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1.
Appl Geogr ; 133: 102473, 2021 Aug.
Article in English | MEDLINE | ID: mdl-34103772

ABSTRACT

COVID-19 has emerged as a global pandemic caused by its highly transmissible nature during the incubation period. In the absence of vaccination, containment is seen as the best strategy to stop virus diffusion. However, public awareness has been adversely affected by discourses in social media that have downplayed the severity of the virus and disseminated false information. This article investigates COVID-19 related Twitter activity in May and June 2020 to examine the origin and nature of misinformation and its relationship with the COVID-19 incidence rate at the state and county level. A geodatabase of all geotagged COVID-19 related tweets was compiled. Multiscale Geographically Weighted Regression was employed to examine the association between social media activity and the spatial variability of disease incidence. Findings suggest that MGWR could explain 80% of the COVID-19 incidence rate variations indicating a strong spatial relationship between social media activity and spread of the Covid-19 virus. Discourse analysis was conducted on tweets to index tweets downplaying the pandemic or disseminating misinformation. Findings indicate that sites of Twitter misinformation showed more resistance to pandemic management measures in May and June 2020 later experienced a rise in the number of cases in July.

2.
Am J Med Qual ; 39(4): 145-153, 2024.
Article in English | MEDLINE | ID: mdl-39038274

ABSTRACT

Regulatory bodies in the United States have implemented quality metrics aimed at improving outcomes for patients with severe sepsis and septic shock. The current study was a quality improvement (QI) project in a community-based academic center aimed at improving adherence to sepsis quality metrics, time to antibiotic administration, and patient outcomes. Electronic health record systems were utilized to capture sepsis-related data. Regular audits and feedback sessions were conducted to identify areas for improvement, with a focus on the timely administration of antibiotics. Interventions included improving access to antibiotics, transitioning from intravenous piggyback to intravenous push formulations, and providing continuous staff education and training. This multidisciplinary QI initiative led to significant improvements in the mortality index, length of stay index, and direct cost index for patients with sepsis. Targeted multidisciplinary QI interventions resulted in improved quality metrics and patient outcomes.


Subject(s)
Anti-Bacterial Agents , Quality Improvement , Sepsis , Humans , Quality Improvement/organization & administration , Sepsis/therapy , Sepsis/mortality , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/administration & dosage , Male , Female , Length of Stay , Middle Aged , Electronic Health Records , Aged , Guideline Adherence , Academic Medical Centers/organization & administration
3.
JMIR Public Health Surveill ; 10: e52691, 2024 May 03.
Article in English | MEDLINE | ID: mdl-38701436

ABSTRACT

BACKGROUND: Structural racism produces mental health disparities. While studies have examined the impact of individual factors such as poverty and education, the collective contribution of these elements, as manifestations of structural racism, has been less explored. Milwaukee County, Wisconsin, with its racial and socioeconomic diversity, provides a unique context for this multifactorial investigation. OBJECTIVE: This research aimed to delineate the association between structural racism and mental health disparities in Milwaukee County, using a combination of geospatial and deep learning techniques. We used secondary data sets where all data were aggregated and anonymized before being released by federal agencies. METHODS: We compiled 217 georeferenced explanatory variables across domains, initially deliberately excluding race-based factors to focus on nonracial determinants. This approach was designed to reveal the underlying patterns of risk factors contributing to poor mental health, subsequently reintegrating race to assess the effects of racism quantitatively. The variable selection combined tree-based methods (random forest) and conventional techniques, supported by variance inflation factor and Pearson correlation analysis for multicollinearity mitigation. The geographically weighted random forest model was used to investigate spatial heterogeneity and dependence. Self-organizing maps, combined with K-means clustering, were used to analyze data from Milwaukee communities, focusing on quantifying the impact of structural racism on the prevalence of poor mental health. RESULTS: While 12 influential factors collectively accounted for 95.11% of the variability in mental health across communities, the top 6 factors-smoking, poverty, insufficient sleep, lack of health insurance, employment, and age-were particularly impactful. Predominantly, African American neighborhoods were disproportionately affected, which is 2.23 times more likely to encounter high-risk clusters for poor mental health. CONCLUSIONS: The findings demonstrate that structural racism shapes mental health disparities, with Black community members disproportionately impacted. The multifaceted methodological approach underscores the value of integrating geospatial analysis and deep learning to understand complex social determinants of mental health. These insights highlight the need for targeted interventions, addressing both individual and systemic factors to mitigate mental health disparities rooted in structural racism.


Subject(s)
Machine Learning , Humans , Wisconsin/epidemiology , Female , Male , Mental Health/statistics & numerical data , Health Status Disparities , Spatial Analysis , Adult , Systemic Racism/statistics & numerical data , Systemic Racism/psychology , Racism/statistics & numerical data , Racism/psychology , Middle Aged
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