Bridging the gap: to what extent do socioeconomic barriers impede response to emerging public health threats?

It is crucial for public health emergency planners and responders to realize and account for socioeconomic barriers and the challenges they pose when faced with a bioterrorism, infectious disease, or other emerging public health threat impacting the homeland. The study design of this research incorporated two particular paradigms, investigative and predictive. The researcher found that social and economic factors account for nearly 40 percent of health outcomes in the United States. Public health and its response partners need to plan for emergencies using a 60/40 lens. He discovered that at least 40 percent of populations may not receive the critical health care they require in emergencies because of socioeconomic status or related factors. This thesis investigated the language, culture and historical trauma barriers—and affiliated challenges, such as fear and distrust—that exist throughout the country. Given these findings, this thesis provides both policy- and strategy-level recommendations to assist public health and healthcare practitioners in their efforts to bridge the gap that exists within and between community populations in the United States. Disciplines that consider implementing these recommendations will help minimize significant, and perhaps avoidable, consequences that follow health-related emergencies or varied disasters impacting the homeland.http://archive.org/details/bridginggaptowha1094553023Emergency Medical Countermeasures Program Manager, Wisconsin Department of Health Services/Division of Public Health, Madison, WisconsinApproved for public release; distribution is unlimited

DEVELOPMENT OF A STRAIN-ADAPTIVE MATERIAL MODEL OF BONE TISSUE IN THE DISTAL ULNA IMPLEMENTED THROUGH A FINITE ELEMENT ANALYSIS

Finite element (FE) modeling applied to orthopaedic biomechanics is increasing in popularity. An area of current interest is in the development of the time-dependent material models of bone tissue that can be applied to the study of natural bone formation or changes in bone density following joint replacement surgery. This thesis focuses on the development of such a model for the distal ulna, with implications for implant design. This was completed in a series of three studies. First, an empirically derived density- elastic modulus relationship for the ulna was validated through a range of bending modes. Second, a strain-adaptive material model for the distal ulna was developed and optimized. Third, this material model was used to assess the influence of implant material on the extent of bone resorption using a commercially available prosthetic. These studies represent the first application of a strain-adaptive material model to arthroplasty of the distal uln

Use of Eye Tracking in Cognitive Pretests (Version 1.0)

Cognitive pretesting is generally considered to be indispensable for the successful development of new survey questions, and hence for the quality of the data obtained by the survey. Supplementing cognitive interviewing with the method of eye tracking offers the possibility to observe eye movements of respondents in real-time providing additional information about cognitive processes of respondents. Research suggests that combining both methods helps to identify additional problems with questions that would remain undetected if only one method was applied. This contribution provides an introduction to cognitive interviewing in combination with eye tracking. The following questions are addressed: What is the rationale behind combining cognitive interviewing and eye tracking? How should eye tracking be implemented into cognitive interviewing? How can eye-tracking data be used and analyzed in the context of cognitive pretesting

Incorporating eye tracking into cognitive interviewing to pretest survey questions

In this study, we investigated whether incorporating eye tracking into cognitive interviewing is effective when pretesting survey questions. In the control condition, a cognitive interview was conducted using a standardized interview protocol that included pre-defined probing questions for about one-quarter of the questions in a 52-item questionnaire. In the experimental condition, participants' eye movements were tracked while they completed an online version of the questionnaire. Simultaneously, their reading patterns were monitored for evidence of response problems. Afterward, a cognitive interview was conducted using an interview protocol identical to that in the control condition. We compared both approaches with regard to the number and types of problems they detected. We found support for our hypothesis that cognitive interviewing and eye tracking complement each other effectively. As expected, the hybrid method was more productive in identifying both questionnaire problems and problematic questions than applying cognitive interviewing alone

The Development And Application Of A Statistical Shape Model Of The Human Craniofacial Skeleton

Biomechanical investigations involving the characterization of biomaterials or improvement of implant design often employ finite element (FE) analysis. However, the contemporary method of developing a FE mesh from computed tomography scans involves much manual intervention and can be a tedious process. Researchers will often focus their efforts on creating a single highly validated FE model at the expense of incorporating variability of anatomical geometry and material properties, thus limiting the applicability of their findings. The goal of this thesis was to address this issue through the use of a statistical shape model (SSM). A SSM is a probabilistic description of the variation in the shape of a given class of object. (Additional scalar data, such as an elastic constant, can also be incorporated into the model.) By discretizing a sample (i.e. training set) of unique objects of the same class using a set of corresponding nodes, the main modes of shape variation within that shape class are discovered via principal component analysis. By combining the principal components using different linear combinations, new shape instances are created, each with its own unique geometry while retaining the characteristics of its shape class. In this thesis, FE models of the human craniofacial skeleton (CFS) were first validated to establish their viability. A mesh morphing procedure was then developed to map one mesh onto the geometry of 22 other CFS models forming a training set for a SSM of the CFS. After verifying that FE results derived from morphed meshes were no different from those obtained using meshes created with contemporary methods, a SSM of the human CFS was created, and 1000 CFS FE meshes produced. It was found that these meshes accurately described the geometric variation in human population, and were used in a Monte Carlo analysis of facial fracture, finding past studies attempting to characterize the fracture probability of the zygomatic bone are overly conservative

A Comparison of Two Cognitive Pretesting Techniques Supported by Eye Tracking

In questionnaire pretesting, supplementing cognitive interviewing with eye tracking is a promising new method that provides additional insights into respondents' cognitive processes while answering survey questions. When incorporating eye tracking into cognitive interviewing, two retrospective probing techniques seem to be particularly useful. In the first technique - retrospective probing - participants complete an online questionnaire, while cognitive interviewers monitor participants’ eye movements in an adjacent room and note down any peculiarities in their reading patterns. Afterward, the interviewers ask targeted probing questions about these peculiarities in a subsequent cognitive interview. In the second technique - gaze video cued retrospective probing - respondents are additionally shown a video of their eye movements during the cognitive interview. This video stimulus is supposed to serve as a visual cue that may better enable respondents to remember their thoughts while answering the questions. We examine whether one of the two techniques is more effective when it comes to identifying problematic survey questions. In a lab experiment, participants' eye movements (n = 42) were tracked while they completed six questions of an online questionnaire. Simultaneously, their reading patterns were monitored by an interviewer for evidence of response problems. After completion of the online survey, a cognitive interview was conducted. In the retrospective probing condition, probing questions were asked if peculiar reading patterns were observed during the eye-tracking session (e.g., rereadings of specific words or text passages). In the other condition, participants were shown a video of their recorded eye movements, in addition to receiving probing questions about the questions displayed. Results show that both techniques did not differ in terms of the total number of problems identified. However, gaze video cued retrospective probing identified fewer unique problems and fewer types of problems than pure retrospective probing

Rate thresholds in cell signaling have functional and phenotypic consequences in non-linear time-dependent environments

All cells employ signal transduction pathways to respond to physiologically relevant extracellular cytokines, stressors, nutrient levels, hormones, morphogens, and other stimuli that vary in concentration and rate in healthy and diseased states. A central unsolved fundamental question in cell signaling is whether and how cells sense and integrate information conveyed by changes in the rate of extracellular stimuli concentrations, in addition to the absolute difference in concentration. We propose that different environmental changes over time influence cell behavior in addition to different signaling molecules or different genetic backgrounds. However, most current biomedical research focuses on acute environmental changes and does not consider how cells respond to environments that change slowly over time. As an example of such environmental change, we review cell sensitivity to environmental rate changes, including the novel mechanism of rate threshold. A rate threshold is defined as a threshold in the rate of change in the environment in which a rate value below the threshold does not activate signaling and a rate value above the threshold leads to signal activation. We reviewed p38/Hog1 osmotic stress signaling in yeast, chemotaxis and stress response in bacteria, cyclic adenosine monophosphate signaling in Amoebae, growth factors signaling in mammalian cells, morphogen dynamics during development, temporal dynamics of glucose and insulin signaling, and spatio-temproral stressors in the kidney. These reviewed examples from the literature indicate that rate thresholds are widespread and an underappreciated fundamental property of cell signaling. Finally, by studying cells in non-linear environments, we outline future directions to understand cell physiology better in normal and pathophysiological conditions

An experimental test of the effectiveness of cognitive interviewing in pretesting questionnaires

Pretesting survey questions via cognitive interviewing is based on the assumptions that the problems identified by the method truly exist in a later survey and that question revisions based on cognitive interviewing findings produce higher-quality data than the original questions. In this study, we empirically tested these assumptions in a web survey experiment (n = 2,200). Respondents received one of two versions of a question on self-reported financial knowledge: either the original draft version, which was pretested in ten cognitive interviews, or a revised version, which was modified based on the results of the cognitive interviews. We examined whether the cognitive interviewing findings predicted problems encountered in the web survey and whether the revised question version was associated with higher content-related and criterion-related validity than the draft version. The results show that cognitive interviewing is effective in identifying real question problems, but not necessarily in fixing survey questions and improving data quality. Overall, our findings point to the importance of using iterative pretesting designs, that is, carrying out multiple rounds of cognitive interviews and also testing the revisions to ensure that they are indeed of higher quality than the draft questions