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Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Differentiating Opioid Use Disorder From Healthy Controls Via Ml Analysis Of Rs-Fmri Networks, Ahmed Temtam, Megan A. Witherow, Liangsuo Ma, M. Shibly Sadique, F. Gerard Moeller, C. Kenneth, Dianne Wright, Khan M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Objectives/Goals: This work aims to identify functional brain networks that differentiate opioid use disorder (OUD) subjects from healthy controls (HC) using machine learning (ML) analysis of resting-state fMRI (rs-fMRI). We investigate the default mode network (DMN), salience network (SN), and executive control network (ECN), as well as demographic features. Methods/Study Population: This work uses high-resolution rs-fMRI data from a National Institute on Drug Abuse study (IRB #HM20023630) with 31 OUD and 45 HC subjects. We extract rs-fMRI blood oxygenation level-dependent (BOLD) features from the DMN, SN, and ECN. The Boruta ML algorithm identifies statistically significant features and brain activity mapping …

Improved Survival And Decreased Cancer Deaths In Young Adults With Cancer After Passage Of The Affordable Care Act Dependent Coverage Expansion, Michael Roth, Clark R Andersen, Amy Berkman, Stuart Siegel, Branko Cuglievan, J Andrew Livingston, Michelle Hildebrandt, Jaime Estrada, Archie Bleyer

Faculty, Staff and Student Publications

Background: The Patient Protection and Affordable Care Act (ACA) allowed Americans aged 19-25 years to remain on their parents' health insurance plans until age 26 years (the Dependent Care Expansion [DCE]). Have those with cancer diagnoses benefited?

Methods: The ACE DCE 7-year age range of 19-25 years was compared for changes in cancer survival and mortality before and after enactment of the ACA with groups that were younger and older (in 7-year age spans: ages 12-18 and 26-32 years, respectively). Cancer death data for the entire United States were obtained from the Centers for Disease Control and Prevention, and relative …

Dose Planning And Radiation Optimization For Thoracic Conventional, Twice Daily, And Stereotactic Radiation Therapy: A Delphi Consensus From A National Survey Of Practitioners, Julius Weng, Jeff Ryckman, Matthew S Katz, Hina Saeed, Christopher Estes, Issam El Naqa, Amy Moreno, Sue S Yom

Faculty, Staff and Student Publications

Purpose: We sent surveys to a large number of radiation oncologists with active thoracic cancer practices and applied the Delphi method over 3 rounds to generate consensus dose-volume histogram metrics. We used these results to create consensus-based organs-at-risk dose constraints and target goal templates for practical implementation.

Methods and materials: In this institutional review board-approved study, data were collected using REDCap electronic data capture on a secure server. Radiation oncologists identified from the Accreditation Council for Graduate Medical Education-accredited departments' websites were asked to confirm their self-identification as thoracic radiation oncologists and nominate other respondents. All invitees were asked to …

The Usual Suspects: A Review Of Common Dysbiosis Of The Human Mouth, And The Associated Microbial Species, Sophie Katherine Shields

Honors Theses and Capstones

The mouth, often referred to as the oral cavity in scientific literature, is described as the second most diversely populated microbiome in the human body, only after the gut. The cavity’s temperature, abundant water, high nutrient levels, and diversity of sites are all critical factors that make the oral cavity a space booming with life. The mouth harbors over 700 species of bacteria, in addition to numerous fungi, viruses, and protozoa species. Together, when working in harmony, these species provide critical supports to the functions of the human body. When dysbiosis occurs, however, the overgrowth of a single species may …

Invasive Fungal Disease In Solid Organ And Hematopoietic Cell Transplant Recipients, United States, Jeremy A W Gold, Kaitlin Benedict, Elizabeth Sajewski, Tom Chiller, Meghan Lyman, Mitsuru Toda, Jessica S Little, Luis Ostrosky-Zeichner

Faculty, Staff and Student Publications

Background: Updated benchmark data on invasive fungal disease (IFD) in solid organ transplantation (SOT) and hematopoietic cell transplantation (HCT) recipients are necessary to increase clinical recognition and inform treatment and prevention strategies. We estimated IFD incidence and potential risk factors in transplant recipients in a large US commercial health insurance database.

Methods: We observed patients who received SOT or HCT during 2018-2022 until IFD development, disenrollment, or database end date (July 31, 2023). We calculated incidence (per 1000 person-years) and time to IFD development, comparing demographic features and underlying conditions for IFD versus non-IFD patients.

Results: Overall, 9143 patients received …

Perspectives Of Healthcare Providers And Patients With Relapsed/Refractory Multiple Myeloma On Treatment Priorities And Novel Therapies., Sikander Ailawadhi, Yelak Biru, Solène Clavreul, Maite San Miguel, Nicolas Cormier, Yvonne Efebera, Maximilian Merz, Anna Sato, Cathy Zeanah, Jack L Watkins, James Farrell, Erinn Hoag Goldman, Rakesh Popat

Oncology Articles

PURPOSE: With novel therapies including chimeric antigen receptor T-cell (CAR-T) therapy and bispecific antibodies (BsAbs), healthcare providers (HCPs) face complexities managing treatment for patients with relapsed/refractory multiple myeloma (RRMM). This study, among the largest surveys on RRMM, examined unmet needs in care access, barriers to novel therapy use, and treatment decision-making.

METHODS: This survey-based study (March-June 2024) enrolled 2284 participants (patients: 1301; HCPs: 983) across 7 countries. Patients with >1 relapse/progression and HCPs managing ≥3 patients were included. Data were analyzed using descriptive statistics and Χ

RESULTS: For patients, treatment priorities included slowing disease progression (second line [2L], 47%; third …

Virtually Assisted Home Rehabilitation After Acute Stroke (Vast-Rehab): A Descriptive Pilot Study For Young And Underserved Stroke Survivors, Emily A Stevens, Neha Muraly, Carolyn P Da Silva, Lorie Richards, Aylen Sosa, Heather Smith, Allyson Seals Richard, Shehzeen Manji, Mary E Russell, Sean I Savitz

Faculty, Staff and Student Publications

Introduction: The objective of Virtually Assisted home rehabilitation after acute STroke was to offer a fully remote telerehabilitation intervention to stroke survivors during the COVID-19 pandemic.

Methods: Participants were recruited from acute care, inpatient rehab, or provider/self-referral if they had a stroke within the previous year, prestroke modified Rankin Scale < 3, were recommended to participate in rehab, and had internet access. Exclusions were: prior injury/diagnoses that impacted functional level, life expectancy of less than six months, or safety concerns. Outcomes were within one week prior to initiation and within one week after completion of telerehabilitation sessions. Video call sessions were completed 1-2 times a week for 12 weeks. Occupational therapy, physical therapy, and/or speech therapy were provided. Analyses involved descriptive statistics; qualitative comments were aggregated and analyzed for broader themes. Twenty participants were consented.

Results: Of the 20 participants (39-71 years old, 35% White, 50% female), 12 completed study activities, five completed exit interview; 10 demonstrated improvement on National Institute of Health Stroke Scale from a mean of 5.6 at baseline to 2.7 at end of study, six demonstrated improvement in modified Rankin Score …

The Future Of Parkinson’S Care: A Need To Expand Access, Sana Aslam, Anjail Z Sharrief, Samantha K Holden, Michelle Fullard, Jodi S Holtrop, Anna M Maw, Amy W Amara

Faculty, Staff and Student Publications

Parkinson's disease (PD) affects over one million Americans, with prevalence expected to double by 2040, creating rising challenges for healthcare systems. While neurologist-led care, particularly by movement disorder specialists (MDS), is associated with improved patient outcomes, only a small fraction of PD patients access this level of expertise. Many, various, barriers lead to delays or missed opportunities for advanced treatments such as deep brain stimulation and infusion therapies. This Perspective article issues a call to action for improving referral pathways and care coordination in PD, addressing both clinical and systems-level gaps. We propose several pragmatic strategies, including the development of …

Exploring Institutional Stratification: Minority-Serving Institutional Pathways To Medical School Acceptance In The United States, Amanda K. Burbage, Eushekia Y. Hewitt

EVMS School of Health Professions Faculty Publications

Introduction

Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID-19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority-serving institutions (MSIs) in the United States to medical school (MD) are not well understood.

Method

A hierarchical logistic regression analysis of 328 488 de-identified applicants to US MD-granting medical schools for academic years 2017-2018 …

Exploring The Reassessment Of Palliative Home Care Clients: A Mixed Methods Study, Maya Canham

Theses and Dissertations (Comprehensive)

Introduction: The timely reassessment of clients receiving palliative home care (HC) is critical for supporting clinicians with care planning and service delivery. However, there is little information on the frequency of reassessments and factors driving reassessment in palliative HC clients.

Objectives: The objectives of this study were to: (i) determine the proportion of palliative HC clients reassessed with the interRAI Palliative Care (interRAI PC) instrument, (ii) calculate the average interRAI PC reassessment interval, (iii) identify the key factors driving interRAI PC reassessment at various intervals, and (iv) explore the factors that influence palliative HC clinicians to reassess their clients in …

Generating Real-World Evidence In Early Alzheimer's Disease: Considerations For Applying The Target Trial Emulation Framework To Study The Safety Of Anti-Amyloid Therapies, Xiaojuan Li, Sonal Singh, Bahareh Rasouli, Jennifer Lyons, Noelle M. Cocoros, Richard Platt, Ivan Abi-Elias, Jerry H. Gurwitz

Department of Medicine Faculty Publications

Anti-amyloid beta monoclonal antibodies (anti-Aβ mAbs) have received approval from the US Food and Drug Administration for the treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer's disease (collectively known as early AD) based on evidence from clinical trials. However, whether findings from these trials are generalizable to the real world is uncertain. We need reliable evidence on the real-world safety of these treatments to inform decision making for clinicians, patients, and caregivers. Using lecanemab as an exemplar, we outline the key considerations in designing and implementing an observational study on safety and utilization outcomes using …

Politics In Public Health: Growing Partisan Divides In Covid-19 Vaccine Attitudes And Uptake Post-2021 Presidential Inauguration, Hongbin Fan, Zhongliang Zhou, Guanping Liu, Chi Shen, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: To investigate whether the 2021 U.S. presidential inauguration contributed to a widening of partisan divides in COVID-19 vaccine attitudes and uptake. Methods: We leverage the presidential inauguration as a natural experiment and analyze data from the Household Pulse Survey and CDC vaccination records. Using a difference-in-differences framework with continuous treatment, we examine how the transition differentially affected state-level vaccine refusal rates and county-level vaccination rates, based on varying levels of partisanship as measured by the Trump-Biden vote gap. Results: Following Biden's inauguration, vaccine refusal declined more in pro-Biden states. Distrust in government and vaccines accounted for approximately 80% of …

Pediatric Cancer Incidence, Temporal Trends, And Mortality In The United States By Health Disparities Indicators, Seer (1973-2014), Prachi P. Chavan, Laurens Holmes Jr.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged < 1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.

Disparities In Breast Cancer Detection Modalities And Outcomes Among Geriatric Female Cancer Patients, Zhaoli Liu, Mathilda Nicot-Cartsonis, Biai D E Digbeu, Daoqi Gao, Sharon H Giordano, Yong-Fang Kuo

Faculty, Staff and Student Publications

This study examined racial and geographic disparities in breast cancer detection modalities (screening-, diagnostic-, or non-mammography) with cancer stage and mortality. A retrospective cohort study was conducted using Texas Cancer Registry-Medicare linkage data for geriatric women. Cancers detected through screening and diagnostic mammography had 43 % (95 % CI, 39 %-46 %, p < .0001) and 31 % (95 % CI, 27 %-35 %, p < .0001) lower all-cause mortality, and 49 % (95 % CI, 41 %-54 %, p < .0001) and 37 % (95 % CI, 32 %-43 %, p < .0001) lower cancer-specific mortality, respectively, compared to non-mammography-detected breast cancers. Patients from rural areas were 17 % (95 % CI, 1.06 - 1.29) more likely to be diagnosed with mid- (p = .0023) and advanced stage (p = .003) cancers compared to their urban counterparts. Racial or geographic disparities in cancer detection modalities with associated mortality no longer exist after adjusting for covariates. Healthcare professionals can leverage these findings to promote rural cancer health equity.

Effectiveness And Acceptability Of Ventilation Modifications In Healthcare Facilities, Liberia 2022–2023, Ronan F Arthur, Ashley Styczynski, Krithika Srinivasan, Amos Tandanpolie, Philip Bemah, Ethan Bell, Jason R Andrews, Tom Baer, Jorge L Salinas

Faculty, Staff and Student Publications

Objective: To evaluate the effectiveness and acceptability of ventilation interventions in naturally ventilated hospitals in Liberia.

Design: Difference-in-differences analysis of pre- and post-air changes per hour of intervention and control spaces.

Setting: Hospitals in Bong and Montserrado Counties, Liberia.

Participants: Seventy patient care spaces were evaluated at baseline. Six spaces underwent physical intervention modifications, while 2 spaces were assessed for indirect effects and 2 others used as controls. Healthcare workers were interviewed to assess ventilation knowledge and acceptability.

Interventions: Ventilation interventions included the installation of window screens, louvered doors and windows, and wind turbines.

Methods: We measured carbon dioxide levels …

Impact Of Rurality On Health Care Utilization Among Australian Residents From 2009 To 2021, Engida Yisma, Martin Jones, Lee San Pauh, Sandra Walsh, Sara Jones, Esther May, Marianne Gillam

Research outputs 2022 to 2026

Purpose: In Australia, there is limited research regarding the effect of rurality on health care utilization using longitudinal data.

Methods: We analyzed data from four annual waves (2009, 2013, 2017, and 2021) of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey to examine changes in the health care utilization over time among urban and rural residents. Poisson regression models estimated adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CIs) for rural versus urban residents, accounting for a range of health-related and sociodemographic characteristics. Health care utilization was measured using four key indicators: visits to family doctor …

Translating Acceptability To Sustained Delivery: Clinician And Manager Perspectives On Implementing Modified Constraint-Induced Movement Therapy In An Early-Supported Discharge Rehabilitation Service, Ashan Weerakkody, Erin Godecke, Barby Singer

Research outputs 2022 to 2026

Background: Modified constraint-induced movement therapy (mCIMT) improves upper limb (UL) function after stroke. Despite up to one-third of stroke survivors being eligible, clinical uptake remains poor. To address this, a multi-modal behaviour change intervention was implemented across a large seven-site early-supported discharge (ESD) rehabilitation service. This study investigated the acceptability of mCIMT implementation within this ESD service and identified adaptations required for sustained delivery.

Methods: This qualitative study was nested within a mixed-methods process evaluation of mCIMT implementation. Four focus groups (n = 24) comprising therapists (two groups), therapy assistants (one group), and allied health managers (one group) were conducted. …

Elizabeth Usher Memorial Lecture 2024: Speech-Language Pathology Practice In Aboriginal Spaces: A Journey Of Learning And Unlearning, Elizabeth Armstrong

Research outputs 2022 to 2026

In this paper I describe learnings gained from 15 years collaboration with Aboriginal colleagues in Australia, in endeavours to improve rehabilitation services for Aboriginal people with brain injury and their families. Colleagues include Aboriginal researchers, clinicians, and people with communication and other disorders associated with brain injury and their families. My research journey in this field has been made possible through the work, mentoring, and support of these colleagues who introduced me to Aboriginal ways of knowing, being, and doing. My journey has involved challenging and un-learning some widely accepted Western tenets of speech-language pathology practice in order to explore …

Cocreating A Programme To Prevent Injuries And Improve Performance In Australian Police Force Recruits: A Study Protocol, Myles C. Murphy, Andrea B. Mosler, Jonathan Hodgson, Sophia Nimphius, Evert Verhagen, Joanne Kemp, Alex Donaldson, Debra Langridge, Vanessa R. Sutton, Kay M. Crossley, Clare L. Ardern, Carolyn A. Emery, Mary A. Kennedy, Simone Radavelli-Bagatini, Martin Hägglund, Brady Green, G. Gregory Haff, Garth Allen, Andrea Bruder

Research outputs 2022 to 2026

A healthy police force is a key component of a well-functioning society, yet 1 in 20 law enforcement recruits drop out of the recruit training programme due to injury. This drop-out rate has substantial economic and workforce ramifications. In the Western Australia Police Force, one in five recruits suffers a musculoskeletal injury during the recruit training programme, causing time-loss from work. We will now identify the critical elements of an injury prevention intervention and investigate the needs, experiences and suggested solutions to address potential implementation challenges. Our objective is to co-create an intervention with content and context experts, specifically for …

Nuclear Intron Sequence Variation Of The Bulinus Globosus Complex (Mollusca: Planorbidae): Implications For Molecular Systematic Analyses, Chairat Tantrawatpan, Kotchaphon Vaisusuk, Chrysantus M. Tanga, Warayutt Pilap, Naruemon Bunchom, Ross H. Andrews, Tongjit Thanchomnang, Wanchai Maleewong, Weerachai Saijuntha

All Peer-Reviewed Publications

Urinary schistosomiasis is caused by the blood fluke Schistosoma haematobium, which is predominantly found in Africa. The freshwater snail Bulinus globosus is its main intermediate host. The species that make up the B. globosus group are genetically complex, and their taxonomic status remains controversial. Genetic variation, heterozygosity, and DNA recombination in B. globosus were examined using the mitochondrial cytochrome c oxidase subunit 1 (COI) and the intron 3 region of the arginine kinase gene (AkInt3). A total of 81 B. globosus snails were collected from three different localities in Kwale County, Kenya. Genomic diversity, heterozygosity, DNA recombination, and haplotype network …

The Relationship Between Food Insecurity And Low Birthweight Across Us Counties And Related Racial Disparities, Marissa A. Beldon, Shondra L. Clay, M. Courtney Hughes, Kathryn Mazurek

Faculty Articles, Papers, and Other Scholarship

Objective

To explore the relationship between low birthweight (LBW) and food insecurity across US counties and determine whether this relationship differs between Black and White women.

Methods

LBW data was derived from the 2013–2019 National Center for Health Statistics and National Vital Statistics System Birth Files. Food insecurity data was derived from Feeding America’s 2013–2019 Map the Meal Gap project. Analyses included descriptive statistics and regression models.

Results

Data were available for 3037 US counties. Food insecurity significantly predicted county-level LBW (t(3035) = 44.48, P <  .001) and explained 39.46% of the variance in LBW (F(13,035) = 1978.03, P <  .001, R = .63). Food insecurity predicted LBW for …

Schistosomiasis Interventions In Africa: Assessment And Systematic Review, Christopher Yaw Dumevi, George Boateng Kyei, Patience B Tetteh-Quarcoo, James-Paul Kretchy, Irene Ayi, Patrick F Ayeh-Kumi

2020-Current year OA Pubs

No abstract provided.

Investigating Socioeconomic Deprivation And Antibiotic Prescribing Among Older Medicare Patients Using An Instrumental Variable Approach, Mayar Al Mohajer, David Slusky, David Nix, Catia Nicodemo

Faculty, Staff and Students Publications

Background: Socioeconomic deprivation has been associated with antibiotic overprescription in the US; however, prior studies could not quantify a causal relationship due to endogeneity. This study examines how socioeconomic deprivation is related to the rate of antibiotic days supplied to older Medicare Part D beneficiaries, utilizing an Instrumental Variable (IV) approach.

Methods: Data from the Medicare Part D and the Social Deprivation Index (SDI) repositories were analyzed. To address potential endogeneity and omitted variable bias in the relationship between SDI and antibiotic prescribing, we used the maximum Earned Income Tax Credit as an IV. Bivariate Moran's I assessed the spatial …

Rapid Implementation Of Open-Access Pandemic Education For Global Frontline Healthcare Workers, Jacqueline Christianson, Erica Frank, Stacen Keating, Susan Boyer, Miriam Chickering

College of Nursing Faculty Research and Publications

Background

The recent global pandemic posed extraordinary challenges for healthcare systems. Frontline healthcare workers required focused, immediate, practical, evidence-based instruction on optimal patient care modalities as knowledge evolved around disease management.

Objective

This course was designed to provide knowledge to protect healthcare workers; combat disease spread; and improve patient outcomes.

Methods

A team of global healthcare workers responded by rapidly creating a competency-based online course. To promote transcultural applicability, the course was developed by an international team of more than 45 educators from over 20 countries. Course delivery included a built-in language translation tool, routine updates, and several innovative course …

Impact Of An Electronic Medical Record Quality Improvement Intervention On Helicobacter Pylori Treatment And Eradication Rates In A U.S. Hospital System, Shivani Kastuar, Samanthika Devalaraju, Juan Gomez Cifuentes, Hashem B El-Serag, Mimi C Tan

Faculty, Staff and Students Publications

Background: In this pre- and post-intervention quality improvement (QI) study, the impact of an electronic medical record (EMR) order set for Helicobacter pylori treatment was assessed. We evaluated changes in optimal treatment regimen usage, eradication testing, and successful eradication rates based on the intervention.

Materials and methods: Data were collected from patients within the Harris Health System (Houston, TX) with H. pylori infection. The pre-intervention cohort included patients with a positive H. pylori test from January to February 2022. An EMR order set for H. pylori treatment implemented in May 2022 included optimal treatment recommendations using local antibiotic resistance patterns …

Diversity Within Species: Mechanisms, Evolution And Implications In Bacterial Disease, Kathryn R. Piper

Electronic Theses & Dissertations (2024 - present)

The Gram-positive bacterium Staphylococcus aureus and the Gram-negative bacterium Escherichia coli are ubiquitous commensal and opportunistic pathogens. In humans, S. aureus is commonly found on the skin and mucus membranes, and is known to cause infections in the skin, bloodstream and brain. E. coli is a normal part of the gut microbiota in humans and can cause intestinal and extraintestinal infections alike. S. aureus and E. coli pose global threats to public health, due to the high morbidity and mortality of invasive strains. The wide range of infections they cause in humans and other animals are exacerbated by the presence …

Differences In Mental Health Care Use Between Urban And Rural Populations In New York State, 2017-2022, Anna J. Papa

Electronic Theses & Dissertations (2024 - present)

Objective

This study aimed to determine whether rural New York State residents receive mental health care at the same rate as urban residents, how poverty rates in New York State relate to rurality and mental health care use, and how pre-pandemic mental health care use rates compare to 2022 use rates. The goal was not to estimate the burden of disease, nor to estimate the number of patients engaged in care in each zip code, but to highlight the potential differences in service use between urban and rural New York State Office of Mental Health clients.

Methods

A secondary analysis …

Theoretical Foundations And Applied Performance Of Periodicity-Aware Imputation: Variable Bandpass Block Bootstrap Methods For Incomplete Time Series, Asmaa Ahmad

Electronic Theses & Dissertations (2024 - present)

Time series data are prevalent across a wide range of disciplines, including health surveillance, public policy, and environmental monitoring. In the presence of underlying cyclical patterns, the integrity of time series analysis depends critically on the ability to detect, model, and impute structured missing data without compromising the temporal structure. This dissertation introduces and validates a novel imputation framework that integrates the Variable Bandpass Periodic Block Bootstrap (VBPBB) into multiple imputation procedures, improving the accuracy, robustness, and interpretability of time series models under high rates of missingness and noise. The overarching goal of this dissertation was to develop and evaluate …

Large‐Vessel Occlusion Stroke Knowledge And Training For Stroke Severity Assessment Among Emergency Medical Services Personnel In The United States, Kaiz S. Asif, Robin Novakovic, Thanh N. Nguyen, Santiago Ortega‐Gutierrez, Youngran Kim, Amanda Jagolino‐Cole, Sushanth Aroor, Alicia Castonguay, Prateek Kumar, Ameer E. Hassan

School of Medicine Publications

Background

Prehospital identification of large‐vessel occlusion (LVO) stroke facilitates the development of a regional triage protocol that could lead to an improvement in intrahospital and interhospital workflows. This requires stroke education of emergency medical services (EMS) personnel to improve stroke recognition, severity assessment, and prenotification. However, the current state of EMS personnel's knowledge of LVO stroke, their training for stroke severity assessment, and their preferences for educational methods are unknown. We conducted a nationwide EMS survey across the United States to glean insights that can inform and customize future EMS educational efforts.

Methods

The Society of Vascular and Interventional Neurology, …