Search

Financial exploitation (FE) is one of the most common reports to Adult Protective Services (APS) and the cases are often complex. Consequently, APS caseworkers report FE investigations to be among the most difficult while simultaneously reporting low confidence in productive outcomes for these investigations. This necessitates finding ways to support APS FE investigations. This paper describes the structure, process, and formative findings of a collaboration between forensic accounting examiners and APS workers to investigate complex cases of FE. Among the 77 FE cases completed, forensic examiners reviewed multiple years of financial records which included over 101,000 transactions, totaling over $213,000,000.00 in finances, and identified over $8,000,000 in questionable activity. Scores on the 8-item Client Satisfaction Questionnaire were high indicating high program satisfaction by APS workers, subject matter experts, and forensic examiners. These findings support the feasibility and acceptability of forensic accounting and APS collaborations to investigate complex cases of FE. [ABSTRACT FROM AUTHOR]

Background: Drug overdose deaths in Texas have been accelerating in recent years with an increase of 33% in the 12 months leading up to December 2020. Accurate counts of nonfatal overdoses – including associated aspects of overdose, such as substances involved, demographic information, and reversal agents administered is critical to increase timely and adequate response to individuals and communities in need. Methods: Twenty semi-structured interviews were conducted with harm reduction workers across four Texas counties to understand existing methods of reporting overdoses, naloxone dissemination/administration, and recommendations for improving overdose surveillance. Interviews were transcribed and emergent themes were identified based on the a priori research goals. Results: Findings highlighted a variety of overdose data collection methods and tools among harm reduction organizations including Excel spreadsheet, web-based TONI application, notes on personal cell phones, and paper notes. Types of overdose data collected varied widely. Participants noted existing methods are suboptimal and that there is a need for a unified, statewide reporting system to improve overdose data capture. Participants also highlighted that overdose surveillance should include "hidden populations" of people who use drugs that are not currently counted in surveillance methods as a result of not interacting with the healthcare system. Conclusions: Texas lacks a unified overdose reporting system to capture critical data to inform overdose response and prevention efforts. Nontraditional reporters may be critical toward improving overdose syndromic efforts and capturing data among hard-to-reach populations. Harm reduction organizations are uniquely positioned to facilitate reporting among community gatekeepers and people who use drugs. [ABSTRACT FROM AUTHOR]

Approximately one-third of the veteran population suffers from post-traumatic stress disorder, a mental illness that is often co-morbid with social anxiety disorder. Student veterans are especially vulnerable as they struggle to adapt to a new, less structured lifestyle with few peers who understand their difficulties. To support mental health experts in the treatment of social anxiety disorder, this study utilized machine learning to detect anxiety in text transcribed from interviews with patients and applied topic modeling to highlight common stress factors for student veterans. We approach our anxiety detection task by exploring both deep learning and traditional machine learning strategies such as transformers, transfer learning, and support vector classifiers. Our models provide a tool to support psychologists and social workers in treating social anxiety. The results detailed in this paper could also have broader impacts in fields such as pedagogy and public health.1 [ABSTRACT FROM AUTHOR]

Objective: Healthcare spending in the US is $3.2 trillion. $1.1 trillion is attributed to hospital care, including emergency department (ED) visits and hospitalizations. There is a relationship between ED utilization, hospitalizations, and health literacy in the general population. Health literacy may play a role in frequent ED visits and hospitalizations in patients with sickle cell disease (SCD). The purpose of this paper is to describe the relationship among health literacy levels, annual hospital encounters, annual clinic visits, annual ED visits, and annual hospitalizations in 134 Black, non‐Hispanic adolescents aged 10–19 years with SCD. Design: This is a cross‐sectional, descriptive correlational study evaluating facilitators and barriers to health literacy and clinical outcomes in adolescents with SCD. Sample: Data were collected from 134 Black, non‐Hispanic adolescents with SCD at a large, tertiary care center in Texas. Measurements: The Newest Vital Sign and REALM‐Teen health literacy instruments were used to evaluate health literacy. Results: Contrasting previous studies evaluating the influence of health literacy on ED visits and hospitalizations in the general population, there were no significant relationships within this sample. Conclusions: This study gives insight into future research to evaluate other potential influences on ED utilization and hospitalizations in pediatric patients with SCD. [ABSTRACT FROM AUTHOR]

This paper describes HIV testing behaviors among undocumented Central American immigrant women living in Houston, Texas, USA. Respondent driven sampling was used to recruit participants for an HIV behavioral survey. HIV testing items included lifetime history of testing, date and location of the most recent test, and reason for testing. Multivariate logistic regression was used to assess the demographic, behavioral, and structural characteristics associated with testing. The lifetime prevalence of HIV testing was 67%. Half of those who tested did so within the past 2 years and almost 80% received their most recent test in a healthcare setting. The primary reason for testing was pregnancy. Lifetime testing was associated with being from Honduras, having over a sixth grade education, having a regular healthcare provider, and having knowledge of available healthcare resources. Our results suggest that expanding access to healthcare services may increase the prevalence of HIV testing in this population. [ABSTRACT FROM AUTHOR]

Findings from previous research linking sedentary time with cardiometabolic risk factors and body composition are inconsistent, and few studies address population groups most vulnerable to these compromising conditions. The purpose of this paper was to investigate the relationship of sitting time to cardiometabolic risk factors and body composition among African American women. A subsample of African American women (N = 135) completed health and laboratory assessments, including measures of blood pressure, resting heart rate, cholesterol, triglycerides, glucose, body mass index, body fat, sitting time, and demographics. Simultaneous, adjusted regression models found a positive association between weekend sitting time and glucose and an inverse association between weekly sedentary time and cholesterol (ps < .05). There were no significant associations between sedentary behavior and body composition. The unexpected relationship between sedentary time and cholesterol suggests that the relationship of sedentary behavior to cardiometabolic risk factors may depend on existing characteristics of the population and measurement definition of sedentary behavior. Results suggest distinctly different relationships between weekend and weekday sitting time, implicating a need for careful measurement and intervention that reflects these differences. [ABSTRACT FROM AUTHOR]

We sought to determine whether computerized physician order entry (CPOE) improves the induction agent turnaround time on the labor and delivery unit (L&D) compared with paper-based order entry (PBOE). We conducted a retrospective study of singleton, term pregnancies admitted to L&D for induction of labor. Outcomes of women who delivered 3 months before or 3 months after universal CPOE implementation were compared including induction agent turnaround time. The induction agent turnaround time was significantly shorter in the CPOE group ( N = 83) compared with PBOE group ( N = 71) [71 (range 8 to 411) versus 100 (2 to 442) minutes, P = 0.004]. There were no differences in cesarean section rate or length of hospital stay. After controlling for time of day of induction, induction agent, and type of order entry, CPOE continued to significantly decrease the induction agent turnaround time by 25 minutes ( P = 0.042). CPOE improved the process of induction of labor and efficiency of care of pregnant women. [ABSTRACT FROM AUTHOR]