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Characterization And Economic Burden Associated With Pediatric Opioid Exposures And Poisonings, Anisha M. Patel

Theses and Dissertations

Introduction

The main objectives of this study were: 1) to examine the prevalence and characteristics of opioid exposures, 2) to estimate the economic costs associated with opioid poisonings, and 3) to examine the characteristics associated with opioid poisoning-related health care resource use (HCRU) and costs in children.

Methods

Data from the National Poison Data System from January 1, 2010 to December 31, 2014 were utilized to examine the prevalence and characteristics of opioid exposures and poisonings in children <18 years. Economic costs were estimated using the 2012 Nationwide Emergency Department Sample, Kids’ Inpatient Database, Multiple Cause-of-Death file and other published sources, applying a societal perspective. Direct costs included costs associated with ED visits, hospitalizations and ambulance transports. Indirect cost included productivity costs due to caregivers’ absenteeism and premature mortality among children.

Results

There were a total of 83,418 pediatric opioid exposures and nearly half of them resulted in poisoning. The epidemiology of opioid …

The Impact Of Medicaid Reform On Dental Practice Setting, Barrett W. R. Peters

Theses and Dissertations

Purpose: To assess the impact of dental Medicaid reform in Virginia on dental practice settings (private practice, corporate practice and safety net clinics). Methods: This retrospective cohort study of 16.2 million dental claims is from the Virginia Department of Medical Assistance Services, which included claims for providers participating in Virginia’s Medicaid program during a 10-year period (2002-2012). The dividing date for the reform was July 1, 2005. The outcome measure was mean claims per participating provider. A Poisson regression model was used to predict the mean number of claims per provider with the following predictors: reform period, practice setting, provider …

Dental Plan Performance With Medicaid Reform In Virginia, James Reed

Theses and Dissertations

Purpose: To assess the effect of dental Medicaid reforms in the state of Virginia on dental plan performance. Methods: This project is a retrospective cohort study of 825,000 dental claims obtained from the Virginia Department of Medical Assistance Services. This cohort includes dental claims for children enrolled in Virginia’s Medicaid program from July 1, 2002 through June 30, 2008. The independent variable was enrollment pre or post policy reform with July 1, 2005 as the period dividing date. The dependent variable was dental benefit utilization measured as the average number of restorative, preventative, and total procedures. Statistical methods include Welch’s …

Evaluating Dental Surgery Post-Operative Pain In Children Following Treatment Under General Anesthesia, Malinda Husson

Theses and Dissertations

Purpose: The purpose of this pilot study was to determine if there is a difference in post-operative pain experience for children following dental restorations and/or extractions under general anesthesia (GA), with and without local anesthetic (LA). The alternative hypothesis is that children will experience less post-operative discomfort and soft tissue trauma when using intra-ligamental local anesthetic during the intra-operative time period. Methods: Patients were recruited for this single blind, randomized, prospective cohort study with the following inclusion criteria, children age 2-6 years requiring general anesthesia for dental treatment. Patients were randomized into categories of either receiving a standardized local anesthetic …

A Study On The Effects Of Therapeutic Listening On The Social And Functional Behavior Of Preschool Children With Autism Spectrum Disorder, Robin Abbott

Theses and Dissertations

Auditory sensory differences and sensitivities are often mentioned by parents of children with Autism Spectrum Disorder (ASD), and in research involving children with ASD. Addressing these auditory processing differences is the goal of various auditory treatment techniques, but current research does not yield a body of evidence in support of auditory therapy as a treatment for children with ASD. This study is a single-subject study, repeated across two subjects, to investigate the effect of the Therapeutic Listening program on the social engagement and self-care skills of preschool-aged children with ASD. Both social engagement and self-care skills increased with for both …

The Association Between Breast Feeding And Being Overweight In Children, Naja Jamil Eldanaf

Theses and Dissertations

Purpose: Obesity/Overweight in children is an epidemic and the most common disorder of childhood in the developed world. Prevalence is increasing, leading to short- and long-term complications. Breastfeeding may protect against childhood obesity, but the debate is ongoing. The main purpose of this project was to assess the relationship between breastfeeding and being overweight in early childhood.Methods: Data were collected from the State and Local Area Integrated Telephone survey; National Survey of Children's Health, 2003. Overall, 16,358 children, ages 3 to 5, were included in the sample. SPSS Complex Sample software was utilized to generate for all analyses. Complex samples …

Lack Of Knowledge Of Mother-To-Child Transmission In Kenya Among Women Ages 15-49, Nisha Warrier

Theses and Dissertations

Purpose: The epidemic of mother-to-child transmission (MTCT) of HIV/AIDS in resource-poor countries is dramatic; it is responsible for nearly 90% of childhood infections. The primary purpose of analysis was to understand the distribution of factors and their association with lack of knowledge of MTCT in Kenya. In parallel, another aim was to identify the relationship between media, particularly frequency of radio exposure, and lack of knowledge.Methods: This study used the 2003 Kenya Demographic and Health Survey (DHS) collected for 8,195 women, ages 15-49. Descriptive analysis, univariate analysis, and logistic regression were completed on SPSS 14 software.Results: In the sample, 1151 …

Factors Associated With Hospital Commitment To Provide Child/Adolescent Psychiatric Services, Lea Anne Gardner

Theses and Dissertations

General acute care hospitals play a particularly important role in the delivery of children's mental health given the extant lack of alternatives to long term hospitals for patients requiring a restrictive treatment environment (Glied and Cuellar, 2003). This cross-sectional study identifies environmental and organizational factors associated with general acute care and children's hospitals in the United States that provide hospital-based child/adolescent psychiatric services and the number of services. Two macro-level theories, Resource Dependence Theory and Institutional Theory were used to identify environmental and organizational factors. A nationwide sample of hospitals was drawn from the 2003 AHA annual survey. Data from …

Effect Of Medicaid/Schip And Wic On Oral Health Of Low-Income Children, Dahlia Naqib

Theses and Dissertations

Oral caries is the most prevalent chronic disease among US children, and disproportionately impacts those of low socioeconomic status. Studies have shown that the Special Supplemental Nutrition Program for Women Infants and Children (WIC) improves access to dental care among Medicaid children. This study investigated the impact of WIC, Medicaid, and the State Children's Health Insurance Program (SCHIP) on the prevalence of dental caries among low-income children. The 1999-2000 and 2001-2002 NHANES data were utilized for this analysis. Children 2-4 years old who participated in WIC, Medicaid, or SCHIP, or who were uninsured, and for whom both interview and complete …