Matching Items (101)
Description
The purpose of this report is to review the current literature concerning management of the COVID-19 pandemic in homeless populations, and to use it to analyze the specific interventions established in Maricopa County—such as those aimed at education, vaccination and testing, and maintaining continuity of care. In doing so, I hope to illustrate the unique challenges faced by people experiencing homelessness, provide context for disparities in health outcome, and inform action for both the ongoing pandemic and future outbreaks
ContributorsNewell, James (Author) / Gaughan, Monica (Thesis director) / Hruschka, Daniel (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / Watts College of Public Service & Community Solut (Contributor)
Created2022-05
Description
Opioid use disorder (OUD) has been a growing problem in the United States since the start of the 20th century, but a new wave of the “Opioid Epidemic” began in the mid-1990s when the use of opioid analgesics became the premier method for treating acute pain. In response to the increasing rates of OUD, in 2002 the Federal Drug Administration (FDA) approved a treatment course known as medication-assisted treatment (MAT), which is a combination therapy that uses buprenorphine, a partial opioid analgesic, and behavioral therapy to treat OUD. However, the use of buprenorphine to treat OUD is relatively controversial and as a result, is not widespread in primary care settings. New Mexico is an area that has seen some of the highest rates of OUD, with patient populations that suffer from the disorder prevalent in both rural and urban areas. This paper seeks to identify the barriers that urban and rural medical providers face when it comes to successfully establishing medication-assisted treatment options for opioid use disorder patients. To answer this question, 20 medical practitioners across the state of New Mexico shared their opinions on the subject in semi-structured interviews. A qualitative analysis of the information gathered from these interviews concluded that there are 3 main barriers (patient-related, provider-related, and medical system-related) that contribute to the inconsistent spread of MAT services in New Mexico. These barriers are relatively consistent across both rural and urban communities, however, in specific instances, they manifest differently. The preliminary findings from this study highlight multiple methods for reducing barriers to the implementation of MAT including starting provider education about OUD and MAT earlier (i.e. in residency) and improving the infrastructure and support systems available to vulnerable patient groups (including those in rural areas and homeless individuals).
ContributorsPentecost, Abigail (Author) / Hruschka, Daniel (Thesis director) / Drake, Alexandria (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor)
Created2022-05
Description
HIV/AIDS remains a pressing global health challenge, not only because of its medical complexities but also due to associated stigma and the lack of knowledge of the illness in communities around the world. This thesis analyzed cross-cultural differences and long-term changes in women’s knowledge and stigma around HIV/AIDS in low- and middle-income countries. Using Demographic and Health Survey (DHS) data from 24 countries for knowledge and stigma from 2000-2018, we examined changes in HIV/AIDS knowledge score and stigma score. The findings shed light on the perception of HIV/AIDS knowledge improving while stigma persisted indicative of remaining concerns about the illness amongst women.
ContributorsMurala, Divya Sruthi (Author) / Hruschka, Daniel (Thesis director) / Loebenberg, Abby (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor) / School of Life Sciences (Contributor) / Department of Information Systems (Contributor)
Created2023-12
Description
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
ContributorsDrake, Alexandria (Author) / Hruschka, Daniel (Thesis advisor) / Jehn, Megan (Committee member) / Scott, Mary Alice (Committee member) / Arizona State University (Publisher)
Created2023
Description
Previous work suggests that lower-income individuals are more likely to engage in mutual aid as a means to manage risk, giving rise to a psychology that is other-oriented, including an empathetic disposition and a proclivity to help people in need. While no study has directly investigated whether helping in times of need increases dispositional empathic concern over time, this assumption is deep-seated among social psychologists. Employing a two-year longitudinal survey of US adults (N = 915), I show that people who experience more needs report helping others when in need a greater number of times, in turn leading to a small but positive increase in their empathetic disposition. This study also identifies the types of needs that elicit empathic concern (i.e., those that arise from unpredictable sources of risk), and shows why cultivating an empathetic disposition is likely to pay off in the long run: those who provide help are more likely to receive help during future times of need. Moreover, this study identifies the types of targets for whom providing help might cultivate an empathetic disposition: those with whom people are likely to share lower interdependence. While previous theoretical frameworks posit that empathic concern selectively directs investment towards interdependent others, providing help to non-interdependent targets might allow people to build positive interdependence with prospective risk pooling partners. Cultivating an empathetic disposition and building interdependence with prospective risk pooling partners can allow people to manage needs that arise from unpredictable sources of risk.
ContributorsGuevara Beltran, Diego (Author) / Aktipis, Athena (Thesis advisor) / Hruschka, Daniel (Committee member) / Kenrick, Douglas (Committee member) / Shiota, Michelle (Committee member) / Arizona State University (Publisher)
Created2023
Description
Significant health inequalities exist between different castes and ethnic communities in India, and identifying the roots of these inequalities is of interest to public health research and policy. Research on caste-based health inequalities in India has historically focused on general, government-defined categories, such as “Scheduled Castes,” “Scheduled Tribes,” and “Other Backward Classes.” This method obscures the diversity of experiences, indicators of well-being, and health outcomes between castes, tribes, and other communities in the “scheduled” category. This study analyzes data on 699,686 women from 4,260 castes, tribes and communities in the 2015-2016 Demographic and Health Survey of India to: (1) examine the diversity within and overlap between general, government-defined community categories in both wealth, infant mortality, and education, and (2) analyze how infant mortality is related to community category membership and socioeconomic status (measured using highest level of education and household wealth). While there are significant differences between general, government-defined community categories (e.g., scheduled caste, backward class) in both wealth and infant mortality, the vast majority of variation between communities occurs within these categories. Moreover, when other socioeconomic factors like wealth and education are taken into account, the difference between general, government-defined categories reduces or disappears. These findings suggest that focusing on measures of education and wealth at the household level, rather than general caste categories, may more accurately target those individuals and households most at risk for poor health outcomes. Further research is needed to explain the mechanisms by which discrimination affects health in these populations, and to identify sources of resilience, which may inform more effective policies.
ContributorsClauss, Colleen (Author) / Hruschka, Daniel (Thesis director) / Davis, Mary (Committee member) / Barrett, The Honors College (Contributor) / School of Human Evolution & Social Change (Contributor) / Department of Psychology (Contributor)
Created2022-05
Description
Earth-system models describe the interacting components of the climate system and
technological systems that affect society, such as communication infrastructures. Data
assimilation addresses the challenge of state specification by incorporating system
observations into the model estimates. In this research, a particular data
assimilation technique called the Local Ensemble Transform Kalman Filter (LETKF) is
applied to the ionosphere, which is a domain of practical interest due to its effects
on infrastructures that depend on satellite communication and remote sensing. This
dissertation consists of three main studies that propose strategies to improve space-
weather specification during ionospheric extreme events, but are generally applicable
to Earth-system models:
Topic I applies the LETKF to estimate ion density with an idealized model of
the ionosphere, given noisy synthetic observations of varying sparsity. Results show
that the LETKF yields accurate estimates of the ion density field and unobserved
components of neutral winds even when the observation density is spatially sparse
(2% of grid points) and there is large levels (40%) of Gaussian observation noise.
Topic II proposes a targeted observing strategy for data assimilation, which uses
the influence matrix diagnostic to target errors in chosen state variables. This
strategy is applied in observing system experiments, in which synthetic electron density
observations are assimilated with the LETKF into the Thermosphere-Ionosphere-
Electrodynamics Global Circulation Model (TIEGCM) during a geomagnetic storm.
Results show that assimilating targeted electron density observations yields on
average about 60%–80% reduction in electron density error within a 600 km radius of
the observed location, compared to 15% reduction obtained with randomly placed
vertical profiles.
Topic III proposes a methodology to account for systematic model bias arising
ifrom errors in parametrized solar and magnetospheric inputs. This strategy is ap-
plied with the TIEGCM during a geomagnetic storm, and is used to estimate the
spatiotemporal variations of bias in electron density predictions during the
transitionary phases of the geomagnetic storm. Results show that this strategy reduces
error in 1-hour predictions of electron density by about 35% and 30% in polar regions
during the main and relaxation phases of the geomagnetic storm, respectively.
technological systems that affect society, such as communication infrastructures. Data
assimilation addresses the challenge of state specification by incorporating system
observations into the model estimates. In this research, a particular data
assimilation technique called the Local Ensemble Transform Kalman Filter (LETKF) is
applied to the ionosphere, which is a domain of practical interest due to its effects
on infrastructures that depend on satellite communication and remote sensing. This
dissertation consists of three main studies that propose strategies to improve space-
weather specification during ionospheric extreme events, but are generally applicable
to Earth-system models:
Topic I applies the LETKF to estimate ion density with an idealized model of
the ionosphere, given noisy synthetic observations of varying sparsity. Results show
that the LETKF yields accurate estimates of the ion density field and unobserved
components of neutral winds even when the observation density is spatially sparse
(2% of grid points) and there is large levels (40%) of Gaussian observation noise.
Topic II proposes a targeted observing strategy for data assimilation, which uses
the influence matrix diagnostic to target errors in chosen state variables. This
strategy is applied in observing system experiments, in which synthetic electron density
observations are assimilated with the LETKF into the Thermosphere-Ionosphere-
Electrodynamics Global Circulation Model (TIEGCM) during a geomagnetic storm.
Results show that assimilating targeted electron density observations yields on
average about 60%–80% reduction in electron density error within a 600 km radius of
the observed location, compared to 15% reduction obtained with randomly placed
vertical profiles.
Topic III proposes a methodology to account for systematic model bias arising
ifrom errors in parametrized solar and magnetospheric inputs. This strategy is ap-
plied with the TIEGCM during a geomagnetic storm, and is used to estimate the
spatiotemporal variations of bias in electron density predictions during the
transitionary phases of the geomagnetic storm. Results show that this strategy reduces
error in 1-hour predictions of electron density by about 35% and 30% in polar regions
during the main and relaxation phases of the geomagnetic storm, respectively.
ContributorsDurazo, Juan, Ph.D (Author) / Kostelich, Eric J. (Thesis advisor) / Mahalov, Alex (Thesis advisor) / Tang, Wenbo (Committee member) / Moustaoui, Mohamed (Committee member) / Platte, Rodrigo (Committee member) / Arizona State University (Publisher)
Created2018
Description
Two urban flows are analyzed, one concerned with pollutant transport in a Phoenix, Arizona neighborhood and the other with windshear detection at the Hong Kong International Airport (HKIA).
Lagrangian measures, identified with finite-time Lyapunov exponents, are first used to characterize transport patterns of inertial pollutant particles. Motivated by actual events the focus is on flows in realistic urban geometry. Both deterministic and stochastic transport patterns are identified, as inertial Lagrangian coherent structures. For the deterministic case, the organizing structures are well defined and are extracted at different hours of a day to reveal the variability of coherent patterns. For the stochastic case, a random displacement model for fluid particles is formulated, and used to derive the governing equations for inertial particles to examine the change in organizing structures due to ``zeroth-order'' random noise. It is found that, (1) the Langevin equation for inertial particles can be reduced to a random displacement model; (2) using random noise based on inhomogeneous turbulence, whose diffusivity is derived from $k$-$\epsilon$ models, major coherent structures survive to organize local flow patterns and weaker structures are smoothed out due to random motion.
A study of three-dimensional Lagrangian coherent structures (LCS) near HKIA is then presented and related to previous developments of two-dimensional (2D) LCS analyses in detecting windshear experienced by landing aircraft. The LCS are contrasted among three independent models and against 2D coherent Doppler light detection and ranging (LIDAR) data. Addition of the velocity information perpendicular to the lidar scanning cone helps solidify flow structures inferred from previous studies; contrast among models reveals the intramodel variability; and comparison with flight data evaluates the performance among models in terms of Lagrangian analyses. It is found that, while the three models and the LIDAR do recover similar features of the windshear experienced by a landing aircraft (along the landing trajectory), their Lagrangian signatures over the entire domain are quite different - a portion of each numerical model captures certain features resembling those LCS extracted from independent 2D LIDAR analyses based on observations. Overall, it was found that the Weather Research and Forecast (WRF) model provides the best agreement with the LIDAR data.
Finally, the three-dimensional variational (3DVAR) data assimilation scheme in WRF is used to incorporate the LIDAR line of sight velocity observations into the WRF model forecast at HKIA. Using two different days as test cases, it is found that the LIDAR data can be successfully and consistently assimilated into WRF. Using the updated model forecast LCS are extracted along the LIDAR scanning cone and compare to onboard flight data. It is found that the LCS generated from the updated WRF forecasts are generally better correlated with the windshear experienced by landing aircraft as compared to the LIDAR extracted LCS alone, which suggests that such a data assimilation scheme could be used for the prediction of windshear events.
Lagrangian measures, identified with finite-time Lyapunov exponents, are first used to characterize transport patterns of inertial pollutant particles. Motivated by actual events the focus is on flows in realistic urban geometry. Both deterministic and stochastic transport patterns are identified, as inertial Lagrangian coherent structures. For the deterministic case, the organizing structures are well defined and are extracted at different hours of a day to reveal the variability of coherent patterns. For the stochastic case, a random displacement model for fluid particles is formulated, and used to derive the governing equations for inertial particles to examine the change in organizing structures due to ``zeroth-order'' random noise. It is found that, (1) the Langevin equation for inertial particles can be reduced to a random displacement model; (2) using random noise based on inhomogeneous turbulence, whose diffusivity is derived from $k$-$\epsilon$ models, major coherent structures survive to organize local flow patterns and weaker structures are smoothed out due to random motion.
A study of three-dimensional Lagrangian coherent structures (LCS) near HKIA is then presented and related to previous developments of two-dimensional (2D) LCS analyses in detecting windshear experienced by landing aircraft. The LCS are contrasted among three independent models and against 2D coherent Doppler light detection and ranging (LIDAR) data. Addition of the velocity information perpendicular to the lidar scanning cone helps solidify flow structures inferred from previous studies; contrast among models reveals the intramodel variability; and comparison with flight data evaluates the performance among models in terms of Lagrangian analyses. It is found that, while the three models and the LIDAR do recover similar features of the windshear experienced by a landing aircraft (along the landing trajectory), their Lagrangian signatures over the entire domain are quite different - a portion of each numerical model captures certain features resembling those LCS extracted from independent 2D LIDAR analyses based on observations. Overall, it was found that the Weather Research and Forecast (WRF) model provides the best agreement with the LIDAR data.
Finally, the three-dimensional variational (3DVAR) data assimilation scheme in WRF is used to incorporate the LIDAR line of sight velocity observations into the WRF model forecast at HKIA. Using two different days as test cases, it is found that the LIDAR data can be successfully and consistently assimilated into WRF. Using the updated model forecast LCS are extracted along the LIDAR scanning cone and compare to onboard flight data. It is found that the LCS generated from the updated WRF forecasts are generally better correlated with the windshear experienced by landing aircraft as compared to the LIDAR extracted LCS alone, which suggests that such a data assimilation scheme could be used for the prediction of windshear events.
ContributorsKnutson, Brent (Author) / Tang, Wenbo (Thesis advisor) / Calhoun, Ronald (Committee member) / Huang, Huei-Ping (Committee member) / Kostelich, Eric (Committee member) / Mahalov, Alex (Committee member) / Arizona State University (Publisher)
Created2018
Description
Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal plan use, may help decrease nutrition-related issues.
Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.
Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.
Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.
Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.
Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Contributorsvan Woerden, Irene (Author) / Bruening, Meg (Thesis advisor) / Hruschka, Daniel (Committee member) / Schaefer, David (Committee member) / Vega-Lopez, Sonia (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019
Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015