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Part 3: Splish - Splash - Cash: Swimming In Hampton Roads, Dragas Center For Economic Analysis And Policy, Old Dominion University

State of the Region Reports: Hampton Roads

Hampton Roads is known for its relationship with water. For some, it is too much water in the wrong place at the wrong time. For others, it is how water can transform lives. Hampton Roads is home to several premier swimming organizations, and Hampton is opening a state-of-the-art aquatics facility. We explore how swimming is intertwined with the history of the region and the economic impact of the sport on the economy and lives of the region’s resident

Part 5: Strangers In A Strange Land: Finding Refuge In Hampton Roads, Dragas Center For Economic Analysis And Policy, Old Dominion University

State of the Region Reports: Hampton Roads

In 2021, a record breaking 90 million people were forcibly displaced, fleeing war, violence, human rights violations, and persecution. In early 2022, Russia’s invasion of Ukraine added to this toll, pushing the estimated number of refugees past the 100- million- person mark This chapter explores how all of these developments are affecting Hampton Roads, which has received more than 300 Afghans and other political refugees over the past eighteen months.

From Moral Panic To Permanent War: Rhetoric And The Road To Invading Iraq, Kai Philippe

Honors Papers

This thesis seeks to understand the conditions in the United States post-9/11 that enabled the Bush administration to pursue a wide-ranging and all-encompassing “War on Terror,” with substantial support from the general public. I am principally focused on two significant facets of the War on Terror: the invasion of Iraq and the establishment of a permanent security state (and the interrelated creation of a new state of exception). I ask why the George W. Bush administration was so successful in generating support for both the invasion and occupation of Iraq, and for policies that violated fundamental civil liberties; I argue …

Hispanic Ethnicity And Mortality Among Critically Ill Patients With Covid-19, Ana C Ricardo, Jinsong Chen, Stephanie M Toth-Manikowski, Natalie Meza, Min Joo, Shruti Gupta, Deepa G Lazarous, David E Leaf, James P Lash

Faculty, Staff and Student Publications

BACKGROUND: Hispanic persons living in the United States (U.S.) are at higher risk of infection and death from coronavirus disease 2019 (COVID-19) compared with non-Hispanic persons. Whether this disparity exists among critically ill patients with COVID-19 is unknown.

OBJECTIVE: To evaluate ethnic disparities in mortality among critically ill adults with COVID-19 enrolled in the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID).

METHODS: Multicenter cohort study of adults with laboratory-confirmed COVID-19 admitted to intensive care units (ICU) at 67 U.S. hospitals from March 4 to May 9, 2020. Multilevel logistic regression was used to evaluate …

Investigating Public Support For Biosecurity Measures To Mitigate Pathogen Transmission Through The Herpetological Trade, Elizabeth F. Pienaar, Diane J. Episcopio-Sturgeon, Zachary T. Steele

Biological Sciences Faculty Publications

The expanding global trade in herpetofauna has contributed to new infectious disease dynamics and pathways that allow for the rapid spread of pathogens geographically. Improved biosecurity is needed to mitigate adverse biodiversity, economic and human health impacts associated with pathogen transmission through the herpetological trade. However, general lack of knowledge of the pathogen transmission risks associated with the global trade in herpetofauna and public opposition to biosecurity measures are critical obstacles to successfully preventing pathogen transmission. In 2019 we administered a survey to 2,007 members of the public in the United States of America to ascertain their support for interventions …

The Impact Of Covid-19 On Wildlife Strike Rates In The United States, Dan Parsons, Michael Malouf, Wayne Martin

Human–Wildlife Interactions

Shortly after the COVID-19 pandemic impacted air traffic, industry bodies warned of the potential increase in wildlife strike risk. Prior to the pandemic, wildlife strikes were already a concern to the industry. We sought to evaluate industry warnings using interrupted time series analysis of wildlife strike trends in the United States. Using pre-pandemic wildlife strike trends, we compared a forecast of the expected monthly strike rates through the COVID-19 impact period (March 2020 to December 2020) to the actual wildlife strike rates for the same period. Our results showed an increase in wildlife strike rates in 5 out of the …

Frequent Mental Distress Among Adults In The United States And Its Association With Socio-Demographic Characteristics, Unhealthy Lifestyle, And Chronic Physical Health Status, Mamunur Rashid, M. Mazharul Islam, Aiping Li, Naima Shifa

Mathematics Faculty Publications

Frequent mental distress (FMD) is a measure of poor mental health days for at least 14 days out of 30 days. It is one of the important dimensions of the health-related quality of life. The underlying causes of FMD are diverse. However, the issue has not been explored extensively due to the lack of reliable data on mental health. The aim of this study was to examine the level and trends of FMD among the adults of the United States (US) and identify the socio-demographic, lifestyles, and chronic health outcomes related correlates of FMD. The data for the study was …

Cost Of Care For Asylum Seekers And Refugees Entering The United States: The Case Of Volunteer Medical Providers In El Paso, Texas, Rigoberto I Delgado, Manuel De La Rosa, Marlon A Picado, Lisa Ayoub-Rodriguez, Celia E Gonzalez, Leopold Gemoets

Faculty, Staff and Student Publications

BACKGROUND: Between October 2018, and February 2020, the United States saw an unprecedented increase in the number of asylum seekers and refugees arriving unexpectedly at international crossings along the US-Mexico Border. Many of these migrants needed proper medical attention, and consequently created significant pressure on local health systems. In El Paso, Texas, volunteer clinicians, collaborating closely with religious organizations and non-governmental organizations, provided outpatient medical care for the new arrivals; the county hospital provided in-patient care at local tax payers' expense. The objective of this study was to estimate costs of healthcare services offered by these volunteers in order to …

How To "Start Small And Just Keep Moving Forward": Mixed Methods Results From A Stepped-Wedge Trial To Support Evidence-Based Processes In Local Health Departments, Rebekah R Jacob, Renee G Parks, Peg Allen, Stephanie Mazzucca, Yan Yan, Sarah Kang, Debra Dekker, Ross C Brownson

2020-Current year OA Pubs

BACKGROUND: Local health departments (LHDs) in the United States are charged with preventing disease and promoting health in their respective communities. Understanding and addressing what supports LHD's need to foster a climate and culture supportive of evidence-based decision making (EBDM) processes can enhance delivery of effective practices and services.

METHODS: We employed a stepped-wedge trial design to test staggered delivery of implementation supports in 12 LHDs (Missouri, USA) to expand capacity for EBDM processes. The intervention was an in-person training in EBDM and continued support by the research team over 24 months (March 2018-February 2020). We used a mixed-methods approach …

Barriers And Facilitators To Diabetes Screening And Prevention After A Pregnancy Complicated By Gestational Diabetes, Drishti D. Sinha, Roxann C. Williams, Laura N. Hollar, Hannah R. Lucas, Bethany Johnson-Javois, Heidi B. Miller, Amanda Stoermer, Graham A. Colditz, Aimee S. James, Cynthia J. Herrick

2020-Current year OA Pubs

OBJECTIVE: Gestational diabetes mellitus (GDM) is increasing in the United States, with higher rates among minoritized racial and ethnic populations and lower income populations. GDM increases risk for type 2 diabetes (T2DM), and postpartum diabetes screening and prevention are imperative. This qualitative study examines barriers and facilitators to postpartum T2DM screening and prevention among non-privately insured individuals with a history of GDM in a state prior to Medicaid expansion.

METHODS: Thirty-six non-privately insured women with a history of GDM completed semi-structured interviews. Four focus groups and seven interviews were conducted with 30 nurse practitioners, physicians, physician assistants, nurses and registered …

Voting Behavior During Fda Medical Device Advisory Committee Panel Meetings, Amanda Maisel-Campbell, Daniel I Schlessinger, Arianna F. Yanes, Emir Veledar, Kelly A. Reynolds, Sarah A. Ibrahim, Bianca Y. Kang, Noor Anvery, Emily Poon, Murad Alam

2020-Current year OA Pubs

OBJECTIVES: During premarket review, the US Food and Drug Administration may ask its Medical Device Advisory Committee (MDAC) Panels to assess the safety and effectiveness of medical devices being considered for approval. The objective of this study is to assess the relationship, if any, between individual votes and Panel recommendations and: (1) the composition of Panels, specifically the expertise and demographic features of individual members; or (2) Panel members' propensity to speak during Panel deliberations.

METHODS: This was a retrospective cohort study of routinely collected data from voting members of MDAC panels convened between January 2011 to June 2016 to …

Racial/Ethnic Variations In Alcohol And Cigarette Use By Pregnancy Status Among 20- To 44-Year-Old Women, Nhanes 2001–2018, Jacqueline M Hirth, Catherine Valadez, Sandra Gonzalez, Alicia Kowalchuk, Judith A Gutierrez, Roger Zoorob

Faculty, Staff and Students Publications

OBJECTIVES: This study examines alcohol consumption and smoking behaviors by pregnancy status and race/ethnicity in order to inform improved interventions designed to assist women of all races to avoid alcohol and tobacco use during pregnancy for their health and to prevent potential fetal exposure.

METHODS: This retrospective secondary data analysis utilized nationally representative National Health and Nutrition Examination Survey data between 2001 and 2018. Smoking and alcohol use were evaluated by race/ethnicity and pregnancy risk. Sexual behavior, reproductive health, and prescription drug use determined pregnancy risk, categorized as low pregnancy risk, at risk of becoming pregnant, and pregnant. Binary and …

An Introductory Point-Of-Care Ultrasound Curriculum For An Anesthesiology Residency Program, Susan C Lee, Edward C Yang, Jovany Cruz Navarro, Charles G Minard, Xiaofan Huang, Yi Deng

Faculty, Staff and Students Publications

INTRODUCTION: The use of point-of-care ultrasound (POCUS) is a growing trend in the field of anesthesiology. However, formal POCUS curriculums are still not widely implemented in residency programs. As the Accreditation Council for Graduate Medical Education and the American Board of Anesthesiology have both incorporated POCUS into their educational aims and expectations for graduates, we recognized the need for a formal POCUS curriculum for our residency program. We developed and implemented a comprehensive 3-week POCUS curriculum for our first-year anesthesiology residents (CA1s) in the latter half of their academic year.

METHODS: Twenty CA1s participated in this educational activity. The POCUS …

The Nhlbi Study On Long-Term Outcomes After The Multisystem Inflammatory Syndrome In Children (Music): Design And Objectives, Dongngan T Truong, Felicia L Trachtenberg, Gail D Pearson, Audrey Dionne, Matthew D Elias, Kevin Friedman, Kerri H Hayes, Lynn Mahony, Brian W Mccrindle, Matthew E Oster, Victoria Pemberton, Andrew J Powell, Mark W Russell, Lara S Shekerdemian, Mary Beth Son, Michael Taylor, Jane W Newburger

Faculty, Staff and Students Publications

BACKGROUND: The Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood.

METHODS: This multicenter observational cohort study will enroll at least 600 patientsyears, and optional genetic testing. Cardiac imaging at specific time points includes standardized echocardiographic assessment (all participants) and cardiac magnetic resonance imaging (CMR) in those with left ventricular ejection fraction (LVEF)

CONCLUSION: The MUSIC study, with the largest cohort of MIS-C patients and the longest …

Depression And Anxiety Are Common Among Patients With Cirrhosis, Ruben Hernaez, Jennifer R Kramer, Aisha Khan, Jessica Phillips, Katharine Mccallister, Kassie Chaffin, Adriana Portela Hernandez, Hannah Fullington, Cynthia Ortiz, James-Michael Blackwell, Adam Loewen, Yan Liu, Jasmin A Tiro, Simon C Lee, Amit G Singal

Faculty, Staff and Students Publications

BACKGROUND & AIMS: Depression and anxiety can have negative effects on patients and are important to treat. There have been few studies of their prevalence among patients with cirrhosis. We aimed to characterize the prevalence and risk factors for depression and anxiety in a large multi-center cohort of patients with cirrhosis.

METHODS: We conducted a telephone-based survey of patients with cirrhosis at 3 health systems in the United States (a tertiary-care referral center, a safety net system, and a Veterans hospital) from April through December 2018. Of 2871 patients approached, 1021 (35.6%) completed the survey. Depression and anxiety were assessed …

Disclosures Pursuant To Section 11(S) Of The Federal Reserve Act - Main Street Lending Program, Federal Reserve System: Board Of Governors

Documents

https://www.federalreserve.gov/publications/disclosures-in-response-to-covid-19-pursuant-to-section-11-s.htm

Women And Ethnoracial Minorities With Poor Cardiovascular Health Measures Associated With A Higher Risk Of Developing Mood Disorder, Aixia Guo, Kari A Stephens, Yosef M Khan, James R Langabeer, Randi E Foraker

2020-Current year OA Pubs

BACKGROUND: Mood disorders (MDS) are a type of mental health illness that effects millions of people in the United States. Early prediction of MDS can give providers greater opportunity to treat these disorders. We hypothesized that longitudinal cardiovascular health (CVH) measurements would be informative for MDS prediction.

METHODS: To test this hypothesis, the American Heart Association's Guideline Advantage (TGA) dataset was used, which contained longitudinal EHR from 70 outpatient clinics. The statistical analysis and machine learning models were employed to identify the associations of the MDS and the longitudinal CVH metrics and other confounding factors.

RESULTS: Patients diagnosed with MDS …

Why Secular Society Desperately Needs The Recognition Of Religious Holidays, Bruce Ledewitz

Ledewitz Papers

Published scholarship collected from academic journals, law reviews, newspaper publications & online periodicals.

How Should The Law Adjust To The Rittenhouse Verdict?, Bruce Ledewitz

Newspaper Columns

Collected biweekly contributions to the Pennsylvania Capital-Star, a nonpartisan, nonprofit news site.

Real-World Impact Of Fremanezumab On Migraine Symptoms And Resource Utilization In The United States, Peter Mcallister, Lois Lamerato, Lynda J. Krasenbaum, Joshua M. Cohen, Krishna Tangirala, Stephen Thompson, Maurice Driessen, Julian Casciano, Zenobia Dotiwala, Alexander Mauskop

Public Health Sciences Articles

BACKGROUND: Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), is approved for migraine prevention in adults. Real-world data on the effectiveness of fremanezumab are limited. This retrospective, observational cohort study assessed patient-reported migraine symptoms, health care resource utilization (HCRU), and direct medical costs before and after fremanezumab treatment initiation.

METHODS: Data were extracted from September 2018 through June 2020 from the Midwest component of EMRClaims+®, an integrated health services database containing > 20 million medical records from national commercial insurance claims, Medicare claims, and regional electronic medical records. Patients included in the cohort analysis were …

Relationships Among College-Level Science Course Enrollment, Environmental Perception, And Pro-Environmental Attitude: Evidence From The Us General Social Survey, Mazbahul G. Ahamad, Fahian Tanin

Department of Agronomy and Horticulture: Faculty Publications

Understanding pro-environmental attitudes is critical to encouraging pollution-minimizing behaviors. Therefore, identifying associated factors is essential for understanding different types of pro-environmental attitudes. We aimed to investigate the associations among individuals’ college-level science course enrollment and their perceptions of the level of spending to improve and protect the environment, as well as their pro-environmental attitudes. We used nationwide population-based cross-sectional survey data from 2,348 individuals obtained from the General Social Survey in the United States. An ordered logistic model was used to examine the associations among college-level science course enrollment, environmental perception, and pro-environmental attitude. We found that science course enrollment …

Phase 3 Safety And Efficacy Of Azd1222 (Chadox1 Ncov-19) Covid-19 Vaccine, Ann R Falsey, Magdalena E Sobieszczyk, Ian Hirsch, Stephanie Sproule, Merlin L Robb, Lawrence Corey, Kathleen M Neuzil, William Hahn, Julie Hunt, Mark J Mulligan, Charlene Mcevoy, Edwin Dejesus, Michael Hassman, Susan J Little, Barbara A Pahud, Anna Durbin, Paul Pickrell, Eric S Daar, Larry Bush, Joel Solis, Quito Osuna Carr, Temitope Oyedele, Susan Buchbinder, Jessica Cowden, Sergio L Vargas, Alfredo Guerreros Benavides, Robert Call, Michael C Keefer, Beth D Kirkpatrick, John Pullman, Tina Tong, Margaret Brewinski Isaacs, David Benkeser, Holly E Janes, Martha C Nason, Justin A Green, Elizabeth J Kelly, Jill Maaske, Nancy Mueller, Kathryn Shoemaker, Therese Takas, Richard P Marshall, Menelas N Pangalos, Tonya Villafana, Antonio Gonzalez-Lopez

Faculty, Staff and Student Publications

BACKGROUND: The safety and efficacy of the AZD1222 (ChAdOx1 nCoV-19) vaccine in a large, diverse population at increased risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the United States, Chile, and Peru has not been known.

METHODS: In this ongoing, double-blind, randomized, placebo-controlled, phase 3 clinical trial, we investigated the safety, vaccine efficacy, and immunogenicity of two doses of AZD1222 as compared with placebo in preventing the onset of symptomatic and severe coronavirus disease 2019 (Covid-19) 15 days or more after the second dose in adults, including older adults, in the United States, Chile, and Peru.

RESULTS: …

The Five Ds Of Outpatient Antibiotic Stewardship For Urinary Tract Infections, Melanie C Goebel, Barbara W Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

Urinary tract infections (UTI) are one of the most common indications for antibiotic prescriptions in the outpatient setting. Given rising rates of antibiotic resistance among uropathogens, antibiotic stewardship is critically needed to improve outpatient antibiotic use, including in outpatient clinics (primary care and specialty clinics) and emergency departments. Outpatient clinics are in general a neglected practice area in antibiotic stewardship programs, yet most antibiotic use in the United States is in the outpatient setting. This article provides a comprehensive review of antibiotic stewardship strategies for outpatient UTI in the adult population, with a focus on the "five Ds" of stewardship …

The Flag Can Travel But The Constitution Must Ask Permission: How The First Circuit And The District For Puerto Rico Commit To Equal Protection Without Abandoning The Insular Cases Doctrine, Alejandro J. Anselmi González

University of Miami Inter-American Law Review

For American citizens, one of the most important safeguards guaranteed by the Constitution of the United States is the equal protection of the law. The United States prides itself on the doctrine and jurisprudence of equal protection because of the social progression achieved since the end of the Civil War. The Reconstruction Amendments to the Constitution eliminated the institution of slavery and were supposed to guarantee equal civil and legal status to all citizens. The Constitution, however, has not been consistently interpreted in this way since the end of the Spanish-American War in 1898. The nation emerged from this conflict …

Covid–19, Housing And Evictions: A Comparative Case Study Of Housing Law And Policy In The United States And Argentina Through An International Human Rights Lens, Lily Frances Fontenot

University of Miami Inter-American Law Review

This Note seeks to address the impact of international human rights obligations on domestic housing laws and policies through a comparative case study of Argentina and the United States. Specifically, it will discuss each country’s response to the COVID-19 pandemic, their housing obligations under international human rights law, and how each country is addressing their own unique housing and eviction crises. Finally, this Note will offer recommendations on how each country should modify their housing policies in light of the pandemic in order to comply with international human rights standards.

Legal And Ethical Implications Of U.S. And Canadian Vaccine Contracts: The Impact Of Vaccine Nationalism On The Global Pandemic Response, Ryan S. Tahiri

University of Miami Inter-American Law Review

This note explores the COVID-19 vaccine contracts between the U.S. and Canada and the impact of these types of agreements on the global pandemic response. These “pre-purchases,” many of which were executed before the development of a vaccine, have afforded a select few nations the opportunity to stockpile vaccines, while other nations with fewer resources are unable to secure any doses. An effective method to counter the effects of the pandemic is the creation of a global vaccine network that provides equitable access to vaccine doses for nations in need. COVAX was launched to ensure that lower and middle-income nations …

Stop Calling Kyle Rittenhouse A Hero. He Killed Two Unarmed People, Bruce Ledewitz

Newspaper Columns

Collected biweekly contributions to the Pennsylvania Capital-Star, a nonpartisan, nonprofit news site.

Electronically Available Patient Claims Data Improve Models For Comparing Antibiotic Use Across Hospitals: Results From 576 Us Facilities, Katherine E Goodman, Lisa Pineles, Laurence S Magder, Deverick J Anderson, Elizabeth Dodds Ashley, Ronald E Polk, Hude Quan, William E Trick, Keith F Woeltje, Surbhi Leekha, Sara E Cosgrove, Anthony D Harris

2020-Current year OA Pubs

BACKGROUND: The Centers for Disease Control and Prevention (CDC) uses standardized antimicrobial administration ratios (SAARs)-that is, observed-to-predicted ratios-to compare antibiotic use across facilities. CDC models adjust for facility characteristics when predicting antibiotic use but do not include patient diagnoses and comorbidities that may also affect utilization. This study aimed to identify comorbidities causally related to appropriate antibiotic use and to compare models that include these comorbidities and other patient-level claims variables to a facility model for risk-adjusting inpatient antibiotic utilization.

METHODS: The study included adults discharged from Premier Database hospitals in 2016-2017. For each admission, we extracted facility, claims, and …

Insulin And Glucose Metabolism With Olanzapine And A Combination Of Olanzapine And Samidorphan: Exploratory Phase 1 Results In Healthy Volunteers, Frederico G S Toledo, William F Martin, Linda Morrow, Carine Beysen, Daiva Bajorunas, Ying Jiang, Bernard L Silverman, David Mcdonnell, Mark N Namchuk, John W Newcomer, Christine Graham

Open Access Publications

A combination of olanzapine and samidorphan (OLZ/SAM) received US Food and Drug Administration approval in May 2021 for the treatment of adults with schizophrenia or bipolar I disorder. OLZ/SAM provides the efficacy of olanzapine, while mitigating olanzapine-associated weight gain. This exploratory study characterized the metabolic profile of OLZ/SAM in healthy volunteers to gain mechanistic insights. Volunteers received once-daily oral 10 mg/10 mg OLZ/SAM, 10 mg olanzapine, or placebo for 21 days. Assessments included insulin sensitivity during an oral glucose tolerance test (OGTT), hyperinsulinemic-euglycemic clamp, other measures of glucose/lipid metabolism, and adverse event (AE) monitoring. Treatment effects were estimated with analysis …

Fostering Distance Education: Lessons From A United States-England Partnered Collaborative Online International Learning Approach, Lucy A. Ingram, Courtney M. Monroe, Haley Wright, Amy Burrell, Rebecca Jenks, Simon Cheung, Daniela B. Friedman Ph.D.

Faculty Publications

Collaborative Online International Learning (COIL) is a teaching and learning approach whereby entire courses or modules are co-developed and team taught by instructors from different institutions for students of both institutions. Since 2006, the approach has been gaining in mass appeal; however, considering our present-day global coronavirus pandemic, COILs have a renewed relevance in academia. Faculty from the University of South Carolina (United States) and Coventry University (England) embarked on a COIL partnership yielding a valuable experience that can serve as a model for other institutions that are interested in developing innovative and cross-cultural distance learning opportunities. The purpose of …