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Full-Text Articles in Medicine and Health Sciences

Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. Mcmanus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg Dec 2018

Magnitude And Impact Of Multiple Chronic Conditions With Advancing Age In Older Adults Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, Hoa L. Nguyen, Jerry H. Gurwitz, David D. Mcmanus, Joel M. Gore, Sonal Singh, Jorge L. Yarzebski, Robert J. Goldberg

Open Access Articles

BACKGROUND: To examine age-specific differences in the frequency and impact of cardiac and non-cardiac conditions among patients aged 65years and older hospitalized with acute myocardial infarction (AMI).

METHODS: Study population consisted of 3863 adults hospitalized with AMI at 11 medical centers in central Massachusetts on a biennial basis between 2001 and 2011. The presence of 11 chronic conditions (five cardiac and six non-cardiac) was based on the review of hospital medical records.

RESULTS: Participants' median age was 79years, 49% were men, and had an average of three chronic conditions (average of cardiac conditions: 2.6 and average of non-cardiac conditions ...


Factors Associated With Follow-Up Compliance Among Clients Referred By A Local Health Department For Hiv Pre-Exposure Prophylaxis, Lauren R. Cirrincione Dec 2018

Factors Associated With Follow-Up Compliance Among Clients Referred By A Local Health Department For Hiv Pre-Exposure Prophylaxis, Lauren R. Cirrincione

Service Learning/Capstone Experience

Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is a public health strategy to limit HIV infection among at-risk populations. Local health departments (LHDs) promote PrEP initiation by referring patients to private and academic specialty care centers. However, low follow-up compliance remains a challenge in this setting. Between January 2016 and September 2018, Douglas County Health Department, a LHD in Omaha, Nebraska, externally referred 126 clients for PrEP at an academic specialty care center, and only 20 (15%) clients completed a PrEP initiation follow-up appointment. The purpose of this study is to describe the characteristics of clients referred by ...


Standardising The Collection Of Patient-Reported Experience Measures To Facilitate Benchmarking And Drive Service Improvement, Kathleen L. Withers, Sarah Puntoni, Susan O'Connell, Robert I. Palmer, Grace Carolan-Rees Nov 2018

Standardising The Collection Of Patient-Reported Experience Measures To Facilitate Benchmarking And Drive Service Improvement, Kathleen L. Withers, Sarah Puntoni, Susan O'Connell, Robert I. Palmer, Grace Carolan-Rees

Patient Experience Journal

Patient experience teams in NHS Wales’ Health Boards and Trusts are working across the country to collect patient experience feedback from members of the public who access health care services. Although this work is advanced in many areas, there is currently no way of benchmarking across organisations, reducing opportunities for shared learning. We aimed to work with patients and colleagues across Wales to agree a set of universal Patient Reported Experience Measures (PREMs) questions. Working with patient experience teams, patient groups and Welsh Government, the NHS Wales Patient Reported Outcome Measures (PROMs), Patient Reported Experience Measures (PREMs) and Effectiveness Programme ...


Progress In Documented Early Identification And Intervention For Deaf And Hard Of Hearing Infants – Cdc’S Hearing Screening And Follow-Up Survey, United States, 2006–2016, Krishnaveni Subbiah, Craig A. Mason, Marcus Gaffney, Scott D. Grosse Nov 2018

Progress In Documented Early Identification And Intervention For Deaf And Hard Of Hearing Infants – Cdc’S Hearing Screening And Follow-Up Survey, United States, 2006–2016, Krishnaveni Subbiah, Craig A. Mason, Marcus Gaffney, Scott D. Grosse

Journal of Early Hearing Detection and Intervention

The national EHDI 1-3-6 goals state that all infants should be screened for hearing loss before 1 month of age; with diagnostic testing before 3 months of age for those who do not pass screening; and early intervention (EI) services before 6 months of age for those with permanent hearing loss. This report updates previous summaries of progress on these goals by U.S. states and territories. Data are based on the Hearing Screening and Follow-up Survey (HSFS) conducted annually by the Centers for Disease Control and Prevention for the years 2006–2016. Trends were assessed using 3-year moving averages ...


Association Of Religiosity And Spirituality With Quality Of Life In Patients With Cardiovascular Disease: A Systematic Review, Hawa Abu, Christine M. Ulbricht, Eric Y. Ding, Jeroan J. Allison, Elena Salmoirago-Blotcher, Robert J. Goldberg, Catarina I. Kiefe Nov 2018

Association Of Religiosity And Spirituality With Quality Of Life In Patients With Cardiovascular Disease: A Systematic Review, Hawa Abu, Christine M. Ulbricht, Eric Y. Ding, Jeroan J. Allison, Elena Salmoirago-Blotcher, Robert J. Goldberg, Catarina I. Kiefe

Quantitative Health Sciences Publications and Presentations

Purpose: This review systematically identified and critically appraised the available literature that has examined the association between religiosity and/or spirituality (R/S) and quality of life (QOL) in patients with cardiovascular disease (CVD).

Methods: We searched several electronic online databases (PubMed, SCOPUS, PsycINFO, and CINAHL) from database inception until October 2017. Included articles were peer-reviewed, published in English, and quantitatively examined the association between R/S and QOL. We assessed the methodological quality of each included study.

Results: The 15 articles included were published between 2002 and 2017. Most studies were conducted in the US and enrolled patients with ...


Disease Prevalence And Politics- A Study Of Chagas Disease In Bolivia, Rebecca Dickson Oct 2018

Disease Prevalence And Politics- A Study Of Chagas Disease In Bolivia, Rebecca Dickson

Access*: Interdisciplinary Journal of Student Research and Scholarship

Reducing disease prevalence within South America is critical for reaching global health goals and increasing life expectancy of vulnerable populations. Chagas disease, often referred to the “the New HIV/AIDS of the Americas,” is a prevalent cause of disability and death within Bolivia (Hotez et al. 1). The Plurinational State of Bolivia, a large South American nation-state, is a crucial player in promoting global health outcomes. However, intra-state political turmoil and historical tensions often affect its healthcare systems, which in turn affect individual health outcomes. This paper traces these connections within the Bolivian healthcare system- first by identifying political and ...


Application Of Data Assimilation In Forecasting Of Influenza In The United States, Hannah Biegel Oct 2018

Application Of Data Assimilation In Forecasting Of Influenza In The United States, Hannah Biegel

Annual Symposium on Biomathematics and Ecology: Education and Research

No abstract provided.


Simulating Antibiotic Resistance In The Computer Lab And Biology Lab: Ideas For Undergraduate Projects, Anne E. Yust Oct 2018

Simulating Antibiotic Resistance In The Computer Lab And Biology Lab: Ideas For Undergraduate Projects, Anne E. Yust

Annual Symposium on Biomathematics and Ecology: Education and Research

No abstract provided.


Dynamics Of Visceral Leishmaniasis For Different Distributions Of Non-Adherence To The Treatment In The Population Of Bihar, India And Its Effect On Elimination, Mugdha Thakur Oct 2018

Dynamics Of Visceral Leishmaniasis For Different Distributions Of Non-Adherence To The Treatment In The Population Of Bihar, India And Its Effect On Elimination, Mugdha Thakur

Annual Symposium on Biomathematics and Ecology: Education and Research

No abstract provided.


The Regressive Burden Of Water-Related Infections On Income Disparity In Ecuador, Cesar Montalvo Oct 2018

The Regressive Burden Of Water-Related Infections On Income Disparity In Ecuador, Cesar Montalvo

Annual Symposium on Biomathematics and Ecology: Education and Research

No abstract provided.


Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke Oct 2018

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival ...


Breastfeeding History And Risk Of Stroke Among Parous Postmenopausal Women In The Women's Health Initiative, Lisette T. Jacobson, Erinn M. Hade, Tracie C. Collins, Karen L. Margolis, Molly E. Waring, Linda V. Van Horn, Brian Silver, Maryam Sattari, Chloe E. Bird, Kim Kimminau, Karen Wambach, Marcia L. Stefanick Sep 2018

Breastfeeding History And Risk Of Stroke Among Parous Postmenopausal Women In The Women's Health Initiative, Lisette T. Jacobson, Erinn M. Hade, Tracie C. Collins, Karen L. Margolis, Molly E. Waring, Linda V. Van Horn, Brian Silver, Maryam Sattari, Chloe E. Bird, Kim Kimminau, Karen Wambach, Marcia L. Stefanick

Open Access Articles

Background: Stroke is the third leading cause of death among US Hispanic and non-Hispanic black women aged 65 and older. One factor that may protect against stroke is breastfeeding. Few studies have assessed the association between breastfeeding and stroke and whether this association differs by race and ethnicity.

Methods and Results: Data were taken from the Women's Health Initiative Observational Study with follow-up through 2010; adjusted hazard ratios for stroke subsequent to childbirth were estimated with Cox regression models accounting for left and right censoring, overall and stratified by race/ethnicity. Of the 80 191 parous women in the ...


Objective Measurement Of Physical Activity Outcomes In Lifestyle Interventions Among Adults: A Systematic Review, Valerie J. Silfee, Christina Haughton, Danielle E. Jake-Schoffman, Andrea Lopez-Cepero, Christine N. May, Meera Sreedhara, Milagros C. Rosal, Stephanie Lemon Sep 2018

Objective Measurement Of Physical Activity Outcomes In Lifestyle Interventions Among Adults: A Systematic Review, Valerie J. Silfee, Christina Haughton, Danielle E. Jake-Schoffman, Andrea Lopez-Cepero, Christine N. May, Meera Sreedhara, Milagros C. Rosal, Stephanie Lemon

UMass Center for Clinical and Translational Science Supported Publications

Valid, reliable, and direct measures of physical activity (PA) are critical to assessing the impact of lifestyle PA interventions. However, little is known about the extent to which objective measures have been used to assess the outcomes of lifestyle PA interventions. This systematic review had two aims: 1) evaluate the extent to which PA is measured objectively in lifestyle PA interventions targeting adults and 2) explore and summarize what objective measures have been used and what PA dimensions and metrics have been reported. Pubmed, Cochrane Central Register, and PsychInfo were searched for lifestyle PA interventions conducted between 2006 and 2016 ...


Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr. Aug 2018

Coping With Chronic Fungal Rhinosinusitis: Diagnosis To Therapy, Veronica Corcino, Leslie Beavin, Shengli Lu, Ashley Ross, Carmen V. Sciortino Jr.

The University of Louisville Journal of Respiratory Infections

No abstract provided.


A Continuum Of Disease From Community-Acquired Pneumonia To Multiple Organ Dysfunction Syndrome, Julio A. Ramirez Aug 2018

A Continuum Of Disease From Community-Acquired Pneumonia To Multiple Organ Dysfunction Syndrome, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.


Characteristics And Clinical Outcomes Of Hospitalized Patients With Community-Acquired Pneumonia Who Are Active Intravenous Drug Users, Vidyulata Salunkhe, Paula Peyrani, Leslie A. Beavin, Stephen P. Furmanek, Julio A. Ramirez Aug 2018

Characteristics And Clinical Outcomes Of Hospitalized Patients With Community-Acquired Pneumonia Who Are Active Intravenous Drug Users, Vidyulata Salunkhe, Paula Peyrani, Leslie A. Beavin, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Intravenous drug users (IVDU) have a 10-fold increased risk of community-acquired pneumonia (CAP) compared to the general population. There is scarce data available evaluating the clinical outcomes of IVDU hospitalized patients with CAP and that data mostly focuses on mortality. The objective of this study was to evaluate the clinical characteristics, incidence and outcomes of hospitalized patients with CAP in active intravenous drug users in Louisville, Kentucky.

Methods: This was a secondary data analysis of the University of Louisville Pneumonia study. IVDU patients were propensity score matched to a non-IVDU group. Study outcomes were time to clinical stability (TCS ...


Pulmonary Aspergillosis: A Review On Diagnosis And Management, Bilal A. Jalil, Juan M. Galvis, Karim A. El Kersh, Mohamed Saad, Mostafa M. Fraig, Juan J. Guardiola Ii Aug 2018

Pulmonary Aspergillosis: A Review On Diagnosis And Management, Bilal A. Jalil, Juan M. Galvis, Karim A. El Kersh, Mohamed Saad, Mostafa M. Fraig, Juan J. Guardiola Ii

The University of Louisville Journal of Respiratory Infections

Aspergillosis is acquired by inhalation of spores of Aspergillus, a ubiquitous species in the environment. In normal hosts, spore inhalation rarely causes lung disease.

Pulmonary aspergillosis covers a wide spectrum of clinical syndromes depending on the interaction between Aspergillus and the host (immune-status, prior bronchopulmonary disease). It runs the gamut from invasive aspergillosis to Aspergillus bronchitis and colonization.

Invasive aspergillosis occurs in severely immunocompromised patients, typically with neutropenia. Chronic pulmonary aspergillosis affects patients with chronic structural lung disease such as chronic obstructive pulmonary disease, mycobacterial lung disease, but without significant immunocompromise. Aspergillus bronchitis affects patients with bronchial disease such as ...


Pulmonary Histoplasmosis In A Patient With Cough, Dyspnea, Pulmonary Nodule And Rheumatologic Manifestations: Case Report And Review, Johnson Britto Aug 2018

Pulmonary Histoplasmosis In A Patient With Cough, Dyspnea, Pulmonary Nodule And Rheumatologic Manifestations: Case Report And Review, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report we describe a case of pulmonary histoplasmosis in a healthy adult female living in Kentucky. The patient presented with two months history of poly-arthralgia and myalgia, intermittent dry cough, chest tightness, exertional dyspnea, malaise, fatigue and one week history of skin rash. She did not respond to broad-spectrum antibiotic therapy and she also had extensive endocrine and rheumatologic work up that was negative. A diagnosis of histoplasmosis was established based on radiological findings as well as endobronchial ultrasound-guided transbronchial needle aspiration cytology (EBUS-TBNA) of mediastinal lymph nodes demonstrating necrotizing granuloma with fungal stains positive for Histoplasma ...


Lemierre’S Syndrome, A Case Report And Review Of Literature., Casmiar I. Nwaigwe, Jason Greenwood Aug 2018

Lemierre’S Syndrome, A Case Report And Review Of Literature., Casmiar I. Nwaigwe, Jason Greenwood

The University of Louisville Journal of Respiratory Infections

Lemierre’s syndrome is a suppurative thrombophlebitis of the internal jugular vein. In this paper we describe a case of severe Lemierre’s syndrome in a healthy 18 year-old woman. She initially presented with sore throat, and failed outpatient antibiotic therapy. She quickly progressed to septic shock, internal jugular vein septic thrombophlebitis, septic pulmonary emboli, empyema and respiratory failure. Successful treatment included intravenous antibiotics and thoracotomy. It is a rare disease that has been kept at bay with the widespread use of antibiotics for upper respiratory infections. However in recent years there seems to be an increase in number of ...


Sex-Specific Associations Of Infants’ Gut Microbiome With Arsenic Exposure In A Us Population, Anne G. Hoen, Juliette C. Madan, Zhigang Li, Modupe Coker, Sara N. Lundgren, Hilary G. Morrison, Thomas J. Palys, Brian P. Jackson, Mitchell L. Sogin, Kathryn L. Cottingham, Margaret R. Karagas Aug 2018

Sex-Specific Associations Of Infants’ Gut Microbiome With Arsenic Exposure In A Us Population, Anne G. Hoen, Juliette C. Madan, Zhigang Li, Modupe Coker, Sara N. Lundgren, Hilary G. Morrison, Thomas J. Palys, Brian P. Jackson, Mitchell L. Sogin, Kathryn L. Cottingham, Margaret R. Karagas

Open Dartmouth: Faculty Open Access Articles

Arsenic is a ubiquitous environmental toxicant with antimicrobial properties that can be found in food and drinking water. The influence of arsenic exposure on the composition of the human microbiome in US populations remains unknown, particularly during the vulnerable infant period. We investigated the relationship between arsenic exposure and gut microbiome composition in 204 infants prospectively followed as part of the New Hampshire Birth Cohort Study. Infant urine was analyzed for total arsenic concentration using inductively coupled plasma mass spectrometry. Stool microbiome composition was determined using sequencing of the bacterial 16S rRNA gene. Infant urinary arsenic related to gut microbiome ...


Both Maternal And Paternal Risk Factors For Term Singleton Low Birthweight Infants In Rural Chinese Population: A Population-Based, Retrospective Cohort Study, Shi Chen, Bill Q. Lian, Hui Pan Aug 2018

Both Maternal And Paternal Risk Factors For Term Singleton Low Birthweight Infants In Rural Chinese Population: A Population-Based, Retrospective Cohort Study, Shi Chen, Bill Q. Lian, Hui Pan

Open Access Articles

No large population-based study has focused on both maternal paternal risk factors for low birthweight (LBW) in China. We aimed to identify parental risk factors associated with LBW. A population-based, retrospective cohort study was conducted on 202,725 singleton infants at 37-42 weeks. These term singleton newborns were classified as LBW with birthweight < /=2500 g(TLBW) and normal birthweight between 50(th) to 97(th) percentile (TNBW 50(th)-97(th)) according to Chinese singleton norms. Multiple logistic regression analyses were used to find those parental risk factors of LBW by comparing two groups. TLBW and TNBW(50(th)-97(th)) occupied 4.8% and 70.8% of the study population, respectively. Logistic regression showed a significant association with positive maternal hepatitis B surface antigen (RR = 1.979, P = 0.047), irregular folic acid intake (RR = 1.152, P = 0.003), paternal history of varicocele (RR = 2.404, P = 0.003) and female babies (RR = 1.072, P = 0.046). Maternal smoking, hypertension and history of stillbirth were found related to LBW but no statistically significant. Positive maternal hepatitis B surface antigen, irregular folic acid intake, paternal history of varicocele had a negative effect on birth weight. Measures are necessarily taken to avoid them to improve pregnancy outcomes. Further studies should be done to investigate each detailed risk factors on LBW.


Predictors Of Patient Activation At Acs Hospital Discharge And Health Care Utilization In The Subsequent Year, Rebecca L. Kinney Aug 2018

Predictors Of Patient Activation At Acs Hospital Discharge And Health Care Utilization In The Subsequent Year, Rebecca L. Kinney

GSBS Dissertations and Theses

Background. AHA guidelines have been established to reduce Acute Coronary Syndrome (ACS)-related morbidity, mortality and recurrent events post-discharge. These recommendations emphasize the patient as an engaged member of the health care team in secondary prevention efforts. Patients with high levels of activation are more likely to perform activities that will promote their own health and are more likely to have their health care needs met. Despite evidence and strong expert consensus supporting patients as active collaborators in their own ACS care, the complexity and unexpected realities of self-managing one’s care at home are often underestimated. This study seeks ...


Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu Aug 2018

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI ...


Human Papillomavirus Infections In The Southern And Other United States Regions, Dudith Pierre-Victor, Mary Jo Trepka, Dionne Stephens, Tan Li, Timothy Page, Purnima Madhivanan Aug 2018

Human Papillomavirus Infections In The Southern And Other United States Regions, Dudith Pierre-Victor, Mary Jo Trepka, Dionne Stephens, Tan Li, Timothy Page, Purnima Madhivanan

Journal of Health Disparities Research and Practice

Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide and has been linked to several cancers, including cervical cancer. In the United States, the Southern region has a disproportionate burden of cervical cancer, and research about the epidemiology of HPV in the region is scarce. This study estimates the prevalence and correlates of HPV infection among 14–59 year-old females.

Data from 4,250 females aged 14–59 years collected during the 2007–2010 National Health and Nutrition Examination Survey (NHANES) were used. We estimated the prevalence of HPV infection for the South and the rest of ...


Improving Prediction Of Systemic Statin Exposure Using Concomitant Medications, Non-Linear Modelling And Novel Snp Discovery, Rhiannon Rose Aug 2018

Improving Prediction Of Systemic Statin Exposure Using Concomitant Medications, Non-Linear Modelling And Novel Snp Discovery, Rhiannon Rose

Electronic Thesis and Dissertation Repository

Introduction: Statin drugs are a highly efficacious treatment for hypercholesterolemia and adherent treatment with statins reduces the risk of cardiovascular disease. Although statins are generally well tolerated, myalgia (muscle pain) is a common side effect and can lead to non-compliance with treatment. Increased systemic exposure may contribute to the development of myalgia. Drug-drug interactions inhibiting statin metabolism and impaired drug transporter function may lead to decreased statin clearance. Establishing accurate predictive models is an important step towards preventing adverse drug events by titrating statin dosing to limit systemic exposure.

Objectives: 1) To develop an algorithm to select concomitant medications for ...


Post-Diagnosis Quality Of Life And Mortality In Non-Hispanic White And Hispanic Women Diagnosed With Invasive Breast Cancer., Delvon T. Mattingly Aug 2018

Post-Diagnosis Quality Of Life And Mortality In Non-Hispanic White And Hispanic Women Diagnosed With Invasive Breast Cancer., Delvon T. Mattingly

Electronic Theses and Dissertations

The prevalence of breast cancer is increasing, and the health-related quality of life (HRQOL) of breast cancer survivors may help to further understand survivorship. This study evaluated HRQOL as a potential prognostic factor for mortality among Non-Hispanic White (NHW) and Hispanic women diagnosed with invasive breast cancer. Data were used from the Health, Eating, Activity, and Lifestyle (HEAL) Study. Data for 351 participants were analyzed for associations between HRQOL scores (subscale, component) and mortality. Cox proportional hazards regression was conducted to assess the relationship between HRQOL and mortality outcomes (all-cause, breast cancer-specific, non-cancer). Median follow-up time from HRQOL assessment (approximately ...


Coal Ash Exposure And Behavioral Impairments Among Children In Louisville, Kentucky., Chisom Nmesoma Odoh Aug 2018

Coal Ash Exposure And Behavioral Impairments Among Children In Louisville, Kentucky., Chisom Nmesoma Odoh

Electronic Theses and Dissertations

Introduction: Coal ash, generated from the combustion of coal is principally made up of fly ash, which consists of small particles and metals that can affect the development of children. Coal ash is predominately stored in landfills and surface impoundments, of which many are in proximity to residential areas. According to the Environmental Protection Agency, 25% of residents in proximity to electric power plants are children. Few studies have reported a positive association between coal ash and its by-products and neurobehavioral disorders. The purpose of this study was to explore the relationship between coal ash and its components and behaviors ...


A Decade Of Veteran Voices: Examining Patient Portal Enhancements Through The Lens Of User-Centered Design, Kim M. Nazi, Carolyn L. Turvey, Dawn M. Klein, Timothy P. Hogan Jul 2018

A Decade Of Veteran Voices: Examining Patient Portal Enhancements Through The Lens Of User-Centered Design, Kim M. Nazi, Carolyn L. Turvey, Dawn M. Klein, Timothy P. Hogan

Quantitative Health Sciences Publications and Presentations

BACKGROUND: Health care systems have entered a new era focused on patient engagement. Patient portals linked to electronic health records are recognized as a promising multifaceted tool to help achieve patient engagement goals. Achieving significant growth in adoption and use requires agile evaluation methods to complement periodic formal research efforts.

OBJECTIVE: This paper describes one of the implementation strategies that the Department of Veterans Affairs (VA) has used to foster the adoption and sustained use of its patient portal, My HealtheVet, over the last decade: an ongoing focus on user-centered design (UCD). This strategy entails understanding the users and their ...


Cellphone Usage And The Risk Of Cancer, Mia Ye Jun 2018

Cellphone Usage And The Risk Of Cancer, Mia Ye

The International Student Science Fair 2018

Introduction: As the use of cell phones have increased immensely in the last two decades, so has public concern regarding cell phone and its relationship to cancer. Cell phones emit radio frequency waves, a type of electromagnetic energy. Theoretically, these radiofrequency waves are considered as a form of non-ionizing radiation, and do not contain enough energy to damage DNA. However, human and animal studies on cell phone use and cancer risk have shown mixed results. The Danish cohort study, one of the largest long-term studies to date, compared everyone in Denmark with cell phone subscriptions between 1982 and 1995, and ...


A Qualitative Study Examining The Benefits And Challenges Of Incorporating Patient-Reported Outcome Substance Use And Mental Health Questionnaires Into Clinical Practice To Improve Outcomes On The Hiv Care Continuum., Anne K Monroe, Sarah M Jabour, Sebastian Peña, Jeanne C Keruly, Richard D Moore, Geetanjali Chander, Kristin A Riekert Jun 2018

A Qualitative Study Examining The Benefits And Challenges Of Incorporating Patient-Reported Outcome Substance Use And Mental Health Questionnaires Into Clinical Practice To Improve Outcomes On The Hiv Care Continuum., Anne K Monroe, Sarah M Jabour, Sebastian Peña, Jeanne C Keruly, Richard D Moore, Geetanjali Chander, Kristin A Riekert

Epidemiology and Biostatistics Faculty Publications

BACKGROUND: Inadequate identification and treatment of substance use (SU) and mental health (MH) disorders hinders retention in HIV care. The objective of this study was to elicit stakeholder input on integration of SU/MH screening using computer-assisted patient-reported outcomes (PROs) into clinical practice.

METHODS: We conducted semi-structured interviews with HIV-positive patients who self-reported SU/MH symptoms on a computer-assisted PROs (n = 19) and HIV primary care providers (n = 11) recruited from an urban academic HIV clinic. Interviews were audio-recorded and transcribed. We iteratively developed codes and organized key themes using editing style analysis.

RESULTS: Two themes emerged: (1) Honest Disclosure ...