Browsing by Author "Hudnall, Matthew"
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Item Autonomous Vehicle Handling Analysis for an Indy Autonomous Challenge Car(University of Alabama Libraries, 2023) Frederick, Robert Cole; Dixon, Brandon DThis dissertation aims to present a handling analysis package developed to keep the car from crossing the limit of traction for the first fully autonomous head-to-head race. The Indy Autonomous Challenge is a fully autonomous racing competition with ten university-based teams competing with identical cars. The University of Alabama participated in the IAC as a part of the PoliMOVE team. The competition challenged teams to integrate software and hardware and develop algorithms for autonomy and control. A portion of the software and hardware integration is the vehicle's control and dynamics, which is essential to keep the car on track. This research focuses on determining methods and algorithms to analyze the vehicle's handling to keep the car below the traction limit. An understeer/oversteer controller is proposed to solve the negative effects from the controller on a lateral controller. An application was created to analyze data and to rapidly develop algorithms for interrupting the raw vehicle data. Quick data analysis is critical to managing the vehicle's handling, which is why the team analyzes data live through telemetry. In contrast, other data is post-processed to ensure the car's safe operation. Crashes cost tens of thousands of dollars and can cause the team to miss crucial test sessions for developing the vehicle. The paper presents the analysis package, controller, and algorithms designed for the PoliMOVE team car.Item Effect of Patient-Physician Relationship on Withholding Information Behavior: Analysis of Health Information National Trends Survey (2011-2018) Data(JMIR Publications, 2020) Yang, Xin; Parton, Jason; Lewis, Dwight; Yang, Ning; Hudnall, Matthew; University of Alabama TuscaloosaBackground: Patients' withholding information from doctors can undermine medical treatment, create barriers for appropriate diagnoses, and increase systemic cost in health care systems. To date, there is limited literature detailing the association between trends of patients withholding information behavior (WIB) and the patient-physician relationship (PPR). Objective: The aim of this study was to explore the prevalence trend of WIB after 2011 and examine the effects of PPR on WIB and its time trend. Methods: A total of 5 iterations of data from the Health Information National Trends Survey (years: 2011-2018; n=11,954) were used to explore curvilinear trends of WIB among the US population. Multiple logistic regression models were used to examine curvilinear time trends of WIB, effects of PPR on WIB, and moderation effects of PPR on the WIB time trend. Results: The WIB prevalence has an increasing trend before 2014, which has the highest rate of 13.57%, and then it decreases after 2014 to 8.65%. The trend of WIB is curvilinear as the quadratic term in logistic regression model was statistically significant (P=.04; beta=-.022; SE=0.011; odds ratio [OR] 0.978, 95% CI 0.957-0.999). PPR is reversely associated with WIB (P<.001; beta=-.462; SE=0.097; OR 0.630, 95% CI 0.518-0.766) and has a significant moderation effect on time trends (P=.02; beta=-.06; SE=0.025; OR 0.941, 95% CI 0.896-0.989). In general, poor quality of PPR not only significantly increased the WIB probability but also postponed the change of point for WIB curvilinear trend. Conclusions: Findings suggest that the time trend of WIB between 2011 and 2018 is curvilinear and moderated by the quality of the PPR. Given these results, providers may reduce WIB by improving PPR. More research is needed to confirm these findings.Item Lessons learned from developing a statewide research data repository to combat the opioid epidemic in Alabama(Oxford University Press, 2022) Hudnall, Matthew; Lewis, Dwight; Parton, Jason; Sellers, Christopher; University of Alabama TuscaloosaMany states are continuing to struggle with opioids and other commonly abused drugs. Alabama, being the highest opioid prescription per-capita state since 2012, has pulled together state agencies, private companies, academia, and community organizations to form a data council and repository to provide unified insights and information to the public and partner stakeholders. The lessons learned in constructing this data environment are documented so that other states and organizations can benefit from the challenges and success that Alabama has experienced. The centralized data repository consists of almost a dozen data streams from public agencies and private companies. The data are transformed and linked within the repository to provide geo-temporal linkages between data sources. The data are stored in a secure multi-tiered environment in a Microsoft SQL Server database, de-identified, aggregated, and then published to a public web portal for open consumption. The public-facing website from the project successfully integrates multiple disparate data sources into a common platform for streamlined and cohesive data communications. Drug addiction cannot be easily quantified, viewed, or otherwise examined when only looking at a portion of society. By bringing together multiple data sources and linking them, a more clear picture of trends, influences, and metrics can be obtained. A statewide drug use data partnership between public and private entities is both possible as well as beneficial to all parties involved. Items like legal contracts can inhibit data sharing, but certain best practices can help scale and streamline multiple agreements. Lay Summary As state and federal policies have facilitated a downward trend in the abuse and misuse of prescription opioids, the incidence of deaths due to illicit synthetic opioids perpetuates the well-documented public health challenge of opioids in the United States. The transient nature of America's opioid epidemic produces the demand for timely data from multiple sources to mitigate this multi-faceted problem. Moreover, many state government agencies experience challenges in recruiting and retaining personnel with the needed advanced analytic skillsets to promote effective planning management strategies to combat the opioid epidemic. So analytic support from neighboring universities could address this human capital challenge. The purpose of this case report is to highlight activities in developing Alabama's Drug Use Centralized Data Repository (DrugUse-CDR). More specifically, we will highlight (1) the origins of DrugUse-CDR, (2) the academic-government collaboration in DrugUse-CDR, (3) the success and challenges of DrugUse-CDR, and (4) the next steps of the program.Item Mailtrust: attribute-based dynamic encrypted email(University of Alabama Libraries, 2017) Hudnall, Matthew; Vrbsky, Susan V.; Parrish, Allen Scott; University of Alabama TuscaloosaE-mail is generally regarded as an insecure method of electronic communication for numerous reasons. Most notably, the default does not guarantee the authentic identity of either the intended sender or receiver of a message, nor does it guarantee the confidentiality and integrity of the message. While these problems can partially be addressed with commonly utilized technologies involving certificates and e-mail client plugins, current practice is insufficient for high-security applications, such as classified communications among clients of different email systems. The research presented here leverages “Trustmarks” (which were developed primarily to support efficient single sign on in a federated environment) to support secure e-mails between multiple systems where there are particularly stringent confidentiality and integrity requirements. Such a system could increase the ability of users at disparate organizations to communicate without fear that sensitive information might intentionally or accidentally be disclosed. Although there are many barriers to adoption, such a system might also eventually reduce the reliance on separate communication networks and systems for classified communications.Item Pandemic-Triggered Adoption of Telehealth in Underserved Communities: Descriptive Study of Pre- and Postshutdown Trends(JMIR Publications, 2022) Xu, Pei; Hudnall, Matthew; Zhao, Sidi; Raja, Uzma; Parton, Jason; Lewis, Dwight; Auburn University; University of Alabama TuscaloosaBackground: The adoption of telehealth services has been a challenge in rural communities. The reasons for the slow adoption of such technology-driven services have been attributed to social norms, health care policies, and a lack of infrastructure to support the delivery of services. However, the COVID-19 pandemic-related shutdown of in-person health care services resulted in the usage of telehealth services as a necessity rather than a choice. The pandemic also fast-tracked some needed legislation to allow medical cost reimbursement for remote examination and health care services. As services return to normalcy, it is important to examine whether the usage of telehealth services during the period of a shutdown has changed any of the trends in the acceptance of telehealth as a reliable alternative to traditional in-person health care services. Objective: Our aim was to explore whether the temporary shift to telehealth services has changed the attitudes toward the usage of technology-enabled health services in rural communities. Methods: We examined the Medicaid reimbursement data for the state of Alabama from March 2019 through June 2021. Selecting the telehealth service codes, we explored the adoption rates in 3 phases of the COVID-19 shutdown: prepandemic, pandemic before the rollout of mass vaccination, and pandemic after the rollout of mass vaccination. Results: The trend in telemedicine claims had an opposite pattern to that in nontelemedicine claims across the 3 periods. The distribution of various characteristics of patients who used telemedicine (age group, gender, race, level of rurality, and service provider type) was different across the 3 periods. Claims related to behavior and mental health had the highest rates of telemedicine usage after the onset of the pandemic. The rate of telemedicine usage remained at a high level after the rollout of mass vaccination. Conclusions: The current trends indicate that adoption of telehealth services is likely to increase postpandemic and that the consumers (patients), service providers, health care establishments, insurance companies, and state and local policies have changed their attitudes toward telehealth. An increase in the use of telehealth could help local and federal governments address the shortage of health care facilities and service providers in underserved communities, and patients can get the much-needed care in a timely and effective manner.Item Patterns and Influencing Factors of eHealth Tools Adoption Among Medicaid and Non-Medicaid Populations From the Health Information National Trends Survey (HINTS) 2017-2019: Questionnaire Study(JMIR Publications, 2021) Yang, Xin; Yang, Ning; Lewis, Dwight; Parton, Jason; Hudnall, Matthew; University of Alabama TuscaloosaBackground: Evidence suggests that eHealth tools adoption is associated with better health outcomes among various populations. The patterns and factors influencing eHealth adoption among the US Medicaid population remain obscure. Objective: The objective of this study is to explore patterns of eHealth tools adoption among the Medicaid population and examine factors associated with eHealth adoption. Methods: Data from the Health Information National Trends Survey from 2017 to 2019 were used to estimate the patterns of eHealth tools adoption among Medicaid and non-Medicaid populations. The effects of Medicaid insurance status and other influencing factors were assessed with logistic regression models. Results: Compared with the non-Medicaid population, the Medicaid beneficiaries had significantly lower eHealth tools adoption rates for health information management (11.2% to 17.5% less) and mobile health for self-regulation (0.8% to 9.7% less). Conversely, the Medicaid population had significantly higher adoption rates for using social media for health information than their counterpart (8% higher in 2018, P=.01; 10.1% higher in 2019, P=.01). Internet access diversity, education, and cardiovascular diseases were positively associated with health information management and mobile health for self-regulation among the Medicaid population. Internet access diversity is the only factor significantly associated with social media adoption for acquisition of health information (OR 1.98, 95% CI 1.26-3.11). Conclusions: Our results suggest digital disparities in eHealth tools adoption between the Medicaid and non-Medicaid populations. Future research should investigate behavioral correlates and develop interventions to improve eHealth adoption and use among underserved communities.Item Physician Gender, Patient Risk, and Web-Based Reviews: Longitudinal Study of the Relationship Between Physicians' Gender and Their Web-Based Reviews(JMIR Publications, 2022) Saifee, Danish Hasnain; Hudnall, Matthew; Raja, Uzma; University of Alabama Tuscaloosa; Auburn UniversityBackground: Web-based reviews of physicians have become exceedingly popular among health care consumers since the early 2010s. A factor that can potentially influence these reviews is the gender of the physician, because the physician's gender has been found to influence patient-physician communication. Our study is among the first to conduct a rigorous longitudinal analysis to study the effects of the gender of physicians on their reviews, after accounting for several important clinical factors, including patient risk, physician specialty, and temporal factors, using time fixed effects. In addition, this study is among the first to study the possible gender bias in web-based reviews using statewide data from Alabama, a predominantly rural state with high Medicaid and Medicare use. Objective: This study conducts a longitudinal empirical investigation of the relationship between physician gender and their web-based reviews using data across the state of Alabama, after accounting for patient risk and temporal effects. Methods: We created a unique data set by combining data from web-based physician reviews from the popular physician review website, RateMDs, and clinical data from the Center for Medicare and Medicaid Services for the state of Alabama. We used longitudinal econometric specifications to conduct an econometric analysis, while controlling for several important clinical and review characteristics across four rating dimensions (helpfulness, knowledge, staff, and punctuality). The overall rating and these four rating dimensions from RateMDs were used as the dependent variables, and physician gender was the key explanatory variable in our panel regression models. Results: The panel used to conduct the main econometric analysis included 1093 physicians. After controlling for several clinical and review factors, the physician random effects specifications showed that male physicians receive better web-based ratings than female physicians. Coefficients and corresponding SEs and P values of the binary variable GenderFemale (1 for female physicians and 0 otherwise) with different rating variables as outcomes were as follows: OverallRating (coefficient -0.194, SE 0.060; P=.001), HelpfulnessRating (coefficient -0.221, SE 0.069; P=.001), KnowledgeRating (coefficient -0.230, SE 0.065; P<.001), StaffRating (coefficient -0.123, SE 0.062; P=.049), and PunctualityRating (coefficient -0.200, SE 0.067; P=.003). The negative coefficients indicate a bias toward male physicians versus female physicians for aforementioned rating variables. Conclusions: This study found that female physicians receive lower web-based ratings than male physicians even after accounting for several clinical characteristics associated with the physicians and temporal effects. Although the magnitude of the coefficients of GenderFemale was relatively small, they were statistically significant. This study provides support to the findings on gender bias in the existing health care literature. We contribute to the existing literature by conducting a study using data across the state of Alabama and using a longitudinal econometric analysis, along with incorporating important clinical and review controls associated with the physicians.Item The Role of Stress Among Cybersecurity Professionals(University of Alabama Libraries, 2021) Singh, Tripti; Johnston, Allen C.; University of Alabama TuscaloosaThe concept of stress has gained significant attention from researchers across several disciplines. Among this research, information systems (IS) scholars have contributed to our understanding of stress by detailing individual experiences of stress that occur from the use of technology, adherence to information security requirements, and other workplace circumstances such as work overload. Yet, even among this IS focused research, there are different conceptualizations and operationalizations of stress; how it is formed, how it is measured, and how individuals respond to it. This dissertation seeks to provide some needed clarity and insight to this stream of research and does so by focusing on one of the most stress-prone, but least understood segments of the information security (InfoSec) practice community, cybersecurity professionals. In this two-essay dissertation, we accomplish two broad goals. First, in essay one we synthesize the trends, gaps, and limitations of the research on stress as it applies to cybersecurity professionals and develop a set of opportunities for future research. Second, in essay two we describe and test a demand appraisal model for cybersecurity professionals to show how cybersecurity professionals experience and respond to stress stemming from the demands associated with implementing and/or maintaining their organizations’ electronic monitoring and surveillance (EMS) technologies.Item Sharing is Caring: Essays on Online Self-Disclosure(University of Alabama Libraries, 2020) Nabity-Grover, Teagen M; Thatcher, Jason; Johnston, Allen; University of Alabama TuscaloosaOnline self-disclosure has been studied in a variety of disciplines for more than two decades. Self-disclosure is any information about the self communicated to another person; it is generally decomposed into five dimensions: amount, depth or intimacy, honesty and accuracy, polarity, and intent. In this dissertation, we offer a new contextualization of self-disclosure to online settings. While our review of the literature suggests four dimensions are conceptually similar across contexts, the fifth – intent – is problematic. Intent refers to the willingness to share personal information. In the online context, intent items direct attention to whether one intends to post or is unaware they are posting certain information. In the offline context, unintentional or accidental disclosures occur mostly due to environmental (i.e. seeing a colleague in a locker room) or nonverbal (i.e. facial expressions) cues. However, online communication differs from offline communication in four ways: reduced nonverbal cues, asynchronicity, editability, and breadth of audience. The first three of these unique attributes imply online intent is fundamentally different from offline intent. To account for these differences, there is a need to contextualize self-disclosure to the online environment. We accomplish the contextualization of online self-disclosure through two essays. In essay one, we conduct a thorough review of the literature to evaluate the contextualization of the measures of online self-disclosure and identify areas for improving the construct’s measurement. Based on the analysis, we propose four context-specific dimensions to supplant intent in the decomposition of online self-disclosure: willingness to participate, reciprocity, audience control, and conscientious use. In essay two, we develop an operational long- and short-form measure and subject it to rigorous validity testing; in doing so, we compare the new measure to two established instruments and examine its performance within a nomological model. We find support for two of the proposed dimensions and for a new structural definition of online self-disclosure involving two intermediate latent variables: message and behavior. This new structure could help improve the content validity of short, simple instruments that are frequently seen in the literature.Item Visualizing Potential Effects of Dentist Retirements on Accessibility to Dental Care Among Children in Alabama, 2019(Centers for Disease Control and Prevention, 2021) Samsel, Steven; Tramp, Ryan; Orgut, Irem Sengul; Freeman, Nickolas; Parton, Jason; Hudnall, Matthew; Lewis, Dwight; University of Alabama Tuscaloosa