Medicine and Health Sciences Commons^™

Test–Retest Reliability And Minimal Detectable Change Of Corticospinal Tract Integrity In Chronic Stroke, Allison F. Lewis, Makenzie Myers, Jenny Heiser, Jessica F. Baird, Jill C. Stewart

Faculty Publications

Diffusion tensor imaging (DTI) can be used to index white matter integrity of the corticospinal tract (CST) after stroke; however, the psychometric properties of DTI‐based measures of white matter integrity are unknown. The purpose of this study was to examine test–retest reliability as determined by intraclass correlation coefficients (ICC) and calculate minimal detectable change (MDC) of DTI‐based measures of CST integrity using three different approaches: a Cerebral Peduncle approach, a Probabilistic Tract approach, and a Tract Template approach. Eighteen participants with chronic stroke underwent DTI on the same magnetic resonance imaging scanner 4 days apart. For the Cerebral Peduncle approach, …

Icope A Multi-Level, Cluster Randomized, 36-Month, Parallel-Group Study To Assess The Efficacy Of Hiv Disclosure Intervention In Hiv Parental Disclosure Among Parents Living With Hiv In China, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

Objectives: Parents living with HIV who disclose their HIV status to their children could benefit from the parental HIV disclosure. However, it is also very challenging because of persistent stigma and discrimination against HIV. This report describes the study design and protocol of the “Interactive Communication with Openness, Passion, and Empowerment (iCOPE)” randomized controlled trial aimed at assisting parents living with HIV in conducting culturally and developmentally appropriate disclosure to their uninfected children in China through trainings among both parents living with HIV and healthcare providers.

Methods: A total of 791 parents living with HIV with children aged between 6 …

Agricultural And Finance Intervention Increased Dietary Intake And Weight Of Children Living In Hiv-Affected Households In Western Kenya, Lisa M. Butler, Shiva Bhandari, Phelgona Otieno, Sheri D. Weiser, Craig R. Cohen, Edward A. Frongillo Jr.

Faculty Publications

We tested whether a multisectoral household agricultural and finance intervention increased the dietary intake and improved the nutritional status of HIV-affected children. Two hospitals in rural Kenya were randomly assigned to be either the intervention or the control arm. The intervention comprised a human-powered water pump, microfinance loan for farm commodities, and training in sustainable farming practices and financial management. In each arm, 100 children (0-59 mo of age) were enrolled from households with HIV-infected adults 18-49 y old. Children were assessed beginning in April 2012 and every 3 mo for 1 y for dietary intake and anthropometry. Children in …

Gestational Infections And Obesity: Implications For Intellectual Disability Risk, Maggie S. J. Mccarter

Theses and Dissertations

Maternal body weight, measured as Body Mass Index (BMI) and infection during pregnancy are established risk factors of multiple adverse birth outcomes that are also associated with intellectual disability (ID) in children, but little is known of the interaction of these two factors. This retrospective cohort study sought to explore whether BMI is an effect modifier in the association between maternal infection during pregnancy and ID of the child, and to make comparisons between categories of gestational infection. The study sample (n= 124,047 after exclusion) was derived from Medicaid administrative data. After preliminary analysis of interaction, stratified logistic regression analysis …

Social, Economic, And Political Events Affect Gender Equity In China, Nepal, And Nicaragua: A Matched, Interrupted Time-Series Study, Tuan T. Nguyen, Ashley Darnell, Amy Weissman, Edward A. Frongillo Jr., Roger Mathisen, Karin Lapping, Timothy D. Mastro, Mellissa Withers

Faculty Publications

: Progress in gender equity can improve health at the individual and country levels.: This study's objective was to analyze recent trends in gender equity and identify historical and contextual factors that contributed to changes in gender equity in three countries: China, Nepal, and Nicaragua.: To assess gender equity trends, we used the Gender Gap Index (GGI) from the World Economic Forum's Global Gender Gap Report (2006-2017). The GGI incorporated data on economic participation, educational attainment, health, and political empowerment for almost 150 countries. We selected China, Nepal, and Nicaragua because of their major changes in GGI and diversity in …

Nutrition Intervention Using Behavioral Change Communication Without Additional Material Inputs Increased Expenditures On Key Food Groups In Bangladesh, Andrea M. Warren, Edward A. Frongillo, Phuong H. Nguyen, Purnima Menon

Faculty Publications

Background

Behavioral change communication (BCC) promotes skills and knowledge to improve infant and young child feeding, but without additional material inputs, recipients must develop strategies to translate knowledge into action. Using data from the Alive & Thrive initiative in Bangladesh (2010–2014), we aimed to test whether households receiving the intensive intervention (opposed to the nonintensive intervention) increased expenditures on key foods for mothers and children (e.g., foods that were promoted by the intervention and also changed in maternal and child diets).

Methods

The intensive intervention provided interpersonal counseling, community mobilization, and mass media campaigns to promote breastfeeding and complementary feeding. …

Research With Novel Technology: Advances In Concussion Diagnosis And Mouthpiece Utilization During Performance, Dena P. Garner

Journal of the South Carolina Academy of Science

No abstract provided.

Effects Of The Affordable Care Act On The Receipt Of Colonoscopies Among The Insured Elderly, Minjee Lee, M Mahmud Khan, Heather M. Brandt, Ramzi G. Salloum, Brian Chen

Faculty Publications

BACKGROUND: The Affordable Care Act (ACA) waived deductibles and eliminated coinsurance for colonoscopies for Medicare beneficiaries beginning in January 1, 2011. This study investigated the effect of the ACA's directive to remove the financial barriers on the receipt of colonoscopies among the elderly insured, who are predominantly covered by Medicare. METHODS: Data from the 2008-2016 Behavioral Risk Factor Surveillance System (BRFSS) were used to examine the receipt of colonoscopies in two years prior to the implementation of the ACA (2008 and 2010) and three years after the change (2012, 2014, and 2016). Multivariate logistic regressions were estimated to examine the …

Mother-Child Dyadic Influences Of Affect On Everyday Movement Behaviors: Evidence From An Ecological Momentary Assessment Study, Chih-Hsiang Yang, Jimi Huh, Tyler B. Mason, Britni R. Belcher, Martina Kanning, Genevieve F. Dunton

Faculty Publications

Background

Research has shown that affect is associated with everyday movement behaviors in children and adults. However, limited work to date has investigated dyadic influences of momentary affect on moderate-to-vigorous physical activity (MVPA) and sedentary time among children and their mothers using ecological momentary assessment (EMA).

Methods

Mothers and their children (eight to 12-years-old at baseline) from the Los Angeles metropolitan area participated in a longitudinal study with six semi-annual measurement waves across three years. During each measurement wave, mothers and children reported momentary negative and positive affect via a custom smartphone-based EMA application across seven days (randomly sampled up …

Healthcare Practitioners’ Views Of Social Media As An Educational Resource, Adam G. Pizzuti, Karan H. Patel, Erin K. Mccreary, Emily Heil, Christopher M. Bland, Eric Chinaeke, Bryan L. Love, P Brandon Bookstaver

Faculty Publications

Social media is increasingly utilized as a resource in healthcare. We sought to identify perceptions of using social media as an educational tool among healthcare practitioners. An electronic survey was distributed to healthcare administrators, nurses, nurse practitioners, pharmacists, physicians, and physician assistants f hospital systems and affiliated health science schools in Georgia, Maryland, South Carolina, and Wisconsin. Survey questions evaluated respondents' use and views of social media for educational purposes and workplace accessibility using a Likert scale (1 = strongly disagree, 5 = strongly agree). Nurses (75%), pharmacists (11%), and administrators (7%) were the most frequent respondents. Facebook® (27%), Pinterest® …

Evaluating Appropriateness And Diagnostic Stewardship Opportunities Of Multiplex Polymerase Chain Reaction Gastrointestinal Testing Within A Hospital System, Melissa O'Neal, Hanna Murray, Sangita Dash, Majdi N. Al-Hasan, Julie Ann Justo, P Brandon Bookstaver

Faculty Publications

Objective: This single-center, retrospective, observational cohort study evaluates the appropriateness of the BioFire® FilmArray® Gastrointestinal (GI) multiplex PCR panel testing at a community-teaching hospital. Methods: All adult, hospitalized patients at Prisma Health Richland Hospital with a documented GI multiplex PCR panel from 1 April 2015 through 28 February 2018 were included in the analysis. Inappropriate use of the GI panel was defined as a test obtained without documented diarrhea, greater than 2 days of hospitalization, redundant use with other diagnostic tests (e.g. PCR), or laxative use in the preceding 48 h. Antibiotic use and host variables were compared between groups …

Association Of Patient-Centered Medical Home Designation And Quality Indicators Within Hrsa-Funded Community Health Center Delivery Sites, Nathaniel Bell, Rebecca Wilkerson, Kathy Mayfield-Smith, Ana Lopez-De Fede

Publications

Background: Patient-Centered Medical Home (PCMH) adoption is an important strategy to help improve primary care quality within Health Resources and Service Administration (HRSA) community health centers (CHC), but evidence of its effect thus far remains mixed. A limitation of previous evaluations has been the inability to account for the proportion of CHC delivery sites that are designated medical homes. Methods: Retrospective cross-sectional study using HRSA Uniform Data System (UDS) and certification files from the National Committee for Quality Assurance (NCQA) and the Joint Commission (JC). Datasets were linked through geocoding and an approximate string-matching algorithm. Predicted probability scores were regressed …

Community Social Determinants And Health Outcomes Drive Availability Of Patient-Centered Medical Homes, Nathaniel Bell, Rebecca Wilkerson, Kathy Mayfield-Smith, Ana Lopez-De Fede

Publications

The collaborative design of America’s patient-centered medical homes places these practices at the forefront of emerging efforts to address longstanding inequities in the quality of primary care experienced among socially and economically marginalized populations. We assessed the geographic distribution of the country’s medical homes and assessed whether they are appearing within communities that face greater burdens of disease and social vulnerability. We assessed overlapping spatial clusters of mental and physical health surveys; health behaviors, including alcohol-impaired driving deaths and drug overdose deaths; as well as premature mortality with clusters of medical home saturation and community socioeconomic characteristics. Overlapping spatial clusters …

Online Availability Of Fish Antibiotics And Documented Intent For Self-Medication, Weiwei Zhang, Austin Williams, Nicole Griffith, Jessica Gaskins, P Brandon Bookstaver

Faculty Publications

Self-medication and antibiotic utilization without healthcare oversight may lead to delayed appropriate treatment, transmission of communicable infections, untoward adverse events, and contribute to antimicrobial resistance. Previous data suggest people obtain over-the-counter (OTC) animal antibiotics for their personal use. This study examined the availability of OTC fish antibiotics online and the documented intent for self-medication. The authors conducted a web-based cross-sectional study using Google search engine to identify vendor websites selling fish antibiotics in the United States. Vendor websites were included if product information, consumer reviews, and comments were publicly available. Nine fish antibiotics were chosen due to their possibility of …

Explainable Ai Using Knowledge Graphs, Manas Gaur, Ankit Desai, Keyur Faldu, Amit Sheth

Publications

During the last decade, traditional data-driven deep learning (DL) has shown remarkable success in essential natural language processing tasks, such as relation extraction. Yet, challenges remain in developing artificial intelligence (AI) methods in real-world cases that require explainability through human interpretable and traceable outcomes. The scarcity of labeled data for downstream supervised tasks and entangled embeddings produced as an outcome of self-supervised pre-training objectives also hinders interpretability and explainability. Additionally, data labeling in multiple unstructured domains, particularly healthcare and education, is computationally expensive as it requires a pool of human expertise. Consider Education Technology, where AI systems fall along a …

Developing Implementation Research Capacity: Longitudinal Evaluation Of The King’S College London Implementation Science Masterclass, 2014-2019, Rachel Davis, Brian Mittman, Madelene Boyton, Aoife Keohane, Lucy Goulding, Jane Sandall, Graham Thornicroft, Nick Sevdalis

Faculty Publications

Background: Despite an increasing number of training opportunities in implementation science becoming available, the demand for training amongst researchers and practitioners is unmet. To address this training shortfall, we developed the King's College London 'Implementation Science Masterclass' (ISM), an innovative 2-day programme (and currently the largest of its kind in Europe), developed and delivered by an international faculty of implementation experts. Methods: This paper describes the ISM and provides delegates' quantitative and qualitative evaluations (gathered through a survey at the end of the ISM) and faculty reflections over the period it has been running (2014-2019). Results: Across the 6-year evaluation, …