Texas A&M School of Public Health

OBJECTIVES:Rural US populations face greater barriers to dental care than urban residents. This study examines emergency department (ED) visits for nontraumatic dental conditions (NTDCs) among adults, comparing rural and urban areas. It also explores how Medicaid expansion and varying state Medicaid dental policies influence the likelihood of NTDC-related ED visits. METHODS:We conducted a cross-sectional analysis using 2019 ED data from eight states. Descriptive statistics characterized NTDC-related ED visits by patient, visit, and county-level variables across four Medicaid policy groups. Chi-squared tests and T-tests assessed rural-urban differences in visit characteristics and payer mix. Logistic regression models estimated the likelihood of NTDC ED visits by rurality and payer type, adjusting for sociodemographic factors and stratified by Medicaid expansion and adult dental benefit status. RESULTS:Rural NTDC ED visits were shorter (2.5 h) and less costly ($1602) than urban visits (over 3 h, $2532). Analysis of rurality and payer mix revealed three key patterns: (i) rural residents consistently had higher visit rates than urban residents in three of the four groups; (ii) uninsured patients-both rural and urban-had the highest probability of NTDC ED visits in three of the four groups; and (iii) among Medicaid-covered visits, rural enrollees in non-expansion states without adult dental benefits had the highest likelihood of NTDC ED visits. CONCLUSIONS:This study highlights continued ED reliance for NTDCs 5 years post-ACA, driven by Medicaid policy and access gaps. Expanding rural oral healthcare remains vital for improving access, especially for the uninsured.

ABSTRACT SARS-CoV-2 transmission has declined, yet ongoing viral evolution continues to pose public health challenges. This study conducted long-term (2020–2024) genomic surveillance within a large and globally diverse university community. Viral genomes obtained from clinical (n = 1,786) and surveillance (n = 888) testing samples were classified under clade, lineage, and variant systems, and compared with global genomic data sets. Local patterns broadly paralleled global evolutionary trends, including the phased emergence of major variants, episodic introductions of new lineages, and shifts in dominant clades. Lineage diversity peaked during fall semesters and was highest among undergraduate-aged individuals, with similar distributions across sexes. Phylogenetic analyses revealed transmission patterns characteristic of semi-contained, high-contact environments. These findings illustrate how large university communities can serve as microcosms of broader SARS-CoV-2 evolution. They also demonstrate the value of targeted genomic surveillance in generating epidemiologic intelligence to support early detection, track viral diversification, and inform public health preparedness.IMPORTANCEThis study highlights the public health and epidemiological value of academic laboratories and campus‑based testing programs in variant monitoring, outbreak detection, and pandemic preparedness. It also demonstrates how locally generated genomic data can effectively complement national and global surveillance networks.

AIM:To identify and map evidence on factors that influence nurses' engagement in clinical research. DESIGN:A scoping review was conducted in accordance with the JBI methodology. METHODS:First, titles and abstracts of articles, then full-text articles, were screened by two independent researchers against inclusion and exclusion criteria. Data was extracted into a data extraction table. Findings from articles were synthesized using thematic analysis. DATA SOURCES:Searches were conducted in Medline All (Ovid), Embase (Ovid), APA PsycInfo (Ovid), CINAHL Plus with Full Text (Ebsco) and Scopus on April 28, 2025. RESULTS:Seventy-nine articles were included in this review. There were significant barriers that prevented nurses from engaging in research, including: lack of time, inadequate training, negative internal beliefs, insufficient organizational support and an unsupportive research culture. Factors that facilitated nurses' engagement in research included: research infrastructure, training and mentorship, visionary leadership, unit-level support, improved motivational components and enhanced organizational research culture. A multi-level framework and strategic recommendations are provided, along with an overview of the 23 interventions reported in the included articles are provided. CONCLUSIONS:Nurses are constrained from conducting research to generate nursing knowledge due to multiple barriers. Visionary leadership is needed that prioritizes nursing research, establishes infrastructure and creates a culture of research excellence to enhance the quality and safety of nursing care. IMPLICATIONS FOR THE PROFESSION AND/OR CLINICAL PRACTICE:Healthcare organizations should support nursing research by providing nurses with paid release time from their clinical duties and building an accessible infrastructure. Infrastructure can include programmes, centres and academic-practice partnerships that provide nurses with access to research training, experienced mentorship, librarian and statistical support, grant and manuscript writing assistance and funding pathways for small and large studies. REPORTING METHOD:This scoping review is reported in accordance with the PRISMA-ScR guidelines. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution. PROTOCOL REGISTRATION:Registered with the Open Science Framework: 10.17605/OSF.IO/5VWE9 (12/03/25).

BACKGROUND AND OBJECTIVES:Alzheimer's disease and related dementias (ADRD) are a leading cause of death, affecting up to 57 million globally. Up to 45% of dementia cases could be prevented or delayed by addressing non-medical drivers of health (NMDoH). Community engagement, health communication, and implementation science are core areas of public health and important to consider when researching ADRD. However, these fields are often siloed, limiting the efficacy of ADRD prevention and intervention. This scoping review maps how researchers have incorporated models and theoretical frameworks from these fields specific to ADRD outcomes and with attention to NMDoH. RESEARCH DESIGN AND METHODS:We searched five social science databases, and articles were included if they were empirical, written in the English language, published 2010 forward, focused on ADRD or cognitive health, guided by or developed a framework, theory, or model, and addressed community engagement, health communication, or implementation science. RESULTS:We retrieved 2,428 articles, which were reviewed in multiple stages by five coauthors, resulting in a final sample of 32 articles. Most articles utilized published frameworks, models, or theories, while five were guided by author-developed approaches. Nine articles integrated two core areas, and only one article integrated all three. DISCUSSION AND IMPLICATIONS:Increased integration of core areas and systematic application of theoretical frameworks are necessary to improve ADRD research with attention to NMDoH. Findings have the potential to inform training and mentorship opportunities for early-career researchers on best practices in interdisciplinary ADRD research, thereby improving community and population health outcomes.

Objectives:Describe parental attitudes toward proposed tax credit policies that would promote pediatric immunization coverage in the United States. Methods:A national survey was conducted from August-September 2025. Participants were recruited from an online panel and asked to use Likert scales to characterize support for proposed policies that would: revise the eligibility criteria of the existing federal child tax credit to include age-appropriate immunization, create a new tax credit for parents providing evidence that their children are age-appropriately immunized, or create a new tax credit for families residing in a state where at least 95% of the children are age-appropriately immunized. Results:The data analysis included 1006 participants. 53.9% expressed support for revising the eligibility criteria of existing child tax credits to include age-appropriate immunization. 62.6% expressed support for creating a new tax credit for parents providing evidence that their children are age-appropriate immunized. 57.4% expressed support for creating a new tax credit for families residing in a state where at least 95% of the children are age-appropriately immunized. Support differed according to participant characteristics, but notably, not according to partisanship or welfare program participation. Conclusions:Most parents in this survey supported novel tax policies that may improve immunization coverage.