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Impact Of Parent’S Hiv Status On Their Uninfected Child—A Comparative Analysis Of The Child’S Healthcare Utilization, Access And Health Outcomes, Arijit Ganguli

Theses and Dissertations (ETD)

With the advent of effective antiretroviral medication and increased expectancy of life span among HIV-infected individuals has lead to an increase in the at-risk population of uninfected children living with their HIV-infected parent(s). The purpose of this study was to investigate the impact of parent’s HIV status on their child’s access to healthcare resources, healthcare utilization and health outcomes.

This was a cross-sectional study in which the information on the children of HIV seropositive parent(s) was collected through a face-to-face interview of the HIV-infected parents having children currently residing with them. The comparative group comprising of children of HIV seronegative …

Preferences And Willingness To Pay For Osteoarthritis Treatments Among The Medicare Population, Meghan Alexis Hufstader

Theses and Dissertations (ETD)

The design of this study is a non-random cross sectional survey to determine Medicare beneficiaries’ preferences and willingness to pay for osteoarthritis (OA) treatments. The population of interest in this study is the Medicare eligible (over age 65) population in Memphis, TN, and surrounding cities. Data were collected at Senior Centers and one internal medicine practice. The sample size was 181.

Choice-based conjoint analysis technique was utilized. The preferences and willingness to pay were determined using choice-based conjoint analysis, advanced design module with a dual-response none option. Choice-based conjoint analysis uses computer guided surveys to elicit patient preference for a …

Stepped Care For Smoking Cessation: A Cost-Effectiveness Analysis And Simulation Of Future Outcomes, Brandi E. Franklin

Theses and Dissertations (ETD)

It has been well established that smoking is the leading avoidable cause of premature morbidity and mortality in the United States and abroad. Smoking is attributable to over 400,000 annual deaths, and $193 billion in healthcare costs and lost productivity. Despite the apparent dangers and tremendous costs of tobacco use and dependence, smokers find difficulty quitting. Recently, stepped care has been proposed as a viable intensive approach for achieving long-term cessation. This research sought to evaluate cost-effectiveness of stepped care in a diverse population of smokers and analyze future health outcomes of smoking cessation.

Cost-effectiveness analysis was conducted from an …

Function And Pain In Community-Dwelling, Adult Mid-Southerners With Limb Loss, Cecile B. Evans

Theses and Dissertations (ETD)

Background: Limb loss affects about 1 in 190 people in the US. Risk factors for limb loss include diabetes, obesity, smoking, minority race, and poverty, which are all common in the Mid-South population. Function is impaired by limb loss, and pain associated with limb loss may further impair function.

Purpose: Describe the function, pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the relationship between function and pain, health status, and demographics of community-dwelling, adult Mid-Southerners with limb loss. Estimate the joint influences on function by pain, health status, and demographics of community-dwelling, adult Mid-Southerners with …

Contribution Of Organic Cation Transporter 2 (Oct2) To Cisplatin-Induced Nephrotoxicity, Kelly K. Filipski

Theses and Dissertations (ETD)

Cisplatin is the most widely used anticancer agent; however, the cellular pharmacokinetics are poorly understood. Cisplatin is predominantly eliminated through the urine via active secretion and is associated with nephrotoxicity. Currently, prehydration therapy is employed to prevent toxic renal side effects; however it has not been completely ameliorated. The studies described herein aim to determine the mechanism in which cisplatin enters the kidney cell from the blood and how it is subsequently secreted into the urine. Organic cation transporter 2 (OCT2) and ABCC2 are highly expressed in the kidney on the basolateral and apical membrane, respectively. We determined the contribution …

Symbiotic Caregivers: A Qualitative Case Study Of African American Custodial Grandparents And Their Grandchildren, Stella Enyichi Nwokeji

Theses and Dissertations (ETD)

Data from the U.S. Census Bureau’s 2005-2007 American Community Survey show that there are 11,436 grandparents in Shelby County, Tennessee, who are responsible for grandchildren. In Memphis only, there are 9,213 grandparents who are responsible for their grandchildren (U.S. Census Bureau, 2000). The Child Welfare League of America (CWLA) 2003 report (2003) showed that 42% of Tennessee grandparents who were responsible for grandchildren who are living with them live in households where the children’s parents are not present. Casper and Bryson (1998) noted that grandparent-headed households are more prevalent in African American communities and are at high risk for poverty. …

Impact Of Cost Sharing Levels On Adherence To Controller Drugs And Consequent Outcomes Among Asthma Patients, Varun Vaidya

Theses and Dissertations (ETD)

Prescription drug cost sharing is an effective tool to reduce the excessive drug consumption. However, many times it could have a negative impact on the drug utilization especially in case of chronic conditions. Chronic conditions such as asthma require appropriate utilization of controller medication to keep the inflammation and symptoms under control. Literature on asthma drug utilization has consistently reported underuse of controller drugs among asthma patients. The present study attempted to investigate the impact of prescription drug cost sharing levels on the controller adherence among the privately insured asthma population with moderate persistent asthma. The study also analyzed the …

The Effects Of Glucose Tolerance, Hypertension, And Race On Heart Rate Variability, Qt Interval Duration, And Left Ventricular Hypertrophy In Overweight-Obese Adolescents, Shirleatha T. Lee

Theses and Dissertations (ETD)

The prevalence of childhood obesity has increased remarkably within the past ten years with black youth disproportionately affected. Childhood obesity is linked to cardiovascular risk. Purposes of this study were to explore relationships between cardiac autonomic risk factors of heart rate variability (HRV), QT corrected (QTc) Interval duration, and Cornell voltage measures for left ventricular hypertrophy (LVH) to body mass index (BMI), relative body mass index (RBMI), and blood pressure (BP) measures, and to examine the effects of impaired glucose tolerance (IGT), hypertension, and race on these cardiac autonomic risk factors in overweight-obese adolescents.

Methods: Overweight and obese adolescents (N …

Immediate Effect Of Complete Denture Occlusal Errors On Masticatory Muscle Emg Activity In Denture Wearers: A Pilot Study, Swati Ahuja

Theses and Dissertations (ETD)

In the last three decades, little scientific progress has been seen in relation to the occlusal aspects in complete dentures. Equal distribution of loading forces to the edentulous denture foundation is an important factor affecting stability, patient comfort and acceptance of complete dentures. Also, understanding the functional behavior of masticatory muscles for complete denture wearers is important for diagnosing and planning the clinical treatment.

The purpose of the present study was to determine the effect of unilateral and bilateral occlusal interferences on the masticatory muscle activity in edentulous patients, and how patients respond to occlusal interferences both physiologically and psychologically …

Characteristics And Outcomes Of Individuals Self-Selecting Yoga Versus Physical Therapy For The Treatment Of Chronic Low Back Pain, Dian Dowling Evans

Theses and Dissertations (ETD)

Chronic low back pain (cLBP) is a significant public health problem that is difficult and costly to treat. Determining whether a patient with cLBP will benefit from a particular treatment approach is challenging, since little is understood about the patient characteristics that predict improved treatment outcomes. Understanding these characteristics could reduce treatment failures and costs of care.

This study was designed to explore the demographic, clinical and treatment- related characteristics of individuals self-selecting yoga versus physical therapy (PT) for treatment of cLBP. A growing body of research demonstrates that yoga reduces pain and improves function in persons with cLBP. However, …

Effect Of Obesity On The Traditional And Emerging Cardiovascular Disease Risk Factors In African American Women, Queen Obiageli Henry-Okafor

Theses and Dissertations (ETD)

Background: Obesity is a growing health care concern with cardiovascular disease (CVD) implications. African American women (AAW) have the highest prevalence rate of obesity and highest CVD morbidity and mortality rate of all ethnic groups. The traditional CVD risk factors have not been sufficient to explain this disparity in disease prevalence and outcomes. Current knowledge is limited regarding the interaction between various levels of adiposity and both traditional and emerging CVD risk factors, particularly in AAW. This study sought to explore these interactions.

Methods: The study design was a cross-sectional, descriptive, correlational analysis of 48 AAW ages 18 to 45 …

Metabolic Syndrome, Inflammation, Heart Rate Variability, And Fitness In Obese African American Youth, Belinda J. Fleming

Theses and Dissertations (ETD)

Purpose. The purposes of this dissertation were to (1) explore the relationships among fitness, heart rate variability (HRV), inflammation and components of the Metabolic Syndrome in obese African American youth participating in a supervised weight management program, (2) examine the effect of change in severity of obesity on these variables, and (3) identify predictors of weight loss.

Method. This study consisted of a post-hoc analysis of existing pre and post-intervention data obtained from 50 African-American youth (70% female, aged 7-18 years). Anthropometric assessment of height, weight, waist circumference, systolic blood pressure, body mass index, body mass index percentile …

Associations Among Health Literacy Levels And Health Outcomes In Pregnant Women With Pregestational And Gestational Diabetes In An Urban Setting, Rosemary Ann Mclaughlin

Theses and Dissertations (ETD)

Purpose/Objectives: Poor health literacy is a problem for over 45% of American adults and is associated with a variety of adverse health outcomes. Low health literacy has been associated with poor prenatal care utilization and a higher likelihood of poorer glycemic control. Poor glycemic control can lead to poor birth outcomes for both the mother and infant. Health literacy levels of pregnant women with diabetes can influence these outcomes and need to be known early in the pregnancy. Interventions can influence tighter glycemic control and lessen the impact of diabetes for the mother and infant. Therefore, the purpose of this …