Math anxiety and math motivation in online learning during stress: The role of fearful and avoidance temperament and implications for STEM education.

Students' math motivation can predict engagement, achievement, and career interest in science, technology, engineering, and mathematics (STEM). However, it is not well understood how personality traits and math anxiety may be linked to different types or qualities of math motivation, particularly during high-stress times such as the COVID-19 pandemic. In this study, we examined how fearful or avoidant temperaments contribute to math anxiety and math motivations for college students during the COVID-19 pandemic. Ninety-six undergraduate students from a large public university were assessed on temperamental fear, math anxiety, and math motivation in an online math course. Results showed that higher levels of temperamental fear are directly linked to higher levels of math anxiety. In addition, temperamental fear is indirectly linked to higher levels of autonomous motivation (i.e., intrinsic motivation and identified regulation) and lower levels of controlled motivation (i.e., external regulation) through math anxiety. Results have implications for helping students at high risk for both high math anxiety and for low motivation to engage in math learning.

Physical Activity Impacts of an Activity-Friendly Community: A Natural Experiment Study Protocol.

Background: Stakeholders from multiple sectors are increasingly aware of the critical need for identifying sustainable interventions that promote healthy lifestyle behaviors. Activity-friendly communities (AFCs) have been known to provide opportunities for engaging in physical activity (PA) across the life course, which is a key to healthy living and healthy aging. Purpose: Our purpose is to describe the study protocol developed for a research project that examines: (a) the short- and long-term changes in total levels and spatial and temporal patterns of PA after individuals move from non-AFCs to an AFC; and (b) what built and natural environmental factors lead to changes in PA resulting from such a move, either directly or indirectly (e.g., by affecting psychosocial factors related to PA). Methods: This protocol is for a longitudinal, case-comparison study utilizing a unique natural experiment opportunity in Austin, Texas, USA. Case participants were those adults who moved from non-AFCs to an AFC. Matching comparison participants were residents from similar non-AFCs who did not move during the study period. Recruitment venues included local businesses, social and print media, community events, and individual referrals. Objectively measured moderate-to-vigorous PA and associated spatial and temporal patterns served as the key outcomes of interest. Independent (e.g., physical environments), confounding (e.g., demographic factors), and mediating variables (e.g., psychosocial factors) were captured using a combination of objective (e.g., GIS, GPS, Tanita scale) and subjective measures (e.g., survey, travel diary). Statistical analyses will be conducted using multiple methods, including difference-in-differences models, repeated-measures linear mixed models, hierarchical marked space-time Poisson point pattern analysis, and hierarchical linear mixed models. Conclusion: Natural experiment studies help investigate causal relationships between health and place. However, multiple challenges associated with participant recruitment, extensive and extended data collection activities, and unpredictable intervention schedules have discouraged many researchers from implementing such studies in community-based populations. This detailed study protocol will inform the execution of future studies to explore how AFCs impact population health across the life course.

Assessing the impact of adding pharmacist management services to an existing discharge planning program on 30-day readmissions.

BACKGROUND: Although hospital readmission rates are declining nationally, avoidable readmissions remain a public health concern. Effective readmission interventions are multifaceted and include discharge planning and transition-of-care coordination. Clinical pharmacists are effective contributors to these processes, bringing expertise to discharge counseling, medication reconciliation, medication adherence, and postdischarge follow-up counseling. OBJECTIVE: We evaluated the impact of adding health plan clinical pharmacy management services to an existing discharge program on all-cause readmissions and postdischarge primary physician visits. METHOD: Pharmacy management services by health plan clinical pharmacists of a large regional integrated delivery system were added to an existing optimal discharge planning (ODP) program. Criteria for eligibility for these pharmacists' services included patients who prescribed a new maintenance medication after discharge, received a therapeutic substitution, had a previous discharge within 30 days, or were taking a high-risk medication. A retrospective, observational analysis of a subgroup of patients, who received the pharmacy management services as part of ODP, was performed using a difference-in-difference model, by comparing propensity-matched discharges from February 22, 2016, to January 31, 2017 (preprogram implementation) with discharges from February 22, 2017, to January 31, 2018 (implementation period), to estimate changes in 30-day readmission rates and postdischarge primary physician visits. RESULTS: A total of 111 of the propensity matched received the pharmacy management services; of these, 73% (ODP) versus 64% (non-ODP) were ≥58 years, 60% were females, and 62% (ODP) versus 52% (non-ODP) were Medicare beneficiaries. There was a 16.7% (P = 0.022) statistically significant reduction in combined inpatient and observation 30-day readmissions and a 19.7% increase in 5-day postdischarge follow-up physician visits (P = 0.037) for the subgroup who also received the pharmacy management services. CONCLUSION: Addition of pharmacist management services to an existing hospital discharge program for select at-risk patients was associated with reduced inpatient and observation 30-day readmissions.

Hemodialysis Clinics in Flood Zones: A Case Study of Hurricane Harvey.

INTRODUCTION: Hurricane Harvey (2017) forced the closure of hemodialysis centers across Harris County, Texas (USA) disrupting the provision of dialysis services. This study aims to estimate the percentage of hemodialysis clinics flooded after Harvey, to identify the proportion of such clinics located in high-risk flood zones, and to assess the sensitivity of the Federal Emergency Management Agency (FEMA) Flood Insurance Rate Maps (FIRMs) for estimation of flood risk. METHODS: Data on 124 hemodialysis clinics in Harris County were extracted from Medicare.gov and geocoded using ArcGIS Online. The FIRMs were overlaid to identify the flood zone designation of each hemodialysis clinic. RESULTS: Twenty-one percent (26 of 124) of hemodialysis clinics in Harris County flooded after Harvey. Of the flooded clinics, 57.7% were in a high-risk flood zone, 30.8% were within 1km of a high-risk flood zone, and 11.5% were not in or near a high-risk flood zone. The FIRMs had a sensitivity of 58%, misidentifying 42% (11 of 26) of the clinics flooded. CONCLUSION: Hurricanes are associated with severe disruptions of medical services, including hemodialysis. With one-quarter of Harris County in the 100-year floodplain, projected increases in the frequency and severity of disasters, and inadequate updates of flood zone designation maps, the implementation of new regulations that address the development of hemodialysis facilities in high-risk flood areas should be considered.

Living Up to a Name: Gender Role Behavior Varies With Forename Gender Typicality.

Forenames serve as proxies for gender labels that activate gender stereotypes and gender socialization. Unlike rigid binary gender categories, they differ in the degree to which they are perceived as "masculine" or "feminine." We examined the novel hypothesis that the ability of a forename to signal gender is associated with gender role behavior in women (n = 215) and men (n = 127; M = 19.32, SD = 2.11) as part of a larger study evaluating forenames used in resume research. Compared to individuals endorsing a "gender-strong" forename, those perceiving their forename as relatively "gender-weak" reported less gender-typical childhood social behavior and a weaker expression of gender-linked personality traits. Our findings suggest that forenames strengthen or weaken gender socialization, gender identification, and so contribute to the variable expression of gender role behavior within binary gender groups.

Assessing the Prevalence of Risk Factors for Neglected Tropical Diseases in Brazos County, Texas.

INTRODUCTION: Although more than one billion people live at risk of neglected tropical diseases (NTDs) in areas of Asia, sub-Saharan Africa, and Latin America, the degree to which they burden countries like the U.S. is unclear. Even though many NTDs such as dengue, leishmaniasis, and Chagas disease are typically not endemic to the U.S., the possibility of their emergence is noteworthy, especially in states like Texas with high levels of poverty, large immigrant populations, geographic proximity to endemic areas, and a climate amenable to the vectors for these diseases. Despite the health threat that emerging NTDs may pose, little is known about the prevalence of risk factors for NTDs in the U.S. METHODS: We tested the Community Assessment for Public Health Emergency Response (CASPER) method to assess the prevalence of risk factors for NTDs in Brazos County, Texas.Results: We found relatively low prevalence of risk factors related to travel (5.2% of respondents visited an endemic area in the previous 3 months); however, few respondents reported adherence to mosquito prevention, such as wearing long sleeves and long pants (14.1%, 95% CI: 13.9,14.4) and repellant containing DEET (13.5%, 95% CI: 13.2,13.7). Between 5.4% and 35.8% of respondents had a visible container (e.g., pet water dishes, flower pots, bird baths) that could support mosquito breeding. DISCUSSION: CASPER findings present public health authorities with potential avenues for implementing health education and other interventions aimed at reducing exposure to risk factors for NTDs among Texas residents.

Developing a CASPER Survey to Assess the Prevalence of Risk Factors for Neglected Tropical Diseases in Texas.

While more than a billion people live at risk of neglected tropical diseases in areas of Asia, sub-Saharan Africa, and Latin America, the degree to which such diseases burden countries like the United States is currently unclear. Even though many neglected tropical diseases such as dengue, leishmaniasis, and Chagas disease are not endemic to the United States, the possibility of their emergence is noteworthy, especially in states like Texas, which has high levels of poverty, a large immigrant population, and a climate amenable to the vectors for these diseases and is geographically proximate to endemic areas. Despite the health threat that emerging neglected tropical diseases may pose, little is known about the prevalence of risk factors for them in the United States. Texas House Bill 2055, enacted on September 1, 2015, mandated the establishment of a surveillance program for neglected tropical diseases in Texas. After reviewing the potential risk factors for transmission in Texas, we developed a 41-question survey that could be implemented using the Community Assessment for Public Health Emergency Response (CASPER) method. In concert with public health surveillance and vector population monitoring, data from CASPERs could be used to quickly and cost-effectively assess the prevalence of risk factors for 10 neglected tropical diseases in Texas or elsewhere in the United States. The data generated by future CASPERs conducted using this survey could be immediately actionable, guiding public health priority setting and decision making.

Fractal analysis of visual search activity for mass detection during mammographic screening.

PURPOSE: The objective of this study was to assess the complexity of human visual search activity during mammographic screening using fractal analysis and to investigate its relationship with case and reader characteristics. METHODS: The study was performed for the task of mammographic screening with simultaneous viewing of four coordinated breast views as typically done in clinical practice. Eye-tracking data and diagnostic decisions collected for 100 mammographic cases (25 normal, 25 benign, 50 malignant) from 10 readers (three board certified radiologists and seven Radiology residents), formed the corpus for this study. The fractal dimension of the readers' visual scanning pattern was computed with the Minkowski-Bouligand box-counting method and used as a measure of gaze complexity. Individual factor and group-based interaction ANOVA analysis was performed to study the association between fractal dimension, case pathology, breast density, and reader experience level. The consistency of the observed trends depending on gaze data representation was also examined. RESULTS: Case pathology, breast density, reader experience level, and individual reader differences are all independent predictors of the complexity of visual scanning pattern when screening for breast cancer. No higher order effects were found to be significant. CONCLUSIONS: Fractal characterization of visual search behavior during mammographic screening is dependent on case properties and image reader characteristics.

KinoHaptics: An Automated, Wearable, Haptic Assisted, Physio-therapeutic System for Post-surgery Rehabilitation and Self-care.

A carefully planned, structured, and supervised physiotherapy program, following a surgery, is crucial for the successful diagnosis of physical injuries. Nearly 50 % of the surgeries fail due to unsupervised, and erroneous physiotherapy. The demand for a physiotherapist for an extended period is expensive to afford, and sometimes inaccessible. Researchers have tried to leverage the advancements in wearable sensors and motion tracking by building affordable, automated, physio-therapeutic systems that direct a physiotherapy session by providing audio-visual feedback on patient's performance. There are many aspects of automated physiotherapy program which are yet to be addressed by the existing systems: a wide classification of patients' physiological conditions to be diagnosed, multiple demographics of the patients (blind, deaf, etc.), and the need to pursue patients to adopt the system for an extended period for self-care. In our research, we have tried to address these aspects by building a health behavior change support system called KinoHaptics, for post-surgery rehabilitation. KinoHaptics is an automated, wearable, haptic assisted, physio-therapeutic system that can be used by a wide variety of demographics and for various physiological conditions of the patients. The system provides rich and accurate vibro-haptic feedback that can be felt by the user, irrespective of the physiological limitations. KinoHaptics is built to ensure that no injuries are induced during the rehabilitation period. The persuasive nature of the system allows for personal goal-setting, progress tracking, and most importantly life-style compatibility. The system was evaluated under laboratory conditions, involving 14 users. Results show that KinoHaptics is highly convenient to use, and the vibro-haptic feedback is intuitive, accurate, and has shown to prevent accidental injuries. Also, results show that KinoHaptics is persuasive in nature as it supports behavior change and habit building. The successful acceptance of KinoHaptics, an automated, wearable, haptic assisted, physio-therapeutic system proves the need and future-scope of automated physio-therapeutic systems for self-care and behavior change. It also proves that such systems incorporated with vibro-haptic feedback encourage strong adherence to the physiotherapy program; can have profound impact on the physiotherapy experience resulting in higher acceptance rate.