Public Health Commons^™

Access To Outreach Athletic Trainers Improves Orthopedic Specialty Appointment Adherence, Katie Sniffen, Katie Smith, Michael Rozier, Katherine Stamatakis, Paula Buchanan, Leslie Hinyard

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Background: Adolescent sports participation carries an inherent risk of musculoskeletal injury, with an estimated 2 million injuries occurring annually among high school athletes. Navigating the healthcare system to receive appropriate care can be challenging, potentially leading to delayed treatment and poorer outcomes. Athletic trainers (ATs) may play a crucial role in facilitating timely access to specialized care. The objective of this study was to assess the relationship between referral pathways (outreach athletic trainers (OATs), non-outreach athletic trainers (ATs), urgent care (UC), and emergency department (ED)) and appointment adherence while controlling for predisposing, enabling, and need factors. Methods: Using electronic medical …

Control Of Clostridioides Difficile Virulence And Physiology By The Flagellin Homeostasis Checkpoint Flic-Fliw-Csra In The Absence Of Motility, Duolong Zhu, Katherine J Wozniak, Firas Midani, Shaohui Wang, Xingmin Sun, Robert A Britton

Faculty, Staff and Students Publications

Mutations affecting Clostridioides difficile flagellin (FliC) have been shown to be hypervirulent in animal models and display increased toxin production and alterations in central metabolism. The regulation of flagellin levels in bacteria is governed by a tripartite regulatory network involving fliC, fliW, and csrA, which creates a feedback system to regulate flagella production. Through genomic analysis of C. difficile clade 5 strains (non-motile), we identified they have jettisoned many of the genes required for flagellum biosynthesis yet retain the major flagellin gene fliC and regulatory gene fliW. We therefore investigated the roles of fliC, fliW …

Associations Of Sociodemographic, Clinical Factors And Hla-B Alleles With Enthesitis And Peripheral Arthritis In Patients With Ankylosing Spondylitis, Benjamin Sornrung Naovarat, Lianne Gensler, Michael Ward, Mark Hwang, Amirali Tahanan, Mohammad Hossein Rahbar, Mariko Ishimori, Minjae Lee, Matthew A Brown, Michael H Weisman, John D Reveille

Faculty, Staff and Student Publications

Objectives: Factors associated with peripheral arthritis and enthesitis, especially Achilles tendonitis and plantar fasciitis, were examined in a longitudinal cohort of 1075 patients with ankylosing spondylitis (AS) (also known as radiographic axial spondyloarthritis).

Methods: Patients were derived from the Prospective Study of Outcomes in Ankylosing Spondylitis cohort. Disease activity and functional indices, as well as physical examination and medications used, were measured at every study visit. Univariable and multivariable analyses of the association of peripheral arthritis and enthesitis with clinical, sociodemographic factors were performed. Human leucocyte antigen (HLA)-B alleles were analysed by single-stranded conformational polymorphism analysis.

Results: Those with peripheral …

Hematopoietic Cell Transplant Compared With Standard Care In Adolescents And Young Adults With Sickle Cell Disease, Mark C Walters, Mary Eapen, Yiwen Liu, Fuad El Rassi, Edmund K Waller, John E Levine, John J Strouse, Joseph H Antin, Suhag H Parikh, Nitya Bakshi, Carlton Dampier, Jennifer J Jaroscak, Shayla Bergmann, Trisha Wong, Vamsi Kota, Betty Pace, Lazaros J Lekakis, Premal Lulla, Robert S Nickel, Kimberly A Kasow, Uday Popat, Wally Smith, Lolie Yu, Nancy Difronzo, Nancy Geller, Naynesh Kamani, Elizabeth S Klings, Kathryn Hassell, Adam Mendizabal, Keith Sullivan, Donna Neuberg, Lakshmanan Krishnamurti

Faculty, Staff and Students Publications

Disease-modifying therapies are standard of care (SOC) for sickle cell disease (SCD), but hematopoietic cell transplantation (HCT) has curative potential. We compared outcomes prospectively through 2 years after biologic assignment to a donor or no donor (SOC) arm based on the availability of an HLA-matched sibling or unrelated donor (BMT CTN 1503). A donor search was commenced after eligibility confirmation. The primary end point was a comparison of survival between the treatment arms 2 years after biologic assignment. Power calculations required 60 participants in the donor arm and 140 in the no donor arm to determine if early transplant-related mortality …

Fact Sheet: Fentanyl, Aaron Hunt, Gabriela Murza, Amy May, Jenna Hawks, Alyssa Ferrin

All Current Publications

This fact sheet provides essential information on fentanyl, a potent synthetic opioid increasingly found in illegal street drugs, posing significant overdose risks. It highlights how opioids affect the body, the dangers of fentanyl, and the importance of harm-reduction strategies, such as fentanyl test strips, naloxone access, and safe syringe disposal. Information on signs and symptoms and how to respond to an overdose are also included.

Does Travel Time Matter?: Predictors Of Transportation Vulnerability And Access To Hiv Care Among People Living With Hiv In South Carolina, Sayward Elizabeth Harrison, Peiyin Hung, Katherine Green, Sarah J. Miller, Mariajosé Patron, Divya Ahuja, Sharon Weissman, Caroline Rudisill, Tammeka Evans

Faculty Publications

Background

People living with HIV (PLHIV) in the southern United States (US) are at high risk for poor outcomes across the HIV care continuum leading to low rates of viral suppression. Understanding structural barriers to care—including transportation vulnerability—is critical to improve HIV outcomes. This study investigated relationships between travel time to HIV care, transportation vulnerability, and HIV care disruptions to inform future transportation interventions for PLHIV residing in South Carolina and other southern US states.

Methods

A total of 160 PLHIV (N = 160) were recruited from a large immunology center in South Carolina. Participants reported on transportation experiences, transportation …

A Qualitative Approach To Identifying Obstacles To Mental Healthcare In The Rio Grande Valley From The Perspective Of Mental Healthcare Professionals., Shania M. Linder, Cristian Botello, Raquel Villarreal, Nelda Rodriguez, Mario Gil, Dayana Zamora

Research Symposium

Background: There are many factors that prevent members of the Hispanic/Latino community from accessing mental health resources. This is important to investigate because there is a lack of knowledge on why residents of the Rio Grande Valley, an underserved region of South Texas, are unable to access and/or utilize mental health resources.

Methods: A focus group session was held at a mental health counseling clinic in Cameron County, Texas on February 1, 2024. The participants consisted of mental health professionals, such as two mental health clinicians, a clinical counselor, two school counselors, a licensed professional counselor supervisor, and a …

Evaluating The Effectiveness Of Cryoneurolysis As A Preoperative Intervention In Total Knee Arthroplasty: A Literature Review, Paul Bonilla, Anesu K. Murambadoro, Juan Pablo Flanagan, Victoria Elizondo, Aamir Ahmad

Research Symposium

Background: Total knee arthroplasty (TKA) is a highly effective treatment for knee osteoarthritis, but significant postoperative pain often necessitates opioid use. Over 70% of patients use opioid drugs 3 weeks after TKA and up to 15% of TKA patients develop opioid dependence, increasing the risk of adverse effects, infections, and contributes to costly revision surgeries. Cryoneurolysis, a minimally invasive technique involving freezing peripheral nerves, has gained attention as a promising preoperative intervention. This study explores the potential of cryoneurolysis as a preoperative intervention to alleviate pain, reduce opioid dependence, and improve functionality.

Methods: A literature search was conducted using the …

Atypical Presentation Of Pediatric Cat Scratch Disease: A Case Report, Paul Bonilla, Kassandra Pulido, Natasha Bell, Otto Velasquez

Research Symposium

Background: Skin lesions and/or regional lymphadenopathy are defining characteristics of Cat Scratch Disease (CSD), a zoonotic infection commonly caused by animals carrying Bartonella henselae. While CSD is often self-limiting, rare cases with a disseminated course and visceral organ involvement may complicate diagnosis, especially in pediatric patients. This case report describes an atypical presentation of B. henselae infection in an 11-year-old female with Type I diabetes (T1D).

Case Presentation: An 11-year-old girl with a history of T1D presented to her pediatrician with abdominal pain and fever. A rapid test confirmed Streptococcal Pharyngitis and she was prescribed amoxicillin and sent home. …

Patterns And Outcomes In Urotrauma: An Analysis Of Fatality Trends And Contributing Factors, Neharika Penmetcha, Aun Bangash, Kelsey Baker

Research Symposium

Background: Urotrauma, involving injuries to the kidneys, ureters, and bladder, represents a critical subset of trauma cases, significantly impacting patient morbidity and mortality. Renal and urogenital injuries account for 10–20% of abdominal trauma in adults and children. Understanding urotrauma's epidemiology is vital for improving care protocols and resource allocation. Despite its impact, data on injury mechanisms, intent, and care modalities specific to urotrauma remain limited. This study investigates patterns in injury mechanisms, intent, transport modalities, and facility transfer status to identify factors influencing patient outcomes and inform trauma care improvements.

Methods: A retrospective review analyzed 3,492 trauma cases, filtered for …

Assisted Reproductive Technology (Art) In The Mountain West, 2022, Caitlin J. Saladino, Kristian Thymianos, William E. Brown Jr., Monserrat Cristando-Romo, Taylor Volk, Yashesvi Sharma

Health

This fact sheet examines data on Assisted Reproductive Technology (ART) clinics located in five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. The Centers for Disease Control and Prevention 2022 Fertility Clinic Success Rates Report includes data from all 50 states and provides information on ART services offered by individual clinics, including data on total cycles, fertility preservation cycles, pregnancies, deliveries, and total infants born.

Heart Failure In Black Populations: Epidemiology, Pathophysiology, And Treatment Disparities, Kazi N. Islam, Rahib K. Islam, Ivan Nguyen, Yasmeen Magherahabed, Humza Pirzadah, M. Bazlur Rashid

School of Medicine Faculty Publications

Heart failure (HF) remains a significant health challenge globally, placing a heavy burden on individuals, families, and healthcare systems. The prevalence of HF continues to rise, posing substantial public health concerns. This burden is particularly pronounced among the Black Population, who face higher prevalence, earlier onset, and greater severity of HF compared to other racial and ethnic groups. This review explores the multifaceted landscape of HF in Black individuals by examining epidemiological patterns, pathophysiological mechanisms, clinical presentations, treatment disparities, and clinical outcomes. Black individuals exhibit distinct pathophysiological characteristics, such as genetic variations contributing to heightened susceptibility and severity of HF. …

Clinical And Genetic Markers Of Vascular Toxicity In Glioblastoma Patients: Insights From Nrg Oncology Rtog-0825, Joshua D Strauss, Mark R Gilbert, Minesh Mehta, Ang Li, Renke Zhou, Melissa L Bondy, Erik P Sulman, Ying Yuan, Yanhong Liu, Elizabeth Vera, Merideth M Wendland, Volker W Stieber, Vinay K Puduvalli, Serah Choi, Nina L Martinez, H Ian Robins, Grant K Hunter, Chi-Fan Lin, Vivian A Guedes, Melissa A Richard, Stephanie L Pugh, Terri S Armstrong, Michael E Scheurer

Faculty, Staff and Students Publications

Background: Glioblastoma (GBM) is an aggressive form of brain cancer in which treatment is associated with toxicities that can result in therapy discontinuation or death. This analysis investigated clinical and genetic markers of vascular toxicities in GBM patients during active treatment.

Methods: In total, 591 non-Hispanic White GBM patients with clinical data were included in the analysis from NRG RTOG-0825. Genome-wide association studies (GWAS) were performed from genotyped blood samples (N = 367) by occurrence of thrombosis or hypertension (grade ≥ 2). A clinical prediction model was produced for each vascular toxicity. Significant GWAS variants were then added to the …

Sudden Infant Death Syndrome Mortality Trends In Mississippi, 2012–2022, Elizabeth Jones

Journal of Public Health in the Deep South

Due to the lack of studies examining SIDS mortality trends and its implications on pediatric populations, this study aimed to address the gap in research and to identify the magnitude and the impact of SIDS by exploring trends in SIDS among infants from 2012 to 2022. The study uses data from the Mississippi Statistically Automated Health Resource System, which is an online database with data collected from vital statistics. Joinpoint regression models were used to calculate Annual Percentage Change (APC) and Average Annual Percentage Change (AAPC) as an indicator of trends. The overall SIDS mortality rate remained 0.5 deaths per …

Exploring Options To Maximize Hpv Vaccination Rates In Mississippi: A Commentary, Mcking I. Amedari

Journal of Public Health in the Deep South

Human Papillomavirus (HPV)-related cancers remain a significant cause of mortality. Nevertheless, disparities in vaccination coverage persist across the U.S., with Mississippi reporting the lowest HPV dose completion rates despite achieving high overall vaccination rates for other vaccines. Dental professionals can play a vital role in improving HPV vaccination rates by promoting and administrating the vaccine. Notably, Mississippi remains one of the few states where the dental board permits dentists to administer the HPV vaccine. This presents a valuable opportunity to expand access points as a preventive strategy against HPV-related cancers. Additionally, there is a need to explore legislative measures to …

Outcomes Of Double Free Flap Reconstruction For Advanced Head And Neck Tumors In A Safety-Net Hospital Population, Yossef Alsabawi, John M. Gaddis, Angela D. Haskins, Jonathan Shum, David J. Hernandez

Research Symposium

Background: Double-free flap reconstruction has emerged as a viable option for addressing more complicated defects after oncologic resection. We aim to report the feasibility of this approach at a single-institutional safety net hospital.

Methods: A retrospective chart review was performed between November 2020 and October 2023 for adult patients who underwent multiple, simultaneous free tissue transfers for head and neck defects following tumor resection. This study occurs at Ben Taub Hospital, a safety net hospital in Houston, Texas. Data collected included demographics, risk factors, oncologic and operative details, complications, and functional and disease outcomes. Socioeconomic status was assessed …

Advancing Telemedicine Adoption: Insights From Health Behavior Models With A Focus On The Multi-Theory Model, Rahib K. Islam, Abigail E. Watson, Alec Robitaille, Manoj Sharma, Robert E. Davis, Joshua T. Clark, Vinayak K. Nahar

Journal of Public Health in the Deep South

Telemedicine, the use of digital communication technologies to deliver clinical healthcare remotely, has emerged as a pivotal advancement in modern medicine. By providing virtual consultations, asynchronous data transmission, and remote patient monitoring (RPM), telemedicine enhances accessibility, particularly for underserved populations, while promoting efficiency and continuity of care. As telemedicine transforms healthcare delivery, its adoption hinges on understanding health behaviors—actions influenced by psychological, sociocultural, and environmental factors. These behaviors can be categorized into preventative, illness, and risk-related actions, with established models like the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Transtheoretical Model (TTM) offering insights into behavior change mechanisms. …

A Review Of Educational Interventions To Increase Human Papillomavirus Vaccination Rates In Low-Income Populations, Maria F. Lozano Bonilla, Bria Okere, Yazeth Gonzalez, Maria Camila Gonzalez Tovar

Research Symposium

Background: The human papillomavirus (HPV) 9-valent vaccine protects against nine high-risk types of HPV which are known to cause genital warts, cervical, vaginal, anal, penile, and oropharyngeal cancer. As of 2022, Texas ranks 48th in HPV vaccine completion rates and 44th in vaccine initiation rates. In Hidalgo County, only 16.8% of females and 16.7% of males aged 9 to 17 have completed the HPV vaccination series. This ranks the county 119th for females and 111th for males out of 254 counties in the state of Texas. These rates are remarkably below the Healthy People 2030 target of an 80% completion …

A Sex Comparison Of Fall And Fracture Occurrence In The Elderly Diabetic Population: A Quantitative Study, Fahamina Ahmed, Kaylin Miller, Meva Beganovic, Ali Siddiqui, Candice Smith

School of Medicine Faculty Publications

AIMS: To assess differences in falls and fractures in men and women with type 2 diabetes mellitus (T2DM) within a diverse population in Southeast Louisiana. METHODS: A list of 1200 patients was generated through an electronic health record system using keywords: diabetic diagnosis, falls, and fractures to conduct this retrospective cohort study. This chart review included adults with T2DM who experienced at least one fall and/or fracture between January 2018 and May 2023 at East Jefferson General Hospital located in Metairie, Louisiana. Only falls and fractures that resulted in a hospital visit were included. Results were compared between males and …

Targets To Increase Hiv Pre-Exposure Prophylaxis (Prep) Uptake Among Communities In Northeast Georgia, Kaley E. Parchinski, Molly Hirsh, Andrew Cheng, Nia Kalifa, Manvi Manyam

Journal of the Georgia Public Health Association

Background: This study seeks to identify targets to increase HIV pre-exposure prophylaxis (PrEP) uptake in Athens-Clarke County, GA, a non-urban area with high HIV burden and poor PrEP utilization.

Methods: A cross sectional survey of adults attending HIV outreach screenings in Athens, GA between November 2022 and March 2023 describes participant demographics and validated scales measuring PrEP knowledge, attitudes, stigma, descriptive norms, and intentions.

Results: Of 136 total participants, key demographic groups included Black (N=84, 61.8%), Latinx (N=10, 8.1%), LGBTQ+ (N=25, 18.4%), and persons who use injection drugs (N=19, 15%); overall, less than half of the PrEP knowledge items were …

Impact Of Primary Care Team Configuration On Access And Quality Of Care, Sylvia J Hysong, Kelley Arredondo, Houston F Lester, Richard Sorelle, Trang Pham, Frederick L Oswald, Lechauncy Woodard, Laura A Petersen, Joshua Hamer, Ashley M Hughes

Faculty, Staff and Students Publications

Background: Team-based primary care has become the norm within many large healthcare systems; however, limited guidance exists on how to optimally staff primary care teams in relationship to healthcare.

Objective: This paper examines the associations between variations in team staffing configurations on primary care access and clinical quality.

Design: Observational study linking national Veterans Health Administration (VHA) data from February 2020 on primary care team staffing configurations to data on access to and quality of care the teams delivered.

Participants: We examined data from 22,390 primary care personnel assigned to 7050 teams from 1050 VA Medical Centers and Community-Based Outpatient …

Overcoming Vaccine Hesitancy: Evidence From Italy During The Covid-19 Pandemic, Alessandro Del Ponte, Audrey De Dominicis, Paolo Canofari

Political Science Faculty Articles and Research

Objectives

Study design

Michelle Obama: Moving Towards Childhood Obesity Solutions, Ian Gallagher

Osmosis Magazine

Throughout the Obamas' time in office, approval ratings made it clear the most popular Obama was not the man in the Oval Office. First Lady Michelle Obama consistently received higher approval ratings than her husband during his time in office. This could be attributed to her strong devotion to her family and her appearance as a genuinely good and caring person. During her time in office she drew the attention of the public by shedding light on one of the worst health epidemics currently afflicting the country: childhood obesity.

The Role Of Chemistry In The Prevention And Containment Of The Zika Virus, Joe Ortolani

Osmosis Magazine

Similar to West Nile and yellow fever, Zika is a mosquito-born e dis ease th at has gained quite a bit of attention since its recent arrival in Latin America for its possible link to a string of fetal brain defects. The Zika virus was first identified in Uganda in 1947, but for much of the late 20th century, very little was known about the virus.

Health Disparities In Third-Degree Burn Care In The State Of Texas, Jocelyn Torres, Isabella Ortigoza Martinez, Saloni Saldhi, Mary Arden Guillory, Shalika Padhi, Ashlyn Holubar

Research Symposium

Background: Third-degree burns are injuries that penetrate through the dermis and can affect underlying tissues, resulting in severe functional and aesthetic impairments. Despite advancements in burn care, challenges remain in care equality. Of note, best practices recommend third-degree burn treatment should occur at a registered burn center due to the high risk of shock and/or infection. Additionally, a burn center provides specialized treatments such as grafts that can lead to improved recovery. Previous studies have shown that marginalized racial groups correlate with worse burn injury outcomes, suggesting that they may not have access to burn centers. This study aimed to …

A Five-Year Study Of Pelvic Fractures In Texas: Demographics, Location And Healthcare Needs, Isabella Ortigoza, Saloni Saldhi, Shalika Padhi, Ashlyn Holubar, Mary Arden Guillory, Jocelyn Torres, Daniel Salinas, Kelsey Baker

Research Symposium

Background: Pelvic fractures, while rare, are one of the more severe fractures due to their potential to damage crucial internal organs. Many are deemed medical emergencies that require immediate surgical attention, highlighting the importance of accessible healthcare. Previous research indicates that pelvic fractures are more prevalent in women and most often as a result from a high impact traumatic injury. However, it remains unclear the impact of epidemiologic factors on pelvic fracture incidence and severity, particularly in minority populations. Here, we sought to evaluate the influence of geographical area on pelvic fracture incidence, including specific injury causes and anatomical fracture …

Pre-Exposure Prophylaxis Uptake Among Black/African American Men Who Have Sex With Other Men In Midwestern, United States: A Systematic Review, Oluwafemi Adeagbo, Oluwaseun Abdulganiyu Badru, Prince Addo, Amber Hawkins, Monique J. Brown Ph.D., Mph, Xiaoming Li, Rima Afifi

Faculty Publications

Introduction: Black/African American men who have sex with other men (BMSM) are disproportionately affected by HIV, experience significant disparities in HIV incidence, and face significant barriers to accessing HIV treatment and care services, including pre-exposure prophylaxis (PrEP). Despite evidence of individual and structural barriers to PrEP use in the Midwest, no review has synthesized this finding to have a holistic view of PrEP uptake and barriers. This review examines patterns of, barriers to, and facilitators of PrEP uptake among BMSM in the Midwest, United States (US).

Methods: Five databases (CINAHL Plus, PUBMED, PsycINFO, SCOPUS, and Web of Science) were searched …

Heart Disease Prediction Using Ensemble Tree Algorithms: A Supervised Learning Perspective, Enoch Sakyi-Yeboah, Edmund F. Agyemang, Vincent Agbenyeavu, Akua Osei- Nkwantabisa, Priscilla Kissi-Appiah, Lateef Moshood, Lawrence Agbota, Ezekiel N.N. Nortey

School of Mathematical & Statistical Sciences Faculty Publications

Heart disease stands as a leading cause of morbidity and mortality globally, presenting a significant public health challenge. Therefore, early prediction and detection are critical, leading to timely and appropriate interventions at early stages. Four ensemble tree-based algorithms were used in this study: adaptive boosting, extreme gradient boosting, random forest, and extremely randomized trees, investigating their ability to predict heart disease. Data related to heart disease clinical features was obtained from the open Kaggle Machine Learning Dataset repository. Adaptive Boosting stands out as the highest performer, achieving an average testing accuracy of 93.70%, precision of 93.71%, recall of 93.70%, and …

Neonatal Outcomes In Periviable Births Weighing ≤ 500 Grams, Bijan Morshedi, Diego Maurente, Ursula Griffiths-Randolph, Elisabeth Kamano, Katharine Hopkins, Dana Baraki, Juliana Martins, Steven Warsof

Eastern Virginia Medical Journal

Background: The average rate of preterm birth in the US in 2021 was 10.1%. Although the rate of mortality from preterm birth has been decreasing, complications remain the leading cause of death in infants under the age of 5 years worldwide. Gestational age (GA) and birth weight (BW) remain the 2 most important variables for predicting survivability in preterm births, and lower GA and BW are both correlated with lower survivability.

Objective: To explore outcomes of neonates born in the periviable period (20 weeks and 0 days to 25 weeks and 6 days) with BW ≤ 500 g and to …

Microglial Disruption In Young Mice With Early Chronic Exposure To Lead, Christina Sobin, Mayra Flores Montoya, Natali Parisi, Tanner Schaub, Miguel Cervantes, Rodrigo Armijos

Departmental Papers (PH)

The mechanisms by which early chronic lead (Pb) exposure alters brain development have not been identified. We examined neuroimmune system effects in C57BL/6J mice with Pb exposure, including levels that may be common among children in lower socioeconomic income environments. Pups were exposed via dams’ drinking water from birth to post-natal day 28 to low, high or no Pb conditions. We compared gene expression of neuroinflammatory markers (study 1); and microglial mean cell body volume and mean cell body number in dentate gyrus, and dentate gyrus volume (study 2). Blood Pb levels in exposed animals at sacrifice (post-natal day 28) …