endocrinological deficits. Despite advances in telehealth, loss to follow-up remains a persistent challenge across neurosurgical patients. This study aims to identify factors to identify patients are at higher risk of being lost to follow-up after surgery. METHODS: A retrospective analysis was conducted on 1,143 adult patients who underwent PitNET resection between 2012 and 2019 at a single institution. Clinical and radiological data were analyzed to assess loss to follow-up in the cohort. Multivariable logistic and negative binomial regression models were used to identify factors independently associated with …

Development And Applications Of A Health Equity Summary Score Using The Medical Expenditure Panel Survey, Ronald R. Sanchez

Dissertations and Theses

Despite sustained national efforts, disparities in healthcare delivery persist among racial and ethnic minorities, low-income individuals, and socially at-risk populations. Monitoring modifiable aspects of care delivery, such as the structures and processes that health systems can directly improve, is a key strategy for addressing these gaps. However, most measures evaluate modifiable aspects of care delivery separately, limiting understanding of how improvements in one domain reinforce the other and how their combined effect influences equitable care.

This dissertation addresses this gap by combining patient experience and clinical quality, two modifiable aspects of care that captures how patients interact with the health …

Comparative Analysis Of Robotic-Assisted, Laparoscopic, And Open Radical Nephrectomy: Utilization, Costs, And Clinical Outcomes, Daniel Huang, Costas D. Lallas, Raegan M. Davis, Scott W. Keith, Patrick J. Moeller, Inkyu K. Kim, Anushka Ghosh, Francisco Aguirre, Rasheed A. M. Thompson, Emmanuel F Drabo, Vittorio Maio

College of Population Health Faculty Papers

BACKGROUND: Minimally invasive approaches, including laparoscopic (LARN) and robotic-assisted radical nephrectomy (RARN), have gained adoption over open surgery (ORN) for renal cancer, despite RARN’s higher costs. This contemporary study evaluates trends in RARN, LARN, and ORN use and compares their hospital costs, clinical complications, and mortality rates.

METHODS: Patients undergoing radical nephrectomy (2016–2019) were identified from the National Inpatient Sample (NIS). Procedures were classified as RARN, LARN, or ORN using ICD-10 and Procedure Coding System codes. Patient demographics and comorbidities, hospital characteristics, length of stay (LOS), clinical complications, and hospital costs were analyzed. Trends in utilization were assessed, and regression …

The National Landscape On Wellness Culture And Well-Being Best Practices In Healthcare Systems And Academic Institutions: Results From The Fourth National Summit On Promoting Clinician Well-Being, Megan Amaya, Bernadette Mazurek-Melnyk, Josh Winn, Jeff Messinger

Journal of Wellness

Introduction: The health of our nation’s healthcare workforce continues to decline. A comprehensive, whole-system, evidence-based approach is key to a successful wellness initiative and is the foundation for culture change. Building a culture of wellness leads to better mental health outcomes, healthier lifestyle behaviors, higher levels of engagement and job satisfaction, improved patient satisfaction and employee retention, and a positive return (ROI) and value on investment (VOI).

Methods: The purpose of this cross-sectional, descriptive, anonymous survey was to assess the organizational wellness culture of participants who attended the National Summit on Promoting Well-being and Resilience in Healthcare Professionals. …

Design And Refinement Of Cybercelltm, A Virtual Reality Health Education Program For Adolescents And Young Adults With Sickle Cell Disease, Aimee Hildenbrand, Melanie Pitone, Benjamin Bear, Corinna L. Schultz, Sherman Finch, Danielle Morley, Stephanie Hubbard, Alyssa Decino, Melissa A. Alderfer, Lori E. Crosby, Fredric Freeman

Department of Pediatrics Faculty Papers

For people living with sickle cell disease (SCD), the risk for disease complications and premature death rises sharply in adolescence and young adulthood, when chronic organ damage is compounded by reduced preventive care. To make informed health care decisions, adolescents and young adults (AYAs) require effective education about their health condition and treatment options. We aimed to systematically design and develop a user-centered, evidence-based virtual reality (VR) health education program to optimize the use of SCD therapies among AYAs with SCD. We engaged a diverse team including AYAs with SCD and their caregivers, multidisciplinary SCD clinicians and researchers, patient education …

Factfinders For Patient Safety: Minimizing Complications In Radiofrequency Neurotomy: Part I-Implantable Devices; Part Ii-Preprocedural Bvnrfn Imaging, David Hao, Gerald Yeung, Haewon Lee, Zheyan Chen, Ben Laplante, Paul Kitei, Reza Ehsanian, David Levi

Moss-Magee Rehabilitation Papers

This series of FactFinders presents a brief summary of the evidence and outlines recommendations regarding minimizing risks with radiofrequency neurotomy procedures. The evidence in support of the following facts is presented: (1) While data on the safety of radiofrequency neurotomy in patients with implanted devices are limited, the procedure can likely be performed safely with careful adherence to best practices and manufacturer recommendations. (2) Basivertebral nerve radiofrequency neurotomy can be performed safely and effectively at the L3 through S1 vertebral levels. Scrutiny of preprocedural imaging may minimize risk. Although the transpedicular approach is preferred, patient anatomy may dictate a non-transpedicular …

An Essay On Trailblazing With Service Animals Langer, Pilot, Bowie, And Izzie: Preserving Non-Partisan Public Health And The Law, Gary C. Norman

Journal of Law and Health

A direct correlation exists among humans, their animals, and human health and wellness. This article will focus concisely on law students with disabilities and lawyers with disabilities and how they can be empowered to be trailblazers while remaining healthy and well. Salutogenic Model should be optimized by lawyers with disabilities working at the intersection of animal law, disability law, and public health law. Service animals have positive and salubrious impacts upon their handlers in several ways, including psychosocial health and wellbeing. The Grand Architect (or in my Cherokee tradition, "great spirit") continuously partners me with complicated but magnificent dog partners …

Mpox Insights: From Structure To Human Cell Interaction, Md. S. Zaman, Robert C. Sizemore, Draven Rodriguez, Emilio Lopez, S. M. Golam Alam, Suleyman Tufa, Juan C Lopez Alvarenga, Nuraly S. Akimbekov, Mohammed S. Razzaque

School of Medicine Publications

Mpox, a zoonotic viral disease, has emerged as a global concern due to outbreaks in both endemic and non-endemic regions in 2022. Rodents, including African squirrels and Gambian pouched rats, are suspected key reservoirs, with human infections occurring through direct contact with infected animals or bushmeat consumption. Previously confined to rural Africa, mpox has spread via international travel and the exotic pet trade. Human-to-human transmission occurs mainly via respiratory droplets and direct contact with bodily fluids or lesions. The virus has a double-stranded DNA genome within a lipid envelope. Despite lower mutation rates in DNA viruses, mpox has developed mutations, …

Defending Science, Rebuilding Trust: Toward A Healthier Louisiana, John A. Cavell Jr.

Journal of the Louisiana Public Health Association

No abstract provided.

Volume 5 November '25 Full Issue, Donna Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Data Driven Policies: An Ideal For Louisiana's Juvenile Justice System, Stephen Phillippi, Sara Juneau, Kelsey Witmeier, Victoria Sacco

Journal of the Louisiana Public Health Association

Background: Data collection and monitoring efforts among juvenile justice agencies have grown exponentially in the United States over the last 50 years. Despite widespread recognition that reliable data is essential to developing strategic evidence-based policies, there are still considerable gaps among the states and locally. In Louisiana, legislators and decision-makers have worked towards advancing juvenile justice policy reforms in recent decades, though the resulting outcomes remain unclear. The goals of the current study were to identify existing data reporting strengths and gaps within the Louisiana juvenile justice system (JJS) and examine how such reports might be better used in data-driven …

From Potholes To Perceived Social Support: Community Influences On Individuals With Mobility Disabilities And Their Care Teams In New Orleans, Kelsey Witmeier, Gabrielle Gonzalez, Michael Norman, Mary Delahoussaye, Phil Wilson, Tung-Sung Tseng

Journal of the Louisiana Public Health Association

Background: Little is known about the role of community in influencing the experiences, needs, and well-being among individuals with mobility impairments and disabilities (IMIDs), caregivers, and service providers in New Orleans. Methods: We conducted semi-structured interviews with 10 individuals who identified as IMIDs, caregivers, and service providers, who were recruited using convenience sampling. Transcripts were transcribed verbatim, and thematic analysis was conducted to identify key themes. Results: Three themes were found: 1) community barriers and facilitators, 2) the community’s role in perceived belongingness, and 3) the unique influences of the community on caregivers. Conclusion: Community influences the experiences of IMIDs …

Differentially Expressed Mirnas Explain Racial Differences In Diagnosis Stage Among Triple Negative Breast Cancer Patients In Louisiana, Yawen Hu, Xioacheng Wu, Meng Luo, Nubaira Rizvi, Amjila Bam, Luis Del Valle, Lucio Miele, Qingzhao Yu

Journal of the Louisiana Public Health Association

Background: Triple-negative breast cancer (TNBC) is a highly aggressive subtype that disproportionately affects African American (AA) women, leading to worse survival rates and higher metastasis risks compared to Caucasian American (CA) women. MicroRNAs (miRNAs) are crucial in cancer development and hold promise as biomarkers, but their role in racial disparities in TNBC outcomes is unclear. Methods: This study used Louisiana Tumor Registry data and collected tumor tissues for miRNA sequencing to examine significant miRNAs differentially expressed by race and TNBC stages at diagnosis among 3,298 TNBC cases diagnosed from 2011 to 2017. Results: Of the TNBC cases, 49.7% were AA. …

Association Between Food Insecurity And Nervous System Disorders In Caddo Parish, La: A Call To Action For Health, Megan Gremillion, Morgan Uebinger, Claire Crosby, Kaitlyn Tholen, Marie Vazquez Morgan, Ammar Husan

Journal of the Louisiana Public Health Association

Background: Food insecurity (FI)–the lack of access to affordable, nutritious food–affects millions of Americans. Caddo Parish, Louisiana, is of interest due to high FI prevalence and socioeconomic risk factors. While FI is known to exacerbate chronic health issues, its association with neurological health remains understudied, especially in high-risk communities. Methods: A cross-sectional study was conducted among adult patients in Caddo Parish in 2022 using Epic Electronic Medical Record data to identify diagnoses of migraine, dementia, and stroke—the top neurological causes of disability-adjusted life years (DALYs) in the United States. FI status was determined using the Hunger Vital Sign screening questionnaire. …

Volume 5 November '25 Cover, Publishing, And Table Of Contents, Donna Wlliams

Journal of the Louisiana Public Health Association

No abstract provided.

Pediatric Firearm Injuries In A Major Urban Louisiana City: A Deadly Public Health Issue, Morgan Brown, Jenny Stevens, Jose Cruz Ayala, Claudia Leonardi, Alison Smith, Fabienne Gray

Journal of the Louisiana Public Health Association

Background: In 2019, firearm injuries surpassed motor vehicle collisions as the leading cause of pediatric death in the US. In Louisiana, firearm injuries represent the leading cause of pediatric death since 2013. A more comprehensive understanding of risk factors associated with pediatric firearm injury is needed to improve outcomes. Methods: A retrospective review from 2016-2023 of pediatric trauma patients presenting to a Level I Adult Trauma Center & Level II Pediatric Trauma Center in a major urban Louisiana city was performed. Demographics, mechanism of injury, and injury intent were evaluated. Results: Among 8,832 patients, 1,116 (12.6%) sustained firearm injuries. Among …

High Activity Urban Event Impacts Local Air Quality Of The Claiborne Corridor In New Orleans, La, Evrim Oral, Daniel Harrington, Mohamed S. Mohamed, Mohamed S. Rahman, Saheba Cuccia, Samrat Mukherjee, Amy Stelly, Barry Keim, Adrienne Katner

Journal of the Louisiana Public Health Association

Background: This paper presents fine particulate matter air pollution measurements in the hours before, during, and after a Port of New Orleans labor strike and a multi-day concert held at the New Orleans Superdome. Both events occurred in areas adjacent to the Claiborne Expressway, an elevated highway extension of Interstate-10 (I-10), which runs through the Claiborne Corridor neighborhood of the City of New Orleans, LA (USA). Methods: Air sensors were located southeast and northwest of the Claiborne Expressway to measure respirable “fine particulate matter” (PM2.5), a traffic-related pollutant associated with cardiovascular and respiratory disease. Ambient PM2.5 concentration measurements were collected …

Characterizing Global Dermatologic Engagement And Needs: A Cross-Sectional Study From 83 Countries, Alexis G. Strahan, Christine Li, Maud Guérin, Tom Allison, Gene Colón, Jehireh Peraza-Williams, Olyvia Zarchin, Morvarid Zehtab, Ann M. Pacheco, Jadesola Akinwuntan, Shivani Jain, Marlous L. Grijsen, Wendemagegn Enbiale, Wingfield Rehmus, L. Claire Fuller, Karolyn Wanat, Esther E. Freeman

School of Medicine Faculty Publications

No abstract provided.

Epidemiology Of Metabolic Syndrome In Patients With Inflammatory Bowel Disease: A Population-Level Cohort Study From The United States, Aakash Desai, Himsikhar Khataniar, Jana G. Hashash, Priya Sehgal, Francis A. Farraye, Gursimran S. Kochhar

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Epidemiological data on metabolic syndrome (MetS) in patients with inflammatory bowel disease (IBD) are limited.

METHODS: A retrospective cohort study was conducted using the United States (US) Collaborative Network (TriNetX) to obtain data for patients with IBD between 2010 and 2023. The primary aim of the study was to estimate the prevalence of MetS in ulcerative colitis (UC) and Crohn's disease (CD). Prevalence was further characterized by age, sex, race, disease location, IBD medications, history of surgery, and IBD phenotype.

RESULTS: Among 100,890 patients with IBD, metabolic syndrome (MetS) affected 34.4% overall (UC 32.4%, CD 34.3%). Prevalence rose sharply …

Understanding The U.S. Maternal Healthcare System At The Intersection Of Asian American Birth Outcomes And The Model Minority Stereotype: A Literature Review, Sophia Hevel

University Honors Theses

This thesis aims to explore the maternal healthcare system in the United States as it pertains to Asian American birthing people, the ways in which their racial, ethnic, and cultural identities are interacted with within the U.S. Healthcare system, and subsequently the detrimental effects of the medical system's devaluation of culturally specific birthing and postpartum practices have on Asian American birthing experiences. This will be accomplished through an exploration of the United States' maternal healthcare system, or rather, its crisis; how Asian Americans navigate a system that has not been structured to support their specific needs; and lastly, a discussion …

The Time-Dependent Association Between Irritable Bowel Syndrome And All-Cause And Cause-Specific Mortality In The Nih-Aarp Cohort Study, Daniela S Gutiérrez-Torres, Fangyu Li, Linda M Liao, Carrie R Daniel, Shreela V Sharma, Ruosha Li, Eric L Brown, Qing Lan, Maki Inoue-Choi, Baharak Moshiree, Paul Albert, Rashmi Sinha, Emily Vogtmann

Faculty, Staff and Student Publications

Introduction: Evidence on the association between irritable bowel syndrome (IBS) and mortality is conflicting. In this study, we estimated the association between IBS and all-cause and cause-specific mortality in the NIH-AARP Diet and Health Study.

Methods: IBS diagnoses between 1994 and 2008 were identified from Medicare claims data, and mortality outcomes through 2019 were obtained through linkage to the National Death Index. Using multivariable Cox proportional hazards regression models, we estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality within partitioned follow-up time categories (>2-5, >5-8, >8-11, >11-14, >14-17, and >17 years) with adjustment …

Risk Factors For Unexpected Death In Patients Identified By A Communication And Resolution Program, Peter Lodato, Neal D. Goldstein, Alexandra M, Mapp, Adebayo Gbadebo, David A. Paul

Department of Pediatrics Faculty Papers

Many patients experience unexpected harm while receiving healthcare, with a lasting impact on patients, families, and caregivers. Communication and Resolution Programs are being adopted with increased frequency, as a more systematic, transparent, and equitable approach to these unexpected outcomes. The aim of this study was to identify whether demographic factors played a role in identifying patients with unexpected death, as managed in our CRP. This nested case-controlled compared 236 patients who experienced an unanticipated death with 2,360 controls who died expectedly over a 10-year period. Patients with unexpected death were more likely to be Black (AOR 2.18 95% CI 1.01-4.68), …

Third Grade Reading Proficiency In Deaf/Hard Of Hearing Children Who Received Early Intervention, Jareen Meinzen-Derr, Cassandra Conrad, Mekibib Altaye, Elodie Betances, Jayna Schumacher, Susan Wiley

Journal of Early Hearing Detection and Intervention

Background

Early enrollment in Part C Early Intervention (EI) by age 6 months is linked to improved language and kindergarten readiness in deaf or hard of hearing (DHH) children, but its effect on later academic outcomes is unclear. This study examines whether earlier (<6 months) or later (>6 months) enrollment influences third-grade reading proficiency.

Method

This study used data linked from three Ohio state agencies for infants identified with permanent hearing loss born 2008-2014 who received EI; 412 had third grade standardized reading tests. Reading levels were categorized from limited to advanced. Logistic regression assessed the association between enrollment timing and reading proficiency, …

Developing A Research Agenda In Partnership With Parents Of Deaf/Hard-Of-Hearing Children, Carrie A. Davenport, Ursula M. Findlen, Ann Schenk Mcalearney, Lisa Vaughn

Journal of Early Hearing Detection and Intervention

Background: Community-based participatory research (CBPR) is an excellent fit for understanding and addressing the unique and diverse needs of deaf or hard-of-hearing (DHH) children and their families.

Objectives: We describe lessons learned from a capacity building project initiating an academic-community partnership between a multidisciplinary research team and a small group of parents of DHH children. Trainings and focus group style discussions created a research agenda reflective of families’ priorities.

Methods: Processes are described related to the development and composition of a Family Advisory Council, training topics and methods, the process for generating and prioritizing topics, and evaluation procedures.

Lessons learned: …

The Follow-Up Gap: Racial Disproportionality And Social Determinants Of Health In New Jersey’S Hearing Detection And Intervention Program, Maryrose Mcinerney, Wendy Zeitlin

Journal of Early Hearing Detection and Intervention

Objectives. To assess how race/ethnicity and social determinants of health are related to loss to follow-up (LTF) from NJ’s Early Hearing Detection and Intervention (EHDI) program.

Methods. All infants born in NJ between June 2015 and June 2017 referring for additional hearing healthcare after hospital discharge were considered for inclusion in this study. The sample consisted of 4,141 babies, 10.7% of which received no follow-up care. Step-wise multi-level logistic regression was used to determine how race/ethnicity, family-level, and community-level social determinants of health (SDOH) were predictive of LTF.

Results. In each model, the odds of being LTF were significantly higher …

Opportunities To Improve Continuity In Medicines Management For Aboriginal And Torres Strait Islander People Accessing Care In South Australian Hospitals: Coverage, Quality, Monitoring And Accountability, Annabelle Cranwell, Cheyne Sullivan, Kezia Daniel, Erik Cornelisse, Brianna Kinnear

Journal of the Australian Indigenous HealthInfoNet

This paper proposes that hospital admissions, which are traditionally considered high risk transitions, can be opportunities to strengthen continuity in medicines management (CMM) for Aboriginal and Torres Strait Islander patients and across the healthcare system. There are four key areas of focus in this paper including CMM coverage, CMM quality, health system monitoring of CMM, and health system accountability for CMM to Aboriginal and Torres Strait Islander people and communities. These areas for improvement are justified by the National Agreement on Closing the Gap (The National Agreement), the Guiding Principles to Achieving continuity in medication management, and Continuity in Medication …

Unveiling The Clinical Profiles Of Critically Ill Covid-19 Patients: Insights From Ezhou During The Early Spread, Guohui Yang, Zewen Liu, Tabitha Abraham, Linwei Li, Tingyang Zhou, Qing Zhang, Li Zuo

School of Medicine Publications

The coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan. This article evaluated clinical characteristics, and imaging manifestations in Ezhou, an early locked-down city, 80 kilometers east of Wuhan. We analyzed data from 98 confirmed severe COVID-19 patients in Ezhou Central Hospital between February 1st and March 22nd, 2020. We compared patients' laboratory results, imaging manifestations, and treatments between survival and death groups. Of these 98 confirmed COVID-19 patients, 24 individuals (24.6%) had chronic diseases. The main symptoms of critically ill patients were fever (86.7%), cough (83.7%), and dyspnea (59.1%). Common complications were acute respiratory distress syndrome (ARDS; 49%), …

Exploring The Acceptability Of The Kimberley Mum’S Mood Scale For Perinatal Mental Health Screening In Gove District Hospital, North-East Arnhem Land, Tom P. Atkinson, Erica P. Spry, David Atkinson, Julia V. Marley, Emma Carlin

Journal of the Australian Indigenous HealthInfoNet

Objective: Across Australia perinatal mental health challenges disproportionately impact Aboriginal women. Identifying Aboriginal women at risk of adverse mental health outcomes in the perinatal period is an important step in supporting their overall health and wellness. Current screening tools have significant limitations when used with Aboriginal women.

The Kimberley Mums Mood Scale (KMMS) is a culturally secure approach to screening for perinatal mental health disorders in Aboriginal women. It has been validated in the Kimberley region of Western Australia and may be able to improve mental health screening in other regions. In this study the KMMS was trialled at a …