Digital Commons Network^™

Successes And Barriers Of Health Information Exchange Participation Across Hospitals In South Carolina From 2014 To 2020: Longitudinal Observational Study, Kausik Lakkaraju, Aniket Gupta, Biplav Srivastava, Marco Valtorta, Dezhi Wu

Publications

Sentiment Analysis Systems (SASs) are data-driven Artificial Intelligence (AI) systems that output polarity and emotional intensity when given a piece of text as input. Like other AIs, SASs are also known to have unstable behavior when subjected to changes in data which can make them problematic to trust out of concerns like bias when AI works with humans and data has protected attributes like gender, race, and age. Recently, an approach was introduced to assess SASs in a blackbox setting without training data or code, and rating them for bias using synthetic English data. We augment it by introducing two …

Kenyan Healthcare Professionals’ Perceptions Of Global Health Engagements In Relation To The Covid-19 Pandemic, Erick Amick

Graduate Research Theses & Dissertations

Over the past 30 years, there has been a significant increase in opportunities available for individuals living in high-income countries (HICs) to participate in programs that provide health services in low- and middle-income countries (LMICs). These global health engagements (GHEs) have become common in many LMICs around the world, including Kenya. Prior to the advent of the COVID-19 pandemic, much of the research exploring individuals’ perspectives of GHEs were situated from the viewpoint of participants traveling from HICs to participate in global health programs. Few studies have examined perspectives of constituent groups in LMICs, such as healthcare professionals (i.e., healthcare …

Racial Disparities In Access To Dbs: Results Of A Real-World U.S. Claims Data Analysis, Michael Frassica, Drew S Kern, Mitra Afshari, Allison T Connolly, Chengyuan Wu, Nathan Rowland, Juan Ramirez-Castaneda, Mwiza Ushe, Claudia Salazar, Xenos Mason

2020-Current year OA Pubs

INTRODUCTION: Deep brain stimulation (DBS) is an effective and standard-of-care therapy for Parkinson's Disease and other movement disorders when symptoms are inadequately controlled with conventional medications. It requires expert care for patient selection, surgical targeting, and therapy titration. Despite the known benefits, racial/ethnic disparities in access have been reported. Technological advancements with smartphone-enabled devices may influence racial disparities. Real-world evidence investigations can shed further light on barriers to access and demographic disparities for DBS patients.

METHODS: A retrospective cross-sectional study was performed using Medicare claims linked with manufacturer patient data tracking to analyze 3,869 patients who received DBS. Patients were …

Assessment Of Spatio-Temporal Variations In Pm2.5 And Associated Long-Range Air Mass Transport And Mortality In South Asia, Md Sariful Islam, Shimul Roy, Tanmoy Roy Tusher, Mizanur Rahman, Ryley C. Harris

Political Science & Geography Faculty Publications

Fine particulate matter (PM_2.5) is associated with adverse impacts on ambient air quality and human mortality; the situation is especially dire in developing countries experiencing rapid industrialization and urban development. This study assessed the spatio-temporal variations of PM_2.5 and its health impacts in the South Asian region. Both satellite and station-based data were used to monitor the variations in PM_2.5 over time. Additionally, mortality data associated with ambient particulate matter were used to depict the overall impacts of air pollution in this region. We applied the Mann–Kendall and Sen’s slope trend analysis tool to investigate the …

Is Knowledge Enough? Exploring Mental Health Literacy And Other Factors Of Help-Seeking In Rural And Urban Emerging-Adult Males, Chris Haydock

Theses

Background and Aim: There is strong evidence to support that mental health concerns become most prevalent among emerging adult males (18-25 years) due to their reluctance to seek-help. Mental Health Literacy (MHL) comprises knowledge, beliefs, and attitudes towards mental health with some evidence suggesting it also enhances help-seeking. However, research has reported that rural residents are less likely to seek help compared to their urban counterparts, despite similarities in MHL. Other factors that impact help-seeking include self-stigma towards mental illness, masculine norms, wellbeing, and access to care. Despite this, there is limited research investigating the influence of MHL in unison …

Educating Nurses To Implement Serious Illness Conversations, Colleen Patricia Desai

Walden Dissertations and Doctoral Studies

AbstractAs part of investigating staff nurses’ reluctance to have serious illness conversations (SIC) at a local hospital, an educational deficit was noted. Nurses articulated they felt uneducated about how to have a SIC with a patient in need and questioned if the practice of conducting SICs was part of the nurses’ scope of practice in the New England State where they were employed. The purpose of this project was to create an educational tool and have it validated by a multidisciplinary group of experts. Once validated, the goal will be to educate nurses, raise awareness on the topic of SICs, …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Variance In Offspring Sex Ratio And Maternal Allocation In A Highly Invasive Mammal, Sarah M. Chinn, Timothy J. Smyser, James C. Beasley

United States Department of Agriculture Wildlife Services: Staff Publications

Skewed sex ratios at birth are widely reported in wild populations, however, the extent to which parents are able to modulate the sex ratio of offspring to maximize their own fitness remains unclear. This is particularly true for highly polytocous species as maximizing fitness may include trade-offs between sex ratio and the size and number of offspring in litters. In such cases, it may be adaptive for mothers to adjust both the number of offspring per litter and offspring sex to maximize individual fitness. Investigating maternal sex allocation in wild pigs (Sus scrofa) under stochastic environmental conditions, we predicted that …

Assessment Of Habitat‐Specific Competition For Oral Rabies Vaccine Baits Between Raccoons And Opossums, James L. Helton, Jacob E. Hill, David A. Bernasconi, Wesley C. Dixon, Richard B. Chipman, Amy Gilbert, James C. Beasley, Guha Dharmarajan, Olin E. Rhodes Jr.

United States Department of Agriculture Wildlife Services: Staff Publications

Throughout the eastern United States, the National Rabies Management Program (NRMP) distributes oral rabies vaccine (ORV) baits to manage rabies virus circulation in raccoon (Procyon lotor) populations. The consumption of vaccine baits by non‐target species including Virginia opossums (Didelphis virginiana) may reduce the effectiveness of ORV programs, but competition for baits remains poorly quantified in many areas of the southeastern United States. We distributed placebo ORV baits injected with a biomarker across 4 land cover types (bottomland hardwood, upland pine, riparian, isolated wetland) on the Savannah River Site in South Carolina, USA, 2017–2019. We then trapped …

Controllable Factors Affecting Accuracy And Precision Of Human Identification Of Animals From Drone Imagery, Landon R. Jones, Jared A. Elmore, B. Santhana Krishnan, Sathishkumar Samiappan, Kristine O. Evans, Morgan B. Pfeiffer, Brad Blackwell, Raymond Iglay

United States Department of Agriculture Wildlife Services: Staff Publications

Surveying animal populations using drones (unoccupied aircraft systems [UAS]) provides numerous advantages; however, few best practices exist to survey animal communities with drones. Among myriad factors that can affect human identification and counts of animals from drone images, we focused on three factors typically controlled in the study design or by the drone pilot: flight altitude, camera angle, and time of day. Identifying interactions and patterns among these three variables represents an important first step to determining best survey practices. We used a drone to survey known numbers of eight animal decoy species, representing a range of body sizes and …

Predicting Dispersal And Conflict Risk For Wolf Recolonization In Colorado, Mark A. Ditmer, George Wittemyer, Katherine A. Zeller, Stewart W. Breck, Robert J. Fletcher Jr., Kevin R. Crooks

United States Department of Agriculture Wildlife Services: Staff Publications

1. The colonization of suitable yet unoccupied habitat due to natural dispersal or human introduction can benefit recovery of threatened species. Predicting habitat suitability and conflict potential of colonization areas can facilitate conservation planning.

2. Planning for reintroduction of gray wolves (Canis lupus) to the United States state of Colorado is underway. Assessing which occupancy sites minimize the likelihood of human-wolf conflict during dispersal events and seasonal movements is critical to the success of this initiative.

3. We used a spatial absorbing Markov chain (SAMC) framework, which extends random walk theory and probabilistically accounts for both movement behavior …

Population Density Of The Small Indian Mongoose (Urva Auropunctata) Across Multiple Habitat Types And Seasons In Puerto Rico, Are R. Berentsen, Caroline C. Sauvé, Mel J. Rivera-Rodriguez, Fabiola B. Torres-Toledo, Richard B. Chipman, Amy T. Gilbert

United States Department of Agriculture Wildlife Services: Staff Publications

The small Indian mongoose (Urva auropunctata) is a rabies reservoir on several Caribbean Islands including Puerto Rico. In the continental United States, oral rabies vaccination (ORV) has been used to control and locally eliminate rabies viruses targeting meso-carnivores including raccoons (Procyon lotor), grey foxes (Urocyon cinereoargenteus), and coyotes (Canis latrans), and has more recently been proposed to mitigate and control mongoose rabies in Puerto Rico. A fundamental understanding of the population density of the target species is an important factor in planning bait application rates prior to ORV operations. In Puerto Rico, …

Novice Advanced Practice Nurses And The Delivery Of Unsatisfactory Health News, Jenny F. Schulte

Graduate Research Projects

No abstract provided.

Residential Segregation And County-Level Covid-19 Booster Coverage In The Deep South: Surveillance Report And Ecological Study, Chengbo Zeng, Jiajia Zhang Ph.D., Zhenlong Li, Xiaowen Sun, Huan Ning, Xueying Yang, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: COVID-19 had a greater impact in the Deep South compared with other regions in the United States. While vaccination remains a top priority for all eligible individuals, data regarding the progress of booster coverage in the Deep South and how the coverage varies by county and age are sparse. Despite existing evidence of racial and ethnic disparities in COVID-19 vaccinations at the individual level, there is an urgent need for evidence at the population level. Such information could highlight vulnerable communities and guide future health care policy-making and resource allocation.

Objective: We aimed to evaluate county-level COVID-19 booster coverage …

Using Geospatial Social Media Data For Infectious Disease Studies: A Systematic Review, Fengrui Jing, Zhenlong Li, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Geospatial social media (GSM) data has been increasingly used in public health due to its rich, timely, and accessible spatial information, particularly in infectious disease research. This review synthesized 86 research articles that use GSM data in infectious diseases published between December 2013 and March 2022. These articles cover 12 infectious disease types ranging from respiratory infectious diseases to sexually transmitted diseases with spatial levels varying from the neighborhood, county, state, and country. We categorized these studies into three major infectious disease research domains: surveillance, explanation, and prediction. With the assistance of advanced computing, statistical and spatial methods, GSM data …

Recommendations For Climate Adaptation To Preserve Connecticut Drinking Water Quality And Quantity, Matthew Salvatore Di Vitto

Public Health Theses

Climate change impacts drinking water both directly and indirectly. Increases in temperature, drought frequency, and precipitation are among the climate impacts which currently and are projected to affect water quality and quantity in the continental United States. These impacts limit access to clean and abundant water sources by damaging habitat, spreading toxic substances via runoff and favoring the growth of harmful algal blooms. States can learn from one another to adopt best practices and policies to increase water resilience around the country. This paper explores how Connecticut can employ strategies from the States of New York, New Jersey, Massachusetts, Minnesota, …

Depression And Anxiety Among Plurisexual Teens In The U.S., Olivia Goodwin

Public Health Theses

Background: Little research focuses on the mental health consequences of stigma for plurisexual teens, with even less research comparing cisgender plurisexual youth to nonbinary plurisexual youth.Aims: To assess whether having both a marginalized sexual orientation and a marginalized gender identity is associated with greater risk or greater resilience in depression and anxiety outcomes among teens in the US. Methods: Data was analyzed from the 2022 LGBTQ Teen Survey. Inclusion in the study required being an English speaker living in the US, being 13-18 years old, and identifying as cisgender and plurisexual (n=1547) or gender nonbinary and plurisexual (n=1867). Statistical tests …

The Path To U.S. National Registration Of A Toxic Bait For The Control Of The Small Indian Mongoose, Carmen C. Antaky, Steven C. Hess, Emily W. Ruell, Israel L. Leinbach, Shane R. Siers, Robert T. Sugihara

Human–Wildlife Interactions

The small Indian mongoose (Urva auropunctata [syn. Herpestes auropunctatus]; mongoose) is a highly invasive species in its introduced range that negatively impacts ecosystems. Mongooses depredate native species, serve as a vector of disease posing a risk to human health, and cause sanitation issues in food processing facilities and public areas. Introduced for biocontrol in the late 1800s in Hawaiʻi and the Caribbean, mongooses currently have well-established populations across multiple islands in both island archipelagos and have invaded numerous other locations throughout the world. The concern of accidental introduction to mongoose-free islands, the difficulty in species detection, and the …

Structural Impact Of Epstein-Barr Virus- Encoded Small Rna -1 On Its Transport And Function, Zubaida Hassan

Dissertations

Epstein-Barr Virus (EBV)-Encoded RNAs (EBERs) are two small, noncoding, structurally conserved transcripts that are expressed in millions of copies in all stages of EBV infection. Despite their abundant expression, the role of EBERs in EBV biology or pathogenesis is not well defined. However, they are associated with driving cell proliferation and improving intercellular communication via their secretion in exosomes. In spite of the pathogenic potentials of EBERs, the mechanisms involved in their transport and function remain to be elucidated. The aim of this PhD dissertation was to investigate the structural impact of EBER1 in its transport and function. The conserved …

A Coalition-Driven Examination Of Organization Capacity To Address Food Insecurity In Greater Houston: A Qualitative Research Study, Jemima C John, Jennifer Gonzalez, Sara-Grace Chan, Heidi Mcpherson, Jennifer N Aiyer, Esperanza Galvan, Nicole Browning, Shreela V Sharma

Faculty, Staff and Student Publications

BACKGROUND: Economic and social hardships have worsened food insecurity, particularly among low income and racial-ethnic minority groups. Given the core goal of the 150+ member Houston Health Equity Collective (HEC) to reduce food insecurity by 5% in 2025, we explored member organizations' capacity and challenges faced in screening and responding to food insecurity through care coordination efforts.

METHODS: A twice-administered Qualtrics XM survey (Provo, Utah) with 76 organizations, followed by five focus groups with 22 of these organizations, explored reach and response efforts to food insecurity. Qualitative assessments lasted between 0.5 to 1.5 h, were audio-recorded, cleaned, coded, and thematically …

Provider Racial Concordance And Medical Mistrust In Pediatric Dentistry, Chinelo Eke

Theses and Dissertations

Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.

Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.

Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% …

Food Deserts And Pediatric Oral Health Status In An Under-Resourced Urban Community, Jessica T. Mcauliffe

Theses and Dissertations

Purpose: The aim of this analysis of survey data was to assess the influence of living within a food desert as a predictor of oral health problems among children of East Henrico County, Virginia.

Methods: Survey participants were recruited and questionnaires applied online. Residing in a food desert, using access to affordable produce as a proxy value, was the independent variable, while self- reported assessment of the child’s oral health status was the primary outcome variable. Analyses controlled for other indirect factors of pediatric oral health. Logistic regression was used to model the association between the self-reported access to healthy …

Social Determinant Of Health Impact On Diabetes Device Use And Clinical Outcomes In Youth With Type 1 Diabetes, Emily R Crain, Ryan Ramphul, Ashley M Butler, Xiaofan Huang, Charles G Minard, Maria J Redondo, Daniel J Desalvo

Faculty, Staff and Student Publications

Background: Youth with Type 1 diabetes (T1D) who are Black, Hispanic, or lower socioeconomic status (SES) have lower rates of diabetes device use, higher hemoglobin A1c (HbA1c), and higher rates of diabetic ketoacidosis (DKA). However, the associations of individual-level social determinants of health (SDoH) and neighborhood-level factors with device use and clinical outcomes are unknown. Area deprivation index (ADI) is a neighborhood level measure of SES reported in deciles (range 1-10 with 10 representing most deprived neighborhood).

Methods: We evaluated the association of ADI and other SDoH factors with pump/continuous glucose monitor (CGM) use, HbA1c, and DKA in 1,461 youth …

A Novel Bayesian Spatial-Temporal Approach To Quantify Sars-Cov-2 Testing Disparities For Small Area Estimation, Cici Bauer, Xiaona Li, Kehe Zhang, Miryoung Lee, Esmeralda Guajardo, Susan Fisher-Hoch, Joseph Mccormick, Maria E Fernandez, Belinda Reininger

Faculty, Staff and Student Publications

Objectives. To propose a novel Bayesian spatial–temporal approach to identify and quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing disparities for small area estimation.

Methods. In step 1, we used a Bayesian inseparable space–time model framework to estimate the testing positivity rate (TPR) at geographically granular areas of the census block groups (CBGs). In step 2, we adopted a rank-based approach to compare the estimated TPR and the testing rate to identify areas with testing deficiency and quantify the number of needed tests. We used weekly SARS-CoV-2 infection and testing surveillance data from Cameron County, Texas, between March 2020 …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Who Was Wearing A Mask In 2021? Update On Gender-, Age-, And Location-Related Differences During The Covid-19 Pandemic, Michael H. Haischer, Rachel Beilfuss, Meggie Rose Hart, Lauren Opielinski, Emma Schmit, David Wrucke, Helena Zhao, Toni D. Uhrich, Sandra K. Hunter

Exercise Science Faculty Research and Publications

Previous observational work from 2020 demonstrated gender-, age-, and location-related differences in mask-wearing behavior, despite the efficacy and public health messaging that emphasized face coverings in combatting the spread of COVID-19. In 2021, COVID-19 vaccinations and a corresponding change in public health policy became new considerations in deciding personal protective behaviors. To provide an update on mask wearers and resistors approximately one year after our initial study, we observed shoppers (n = 6,118) entering retail stores using the same experimental methodology. Approximately 26% of individuals wore a mask. Mask wearing has decreased across demographic groups compared to 2020. Aligning …

The Association Of Availability And Accessibility Of Federally Qualified Health Centers On Hospitals' Reported Charity Care, Philip Cendoma

All ETDs from UAB

Hospitals are facing financially challenging times. Each year, billions of dollars are spent by hospitals to provide care to patients that, ultimately, will go unreimbursed. How to effectively provide accessible and affordable health care to the uninsured population continues to be a topic of discussion for policymakers, healthcare administrators, as well as healthcare-based consortiums, and consultant. The cost of charity care consists largely of the care provided to the uninsured population. Federally Qualified Health Centers (FQHCs) play an important role in providing primary care to the uninsured population, regardless of the patient’s ability to pay. Based on the 5 A’s …

Strategic Balance In Healthcare Organizations, Corey Spraberry

All ETDs from UAB

The purpose of this dissertation was to assess the relationship between service mix offerings relative to competitors and firm performance. Specifically, this study explores if an optimal point of service offerings in the competitive market is associated with financial performance. This study is important to both researchers and healthcare leaders as it helps understand the relationship between optimal service mix and firm performance. The results find a relationship that suggests a differentiated service mix compared to a generalized service mix is associated with financial performance. Additionally, hospital characteristics are associated with service duplication and differentiation. The findings of this research …

Transmission Competence Of B. Burgdorferi Infected Ixodes Ticks And Development Of An Ospc-Based Lyme Disease Vaccine, Samanta Kamalika

Theses and Dissertations (ETD)

Introduction. Lyme disease, otherwise called Lyme borreliosis, is a vector-borne infectious disease caused by the spirochete Borrelia burgdorferi (Bb). Studying the increase in overall Lyme disease incidence requires understanding the role of the vector Ixodes scapularis (I. scapularis) as the agent that carries the spirochete which is important to limit the occurrence of Lyme disease. Once we understand the vector-pathogen response, it also becomes important to determine the remedies for Lyme disease. Lyme disease can be treated with antibiotics if detected early, but the major obstacle lies in the early detection process. Therefore, it is important to investigate alternative preventive …

Understanding How Multi-Level Factors Influence Cancer Clinical Trial Enrollment Decisions By Patients Living In Higher Disadvantaged Areas, Nicole Caston

All ETDs from UAB

Cancer clinical trials offer current patients with cancer new treatment and novel interventions to treat their cancer, while advancing the care of future patients. Clinical trials test new drugs against the standard of care to determine drug efficacy and safety. There are many groups of patients who are either unrepresented or underrepresented in cancer clinical trials and there is a plethora of reasons they are not represented. One underrepresented population of interest is patients with cancer who live in highly disadvantaged neighborhoods. Previous research found that when compared to patients who live in areas of lower disadvantage, patients living in …