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Exploring Telehealth Utilization Through Data Analytics, Statistical Analyses, and Machine Learning Techniques
Get PDFThis dissertation investigates the utilization of telehealth services, initially focusing on the Arkansas healthcare system and then extending the analysis nationwide. It aims to understand the factors influencing telehealth adoption and its impact on healthcare delivery. After examining telehealth utilization in Arkansas from 2018 to 2022, the research utilizes a comprehensive dataset from Epic Cosmos, which includes a wide range of patient and visit data from multiple healthcare facilities across the United States from 2018 to 2023. This timeframe allows for a detailed analysis of telehealth trends before, during, and after the COVID-19 pandemic. In Chapter 2, we analyze key demographic and socioeconomic factors affecting telehealth use in Arkansas. We identify population density, broadband subscription, and computer use as significant determinants, with education level and disability also playing crucial roles. These insights are critical for policymakers and healthcare providers to make informed decisions to enhance telehealth accessibility. The findings suggest that improvements in broadband infrastructure, computer literacy, and educational initiatives can significantly enhance telehealth’s effectiveness and reach, particularly in rural and underserved areas. In Chapter 3, we examine the insurance coverage for telehealth services, revealing changes in reimbursement policies and their impact on telehealth and in-person visit patterns. The analysis highlights a decrease in in-person visits covered by Medicare and Medicaid from 2020 to 2022, compared to 2019, underscoring the role of insurance in shaping healthcare delivery trends. We also include a procedure to calculate appointment performance metrics such as waiting time and appointment length. Our analysis reveals Psychiatry, OB/GYN, and Family Medicine had the highest number of telehealth visits. The waiting time for Psychiatry telehealth visits was almost 50% shorter than in-person visits. These findings highlight the potential benefits of telehealth in providing access to healthcare, particularly for patients needing psychiatric care. In Chapter 4, we delve into the resource utilization in telehealth, assessing appointment durations and patient-to-provider ratios across various specialties. We identify specialties with the highest telehealth use and examines geographical variations in telehealth access, particularly between rural and urban regions. Our findings show significant increases in telehealth use, reduced appointment durations, and improved patient-to-provider ratios. The study underscores the potential of telehealth to enhance healthcare accessibility and resource utilization. In conclusion, this dissertation provides valuable insights into the factors driving telehealth adoption and its implications for healthcare delivery. It highlights the need for special intervention in technology and education to enhance telehealth accessibility and effectiveness. The findings contribute to the growing body of knowledge on telehealth, offering practical recommendations for policymakers, healthcare providers, and insurers to improve telehealth services and ensure equitable healthcare access for all populations
Advancing Qualitative Inquiry in Agricultural Communications: An Analysis of Theories, Methodologies, and Standards for Quality
Get PDFThis dissertation offers a deep dive into the evolving landscape of qualitative research within the field of agricultural communications. Through a trio of research articles, this research critically assesses the application of theories, methodologies, and standards for quality across studies published in six disciplinary journals from 2003 to 2023. The first manuscript explores the theoretical frameworks guiding qualitative research in agricultural communications, uncovering a diverse but scattered theoretical underpinning with Framing, Diffusion of Innovations, and Uses and Gratifications Theory emerging as the most prevalent. The second manuscript meticulously examines the methodologies employed, revealing a growing acceptance and application of qualitative approaches, albeit with ongoing challenges related to research quality and consistency. The third manuscript evaluates the standards of rigor, indicating a need for enhanced clarity and application of qualitative research standards within the discipline. The collective findings illuminate the current state of qualitative research in agricultural communications, characterized by a theoretical diversity yet marked by inconsistencies in methodology application and rigor standards. This research highlights the discipline\u27s progression towards a more reflective and methodologically diverse future while identifying areas for further improvement. It calls for a concerted effort to refine qualitative research practices, advocate for clearer theoretical and methodological articulation, and uphold rigorous standards of quality to advance the field. This dissertation not only serves as a comprehensive assessment of the state of qualitative inquiry in agricultural communications but also as a roadmap for future research endeavors aimed at enhancing the discipline\u27s theoretical and methodological foundation
Use of Herbicides Coated onto Fertilizer and Applied Over-the-Top of Cotton
Get PDFCotton (Gossypium hirsutum L.) production faces numerous challenges, many related to weed management. A herbicide application method that focuses on combing resources that producers already have access to, such as herbicide-coated fertilizers, could be a practical approach for addressing late-season control of Palmer amaranth (Amaranthus palmeri S. Wats) and other problematic weed species. Two main factors would potentially impact the efficiency of utilizing this method: cotton tolerance to the application and weed control provided by the herbicide-coated fertilizers. Some considerations could affect the efficacy of these applications, such as when the treatments are applied and when they are activated by rainfall or irrigation. Therefore, experiments were conducted to 1) understand cotton tolerance to herbicides coated onto fertilizer, 2) evaluate the residual control of Palmer amaranth with herbicide-coated fertilizers, and 3) determine the influence of irrigation and application timing on weed control and cotton tolerance. In general, herbicide-coated fertilizer applications did not cause adverse effects on the crop, and there was no reduction in seedcotton yield was evident for any treatment. These coated fertilizer applications did not affect cotton groundcover compared to the nontreated check. All herbicide-coated fertilizer treatments provided at least 73% Palmer amaranth control at 28 d after treatment (DAT). While some herbicide treatments did experience a decrease in control across evaluation dates, from 14 to 28 DAT, certain treatments provided weed control that was similar at both evaluation dates, such as fluridone, fluridone plus fluometuron, pyroxasulfone, pyroxasulfone plus fluridone, and S-metolachlor. Palmer amaranth present in plots did not interfere with cotton growth and development, and no reduction in seedcotton yield occurred. Irrigation/activation timing of the herbicide-coated fertilizers can greatly impact the efficacy of the application. Control of both Palmer amaranth and barnyardgrass [Echinochloa crus-galli (L.) P. Beauv.] was decreased when irrigation was applied 10 d after application (DAA). Applying irrigation 0 or 3 DAA greatly increases herbicide activity, resulting in greater Palmer amaranth and barnyardgrass control. Florpyrauxifen-benzyl, while not labeled in cotton, did not cause more than 20% injury regardless of application timing when applied coated onto fertilizer. Many herbicides applied in this manner provide added residual Palmer amaranth control without causing adverse effects to cotton. Based on the results of these experiments, many herbicides have the potential to be integrated into cotton production systems in season coated onto fertilizers
Impact of Equipment Type on Measured Particle Size of Civil Engineering Materials
Get PDFParticle size analysis (PSA) captures the size distribution of fine-grained or emulsified materials with particles generally smaller than 1000 microns. Asphalt emulsions and many other civil engineering materials do not leverage PSA for material specifications or acceptance despite the insight into material performance and quality gained through understanding the particle size. The objectives of this study are to compare PSA measurement principles by testing 13 civil engineering materials by laser diffraction, Coulter counter, and microscopy and to develop a draft standard procedure for asphalt emulsion PSA. Asphalt emulsions, cementitious materials, sands, clays, and biological samples were selected to represent a wide set of interests and shapes. It was found that between laser diffraction and Coulter counter measurements for materials of the same batch the median (d50) differed by 6% for sand to 37% for cement and the span differed by 26% for clay to 84% for sand. The size of higher sphericity particles was more consistent across measurement principles, highlighting potential measurement biases due to spherical particle idealization prevalent in sizing equipment. New information advised for reporting in PSA results includes sizing bin details and replicate configuration. The draft emulsion PSA procedure should be refined with input from future studies
White Guilt: An Ameliorative Proposal
Get PDFCommon in the philosophy of race literature – notably those centered on critiques of whiteness and the oppressive structures therein – we find that guilt is looked upon rather divisively. On one hand, representative of what I call the “abolitionist” position, we find that such states serve no function but to stifle progress towards social justice. Feeling such emotions in relation to one\u27s race seems to lead necessarily to a retreat from the social endeavor of racial justice, resulting in selfish requests for absolution. On the other hand, representative of what I call the “proponent” position, we find prescriptions to lean into these emotions and feel them with all of their force. In doing so, white persons are said to be engaging in a fruitful, self-reflective project that, in a variety of ways, makes them more capable agents of antiracist change. While both positions illuminate important truths about white guilt, I argue that they both implicitly subscribe to a certain conception of white guilt – what I call “the commonplace conception of white guilt.” In so conceiving, I argue that we are met with a justifiable, but regrettable, conclusion in which we are led to avoid the affective state of white guilt and, consequently, its potential as a space for the interrogation of whiteness. This is due to the fact that the argument proffered by the proponent camp implicitly entails a refocus on white sentiments, effectively ignoring the woes of Black persons who undergo extended emotional labor for white persons affected by white guilt. Additionally, as a Black-centered theoretical lens is a virtue of the commonplace conception, we have good reason to follow prescriptions for white guilt that come from the embodied knowledge of Black scholars in the abolitionist camp. With this considered, I construe the abolitionists as giving a prescription of avoidance when white guilt rears its head. While I believe that we are unable to rectify these issues given the commonplace conception of white guilt, I argue that there is conceptual space to redefine white guilt in such a way to capture the theoretical needs of the commonplace conception while prescribing a response to white guilt other than avoidance – i.e., introspection that interrogates one’s place in a racist system and the norms of whiteness therein. So redefined, I argue that white guilt can be rescued – or more appropriately, reappropriated – as a reaction that sets white persons’ focus on systems of oppression rather than their own absolution as good moral persons. This reappropriation, I suggest, allows us to avoid prescribing the non-feeling of white guilt, and literature that invokes or implies its affect, which opens a visceral route for investigating the racist structure of our society and white persons’ part in it
Advancing Prediction and Decision Analytics Techniques to Improve Treatment of Tuberculosis
No full textTuberculosis (TB) remains a global health challenge, significantly impacting morbidity and mortality rates worldwide. Despite advancements in diagnosis and treatment, TB continues to pose substantial challenges, particularly in low-resource settings. This dissertation aims to develop a robust treatment monitoring framework for TB patients to ensure personalized and effective treatment using demographic and clinical information. The current standard TB treatment framework, recommended by the World Health Organization (WHO), involves monitoring patients through laboratory tests such as smear and culture sputum tests at specific time points during treatment. These tests, however, are not fast and accurate enough to determine the severity of the disease, and they often fail to detect drug-resistant TB, which complicates treatment further. Drug-resistant TB requires longer, more complex, and expensive treatment regimens, making timely and accurate monitoring crucial for effective treatment and management. In this context, the dissertation explores innovative approaches to improve TB treatment monitoring through the integration of advanced modeling techniques and machine learning algorithms. Chapter 2 of this dissertation introduces a framework that combines landmark modeling with Random Forest classification to dynamically predict TB treatment outcomes. This approach utilizes follow-up records of TB patients to provide timely predictions of treatment outcome, classified as cured, not cured, or death, 24 months after treatment initiation. The landmarking technique captures the dynamic characteristics of follow-up test results, offering a more accurate and informative prediction model compared to static models. Chapter 3 addresses the issue of low sensitivity in smear test results and its impact on treatment outcome predictions. A mathematical model is introduced to derive prediction uncertainties in binary classification deep neural network models, considering errors in variables. By modeling these errors as following a known discrete distribution, the research quantifies the prediction uncertainties both with and without accounting for smear test sensitivity. The findings highlight the importance of considering errors in variables to ensure reliable treatment outcome predictions. Chapter 4 presents a sequential decision-making model to optimize the timing and necessity of ordering expensive laboratory tests, such as culture tests. The model aims to balance the cost and accuracy of TB treatment monitoring by determining when the benefits of waiting for culture test results outweigh the risk of inaccurate predictions based on smear test results alone. Transition probabilities are derived from the models introduced in the previous chapter, and a reinforcement learning approach is used to map actions to situations, enhancing the decision-making process. Overall, this dissertation contributes to the field of TB treatment monitoring by developing novel models and methodologies that address critical challenges in current practices. The integration of landmark modeling, machine learning algorithms, and sequential decision-making frameworks provides a comprehensive approach to improving the accuracy, timeliness, and cost-effectiveness of TB treatment monitoring. The findings of this research have the potential to inform clinical practices and policy-making, ultimately contributing to improved TB management and patient outcomes
Investigating the Applications of PEPS to the Measurement of the Stabilities of Staphylococcal Nuclease (STW) and Human Acidic Fibroblast Growth Factor (hFGF1)
Get PDFThis dissertation presents a detailed investigation into the applications of Protein Equilibrium Population Snapshot H/D Exchange Electrospray Ionization Mass Spectrometry (PEPS-H/D exchange or PEPS) method. This method is based on protein equilibrium unfolding, and its fundamental capability is to capture a snapshot of the protein\u27s state, allowing us to monitor the ratio of the unfolded to folded populations at different chemical denaturant concentrations. First, to increase the accuracy of PEPS data analysis for assessing protein stability, the traditional linear extrapolation method (LEM) was replaced. Instead of using LEM, which calculates free energy change based on the peak ratio of unfolded and folded population mass-to-charge ratios (m/z), the use of a weighted average of both m/z values was adopted to determine the molecular weight. The molecular weights obtained from all the denaturant concentrations are then fitted to a theoretical (calculated) molecular weight using a non-linear regression tool. This optimized PEPS was then utilized to measure the stability of staphylococcal nuclease (STW) and human acidic fibroblast growth factor (hFGF1) under chemical denaturing conditions. For STW, PEPS experiments yielded reproducible values for free energy change (ΔG), linear denaturation constant (m-value), and concentration at which half of the protein is denatured (Cm), consistent with literature values from other techniques. Regional unfolding dynamics were mapped by peptide-level H/D exchange after pepsin digestion of the intact protein, revealing a correlation between secondary structure content and susceptibility to chemical denaturation. The study extended the promising results from STW analysis to investigate the stability of wild-type hFGF1 and its R136D variant. The R136D mutation enhanced protein stability, indicated by an increased Cm. PEPS data for hFGF1 agreed with theoretical solvent accessibility after correcting for back-exchange. Furthermore, the influence of pH and salt concentration on hFGF1 stability was systematically evaluated using intrinsic fluorescence spectroscopy. Increased pH and ammonium sulfate concentration increased Cm values, suggesting improved stability. However, the ion pairing interactions between guanidinium and sulfate ions, known to stabilize proteins, may have contributed to increased Cm values. Also, the distinct patterns in hFGF1 unfolding in response to extreme pH and the addition of various concentrations of ammonium sulfate provided insights into possible stable intermediates in the protein. This work demonstrates the utility of PEPS techniques, particularly for determining protein stability parameters and regional unfolding dynamics. It also provided insight into the effect of mutation and environmental conditions on the electrostatic interactions within hFGF1. This dissertation demonstrates that PEPS is consistent with other methods, underscoring its potential for wider proteomics, structural biology, and biomarker discovery applications. This work contributes to understanding the relationships between protein structure and function and the environmental factors that influence protein stability
Environments and Controls of Erosional Bedforms in Soluble Channels
No full textErosional bedforms, such as scallops, preserve valuable information on the paleohydrologic conditions forming soluble channels in karst systems. While these bedforms are commonly used to interpret past conditions, questions about their formation remain. Mathematical models of speleogenesis in turbulent flow predict that the conditions for forming scallops do not occur in natural carbonate systems. However, scallops are readily found in caves throughout the world. This conundrum has several possible resolutions, but each lacks field-based observations. We present a field-based study of the environments and controls of scallops in gypsum, limestone, and dolostone caves. Our results are based on field observation, petrography, confocal microscopy, environmental scanning microscopy, and photographic analysis. We present characteristics that may control scalloping, such as lithology, and discuss the interplay of erosional processes, spectrums of erosional features, and implications for understanding erosion in karst conduits
Measurement Reliability for Intentions to Change Behavior
Get PDFIt is common for researchers to ask participants to associate probabilities with words, often using tools like the Likert scale to measure behavioral intentions and attitudes. However, it remains unclear what specific probabilities participants assign to the response options on a Likert scale, how much variation exists across these options, and whether these probabilities differ across various behaviors. The purpose of this paper is to explore the numeric probabilities that participants associate with different Likert scale points, to understand their perception of the variation at each point, and to compare these perceptions across three behaviors: eating more vegetables, exercising more, and taking a risk. The findings of this study will provide valuable insights for future research using Likert scale response options. Our results reveal that participants perceive the Likert scale as more condensed than researchers typically assume. Rather than ranging from 0 to 100, participants\u27 perceived probabilities span from approximately 22 to 86. Furthermore, the variation across response points increases as the likelihood increases, indicating that participants are more certain when they answer, extremely unlikely compared to extremely likely. Finally, only minor differences were observed across the three behaviors studied, which will be discussed in more detail in the results section of this paper
Self-Reflections: A Journey of Practice in Art Education
Get PDFAbstract This self-study explores the convergence of Culturally Sustaining Teaching within the realm of art education, focusing on the author’s journey as a white, middle-aged, cisgender, southern American woman teaching art in a parochial school environment. The study investigates the dynamics between cultural responsiveness and the acknowledgement of material agency in art classrooms. By integrating principles of culturally sustaining teaching into the art curriculum, the author aims to honor students’ cultural backgrounds while fostering critical consciousness and earthly sustainability awareness. The research questions delve into the connections between culturally sustaining teaching and how the author’s personal identity impacts choice in artifact creations and how to facilitate a deeper understanding of personal agency among students. Through reflective practice and engagement with difficult knowledge, the author confronts biases and seeks to transform pedagogical approaches to create more inclusive and empowering learning environments. The study unfolds as a personal narrative, situated within the author’s classroom, aiming to enhance student engagement, interest, and the quality of their artistic experience. Ultimately, this research strives to contribute to the evolution of art education paradigms, advocating for culturally sustaining and materially sustainable practices that resonate with students’ lived experiences and foster a sense of community, care and love within the classroom