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Articles 31 - 60 of 214
Full-Text Articles in Psychology
Determining The Racial And Ethnic Differences In Neonatal Intensive Care Unit Admission Rates, Youngran Kim
Determining The Racial And Ethnic Differences In Neonatal Intensive Care Unit Admission Rates, Youngran Kim
Dissertations & Theses (Open Access)
Background: Recent trends show that the utilization of neonatal intensive care unit (NICU) has extended beyond severely ill infants and increased substantially across all birth weights. However, little is known about what drives the growth of NICU admission rates and whether these trends differ by race/ethnicity. Methods: The study used 2008-2018 Natality Files with restricted use of state and county-level information. Crude and risk-adjusted NICU admission rates, overall and stratified by birth weight group, were compared between black and white infants and between Hispanic and white infants. Kitagawa decomposition and Oaxaca-Blinder decomposition analyses were conducted for the temporal increase in …
Using Spatial Methods To Better Understand Food Insecurity And Snap Under-Participation In Texas, Ryan Ramphul
Using Spatial Methods To Better Understand Food Insecurity And Snap Under-Participation In Texas, Ryan Ramphul
Dissertations & Theses (Open Access)
The overall objective of this research is to use spatial methods to better understand food insecurity and SNAP under-participation in Texas. Paper 1 assesses whether a sample of community dwelling Medicare and Medicaid beneficiaries, who screen positive for food insecurity at healthcare locations in Harris County, exhibit a spatial pattern in terms of where they live. In other words, it tests whether or not there are statistically significant neighborhood hot spots or cold spots of food insecurity against a null hypothesis of complete spatial randomness. This approach is novel because it uses address-level data on patients who report being food …
Physician Burnout: Slowing The Burn Through Positive Deviance Strategies, Swapna Reddy
Physician Burnout: Slowing The Burn Through Positive Deviance Strategies, Swapna Reddy
Dissertations & Theses (Open Access)
Introduction: Affecting 42% of physicians in the United States, “physician burnout” is considered a public health crisis with adverse impacts for personal providers, patients and organizations. Though much research has been devoted to the existence and causes of burnout, to date few studies have been conducted to identify factors associated with physician fulfillment. Aims: This dissertation research was intended to increase and improve knowledge of factors effective in contributing to physician professional fulfillment utilizing a Positive Deviance based approach. To that end, two studies were conducted: the first, a narrative review of the literature to identify specific correlates of physician …
Bayesian Modeling Of Censored Data With Application To Meta-Analysis Of Immunotherapy Trials, Xinyue Qi
Bayesian Modeling Of Censored Data With Application To Meta-Analysis Of Immunotherapy Trials, Xinyue Qi
Dissertations & Theses (Open Access)
My dissertation builds on a systematic review of 125 clinical trials reporting on treatment-related adverse events (AEs) associated with PD-1/PD-L1 inhibitors published from 2010 to 2018. The motivating dataset contained the following study-level components extracted from each publication: trial name, number of treated patients, selected immunotherapy drug, dosing schedule, cancer type, number of AEs within each category, and the pre-specified criteria for AE reporting. The number of AEs were reported based upon all-grade (Grade 1-5) and Grade 3 or higher (Grade 3-5) severity. My overall objective was to increase our understanding of the toxicity profiles of five most common cancer …
The Role Of Dna Methylation In White Matter Hyperintensity Burden: An Integrative Approach, Yunju Yang
The Role Of Dna Methylation In White Matter Hyperintensity Burden: An Integrative Approach, Yunju Yang
Dissertations & Theses (Open Access)
Cerebral white matter hyperintensities (WMH) on MRI are an indicator of cerebral small vessel disease, a major risk factor for vascular dementia and stroke. DNA methylation may contribute to the molecular underpinnings of WMH, which are highly heritable. We performed a meta-analysis of 11 epigenome-wide association studies in 6,019 middle-aged to elderly subjects, who were free of dementia and stroke and were of African (AA) or European (EA) descent. In each study, association between WMH volume and each CpG was tested within ancestry using a linear mixed model, adjusted for age, sex, total intracranial volume, white blood cell count, technical …
Sample Size Calculations For Longitudinal Mediation Analysis With Continuous-Time Markov Chain Variables, Abigail Christine Sedory
Sample Size Calculations For Longitudinal Mediation Analysis With Continuous-Time Markov Chain Variables, Abigail Christine Sedory
Dissertations & Theses (Open Access)
Mediation is a type of analysis used to determine the causal mechanism linking a predictor and an outcome through a mediator variable. Various research has examined the inclusion of different variable types for the predictor, mediator, and outcome. However, no studies include the presence of a continuous-time Markov chain (CTMC) as any of the components in a mediating model. If researchers wanted to design a study with a CTMC in the mediating process, one of the first steps would be to determine the minimum number of subjects or observations needed to detect a significant mediating effect. Therefore, in this study, …
THe EFfect Of UNconventional GAs And OIl DRilling EMissions On ASthma And REspiratory DIseases In The BArnett SHale Of TExas, Stella A. Okoroafor
THe EFfect Of UNconventional GAs And OIl DRilling EMissions On ASthma And REspiratory DIseases In The BArnett SHale Of TExas, Stella A. Okoroafor
Dissertations & Theses (Open Access)
Unconventional gas and oil drilling (UGOD) has increased substantially in the United States for more than a decade. The resultant environmental unsafe air pollution effects of UGOD both locally and regionally have been well documented in the literature. Despite the dramatic increase in unconventional well drilling and the toxicant exposure, the health consequences of UGOD remain largely uncertain. This study assesses the relationship between active wells and healthcare use for respiratory diseases by zip code from 2004 to 2008 in the Barnett shale area of Texas. The first modern shale gas well was drilled in the Barnett shale area of …
Understanding Participation In A Workplace Physical Activity Intervention Using Self-Determination Theory: The Booster Break Study, Kathleen Ochipa
Understanding Participation In A Workplace Physical Activity Intervention Using Self-Determination Theory: The Booster Break Study, Kathleen Ochipa
Dissertations & Theses (Open Access)
Abstract: Sedentary behavior can lead to premature mortality, cardiovascular disease, Type 2 diabetes, and cancer incidence. Office workers are at risk for high amounts of sedentary behavior. Even brief bouts of physical activity that interrupt sedentary behavior can improve office workers’ physical and mental health. The workplace is an optimal setting for increasing physical activity and reducing sedentary behavior among office workers. However, limited literature exists related to the characteristics of participants that adhere to workplace physical activity interventions. This study aimed to identify characteristics of participants who enrolled in the Booster Break program, a 15 minute once-daily intervention during …
Safe Patient Handling – A Case For National Legislation, David O. Oba
Safe Patient Handling – A Case For National Legislation, David O. Oba
Dissertations & Theses (Open Access)
Introduction: This study examined the effectiveness of Safe Patient Handling (SPH) legislations in difference states across the country. In January 2006, the state of Texas legislated the Safe Patient Handling and Movement Practices Act which required all hospitals and nursing homes to implement safe patient handling and movement program. To date, 10 other states have enacted law or regulations to control work-related musculoskeletal disorders (MSDs) among healthcare workers (HW). Despite the effectiveness of these policies in the individual states, MSDs remain prevalent among HW nationwide. Hence, the call for national legislation. Methods: Using the state-level incidence rate data from the …
A Partial Likelihood Approach To Longitudinal Categorical Data Using A Continuous Time Semi-Markov Chain Model, Kusha A. Mohammadi
A Partial Likelihood Approach To Longitudinal Categorical Data Using A Continuous Time Semi-Markov Chain Model, Kusha A. Mohammadi
Dissertations & Theses (Open Access)
Longitudinal studies have been critical in understanding the characteristics of chronic diseases or interventions. Since many processes have natural multi-categorical responses over time, multi-state stochastic models have been used to estimate the transition rates between stages. Some multi-state models applied in practice assume the Markov property. The Markov property constrains the sojourn distribution to be exponentially distributed. While useful theoretical properties arise by the Markov assumption, we will consider a more flexible framework by allowing arbitrarily distributed waiting times. This describes a semi-Markov process which has already been applied to various fields in Public Health. Similar to Markov model developments, …
Comparison Of Interactive Electronic Versus Standard Document Method For Obtaining Patient Informed Consent, Jermaine Mcmillan
Comparison Of Interactive Electronic Versus Standard Document Method For Obtaining Patient Informed Consent, Jermaine Mcmillan
Dissertations & Theses (Open Access)
The primary objective of this study was to determine whether participants who received an interactive electronic consent (EC) had a better understanding of a medical procedure (apheresis) compared to those who received the standard document (SD) consent. The study was conducted with apheresis donors whose responses were used to determine if the EC facilitated better comprehension and retention of consent information by the study participants than by SD consenting methods. By comprehension, the goal was to have participants who can understand, summarize, or make judgments based on the content presented in the informed consent. By retention, the goal was to …
Development Of A Culinary Nutrition-Based Training For Dietitians And A Clinic-Based Nutrition Intervention To Improve Health Outcomes Among Low-Income Minority Patients, John Wesley Mcwhorter
Development Of A Culinary Nutrition-Based Training For Dietitians And A Clinic-Based Nutrition Intervention To Improve Health Outcomes Among Low-Income Minority Patients, John Wesley Mcwhorter
Dissertations & Theses (Open Access)
Substantial evidence demonstrates the relations between a healthy dietary pattern rich in fruits, vegetables, and whole grains and a lower risk of chronic diseases including type 2 diabetes. Despite well supported studies, programs, and public health campaigns presenting the health benefits of consuming a healthy dietary pattern, most Americans fall far short of the recommendations. Further, the compounding effects of food insecurity and the consumption of energy-dense and nutrient-deficient foods disproportionately affect low income minority populations. Culinary medicine (CM) and food prescription programs are gaining popularity as tools for (1) decreasing food insecurity; (2) increasing personal agency; (3) promoting healthy …
Exploring Community-Based Weight Loss Initiatives, Retention, And Motivation, Miriam Martinez
Exploring Community-Based Weight Loss Initiatives, Retention, And Motivation, Miriam Martinez
Dissertations & Theses (Open Access)
Obesity puts individuals at risk of developing diabetes, cardiovascular disease, and cancer. Traditionally obesity was primarily perceived as a personal disorder requiring treatment at the individual level. Strategies to prevent obesity have shifted to an ecological approach. Organizations such as the World Health Organization recommend population based community approaches that connect people, families, schools, and municipalities. Community programs to facilitate weight loss are an effective strategy to reach large populations. The overall goal of this study is to assess community programs, factors associated with retention, and motivation for completing a community weight-loss initiative. A systematic review was conducted to characterize …
Shared Decision Making In The Care Of Post-Acute Psychiatric Individuals With Serious Mental Illness, Natalie J. Maples
Shared Decision Making In The Care Of Post-Acute Psychiatric Individuals With Serious Mental Illness, Natalie J. Maples
Dissertations & Theses (Open Access)
Severe mental illness in adults refers to a group of mental health conditions including schizophrenia and schizoaffective, bipolar and major depressive disorders. These conditions are often characterized by recurring symptoms, multiple hospitalizations, and significant disability. The public health concern with these conditions is amplified because many individuals with severe mental illness fail to engage in outpatient treatment. Methods to support greater rates of participation in outpatient treatment are needed. Encouraging participation in medical decision making is viewed as one method to optimize patient empowerment, increase engagement in care and decrease the negative outcomes that often characterize this population. Shared Decision …
Using Technology To Reduce Barriers In Community Health: An Intersection Between Broadband Access, Ehr & Telehealth Adoption In Federally Qualified Health Centers, Renita Madu
Dissertations & Theses (Open Access)
While Federally Qualified Health Centers (FQHCs) provide affordable, high quality, accessible and cost–effective primary health care to all individuals regardless of their inability to pay, patients continue to have difficulty accessing affordable primary care as well as broader specialty services that other patients may receive living near larger health systems and hospitals. Health information technology (HIT) serves as a cost-effective means to overcome barriers related to accessing care, particularly for individuals living in rural and remote areas. We examined if the key influencers of an FQHC’s structure, broadband access and/ or state and federal policies impacted the utilization of telehealth …
Personalized Estimation And Causal Inference Via Deep Learning Algorithms, Yuanyuan Liu
Personalized Estimation And Causal Inference Via Deep Learning Algorithms, Yuanyuan Liu
Dissertations & Theses (Open Access)
Personalized approaches have shown great potential to transform modern medicine. As challenging as it may sound, we are making tremendous progress with the help of data sciences and machine learning. Two fundamental tasks in data sciences are prediction and inference. In this dissertation, I proposed to address these two tasks using deep learning approaches in the setting of personalized medicine. First, I developed a novel framework to estimate individualized treatment effects (ITE), which quantified the variation in response to the same treatment among patients with heterogeneous profiles. The ITE estimation has the potential to replace the one-size-fits-all average treatment effects …
Pediatric Wound Care: What Can We Learn From A Systematic Review Of The Literature? Using A Systematic Review And A Clinical Consensus Group To Assess The Quality And Content Of Systematic Reviews Focusing On Pediatric Wound Care. Then Providing And Analytical Outline For Creation Of Pediatric Wound Care Guidelines For Evidence Based Clinical Practice, Ryan Krasnosky
Dissertations & Theses (Open Access)
Background: Wound care practices for neonatal and pediatric patients including the category of products, specific products within each category, and length of application of the products have created lack of standardized evidence-based guidelines for treatments in clinical practices. This dissertation addresses this concern by encompassing three crucial steps in developing evidence-based clinical guidelines for wound care specialists. Using a three-paper method, an expert consensus group was formed, a systematic review of reviews completed and a process for creating clinical decision trees created. Methods: Criteria for selection of the consensus group members included: 1) Research graduate active in Pediatric Wound Care …
An Assessment Of Outpatient Clinic Room Ventilation Systems And Possible Relationship To Disease Transmission, Kristin G. King
An Assessment Of Outpatient Clinic Room Ventilation Systems And Possible Relationship To Disease Transmission, Kristin G. King
Dissertations & Theses (Open Access)
The delivery of healthcare in the United States is shifting from a largely inpatient model to an outpatient services model, but the physical infrastructure for outpatient clinics or medical offices may not be as robust as inpatient hospitals regarding whole room ventilation requirements. Guidelines for the design of healthcare facilities and national standards for ventilation establish generally acceptable ventilation rates for outpatient clinics, but it is unclear if these standards are actually being integrated into these settings. Published peer reviewed literature indicates that inadequate ventilation rates can be a risk factor in airborne transmission of infectious diseases in outpatient clinics, …
The Influence Of Brand Equity On Prescriber Behaviour In A Multisource Drug Market, Wanjiku Kariuki
The Influence Of Brand Equity On Prescriber Behaviour In A Multisource Drug Market, Wanjiku Kariuki
Dissertations & Theses (Open Access)
When a patent expires, innovator (brand-name) drugs lose their monopoly status and new generic competitors are free to enter the market. Theoretically, free market entry and exit should lead to a drop in the price of the innovator drug as per the tenets of perfect competition. Yet instead of prices decreasing, innovator drug prices are often minimally impacted by generic competition and the innovator continues to maintain both market power and market share – a phenomenon labelled the generic competitor paradox (Scherer, 1993) That the expected supply and demand dynamic is less pronounced in multisource drug markets, suggests that non-price …
The Intersection Of Diet, Health And The Environment: Plant Based Diets And Public Health, Christine E. Jovanovic
The Intersection Of Diet, Health And The Environment: Plant Based Diets And Public Health, Christine E. Jovanovic
Dissertations & Theses (Open Access)
Both globally and within the United States, chronic disease has become a major driver of mortality and morbidity. In the United States in 2017, the top ten causes of mortality accounted for 74% of all deaths [2]; of these causes, half are closely linked to diet (heart disease, cancer, stroke, Alzheimer’s and diabetes). [3] In 2013, Ioannidis estimated that 26% of deaths and 14% of disability adjusted life years (DALYs) in the United States may be attributable to dietary risk factors, controlling for obesity. [4] At the same time, diet also has an important impact on the environment. Direct emissions …
A Geospatial Examination Of The Association Between Geographic Food Access And Food Insecurity In Central Texas: The Role Of Race/Ethnicity And Urbanicity, Kathryn Janda
Dissertations & Theses (Open Access)
Food insecurity is a public health issue that affects one in ten Americans, one in seven Central Texans, and is associated with malnutrition, chronic disease, and obesity. Geographic food access is the most intervened upon aspect of food insecurity and is often measured objectively through mapping software, such as ArcGIS. Yet when geographic food access is only measured in terms of distance to food retail, analyses do not full capture the nuances of community context. Thus, other sources of data, like survey data, and demographic indicators, such as race/ethnicity and urbanicity, should be incorporated into the research exploring the association …
Estimating Means And Distributions Of Count Data From Surveys Invoking Complex Sampling Designs: Application To Measuring Cross-Sectional And Lifetime Alcohol Intake From Nhanes And Nlsy, Elysia A. Garcia
Dissertations & Theses (Open Access)
It is often of interest to measure the distribution (i.e. mean and percentiles) of count outcomes from national survey data to assess population consumption and guide public health efforts for substances such as alcohol, cigarettes, marijuana, and other illicit or licit drugs. Currently available methods for estimating the distribution of dietary intakes do not immediately lend themselves to estimating the consumption of substances measured as counts, nor do they accommodate the complex design elements – strata, cluster, and weight – characteristic of national surveys. We introduce an accurate methodology, called the Survey Adjusted Count (SAC) method, and an associated SAS …
Understanding Factors That Impact Health Behaviors And Access To Healthcare Among Youth Experiencing Homelessness, Kathryn Rosales Gallardo
Understanding Factors That Impact Health Behaviors And Access To Healthcare Among Youth Experiencing Homelessness, Kathryn Rosales Gallardo
Dissertations & Theses (Open Access)
Youth experiencing homelessness (YEH) have a high risk of adverse health outcomes and their utilization of healthcare services is low. This dissertation aims to further understand factors that impact YEH’s health behaviors and access to healthcare services. This dissertation is in the form of three manuscripts that each contribute to the overall aim. In manuscript 1, we examined the rates and correlates of human papillomavirus (HPV) vaccination initiation and completion among a sample of YEH in seven U.S. cities using logistic regression models. We found that HPV vaccination completion is low among male (19%) and female (37%) YEH. Among male …
Consider Us: Analysis Of National Mammography Screening Recommendations On African American Women, Gayla M. Ferguson
Consider Us: Analysis Of National Mammography Screening Recommendations On African American Women, Gayla M. Ferguson
Dissertations & Theses (Open Access)
Breast cancer is the second most common cause of cancer related death in women in the United States with one in eight women expected to develop the disease in their lifetime. Unfortunately, breast cancer is the leading cause of cancer related death among African American women. African American women are four times more likely to die from breast cancer that Caucasian women. Mammography screenings are the most effective method of reducing breast cancer mortality in African American women. This study aimed to determine if the changes made to the mammography screening recommendations put forth by the U.S. Preventive Services Task …
Social Work Involvement In Hurricane Harvey Relief Efforts, Claire Crawford
Social Work Involvement In Hurricane Harvey Relief Efforts, Claire Crawford
Dissertations & Theses (Open Access)
Hurricane Harvey brought 33 trillion gallons of rainfall to Texas and Louisiana and damaged more than 100,000 homes in August 2017. Social workers worked during and after the storm to provide services to those affected. The primary research question guiding this dissertation was: What were social workers’ experiences as they were involved in relief efforts during and immediately after Hurricane Harvey? The study group comprised 39 participants (35 female, 4 male); of these, 19 were masters-level social workers who volunteered at shelters in Houston following Hurricane Harvey, 14 were masters-level social workers who worked at a pediatric children’s hospital on …
Exploration Of Breastfeeding As A Protective Factor For Breast Cancer In South African Women: A Nested Case-Control Study, Booker S. Quiera
Exploration Of Breastfeeding As A Protective Factor For Breast Cancer In South African Women: A Nested Case-Control Study, Booker S. Quiera
Dissertations & Theses (Open Access)
Background. South African’s (SA) breast cancer incidence rate is continually increasing (39 per 100,000 (2012) versus 46.2 per 100,000 (2018) with trends towards later-stage diagnosis. In previous literature, breastfeeding has been assessed as a protective factor for breast cancer; however, the SA population experiences inconsistent breastfeeding trends, rates, and support services. Therefore, this study will evaluate the inverse association between breast cancer and breastfeeding history. Methods. Cases (breast cancer) and controls (mastalgia) were matched 1:1 on clinical visit from May-August 2019 at Groote Schuur Hospital (GSH) in Cape Town, Western Cape, South Africa. Breastfeeding history, breast carcinoma diagnosis, and clinically …
The Influence Of Sodium And Potassium On Blood Pressure Genetics In The Population Architecture Using Genomics And Epidemiology Study, Cynthia S. Bell
The Influence Of Sodium And Potassium On Blood Pressure Genetics In The Population Architecture Using Genomics And Epidemiology Study, Cynthia S. Bell
Dissertations & Theses (Open Access)
Multiple polymorphisms have shown associations with blood pressure (BP) levels and hypertension status, but the overall genetic effect on BP has been small and accounts for only a small fraction of the variation in population-wide BP characteristics. These weak associations of BP with genotype may not be attributable to the examining the “wrong” single nucleotide polymorphism (SNP) but may instead be the result of noisy BP phenotypes based on mmHg alone. Adding information from the underlying mechanisms of nutritional intake, reuptake, and excretion on BP may produce more informative BP phenotypes to study. To explore this complex relationship between diet, …
Estimating Children’S Health Risks From Recreational Beach Play Following An Oil Spill, Tanu K. Altomare
Estimating Children’S Health Risks From Recreational Beach Play Following An Oil Spill, Tanu K. Altomare
Dissertations & Theses (Open Access)
Environmental contamination from marine oil spills can have damaging impacts on ecosystems and human health. In 2010, an explosion of the Deepwater Horizon (DWH) oil drilling platform resulted in approximately 1,728 km of shoreline oiling. Existing research characterizes health risk from exposure to oil spill chemicals (OSCs) for adults; however, data on impacts to child health are limited. One objective of the Beach Exposure And Child HEalth Study (BEACHES), funded by the Gulf of Mexico Research Initiative, is to estimate health risks to children between walking and six years of age from exposure to OSCs in a post-oil spill scenario …
Measuring Cultural Humility Of Community Health Workers, Nayeema Ahmed
Measuring Cultural Humility Of Community Health Workers, Nayeema Ahmed
Dissertations & Theses (Open Access)
This study examined cultural humility of community health workers (CHWs) in ambulatory clinical settings. Cultural humility has been defined as an attitude, or process that incorporates openness, power-balance, and critical self-reflection when interacting with people of cultural differences. It differs from the more well-known concept of cultural competence in that cultural humility is not culture specific and reflects provider attitudes and an orientation towards recognizing differences rather than specific knowledge about another culture. As such, cultural humility may lend itself to improving the care process across diverse patient populations. The literature on cultural humility and its relationship with CHWs is …
Determining The Drivers Of Quality Of Life In Hiv Patints Treated With Antiretroviral Therapy In Subsaharan Africa, Oubote Sangbana
Determining The Drivers Of Quality Of Life In Hiv Patints Treated With Antiretroviral Therapy In Subsaharan Africa, Oubote Sangbana
Dissertations & Theses (Open Access)
During the last decade, HIV in sub-Saharan Africa has shifted from a fatal disease to a chronic condition thanks to the expansion of antiretroviral therapy (ART). As a result, the focus of care has transitioned from survival to quality of life (QoL), and the latter has become a significant outcome measure during patient follow up. Yet, the determinants of QoL among HIV patients in western and central Africa are not well known. The objective of this dissertation was to determine the main factors associated with QoL among ART-treated HIV adult patients in western and central Africa to ensure healthcare providers …