Colleges and Department Research
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Research, creative, and scholarly works created by the university community organized by college.
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Item The omicron variant is deepening severe staffing shortages in medical laboratories across the US(The Conversation US, Inc., 1/19/2022) Rohde, Rodney E.Medical laboratory professionals form the backbone of health care and the public health system. They conduct some 13 billion laboratory medicine tests annually in the U.S. As of January 2022, these individuals had also performed more than 860 million COVID-19 tests and counting during the pandemic. Why should anyone care? Laboratory testing is the single highest-volume medical activity affecting Americans, and it drives about two-thirds of all medical decisions made by doctors and other health care professionals. Simply put, every time you enter a hospital or health care facility for care, your life is in the hands of a medical laboratory professional.Item Comparison of Ankle Strategies for Balance in Persons After Mild Head Injury(1/2/2010) Gobert, Denise V.; Liao, Ursula; Grattan, Shannon; Marie, Martha N.Objective: The purpose of this project was to characterize and compare balance in persons after MHI using an assessment of ankle strategies. Design: This project used an observational cohort study design. Methodology: Thirty male and female participants aged 18 - 40 years of age provided written consent according to university guidelines and were grouped as being with or without a history of MHI over the past 12 months. Computerized protocols of the NeuroCom EquiTest® system included assessments of static and dynamic standing balance during six sensory conditions in the Sensory Organization Test (SOT) and during translational perturbations of the Motor Control Test (MCT). In addition to standard balance scores, a new method proposed by Zhiming et al. (2004) called the “Postural Stability Index” (PSI) was used to process platform data to document ankle stiffness. Data Analysis: Data analysis included standardized Student T-Test statistics (SPSS v.16) at an alpha level of 0.05. Also, a Pearson’s Correlation Coefficient was calculated to identify significant relationships within the data pool. Preliminary Results: Preliminary findings indicate no significant differences according to standard SOT or MCT scores. Results indicate significant differences in ankle stiffness or PSI scores which have been shown to be highly correlated to decreased balance skills in other patient populations. Clinical Relevance: Preliminary results indicate that assessment of ankle strategies used during challenged balance may be a more sensitive indicator of balance skills in patients after MHI. Final results will be presented along with a discussion of possible clinical use in rehabilitation programs.Item The Impact of COVID-19 on Telemedicine Utilization Across Multiple Service Lines in the United States(Multidisciplinary Digital Publishing Institute, 10/1/2020) Betancourt, Jose; Rosenberg, Matthew; Zevallos, Ashley; Brown, Jon R.; Mileski, MichaelThe impact of COVID-19 on the U.S. healthcare industry cannot be overstated. Telemedicine utilization increased overnight as all healthcare providers rushed to implement this delivery model to ensure accessibility and continuity of patient care. Our research objective was to determine measures that were implemented to accommodate community and individual patient needs to afford access to critical services and to maintain safety standards. We analyzed literature since 2016 from two databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We compared observations, themes, service lines addressed, issues identified, and interventions requiring in-person care. From 44 articles published, we identified ten effectiveness themes overall and drew conclusions on service line successes. COVID-19 has caused rapid expansion in telemedicine. Necessary and required changes in access, risk mitigation, the need for social distancing, compliance, cost, and patient satisfaction are a few of the driving factors. This review showcased the healthcare industry’s ability to rapidly acclimate and change despite the pervasive spread of COVID-19 throughout the U.S. Although imperfect, unique responses were developed within telemedicine platforms to mitigate disruptions broadly and effectively in care and treatment modalities.Item Provision of Palliative Care during the COVID-19 Pandemic: A Systematic Review of Ambulatory Care Organizations in the United States(Multidisciplinary Digital Publishing Institute, 10/18/2021) Lieneck, Cristian H.; Betancourt, Jose; Daemen, Cynthia; Eich, Rhiannon; Monty, Elisabeth; Petty, Mindy JoBackground and objectives: Ambulatory (outpatient) healthcare organizations continue to respond to the COVID-19 global pandemic using an array of initiatives to sustain a continuity of palliative care. Continuance of palliative care during major crises has been previously accomplished; however, the global pandemic presents new challenges to the US healthcare industry. Materials and methods: This systematic review queried four research databases to identify applicable studies related to the provision of palliative care during the pandemic in outpatient organizations within the United States. Results: There are two primary facilitators for the ongoing provision of palliative care for the outpatient segment of the United States healthcare industry: technology and advanced care planning. Researchers also identified two primary barriers in the outpatient setting impacting the continuance of palliative care: lack of resources and accessibility to care. Conclusions: This systematic review identified facilitators and barriers for palliative care initiatives in the United States that can further assist future outpatient (ambulatory care) providers at a global level as the pandemic and associated public health initiatives continueItem Examining Predictors of Myocardial Infarction(Multidisciplinary Digital Publishing Institute, 10/27/2021) Dolezel, Diane; McLeod, Alexander; Fulton, Lawrence V.Cardiovascular diseases are the leading cause of death in the United States. This study analyzed predictors of myocardial infarction (MI) for those aged 35 and older based on demographic, socioeconomic, geographic, behavioral, and risk factors, as well as access to healthcare variables using the Center for Disease (CDC) Control Behavioral Risk Factor Surveillance System (BRFSS) survey for the year 2019. Multiple quasibinomial models were generated on an 80% training set hierarchically and then used to forecast the 20% test set. The final training model proved somewhat capable of prediction with a weighted F1-Score = 0.898. A complete model based on statistically significant variables using the entirety of the dataset was compared to the same model built on the training set. Models demonstrated coefficient stability. Similar to previous studies, age, gender, marital status, veteran status, income, home ownership, employment status, and education level were important demographic and socioeconomic predictors. The only geographic variable that remained in the model was associated with the West North Central Census Division (in-creased risk). Statistically important behavioral and risk factors as well as comorbidities included health status, smoking, alcohol consumption frequency, cholesterol, blood pressure, diabetes, stroke, chronic obstructive pulmonary disorder (COPD), kidney disease, and arthritis. Three access to healthcare variables proved statistically significant: lack of a primary care provider (Odds Ratio, OR = 0.853, p < 0.001), cost considerations prevented some care (OR = 1.232, p < 0.001), and lack of an annual checkup (OR = 0.807, p < 0.001). The directionality of these odds ratios is congruent with a marginal effects model and implies that those without MI are more likely not to have a primary provider or annual checkup, but those with MI are more likely to have missed care due to the cost of that care. Cost of healthcare for MI patients is associated with not receiving care after accounting for all other variables.Item Patient Throughput Initiatives in Ambulatory Care Organizations during the COVID-19 Pandemic: A Systematic Review(Multidisciplinary Digital Publishing Institute, 10/30/2021) Lieneck, Cristian H.; Ramamonjiarivelo, Zo; Cox, Jennifer; Dominguez, Jack; Gersbach, Kendal; Heredia, Edward; Khan, AfrozaBackground and objectives: Ambulatory (outpatient) health care organizations continue to respond to the COVID-19 global pandemic using an array of initiatives to provide a continuity of care for both COVID-19 and non-COVID-19 patients. The purpose of this study is to systematically identify the facilitators and barriers experienced by outpatient health care organizations in an effort to maintain effective and efficient patient throughput during the pandemic. Materials and methods: This study systematically reviewed articles focused on initiatives taken by ambulatory care organizations to maintain optimal outpatient throughput levels while balancing pandemic precautions, published during 2020. Results: Among the 30 articles that met the inclusion criteria, three initiatives healthcare organizations have taken to maintain throughput were identified: the use (and enhanced use) of telehealth, protocol development, and health care provider training. The research team also identified three barriers to patient throughput: lack of telehealth, lack of resources, and overall lack of knowledge. Conclusions: To maintain patient throughput during the COVID-19 pandemic, healthcare organizations need to develop strategies such as the use of virtual consultation and follow-up, new guidelines to move patients along the care delivery value-chain, and ongoing training of providers. Additionally, the availability of required technology for telehealth, availability of resources, and adequate knowledge are vital for continuous patient throughput to ensure continuity of care during a pandemic.Item Sustainability and CSR: The Relationship with Hofstede Cultural Dimensions(Multidisciplinary Digital Publishing Institute, 11/1/2021) Tehrani, Minoo; Rathgeber, Andreas W.; Fulton, Lawrence V.; Schmutz, BryanThis research explores the relationship between Hofstede’s femininity cultural dimension of quality of life and the masculinity cultural dimension of drive for success manifested by materialistic wealth by investigating the market value of the publicly traded firms appearing on the Dow Jones Sustainability Indices (DJSIs). The firms added to the DJSIs between the years 2010–2019 in countries with the femininity cultural dimension indicated by scores of ≤42, were selected for the first part of this study. In addition, France, with a masculinity score of 43 and Japan, with the highest masculinity score of 92, were chosen for comparison with the results from the countries with the femininity cultural dimension. The findings of this study indicate that companies in developed and emerging countries with the femininity cultural dimension show significant positive impact on their market values when added to the DJSIs. The publicly traded firms in France show a significant negative impact on their market values when added to the DJSIs. On the other hand, Japanese companies on the addition lists of DJSIs show a significant positive impact on their market values, despite Japan having the highest Hofstede masculinity score, a potential sign of cultural change in Japan.Item What monoclonal antibodies are - and why we need them as well as a vaccine(The Conversation US, Inc., 11/16/2020) Rohde, Rodney E.When President Trump was diagnosed with COVID-19, one of the cutting-edge experimental therapies he received was a mixture of monoclonal antibodies. But now a vaccine may soon be available. So are other therapies necessary or valuable? And what exactly is a monoclonal antibody? Over the past few months, the public has learned about many treatments being used to combat COVID-19. An antiviral like remdesivir inhibits the virus from replicating in human cells. Convalescent plasma from the blood of donors who have recovered from COVID-19 may contain antibodies that suppress the virus and inflammation. Steroids like dexamethasone may modify and reduce the dangerous inflammatory damage to the lungs, thereby slowing respiratory failure. The FDA issued emergency use authorization for Eli Lilly’s monoclonal antibody, called bamlanivimab, and Regeneron is waiting for FDA’s green light for its antibody treatment. Monoclonal antibodies are particularly promising in therapy because they can neutralize the SARS-CoV-2 virus, which causes COVID-19, and block its ability to infect a cell. This might be a lifesaving intervention in people who are unable to mount a strong natural immune response to the virus – those over 65 or with existing conditions that make them more vulnerable. I’ve worked in public health and medical laboratories for decades, specializing in the study of viruses and other microbes. Even when a vaccine for COVID-19 becomes available, I see a role for monoclonal antibody therapy in getting the pandemic under control.Item Protective and Non-Protective Factors of Mental Health Distress in the United States during the COVID-19 Pandemic: A Systematic Review(Multidisciplinary Digital Publishing Institute, 12/17/2021) Lieneck, Cristian H.; Bosworth, Michele; Weaver, Eric; Heinemann, Katharine; Patel, JankiBackground and objectives: Health care organizations continue to respond to the COVID-19 global pandemic and an ongoing array of related mental health concerns. These pandemic-related challenges continue to be experienced by both the U.S. population and those abroad. Materials and methods: This systematic review queried three research databases to identify applicable studies related to protective and non-protective factors of mental health distress experienced during the pandemic within the United States. Results: Three primary factors were identified as protective factors, potentially helping to moderate the incidence of mental distress during the pandemic: demographics, personal support/self-care resources, and income/financial concerns. Researchers also identified these same three constructs of non-protective factors of mental health distress, as well as two additional variables: health/social status and general knowledge/government mistrust. Conclusions: This systematic review has identified protective and non-protective factors of mental health distress experienced in the United States during the COVID-19 pandemic (to date) that can further assist medical providers in the U.S. and beyond as the pandemic and related mental health concerns continue at a global level.Item Testing Kissick’s Iron Triangle—Structural Equation Modeling Analysis of a Practical Theory(Multidisciplinary Digital Publishing Institute, 12/18/2021) Beauvais, Bradley; Kruse, Clemens S.; Fulton, Lawrence V.; Brooks, Matthew; Mileski, Michael; Lee, Kimberly; Ramamonjiarivelo, Zo; Shanmugam, RamalingamBackground/Purpose: The purpose of this research is to determine if the tradeoffs that Kissick proposed among cost containment, quality, and access remain as rigidly interconnected as originally conceived in the contemporary health care context. Although many have relied on the Kissick model to advocate for health policy decisions, to our knowledge the model has never been empirically tested. Some have called for policy makers to come to terms with the premise of the Kissick model tradeoffs, while others have questioned the model, given the proliferation of quality-enhancing initiatives, automation, and information technology in the health care industry. One wonders whether these evolutionary changes alter or disrupt the originality of the Kissick paradigms themselves. Methods: Structural equation modeling (SEM) was used to evaluate the Kissick hypothetical relationships among the unobserved constructs of cost, quality, and access in hospitals for the year 2018. Hospital data were obtained from Definitive Healthcare, a subscription site that contains Medicare data as well as non-Medicare data for networks, hospitals, and clinics (final n = 2766). Results: Reporting significant net effects as defined by our chosen study variables, we find that as quality increases, costs increase, as access increases, quality increases, and as access increases, costs increase. Policy and Practice Implications: Our findings lend continued relevance to a balanced approach to health care policy reform efforts. Simultaneously bending the health care cost curve, increasing access to care, and advancing quality of care is as challenging now as it was when the Kissick model was originally conceived.Item Models for Heart Failure Admissions and Admission Rates, 2016 through 2018(Multidisciplinary Digital Publishing Institute, 12/27/2020) Kruse, Clemens S.; Beauvais, Bradley; Brooks, Matthew; Mileski, Michael; Fulton, Lawrence V.Background: Approximately 6.5 to 6.9 million individuals in the United States have heart failure, and the disease costs approximately $43.6 billion in 2020. This research provides geographical incidence and cost models of this disease in the U.S. and explanatory models to account for hospitals’ number of heart failure DRGs using technical, workload, financial, geographical, and time-related variables. Methods: The number of diagnoses is forecast using regression (constrained and unconstrained) and ensemble (random forests, extra trees regressor, gradient boosting, and bagging) techniques at the hospital unit of analysis. Descriptive maps of heart failure diagnostic-related groups (DRGs) depict areas of high incidence. State- and county-level spatial and non-spatial regression models of heart failure admission rates are performed. Expenditure forecasts are estimated. Results: The incidence of heart failure has increased over time with the highest intensities in the East and center of the country; however, several Northern states have seen large increases since 2016. The best predictive model for the number of diagnoses (hospital unit of analysis) was an extremely randomized tree ensemble (predictive R2 = 0.86). The important variables in this model included workload metrics and hospital type. State-level spatial lag models using first-order Queen criteria were best at estimating heart failure admission rates (R2 = 0.816). At the county level, OLS was preferred over any GIS model based on Moran’s I and resultant R2; however, none of the traditional models performed well (R2 = 0.169 for the OLS). Gradient-boosted tree models predicted 36% of the total sum of squares; the most important factors were facility workload, mean cash on hand of the hospitals in the county, and mean equity of those hospitals. Online interactive maps at the state and county levels are provided. Conclusions. Heart failure and associated expenditures are increasing. Costs of DRGs in the study increased $61 billion from 2016 through 2018. The increase in the more expensive DRG 291 outpaced others with an associated increase of $92 billion. With the increase in demand and steady-state supply of cardiologists, the costs are likely to balloon over the next decade. Models such as the ones presented here are needed to inform healthcare leaders.Item Utilization Barriers and Medical Outcomes Commensurate With the Use of Telehealth Among Older Adults: Systematic Review(JMIR Publications, 12/8/2020) Kruse, Clemens S.; Fohn, Joanna; Wilson, Nakia; Patlan, Evangelina Nunez; Zipp, Stephanie; Mileski, MichaelBackground: Rising telehealth capabilities and improving access to older adults can aid in improving health outcomes and quality of life indicators. Telehealth is not being used ubiquitously at present. Objective: This review aimed to identify the barriers that prevent ubiquitous use of telehealth and the ways in which telehealth improves health outcomes and quality of life indicators for older adults. Methods:This systematic review was conducted and reported in accordance with the Kruse protocol and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Reviewers queried the following four research databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed (MEDLINE), Web of Science, and Embase (Science Direct). Reviewers analyzed 57 articles, performed a narrative analysis to identify themes, and identified barriers and reports of health outcomes and quality of life indicators found in the literature. Results: Reviewers analyzed 57 studies across the following five interventions of telehealth: eHealth, mobile health (mHealth), telemonitoring, telecare (phone), and telehealth video calls, with a Cohen κ of 0.75. Reviewers identified 14 themes for barriers. The most common of which were technical literacy (25/144 occurrences, 17%), lack of desire (19/144 occurrences, 13%), and cost (11/144 occurrences, 8%). Reviewers identified 13 medical outcomes associated with telehealth interventions. The most common of which were decrease in psychological stress (21/118 occurrences, 18%), increase in autonomy (18/118 occurrences, 15%), and increase in cognitive ability (11/118 occurrences, 9%). Some articles did not report medical outcomes (18/57, 32%) and some did not report barriers (19/57, 33%). Conclusions: The literature suggests that the elimination of barriers could increase the prevalence of telehealth use by older adults. By increasing use of telehealth, proximity to care is no longer an issue for access, and thereby care can reach populations with chronic conditions and mobility restrictions. Future research should be conducted on methods for personalizing telehealth in older adults before implementation.Item Item The Relation of Normal School Music to Public School Work(1909-12) Butler, Mary StuartNo abstract prepared.Item The Rural Schools of Hays County, Texas(Southwest Texas State Normal College, 1918-01) Burkholder, Aldine CliffordThis study of the Rural Schools of Hays County, Texas, does not presume to be a detailed analysis of the rural school system. Only the general features are surveyed and discussed, in no case with a view to unkind criticism, but with the hope that the people of the County may see their schools in their true light, and that some recommendations may be offered which will be constructively helpful. If such be the results, then the writer will feel abundantly rewarded for his efforts. Almost no attempts have been made to compare the Hays County schools with those of other countries. In fact, the writer has not made a survey of the schools of any other county of the State, but he is of the opinion that the Hays County rural schools are fairly representative of the rural schools of Southwest Texas, and perhaps do not differ essentially from those of the larger part of the State. An expression of grateful appreciation is hereby extended to all those who have in any way contributed to this study : to the teachers of the common schools who responded so promptly and carefully to the questionnaire sent them; to the superintendents of the three independent districts of the County- Buda, Kyle, and San Marcos- for special data concerning their schools; to Mr. S. W. Henderson for the privilege of using materials from his excellent paper on the Financial History of the Schools of Hays County; to County Superintendent, J. H. Saunders, for the data given in his annual reports and for other information both personal and official; to Professor E. E. Davis of the Department of Extension of the University of Texas for statistical and other data gleaned from his Study of the Rural Schools of Travis County, Texas; and to any others who may have offered suggestions or given advice.Item Item Getting and Communicating Thought(Southwest Texas State Teachers College, 1933-01) Thomas, GatesA tentative endeavor to assist first-semester students in Freshman Composition to attain more easily there putative proficiency-level in the subject, by supplying them with such supplemental materials as they need at this stage--material the average composition text does not supply.Item The Journey of Pedro de Rivera, 1724-1728(Texas State Historical Association, 1937-10) Murphy, RettaThis paper is partly a summary of and partly a series of selections from a longer study on the subject of the inspection of military posts in New Spain by Pedro de Rivera in the third decade of the eighteenth century. The facts selected from the longer study, for the main parts of this paper, relate to his travels in Texas and in three other provinces of New Spain which were nearest to Texas: namely, New Mexico, Coahuila, and Nuevo Leon. Preceding these facts in an introductory explanation of the origin and the general nature of his entire journey of inspection. The explanation is derived from official papers written in Madrid and the City of Mexico. The description of the selected portions of his journey is based upon, and quoted from, his own diary of that event. This paper was read at the meeting of the Texas State Historical Association in Austin, Texas, on April 24, 1937.Item A Source Book of Materials on the San Marcos Chautauqua, 1885-1895(1938-01) Henderson, RubyTerm paper prepared for the University of Texas course 384f, The history of education in Texas, taught by Dr. Eby, 1937-1938.Item Leathercoat: The Life History of A Texas Patriot(Standard Printing Company, 1938-01) Elliott, ClaudeThe life history of a Texas patriot, James W. Throckmorton, Texas Ranger, Mexican War Veteran, member of the Senate and House of Representatives of Texas, Unionist, Confederate soldier, Confederate Commissioner to the Indians, President of the Constitutional Convention of 1866, Governor of the Lone Star State, and a member of the Congress from Texas. The first biography of a picturesque Texan whose colorful life materially affected the history of Texas from 1842 to 1894.