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Factors Associated With Mortality After Undergoing Thrombectomy For Acute Ischemic Stroke, Hannah Lin Jun 2020

Factors Associated With Mortality After Undergoing Thrombectomy For Acute Ischemic Stroke, Hannah Lin

GSBS Dissertations and Theses

Background: Mechanical thrombectomy is the gold standard for treating patients with certain acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, even with major advancements and increasing procedural volumes, acute endovascular therapy remains a high-risk procedure with a considerable 90-day mortality rate, affected by a variety of factors.

Purpose: To investigate various clinical and procedural factors associated with 90-day mortality in patients undergoing mechanical thrombectomy for emergent treatment of AIS and determine which of these factors made unique contributions to post-thrombectomy prognosis.

Methods: We examined a prospective registry of 323 patients treated with endovascular thrombectomy for AIS between ...


Frequency Of Complications Following Spinal Fusion In Children With Cerebral Palsy, Nili S. Amir May 2020

Frequency Of Complications Following Spinal Fusion In Children With Cerebral Palsy, Nili S. Amir

GSBS Dissertations and Theses

Background:

Neuromuscular Scoliosis is a frequent complication of Cerebral Palsy that requires surgical management including spinal fusion. The objective of this observational study was to describe differences in the frequency of postoperative complications in children with Cerebral Palsy following spinal fusion surgery compared to children with Idiopathic Scoliosis.

Methods:

The 2016 Kids’ Inpatient Database was queried to identify pediatric patients (old) with concurrent diagnoses of Cerebral Palsy and Neuromuscular Scoliosis undergoing spinal fusion surgery. Cases were compared to children without Cerebral Palsy and with a diagnosis of Idiopathic Scoliosis undergoing the same procedure. Fitted Poisson regression analysis with robust variance ...


Association Of Race/Ethnicity And Population Density With Disparities In Timeliness Of Rectal Cancer Therapy, Susanna S. Hill Apr 2020

Association Of Race/Ethnicity And Population Density With Disparities In Timeliness Of Rectal Cancer Therapy, Susanna S. Hill

GSBS Dissertations and Theses

Objective:

Access to care is key to effective rectal cancer treatment. We hypothesized that ethnic/racial minorities living in high population density areas would have the greatest delays in cancer care compared to whites living in medium population density areas.

Methods:

Using 2004-2016 National Cancer DataBase data, we identified stage I-III patients with invasive rectal adenocarcinoma who underwent surgery. The data were analyzed by race/ethnicity (whites, blacks, or Hispanics) and population density (metropolitan or urban/rural). Multivariable ANCOVA was performed to evaluate the duration of time from diagnosis to surgery.

Results:

The study population consisted of 76,131 patients ...


Evaluation Of A Tiered Opioid Prescribing Guideline For Inpatient Colorectal Operations, David C. Meyer Apr 2020

Evaluation Of A Tiered Opioid Prescribing Guideline For Inpatient Colorectal Operations, David C. Meyer

GSBS Dissertations and Theses

Background:

In light of the opioid epidemic, reducing excess prescription quantities while tailoring to patient need is key. We previously created an opioid prescribing guideline using retrospective institutional data to satisfy the majority of patients’ opioid needs following inpatient colorectal surgery.

Objective:

This study sought to prospectively validate an institutional prescribing guideline based on previously-defined opioid consumption patterns following inpatient colorectal operations.

Methods:

We carried out a cohort study comparing opioid prescribing and consumption patterns before (7/18 – 1/19) and after (9/19 – 2/20) adoption of a tiered opioid prescribing guideline for inpatient elective colorectal operations (colectomies, proctectomies ...


Trends, Predictors, And Consequences Of Child Undernutrition In India, Apurv Soni Apr 2019

Trends, Predictors, And Consequences Of Child Undernutrition In India, Apurv Soni

GSBS Dissertations and Theses

Background: India has the highest number of undernourished children worldwide. Understanding trends, predictors, and consequences of child undernutrition is important to inform strategy for addressing this public health crisis.

Methods: We used data from four National Family Health Surveys (1992-93, 1998-99, 2005-6, 2015-16 NFHS) to examine trends of undernutrition before and after the 2005 implementation of the National Rural Health Mission, India’s flagship public health initiative (Aim 1). We used the 2016 NFHS to build a predictive model that identifies infants at-risk for child undernutrition (Aim 2). Lastly, we used data from the 2005 and 2012 India Human Development ...


Physiological And Psychological Stressors Associated With Glucose Metabolism In The Boston Puerto Rican Health Study, Andrea A. Lopez-Cepero Mar 2019

Physiological And Psychological Stressors Associated With Glucose Metabolism In The Boston Puerto Rican Health Study, Andrea A. Lopez-Cepero

GSBS Dissertations and Theses

Background: Puerto Ricans experience high prevalence of type 2 diabetes (diabetes). Stress is a risk factor for diabetes. The allostatic load (AL) model explains how stress influences disease through a chain of physiological changes. Puerto Ricans experience psychological and physiological (obesity and high glycemic load (GL)) stressors linked with diabetes, yet how these stressors impact the AL chain and how their interplay affects glucose metabolism remains unknown.

Methods: Using data from the Boston Puerto Rican Health Study, this thesis sought to examine: 1) the relationship between GL and primary AL markers, 2) the interaction between perceived stress and GL on ...


Understanding The Experience And Evaluating The Occurrence Of Depression In A Sample Of Pregnant Veterans, Aimee R. Kroll-Desrosiers Jan 2019

Understanding The Experience And Evaluating The Occurrence Of Depression In A Sample Of Pregnant Veterans, Aimee R. Kroll-Desrosiers

GSBS Dissertations and Theses

Background: The Veterans Health Administration (VHA) encourages depression screening and treatment for pregnant veterans; however, rates of depression symptoms and treatment utilization during pregnancy have not been well-studied.

Methods: We used data from the Maternity Care Coordination for Women Veterans cohort study. Specifically, our aims were to: 1) examine rates and correlates of depression symptoms in a sample of pregnant veterans; 2) understand mental health care treatment utilization and explore the experiences of veterans accessing mental health care at the VHA during pregnancy; and 3) examine VHA mental health provider's perspectives on depression screening and treatment in the perinatal ...


Factors Associated With Weight Management Counseling During Primary Care Clerkships, Karen M. Ashe Jan 2019

Factors Associated With Weight Management Counseling During Primary Care Clerkships, Karen M. Ashe

GSBS Dissertations and Theses

Background: The United States Preventive Services Task Force guidelines support screening and provision of intensive multi-component behavioral counseling for adults who have obesity. One barrier to providing such counseling is lack of training in medical school. Not much is known about factors associated with medical students’ perceived weight management counseling (WMC) skills or whether preceptors model or teach WMC during primary care clerkships.

Methods: A mixed methods approach addressed factors affecting WMC training during primary care clerkships. A secondary analysis of 3rd year medical students (n=730) described students’ perceived WMC skills, attitudes and frequency of engagement in 5As ...


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 ...


Ventricular Arrhythmias Complicating Coronary Artery Disease: Recent Trends, Risk Associated With Serum Glucose Levels, And Psychological Impact, Hoang V. Tran Jun 2018

Ventricular Arrhythmias Complicating Coronary Artery Disease: Recent Trends, Risk Associated With Serum Glucose Levels, And Psychological Impact, Hoang V. Tran

GSBS Dissertations and Theses

Introduction: Ventricular arrhythmias (VAs) are common after an acute coronary syndrome (ACS) and are associated with worse clinical outcomes. However, little is known about recent trends in their occurrence, their association with serum glucose levels, and their psychological impact in ACS setting.

Methods: We examined 25-year (1986-2011) trends in the incidence rates (IRs) and hospital case-fatality rates (CFRs) of VAs, and the association between serum glucose levels and VAs in patients with an acute myocardial infarction (AMI) in the Worcester Heart Attack Study. Lastly, we examined the relationship between in-hospital occurrence of VAs and 12-month progression of depression and anxiety ...


National Trends In Elective Ileal Pouch-Anal Anastomosis For Ulcerative Colitis, Chau Maggie Hoang Jun 2018

National Trends In Elective Ileal Pouch-Anal Anastomosis For Ulcerative Colitis, Chau Maggie Hoang

GSBS Dissertations and Theses

Background: Recent national trends and distribution of ileal pouch-anal anastomosis (IPAA) procedures for patients with ulcerative colitis (UC) are unknown. We examined the frequency of use of elective IPAA procedures among patients with UC and the distribution of IPAA procedures across more than 140 U.S. academic medical centers and their affiliates.

Methods: Data were obtained from the University HealthSystem Consortium for patients with a primary diagnosis of UC admitted electively between 2012 and 2015.

Results: The mean age of the study population (n=6,875) was 43 years and 57% were men. Among these, one-third (n=2,307) underwent ...


Follow Your Heart: Evaluating Cardiac Function To Predict Outcomes Among Icu Patients With Traumatic Brain Injury, Patric Gibbons May 2018

Follow Your Heart: Evaluating Cardiac Function To Predict Outcomes Among Icu Patients With Traumatic Brain Injury, Patric Gibbons

GSBS Dissertations and Theses

Introduction: Traumatic Brain Injury (TBI) remains a significant public health burden in the United States. Persons afflicted with more severe TBIs are usually admitted to an ICU, where they are at risk for a number of complications throughout their hospitalization. Recent literature has attempted to describe such complications from a cardiovascular perspective as part of a “cardio-cerebral syndrome.” We described the frequency of cardiac complications in the ICU among patients with a TBI and compared patients with and without measured cardiac dysfunction. We investigated the potential impact of cardiac dysfunction on in-hospital mortality.

Methods: This was a retrospective review of ...


Evaluating Multi-Level Factors Influencing Adolescent Sugar Sweetened Beverage Consumption, Christina F. Griecci Mar 2018

Evaluating Multi-Level Factors Influencing Adolescent Sugar Sweetened Beverage Consumption, Christina F. Griecci

GSBS Dissertations and Theses

Background: Sugar sweetened beverages (SSBs) comprise the largest source of added sugars in US adolescents’ diets. SSB consumption is pervasive in US culture and is a critical risk factor for weight gain and obesity in adolescents. This thesis evaluates multi-level factors that influence adolescent SSB consumption.

Methods: The first two aims of this thesis utilized data from the cross sectional, internet based Family Life, Activity, Sun, Health and Eating (FLASHE) study to: 1) examine availability of SSBs in multiple settings (home, school, neighborhood) and adolescent SSB consumption, 2) examine the associations between perceptions of parenting practices and adolescent SSB consumption ...


Clostridium Difficile Colonization And Infection In The Elderly And Associations With The Aging Intestinal Microbiome, John P. Haran Mar 2018

Clostridium Difficile Colonization And Infection In The Elderly And Associations With The Aging Intestinal Microbiome, John P. Haran

GSBS Dissertations and Theses

The widespread use of antibiotics has led to dramatic increases in the incidence and severity of Clostridium difficile infection (CDI). No group of patients suffers more from CDI than the elderly. Nursing homes (NH) represent the perfect storm of a vulnerable group of frail elders living in confined communities. Nursing home residents suffer from increased morbidity and mortality from CDI and corresponding high rates of C. difficile colonization. Upwards of 40 to 50% of CDI current cases originate from NHs and the prevalence of colonization rates remain high within these facilities, with as many as half of the residents being ...


Identification Of Novel Genetic Variations For Amyotrophic Lateral Sclerosis (Als), Guang Xu Feb 2018

Identification Of Novel Genetic Variations For Amyotrophic Lateral Sclerosis (Als), Guang Xu

GSBS Dissertations and Theses

A list of genes have been identified to carry mutations causing familial ALS such as SOD1, TARDBP, C9orf72. But for sporadic ALS, which is 90% of all ALS cases, the underlying genetic variants are still largely unknown. There are multiple genome-wide association study (GWAS) for sporadic ALS, but usually a large number nominated SNP can hardly be replicated in larger cohort analysis. Also majority of GWAS SNP lie within noncoding region of genome, imposing a huge challenge to study their biological role in ALS pathology. With the rapid development of next-generation sequencing technology, we are able to sequence exome and ...


Genomic And Transcriptomic Investigation Of Endemic Burkitt Lymphoma And Epstein Barr Virus, Yasin Kaymaz Jul 2017

Genomic And Transcriptomic Investigation Of Endemic Burkitt Lymphoma And Epstein Barr Virus, Yasin Kaymaz

GSBS Dissertations and Theses

Endemic Burkitt lymphoma (eBL) is the most common pediatric cancer in malaria-endemic equatorial Africa and nearly always contains Epstein-Barr virus (EBV), unlike sporadic Burkitt Lymphoma (sBL) that occurs with a lower incidence in developed countries. Despite this increased burden the study of eBL has lagged. Additionally, while EBV was isolated from an African Burkitt lymphoma tumor 50 years ago, however, the impact of viral variation in oncogenesis is just beginning to be fully explored. In my thesis research, I focused on investigating molecular genetics of the endemic form of this lymphoma with a particular emphasis on the role of the ...


The Role Of Skeletal Survey In Identifying Non-Accidental Trauma In Pediatric Trauma Patients, Jonathan Green Jun 2017

The Role Of Skeletal Survey In Identifying Non-Accidental Trauma In Pediatric Trauma Patients, Jonathan Green

GSBS Dissertations and Theses

Background: Non-accidental Trauma (NAT) is a major cause of morbidity and mortality in children. Children less than 2 years old are at greater risk of NAT than older children. A skeletal survey is a series of X-rays of all the bones in the body, or at least the axial skeleton and the large cortical bones used to identify NAT in children. In this observational study, we examined the association between a child’s age, frequency of positive skeletal surveys, and the types of injuries discovered in pediatric patients undergoing a trauma work-up.

Methods: The study sample consisted of all pediatric ...


Inhibiting Axon Degeneration In A Mouse Model Of Acute Brain Injury Through Deletion Of Sarm1, Nils Henninger May 2017

Inhibiting Axon Degeneration In A Mouse Model Of Acute Brain Injury Through Deletion Of Sarm1, Nils Henninger

GSBS Dissertations and Theses

Traumatic brain injury (TBI) is a leading cause of disability worldwide. Annually, 150 to 200/1,000,000 people become disabled as a result of brain trauma. Axonal degeneration is a critical, early event following TBI of all severities but whether axon degeneration is a driver of TBI remains unclear. Molecular pathways underlying the pathology of TBI have not been defined and there is no efficacious treatment for TBI.

Despite this significant societal impact, surprisingly little is known about the molecular mechanisms that actively drive axon degeneration in any context and particularly following TBI. Although severe brain injury may cause ...


Characterization Of Severe Malaria In Liberian Children 5 Years Old And Younger, Patricia A. Mcquilkin May 2017

Characterization Of Severe Malaria In Liberian Children 5 Years Old And Younger, Patricia A. Mcquilkin

GSBS Dissertations and Theses

Malaria continues to be a challenging problem in the developing world, and the burden of this life threatening disease continues to be borne by young children living in Sub Saharan Africa. One of the biggest challenges to the prevention and control of this problem lies in accurately diagnosing malaria, and distinguishing it from the many other febrile illnesses which present in children in this age group.

Liberia is a West African country with a high burden of malaria. Very little is known about the presentation of severe malaria in children aged 5 years old and younger in Liberia. We undertook ...


Recent Trends In Sepsis Mortality, Associations Between Initial Source Of Sepsis And Hospital Mortality, And Predictors Of Sepsis Readmission In Sepsis Survivors, Christine Motzkus Apr 2017

Recent Trends In Sepsis Mortality, Associations Between Initial Source Of Sepsis And Hospital Mortality, And Predictors Of Sepsis Readmission In Sepsis Survivors, Christine Motzkus

GSBS Dissertations and Theses

Background: Sepsis, a leading cause of US deaths, is associated with high mortality, although advances in early recognition and treatment have increased survivorship. Many aspects of sepsis pathophysiology and epidemiology have not been fully elucidated; the heterogeneous nature of infections that lead to sepsis has made fully characterizing the underlying epidemiology challenging.

Methods: The University HealthSystem Consortium (UHC) from 2011-2014 and the Cerner HealthFacts® database from 2008-2014 were used. We examined associations between infection source and in-hospital mortality in the UHC dataset, stratified by age and presenting sepsis stage. We examined recent temporal trends in present-on-admission (POA) sepsis diagnoses and ...


Exploring New Therapeutic Strategies For Osteoarthritis: From Genetic Manipulation Of Skeletal Tissues To Chemically-Modified Synthetic Hydrogels, Henry Huang Mar 2017

Exploring New Therapeutic Strategies For Osteoarthritis: From Genetic Manipulation Of Skeletal Tissues To Chemically-Modified Synthetic Hydrogels, Henry Huang

GSBS Dissertations and Theses

Osteoarthritis (OA), a degenerative disease of articular joints, is the leading cause of chronic disability in the US and affects more than a third of adults over 65 years old. Due to the obesity epidemic and an aging population, the prevalence of OA is expected to rise in both young and old adults. There are no disease modifying OA drugs. Therefore, providing any treatment options that delay the onset or progression of OA is highly desirable. The scope of this dissertation examines two different strategies to promote translational therapies for OA. The first approach investigated whether Smad ubiquitin regulatory factor ...


Impact Of Intra-Articular Injection Use On Patient-Reported Outcomes Among Patients With Knee Osteoarthritis, Shao-Hsien Liu Mar 2017

Impact Of Intra-Articular Injection Use On Patient-Reported Outcomes Among Patients With Knee Osteoarthritis, Shao-Hsien Liu

GSBS Dissertations and Theses

Background: Knee osteoarthritis (OA) is the most common type of OA and is a major cause of pain and thus results in disability for daily activities among persons living in the community. OA currently has no cure. In addition to the conflicting recommendations from clinical guidelines, evidence about the extent to which long-term use of intra-articular injections improves patient outcomes is also lacking.

Methods: Using data from the Osteoarthritis Initiative (OAI), marginal structural models (MSMs) applying inverse probability treatment weights (IPTW) were used to examine the effectiveness of intra-articular injections and changes in symptoms over time. The specific aims of ...


Patient And Social Determinants Of Health Trajectories Following Coronary Events, Lisa Nobel Mar 2017

Patient And Social Determinants Of Health Trajectories Following Coronary Events, Lisa Nobel

GSBS Dissertations and Theses

More than 1.2 million Americans are hospitalized annually with an acute coronary syndrome (ACS); many impaired quality of life after discharge with an ACS. This dissertation focuses on two novel aspects of patient health status (PHS) after ACS: how it can be predicted based on the socioeconomic status (SES) of the patient, and how it evolves over time. We used data from TRACE-CORE, a longitudinal prospective cohort of patients hospitalized with ACS. We measured PHS using both the SF-36 mental and physical component subscales (MCS and PCS) and the Seattle Angina Questionnaire (SAQ) health-related quality of life (HRQoL) and ...


Targeting Drug Resistance In Chronic Myeloid Leukemia: A Dissertation, Leyuan Ma Nov 2016

Targeting Drug Resistance In Chronic Myeloid Leukemia: A Dissertation, Leyuan Ma

GSBS Dissertations and Theses

Inhibiting BCR-ABL kinase activity with tyrosine kinase inhibitors (TKIs) has been the frontline therapy for CML. Resistance to TKIs frequently occurs, but the mechanisms remain elusive.

First, to uncover survival pathways involved in TKI resistance in CML, I conducted a genome-wide RNAi screen in human CML cells to identify genes governing cellular sensitivity to the first generation TKI called IM (Gleevec). I identified genes converging on and activating the MEK/ERK pathway through transcriptional up-regulation of PRKCH. Combining IM with a MEK inhibitor synergistically kills TKI-resistant CML cells and CML stem cells.

Next, I performed single cell RNA-seq to compare ...


Evaluating Acceptability, Feasibility And Efficacy Of A Diabetes Care Support Program Facilitated By Cellular-Enabled Glucose Meters: A Dissertation, Daniel J. Amante Oct 2016

Evaluating Acceptability, Feasibility And Efficacy Of A Diabetes Care Support Program Facilitated By Cellular-Enabled Glucose Meters: A Dissertation, Daniel J. Amante

GSBS Dissertations and Theses

Background. Diabetes requires significant disease management, patient-provider communication, and interaction between patients, family members, caregivers, and care teams. Emerging patient-facing technologies, such as cellular-enabled glucose meters, can facilitate additional care support and improve diabetes self-management. This study evaluated patient acceptability, feasibility, and efficacy of a diabetes care support program facilitated by cellular-enabled glucose meters.

Methods. A two-phase study approach was taken. Get In Touch – Phase 1 (GIT-1) was a 1-month pilot involving patients with type 1 and type 2 diabetes. Get In Touch – Phase 2 (GIT-2) was a 12-month randomized controlled crossover trial involving patients with poorly-controlled type 2 diabetes ...


Histopathological Characterization Of The Dystrophic Phenotype And Development Of Therapeutic Candidates For A Gene Therapy Pre-Clinical Study In Dysferlin Deficient Mice, Leticia Fridman Sep 2016

Histopathological Characterization Of The Dystrophic Phenotype And Development Of Therapeutic Candidates For A Gene Therapy Pre-Clinical Study In Dysferlin Deficient Mice, Leticia Fridman

GSBS Dissertations and Theses

Dysferlin deficient muscular dystrophy is a devastating disease that leads to loss of mobility and quality of life in patients. Dysferlin is a 230 kD protein primarily expressed in skeletal muscle that functions in membrane resealing. Dysferlin loss of function leads to a decrease in the membrane resealing response after injury in skeletal muscle, which is thought to cause degeneration of the musculature over time. Dysferlin cDNA is 7.4 kb and exceeds AAV packaging capacity of ~ 5kb. This thesis focuses on the generation of mini dysferlin mutants that can be packaged in AAV for downstream testing of therapeutic efficacy ...


Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos Jul 2016

Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos

GSBS Dissertations and Theses

Background: Traumatic injury remains a major cause of mortality in the US. Older Americans experience lower rates of injury and higher rates of death at lower injury severity than their younger counterparts. The objectives of this study were to explore pre-injury factors and injury patterns that are associated with post-discharge mortality among injured elderly surviving index hospitalization.

Methods: We queried a 5% random sample of Medicare beneficiaries (n=2,002,420) for any hospitalization with a primary ICD-9 diagnosis code for injury. Patients admitted without urgent/emergent admission were excluded, as well as patients presenting from inpatient hospitalization or rehabilitation ...


Activation Of Mtorc1 Improves Cone Cell Metabolism And Extends Vision In Retinitis Pigmentosa Mice: A Dissertation, Aditya Venkatesh Apr 2016

Activation Of Mtorc1 Improves Cone Cell Metabolism And Extends Vision In Retinitis Pigmentosa Mice: A Dissertation, Aditya Venkatesh

GSBS Dissertations and Theses

Retinitis Pigmentosa (RP) is an inherited photoreceptor degenerative disease that leads to blindness and affects about 1 in 4000 people worldwide. The disease is predominantly caused by mutations in genes expressed exclusively in the night active rod photoreceptors; however, blindness results from the secondary loss of the day active cone photoreceptors, the mechanism of which remains elusive. Here, we show that the mammalian target of rapamycin complex 1 (mTORC1) is required to delay the progression of cone death during disease and that constitutive activation of mTORC1 is sufficient to maintain cone function and promote cone survival in RP. Activation of ...


Frailty And Outcomes In Liver Transplantation: A Dissertation, Natasha H. Dolgin Apr 2016

Frailty And Outcomes In Liver Transplantation: A Dissertation, Natasha H. Dolgin

GSBS Dissertations and Theses

In recent years, the transplant community has explored and adopted tools for quantifying clinical insight into illness severity and frailty. This dissertation work explores the interplay between objective and subjective assessments of physical health status and the implications for liver transplant candidate and recipient outcomes. The first aim characterizes national epidemiologic trends and the impact of Centers for Medicare and Medicaid quality improvement policies on likelihood of waitlist removal based on the patient being too frail to benefit from liver transplant (“too sick to transplant”). This aim includes more than a decade (2002–2012) of comprehensive national transplant waitlist data ...


Contraceptive Utilization And Downstream Feto-Maternal Outcomes For Women With Substance Use Disorders: A Dissertation, Gillian J. Griffith Mar 2016

Contraceptive Utilization And Downstream Feto-Maternal Outcomes For Women With Substance Use Disorders: A Dissertation, Gillian J. Griffith

GSBS Dissertations and Theses

Background: One in ten people in the U.S. are affected by a substance use disorder (SUD), roughly one third of whom are women. Rates of unintended pregnancy are higher in this population than in the general public. Little is understood about how women with SUD use prescription contraception and think about pregnancy.

Methods: By analyzing Medicaid claims data and conducting qualitative interviews with women with SUD, this doctoral thesis seeks to: 1) compare any use of and consistent, continued coverage by prescription contraceptives between women with and without SUD; 2) determine the extent to which SUD is associated with ...