Adolescent Depression Management: An Inner City Federally Qualified Health Center Program Evaluation

Background: Within the state, approximately 119,000 adolescents aged 12-17 have depression, and it is estimated that 57.8% do not receive any mental health care (National Alliance on Mental Illness [NAMI], 2021). Objectives: The purpose of this program evaluation is to evaluate the management of adolescent depression. This evaluation focused on adolescent depression screening rates, medication prescribing and adherence, counseling referrals and initiation, barriers to treatment, follow-up visits, and parent feedback about the care received. Methods: All adolescents who did not have previously diagnosed depression or developmental delay were included in this program evaluation., A weekly manual chart review was used to collect each adolescent’s age, gender, and PHQ-9 score. The parents of each adolescent with PHQ-9 score of 10 or higher were called for a follow-up to evaluate their experience. Results: Only 64.4% of adolescent age 12-18 were screened for depression during their wellchild visit. Of the 45 adolescents screened, three had a PHQ-9 score of 10 or above. Only one patient parent answered the follow-up call. Conclusions: To be adherent with clinical practice guidelines, adolescent depression screening rates must be improved. Generalizability of project findings is limited by the participation of only one provider, a small sample size, and a short implementation timeline. Implications: Providers should continue to be educated on current guidelines. Future projects should focus on implementation of routine adolescent PHQ-9 screenings among all providers at the office. Future projects can also be used to medications, counseling, and follow-up care

Explaining the Nazi Vote: The Findings and Limits of Ecological Analysis

http://deepblue.lib.umich.edu/bitstream/2027.42/50909/1/134.pd

Short communication: Multi-scale topographic anisotropy patterns on a Barrier Island

Barrier islands exhibit a range of landforms that reflect the complex and varied combination of coastal and aeolian processes realized over the evolution of the island. A detailed analysis of the topography can be used to describe the evolution of a barrier island and provide insight on how it may be affected by a change in sea level, storm activity and wind exposure patterns. Topographic anisotropy, or the directional dependence of relief of landforms, can be used to determine the relative importance of different processes to island evolution at a range of scales. This short communication describes the use of scale-dependent topographic anisotropy to characterize the structure of Santa Rosa Island in northwest Florida. Scale-dependent topographic relief and asymmetry were assessed from a LiDAR-derived DEM from May 2004, a few months before the island experienced widespread erosion and overwash during Hurricane Ivan. This application demonstrates how anisotropy can be used to identify unique scale-dependent structures that can be used to interpret the evolution of this barrier island. Results of this preliminary study further highlight the potential of using topographic anisotropy to controls on barrier island response and recovery to storms as well as island resiliency with sea level rise and storm activity

Classification of Lakebed Geologic Substrate in Autonomously Collected Benthic Imagery Using Machine Learning

Mapping benthic habitats with bathymetric, acoustic, and spectral data requires georeferenced ground-truth information about habitat types and characteristics. New technologies like autonomous underwater vehicles (AUVs) collect tens of thousands of images per mission making image-based ground truthing particularly attractive. Two types of machine learning (ML) models, random forest (RF) and deep neural network (DNN), were tested to determine whether ML models could serve as an accurate substitute for manual classification of AUV images for substrate type interpretation. RF models were trained to predict substrate class as a function of texture, edge, and intensity metrics (i.e., features) calculated for each image. Models were tested using a manually classified image dataset with 9-, 6-, and 2-class schemes based on the Coastal and Marine Ecological Classification Standard (CMECS). Results suggest that both RF and DNN models achieve comparable accuracies, with the 9-class models being least accurate (~73–78%) and the 2-class models being the most accurate (~95–96%). However, the DNN models were more efficient to train and apply because they did not require feature estimation before training or classification. Integrating ML models into benthic habitat mapping process can improve our ability to efficiently and accurately ground-truth large areas of benthic habitat using AUV or similar images

Domestic Conflicts and Political Success in the United States and Weimar Germany: A Comparison of Two Studies

http://deepblue.lib.umich.edu/bitstream/2027.42/50910/1/135.pd

The Process and Payoff of Political Mobilization: The Nazis in 1930

http://deepblue.lib.umich.edu/bitstream/2027.42/50908/1/133.pd

Differentiating tidal and groundwater dynamics from barrier island framework geology: Testing the utility of portable multifrequency electromagnetic induction profilers

Electromagnetic induction (EMI) techniques are becoming increasingly popular for near-surface coastal geophysical applications. However, few studies have explored the capabilities and limitations of portable multifrequency EMI profilers for mapping large-scale (101-102 km) barrier island hydrogeology. The purpose of this study is to investigate the influence of groundwater dynamics on apparent conductivity σa to separate the effects of hydrology and geology from the σa signal. Shorenormal and alongshore surveys were performed within a highly conductive barrier island/wind-tidal flat system at Padre Island National Seashore, Texas, USA. Assessments of instrument calibration and signal drift suggest that σa measurements are stable, but vary with height and location across the beach. Repeatability tests confirm σa values using different boom orientations collected during the same day are reproducible. Measurements over a 12 h tidal cycle suggest that there is a tide-dependent step response in sa, complicating data processing and interpretation. Shore-normal surveys across the barrier/wind-tidal flats show that σa is roughly negatively correlated with topography and these relationships can be used for characterizing different coastal habitats. For all surveys, σa increases with decreasing frequency. Alongshore surveys performed during different seasons and beach states reveal a high degree of variability in sa. Here, it is argued that surveys collected during dry conditions characterize the underlying framework geology, whereas these features are somewhat masked during wet conditions. Differences in EMI signals should be viewed in a relative sense rather than as absolute magnitudes. Small-scale heterogeneities are related to changing hydrology, whereas low-frequency signals at the broadest scales reveal variations in framework geology. Multiple surveys should be done at different times of the year and tidal states before geologic interpretations can confidently be made from EMI surveys in coastal environments. This strategy enables the geophysicist to separate the effects of hydrology and geology from the σa signal. © 2016 Society of Exploration Geophysicists. All rights reserved

Assessing the Role of Framework Geology on Barrier Island Geomorphology

Extreme storms, hurricanes, nor’easters, and tropical depressions can cause widespread erosion and washover on barrier islands and threaten coastal communities. The strong winds and waves of these storms can erode the beach and dunes, causing significant damage to coastal infrastructure and threatening human lives. Coastal vulnerability and resiliency depend on the coastal morphology (i.e. nearshore, beach, and dune morphology) in conjunction with storminess (i.e. storm frequency and magnitude) and the rate of sea level rise. Variations in the initial coastal morphology, such as undulations in dune height, can propagate through as heterogeneity in the modern barrier island morphology. Given that the modern landscape can inherit features and patterns of variability through time, it is important to understand what factors influenced the initial coastal morphology in order to more accurately predict future changes in response to storms and sea level rise. Improving the accuracy of future change models requires that we more accurately understand how a multitude of coastal processes interact to change the coastal geomorphology. This dissertation demonstrates that framework geology is a significant driver of barrier island evolution by setting up initial variation in the beach and dune morphology and modifying normal conditions and coastal processes. Field-based surveys and public DEM data were used to: (1) extract beach, dune, and island morphometrics using a multiscale relative relief approach, (2) quantitatively demonstrate that paleochannels in the framework geology interact with daily wave reflection and refraction patterns to influence the modern barrier island, and (3) demonstrate that paleochannels in the framework geology can have an asymmetric influence on the barrier island morphology, given a persistent alongshore sediment transport gradient. In light of new information about the effects of framework geology on barrier island evolution, this dissertation proposes that the currently accepted theory of formation for Padre Island National Seashore is incomplete and should be re-evaluated in context of framework geology

GIS Modeling of Air Toxics Releases from TRI-Reporting and Non-TRI-Reporting Facilities: Impacts for Environmental Justice

The Toxics Release Inventory (TRI) requires facilities with 10 or more full-time employees that process > 25,000 pounds in aggregate or use > 10,000 pounds of any one TRI chemical to report releases annually. However, little is known about releases from non-TRI-reporting facilities, nor has attention been given to the very localized equity impacts associated with air toxics releases. Using geographic information systems and industrial source complex dispersion modeling, we developed methods for characterizing air releases from TRI-reporting as well as non-TRI-reporting facilities at four levels of geographic resolution. We characterized the spatial distribution and concentration of air releases from one representative industry in Durham County, North Carolina (USA). Inclusive modeling of all facilities rather than modeling of TRI sites alone significantly alters the magnitude and spatial distribution of modeled air concentrations. Modeling exposure receptors at more refined levels of geographic resolution reveals localized, neighborhood-level exposure hot spots that are not apparent at coarser geographic scales. Multivariate analysis indicates that inclusive facility modeling at fine levels of geographic resolution reveals exposure disparities by income and race. These new methods significantly enhance the ability to model air toxics, perform equity analysis, and clarify conflicts in the literature regarding environmental justice findings. This work has substantial implications for how to structure TRI reporting requirements, as well as methods and types of analysis that will successfully elucidate the spatial distribution of exposure potentials across geographic, income, and racial lines

An Analysis of Chemical Stockpile Emergency Preparedness Program Exercise Results. Volume 2: Preliminary Evaluation and Analysis of CSEPP Exercise Database

This study investigated the quality and usefulness of the information in the Chemical Stockpile Emergency Preparedness Program (CSEPP) exercise database. It incorporates the results of two separate analytical efforts. The first effort investigated the process of assigning standardized codes to issues identified in CSEPP exercise reports. A small group of issues was coded independently by each of several individuals, and the results of the individual codings were compared. Considerable differences were found among the individuals` codings. The second effort consisted of a statistical multivariate analysis, to investigate whether exercise issues are evenly distributed among exercise tabs, sites, and objectives. It was found that certain tabs, sites, and objectives were disproportionately associated with problem areas in exercises. In some cases, these problem areas have persisted over time, but in other cases they have undergone significant shifts over the time span of the investigation. The study concludes that the database can be a useful resource for analyzing problem areas and setting priorities for CSEPP program resources. However, some further analyses should be performed in order to more fully explore the data and increase confidence in the results