Neighborhood Change on the Mississippi Coast After Hurricane Katrina (2006 – 2019)

Hurricane Katrina was a historic event, forever changing many lives as well as altering impacted communities in the short and long term. In the fifteen years since the storm, patterns of damage, recovery programs and dollars, and existing neighborhood change have altered demographics in coastal Mississippi. This thesis investigates how population, median age, race, and education demographics have changed at the census tract level in the fourteen years since Hurricane Katrina (2006-2019) compared to pre-Katrina trends (1990-2000). A moving average using American Community Survey data as well as interval changes measure how different neighborhoods have been altered since the storm. Local Moran’s I cluster and outlier analysis combined with a change concept test identified clusters of large and small change. Large changes were focused on the Gulf Coast and inland tracts where development has focused since the storm while small changes were less common and scattered throughout the tri-county study area. The subsequent case study on coastal Mississippi considered damage, FEMA assistance recipients, and the growth of impervious areas before reviewing reports on Katrina recovery, city and county development, and regional plans for the future. The case study found that housing development was focused away from the coast, with many people priced out of rebuilding homes directly on the coast or opting away from future risk. For the most part, economic development remained focused on the coast, including tourism and multiple ports, which have been repeatedly impacted after Hurricane Katrina, including the 2010 BP oil spill

Spatial Disparities of COVID-19 Cases and Fatalities in United States Counties

This paper examines the spatial and temporal trends in county-level COVID-19 cases and fatalities in the United States during the first year of the pandemic (January 2020–January 2021). Statistical and geospatial analyses highlight greater impacts in the Great Plains, Southwestern and Southern regions based on cases and fatalities per 100,000 population. Significant case and fatality spatial clusters were most prevalent between November 2020 and January 2021. Distinct urban–rural differences in COVID-19 experiences uncovered higher rural cases and fatalities per 100,000 population and fewer government mitigation actions enacted in rural counties. High levels of social vulnerability and the absence of mitigation policies were significantly associated with higher fatalities, while existing community resilience had more influential spatial explanatory power. Using differences in percentage unemployment changes between 2019 and 2020 as a proxy for pre-emergent recovery revealed urban counties were hit harder in the early months of the pandemic, corresponding with imposed government mitigation policies. This longitudinal, place-based study confirms some early urban–rural patterns initially observed in the pandemic, as well as the disparate COVID-19 experiences among socially vulnerable populations. The results are critical in identifying geographic disparities in COVID-19 exposures and outcomes and providing the evidentiary basis for targeting pandemic recovery

De verraderlijke mitralisklepstenose

Door de lage incidentie van acuut reuma in Europa zien we in de praktijk nog maar weinig patiënten met reumatisch kleplijden. Door migratie van mensen uit gebieden waar acuut reuma nog endemisch is, zien we toch sporadisch patiënten met een mitralisklepstenose. Bij deze patiënten wordt de diagnose in eerste instantie gemakkelijk over het hoofd gezien

Insidious mitral valve stenosis

Door de lage incidentie van acuut reuma in Europa zien we in de praktijk nog maar weinig patiënten met reumatisch kleplijden. Door migratie van mensen uit gebieden waar acuut reuma nog endemisch is, zien we toch sporadisch patiënten met een mitralisklepstenose. Bij deze patiënten wordt de diagnose in eerste instantie gemakkelijk over het hoofd gezien

Prisoners of Scale: Downscaling Community Resilience Measurements for Enhanced Use

As improved data availability and disaster resilience knowledge help progress community resilience quantification schemes, spatial refinements of the associated empirical methods become increasingly crucial. Most existing empirically based indicators in the U.S. use county-level data, while qualitatively based schemes are more locally focused. The process of replicating resilience indices at a sub-county level includes a comprehensive study of existing databases, an evaluation of their conceptual relevance in the framework of resilience capitals, and finally, an analysis of the statistical significance and internal consistency of the developed metrics. Using the U.S. Gulf Coast region as a test case, this paper demonstrates the construction of a census tract-level resilience index based on BRIC (Baseline Resilience Indicators for Communities), called TBRIC. The final TBRIC construct gathers 65 variables into six resilience capitals: social, economic, community, institutional, infrastructural, and environmental. The statistical results of tract- and county-level BRIC comparisons highlight levels of divergence and convergence between the two measurement schemes and find higher reliability for the fine-scale results

Prisoners of Scale: Downscaling Community Resilience Measurements for Enhanced Use

As improved data availability and disaster resilience knowledge help progress community resilience quantification schemes, spatial refinements of the associated empirical methods become increasingly crucial. Most existing empirically based indicators in the U.S. use county-level data, while qualitatively based schemes are more locally focused. The process of replicating resilience indices at a sub-county level includes a comprehensive study of existing databases, an evaluation of their conceptual relevance in the framework of resilience capitals, and finally, an analysis of the statistical significance and internal consistency of the developed metrics. Using the U.S. Gulf Coast region as a test case, this paper demonstrates the construction of a census tract-level resilience index based on BRIC (Baseline Resilience Indicators for Communities), called TBRIC. The final TBRIC construct gathers 65 variables into six resilience capitals: social, economic, community, institutional, infrastructural, and environmental. The statistical results of tract- and county-level BRIC comparisons highlight levels of divergence and convergence between the two measurement schemes and find higher reliability for the fine-scale results

Mobile Health Daily Life Monitoring for Parkinson Disease:Development and Validation of Ecological Momentary Assessments

Background: Parkinson disease monitoring is currently transitioning from periodic clinical assessments to continuous daily life monitoring in free-living conditions. Traditional Parkinson disease monitoring methods lack intraday fluctuation detection. Electronic diaries (eDiaries) hold the potential to collect subjective experiences on the severity and burden of motor and nonmotor symptoms in free-living conditions. Objective: This study aimed to develop a Parkinson disease-specific eDiary based on ecological momentary assessments (EMAs) and to explore its validation. Methods: An observational cohort of 20 patients with Parkinson disease used the smartphone-based EMA eDiary for 14 consecutive days without adjusting free-living routines. The eDiary app presented an identical questionnaire consisting of questions regarding affect, context, motor and nonmotor symptoms, and motor performance 7 times daily at semirandomized moments. In addition, patients were asked to complete a morning and an evening questionnaire. Results: Mean affect correlated moderate-to-strong and moderate with motor performance (R=0.38 to 0.75; P Conclusions: We presented a Parkinson disease-specific EMA eDiary. Correlations between given answers support the internal validity of the eDiary and underline EMA's potential in free-living Parkinson disease monitoring. Careful patient selection and EMA design adjustment to this targeted population and their fluctuations are necessary to generate robust proof of EMA validation in future work. Combining clinical Parkinson disease knowledge with practical EMA experience is inevitable to design and perform studies, which will lead to the successful integration of eDiaries in free-living Parkinson disease monitoring

Monitoring Parkinson's disease symptoms during daily life:a feasibility study

Parkinson's disease symptoms are most often charted using the MDS-UPDRS. Limitations of this approach include the subjective character of the assessments and a discrepant performance in the clinic compared to the home situation. Continuous monitoring using wearable devices is believed to eventually replace this golden standard, but measurements often lack a parallel ground truth or are only tested in lab settings. To overcome these limitations, this study explores the feasibility of a newly developed Parkinson's disease monitoring system, which aims to measure Parkinson's disease symptoms during daily life by combining wearable sensors with an experience sampling method application. Twenty patients with idiopathic Parkinson's disease participated in this study. During a period of two consecutive weeks, participants had to wear three wearable sensors and had to complete questionnaires at seven semi-random moments per day on their mobile phone. Wearable sensors collected objective movement data, and the questionnaires containing questions about amongst others Parkinson's disease symptoms served as parallel ground truth. Results showed that participants wore the wearable sensors during 94% of the instructed timeframe and even beyond. Furthermore, questionnaire completion rates were high (79,1%) and participants evaluated the monitoring system positively. A preliminary analysis showed that sensor data could reliably predict subjectively reported OFF moments. These results show that our Parkinson's disease monitoring system is a feasible method to use in a diverse Parkinson's disease population for at least a period of two weeks. For longer use, the monitoring system may be too intense and wearing comfort needs to be optimized.</p

Mobile Health Daily Life Monitoring for Parkinson Disease: Development and Validation of Ecological Momentary Assessments

Background: Parkinson disease monitoring is currently transitioning from periodic clinical assessments to continuous daily life monitoring in free-living conditions. Traditional Parkinson disease monitoring methods lack intraday fluctuation detection. Electronic diaries (eDiaries) hold the potential to collect subjective experiences on the severity and burden of motor and nonmotor symptoms in free-living conditions. Objective: This study aimed to develop a Parkinson disease-specific eDiary based on ecological momentary assessments (EMAs) and to explore its validation. Methods: An observational cohort of 20 patients with Parkinson disease used the smartphone-based EMA eDiary for 14 consecutive days without adjusting free-living routines. The eDiary app presented an identical questionnaire consisting of questions regarding affect, context, motor and nonmotor symptoms, and motor performance 7 times daily at semirandomized moments. In addition, patients were asked to complete a morning and an evening questionnaire. Results: Mean affect correlated moderate-to-strong and moderate with motor performance (R=0.38 to 0.75; P Conclusions: We presented a Parkinson disease-specific EMA eDiary. Correlations between given answers support the internal validity of the eDiary and underline EMA's potential in free-living Parkinson disease monitoring. Careful patient selection and EMA design adjustment to this targeted population and their fluctuations are necessary to generate robust proof of EMA validation in future work. Combining clinical Parkinson disease knowledge with practical EMA experience is inevitable to design and perform studies, which will lead to the successful integration of eDiaries in free-living Parkinson disease monitoring