Arizona Research Articles

Evaluating the network adequacy of vision care services for children in Arizona: A cross sectional study.

Vision challenges are among the most prevalent disabling conditions in childhood, affecting up to 28% of school-age children. These issues can impact the development, learning, and literacy skills of affected children. While vision problems are correctable with timely diagnosis and treatment, insufficient networks can impede children's access to comprehensive, and high-quality care. The study aims to determine where pediatric vision care network adequacy exists in the state of Arizona and where there are gaps in receiving vision care for children. This cross-sectional study assessed the adequacy of pediatric vision care networks in Arizona through a "secret shopper" phone survey. Calls were made to practices that accept Arizona's Medicaid program, Arizona Health Care Cost Containment System (AHCCCS) and/or commercial insurance. Providers were contacted following a standardized script to schedule routine appointments on behalf of 10 and 3-year-old patients enrolled in either Medicaid or commercial health insurance plans. The study examined various components of children's access to vision care services, including the reliability of provider directory information, time until the next available appointment, bilingual service offerings, ages served, region of practice and types of care available. A total of 556 practices in Arizona were evaluated through simulations as patients on AHCCCS, and 510 practices were assessed through simulations as patients with commercial health insurance plans. The average wait time for the next available appointment was 13 days for both insurance types. Alarmingly, up to 74% of vision care practices in Arizona do not serve children covered by AHCCCS. Furthermore, only 41% provide services to children 5 years and younger. Our findings underscore the need to improve access to vision care services for children in Arizona, especially racial/ethnic minorities, low-income groups, and rural residents.

Ethical and Legal Issues in COVID-19 Case Investigation and Contact Tracing: A Case Study of A Large Academic Public Health Partnership.

In an effort to respond to the large surge in COVID-19 cases in Arizona that began between May and July 2020, the Arizona State University (ASU) Student Outbreak Response Team (SORT) formed a remote, volunteer-based case investigation team that worked in partnership with a local public health department through delegated public health authority.

Identification of small circular DNA viruses in coyote fecal samples from Arizona (USA).

Coyotes (Canis latrans) have a broad geographic distribution across North and Central America. Despite their widespread presence in urban environments in the USA, there is limited information regarding viruses associated with coyotes in the USA and in particular the state of Arizona. To explore viruses associated with coyotes, particularly small DNA viruses, 44 scat samples were collected (April-June 2021 and November 2021-January 2022) along the Salt River near Phoenix, Arizona (USA), along 43 transects (500m). From these samples, we identified 11 viral genomes: two novel circoviruses, six unclassified cressdnaviruses, and two anelloviruses. One of the circoviruses is most closely related to a circovirus sequence identified from an aerosolized dust sample in Arizona, USA. The second circovirus is most closely related to a rodent-associated circovirus and canine circovirus. Of the unclassified cressdnaviruses, three encode replication-associated proteins that are similar to those found in protists (Histomonas meleagridis and Monocercomonoides exilis), implying an evolutionary relationship with or a connection to similar unidentified protist hosts. The two anelloviruses are most closely related to those found in rodents, and this suggests a diet-related identification.

Policies, Leadership, and Funding - Oh, My! How we are working together to improve perinatal care access & integration in Arizona, U.S.

The United States has the highest maternal mortality rate of any high resource country, and it is the only country outside of Afghanistan and Sudan where the rate is rising. The rate of pregnancy-related mortality in the US increased from 7.2 pregnancy-related deaths per 100,000 live births per year in 1987 to 17.2 in 2017. In Arizona, almost half of all pregnancy-associated deaths in 2016-2018 or three out of five deaths were related to mental health conditions or substance use disorder, and 98% of those deaths were deemed preventable with 48.5% of deaths having a good chance to prevent the death. Over 40% of these deaths were accidents or unintentional overdoses. Social determinants of health, system, and community factors have increasingly been acknowledged as contributing factors to the increasing rate of poor maternal health outcomes nationally, yet few states have been able to comprehensively address these issues due to fragmented health and public health systems of care, as well as severe workforce shortages. 
 The State of Arizona launched a series of initiatives beginning or enhanced in 2019 to improve maternal health outcomes for persons of reproductive age in the State, including a grant-funded initiative to strengthen Arizona’s Maternal Mortality Review Committee and to fund prevention efforts. In 2020, maternal mental health was spotlighted by stakeholders as a crisis related to the COVID-19 pandemic. A maternal mental health task force was appointed by the state legislature and funded through a federal grant to bring statewide stakeholders together to identify gaps in care for the perinatal population, improve statewide data on maternal mortality, and to form a statewide action plan to promote and execute innovation in maternal health service delivery including recommendations to the state government for providers and facilities, regulatory and state policy, payers, law enforcement, other systems, public health, and communities.
 While the effort to improve perinatal care statewide has legislative and grant-funded support, the input from individuals with lived experience, healthcare professionals specializing in serving this population, and our community health workers such as peer support professionals, patient advocates, and BIPOC advocacy organizations have been the key to our momentum and successes. Ultimately, a legion of volunteers (primarily mothers) across the state have co-designed improvements that truly meet the needs in close partnership with the state department of health and state medicaid agency. 
 
 Through community and provider participation, workforce development initiatives, compassionate and informed leadership, change management, and policy making, we have developed a comprehensive strategy to expand access to better care across the continuum of providers and facilities involved in perinatal care outcomes in our state. 
 What we’ve learned and achieved through our evolving statewide efforts will contribute to the efforts of others in communities globally who are working to reduce adverse maternal health outcomes. Lessons learned and best practices in capacity building and sustainability will be shared. 

Linguistic variation in functional types of statutory law

When the meaning of an ambiguous word, phrase or grammatical structure in a statutory provision is disputed, courts are tasked with identifying the best meaning of the contested language. A common method of resolving linguistic ambiguities is to investigate the meaning of the contested word or structure in statutory provisions with similar subject matter. While the subject matter of a text has a demonstrated effect on language use, register variation research shows that the function of a text is also highly influential in predicting linguistic variation. Thus far, the function of a statutory provision (e.g., obligation to act, authorization to act) has not been considered in legal interpretative research. In the present study, I investigate the extent to which function influences the lexico-grammatical characteristics of statutory texts. 2,573 statutory provisions from the Arizona State Code are individually assigned to one of seven categories representing their function: Duties, Permissions, Impersonal Rules, Operational Definitions, Prohibitions, Procedural Guidelines, and Criminal Offenses. Key feature analysis is used to identify and describe patterns of lexico-grammatical variation between the seven functional types. Results reveal a great deal of lexico-grammatical variation associated with function in the register of statutory law. Furthermore, some functional types of statutory provisions are more linguistically distinct than others. These findings suggest that it may be beneficial to consider communicative function when investigating legal interpretative questions.

Medium‐term load forecasting of power system based on BiLSTM and parallel feature extraction network

AbstractWith the diversification of users’ energy demands, accurate load forecasting is an important prerequisite for optimal scheduling and economic operation of the system, but a single‐load forecasting method cannot effectively predict multi‐energy loads accurately. Therefore, this paper proposes a multi‐energy load forecasting method based on bidirectional long short‐term memory (BiLSTM) and parallel feature extraction networks. Firstly, residual network and convolutional block attention module were used to extract the spatial coupling features of multi‐energy load data. Secondly, BiLSTM is used to capture the temporal features and long‐term dependencies in the load data, and the spatial coupling features are fused to obtain non‐linear prediction results. Finally, the non‐linear prediction results and the linear prediction results obtained by using multi‐energy linear regression were linearly superimposed to obtain the final prediction results. In this paper, IES load data of Tempe Campus of Arizona State University was used to verify and compared with several existing methods, and the results showed that Weighted Mean Absolute Percentage Error decreased by more than 20%.

Characteristics of Overdose Deaths Related to Illicitly Manufactured Fentanyl – Arizona, July 2019 – June 2020

ABSTRACT Using the Arizona State Unintentional Drug Overdose Reporting System (AZ-SUDORS), the study aims to identify the social and drug characteristics of illicitly manufactured fentanyl (IMF)-related overdose deaths. The data include drug overdose deaths from July 1, 2019 to June 30, 2020. Decedents were categorized into four groups by types of opioids detected: (1) IMF-positive; (2) heroin-positive (negative for IMF); (3) pharmaceutical opioid-positive (negative for heroin or IMF); (4) nonopioid. Bivariate statistics were used to compare differences between IMF and other groups. Among 2,029 decedents, 77.8% tested positive for opioids. The IMF group included 57.9%, the heroin group included 9.5%, the pharmaceutical opioid group 10.5%, and the nonopioid group 22.2%. The IMF group was younger (mean age 35.0), more likely to be from a large urban area (78.2%), and with a greater proportion of ethnic/racial minorities (48.6%), compared to the other three groups. The IMF group was less likely to test positive for methamphetamine (24.9%), compared to heroin (63.7%) or pharmaceutical opioid groups (34.0%), but more likely to test positive for cannabis (31.3%), compared to the other three groups. Our data show disproportionate IMF impacts on younger persons and ethnic minorities. Interventions need to be tailored to account for distinct psychosocial profiles associated with IMF use.

Common Ground: The Unique Synergy Between the Oil Field and Aerospace

Though disparate locations, outer space and the oil field have much more in common than one might think. Both can be taxing on operations and often redefine the idea of an isolated and, at times, hostile work environment. Harsh atmospheric conditions and wide-ranging pressure regimes call for unique technological applications and operations to achieve the best performance and results, whether it’s the gravitational and meteorological challenges of another planet or the crushing pressures and changing meta-ocean conditions of the deep offshore. Despite the obvious differences, operating in both the terran oil field and the blackness of space offer hurdles that can be cleared by similar means. Shared technologies between the two industries have been around for decades and center around disciplines like automation, robotics, and remote sensing. The National Aeronautics and Space Administration (NASA) itself has dabbled in oilfield studies, especially when it comes to greenhouse gas emissions and their impact on the atmosphere. In 2021, the agency’s Jet Propulsion Laboratory, along with the University of Arizona and Arizona State University, completed a study to identify methane super-emitters in the Permian Basin. The month-long, airborne study concluded that fixing the worst leaks identified in the area’s infrastructure could cut methane emissions by 55 tons an hour, equivalent to 5.5% of the US Environmental Protection Agency’s estimates of all methane emissions from hydrocarbon production across the entire US. The study pointed to malfunctioning equipment as the likely culprit for the 123 sources found. Conversely, NASA has also tapped into oilfield technology for some of its planned drilling operations on the moon. It will be the first such operation on any planetary body outside of the Earth. One of the earliest directives of NASA’s Artemis program is to try and find water near the lunar South Pole. Polar Resources Ice Mining Experiment-1 (PRIME-1) will be the first in-situ resource utilization demonstration on the moon. For the first time, NASA will robotically sample and analyze for ice from below the surface. PRIME-1 will use TRIDENT (The Regolith and Ice Drill for Exploring New Terrain) to drill in a single location at a site with a high likelihood of having water, whether in liquid or ice form. TRIDENT was developed and supplied by Honeybee Robotics, which also supplies geotechnical tools and sensors, among other tech, to the oil patch. The system, to be integrated into VIPER, NASA’s first robotic moon rover, will drill about a meter below the surface, each time bringing up samples that NASA will analyze with a mass spectrometer. The launch of the NOVA-C, which carries the PRIME-1, was previously delayed. At press time, the payload was due to blast off on board Space X’s Falcon 9 rocket in early 2024. NASA said in October the VIPER will reach its destination at Mons Mouton near the lunar South Pole in November 2024.

Identify successful restrictions in suppressing the early outbreak of COVID-19 in Arizona, United States: Interrupted time series analysis.

COVID-19 was responsible for many deaths and economic losses around the globe since its first case report. Governments implemented a variety of policies to combat the pandemic in order to protect their citizens and save lives. Early in 2020, the first cases were reported in Arizona State and continued to rise until the discovery of the vaccine in 2021. A variety of strategies and interventions to stop or decelerate the spread of the pandemic has been considered. It is recommended to define which strategy was successful for disease propagation prevention and could be used in further similar situations. This study aimed to evaluate the effect of people's contact interventions strategies which were implemented in Arizona State and their effect on reducing the daily new COVID-19 cases and deaths. Their effect on daily COVID-19 cases and deaths were evaluated using an interrupted time series analysis during the pandemic's first peaks to better understand the onward situation. Canceling the order of staying at home (95% CI, 1718.52 to 6218.79; p<0.001) and expiring large gatherings (95% CI, 1984.99 to 7060.26; p<0.001) on June 30 and August 17, 2020, respectively, had a significant effect on the pandemic, leading to the daily cases to grow rapidly. Moreover, canceling the stay at home orders led to an increase in the number of COVID-19 daily deaths by 67.68 cases (95% CI, 27.96 to 107.40; p<0.001) after about 21 days while prohibiting large gatherings significantly decreased 66.76 (95% CI: 20.56 to 112.96; p = 0.004) the number of daily deaths with about 21 days' lag. The results showed that strategies aimed at reducing people's contact with one another could successfully help fight the pandemic. Findings from this study provide important evidence to support state-level policies that require observance of social distancing by the general public for future pandemics.

MCDM-Based Wildfire Risk Assessment: A Case Study on the State of Arizona

The increasing frequency of wildfires has posed significant challenges to communities worldwide. The effectiveness of all aspects of disaster management depends on a credible estimation of the prevailing risk. Risk, the product of a hazard’s likelihood and its potential consequences, encompasses the probability of hazard occurrence, the exposure of assets to these hazards, existing vulnerabilities that amplify the consequences, and the capacity to manage, mitigate, and recover from their consequences. This paper employs the multiple criteria decision-making (MCDM) framework, which produces reliable results and allows for the customization of the relative importance of factors based on expert opinions. Utilizing the AROMAN algorithm, the study ranks counties in the state of Arizona according to their wildfire risk, drawing upon 25 factors categorized into expected annual loss, community resilience, and social vulnerability. A sensitivity analysis demonstrates the stability of the results when model parameters are altered, reinforcing the robustness of this approach in disaster risk assessment. While the paper primarily focuses on enhancing the safety of human communities in the context of wildfires, it highlights the versatility of the methodology, which can be applied to other natural hazards and accommodate more subjective risk and safety assessments.

Lessons from a “Scholar on Fire” for a World on Fire: A Framework to Position Technical and Professional Communication Scholars for Policy Impact

Technical and Professional Communication (TPC) scholars and practitioners (TPCers) see a need to intervene in a range of complex problems. Yet scholars such as Leah Ceccarelli and Lauren Cagle have noted a gap between scholarly research findings and policy changes. To address this gap, I theorize a strategic grounding framework, consisting of multiple, linked tactics that over time enable TPCers to make a case to gain a seat at the table to shape policy. I theorize this framework through a case study of Stephen J. Pyne, founder of the subfield of Fire History, who influenced national and global fire management policy. I examine Pyne's professional papers, housed in the Stephen J. Pyne Papers Collection at the Arizona State University Archives. The framework offers TPCers a series of tactics that position TPCers as change makers as they place their expertise to shape policy that addresses complex problems.

Trypanosoma cruzi infection in dogs along the US-Mexico border: R0 changes with vector species composition

Infection with Trypanosoma cruzi, etiological agent of Chagas disease, is common in US government working dogs along the US-Mexico border. This 3145 km long border comprises four states: Texas (TX), New Mexico (NM), Arizona (AZ) and California (CA) with diverse ecosystems and several triatomine (a.k.a., kissing bug) species, primary vectors of T. cruzi in this region. The kissing bug (Heteroptera: Reduviidae) community ranging from CA to TX includes Triatoma protracta (Uhler), Triatoma recurva (Stål) and Triatoma rubida (Uhler) and becomes dominated by Triatoma gerstaeckeri Stål in TX. Here, we ask if T. cruzi infection dynamics in dogs varies along this border region, potentially reflecting changes in vector species and their vectorial capacity. Using reversible catalytic models of infection, where seropositivity can be lost, we estimated an R0 (Estimate ± S.E.) of 1.192 ± 0.084 for TX and NM. In contrast, seropositivity decayed to zero as dogs aged in AZ and CA. These results suggest that dogs are likely infected by T. cruzi during their training in western TX, with a force of infection large enough for keeping R0 above 1, i.e., the disease endemically established, in TX and NM. In AZ and CA, a lower force of infection, probably associated with different vector species communities and associated vectorial capacity and/or different lineages of T. cruzi, results in dogs decreasing their seropositivity with age.

Analysing Witczak 1-37A, Witczak 1-40D and Modified Hirsch Models for asphalt dynamic modulus prediction using global sensitivity analysis

ABSTRACT The dynamic modulus (∣E*∣) of hot-mix asphalt mixes is one of the most time-consuming and labour-intensive material metrics to evaluate in the laboratory. This study introduces a novel paradigm for assessing the ∣E*∣'s most influential elements by employing widely accepted literature models. Witczak 1-37A, Witczak 1-40D, and Modified Hirsch Models are selected for analysing the asphalt dynamic modulus. First, a thorough laboratory database of Arizona State University is used to account for all major input factors, such as mixture gradation, binder qualities, volumetric properties, and testing conditions parameters, during models' validation. Second, each model's performance is evaluated using standard measures to build confidence levels in the subsequent analysis stage. Finally, with the aid of Latin Hypercube Simulation, a comprehensive global sensitivity analysis (GSA) is performed. Three unique GSA approaches are used; namely, elementary effects, variance-based, and PAWN methods, to highlight the effect of each input variable on the magnitude of ∣E*∣. Different GSA tools are strongly recommended since there is no analytical tool for validating the findings with the complex formulations of the selected mathematical models. The GSA demonstrates that the voids ratio in total mix, binder shear modulus, viscosity, phase angle, and binder quantity are the most significant factors.

Canine Parvovirus 2C Identified in Dog Feces from Poop Bags Collected from Outdoor Waste Bins in Arizona USA, June 2022.

Canine parvoviruses (CPVs) are a major cause of morbidity and mortality in dogs. However, surveillance has been largely limited to clinically manifest cases, resulting in a dearth of CPV genomic information on virus type, abundance, and diversity, limiting our understanding of its evolutionary dynamics. We tested the feasibility of using dog feces in poop bags collected from outdoor waste bins as a source for environmental surveillance of CPV. After polymerase chain reaction, long-read sequencing, and bioinformatics, we identified that CPV-2c was present in Arizona, USA, in June 2022 and documented variants with amino acid substitutions 530E and 101K in NS1 and NS2, respectively. Based on publicly available sequence data in GenBank as of January 2023, the CPV genome described here represents the only CPV genome described in the USA from the 2022 season, despite news of CPV outbreak-associated fatalities in dogs in the USA. This highlights the need for more studies that document CPV complete or near complete genomes, as well as experimental studies, to further our understanding of its evolutionary process.

The bans on teaching CRT and other ‘divisive concepts’ in America’s public schools

ABSTRACT The Arizona state legislature has aimed to pass a series of bills banning those in schools from teaching topics associated with inclusion, social justice, and equity. Since 2020, the legislature has targeted teaching ‘critical race theory’ (CRT), often (mis)using the term to refer to any ideas related to systemic discrimination and racial inequality. The debates on the need to educate children about race and racism are ongoing, and school leaders in Arizona have been cast into the debate on the CRT bans. In this study, I put actor–network theory (ANT) to work to explore how school leaders navigate the uncertainties, contradictions, and controversies of the debate and potential bans. I demonstrate the ways in which ANT is particularly useful in exploring controversies in education leadership and policy that bring to the fore the uncertainties of who is acting, when, with what and whom – for what purposes.

Growth and Evolution of the Symbiota Portal Network

Symbiota is empowering biodiversity collections communities across the globe to efficiently manage and mobilize their data. Beginning with only a handful of collections in two major portals in the early 2010s (Gries et al. 2014), Symbiota now acts as the primary content management system for over 1,000 collections in more than 50 portals. Over 1,800 collections share data through Symbiota portals, constituting over 90+ million records and 42+ million images. The iDigBio Symbiota Support Hub, a team and cyberinfrastructure based out of Arizona State University and supported by the United States (U.S.) National Science Foundation, hosts 52 Symbiota portals and provides daily help and resources to all Symbiota user communities. The Symbiota codebase is being actively developed in collaboration with several funded projects, including the U.S. National Ecological and Observatory Network (NEON), to support new data types and connections, such as between Symbiota portals and other collections management systems, and to other resources (e.g., Index Fungorum, Global Registry of Scientific Collections, Bionomia, Environmental Data Initiative). Because the Symbiota codebase is open source and shared among portals, new developments in any portal empower the entire network. Here we describe recent expansions of the Symbiota network, including new portals, collaborations, functionalities, and sustainability actions. We look forward to building further collaborations with diverse, international collections data communities.

Abstract 15 A State-Run Public Cord Blood Collection Program

Abstract Introduction The Arizona Public Cord Blood Program was created in 2011 by the Arizona Biomedical Research Centre, a sub-section of the Arizona Department of Health Services, to advance the collection and increase the number of racially and ethnically diverse cord blood units available for transplantation, as well as promote awareness of the benefits of cord blood stem cells through our educational partner, Save the Cord Foundation (STCF). Objectives Create a sustainable program for women of all racial and ethnic backgrounds to have the opportunity to donate cord blood, with the primary goal of transplantation, and secondary goal of providing non-transplantable cord blood units for research. A second objective was to educate the residents of the state of Arizona about cord blood stem cells and the need for their preservation. Methods A portion of state lottery funds supports the program monetarily. Those funds are provided to four collection hospitals who employ "cord blood consenters" whose responsibility it is to consent patients, assist delivery providers with collections, and package and ship cord blood units to our partner cord blood bank at MD Anderson Cancer Center. There are also two clinical coordinators who educate and train hospital staff on quality collection practices, with special emphasis on the importance of high volume, sterile collections. STCF provides education across the state to expectant parents, healthcare providers, schools, and the public about the need for cord blood stem cell donation for transplant and research. Results Since 2011, the Arizona Public Cord Blood Program has banked hundreds of racially and ethnically diverse cord blood units with the National Marrow Donor Program, and has had 86 life-saving cord blood units matched with patients in need around the globe. This innovative program has not only expanded cord blood awareness and promoted the preservation of cord blood; it has resulted in the creation of an economic engine for the state of Arizona that is an attractant for STEM based businesses and careers. Discussion A decade later, the Arizona Public Cord Blood Program has proven to be a sustainable model for collecting and providing suitable cord blood units for transplant to diverse patient populations.

Evaluation of Familial Similarity of Carabelli’s Trait in South Kerala Population: A Pilot Study

Abstract Background: The distribution of Carabelli’s trait is variable in different individuals and also amongst children and their parents. Knowledge and distribution of Carabelli’s trait and evaluating their familial similarity can be very useful in forensic dentistry. The forensic implication also includes the identification of deceased individuals, racial identification and cases of disputed paternity. Aim and Objective: The aim of this study was to determine the familial similarity of Carabelli’s trait in South Kerala population and to determine the extent of expression of Carabelli’s pattern in both child and parent. Materials and Methods: Children and their parents from the department of pedodontics over 1 month were selected and examined for the expression of Carabelli’s trait in the maxillary primary second molar and permanent maxillary first molars. For this study, non-carious teeth with good anatomical landmarks are selected. Caries tooth, fractured tooth and supernumerary para molars are excluded from the study. Child age groups between 6 and 12 years were selected and parents of any age groups were selected for the study. Informed consent both verbal and written was taken before taking intraoral impressions and photographs. Maxillary impressions and intraoral photographs of both child and their parent were recorded, and further examination and scoring were done on cast and photographs on the basis of the classification developed by the Arizona State University Dental Anthropology system which specifies the eight grades of expression of Carabelli’s pattern. Result: In our study, we are able to identify a familial similarity in the expression of Carabelli’s trait in children and parents in the South Kerala population. Conclusion: Cusp of carabell’s trait in south Kerala population.

Falling Out of Postural Instability: Evaluating the Contribution of Somatosensation to Standing Balance in Parkinson's Disease

People with PD (PwPD) experience a variety of motor symptoms, including postural instability, impaired gait, tremors, and falls. Falls among PwPD are especially debilitating, as they can result in fracture risk, increased progression of the disease, and even death. Previous research has demonstrated that the somatosensory system, consisting of tactile sensation (which is responsible for feelings of touch and pressure) and proprioceptive feedback (which is important in joint position sense), is crucial for reactive balance control. The primary goal of this project was to determine the unique contributions of the tactile and proprioceptive systems to standing balance control in PD. Participants at the Gait and Balance Disorders Lab at Arizona State University were asked to maintain their balance while experiencing 3 sensory vibration conditions from vibrotactile transducers 1) a control condition with no vibration, 2) vibration underneath the feet to disturb tactile sensation, and 3) vibration on top of their feet (dorsiflexor tendon) to manipulate proprioception. Another goal was to identify predictors of somatosensory impairment during standing balance (i.e., participants affected most by sensory vibration) by associating clinical characteristics with change scores in balance outcomes from the no vibration-control condition to the tactile and proprioceptive stimulation conditions. The results of this study indicate that vibrotactile stimulation had minimal impacts on standing balance responses. This study also found few predictors of somatosensory impairments. Further research is needed to enhance clinical efficiency in designing treatments that have the most impact on improving balance control and preventing falls.

Utilization of street-based COVID-19 vaccination clinics in Phoenix's homeless population.

The novel Coronavirus (COVID-19) is a highly contagious viral illness that has caused the most significant global health crisis in recent human history. Individuals experiencing homelessness represent one of the more vulnerable populations for COVID-19 infection and morbidity. Amongst individuals experiencing homelessness in Phoenix, a student-led interprofessional organization called Street Medicine Phoenix (SMP) sought to both reduce the risk of COVID-19 transmission and morbidity/mortality related to infection. Through collaborations with the Maricopa County Department of Public Health and various community organizations, SMP developed a format for street-based vaccination clinics. SMP deployed these clinics on numerous occasions to the streets directly surrounding the community homeless shelter, allowing SMP to vaccinate individuals directly in their encampments. Through SMP's efforts starting in February 2021, 400 individuals experiencing homelessness have received at least one COVID-19 vaccine. Challenges encountered included low health literacy, lack of established rapport and trust, low vaccine confidence, difficulty verifying patients' vaccination status, difficulty obtaining sufficient information from patients to create a record in the Arizona State Immunization Information System (ASIIS), monitoring patients post-vaccination, transporting vaccine supplies from encampment to encampment, and lack of patient awareness of the mobile vaccine clinic services. Despite challenges, SMP's outreach efforts have demonstrated the feasibility and importance of mobile public health services to reach homeless encampments, particularly mobile vaccination clinics in response to disease outbreaks, and the necessity of strategic partnerships with community agencies to effectively meet the needs of underserved populations.