Medicine and Health Sciences Commons^™

Observed Cooking Behaviors Of Families With And Without Childhood Cancer Survivors And The Development Of A Healthy Cooking Assessment Tool, Margaret Pleta Raber

Dissertations and Theses (Open Access)

Diet is a modifiable risk factor for several cancers and other chronic diseases. Cooking skills are a target for dietary intervention, with much of the general population reporting infrequent and inadequate home preparation of meals. Childhood cancer survivors (CCS) are a population at high risk of several chronic conditions including secondary cancers that may be influenced by home cooking behaviors. We conducted observations of food preparation practices in 29 parents of healthy school-aged children and 11 parents of CCS. Observations included an audio and video recording of one evening meal per family. Parents were asked to wear a small body …

Chagas Disease Awareness Amongst Texas Physicians, Gerardo J. Pacheco

Dissertations and Theses (Open Access)

An estimated 300,000 people in the U.S. are living with Chagas Disease (CD), many of whom may not yet know they are infected. Approximately 20% to 30% of individuals with CD are expected to develop clinical symptoms that may manifest as heart disease and result in death if left untreated. The prevalence of CD in humans is not well understood. Given its asymptomatic manifestation and the rarity in cases seen by physicians in general, CD may be under-recognized by physicians.

The purpose of this research was to explore the understanding and knowledge of CD in Texas HCP populations (cardiologists, infectious …

Sequential Monitoring Of Adaptive Randomized Clinical Trials With Sample Size Re-Estimation, Jun Yu

Dissertations and Theses (Open Access)

Clinical trials are complicated and involve human beings. Therefore, lots of ethical and efficient objectives are expected to be achieved. These objectives include maximizing the power of detecting the treatment effects, assigning more patients to the better treatments, saving the cost and time, and controlling the type I error rate. A variety of adaptive designs have been proposed to achieve different aims, among which sequential monitoring and sample size re-estimation are very popular in real clinical trials. In addition, adaptive randomization designs sequentially update the allocation probability aiming to target different allocation proportions and achieve different aims. Hu and Rosenberger …

Validation Of A Type 2 Diabetes Risk Stratification Tool In A Low Income Hispanic Population, Dara Grieger

Dissertations and Theses (Open Access)

A pilot study was undertaken to evaluate the appropriateness of a previously published diabetes risk stratification tool in a diabetic population. The tool was applied to a sample of 500 prediabetic and diabetic adults receiving primary care services at a Federally Qualified Health Center (FQHC) in Cameron County, Texas. The study population was largely Hispanic and underserved. The National Health and Nutrition Examination Survey (NHANES) 2015-2016 data set was used as a comparison group. The risk assessment tool was applied to separately to the prediabetic and diabetic subset of both study groups. The tool stratified the patients into three risk …

Impacts Of Cold Weather On Health In Texas, Tsun-Hsuan Chen

Dissertations and Theses (Open Access)

Recent events with recorded low temperature and unusual snow accumulation in the United States and Europe have raised the public awareness of the potential health impacts of extreme winter weather. Excessive cold was the leading cause of weather-related death during 2006-2010 in the U.S., accounting for 63% of weather related deaths. Several studies worldwide have demonstrated that, in general, mortality rates are higher in winter compared to summer. Studies have also shown that the association between cold temperature and death vary across cities, regions and countries and is especially relevant with decreasing latitude or in regions with mild winter climate. …

Collateral Benefits Of Diabetes Self-Management Associated With Self-Administered Outpatient Parenteral Antimicrobial Therapy, Anisha P. Ganguly

Dissertations and Theses (Open Access)

Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) is a self-care treatment modality in which patients requiring extended courses of intravenous antibiotics are trained to safely self-administer treatment via an indwelling catheter in their home. Many patients seen in the S-OPAT program have a diagnosis of diabetes and present with infections associated with poor glycemic control, including skin and soft-tissue infections and osteomyelitis. Given the degree of patient activation required to successfully complete the S-OPAT process, we hypothesized that participation in this self-care program may benefit patients in self-management of other chronic health conditions, such as diabetes. The study team included Anisha …

Alternative Tobacco Products & Depressive Symptoms Among Young Adults, David Marsden

Dissertations and Theses (Open Access)

The association between cigarette use and depression has been documented in many studies. Fewer studies have examined other tobacco products such as electronic cigarettes (e-cigarettes) and hookah that are used by young adults. This study examined whether increased frequency of use of these products was associated with depressive symptoms in a cohort of n=5,236 Texas college students followed from 2014 to 2017. A hierarchical model showed that increased frequency of single product use of cigarettes, refillable e-cigarettes and hookah was associated with depressive symptoms. Refillable and disposable e-cigarettes were examined separately and results did not provide evidence of a different …

Investigation Of Hantavirus And Leptospira As Possible Contributing Factors Of The Unexplained Kidney Disease Epidemic In Nicaragua, Nicole J. Delgado

Dissertations and Theses (Open Access)

Throughout Latin America, an epidemic of a kidney disease of an unknown etiology has been occurring since the late 1990s, and this disease is being called “Mesoamerican nephropathy.” Mesoamerican nephropathy predominantly affects male sugarcane workers. In Chichigalpa, Chinandega, Nicaragua, there is sugarcane plantation that is being heavily impacted by the Mesoamerican nephropathy epidemic, and they invited researchers from Baylor College of Medicine to investigate the epidemic. The prospective epidemic investigation began in 2015, and it is an ongoing investigation. Based on the compilation of data collected during the preliminary investigation, our hypothesis is that a possible zoonotic disease, such as …

Effects Of Extreme Precipitation On Gastrointesitnal Related Hospital Admissions In Texas, Sharmila Giri

Dissertations and Theses (Open Access)

Extreme precipitation has been implicated in more than 51% of the waterborne disease outbreaks in the United States between 1948-1994. With increased incidence of extreme precipitation projected to be more likely due to ongoing climate change, the burden of waterborne disease is expected to rise even in the United States where drinking water is considered to be one of the safest in the world. In this study we aim to quantify the risk of extreme precipitation on gastrointestinal (GI) related hospital admissions by using meteorological and emergency hospital data from twelve major metropolitan statistical areas (MSA) of Texas from year …

Assessment And Findings Of The Vulnerability Index (Vi-Spdat) Survey Of Individuals Experiencing Homelessness In Travis County, Tx, Benjamin T. King

Dissertations and Theses (Open Access)

Homelessness is a significant barrier to the quality of an individual’s health. Federal housing interventions attempt to eliminate homelessness by providing varying degrees of subsidization, but available units do not currently keep pace with the scale of the problem. Coordinated Assessment is a process requirement put in place by HUD to organize and prioritize the waiting list for housing, based on community priorities. Several tools measuring health and social vulnerability, including the Vulnerability Index-Service Prioritization Decision Assistance Tool (VI-SPDAT), have become popular options for prioritizing housing resources. Such assessments currently in use are not thoroughly researched and the effects of …

Exposure To Ambient Air Pollution And Fetal Death In Harris County, Texas, Amal Rammah

Dissertations and Theses (Open Access)

The evidence from studies of maternal ambient air pollutant exposure (including O3, fine particulate matter (PM2.5) and PM2.5 metal constituents) and stillbirth is limited and equivocal. There is also limited evidence of the acute effect of temperature increases in the week preceding delivery and stillbirth. In the first investigation of ambient air pollution, temperature and stillbirth among a large cohort of women in Harris County, Texas, we obtained birth and fetal death records from 2008-2013 and estimated weekly residential levels of apparent temperature and ozone (O3), fine particulate matter (PM2.5), nitrogen dioxide (NO2) and PM2.5 metals from the local monitoring …

Examining The Effect Of Service Delivery Factors On Timely Initiation Of Tuberculosis Treatment Within Primary Care Settings In Uganda, Michael Juma

Dissertations and Theses (Open Access)

Background: Timeliness of Tuberculosis (TB) treatment is critical to stopping its transmission and preventing disease complications and death. Efficiency in identifying and treating presumptive TB cases is critical to reducing delays.

Aims: We determined the association between health service-related factors and delays in initiating TB treatment within primary care settings in Uganda. Perspectives of healthcare workers on practices underlying healthcare facility level delays were also described.

Methods: A mixed methods study was conducted based on facility-register records of 1199 treated TB cases and key informant interviews with 27 outpatient staffs. Health service-related factors (size, ownership, number of …

Does Space Matter? An Investigation Of The Spatial Variation In Gestational Weight Gain Associations With Country Of Birth Among Hispanic Women And Access To Care In Texas, Christopher R. Webb

Dissertations and Theses (Open Access)

Inadequate and excess gestational weight gain (GWG) are serious, but potentially preventable adverse pregnancy outcomes which affect as many as two-thirds of pregnant women in the United States. While location and space are associated with a variety of pregnancy outcomes, limited research has investigated potential spatial variation in GWG. The goal of this research is to improve the knowledge of how spatial geography is associated with GWG through secondary analyses of 70,000 to 160,000 birth certificate registry records for Texas mothers with a live birth delivery in 2014. Specifically, this research attempts to assess whether access to obstetrics and gynecologist …

Adverse Childhood Experiences, Depression, And Resilience In African-American Adolescents, Jamie C. Freeny

Dissertations and Theses (Open Access)

Research shows that exposure to adverse childhood experiences (ACEs) is common among adolescents; however, no studies have examined the prevalence of ACEs in a racially homogenous sample of African-American adolescents. Thus, the present study examined the cumulative and individual prevalence of ACEs in African-American adolescents. Data were collected from African-American adolescents (n = 241) who attended youth events hosted by churches in Houston, TX. An expanded ACEs tool was used to collect data. ACE scores were summed and dichotomized to 0-3 ACEs versus 4-19 ACEs because a score of four or more indicates a higher risk for adverse mental and …

Factors Associated With Civilian And Police Officer Injury During 10 Years Of Officer-Involved Shooting Incidents: A Cross-Sectional Analysis, Ellen Paddock

Dissertations and Theses (Open Access)

Purpose. Law enforcement officer-involved shootings are uncommon events in the context of encounters with the public, but extreme situations which have the potential to pose immense harm to individuals and communities. Previous research demonstrates that a large proportion of such incidents result in injury or death, most commonly to civilians, but in some cases to officers as well. However, there has been little study of what factors are associated with injury during such incidents, and whether these factors might differ for civilians compared to officers. This study examined the factors associated with both civilian and officer injury and/or fatality during …

Development And Usability Testing Of Quit4health, A Smoking Cessation Smartphone App For Young Adults, Katarzyna Czerniak

Dissertations and Theses (Open Access)

Tobacco use is the leading cause of death in the United States. As of 2016, 23.5% of American 18-25 year olds reported having used cigarettes in the last month compared to 20.2% of adults and only 3.4% of adolescents. Due to the efficacy and widespread general use of mobile technology today, mobile-phone health, or mHealth apps, have become increasingly popular methods of delivering smoking cessation programs. However, there is a lack of evidence in regards to the quality and the effectiveness of using mHealth to deliver smoking cessation interventions to young adults. This study aims to fill this gap to …

Hours Of Gaming Or Non-Academic Computer Use, Substance Use, Mental Health Status And School Performance Among Texas Adolescence: Findings From The 2017 Yrbs In Texas, Shanxiazi Gao

Dissertations and Theses (Open Access)

Online gaming activities among adolescents and adults has increased exponentially in the last decade, and mental health issues associated with excessive gaming have drawn attention from health care professionals worldwide (Griffith, 2016). Recognizing this trend, American Psychiatric Association (APA) categorized gaming disorder/addiction as a mental health condition in 2013 in an effort to prevent the expansion of relevant mental health issues (American Psychiatric Association, 2013). Additionally, the World Health Organization (WHO) declared gaming disorder/addiction as a mental health disease, (World Health Organization, 2018). As a result of this declaration, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has established nine …

How Participatory Are We? A Systematic Review Comparing Women’S Participation In Participatory Action Research, Community Based Participatory Research And Participatory Learning In Action, Magdalene Hakala-Hartman

Dissertations and Theses (Open Access)

Objective. This systematic review compares the extent of participation of women in maternal and child health and healthy living-type research projects based on three participatory research frameworks, Participatory Action Research (PAR), Community Based Participatory Research (CBPR), and Participatory Learning in Action (PLA), by examining roles, tasks, engagement, and the duration and complexity of their participation- as guided by the Community Engagement in Research Index (CERI). The review analyzed differences in underlying structure of the studies connected to their theoretical underpinnings. Methods. Ovid Medline, PubMed, EBSCO, CINAHL, Embase, Scopus, and Academic Search Complete were searched for studies published 2009 – 2018. …

Quantifying The Impact Of Laboratory And Care Systems On Relinkage To Hiv Care In A Southern, Urban Environment, Kellie L. Watkins

Dissertations and Theses (Open Access)

Background: HIV viral suppression reduces the likelihood of transmission to just 5%,1 demonstrating the critical link between care and prevention, yet only 51% of people living with HIV (PLWH) were retained in care and 46% achieved viral suppression in the Houston area (2012), with the out-of-care (OOC) population increasing between 2008-2011.2,3

Methods: Record-search investigations across HIV surveillance and care data systems determined if potentially OOC persons referred to the Houston Health Department (HHD) from 2013-2015 (N=1287) qualified for public health follow up. A portion were randomized to a non-intervention group (n=200) to assess the program effectiveness. Participants without a disposition …

Sociodemographic Determinants Of Mental Health Outcomes Among Unhealthy Weight Youth In The United States, Chenchita Malolan

Dissertations and Theses (Open Access)

Background

The prevalence of unhealthy weight (defined as a body mass index ≥ 85th %ile for age and sex) among children and adolescents in the United States remains unacceptably high. In parallel, the prevalence of mental health issues in youth is rising as well. Current research shows a strong association between overweight/obesity and poor mental health outcomes. Specifically, youth of unhealthy weight have higher rates of anxiety and depression. The objective of this study is to evaluate the specific the current (2016-17) population-level prevalence of unhealthy weight, mental health issues and the sociodemographic (e.g. sex, age, race, ethnicity, household income) …

A Secondary Data Analysis For The Refinement Of Empirical Modelling For The Estimation Of Environmental Health & Safety Program Resourcing For Colleges And Universities, Seth Michael Parker

Dissertations and Theses (Open Access)

The use of potentially hazardous physical, chemical, biological, and radiological agents is inherent to the teaching, research, and services missions of any university. To manage the risks associated with these agents, it is common for universities to host environmental health & safety (EH&S) programs to protect the safety of the institution’s students, faculty, staff, and visitors. However, since EH&S programs in universities are primarily focused on prevention, it is difficult to estimate the appropriate “industry average” in terms of budget and staffing resources a particular university needs for such programs. Historically, the Campus Safety, Health, and Environmental Management Association (CSHEMA) …

Cost Of Caring: The Effects Of Euthanasia On Animal Shelter Workers, Kim L. Nguyen-Finn

Theses and Dissertations

This mixed-methods study focuses on animal shelter workers, a population that has often been overlooked in research and clinical practice, and the emotional strains of the task of euthanasia. The effects of employment in a kill or no-kill shelter, participation in euthanasia, and number of years employed on mental health issues of substance abuse, anxiety, depression, secondary traumatic stress, and burnout were examined. A three-way MANOVA was run to test the hypothesis that there is a cell effect among the type of shelter employed in, participation in euthanasia, and years of experience on mental health, which was not supported by …

The Relationship Between Neuroticism, Self-Esteem, And Disordered Eating Attitudes: Examining The Health At Every Size Theory, Liana Cho

Masters Theses

Background. In the modern day treatment of overweight/obesity, conflicting recommendations regarding treatment have been released by the Academy of Nutrition and Dietetics (AND) and advocates of the Health at Every Size (HAES) movement. While the AND have indicated their support for self-monitoring practices, such as keeping a food diary or tracking calories, HAES advocates have claimed that these restrictive practices may result in increased disordered eating tendencies and poor self-esteem.

Subjects. The participants for this study included 410 students at Grand Valley State University. Almost 80% of participants were female, and just over 85% of participants identified as white. …

Values Vs. Self-Interest As Determinants Of Attitudes: Through A Construal Level Theory Lens, (Sometimes) Self-Interest Wins, Austin D. Eubanks

Graduate Theses and Dissertations

The present study (n = 335) attempted to conceptually replicate Hunt, Kim, Borgida, and Chaiken (2010) with a high-powered design to investigate whether values and self-interest differentially impact attitudes depending on psychological distance. Participants were assigned to complete a task that made self- or other-focused values more accessible, then indicated their attitudes about a student fee increase at a university to fund scholarships the participants would not be eligible to receive (thus going against their own financial self-interest for the well being of someone else). The memo describing the fee increase was manipulated such that the increase would be occurring …

Investigating Affective Pathways For The Influence Of Justification On Self-Control, Morgan Hill

Graduate Theses and Dissertations

People struggle with temptation in their everyday lives. Research often attributes failures in self-regulation to overwhelming and uncontrollable impulses. However, research also supports the idea that cognitive factors (e.g., justification) can license tempting behavior and allow individuals to behave in ways that run counter to their long-term goals. In addition, it is likely that affect plays a role in justification-based self-control failure. The current set of three studies investigated the role of affect in justification-based self-control failure. Study 1 tested the prediction that recall of past successes would result in increased positive affect. Study 2 assessed whether justification results in …

A Support Program For College Students With Autism Spectrum Disorder: The Functioning Of Participants Versus Non-Participants And The Role Of Program-Sponsored Mentoring, Ayla Raven Mapes

Graduate Theses and Dissertations

Increasingly more students with autism spectrum disorder (ASD) are attending college. In response, many colleges are now offering these students the extra support of an Autism Support Program (ASP), many of which include a mentoring component. This study is one of only a handful of attempts to examine these programs empirically. Using a small sample of college students who identified as having ASD, I compared participants and non-participants of a university ASP. An online survey was used to assess demographic characteristics and pre-college academic performance, as well as students’ functioning across the following domains: social, adaptive, academic, emotional, and having …

Acculturation And Internalizing Problems Among Latino Youth: A Meta-Analytic Review, Juventino Hernandez Rodriguez

Graduate Theses and Dissertations

Some studies have found acculturation to be a positive predictor of internalizing problems (i.e., anxiety and depression) in Latino youth (Gonzales et al., 2002), whereas other studies have revealed no relation or a negative relation between acculturation and internalizing problems (Smokowski, Buchanan, & Bacallao, 2009). Narrative reviews of this literature exist (Gonzales et al., 2002; Gonzales et al., 2009) but a quantitative synthesis of the literature has not been conducted. After a systematic literature search that identified 38 studies meeting inclusionary criteria, a meta-analysis was performed to estimate the size and direction of the relation between acculturation and internalizing problems. …

Effects Of Naltrexone On Alcohol And Nicotine Use In Female P Rats, Usman Z. Hamid, Michael T. Bardo Ph.D.

Posters-at-the-Capitol

Title: Effects of Naltrexone on Alcohol and Nicotine Use in Female P Rats

Author: Usman Z. Hamid, Department of Psychology, University of Kentucky

Faculty Mentor: Michael T. Bardo, Ph.D., Department of Psychology, University of Kentucky

Alcohol is the most commonly abused substance worldwide. It is often co-abused with nicotine, which increases the difficulty of cessation of both alcohol and nicotine. Despite having similar mechanisms of action, there is no single medication to treat the co-abuse. The objective of the current study is to analyze the effects of the opiate antagonist naltrexone on alcohol consumption and the co-use of alcohol and …

Scientific Proceedings Of The Texas Children’S Hospital’S 17th Session Of The Advanced Quality Improvement And Patient Safety Program, Arjun M. Dangre Bds Mph, Kelly Wallin Ms Rn Chse, Gertrude A. Leidich Mba, Rn, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety (AQI) Program is a six month mixed didactic and experiential learning experience designed to improve patient care, lower costs, change the culture, and develop quality leaders. As a part of AQI program participants are grouped into teams and each team completes a healthcare related Quality Improvement (QI) project. Each project demonstrates use of various QI tools including process maps, fishbone diagrams, and key driver diagrams. The projects use ‘Model for Improvement’ as the primary QI methodology to achieve their aim. Three or more Plan-do-study-act (PDSA) cycles are required for each …

Scientific Proceedings Of The Texas Children’S Hospital’S 16th Session Of The Advanced Quality Improvement And Patient Safety Program, Arjun M. Dangre Bds, Mph, Kelly Wallin Ms, Rn, Chse, Gertrude A. Leidich Mba, Rn, Angelo P. Giardino Md, Phd

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The Texas Children’s Hospital’s Advanced Quality Improvement and Patient Safety (AQI) Program is a six month mixed didactic and experiential learning experience designed to improve patient care, lower costs, change the culture, and develop quality leaders. As a part of AQI program participants are grouped into teams and each team completes a healthcare related Quality Improvement (QI) project. Each project demonstrates use of various QI tools including process maps, fishbone diagrams, and key driver diagrams. The projects use the IHI ‘Model for Improvement’ as the primary QI methodology to achieve their aim. Three or more Plan-do-study-act (PDSA) cycles are required …