UMBC Emergency and Distaster Health Systems

Permanent URI for this collectionhttp://hdl.handle.net/11603/38

The Department of Emergency Health Services offers a unique opportunity for the education of future Emergency Medical Services, Emergency Public Health, and Emergency Management professionals. This is accomplished by providing a broad liberal-arts and sciences education which enhances the graduate employment opportunities as pre-hospital providers, policy makers, and managers.The Department of Emergency Health Services also provides a cutting edge education for advancement to graduate, medical, and professional studies. The Graduate program is primarily focused on preparing professionals for leadership roles in Disaster Health, Emergency Public Health and Policy Development. The two-track curriculum is designed to provide graduate level training and education to health care providers, researchers, educators, policy makers, and administrators. An Education concentration can be combined with either track. A post-baccalaureate certificate in Emergency Management is also offered. The Academic Department of Emergency and Disaster Health Systems offers a unique opportunity for the education of future Emergency Medical Services, Emergency Public Health, and Emergency Management professionals. This is accomplished by providing broad liberal arts and sciences education which enhances the graduate employment opportunities as pre-hospital providers, policymakers, and managers. The Department of Emergency and Disaster Health Systems also provides a cutting-edge education for advancement to graduate, medical, and professional studies. The Graduate program is primarily focused on preparing professionals for leadership roles in Disaster Health, Emergency Public Health, and Policy Development. The two-track curriculum is designed to provide graduate-level training and education to health care providers, researchers, educators, policymakers, and administrators. An Education concentration can be combined with either track. A post-baccalaureate certificate in Emergency Management is also offered. As of Fall 2017, in conjunction with the School of Public Policy, we now offer concentrations in Emergency Health or Emergency Management within the Public Policy Ph.D. program.

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Now showing 1 - 20 of 192

Demand-Side Approaches: Supporting Healthier Food Choices
(IFPRI, 2024-05-28) Kim, Sunny S.; Koyratty, Nadia; Blake, Christian E.; Kumar, Neha
Understanding the drivers of individual food choices, consumer behavior, and food demand is essential to reshaping food systems
Dietary Predictors of Urinary Biomarkers of Pyrethroids in the General Population – A Scoping Review
(Elsevier, 2024-02-01) Koyratty, Nadia; Olson, James R.; Kawyn, Marissa; Curl, Cynthia L.; Kordas, Katarzyna
Background Pyrethroid pesticides are ubiquitous environmental contaminants, contributing to chronic and potentially harmful exposure among the general population. Although studies have measured pesticide residues on agricultural products, the link between food intake and concentrations of pyrethroid biomarkers in urine remains unclear. Objective This scoping review aims to analyze peer-reviewed publications investigating dietary predictors of pyrethroid exposure through urinary biomarkers. We assess existing evidence, identify research gaps, and highlight current limitations. Methods We conducted a comprehensive search using PubMed and Google Scholar. Eligible studies examined associations between diets, food items or dietary components, and measured urinary pyrethroid biomarkers. No geographical restriction was applied to our search. Results were summarized in themes referring to study characteristics, relevant outcomes, biomarker measurement, dietary assessment and statistical analyses. Results We identified 20 relevant articles. Most studies presented evidence on associations between the consumption of organic diets or food items and reduced concentrations of 3-phenobenzoic acid metabolites in urine. There was less evidence for diet affecting other pyrethroid-specific biomarkers. Dietary assessment methodologies and recall periods varied, as did the number and timing of urine collections. Many studies did not control for potential alternative pyrethroid sources, exposure to other pesticides, or demographic and socioeconomic characteristics. Conclusion Researchers should consider standardized dietary assessment, chemical analyses of foods consumed, adequate recall time, and food preparation methods. Consistency in biomarker measurement, including urine collection time and corrections for specific gravity or creatinine, is needed. Ensuring the validity of such studies also requires larger samples and appropriate control for confounders.
Association between long-term exposure to ambient air pollution and lesion ischemia in patients with atherosclerosis
(Elsevier, 2023-12-11) Xu, Muwu; Hou, Zhihui; Koyratty, Nadia; Huang, Conghong; Mu, Lina; Zhu, Kexin; Yu, Guan; LaMonte, Michael J.; Budoff, Matthew J.; Kaufman, Joel D.; Wang, Meng; Lu, Bin
Background and aims: Air pollution has been associated with coronary artery disease. The underlying mechanisms were understudied, especially in relation to coronary stenosis leading to myocardial ischemia. Advances in computed tomography (CT) allow for novel quantification of lesion ischemia. We aim to investigate associations between air pollution exposures and fractional flow reserve on CT (CT-FFR), a measure of coronary artery blood flow. Methods: CT-FFR, which defines a ratio of maximal myocardial blood flow compared to its normal value (range: 0–100%), was characterized in 2017 patients with atherosclerosis between 2015 and 2017. Exposures to ozone (O3), nitrogen dioxide (NO2), and fine particulate matter (PM2.5) were estimated using high-resolution exposure models. Linear and logistic regression models were used to assess the association of each air pollutant with CT-FFR and with the prevalence of clinically relevant myocardial ischemia (CT-FFR <75%). Results: Participants were on average 60.1 years old. Annual mean O3, NO2, PM2.5 were 61, 47 and 60 µg/m3, respectively. Mean CT-FFR value was 76.9%. In the main analysis, a higher level of O3 was associated with a lower CT-FFR value (-1.74%, 95% CI: -2.85, -0.63 per 8 µg/m3) and a higher prevalence of myocardial ischemia (odds ratio: 1.32, 95% CI: 1.05–1.65), adjusting for potential confounders such as risk factors and plaque phenotypes, independent of the effects of exposure to NO2 and PM2.5. No associations were observed for PM2.5 or NO2 with CT-FFR. Conclusions: Long-term exposure to O3 is associated with lower CT-FFR value in atherosclerotic patients, indicating higher risk of lesion ischemia.
Nutrition and diet profile: Sri Lanka
(CGIAR, 2024-08-02) Koyratty, Nadia; Silva, Renuka; Ranathunga, Thilanka; Olney, Deanna K.
Sri Lanka faces a double burden of malnutrition with the co-existence and persistence of multiple forms of malnutrition, e.g., stunting, wasting, underweight, overweight/ obesity, anemia, and micronutrient deficiences. Inadequate intake of many micronutrients is common across several population groups in Sri Lanka, indicating low intake of nutrient-dense foods such as F&Vs and animal-source foods. A diverse diet with adequate intake of nutrient-dense foods should be encouraged to address nutrient gaps among Sri Lankans and reduce the risk of NCDs. Many government-issued diet- and nutrition-related policies, strategies, and programs have been adopted in Sri Lanka. However, these often do not place enough emphasis on F&Vs. While national food based dietary guidelines exist, as well as other guidelines and policies, there is uncertainty about the level of public awareness and the population’s adherence to the recommendations. Evaluations of diet- and nutrition-related interventions are also scarce, indicating a need for rigorous evidence on what works to help guide programs and policies that aim to improve diet and nutrition outcomes among Sri Lankans.
P-293. Epidemiology of Extraintestinal Invasive Escherichia coli Infections in 9 U.S. Communities, 2023
(Oxford University Press, 2025-01-29) Grome, Heather N.; Brandenburg, Joshua M.; Grass, Julian E.; Parker, Erin; Johnston, Helen; Driscoll, Jennifer; Rebolledo, Paulina; Smith, Gillian; Wilson, Lucy; Luckman, Emily; Zipprich, Jennifer; Garcia, Marco; Hoffman, Marisa; Flores, Kristina; Che Looi, Hsioa; Tellerman, Julia; O’Brien, Shannon C.; Muleta, Daniel; Denzie, Olivia; Guh, Alice
Extraintestinal invasive Escherichia coli (iEC) is a leading cause of sepsis and hospitalization, but US surveillance for iEC has been frequently limited to multidrug-resistant (MDR) strains and hospitalized cohorts. To describe the incidence and clinical characteristics of MDR and non-MDR iEC and inform prevention and vaccine development, CDC’s Emerging Infections Program piloted active population- and laboratory-based surveillance in 9 US sites. Among surveillance area residents ( > 7.3 million people), an incident iEC case was the first isolation of E. coli in a 30-day period from a normally sterile body site (June–August 2023). Demographic, clinical, and laboratory characteristics were assessed by chart review. Annual incidence rates by surveillance area were estimated by multiplying total case number by 4 and used 2022 US census data for denominators. Among 1345 iEC cases in 1334 patients, E. coli was isolated from blood in 1223 (90.9%) and from other sterile sites in 122 (9.1%). Median age was 68 years (IQR 55–79); 766 (57.0%) were female. Overall estimated annual crude incidence rate was 74.5 cases per 100,000 population (range by area 51.3–95.6) and was higher for persons aged ≥ 60 vs < 60 years (228.5 vs 30.4). Cases were most commonly community associated (554, 41.2%) or health care associated community onset (633, 47.1%). Most case-patients (1194, 88.8%) had comorbidities; diabetes was most common (457, 34.0%). Of all cases, 762 (56.7%) were associated with urinary tract infection (UTI), 192 (14.3%) with recurrent UTI, and 213 (15.8%) had a urinary catheter in the 2 days before collection of the iEC-defining specimen. Among 1160 hospitalized cases, median length of stay was 5 days (IQR 3–9), 103 (8.9%) died. Of reported E. coli susceptibilities, 144/500 (28.8%) were fluoroquinolone-resistant, 185/1345 (13.8%) were extended-spectrum β-lactamase producing, and 3/1345 (0.2%) carbapenem-resistant. The burden of iEC disease was substantial compared to other invasive pathogens and primarily affected older adults. Over half of infections accompanied UTIs and involved hospitalization. Continued surveillance to monitor trends over time, inform vaccine development and evaluation, and advise prevention efforts are needed.
Nursing Facility Characteristics Are Differentially Associated With Family Satisfaction and Regulatory Star Ratings
(Southern Gerontological Society, 2025-01-08) Millar, Roberto J.; Diehl, Christin; Kusmaul, Nancy; Stockwell, Ian
Research suggests that nursing facility structural characteristics are important contributors toward residents’ quality of care. We use 2021 data from 220 Maryland nursing facilities to examine associations between two different quality-of-care metrics: family satisfaction and Care Compare five-star quality ratings. We used descriptive statistics to explore differences in quality metrics across facility ownership (for-profit vs. non-profit), geographic location (urban vs. rural), and resident census (1–60, 61–120, and 121+). Relationships were examined across overall ratings, as well as across subdomains of the two frameworks (e.g., staffing). Family members of residents in non-profit, rural, and low-census facilities rated facilities higher. Non-profit and low-resident census facilities were more likely to be rated four or five stars, while no significant association was observed across geographic location, or interactions across structural factors. Findings emphasize the need for comprehensive quality-of-care frameworks that explore quality care across stakeholders and types of facilities.
Family Care Partners and Paid Caregivers: National Estimates of Role-Sharing in Home Care
(Oxford University Press, 2024-12-09) Fabius, Chanee D.; Gallo, Joseph J.; Burgdorf, Julia; Samus, Quincy M.; Skehan, Maureen; Stockwell, Ian; Wolff, Jennifer L.
We describe “role-sharing” in home care, defined as family care partners and paid caregivers assisting with the same task(s).We studied 440 participants in the 2015 National Health and Aging Trends Study (NHATS) receiving paid help with self-care, mobility, or medical care. We describe patterns in receiving paid help only, help from care partners only, and role-sharing. We examine whether sole reliance on paid help or role-sharing differs by Medicaid-enrollment and dementia status.Half (52.9%) of care networks involved role-sharing. Care networks involving role-sharing more often occurred among older adults with dementia (48.7% vs. 25.6%, p<0.001) and less often for those who were Medicaid-enrolled (32.1% vs. 49.4%, p<0.01). Those living with dementia more often experienced role-sharing in eating (OR 3.9 [95% CI 1.20, 8.50]), bathing (OR 2.7, [95% CI 1.50, 4.96]), dressing (OR 2.1 [95% CI 1.14, 3.86]), toileting (OR 2.9 [95% CI 1.23, 6.74]), and indoor mobility (OR 2.8 [95% CI 1.42, 5.56]), and less often received help solely from paid helpers with medication administration (OR 0.24, [95% CI 0.12, 0.46]). Medicaid-enrollees more often received paid help only in dressing (OR 2.0 [95% CI 1.12, 3.74]), outdoor (OR 2.4 [95% CI 1.28, 4.36]) and indoor mobility (OR 4.3 [95% CI 2.41, 7.62]), and with doctor visits (OR 2.8 [95% CI 1.29, 5.94]).Role-sharing is common, especially among older adults living with dementia who are not Medicaid-enrolled. Strategies supporting information sharing and collaboration in home-based care merit investigation.
Care Compare Star Ratings and Family Satisfaction in Maryland Nursing Facilities: A Comparison by Facility Structure
(2024-02-22) Millar, Roberto; Diehl, Christin; Kusmaul, Nancy; Stockwell, Ian
These findings were presented at the Gerontological Society of America’s (GSA) 2023 meeting in Tampa, Florida. Part of a Center and Institute Departmentally-Engaged Research (CIDER) award, this is part of several studies focused on examining quality of care in Maryland nursing facilities.
Validating the Disaster Food Security Scale for Rural U.S. Populations
(Natural Hazards Center, 2023) Clay, Lauren; Koyratty, Nadia; Josephson, Anna; Shanks, Carmen Byker
Although there is a large body of evidence on food security and food systems, similar research is limited in disaster settings. Rural areas are especially at risk for adverse disaster consequences. The goal of this project is to validate the Disaster Food Security Scale (DFSS) for rural populations. Rural population-specific validation is needed to ensure that the scale reliably measures barriers to food security in rural populations, which may have different concerns and issues during disasters when compared to the general or non-rural populations. To validate the DFSS-Rural, the DFSS survey was administered to a national U.S. sample of households that recall a disaster in their community in the past five years. Survey data were analyzed for validity and non-rural and rural populations were compared. The disaster food security construct created through the scale development process was unidimensional allowing the administration and scoring of a single composite scale to capture multiple aspects of food security in a disaster context. The DFSS scale measures food security disruption from a systems perspective, and therefore, identifies where a disruption is occurring in the food system chain and can provide information for public health and emergency management officials, communities, and community service organizations about specific opportunities for intervention to improve food security and improve health outcomes.
US Climate Disasters and Health Disparities: Scoping Review Protocol
(OSF, 2024-08-29) Clay, Lauren; Schreiber, Kerstin; Gillman, Arielle; Tompkins, Dera; Butera, Gisela
This scoping review aims to synthesize the state of science on climate disasters and health disparities in the United States. The review will identify health disparity outcomes, populations, and methodological approaches studied to date and discuss gaps and opportunities for future research to undertake.
Association Between Social Determinants of Health, COVID-19 Stressors, and Mental Health Among New York Residents Early in the Pandemic
(Cambridge University Press, 2024-10-22) Riobueno-Naylor, Alexa; Clay, Lauren; Aubé, Samantha S.; Lai, Betty S.
ObjectiveThe COVID-19 pandemic is a disaster event. Exposure to stressors during and after disaster events is associated with negative mental health symptoms. To inform targeted COVID-19 recovery efforts, data are needed to understand which stressors play a key role in this relationship.MethodsCross-sectional survey data (demographics, impacts of COVID-19, social determinants of health, depression, and anxiety) were collected online from adults living in New York state between May and June 2020. Differences in the proportion of stressors (COVID-19 and social determinants) experienced by race/ethnicity were assessed using chi-square analyses. Logistic regression was used to assess which factors were associated with increased odds of depression and anxiety.ResultsA majority (n = 258, 62.2%) of the 415 respondents reported being directly impacted by the pandemic. Non-white respondents reported a significantly larger proportion of stressors compared to white respondents. Under half of respondents reported depression (n = 171, 41.2%) and anxiety (n = 164, 39.5%). Healthcare and food concerns were associated with increased odds of depression and anxiety, and economic concerns were associated with increased odds of anxiety.ConclusionsFindings underscore the need to respond to the COVID-19 mental health crisis by addressing social determinants of health.
Nurse Staffing in Nursing Facilities and Family Members' Appraisal of Resident Care
(2024-06-29) Millar, Roberto; Diehl, Christin; Cannon-Jones, Stephanie; Kusmaul, Nancy; Stockwell, Ian
Multi-scalar and multi-dimensional conceptions of social capital and mental health impacts after disaster: the case of Hurricane Harvey
(Wiley, 2022-01-11) Smiley, Kevin T.; Clay, Lauren; Ross, Ashley D.; Chen, Yu-An
While much research investigates how social capital relates to mental health after disasters, less work employs a multi-scalar, multi-dimensional social capital framework. This study applies such a construct to an analysis of novel survey data of approximately 1,000 rural and urban Texans after Hurricane Harvey struck the United States in August 2017. On the individual level, it finds that greater social support is linked to fewer mental health impacts, but that greater civic and organisational engagement is connected to greater mental health impacts. At the community level, it finds that neither a density of bridging social capital organisations nor of bonding social capital organisations is associated with poorer mental health, although a greater number of bonding organisations is related to negative mental health impacts on rural residents. The paper concludes by focusing on how individual and community social capital relationships with mental health are contingent on measurement, scale, and rural or urban location.
Multiple Chronic Condition Patterns among Full-Benefit Maryland Medicaid Enrollees
(2024-06-29) Han, Fei; Gill, Christine; Blake, Elizabeth; Stockwell, Ian
Colonialism’s legacy has left Caribbean nations much more vulnerable to hurricanes
(The Conversation, 2024-10-22) Nibbs, Farah
The islands’ vulnerability has roots deep in the exploitative systems forced on them by colonialism, from slave-based land policies to ill-suited development that put lives in harm’s way.
Colonialism’s legacy has left Caribbean nations much more vulnerable to hurricanes
(The Conversation, 2024-10-22) Nibbs, Farah
The islands’ vulnerability has roots deep in the exploitative systems forced on them by colonialism, from slave-based land policies to ill-suited development that put lives in harm’s way.
Enhancing Stress Understanding Through Team Reflection: Technology-Driven Insights in High-Stress Training Scenarios
(ACM, 2024-06-25) Akiri, Surely; Joshi, Vasundhara; Taherzadeh, Sanaz; Jenkins, J. Lee; Williams, Gary; Mentis, Helena; Kleinsmith, Andrea
Systems aimed at stress awareness and reflection training by those in high-stress work environments may aid the development of stress management skills to alleviate and manage future workplace traumas. However, there is a notable gap in research addressing the insights and awareness individuals gain about their stress when they engage in team-based reflection on team-based data. To this end, we designed the Stress Reflection system as a proof-of-concept educational tool to foster and promote stress reflection and awareness by presenting trainees with both internal and external behavioral information, i.e., electrodermal activity (EDA) and corresponding situated simulation videos. We conducted a study within paramedic simulation training to qualitatively assess the insights gained and the depth of reflection achieved by trainees while interacting with each other and their data. Our findings revealed that reflecting together facilitated valuable insights into the emotions, self-expression, and behaviors that manifest during periods of stress. Trainees interacting collaboratively demonstrated emotional intelligence, predominantly engaging in higher-level dialogic reflections. Nonetheless, similar to other studies, transformative and critical reflection was largely absent. We conclude by discussing the primary findings and recommendations for expanding reflective frameworks to assess reflection in collaborative settings. This research contributes to the HCI community by offering empirically supported insights into team-based stress reflection in work and its implications for stress management in high-stress work environments.
Social Enterprise and Democracy in China: The Case of Environmental Nonprofit Organizations
(De Gruyter, 2024-08-19) Xie, Ming; Eikenberry, Angela M.
China is an important example in contemporary society regarding the power relations between government, nonprofit organizations and social enterprise, and the development of civil society and democracy in transitional and authoritarian regimes. Scholars have raised concerns about the impact of a growing reliance on social enterprise on democratic participation and outcomes. This work has largely focused on the US, UK, and other Western democracies. Some scholars alternatively suggest that social enterprise may help organizations to become more independent from the state, alleviating fund-seeking pressure and facilitating the development of civil society. Focusing on lessons learned through three case studies of environmental nonprofit organizations in China, this chapter examines how these organizations have responded to neoliberalization, leveraged social enterprise, and developed public participation. Data shows that the organizations studied adopted developmental approaches to embrace or resist neoliberalization and practice social enterprise and demonstrated limited autonomy and democratic participation.
Dialogue about Syllabus for Education of Research Methods in Journalism and Communication: A Contract, a Plan, a Cognitive Map, or a Communication Device?
(AEJMC, 2023) Xie, Ming; Chao, Chin-Chung
This study explores how the teaching of research methods in journalism and communication is embodied through syllabi in U.S. classrooms. Through emails and an online search, this study collects and reviews syllabi from the 102 accredited programs by Accrediting Council on Education in Journalism and Mass Communications. Based on four major distinct purposes of a syllabus —as a contract, a communication device, a plan, and a cognitive map—we examined the current education status of research methods courses and identified strategies of using syllabi as a learner-centered tool which can empower students to be motivated and self-directed learners
Make Hay While the Sun Shines: How Community Organizations Help Refugees in Preparation for Disasters
(2023-03-02) Xie, Ming; Chen, Li
This article examines community-based nonprofit organizations' (CBOs') perspectives and practices regarding cultivating refugees' disaster resilience. Adopting the theoretical framework of structural and cognitive social capital, we conducted in-depth interviews with leaders, staff members, and volunteers from refugee-serving organizations. The research findings offer new insights into how CBOs help refugees obtain multiple forms of social capital and develop disaster resilience through education and training, resource mobilization, planning, and coordination. The research findings also reveal the flow of social capital exchange during the disaster resilience cultivation process. Similar CBOs can rely on our research findings to develop evidence-based programs and interventions to help culturally and linguistically diverse groups gain social capital and improve disaster resilience.

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