Digital Commons Network^™

Patient-Perceived Patient-Centered Medical Home Characteristics And Healthcare Utilization, Expenditure And Quality, Alissa Ratanatawan

Dissertations & Theses (Open Access)

The patient-centered medical home (PCMH) model is a care delivery model which patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand with the aims to improve healthcare quality while keeping healthcare cost growth under control. The objective of this study was to analyze health service utilization, expenditure and quality of civilian noninstitutionalized US adult population in healthcare facilities that have 3 domains of PCMH features, which are comprehensive care, patient-centered care, and accessible care, using patient’s perspective from the 2016 Medical …

Physical Activity Among Preschool-Aged Children: Considerations For Waking Activity Patterns And Health, Erin Dooley

Dissertations & Theses (Open Access)

With nearly one-quarter (23%) of U.S. preschool children (ages 3-5 years) having overweight or obesity, supporting healthy growth and development is paramount. Hispanic children have the highest prevalence within this age group (15.6%) and a large projected population growth. Energy expenditure through physical activity is one way to combat excess development of obesity and poor health outcomes. Yet there is limited evidence about the correlates associated with physical activity and health within this population. The three studies of this dissertation examined sociodemographic-, cultural-, and context-related factors related to waking activity patterns and the subsequent impact on health indicators. The overall …

Hiv-Related Discriminatlon And Cervical Cancer Screening In Zambia, Crystal J. Cazier

Dissertations & Theses (Open Access)

Background: The Republic of Zambia has the third-highest incidence of cervical cancer in the world, where approximately 700,000 women over age 15 are living with HIV. Women living with HIV (WLHIV) are at increased risk for cervical cancer. While literature suggests that discrimination is a barrier to HIV care, no studies have explored if discrimination experienced in HIV clinics is related to cervical cancer screening using nationally representative datasets. Objective: The primary objective of this study was to examine whether perceived discrimination by healthcare workers due to HIV status is related to having been screened for cervical cancer among WLHIV. …

Integrating Primary Care Into Community Mental Health Centres In Texas, Usa: Results Of A Case Study Investigation, Rebecca Wells, Ellen D Breckenridge, Sasha Ajaz, Aman Narayan, Daniel Brossart, James H Zahniser, Jolene Rasmussen

Journal Articles

INTRODUCTION: Despite evidence that people with serious mental illness benefit from receiving primary care within mental health care settings, there is little research on this type of integration. The objective of this study was to characterize how providers and patients experienced implementation of primary care into specialty mental health services.

METHODS: During site visits, study team members interviewed staff and conducted focus groups with patients at 10 United States community mental health centres then beginning to integrate primary into their practices. One year later, follow up phone interviews with key centre staff informants validated and updated findings. Data analysis included …

9th Annual Postdoctoral Science Symposium, University Of Texas Md Anderson Cancer Center Postdoctoral Association

Annual Postdoctoral Science Symposium Abstracts

The mission of the Annual Postdoctoral Science Symposium (APSS) is to provide a platform for talented postdoctoral fellows throughout the Texas Medical Center to present their work to a wider audience. The MD Anderson Postdoctoral Association convened its inaugural Annual Postdoctoral Science Symposium (APSS) on August 4, 2011.

The APSS provides a professional venue for postdoctoral scientists to develop, clarify, and refine their research as a result of formal reviews and critiques of faculty and other postdoctoral scientists. Additionally, attendees discuss current research on a broad range of subjects while promoting academic interactions and enrichment and developing new collaborations.

Improving The Health Care Of Foster Children Throughout The Us: Texas, A Case Example, Nickolas Agathis, Jean L. Raphael, Christopher Greeley

Journal of Applied Research on Children: Informing Policy for Children at Risk

Children who have been exposed to the foster care system comprise a high-risk, vulnerable, and potentially medically complex population that has both poor health and poor access to health care. This review with Texas as a case example aims to describe the health and health care issues impacting children in foster care (CFCs), the state and federal level mechanisms to ensure appropriate funding for the health care of CFCs, and recent legislative efforts to improve the health and health care access for CFCs. The review discusses potential solutions in regards to improving the health of CFCs through four main domains: …

First Foods Nutrition Curriculum For New Immigrant Families: A Pilot Study, Elizabeth E. Dawson-Hahn M.D., Mph, Lorren Koceja Rd, Cd, Abigail R. Grant M.D., Anisa Ibrahim M.D., Beth Farmer Lcsw, H. Mollie Grow M.D., Mph, Sarah Lowry Phd, Mph, Suzinne Pak-Gorstein Phd, Mph

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: Immigrant families arrive in the US from a variety of nutritional landscapes and educational experiences. Early childhood is a key time to intervene to set children on a healthy path. Creating nutritional education programs tailored for immigrant families may improve nutrition and health outcomes.

Objective: To evaluate the First Foods curriculum as a tool for knowledge and behavior change for new immigrant families of young children.

Methods: Immigrant caregivers of children less than 2 years old were invited to attend First Foods, a 4-class series. Each series was offered in 1 of 5 different languages (Arabic, Dari, Somali, Burmese, …

Unmet Needs Of Unaccompanied Minors From Central America: Perceptions Of Professionals From Multiple Sectors, Sheyla P. Medina, Carol Lewis, Roberta Goldman

Journal of Applied Research on Children: Informing Policy for Children at Risk

Background: In recent years, there has been a significant influx of Central American youth who cross the U.S.-Mexico border without a parent or legal guardian. While federal procedures are established to oversee the treatment and placement of unaccompanied minors, less is known about the needs of unaccompanied minors and available services afterthey are placed in appropriate custody.

Methods: Purposive and strategic sampling of professionals from medical, social work, education and legal fields was conducted. Fourteen informants were recruited across the U.S. for confidential semi-structured interviews, which were audio recorded and transcribed in 2016 to 2017. Standard anthropological …

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Silvia Chiang, Carmen Contreras, Ganmaa Davaasambuu, Wafaie W Fawzi, Molly F Franke, Jerome T Galea, Daniel Garcia-Ferrer, Maria Gil-Fortuño, Barbará Gomila-Sard, Amita Gupta, Nikhil Gupte, Rabia Hussain, Jesus Iborra-Millet, Najeeha T Iqbal, Jose Vicente Juan-Cerdán, Aarti Kinikar, Leonid Lecca, Vidya Mave, Noemi Meseguer-Ferrer, Grace Montepiedra, Ferdinand M Mugusi, Olumuyiwa A Owolabi, Julie Parsonnet, Freddy Roach-Poblete, Maria Angeles Romeu-García, Stephen A Spector, Christopher R Sudfeld, Mark W Tenforde, Toyin O Togun, Rosa Yataco, Zibiao Zhang, Megan B Murray

Journal Articles

BACKGROUND: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.

METHODS AND FINDINGS: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …

Utilizing Temporal Information In The Ehr For Developing A Novel Continuous Prediction Model, Kang Lin Hsieh

Dissertations & Theses (Open Access)

Type 2 diabetes mellitus (T2DM) is a nation-wide prevalent chronic condition, which includes direct and indirect healthcare costs. T2DM, however, is a preventable chronic condition based on previous clinical research. Many prediction models were based on the risk factors identified by clinical trials. One of the major tasks of the T2DM prediction models is to estimate the risks for further testing by HbA1c or fasting plasma glucose to determine whether the patient has or does not have T2DM because nation-wide screening is not cost-effective.

Those models had substantial limitations on data quality, such as missing values. In this dissertation, I …

Integrating Diverse Disciplines To Enhance Interprofessional Competency In Healthcare Delivery, Tiffany Champagne-Langabeer, Lee Revere, Mariya Tankimovich, Erica Yu, Robert Spears, Jennifer Lee Swails

Journal Articles

Interprofessional education (IPE) typically involves clinical simulation exercises with students from medical and nursing schools. Yet, healthcare requires patient-centered teams that include diverse disciplines. Students from public health and informatics are rarely incorporated into IPE, signaling a gap in current educational practices. In this study, we integrated students from administrative and non-clinical disciplines into traditional clinical simulations and measured the effect on communication and teamwork. From July 2017-July 2018, 408 students from five schools (medicine, nursing, dentistry, public health, and informatics) participated in one of eight three-hour IPE clinical simulations with Standardized Patients and electronic health record technologies. Data were …

Assessment Of The Common Dental Needs And Evaluation Of Rate Of Attendance Post Emergency Dental Management Among The Homeless Population In Houston, Texas, Heera Govindarajan Venguidesvarane

Dissertations & Theses (Open Access)

Background: Dental care resources for the homeless population are scarce, underfunded and generally inadequate to meet their oral health needs. While poor oral health is clearly an added burden for people who struggle daily to survive under miserable living conditions, little is known about their views on dental health, their perceived needs and their attitudes towards dental care. The purpose of this study was to determine the most common oral health needs of homeless patients and to identify their participation in receiving comprehensive care. Methods: The study was a cross sectional analysis where data were collected retrospectively using the records …

Additional Healthcare Expenditures Of Depression For Elderly Cancer Patients With Depression, Dian Gu

Dissertations & Theses (Open Access)

The risk of depression is high for cancer patients and a large portion of cancer patients are age 65 and over. Both depression and cancer are economically burdensome and depression is associated with healthcare expenditure increase for elderly patients. However, whether comorbid depression affects healthcare expenditures in elderly cancer patients from payers’ and patients’ perspectives is largely unknown. Objective: To investigate whether depression is associated with higher healthcare expenditure among elderly cancer patients from both payers’ and patients’ perspectives and, and determine whether depression is associated with higher probability of having high out-of-cost burden. Methods: From the Medicare Current Beneficiary …

The Prevalence Of Practicing Safety Professionals’ Knowledge, Involvement, And Competency Associated With Workplace Wellness Programs: Gauging The Safety Profession’S Engagement With The Total Worker Health Initiative, Jennifer C. Laine

Dissertations & Theses (Open Access)

The morbidity and mortality burden of occupational injuries and illnesses in the United States became such a public health concern that in 1970 the Occupational Safety and Health Act was signed into law. This law requires employers to provide workplaces “free from recognized hazards” and spurred the development of specific regulations along with the creation of academic and professional training programs to educate individuals about the safety sciences and careers in safety fields. Today there are an estimated 26,000 professionally trained and board certified safety professionals supporting workplace programs across the country, alongside numerous non-certified, but degreed, practicing safety professionals. …

Evaluating Religiosity Across The Lifespan And Fatalistic Beliefs Among Patients Of A Chronic Care Management Intervention Program With Type 2 Diabetes, Cindy Lynn Salazar

Dissertations & Theses (Open Access)

The overall goal of the present study was to assess the effect of fatalistic beliefs and lifetime religiosity on glycemic control and blood sugar monitoring behavior among Mexican-American participants of a chronic care management intervention program of the Rio Grande Valley. In order to achieve these aims, a mixed methods prospective longitudinal study design was utilized among approximately 500 participants of the Salud y Vida program. Qualitatively, a phenomenological approach was used to analyze semi-structured interview data assessing fatalism and religiosity and type 2 diabetes management among 15 participants stratified by engagement in the Salud y Vida program. Fatalistic beliefs …

Quantitative Imaging For Precision Medicine In Head And Neck Cancer Patients, Rachel Ger

Dissertations & Theses (Open Access)

The purpose of this work was to determine if prediction models using quantitative imaging measures in head and neck squamous cell carcinoma (HNSCC) patients could be improved when noise due to imaging was reduced. This was investigated separately for salivary gland function using dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), overall survival using computed tomography (CT)-based radiomics, and overall survival using positron emission tomography (PET)-based radiomics. From DCE-MRI, where T1-weighted images are serially acquired after injection of contrast, quantitative measures of diffusion can be obtained from the series of images. Radiomics is the study of the relationship of voxels to …

The Impact Of The Aca Cost-Sharing Elimination Provision On The Utilization Of Breast, Cervical, And Colorectal Cancer Screening Services Among Insured Individuals In The United States, Sara Salah Atallah

Dissertations & Theses (Open Access)

Preventive cancer screenings are essential to early detect cancer and subsequently save lives. However, out-of-pocket expenditures for cancer screening services deter individuals from obtaining them. In an effort to improve the utilization of cancer screening, the Affordable Care Act (ACA) implemented a cost-sharing elimination provision that removes all forms of cost sharing including copayments, co-insurance and deductibles from certain preventive care services that are recommended by widely known scientific figures such as the United States Preventive Services Task Force (USPSTF). This study evaluated the impact of the ACA cost-sharing elimination provision for preventive care services from 2008 through 2016 using …

Ic 104 Guide To Texas Medical Center (Tmc) Photograph Collection, 1938-1982, Texas Medical Center

Institutional Finding Aids

The Texas Medical Center (TMC) Photograph Collection contains photographic materials that document the growth and development of the TMC from the 1930s to 1980s. The collection consists of 2525 items and includes photographic prints, aerial photographs, negatives, transparencies and printed materials. The materials depict the institutions of the TMC, their staff, facilities, services, and patient care. Images show buildings and their construction as well as some photographic copies of architectural renderings. Aerial photographs from the 1940s to 1980s show the TMC grow from marshland to an urban center. The collection provides images of the leaders and historical figures that shaped …

Ms 037 Guide To Robert K. Blair, Md Papers (1944-1983), Robert K. Blair (1912-2007)

Manuscript Finding Aids

The Robert K. Blair, MD papers contains 8 record books of daily appointments, Harris County Medical Society bulletins, moving papers and lease agreements, personal letters and correspondence spanning Robert Blair’s career in internal medicine.

See more informaon at MS 037.

Ic 084 Guide To Texas Medical Center Historical Resources Project Records, 1973-1991, Texas Medical Center Historical Resources Project

Institutional Finding Aids

The Texas Medical Center (TMC) Historical Resources Project records contain video oral histories of notable personalities associated with or visiting the TMC. Beginning in 1973, the initial group of interviews focuses on individuals involved in the founding or early days of the TMC. Later “video profiles” also include significant visitors to the TMC. Several of these feature national and international figures in cancer research on their visits to Houston. In total the collection features forty-seven unique recordings of interviews with thirty-eight different individuals. All forty-seven unique recordings have been digitized. See more at IC 084.

Ic 078 Guide To Menninger Foundation [Clinic] Records, 1854-2003, Menninger Foundation

Institutional Finding Aids

The Menninger collection comprises medical realia, publications, and ephemera from the Menninger Clinic and its former owners. The collection illustrates the evolution of the science of psychiatry and psychiatric treatment as seen through the eyes of America's first family of psychiatry, the Menningers, who opened its eponymous clinic in Topeka, Kansas, in 1925. Objects in the collection date as far back as 1854 through 2003, the year the clinic and its archive moved to Houston. See more at IC 078.

Ic 061 Guide To University Of Texas, Division Of Continuing Education Records, 1950-1981, University Of Texas Division Of Continuing Education

Institutional Finding Aids

The University of Texas, Division of Continuing Education records contains budgets, grant requests, residency programs, faculty and staff, and other materials pertaining to the Post Graduate School of Medicine, Graduate School of Biomedical Sciences, and Division of Continuing Education from 1950-1981. See more at IC 061.

Ic 059 Guide To Houston District Dental Society Records, 1961-1968, Greater Houston Dental Society

Institutional Finding Aids

The Houston District Dental Society records contains pictorial rosters. See more at IC 059.

Ic 055 Guide To South Main Center Association Records, 1977-2003, South Main Center Association

Institutional Finding Aids

South Main Center Association records consists primarily of South Main Center Association newsletters (issues from 1978 to 1993). The newsletter focuses on urban and economic development, as well as general community events and news regarding local schools and government in the South Main Street Area. Also included are issues of the SMCA “Summit Bulletin” from Feb. to June/July 1990. See more at IC 055.

Ic 054 Gude To American Heart Association In The Texas Gulf Coast Council Records, 1986-1992, American Heart Association In Texas - Gulf Coast Council

Institutional Finding Aids

The American Heart Association in the Texas Gulf Coast Council records contains the 1986 to 1992 issues of the “Vital Signs” Newsletter published by the Texas Affiliate of the American Heart Association. The last folder contains the institution’s 1986 Annual Report. See more at IC 054.

Ic 015 Guide To Texas Research Institute Of Mental Sciences (Trims) Records, 1957-1985, Texas Research Institute Of Mental Sciences

Institutional Finding Aids

The TRIMs collection contains annual reports, annual financial reports, audit reports, highlights, news clippings and articles, constitution, bylaws, rules and regulations, dedication, publicity, linkages, correspondence, administration, organization of clinical services and committees, library information, audio visual, public information, communications, volunteer services, donations, program change proposals and approvals, evaluations, research advisory council, medical advisory committee, commissioners annual review, legislature visit to medical center, statistical information, comprehensive health planning, medical records, contracts, agreements, memos, manuals, salary increases, equal employment opportunity information and complaints, active medical staff, personnel, incidents, grievances, client abuse reports, travel reports, construction projects, minutes, reports of grants and donations, …

Ic 014 Guide To University Of Texas M.D. Anderson Cancer Center Records, 1946-2000, University Of Texas M.D. Anderson Cancer Center

Institutional Finding Aids

The UT MD Anderson Cancer Center records contains newsletters, articles on Neoplasia, annual reports, staff directories, publications, nursing neogram, research protocols, statistics, committee reports, Dr. Clark’s retirement comments, policies, employee handbooks, clinical training grants, internal reviews, printed materials, academic plans, research reports, and Christmas card project dating from 1946-2000. See more at IC 014.

Disruption Of Immune Homeostasis In Human Dendritic Cells Via Regulation Of Autophagy And Apoptosis By, Mohamed M Meghil, Omnia K Tawfik, Mahmoud Elashiry, Mythilypriya Rajendran, Roger M Arce, David J Fulton, Patricia V Schoenlein, Christopher W Cutler

Journal Articles

As fundamental processes of immune homeostasis, autophagy, and apoptosis must be maintained to mitigate risk of chronic inflammation and autoimmune diseases. Periodontitis is a chronic inflammatory disease characterized by oral microbial dysbiosis, and dysregulation of dendritic cell (DC) and T cell responses. The aim of this study was to elucidate the underlying mechanisms by which the oral microbe

Gwas Of Qrs Duration Identifies New Loci Specific To Hispanic/Latino Populations, Brenton R Swenson, Tin Louie, Henry J Lin, Raúl Méndez-Giráldez, Jennifer E Below, Cathy C Laurie, Kathleen F Kerr, Heather Highland, Timothy A Thornton, Kelli K Ryckman, Charles Kooperberg, Elsayed Z Soliman, Amanda A Seyerle, Xiuqing Guo, Kent D Taylor, Jie Yao, Susan R Heckbert, Dawood Darbar, Lauren E Petty, Barbara Mcknight, Susan Cheng, Natalie A Bello, Eric A Whitsel, Craig L Hanis, Mike A Nalls, Daniel S Evans, Jerome I Rotter, Tamar Sofer, Christy L Avery, Nona Sotoodehnia

Journal Articles

BACKGROUND: The electrocardiographically quantified QRS duration measures ventricular depolarization and conduction. QRS prolongation has been associated with poor heart failure prognosis and cardiovascular mortality, including sudden death. While previous genome-wide association studies (GWAS) have identified 32 QRS SNPs across 26 loci among European, African, and Asian-descent populations, the genetics of QRS among Hispanics/Latinos has not been previously explored.

METHODS: We performed a GWAS of QRS duration among Hispanic/Latino ancestry populations (n = 15,124) from four studies using 1000 Genomes imputed genotype data (adjusted for age, sex, global ancestry, clinical and study-specific covariates). Study-specific results were combined using fixed-effects, inverse variance-weighted …