Laura H Gunn

University of North Carolina at Charlotte | UNC Charlotte · Department of Public Health Sciences

Affirming and accessible health care may improve health outcomes for trans individuals in the U.S. We explored strategies to improve affirming care for trans individuals from the perspectives of providers and transgender and non-binary community members. Forty members of a collective group of gender-affirming providers (GAP) in the southern U.S. we...

Background : Risk-adjustment models are widely used methodological approaches within the healthcare industry to measure hospital performance and quality of care. However, the Centers for Medicare and Medicaid Services (CMS) do not fully adjust for socioeconomic status (SES) in acute myocardial infarction (AMI) models. A review and evidence synthesi...

This manuscript builds on a novel, automatic, freely-available Bayesian approach to extract information in abstracts and titles to classify research topics by quartile. This approach is demonstrated for all N= 149,129 ISI-indexed publications in biological sciences journals during 2017. A Bayesian multinomial inverse regression approach is used to...

The U.S. Centers for Medicare and Medicaid Services’ (CMS’s) Hospital Compare (HC) data provides a collection of risk-adjusted hospital performance metrics intended to allow comparison of hospital-provided care. However, CMS does not adjust for socioeconomic status (SES) factors, which have been found to be associated with disparate health outcomes...

Introduction: In recent years, practice friendly models of suicidal behavior have emerged in the form of “ideation-to-action” frameworks. These frameworks focus on processes influencing both the formation of suicidal ideation and the translation of that ideation to suicide attempt and death. In this paper, we proffer an emerging model of suicide, P...

Objectives To examine potential biases in standardized infection ratio (SIR) metrics due to static U.S. Centers for Disease Control and Prevention (CDC) parameters and non-linearity of infection outcomes with volume. Correspondingly, to enhance the CDC predictions by incorporating additional information from volume metrics and explore an alternativ...

The cost of healthcare in the United States has increased over time. However, patient health outcomes have not trended with spending. There is a need to better comprehend the association between healthcare costs in the United States and hospital quality outcomes. Medicare spending per beneficiary (MSPB), a homogeneous metric across providers, can b...

The relationship between research topics and academic prestige of journals is of relevance to assess venues for current research as well as trending areas of new research. This is of special relevance for those developing a research agenda or with defined productivity outcome expectations. This manuscript extracts prevalent topics using titles and...

Aims Reliably quantifying event rates in secondary prevention could aid clinical decision-making, including quantifying potential risk reductions of novel, and sometimes expensive, add-on therapies. We aimed to assess whether the SMART risk prediction model performs well in a real-world setting. Methods and results We conducted a historical open c...

In a polarized society, it is a university’s responsibility to offer courses that explore highly controversial issues. Traditional forms of debate may create barriers to knowledge and entrenchment of perspectives, with students self-limiting their ability to develop informed opinions. We describe an active learning, double-blinded approach to in-cl...

Background Childhood obesity is a major global health concern. Weight-management camps involving delivery of a program of physical activity, health education, and healthy eating are an effective treatment, although post-intervention weight-management is less well understood. Our objective was to assess the effectiveness of a weight-management camp...

The U.S. Centers for Medicare and Medicaid Services (CMS) assigns quality star ratings to hospitals upon assessing their performance across 57 measures. Ratings can be used by healthcare consumers for hospital selection and hospitals for quality improvement. We provide a simpler, more intuitive modeling approach, aligned with recent criticism by st...

Background The associations between England’s incentivised primary care-based diabetes prevention activities and hard clinical endpoints remain unclear. We aimed to examine the associations between attainment of primary care indicators and incident diabetic retinopathy (DR) among people with type 2 diabetes. Methods A historical cohort ( n = 60,09...

Objectives England has invested considerably in diabetes care over recent years through programmes such as the Quality and Outcomes Framework and National Diabetes Audit. However, associations between specific programme indicators and key clinical endpoints, such as emergency hospital admissions, remain unclear. We aimed to examine whether attainme...

Introduction England has invested considerably in diabetes care through such programs as the Quality and Outcomes Framework (QOF) and National Diabetes Audit (NDA). Associations between program indicators and clinical endpoints, such as amputation, remain unclear. We examined associations between primary care indicators and incident lower limb ampu...

Aims To describe associations between incentivised primary care clinical and process indicators and mortality, among patients with type 2 diabetes in England. Methods A historical 2010-2017 cohort (n=84,441 adults) was derived from the UK CPRD. Exposures included English Quality and Outcomes Framework glycated haemoglobin (HbA1c; 7.5%, 59 mmol/mol...

Aims: To examine the impact of attainment of primary care diabetes clinical indicators on the progression to sight threatening diabetic retinopathy (STDR) among those with mild non-proliferative diabetic retinopathy (NPDR). Materials and methods: A historical cohort study of 18,978 adults (43.63% female) diagnosed with type 2 diabetes before 1 A...

Sonic seasoning refers to the way in which music can influence multisensory tasting experiences. To date, the majority of the research on sonic seasoning has been conducted in Europe or the USA, typically in a within-participants experimental context. In the present study, we assessed the applicability of sonic seasoning in a large-scale between-pa...

Trans individuals (e.g. trans men and women, non-binary, gender fluid) are at higher risk for mental health concerns, in part due to marginalization. Previous work has documented the effects of social support and community engagement on health outcomes. However, individuals’ perceptions of community engagement effects may point to opportunities for...

High sodium consumption is one of the four major risk factors contributing to non-communicable diseases around the world. Thailand has one of the highest rates of sodium consumption, with fish sauce being one of the main sources. The aim of this study was to examine whether changes in the micro-environment factors can affect fish sauce consumption...

IntroductionMedical schools are shifting to a holistic approach for admissions. As non-cognitive abilities become more valued in the medical field and admissions become more competitive, multiple mini-interviews (MMI) are becoming increasingly common in selection criteria. The purpose of this article is to examine the relationship among admissions...

We report a study designed to determine the most efficient means of pursuing sonic seasoning in international marketing. For the first time, music chosen to trigger specific emotional responses was directly and cross-culturally compared with music chosen as crossmodally congruent with specific taste/flavors (the latter usually regarded as ‘sonic se...

Introduction Research productivity has been linked to a country’s intellectual and economic wealth. Further analysis is needed to assess the association between the distribution of research across disciplines and the economic status of countries. Methods By using 55 years of data, spanning 1962 to 2017, of Elsevier publications across a large set...

While Scholastic Assessment Test (SAT) scores are becoming less widespread than in previous years, they continue to be used as an input by many higher education institutions in the United States to select which students to accept among applicants. This paper explores the association between average SAT scores of incoming undergraduate cohorts and m...

In this paper, we propose maximum entropy in the mean methods for propensity score matching classification problems. We provide a new methodological approach and estimation algorithms to handle explicitly cases when data is available: (i) in interval form; (ii) with bounded measurement or observational errors; or (iii) both as intervals and with bo...

Background: Social prescribing programmes expand the range of options available to primary care health professionals to address patients' psychosocial needs, impacting on their health and well-being. The objective of this study was to assess the change in the mental well-being of service users after participation in the Luton social prescribing pr...

The 1960s War on Poverty was based on expectations that certain attitudes could improve health and economic well-being: aspiration and ambition, propensity to plan, personal efficacy, avoidance of unnecessary risk, connectedness to information and help, and trust. If true, promoting those attitudes might improve lives. The nationally representative...

Objectives The objective of this study was to assess the change in energy expenditure levels of service users after participation in the Luton social prescribing programme. Design Uncontrolled before-and-after study. Setting This study was set in the East of England (Luton). Participants Service users with complete covariate information and base...

Objectives Florida ranks highest in the United States among newly diagnosed HIV infections. This ranking reflects the need for investigation of healthcare providers’ knowledge, readiness, prescribing behaviors, and perceived barriers to routine HIV testing and pre-exposure prophylaxis. Methods We adapted national questionnaires with questions co-d...

Supplemental_Tables_I_and_II – Supplemental material for Healthcare providers’ knowledge, readiness, prescribing behaviors, and perceived barriers regarding routine HIV testing and pre-exposure prophylaxis in DeLand, Florida

Background Increased interest about gun ownership and gun control are oftentimes driven by informational shocks in a common factor, namely violent attacks, and the perceived need for higher levels of safety. A causal depiction of the societal interest around violent attacks, gun control and gun purchase, both synchronous and over time, should be a...

In this paper, we propose maximum entropy in the mean methods for propensity score matching classification problems. We provide a new methodological approach and estimation algorithms to handle explicitly cases when data is available: (i) in interval form; (ii) with bounded measurement or observational errors; or (iii) both as intervals and with bo...

Objective Conflicting evidence exists regarding the impact of financial incentives on encouraging attendance at medical screening appointments. The primary aim was to determine whether financial incentives increase attendance at diabetic eye screening in persistent non-attenders. Methods and analysis A three-armed randomised controlled trial was c...

Acne vulgaris is a common skin condition causing blackheads and whiteheads and red spots. Acne often leads to scarring, which is extremely difficult to treat. Acne can produce significant psychological and social problems, including lower self-esteem, anxiety, depression and low mood. Many light-based therapies have been tried for acne vulgaris, bu...

We undertook a Cochrane review of randomized controlled trials (RCTs) evaluating the effects of light-based interventions for acne vulgaris. We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science, and grey literature sources (September 2015). We used the Grading of Recommendations Assessment, Develo...

Background The UK national diabetic eye screening (DES) programme invites diabetic patients aged > 12 years annually. Simple and cost-effective methods are needed to increase screening uptake. This trial tests the impact on uptake of two financial incentive schemes, based on behavioural economic principles. Objectives To test whether or not financ...

Background Automated telephone communication systems (ATCS) can deliver voice messages and collect health-related information from patients using either their telephone's touch-tone keypad or voice recognition software. ATCS can supplement or replace telephone contact between health professionals and patients. There are four different types of ATC...

Background: Acne vulgaris is a very common skin problem that presents with blackheads, whiteheads, and inflamed spots. It frequently results in physical scarring and may cause psychological distress. The use of oral and topical treatments can be limited in some people due to ineffectiveness, inconvenience, poor tolerability or side-effects. Some s...

PURPOSE Evidence from studies mainly in children has shown that orally administered probiotics may prevent respiratory tract infections and associated antibiotic use. We evaluated whether advice to take daily probiotics can reduce antibiotic prescribing for winter respiratory tract infections in people with asthma. METHODS We conducted a randomize...

Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to s...

The challenge of evaluating community asthma management programs is complicated by balancing the emphasis on health outcomes with the need to build community process capacity for conducting and monitoring evidence-based programs. The evaluation of a Georgia Childhood Asthma Management Program, a Healthcare Georgia Foundation-supported initiative fo...

Introduction Despite the importance of continuity of care and patient engagement, few studies have captured patients' views on integrated care. This study assesses patient experience in the Integrated Care Pilot in North West London with the aim to help clinicians and policymakers understand patients' acceptability of integrated care and design fut...

Obesity is a global public health threat. The transtheoretical stages of change (TTM SOC) model has long been considered a useful interventional approach in lifestyle modification programmes, but its effectiveness in producing sustainable weight loss in overweight and obese individuals has been found to vary considerably. OBJECTIVES: To assess the...

Objectives: The efficacy of thiopurines (TPs) in altering the risk of surgery in Crohn's disease (CD) remains controversial. We evaluated the impact of TP therapy, optimal timing, and duration of TP therapy on first intestinal resection rates using a population-based cohort. Methods: We constructed a population-based cohort of incident cases of...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the sensitivity and precision of methodological search filters for the detection of observational studies in MEDLINE and EMBASE.

Asthma is one of the most common long-term conditions worldwide, which places considerable pressure on patients, communities and health systems. The major international clinical guidelines now recommend the inclusion of self management programmes in the routine management of patients with asthma. These programmes have been associated with improved...

In the context of integrated care, Multidisciplinary Group meetings involve participants from diverse professional groups and organisations and are potential vehicles to advance efficiency improvements within the local health economy. We advance a novel method to characterise the communication within Multidisciplinary Group meetings measuring the e...

This paper provides the results of a year-long evaluation of a large-scale integrated care pilot in north-west London. The pilot aimed to integrate care across primary, acute, community, mental health and social care for people with diabetes and/or those aged 75+ through care planning, multidisciplinary case reviews, information sharing and project...

Several local attempts to introduce integrated care in the English National Health Service have been tried, with limited success. The Northwest London Integrated Care Pilot attempts to improve the quality of care of the elderly and people with diabetes by providing a novel integration process across primary, secondary and social care organisations....

Multidisciplinary Group meetings (MDGs) are seen as key facilitators of integration, moving from individual to multi-disciplinary decision-making, and from a focus on individual patients to a focus on patient groups. We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated...

Quality improvement (QI) and evaluation are frequently considered to be alternative approaches for monitoring and assessing program implementation and impact. The emphasis on third-party evaluation, particularly associated with summative evaluation, and the grounding of evaluation in the social and behavioral science contrast with an emphasis on th...

The background to this evaluation is in the Overall Evaluation Framework, dated July 2011, which sets out a number of questions about how the Integrated Care Pilot (ICP) has affected healthcare process and outcomes for patients. Unfortunately there is very little routinely recorded NHS outcome data, and what outcome data there is relates mainly to...

Tobacco control is a top public health priority around the globe due to the high prevalence of cigarette smoking and its associated morbidity and mortality. Much effort has been focused on establishing the effectiveness of different smoking cessation strategies. This review, however, aims to address the initial challenge faced by smoking cessation...

In the context of integrated care, multidisciplinary group (MDG) meetings involve participants who are not only from different professional groups but also from different organisational backgrounds within a complex local health economy. Such meetings therefore provide opportunities for participants to discuss complex care of individual patients, as...

Background: Population-based results for neonatal versus postneonatal outcomes among 7,709 black and white Georgia infant deaths between 1995 and 2004 were assessed on infant (gender, birth weight, gestation length, cause of death) and maternal (age, education, marital status, race, health risk behaviors (alcohol and smoking), medical risks (cardia...

The prevalence of Asthma continues to increase despite growing evidence of effective approaches to manage the disease. We describe an evaluation approach for privately funded community childhood asthma interventions to reduce acute episodes, facilitate effective healthcare, foster community and systems level changes and reduce emergency department...

The goal of this study was to examine factors associated with receiving health care transition counseling services as reported by young adults. We analyzed data from the 2007 Survey of Adult Transition and Health, a nationwide survey of young adults aged 19 to 23 years conducted by the National Center for Health Statistics, to explore self-reported...

Five unique community interventions to reduce childhood asthma morbidity and to facilitate healthcare and community systems level changes were developed and privately funded in GA. In an effort to document these outcomes and facilitate a multi site level of understanding, the funder also contracted with our university-based evaluation team. Our tea...

Population-based trends in infant mortality among Georgia Residents between 1995 and 2003 were assessed on characteristics such as race, birth weight, neonatal and post-neonatal periods, and cause of death. A statistical analysis was conducted to show that the Georgia infant mortality rate (IMR) remained constant throughout the study period and ave...

Population-based trends in infant mortality among Georgia Residents between 1995 and 2003 were assessed on characteristics such as race, birth weight, neonatal and post-neonatal periods, and cause of death. A statistical analysis was conducted to show that the Georgia infant mortality rate (IMR) remained constant throughout the study period and ave...

Reducing dietary fat intake may lower the risk of developing coronary heart disease. This study examined the feasibility of substituting okra gum for 25%, 50%, 75%, or 100% milk fat in frozen chocolate dairy dessert. Fifty-six consumers evaluated the frozen dairy desserts using a hedonic scale. Consumers rated color, smell, texture, flavor, afterta...

Samples of curves are collected in many applications, including studies of reproductive hormone levels in the menstrual cycle. Many approaches have been proposed for correlated functional data of this type, including smoothing spline methods and other flexible parametric modeling strategies. In many cases, the underlying biological processes involv...

Samples of curves are collected in many applications, including studies of reproductive hormone levels in the menstrual cycle. Many approaches have been proposed for correlated functional data of this type, including smoothing spline methods and other flexible parametric modeling strategies. In many cases, the underlying biological processes involv...

In studying rates of occurrence and progression of lesions (or tumors), it is typically not possible to obtain exact onset times for each lesion. Instead, data consist of the number of lesions that reach a detectable size between screening examinations, along with measures of the size/severity of individual lesions at each exam time. This interval-...

this article proposes a transformation approach in which samples from the unconstrained posterior density for the higher level parameters are transformed to the restricted space using a minimal distance projection. This approach is shown to suggest limited bias induced by the order constraint as well as a potential improvement in e#ciency relative...