Medicine and Health Sciences Commons^™

Choices And Consequences: A Mind Is A Terrible Thing To Waste, Ian Elmore-Moore, Demecca Jones, Jalani Traxler, John Doyle, Jimez Alexander

National Youth Advocacy and Resilience Conference

Choices and Consequences: A Mind is a Terrible thing to Waste, is designed for school and community leaders to learn about the human brain. According to Dr. Nirav Shah, a board certified neurosurgeon, “The brain is arguably the most important organ in the human body. It controls and coordinates actions and reactions, allows us to think and feel, and enables us to have memories and feelings – all the things that make us human”. Within our presentation we will highlight the benefits or incorporating brain based instructional practices into the modern classroom. We will display our innovative brain based curriculum …

Differences In Mental Health Education Across Baby Boomers, Generation X, And Millennials, Ashlyn M. Avera

Honors College Theses

There is no denying that mental illness has gained a strong prevalence in the United States. According to the National Alliance on Mental Illness, approximately one in five adults in the United States experiences a mental illness in any given year. Although mental health stigmas have played a role in the past, it does not mean they must continue to play the same role in the future. Research is now looking toward ways to decrease mental health stigma through increasing mental health knowledge. This study examines the starting point for which a society becomes literate in mental health. Using a …

2484: Establishment Of The Tennessee-Sickle Cell Disease Network As A Mechanism For Engaging A Rare Disease Population In Patient Centered Outcomes Research, Tilicia Mayo-Gamble, Velma Mcbride Murry, Michael R. Debaun

Department of Health Policy and Community Health Faculty Publications

OBJECTIVES/SPECIFIC AIMS: Despite the high prevalence of individuals diagnosed with sickle cell disease (SCD) in Tennessee, comprehensive care and education for patients with SCD is not as widely available as healthcare services for individuals managing other chronic illnesses. We aimed to engage SCD stakeholders in patient-centered outcomes research (PCOR) as a mechanism for advancing care and translational research for this rare disease population. METHODS/STUDY POPULATION: Through a partnership with the Sickle Cell Foundation of Tennessee, we implemented Community Health Ambassadors to systematically engage patient partners with SCD and their caregivers, aged 18–50 from rural and urban communities throughout Tennessee, in …

Using The Roc Curve To Measure Association And Evaluate Prediction Accuracy For A Binary Outcome, Jingjing Yin, Robert L. Vogel

Biostatistics Faculty Publications

This review article addresses the ROC curve and its advantage over the odds ratio to measure the association between a continuous variable and a binary outcome. A simple parametric model under the normality assumption and the method of Box-Cox transformation for non-normal data are discussed. Applications of the binormal model and the Box-Cox transformation under both univariate and multivariate inference are illustrated by a comprehensive data analysis tutorial. Finally, a summary and recommendations are given as to the usage of the binormal ROC curve.

Eating Disorders: Identifying, Assessing, And Treatment, Valerie M. Miranda

National Youth Advocacy and Resilience Conference

This presentation will address DSM-V criteria for feeding and eating disorders, demographics for eating disorders, long-term medical issues associated with eating disorders, assessment measures for feeding and eating disorders, and resources for the community. Being able to identify, assess, and treat eating disorders within the children and adolescent population is crucial in their long-term physical development and mental health as eating disorders typically begin in mid-adolescence.

Using Ranked Auxiliary Covariate As A More Efficient Sampling Design For Ancova Model: Analysis Of A Psychological Intervention To Buttress Resilience, Rajai Jabrah, Hani Samawi, Robert Vogel, Haresh Rochani, Daniel Linder

Biostatistics Faculty Publications

Drawing a sample can be costly or time consuming in some studies. However, it may be possible to rank the sampling units according to some baseline auxiliary covariates, which are easily obtainable, and/or cost efficient. Ranked set sampling (RSS) is a method to achieve this goal. In this paper, we propose a modified approach of the RSS method to allocate units into an experimental study that compares L groups. Computer simulation estimates the empirical nominal values and the empirical power values for the test procedure of comparing L different groups using modified RSS based on the regression approach in analysis …

Goal Orientation, Motivational Climate, And Exercise As Predictors Of Eating Disorder Risk Factors Among College Students, Carly Wahl

Electronic Theses and Dissertations

College is a transition period in a young adult’s life in which eating disorder symptomology is especially prevalent. Additionally, motivation-based factors such as goal orientation and motivational climate can influence these eating disorder-like behaviors, especially in a physical activity setting. The present study aimed to examine how goal orientation, motivational climate, and exercise could be used to predict a college students’ eating disorder symptomology. Participants included 276 college-aged males and females from a university in the southeastern United States. These participants had experience using the university recreation activity center and were recruited from a required healthful living course. Each participant …

Examining Preference Of Home-Based Telemental Health Among Rural Veterans, Paige Dixon

Electronic Theses and Dissertations

Rural veterans face significant disparities to health care that have resulted in lower physical and mental health related quality of life when compared to their urban counterparts (Weeks et al., 2006). Such disparities are further complicated by the six-fold increase in prevalence of mental health diagnoses among Operation Enduring Freedom and Operation Iraqi Freedom veterans (Seal et al., 2009). These rising rates are particularly relevant to rural veterans as they represent 41% of the overall Veteran Health Administration enrollees, but only 19% of the general population (U.S., Department of Veterans Affairs, 2012; U.S. Census Bureau, 2014). Rural veterans face three …

Cyberbullying And Self-Perceptions Of Students Associated With Their Academic Performance, Maham Muzamil, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

The aim of this study is to explore the factors influencing students’ academic achievements in secondary school level (grades 09 and 10). Those factors include students’ self-reported psychological and issues (e.g. being bullied through social media) as well as socioeconomic status. Study participants included610 students at senior secondary level (237 male and 363 female) randomly selected from ten different government schools. The schools were randomly selected from the lists provided by their respective Education District Officer (EDO). The data were collected by researchers with the help of teachers. Participants’ were offered as incentives a drawing for a gift certificate. Bivariate …

Evaluating The Efficiency Of Treatment Comparison In Crossover Design By Allocating Subjects Based On Ranked Auxiliary Variable, Yisong Huang, Hani Samawi, Robert Vogel, Jingjing Yin, Worlanyo E. Gato, Daniel Linder

Biostatistics Faculty Publications

The validity of statistical inference depends on proper randomization methods. However, even with proper randomization, we can have imbalanced with respect to important characteristics. In this paper, we introduce a method based on ranked auxiliary variables for treatment allocation in crossover designs using Latin squares models. We evaluate the improvement of the efficiency in treatment comparisons using the proposed method. Our simulation study reveals that our proposed method provides a more powerful test compared to simple randomization with the same sample size. The proposed method is illustrated by conducting an experiment to compare two different concentrations of titanium dioxide nanofiber …

Estimation Of P(X > Y) When X And Y Are Dependent Random Variables Using Different Bivariate Sampling Schemes, Hani M. Samawi, Amal Helu, Haresh Rochani, Jingjing Yin, Daniel Linder

Biostatistics Faculty Publications

The stress-strength models have been intensively investigated in the literature in regards of estimating the reliability θ = P (X > Y) using parametric and nonparametric approaches under different sampling schemes when X and Y are independent random variables. In this paper, we consider the problem of estimating θ when (X, Y) are dependent random variables with a bivariate underlying distribution. The empirical and kernel estimates of θ = P (X > Y), based on bivariate ranked set sampling (BVRSS) are considered, when (X, Y) are paired dependent continuous random variables. The estimators obtained are compared to their counterpart, bivariate simple random …

Fulfilling Community Health Assessment Requirements: Lessons Learned From Facilitating State-Wide Community Health Forums, Ashley D. Walker, Angela Peden, Stuart H. Tedders, John S. Barron, Aaron Jackson, Nicholas Williams, Bethrand Ugwu

Community Health Faculty Publications

Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency.

Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums.

Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status.

Conclusion: Lessons learned from these state-wide community health forums can be applied to …

Improved Estimation Of Optimal Cut-Off Point Associated With Youden Index Using Ranked Set Sampling, Jingjing Yin, Hani M. Samawi, Daniel Linder

Biostatistics Faculty Publications

A diagnostic cut-off point of a biomarker measurement is needed for classifying a random subject to be either diseased or healthy. However, the cut-off point is usually unknown and needs to be estimated by some optimization criteria. One important criterion is the Youden index, which has been widely adopted in practice. The Youden index, which is defined as the maximum of (sensitivity + specificity −1), directly measures the largest total diagnostic accuracy a biomarker can achieve. Therefore, it is desirable to estimate the optimal cut-off point associated with the Youden index. Sometimes, taking the actual measurements of a biomarker is …

“Don’T Shoot The Unicorn!” Finding Transformative Happiness And Resilience Through Developing Your “Anditude”!, M. Bruce Garris, Gary W. Mauk

National Youth Advocacy and Resilience Conference

As a care provider and leader in your community, you understand the challenge of keeping your own resilience high, and maintaining an attitude of hope. This transformational, uplifting program will equip you to develop the skill of happiness, empowering you to lead youths by demonstrating positive approaches in your own life, and impacting them with “Infectious Resilience” as they learn to adopt your Anditude!

A Test Of Symmetry Based On The Kernel Kullback-Leibler Information With Application To Base Deficit Data, Hani M. Samawi, Robert L. Vogel

Biostatistics Faculty Publications

The assumption of the symmetry of the underlying distribution is important to many statistical inference and modeling procedures. This paper provides a test of symmetry using kernel density estimation and the Kullback-Leibler information. Based on simulation studies, the new test procedure outperforms other tests of symmetry found in the literature, including the Runs Test of Symmetry. We illustrate our new procedure using real data.

Correction Of Verication Bias Using Log-Linear Models For A Single Binaryscale Diagnostic Tests, Haresh Rochani, Hani M. Samawi, Robert L. Vogel, Jingjing Yin

Biostatistics Faculty Publications

In diagnostic medicine, the test that determines the true disease status without an error is referred to as the gold standard. Even when a gold standard exists, it is extremely difficult to verify each patient due to the issues of costeffectiveness and invasive nature of the procedures. In practice some of the patients with test results are not selected for verification of the disease status which results in verification bias for diagnostic tests. The ability of the diagnostic test to correctly identify the patients with and without the disease can be evaluated by measures such as sensitivity, specificity and predictive …

Monitoring For Adverse Events Post Marketing Approval Of Drugs, Karl E. Peace, Macaulay Okwuokenye

Biostatistics Faculty Publications

This brief communication provides information to those developing monitoring plans for serious adverse events (SAE’s) following regulatory approval of a new drug. In addition, we (1) illustrate how many patients would need to be treated in order to have high confidence of seeing at least 1 pre-specified SAE, (2) show that absence of proof of a SAE is not proof of absence of that SAE, and (3) identify statistical methodology that could be used for formal statistical monitoring of SAE’s.

Our Collective Law Abiding Mental Illness, Gregory J. Brock

Gregory J. Brock

No abstract provided.

Social And Behavioral Implications Of National Collegiate Athletic Association Sickle Cell Trait Screening: The Athletes' Perspective, Raymona H. Lawrence, Alison Scott, Carlton Haywood Jr., Kayin Robinson, Mondi Mason

Community Health Faculty Publications

Background: In August 2010, the National Collegiate Athletic Association (NCAA) implemented a policy mandating sickle cell trait (SCT) testing for all Division I collegiate athletes. Subsequently, all Division II-III athletes were also compelled to undergo SCT testing. This decision has met with controversy among healthcare providers, researchers, and sickle cell advocates. However, there is little information concerning the athletes’ perspective of this policy. The purpose of this paper is to report the findings of a qualitative study that explored college athletes’ perceptions of sickle cell trait SCT, NCAA policies on SCT testing, and potential implications of SCT screening.

Methods: …

Think Inside The Blocks: Health Literacy Outreach To Disadvantaged People In Their Own Environment, Nancy Patterson

Georgia International Conference on Information Literacy

This bilingual (Spanish/English) poster highlights six creative health literacy outreach projects that have proven to be successful in increasing participation in health-related events in their communities and in boosting health literacy in the process.

For example, in Georgetown, South Carolina, a beauty salon owner, concerned about her clients’ frequent frustration with trying to decipher medical information, partners with her local public library and is grant funded to provide a Wellness Workstation in her salon. Years later, her clients research health information between services using the workstation, evening health literacy classes are regularly conducted for community members and continued funding has …

Exploring Cyber Harassment Among Women Who Use Social Media, Sloane Burke Winkelman, Jody Oomen-Early, Ashley D. Walker, Lawrence Chu, Alice Yick-Flanagan

Community Health Faculty Publications

The number of Internet users around the word is at an all-time high. The majority of North Americans are internet users and over two-thirds participate in some kind of social network (i.e. Facebook, Twitter, etc.). Social networks and mobile technology enable individuals to connect instantaneously or asynchronously, across geographic boundaries publicly or anonymously. Few studies exploring cyber harassment have been conducted, primarily because these technologies are relatively recent. The purpose of this descriptive study was to examine U.S. women's experiences with and attitudes toward cyber harassment by way of an anonymous electronic survey. A total of 293 adult women (mean …

Size And Power Of Tests Of Hypotheses On Survival Parameters From The Lindley Distribution With Covariates, Macaulay Okwuokenye, Karl E. Peace

Biostatistics Faculty Publications

The Lindley model is considered as an alternative model facilitating analyses of time-to-event data with covariates. Covariate information is incorporated using the Cox’s proportional hazard model with the Lindley model at the timedependent component. Simulation studies are performed to assess the size and power of tests of hypotheses on parameters arising from maximum likelihood estimators of parameters in the Lindley model. Results are contrasted with that arising from Cox’s partial maximum likelihood estimator. The Linley model is used to analyze a publicly available data set and contrasted with other models.

Joint Modeling Of Treatment Effect On Time-To-Event Endpoint And Safety Covariates In Control Clinical Trial Data Analysis, Kao-Tai Tsai, Karl E. Peace

Biostatistics Faculty Publications

It is a common practice to perform a separate analysis of efficacy and safety data from clinical trials to estimate the benefit and risk aspects of a particular treatment regimen. However, by doing so, one is likely to miss the complete picture of the treatment effect given that these data are generated from the same study subjects and therefore most likely will be correlated. Therefore, it is desirable to analyze these data jointly to obtain a more complete profile of the treatment regimen. A substantial number of statistical methodologies have been proposed in the last decade to model the time-to-event …

Unsilencing The Voice Within: Expressive Writing As A Therapeutic Tool, Karla L. Sapp

National Youth Advocacy and Resilience Conference

Written words are a very powerful tool that is used to facilitate self-healing, awareness, and growth through the communication of one’s deepest thoughts, emotions, and desires. The purpose of this poster session is to provide mental health providers (community, school, criminal justice) with an overview of expressive writing, forms of expressive writing that can be utilized, and implications for professional practice with At-Risk Youth.

Providing The Teen Outreach Program In School Settings, Phillippia Faust, Tina Thomas, Greg Johnson

National Youth Advocacy and Resilience Conference

MTCI will share the experiences of providing the Teen Outreach Program (TOP). The challenges of providing a year long program within school systems where most students change classes each semester will be addressed, along with effective strategies. The presenters will offer instruction regarding successful program activities for the youth service professional working with high school populations.

Differences In Health Literacy Knowledge And Experiences Among Senior Nursing Students, Sharon S. Williamson, Joanne Chopak-Foss

Community Health Faculty Publications

Background: Low health literacy has been identified as a significant public health problem. Also, higher expenditures due to longer hospital stays have been reported for persons with low health literacy. Nurses can assist patients with low health literacy to reduce their hospital stays and increase compliance with discharge instructions.

Methods: A quantitative, descriptive research design was employed to assess knowledge and experiences of 192 senior nursing students. These students were administered the Health Literacy Knowledge and Experiences Survey (HL-KES), a 2- part survey that included assessment of knowledge about health literacy and experience in working with populations of …

Inequalities And Approximations Of Weighted Distributions By Lindley Reliability Measures, And The Lindley-Cox Model With Applications, Broderick O. Oluyede, Macaulay Okwuokenye, Karl E. Peace

Biostatistics Faculty Publications

In this note, stochastic comparisons and results for weighted and Lindley models are presented. Approximation of weighted distributions via Lindley distribution in the class of increasing failure rate (IFR) and decreasing failure rate (DFR) weighted distributions with monotone weight functions are obtained including approximations via the length-biased Lindley distribution. Some useful bounds and moment-type inequality for weighted life distributions and applications are presented. Incorporation of covariates into Lindley model is considered and an application to illustrate the usefulness and applicability of the proposed Lindley-Cox model is given.

How Long Does That 10-Year Smoke Alarm Really Last? A Survival Analysis Of Smoke Alarms Installed Through The Saife Program In Rural Georgia, Haresh Rochani, Valamar Malika Reagon, Steve Davidson

Biostatistics Faculty Publications

Background: When functioning properly, a smoke alarm alerts individuals in the residence that smoke is near the alarm. Smoke alarms serve as a primary prevention mechanism to abate morbidity and mortality related to residential fires.

Methods: Using survival analysis, we examined the length of operability of 10-year lithium battery powered smoke alarms installed through the Georgia Public Health/CDC SAIFE program in Moultrie, Georgia. Attempts were made to reach all homes in the city limits. The premise of the study is that geographic clusters (in the case of Moultrie city quadrants) are associated with decreases in the length of time that …

A More Efficient Nonparametric Test Of Symmetry Based On Overlapping Coefficient, Hani M. Samawi, Robert L. Vogel

Biostatistics Faculty Publications

In this paper we provide a more efficient nonparametric test of symmetry based on the empirical overlap coefficient using kernel density estimation applied to an extreme order statistics, namely extreme ranked set sampling. Our simulation investigation reveals that our proposed test of symmetry is at least as powerful as currently available tests of symmetry. Intensive simulation is conducted to examine the power of the proposed test. An illustration is provided using cardiac output and body weight of neonates in a neonatal intensive care unit.

Overview Of Inference About Roc Curve In Medical Diagnosis, Jingjing Yin

Biostatistics Faculty Publications

Medical diagnosis aims to identify diseased individuals through the evaluation of the measurements of some biomarkers by performing a diagnostic test based on some biomarker measurements. Biomarkers are measured on either discrete or continuous scale and continuous biomarkers are utilized more often in medical practice. This article introduces the most popular tool for evaluating continuous biomarkers: the Receiver Operating Characteristic (ROC) curve.