Physician Hospital Arrangement Influence On Nonprofit Hospital Quality,Financial Performance And Community Benefit Expenditures, 2020 UTHealth School of Public Health
Physician Hospital Arrangement Influence On Nonprofit Hospital Quality,Financial Performance And Community Benefit Expenditures, Andrea Cervin
Dissertations & Theses (Open Access)
Federal policy has encouraged hospitals to provide certain quality outcomes and cost containment. Hospitals have responded by forming physician hospital organizations in attempts to achieve quality outcomes and capture reimbursements. At the same time, federal policy has awarded hospitals with nonprofit status with the requirement to provide community benefits in exchange for the tax exemption they receive. With the formation of physician hospital organizations, there remains the question of whether hospitals are achieving desired quality metrics and whether hospitals are financially viable. There is also public and media interest recently regarding whether nonprofit hospitals fulfill their obligations for community benefit …
Nudging Quality Improvement In Cancer Care: Influence Of A Clinical Decision Support System To Nudge Adherance To Evidence Based Guidelines In Adult Cancers, 2020 UTHealth School of Public Health
Nudging Quality Improvement In Cancer Care: Influence Of A Clinical Decision Support System To Nudge Adherance To Evidence Based Guidelines In Adult Cancers, Debra Patt
Dissertations & Theses (Open Access)
Cancer care is changing rapidly. Understanding of the increasing subtypes of cancer and exponentially increasing therapeutic interventions are unprecedented due to the rapid pace of scientific discovery and clinical innovation. This immense change within the field, lends itself to quality control initiatives, especially among general oncology providers who see a wide array of cancer types as general oncologists will see many different tumor types, and most of which have several potential treatment choices that have grown over time. Evidence-based pathways are an effective way to nudge quality control by presenting choice architecture at the point of care to facilitate guideline …
Barriers To Integrated Primary Care And Specialty Mental Health Services: Perspectives From Latinx And Non-Latinx White Primary Care Patients, 2020 University of Arkansas, Fayetteville
Barriers To Integrated Primary Care And Specialty Mental Health Services: Perspectives From Latinx And Non-Latinx White Primary Care Patients, Elizabeth A. Anastasia
Graduate Theses and Dissertations
High need, low access, and rising health care costs reveal the inadequacies of the current mental health system in the U.S. Racial/ethnic minorities, including Latinxs, face substantial disparities in accessing mental health treatment compared with non-Latinx Whites. Integrated primary care (IPC) offers an alternate model for meeting mental health needs by providing care in a way that is accessible to the general population. Though it has been suggested that IPC may reduce health disparities by decreasing barriers to mental health treatment, empirical data relevant to this question are limited. A series of three studies were conducted using a mixed methodology …
An Experimental Test Of The Effects Of Sleep Deprivation On Approach Behavior, 2020 University of Arkansas, Fayetteville
An Experimental Test Of The Effects Of Sleep Deprivation On Approach Behavior, Rebecca L. Campbell
Graduate Theses and Dissertations
Emotion regulation and sleep have been identified as mechanisms that may be involved in the development and maintenance of many mental health disorders. However, there has been little research into the relation between sleep and emotion regulation. To address this gap in knowledge, a novel study was conducted. We hypothesized that sleep deprived individuals would demonstrate less approach behavior toward a negatively valenced stimulus, as well as increased self-reported avoidance, compared to a control group. To test this, a randomized controlled experiment using a behavioral measure of approach and a self-report measure of avoidance was conducted. Fifty-two healthy individuals ages …
The Effects Of Auditory And Olfactory Cues On Visual Attention Toward Food Images Under Acute Stress, 2020 University of Arkansas, Fayetteville
The Effects Of Auditory And Olfactory Cues On Visual Attention Toward Food Images Under Acute Stress, Reza Moltaji
Graduate Theses and Dissertations
Psychological stress has been shown to increase preference for high calorie foods containing high levels of sugar and fat. Since excessive intake of high calorie foods may increase potential risk of obesity and other relevant health issues, relieving psychological stress may help in maintaining a balanced diet and good health status. Although a variety of strategies for relieving psychological stress has been suggested, little attention has been paid to regarding whether such strategies can result in balanced diets. Since music therapy and aromatherapy have proven popular approaches to relieving psychological stress, this thesis aimed at determining whether listening to music …
Managing Stress In A Constantly-Changing Workforce, 2020 East Tennessee State University
Managing Stress In A Constantly-Changing Workforce, Lorri Burch-Hubbard
Electronic Theses and Dissertations
When staffing reductions occur in the workplace, staff left behind may face increased stress, may not be given the support they need to manage the feelings caused by the reduction. This study was conducted to evaluate the impact of stress caused by staffing reductions has on medical technologists (MT), medical technicians (MLT) and respiratory therapists (RT), and to identify any common methods of stress management used by those staff who remain in the organization.
Literature research showed the negative impact stress can have on individuals when it is not addressed, such as decreased work performance, health issues, and even the …
Depressive Symptoms And Survival Among Lung Cancer Patients: Biomarkers And Potential Benefits Of An Ipod- And Mindfulness-Based Intervention., 2020 University of Louisville
Depressive Symptoms And Survival Among Lung Cancer Patients: Biomarkers And Potential Benefits Of An Ipod- And Mindfulness-Based Intervention., Chelsea J. Siwik
Electronic Theses and Dissertations
Lung cancer patients experience high levels of distress, which commonly manifests as depressive symptoms. Importantly, depressive symptoms have demonstrated prognostic significance in cancer contexts, although the biological pathways by which depressive symptoms lead to poorer survival remain unclear and warrant greater attention. In addition to understanding the biological pathways by which depressive symptoms accelerate disease, identification of efficacious and effective psychological treatments for depressive symptoms are needed to improve both quality and quantity of life for cancer patients. Interventions that reduce depressive symptoms and improve downstream clinical outcomes are certainty needed; however, because many cancer patients face considerable burden, interventions …
Statistical Methods For Functional Annotation-Based Rare Variant Association Analysis, 2020 UTHealth School of Public Health
Statistical Methods For Functional Annotation-Based Rare Variant Association Analysis, Yiding Ma
Dissertations & Theses (Open Access)
Despite ongoing large-scale population-based whole-genome sequencing (WGS) projects such as the TOPMed program, WGS-based association analysis of complex traits remains a tremendous challenge. External biological knowledge, such as functional annotations based on the ENCODE, Epigenomics Roadmap and GTEx projects, may be helpful in distinguishing causal rare variants from neutral ones; however, each functional annotation can only provide certain aspects of the biological functions. Our knowledge for selecting informative annotations a priori is limited and incorporating non-informative annotations will introduce noise and lose power. In the first part of this dissertation, we propose FunSPU, a versatile and adaptive test that incorporates …
The Effectiveness Of Implementing A Collaborative Mental Health Approach On Quality Of Life For Individuals Of Low Socioeconomic Status, 2020 Missouri State University
The Effectiveness Of Implementing A Collaborative Mental Health Approach On Quality Of Life For Individuals Of Low Socioeconomic Status, Tyler Z. Tooley
MSU Graduate Theses
The ultimate purpose of this study is to provide insight and education to mental health clinicians, politicians and the general public of the numerous effects poverty has on mental health, in addition to the most beneficial ways to combat those insidious effects. The specific barriers met by individuals of low socioeconomic status severely affect psychological and physical health, as well as social and environmental relationships, which therefore diminish overall quality of life. The aim of this study is to examine the effectiveness of implementing a collaborative mental health approach for low income individuals on length of engagement in services and …
The Impact Of Location On Healthcare Access For Individuals With Disabilities, 2020 University of Connecticut
The Impact Of Location On Healthcare Access For Individuals With Disabilities, Addison Kimber
Honors Scholar Theses
This paper analyzes healthcare access for individuals with disabilities living in rural areas. In current political discussion, we typically think of insurance coverage as the metric to analyze healthcare access. However, as demonstrated by studies of healthcare in the United Kingdom, people with disabilities continue to face barriers to health care even with universal healthcare systems. In particular, individuals in rural areas have less healthcare access than urban residents. This is due to factors including socioeconomic status, insurance coverage, access to competent care, and transportation. This study aims to understand if disability status exacerbates the issue of access in rural …
Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, 2020 East Tennessee State University
Polysubstance Exposure And Its Relationship To Pharmacological Treatment Characteristics, Parker Miller
Undergraduate Honors Theses
Neonatal Abstinence Syndrome (NAS) remains an ever-growing public health issue and a continued avenue for future research. The research question for this retrospective study was whether polysubstance exposure is related to the dose of medication the infant received or to the number of opioid-medications required to treat the infants’ withdrawal symptoms? The hypothesis for the retrospective study was there will be a significant relationship between polysubstance exposure and the dose of medication the infant received as well as the number of opioid-medications required to treat the infants’ withdrawal symptoms. A bivariate correlational indicated that there was not a significant association …
Economic Evaluation Of Implementing Hpv Vaccine Promotion Interventions For Cervical Cancer In The United States, 2020 UTHealth School of Public Health
Economic Evaluation Of Implementing Hpv Vaccine Promotion Interventions For Cervical Cancer In The United States, Chi-Fang Wu
Dissertations & Theses (Open Access)
The HPV vaccine has been proven as a safe and effective method for preventing cervical cancer. However, the HPV vaccine coverage rate in the U.S. is suboptimal. Various interventions have been implemented to improve HPV vaccine coverage. However, evidence of the cost-effectiveness of HPV vaccine promotion interventions is lacking. We conducted an economic evaluation to assess HPV vaccine promotion interventions of cervical cancer in the U.S. Firstly, a systematic review was conducted to review evidence on interventions aimed at increasing HPV vaccine coverage and to summarize the cost and effectiveness of these interventions. We included 56 HPV vaccine promotion studies …
A Mixed- Methods Examination Of The Healthcare, Social Support, And Religious Needs Of Sexual And Gender Minority (Sgm) Older Adults In Texas, 2020 UTHealth School of Public Health
A Mixed- Methods Examination Of The Healthcare, Social Support, And Religious Needs Of Sexual And Gender Minority (Sgm) Older Adults In Texas, Jennifer Lynn Holcomb
Dissertations & Theses (Open Access)
Shared historical and social contexts influence a generational group’s needs, risk factors, and resiliency mechanisms. Sexual and gender minority (SGM) older adults have experienced structural exclusion and systematic discrimination throughout their lifetime. The minority stress model posits that SGM individuals experience stressors, like discrimination, unique to their social status which affect physical and mental health. SGM older adults experience worse physical and mental health outcomes than their heterosexual peers suggesting unique needs for SGM older adults. Research also points to resiliency mechanisms that offset the impact of stressors on SGM older adults. The examination of these needs and resiliency mechanisms …
The Association Between Assorted Hormonal Contraceptive Methods And Advanced-Stage Epithelial Ovarian Cancer: A Systematic Review, 2020 UTHealth School of Public Health
The Association Between Assorted Hormonal Contraceptive Methods And Advanced-Stage Epithelial Ovarian Cancer: A Systematic Review, Cheng Cheng
Dissertations & Theses (Open Access)
Epithelial ovarian cancer, the most lethal of the gynecological cancers, is typically diagnosed at advanced stages. Women diagnosed with advance-staged (i.e., stage III and IV according to the International Federation of Gynecology and Obstetrics) epithelial ovarian cancer are more likely to have recurrent episodes within 18 months17. According to a 2012 2016 case analysis conducted by the surveillance, epidemiology, and end results, or SEER program, the incidence of ovarian cancer was 11.4 per 100,000 women in all races per year with the highest incidence in non-Hispanic whites, of 11.9 per 100,000 women and the lowest incidence in Asians / Pacific …
Raft-Versus-Host Disease Occurrence Among Cord Blood Transplantation Recipients In Relation To Human Leukocyte Antigen Match Grade, 2020 UTHealth School of Public Health
Raft-Versus-Host Disease Occurrence Among Cord Blood Transplantation Recipients In Relation To Human Leukocyte Antigen Match Grade, Sarah Chowdhury
Dissertations & Theses (Open Access)
Umbilical cord blood (UCB) transplantation has been consistently found to have low rates of graft-versus-host disease (GVHD), high rates of engraftment, and faster turnaround times in terms of finding suitable donors. In addition, it serves as a viable option for individuals with no matched donor options especially due to its flexible human leukocyte antigen matching criteria. Despite its advantages, there has been an overall decrease in UCB transplantation. However, its advantages emphasize the need for further research and investment in resources such as cord blood banking especially since pediatric populations are most likely to benefit from continued research due to …
Mindful Yoga As A Means Of Reducing College Student Stress, 2020 University of Tennessee at Chattanooga
Mindful Yoga As A Means Of Reducing College Student Stress, Jaylee K. Oliver
Honors Theses
Thousands of years ago, yoga was intended to refocus and prepare an individual for self-exploration. Today, the “colloquial yoga” has manifested as an exercise fad. The aim of this study was to further investigate yoga as a stress reducing technique among a sample of college students. This study examined yoga as a distinct discipline by comparing 3 separate conditions (yoga, active-control, and neutral-control). This research aimed to demonstrate an overall decrease in perceived stress, increase in self-esteem, and increase in ability to psychologically detach from stressors after engaging in a yoga practice, as compared to the two control conditions. Overall, …
Demographic Predictors Of Adult Behaviors In The Pediatric Postoperative Environment, 2020 Chapman University
Demographic Predictors Of Adult Behaviors In The Pediatric Postoperative Environment, Natasha H. Hikita, Amber Osorno, Carlie Taurosa, Michelle A. Fortier, Zeev N. Kain, Brooke N. Jenkins
Student Scholar Symposium Abstracts and Posters
Over 85% of children experience postoperative pain. If poorly treated, pediatric postoperative pain may lead to various negative health outcomes. Adult behaviors may be associated with child experiences in the postoperative environment. For example, adult behaviors such as distraction, humor, and coping advice divert a child’s attention away from their pain and thus, may significantly reduce child postoperative distress. In contrast, adult behaviors such as empathy, reassurance, and apology direct a child’s attention towards their pain which may increase a child’s overall postoperative distress. Moreover, patient demographic factors, like child ethnicity, may significantly alter the frequency of use of these …
Pediatric Postoperative Pain Medication: Child Sex And Ethnicity Interact To Predict Parent Medication Attitudes, 2020 Chapman University
Pediatric Postoperative Pain Medication: Child Sex And Ethnicity Interact To Predict Parent Medication Attitudes, Vivian Luong, Harshitha V. Venkatesh, Michelle Fortier, Zeev N. Kain, Brooke N. Jenkins
Student Scholar Symposium Abstracts and Posters
Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little or even no pain medication at home. Such poor pain management in children can have harmful long-term consequences, both physically and psychologically. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by beliefs and attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify which demographic factors are associated with certain parent analgesic attitudes or misconceptions among pediatric patients …
Incentive Sensitization For Exercise Reinforcement To Increase Exercise Behaviors, 2020 University of Kentucky
Incentive Sensitization For Exercise Reinforcement To Increase Exercise Behaviors, Kyle D. Flack, Harry M. Hays, Jack Moreland
Dietetics and Human Nutrition Faculty Publications
Individuals can be sensitized to the reinforcing effects of exercise, although it is unknown if this process increases habitual exercise behavior. Sedentary men and women (body mass index: 25–35 kg/m2, N = 52) participated in a 12-week aerobic exercise intervention. Exercise reinforcement was determined by how much work was performed for exercise relative to a sedentary alternative in a progressive ratio schedule task. Habitual physical activity was assessed via accelerometry. Post-intervention increases in exercise reinforcement predicted increases in physical activity bouts among those who expended over 2000 kcal per week in exercise and who compensated for less than …
Positive Emotions And Favorable Cardiovascular Health: A 20-Year Longitudinal Study, 2020 Chapman University
Positive Emotions And Favorable Cardiovascular Health: A 20-Year Longitudinal Study, Julia K. Boehm, Ying Chen, Farah Qureshi, Jackie Soo, Peter Umokoro, Rosalba Hernandez, Donald Lloyd-Jones, Laura D. Kubzansky
Psychology Faculty Articles and Research
No studies have examined whether positive emotions lead to favorable cardiovascular health (CVH) early in the lifespan, before cardiovascular disease is diagnosed. Moreover, the direction of the association has not been thoroughly investigated. Among younger adults, we investigated whether baseline positive emotions were associated with better CVH over 20 years. We also considered whether baseline CVH was associated with subsequent positive emotions during the same period.
Participants included 4196 Black and White men and women from the Coronary Artery Risk Development in Young Adults Study. Positive emotions and cardiovascular-related parameters were each assessed in 1990 (this study's baseline), with repeated …