Other Public Health Commons^™

Bemotrizinol And The Modernization Of Us Sunscreen Regulation, Umayr R. Shaikh, Christopher G. Richter, Leela K. Raj, Afrin Mirza, Harold William Higgins, Jane M. Grant-Kels

SKMC Student Presentations and Publications

No abstract provided.

Public Responses About Air Quality In The World’S Ten Most Populous Countries, Noah Lim, Alessandro Del Ponte, Lina Ang, Wei Jie Seow

Political Science Faculty Articles and Research

Understanding how people view and react to outdoor air quality is crucial to effectively managing and responding to air pollution, which is a major threat to global public health. Using a quota sample of 10,618 respondents from 1,372 localities across the world’s ten most populous countries (Bangladesh, Brazil, China, Indonesia, India, Mexico, Nigeria, Pakistan, Russia, and the United States), we assessed the association between exposure to fine particulate matter with diameter ≤ 2.5 micrometers (PM2.5) and people’s knowledge, attitudes, perceptions, practices, and concern about air quality. Overall, we find an inverse association between air pollution exposure and knowledge about air …

Brief Of Public Health And Health Law Scholars As Amici Curiae Urging Affirmance In Support Of Plaintiffs-Appellees, Rachel L. Zacharias, Zeinab Bakhet, Kevin Costello, Maya Manian

Amicus Briefs & Court Filings

INTRODUCTION: Physicians’ use of their judgment and expertise to prescribe drugs and devices for purposes other than those approved by the Food and Drug Administration (“FDA”)—colloquially known as off-label use—is an indispensable feature of modern medicine. The FDA approves drugs as “safe and effective for specific indications.” Christopher M. Wittich, Christopher M. Burkle & William L. Lanier, Ten Common Questions (and Their Answers) About OffLabel Drug Use, 87 Mayo Clinic Procs. 982, 982 (2012). Federal law then generally leaves prescribing decisions, including off-label use of FDA-approved drugs and devices for a patient’s particular indication, to physicians acting under state law …

Using In-Home Air Quality Monitoring To Reduce Cannabis Secondhand Smoke Exposure In Children: Quantitative Pilot Feasibility Study, Vincent Berardi, Bradley N. Collins, Laura M. Glynn, Eusabeia Silfanus, Darby G. Lyons, Stephen J. Lepore

Psychology Faculty Articles and Research

Background: An estimated 5 to 8 million US children live with a parent who uses cannabis, and most cannabis users report smoking cannabis inside their homes, placing children at risk for cannabis secondhand smoke (cSHS) exposure. Indoor air quality (IAQ) monitoring provides real-time feedback on airborne pollutants and has shown promise in reducing in-home tobacco secondhand smoke exposure, suggesting its potential as an effective harm reduction strategy for cSHS.

Objective: This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of using low-cost, off-the-shelf IAQ monitors to increase caregivers’ awareness of children’s cSHS exposure risk and to change …

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Level Of Comfort And Barriers To Pediatric Vaccination Among Pharmacy-Based Immunizers In California, Laressa Bethishou, Karl Hess, Richard Beuttler, Jeffery Goad

Pharmacy Faculty Articles and Research

Background

Pharmacists are increasingly recognized as accessible immunizers, yet pediatric vaccination rates in community pharmacies remain lower than those for adults, likely due to unique barriers. This study aimed to assess the comfort level of pharmacy-based immunizers in California with administering vaccines to pediatric patients and to identify barriers limiting their participation in pediatric immunization.

Methods

An IRB-approved, cross-sectional survey was distributed electronically to pharmacists, student pharmacists, and pharmacy technicians administering vaccines in California community pharmacies between November 2022 and February 2023. The survey measured comfort with vaccinating pediatric age groups, perceived barriers, and collected demographic data. Data analysis included …

Sepsis As An Immune Continuum: Cytokine Storm To Lymphopenia And Pics, Chelsey King

Senior Honors Theses

Sepsis is a leading cause of morbidity and mortality worldwide, driven by a dynamic immune continuum that progresses from early hyperinflammation to profound immunosuppression. This review examines the three overlapping phases of sepsis: the inflammation-mediated cytokine storm driven by dysregulated PRR activation, NF-κB signaling, and NETosis; apoptosis-driven lymphopenia involving caspase-mediated lymphocyte death, dendritic cell dysfunction, and metabolic exhaustion; and prolonged immunoparalysis culminating in persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Key mechanisms linking these phases, including the co-existence of hyper- and hypo-inflammatory states, are synthesized alongside relevant clinical biomarkers such as IL-6, HLA-DR, and single-cell immune profiles. This review highlights …

A Scoping Review Of The Objective Structured Assessment Of Technical Surgical Skills (Osats), David J. O'Regan, Christopher Caddy, Retnagowri Rajandram, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Objective structured assessment of technical skills (OSATS) offers an objective tool for assessing bowel anastomosis on a benchtop. It was developed in 1997 to set appropriate standards and expectations for the surgical trainee. OSATS have become the gold standard of assessment across many disciplines. A global Likert rating scale, including respect for tissues, instrument handling, economy of movement, and flow of the operation predominates the literature. This has led to many questioning OSATS objectivity, claiming the process to be time-consuming, subjective, demanding human resources, and requiring extensive training of the trainer. We believe OSATS scoring has omitted the 22-point …

Thermal Inequities In Public Parks And Open Spaces In Los Angeles Determined By Remote Sensing, Ashley Agatep, Joshua B. Fisher, Kainani Tacazon, Ambar Rivera, Rossmery Zayas, Reginald Archer, Juan Carlos Ruiz Malagon, Jason A. Douglas

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Urban heat island (UHI) effects are amplified by disparities in community-level cooling infrastructure—such as urban public parks and open spaces (PPOS)—with the most severe impacts occurring in communities that lack sufficient city-wide cooling resources. We found that the underserved community of South Los Angeles, as compared to their neighboring West Los Angeles counterparts, suffers a double burden of inequitable (1) access to and (2) absence of cooling materials and surfaces within these spaces, resulting in significantly hotter temperatures. Identifying these inequities requires high-resolution temporal and spatial mapping of surface temperatures, which has been previously limited. In this community-based participatory research …

Comparative Outcomes And Costs Of Robotic Assisted, Laparoscopic, And Open Partial Nephrectomy: A Contemporary Analysis Of National Inpatient Sample Data., Manisha Lin, Elizabeth Sottung, Vietbao H. Phan, Mumbi E. Kimani, Costas D. Lallas, Raegan M Davis, Scott W. Keith, Patrick Moeller, Vittorio Maio

College of Population Health Faculty Papers

PURPOSE: Partial nephrectomy is increasingly favored for small renal masses due to its renal function-preserving benefits. This study compared contemporary utilization patterns, perioperative outcomes, and hospital costs of robotic-assisted (RAPN), laparoscopic (LAPN), and open partial nephrectomy (OPN) among U.S. patients with renal cancer.

METHODS: Using the 2016–2019 National Inpatient Sample, renal cancer patients undergoing RAPN, LAPN, or OPN based on ICD-10-CM/PCS codes were identified. Patient demographics, comorbidities, hospital characteristics, length of stay (LOS), perioperative complications, and hospital costs, were summarized by surgical approach. Regression analyses adjusted for patient- and hospital-level covariates were used to compare perioperative outcomes, LOS, and costs …

Assessment Of Antimicrobial Transition Errors From Hospitals To Skilled Nursing Facilities, Amy Y. Kang, Guarina A. Garcia Delgado, Ashley Nguyen, Maddie Yeh, Tracy Ly, Richard C. Beuttler, Abisay Ortega, Donna Phan Tran, Evelyn Flores, Charis Tjeong, Andrew Bishop, Praneet Kalkat, Loren G. Miller

Pharmacy Faculty Articles and Research

Background More than 1 million Americans reside in skilled nursing facilities (SNFs). Antimicrobial transition errors among patients transferred from hospital to SNFs pose safety risks and may lead to poor outcomes, but data on such errors are limited.   Methods We conducted a retrospective cohort study of infectious diseases clinics from 1 June 2020 through 30 November 2023 at the Los Angeles County Department of Health Services, a large safety-net health system. We performed logistic regression analyses to identify factors associated with antimicrobial transition errors and poor infection outcomes.   Results We screened records of 6865 clinic patients, among whom 112 were …

Heat And Socioeconomic Deprivation Compound To Drive Coronary Heart Disease In Los Angeles, Shutong Huo, Tessa R. Pulido, Reginald S. Archer, Joshua B. Fisher, Jason A. Douglas

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Background:

Socioeconomic deprivation and environmental heat exposure each increase cardiovascular risk, yet evidence is limited on how these stressors co-occur and jointly shape disease burden within cities. Mapping their overlap can inform equity-oriented planning and needs-based allocation of health and social protection resources.

Methods:

We conducted an ecological geospatial analysis of 2,513 census tracts in Los Angeles County. Adult coronary heart disease (CHD) prevalence was obtained from CDC Population Level Analysis and Community Estimates (2021). Socioeconomic deprivation was measured using the Social Deprivation Index (SDI), and heatwave surface heat hazard was measured using land surface temperature (LST) retrieved from the …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

Barriers And Facilitators To Recruiting Older Adult Care Homeresidents Into Clinical Trials Of Medicines And Vaccines: A Scoping Review, Selvarani Subbarayan, Imogen A. Smith-Dodd, Gabriel Nicolson, Jennifer K. Burton, Janet T. Scott, Seshadri S. Vasan, Susan D. Shenkin, Roy L. Soiza, The Watch Consortium

Research outputs 2022 to 2026

Introduction: Excluding Care Home (CH) residents from clinical trials of medicines and vaccines has led to an evidence gap. Findings from younger adults may not be generalisable to CH residents with frailty and dementia. Therefore, it is essential to evaluate pharmacological treatments directly in CH residents to assess their safety and efficacy.

Methods: As part of the Widening Access to Trials in Care Homes project, we conducted a scoping review using Joanna Briggs Institute methodology to identify barriers and facilitators to recruiting CH residents into clinical trials of medicinal products. We searched EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library …

The Weight Of Stigma, Rebekah A. King, Michael S. Sinha

All Faculty Scholarship

Many health care providers, both implicitly and explicitly, perpetuate stigma in their treatment of patients classified as obese. While medical professionals understand that a one-size-fits-all approach to treatment is ineffective, patients classified as obese are frequently offered limited treatment options that fail to account for their unique needs. Access to a range of effective treatment options has historically been limited, but new GLP-1 receptor agonist medicines like Wegovy (semaglutide) and Zepbound (tirzepatide), have shown incredible promise in addressing the obesity crisis. Unfortunately, these transformative drugs are costly, in high demand, and not widely covered by insurance, rendering them inaccessible for …

Natural Resource Rents And Energy Poverty Nexus In Next Eleven Economies, Muhammad Salah Uddin, Ayub Ali, Zobayer Ahmed, Md Nasir Uddin Sikdar, Ahsan Habib, Abdullah Elah Al-Mahde

Finance Faculty Publications

Energy poverty (EP) remains a persistent global challenge with important implications for economic development, public health, and social welfare. While natural resources, particularly oil and gas, are often viewed as key sources of energy access, their effectiveness in mitigating EP remains underexplored in emerging economies. This study examines the relationship between natural resource rents (NRR), specifically oil rents (OR) and natural gas rents (NGR), and energy poverty (EP) in the Next Eleven (N-11) countries from 2000 to 2020. The primary objective is to assess how NRR influences EP at various levels of poverty using the Method of Moments Quantile Regression …

Family Dementia Caregivers’ Disaster Preparedness In Chinese American Communities In New York City, Weiyu Mao, Bei Wu, Yaolin Pei, Zhen Cong

Health Sciences and Kinesiology Faculty Articles

Disaster preparedness is a significant public health concern. Disasters manifest in different forms and often lead to disruption of daily life. This is especially challenging for family dementia caregivers and their care recipients in the community. There remains much unknown regarding dementia caregiver disaster preparedness, especially in ethnic and racial communities. Guided by Protection Motivation Theory, with the backdrop of Hurricane Ida, this study explored the association between caregiving-related characteristics, cognitive appraisals, and disaster preparedness among caregivers in Chinese American communities. Data came from a pilot study on Chinese American family dementia caregivers in New York City between November 2021 …

Addressing Challenges In Accessing Secondary And Tertiary Healthcare Services For Migrants And Refugees In Egypt, Noura Seada, Nehal El-Bakhshawangy, Heba Semary, Fatma Alzahraa Hassan, Ahmed Hammad

Papers, Posters, and Presentations

The growing number of vulnerable migrants and refugees worldwide presents a significant challenge to host countries, particularly in terms of accessing healthcare services. Egypt hosts over 9 million migrants and refugees, with 1.5 million in a vulnerable situation. Despite the country’s efforts in providing adequate healthcare to these vulnerable groups, some challenges persist. This paper addresses the barriers that vulnerable migrants and refugees face when seeking secondary and tertiary healthcare services in Egypt, analyzing the legal, economic, social, and health system factors that contribute to this problem.

In 2018, the Egyptian government began an ambitious journey to reform its healthcare …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

Updated Prevalence Estimates Of Obesity Among Adults In The United States, 2005–2018, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Introduction

Body mass index is an imperfect measure of excess adiposity but is ingrained in both research and clinical practice to define and diagnose adult obesity. The addition of waist circumference measure is recommended to fully capture obesity-related health risks at a population level. The latest reframing of obesity by the Lancet Commission relies on body mass index and waist circumference, as well as organ dysfunction and functional limitations, to differentiate between preclinical and clinical obesity.

Methods

Using data from the National Health and Nutrition Examination Survey (2005–2018), we adhere to the proposed redefinition to examine obesity trends in the …

Design Considerations For Conversational Agents To Assess The Social-Emotional Well-Being Of Young Children In Low-Income South African Communities, Lucretia A. Williams, Elizabeth A. Ankrah, Catherine E. Draper, Caylee J. Cook, Franceli L. Cibrian, Jesus A. Beltran, Kimberley D. Lakes, Gillian R. Hayes

Engineering Faculty Articles and Research

A variety of digital technologies have been used to support early childhood development (ECD) programs in low-income South African communities. Even though technology has provided opportunities to increase access to health interventions, the lack of trust and socio-economic constraints under which these tools would need to work pose complex challenges. We examine home visitors’ work processes, experiences, and preferences of a conversational agent to support their work of administering social-emotional well-being assessments to young children ages 0-5. Analysis of the results of focus groups with 51 home visitors indicates the need for designing conversational agents that support ECD in the …

Documentation And Referral Of Social Determinants Of Health In New Mexico’S Emergency Departments: International Classification Of Disease, Tenth Revision, Clinical Modification, “Z Codes” (Z55-Z65), Samuel L. Swift, Maya Stefanovic, Roselyn Thalathara

Population Health Research and Scholarship

No abstract provided.

Air Pollution And Diseases: Signaling, G Protein-Coupled And Toll Like Receptors, Isabella Cattani-Cavalieri, Katrina F. Ostrom, Jordyn Margolis, Rennolds S. Ostrom, Martina Schmidt

Pharmacy Faculty Articles and Research

Air pollution is a significant public health issue that impacts lung health, particularly in vulnerable populations such as children, the elderly, and individuals with pre-existing respiratory conditions. Both natural and anthropogenic sources of air pollution give rise to a variety of toxic compounds, including particulate matter (PM), ozone (O₃), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), and polycyclic aromatic hydrocarbons (PAHs). Exposure to these pollutants is strongly associated with the development and exacerbation of respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), lung cancer, and idiopathic pulmonary fibrosis (IPF). Notably, early life exposure to pollutants such as …

Kind Kids, Healthy Teens: Child Prosociality And Fruit And Vegetable Intake, Farah Qureshi, Krista P. Woodward, Laura D. Kubzansky, Julia K. Boehm

Psychology Faculty Articles and Research

Introduction

Methods

Identifying And Breaking Barriers: Addressing Disparities In The Care Of Patients With Gynecologic Cancers, Bhavana Pothuri, Michele Muir, Jean Hurteau, John Farley, Michelle D. Lightfoot, Summer Dewdney, Tara Castellano, John K. Chan, Sharad Ghamande, Al Asante-Facey, Marina Stasenko, B J. Rimel, Electra D. Paskett

School of Medicine Faculty Publications

BACKGROUND: Significant disparities exist in the care of patients with gynecologic malignancies. Higher incidences of gynecologic malignancies among underrepresented subpopulations (eg, racial, ethnic, and/or LGBTQAI+) and lack of representative enrollment within clinical trials have highlighted the need to improve healthcare equity. We aimed to identify barriers to equitable health care and clinical trial participation for specific diverse populations of patients with gynecologic malignancies and to identify potential solutions for overcoming these barriers. METHODS: A series of 4 live and 3 asynchronous advisory boards facilitated by GSK was conducted between January 2023 and July 2024; live advisory boards were population specific. …

Tackling Data Quality Challenges In Remote Sensing: Solutions For Reliable Urban Heat Island Analysis, Wei Xia, Aqil Tariq, Hesham El-Askary, Rana Waqar Aslam, Elgar Barboza, Dmitry E. Kucher, Youssef M. Youssef, Habib Kraiem

Mathematics, Physics, and Computer Science Faculty Articles and Research

Urban heat islands (UHIs) pose critical challenges to public health, energy demand, and environmental sustainability, particularly in rapidly expanding urban regions. This study examines the complex relationship between building configurations and integrated green spaces, as well as their combined impact on thermal regulation. It focuses on addressing data quality issues commonly encountered in remote sensing applications. Using high-resolution multispectral and thermal imagery, we developed an integrated modeling approach that captures the collective influence of built form and green infrastructure on urban microclimates. A key finding is the significant linear inverse relationship between green space coverage and land surface temperature, underscoring …

Temporal And Generational Changes In Depression Among Young American Adults, Ashley W. Kranjac, Dinko Kranjac, Valentine Chung

Sociology Faculty Articles and Research

The prevalence of depression among young American adults has risen significantly over the past two decades, but the mechanisms that underlie the population-level changes in depressive symptoms severity remain unclear. We used data from the 2005–2023 National Health and Nutrition Examination Survey (NHANES) and hierarchical age–period–cohort (HAPC) analysis to examine developmental (i.e., age), life stage (i.e., period), and generational (i.e., cohort) distribution of depressive symptoms among American adults aged 20–30 years old over an 18-year period. Our model results indicate that the probability of either mild, moderate, or severe depression increased among young adult females and males between 2005 and …

Improving Hiv Nonoccupational Postexposure Prophylaxis Completion In Survivors Of Sexual Assault, Rebecca Aden

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This project aimed to increase adherence to HIV nonoccupational postexposure prophylaxis (nPEP) among adult survivors of sexual assault using a 24-hour nurse-led callback intervention to reinforce patient education and support treatment completion.

BACKGROUND

This project was implemented within a public healthcare system’s forensic nursing program. Sexual assault survivors face an elevated risk of HIV transmission, yet completion of the 28-day nPEP regimen often remains below 40%. Barriers to completion include limited understanding, gaps in follow-up, as well as psychosocial and socioeconomic challenges.

METHODOLOGY

The FADE QI framework was utilized for this project. The population included adult, non-incarcerated patients who …

The Effect Of Birthweight And Gestational Age On Cognitive Function In Midlife: The Bogalusa Heart Study, Eunsun Gill, David J Libon, Soo Jung Kang, Ileana De Anda-Duran, Lydia A Bazzano, Wei Chen, Camilo Fernandez-Alonso, Emily W Harville

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Although the relationships between birthweight, gestational age (GA), and cognitive function (CF) before midlife have been demonstrated, the relationships after midlife and potential racial disparities remain inconclusive. This study examined the association between birthweight, GA, and midlife CF stratified by race.

METHOD: 1,032 subjects from the Bogalusa Heart Study (67% Whites, 33% Blacks, mean age 48.1 ± 5.3 years) were studied. Cognition was assessed with tests measuring verbal episodic memory, working memory, attention, graphomotor information processing speed, and global CF. Each test was standardized by sex and age, then averaged. The global CF was computed by averaging all cognitive …

How Far-Right Populism Harms Ethnic Minorities’ Health: The Case Of The United States, Dina Rosenberg

Working Papers Series

Public health is a political issue, and the health of ethnic minorities is a key component of it. We argue that far-right populism, whether grassroots or elitist, harms the health of immigrants and minorities. Anti-minority attitudes and policies—such as health chauvinism promoted by far-right populists—along with hate rhetoric and ensuing personal and institutional discrimination create a climate of hostility that negatively affects health outcomes in underprivileged communities. We hypothesize that immigrants and ethnic minorities living in such a climate are more likely to experience health problems and underutilize healthcare. To test this, we leverage the significant variation between U.S. states …