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Articles 1 - 30 of 106
Full-Text Articles in Social and Behavioral Sciences
The Role Of Gamma Oscillations And Cortical Inhibition In The Development Of Working Memory In Adolescence, Christopher P. Walker
The Role Of Gamma Oscillations And Cortical Inhibition In The Development Of Working Memory In Adolescence, Christopher P. Walker
Dissertations & Theses (Open Access)
Adolescence is a dynamic period of social, cognitive, and biological changes. In particular, working memory, the ability to actively encode and maintain information over a short period of time, develops early in childhood and gradually increases in capacity and stability during adolescence. The precise neurophysiological mechanism by which working memory capacity increases during adolescence is unclear. The objective of this investigation was to evaluate the role of cortical gamma-band (> 30 Hz) oscillations—which are associated with working memory in adults—for the development of working memory capacity in adolescents, and to identify the extent to which the temporal profile of gamma-aminobutyric …
Cholesterol Efflux Capacity And Its Association With Metabolic Syndrome In A Multi-Ethnic Population (Dallas Heart Study): A Cross-Sectional Study, Oludamilola Akinmolayemi
Cholesterol Efflux Capacity And Its Association With Metabolic Syndrome In A Multi-Ethnic Population (Dallas Heart Study): A Cross-Sectional Study, Oludamilola Akinmolayemi
Dissertations & Theses (Open Access)
Metabolic syndrome (MetS) is a multi-component risk factor for cardiovascular disease (CVD) and type 2 diabetes. MetS has been found to be associated with increased risk of incident CVD, cardiovascular morbidity and mortality, and prevalence atherosclerosis. Cholesterol efflux capacity (CEC) is a measure of the functional property of high-density lipoprotein cholesterol (HDL-C). In addition, it characterizes the ability of HDL-C to accept cholesterol from extra-hepatic cells in the periphery to the liver and has been shown in clinical studies to be inversely associated with atherosclerosis cardiovascular disease (ASCVD) and incident cardiovascular disease (CVD) . Low HDL-C is one of the …
Factors Affecting Antiretroviral Treatment Entrance, Adherence And Retention Among Hiv Patients In Nigeria And Uganda, Nnenna Ananaba
Factors Affecting Antiretroviral Treatment Entrance, Adherence And Retention Among Hiv Patients In Nigeria And Uganda, Nnenna Ananaba
Dissertations & Theses (Open Access)
Introduction: The maximum benefits of antiretroviral therapy (ART) are achieved when HIV patients follow through the HIV Care Continuum. Understanding the factors that impact the Care Continuum are key in minimizing late ART uptake while increasing treatment retention and adherence in sub-Saharan Africa. Objectives: To explore factors that impact the various phases of the HIV Care Continuum, we review trends in median CD4 cells count and presentation with HIV advanced disease stage between 2013 and 2017. We also examined treatment retention rates and the impact of food security on ART adherence. Methods: Two datasets were reviewed. One dataset consists of …
Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal
Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal
Dissertations & Theses (Open Access)
Background: Lower cranial neuropathy (LCNP) is a rare but potentially disabling late effect of radiotherapy (RT) and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment with deficits in swallowing, speech, and voice. The aims of this research were: 1) to quantify the cumulative incidence of late LCNP and identify clinical predictors of late LCNP; 2) to investigate the impact of late LCNP on severity of cancer treatment-related symptoms, general functional impairment (GFI), and single item scores of the most severe symptoms; and 3) to quantify the association of late LCNP with swallowing-related …
Coy Arjate Adrusted Response Adaptive Randomization Designs With Targeted Learning, Hai Zhu
Coy Arjate Adrusted Response Adaptive Randomization Designs With Targeted Learning, Hai Zhu
Dissertations & Theses (Open Access)
Since Food and Drug Administration (FDA) issued the very first draft guidance in 2010, adaptive designs have been considered to be one of the most promising approaches to make drug development more efficient and less costly. Two approaches, covariate-adjusted response-adaptive (CARA) randomization and adaptive seamless phase II/III design (ASD) have garnered growing attention recently. However, most of the CARA designs are based on parametric models and suffered from model misspecification. The research of incorporating CARA into ASD is also limited and whether type I error rate can be controlled has not been answered. In this dissertation, a new family of …
Insuring The Integrity Of Global Registries, Aardhra Meenakshi Venkatachalam
Insuring The Integrity Of Global Registries, Aardhra Meenakshi Venkatachalam
Dissertations & Theses (Open Access)
Data quality is a priority in public health because it is used for public health program planning and implementation, research, as well as policy. The information gleaned from the data allows us to assess health status, and improve health needs. This paper evaluated methods for cleaning, managing and addressing missing data in the Lagos State Ambulance Service registry. The techniques included screening, data organization, diagnostic phase, treatment phase and a missing data phase to holistically handle the data. The percentage of systemic errors was reduced through the use of the 5-step method. Missing data was informative for state of origin, …
Patient-Perceived Patient-Centered Medical Home Characteristics And Healthcare Utilization, Expenditure And Quality, Alissa Ratanatawan
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 …
The Potential Impact Of Restricting The Sale Of Tobacco At Tobacco Retail Outlets Surrounding Schools Across Major Metropolitan Areas Of Texas On Tobacco Advertisements, Udoka C. Obinwa
Dissertations & Theses (Open Access)
Retail outlets that sell tobacco (ROST) are the leading channel of advertisements and promotional efforts for tobacco companies. Tobacco companies strategically target youth, young adults, racial and ethnic minorities and individuals in lower SES areas with more advertisements, which in turn influences their tobacco use behavior. Researchers have proposed instituting place-based restriction strategies as a way to control tobacco use. This dissertation examined the potential impact of i) restricting the sale of tobacco at ROST within 1000ft of schools and 2000ft of colleges and ii) restricting the sale of tobacco at ROST within 500ft of other ROST, on the number …
Clinical And Demographic Factors Associated With Peg-Asparaginase-Related Toxicities In Patients With Acute Lymphoblastic Leukemia, Priyadarshani Dharia
Clinical And Demographic Factors Associated With Peg-Asparaginase-Related Toxicities In Patients With Acute Lymphoblastic Leukemia, Priyadarshani Dharia
Dissertations & Theses (Open Access)
Introduction: Polyethylene glycol (PEG)-asparaginase is one of the first-line drugs in pediatric ALL treatment. Although a complete and prolonged treatment with PEGasparaginase has been instrumental in improving the survival of ALL patients, it is associated with four common toxicities: hypersensitivity, hyperbilirubinemia, pancreatitis, and venous thromboembolism (VTE). PEG-asparaginase-related toxicities may require modifications and delays in treatment, which often leads to poor treatment outcomes. Previous studies of PEG-asparaginase-related toxicities have mainly focused on individual toxicities. Further, these studies were conducted in study populations which were predominantly self-reported non-Hispanic whites. Therefore, there is a gap in the knowledge regarding the cumulative burden of …
Association Between Childhood Maltreatment And Type 2 Diabetes Mellitus: A Retrospective Cohort Study In The United States, Diep N. Poulos
Association Between Childhood Maltreatment And Type 2 Diabetes Mellitus: A Retrospective Cohort Study In The United States, Diep N. Poulos
Dissertations & Theses (Open Access)
This retrospective cohort study analyzed self-reported and biological data collected from MIDUS in 2004-2006 to understand the association between the types of childhood maltreatment (CM) and Type 2 Diabetes Mellitus (T2DM). The central hypothesis of this study is that childhood maltreatment is positively associated with adult onset diabetes (T2DM). CM has been associated with lifelong morbidity and an increased risk in chronic diseases such as diabetes and heart disease (Bernstein RE, 2013). In this study, CM was defined by the Childhood Trauma Questionnaire (CTQ). The CTQ has three types of abuse: physical, sexual, emotional, and two types of neglect: physical …
Studying The Properties Of Seamless Phase Ii/Phase Iii Clinical Trials Under Covariate Adaptive Randomization, Garrett Miller
Studying The Properties Of Seamless Phase Ii/Phase Iii Clinical Trials Under Covariate Adaptive Randomization, Garrett Miller
Dissertations & Theses (Open Access)
Covariate adaptive randomization is an allocation procedure used in clinical trials that seeks to balance treatment groups. While this method has been shown to reduce bias due to imbalanced treatment groups, the effects of covariate adaptive randomization have not been studied under seamless Phase II/Phase III clinical trials that incorporate short-term endpoint information and treatment selection. Therefore, this analysis sought to determine whether these adaptive randomization methods can be applied to seamless Phase II/Phase III trials while preserving Type I error. In addition, this analysis sought to create R-packages that employ seamless Phase II/Phase III techniques to provide analysis tools …
Hiv-Related Discriminatlon And Cervical Cancer Screening In Zambia, Crystal J. Cazier
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. …
Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang
Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang
Dissertations & Theses (Open Access)
Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …
Moving Beyond The Single Gene: Integrative Gene Set Analysis For Rna-Seq, Andrew Richard Aschenbrenner
Moving Beyond The Single Gene: Integrative Gene Set Analysis For Rna-Seq, Andrew Richard Aschenbrenner
Dissertations & Theses (Open Access)
RNA-seq is the next-generation sequencing technology for gene expression and while many tools have been developed to assess differential expression, most focus on gene-level statistics. Gene-level statistics implicitly ignore any dependence among genes. In order to directly incorporate correlation into testing for differential expression, genes are sorted into networks using Ingenuity Pathway Analysis (IPA) and the gene expression of each network is modeled using Generalized Estimating Equations (GEE). Since the gene network data often exhibits correlation structures containing positive and negative values, a new intermediate correlation structure is developed. This structure provides a compromise between an exchangeable (one parameter for …
Nonlinear Functional Models On Causal Inference, Rong Jiao
Nonlinear Functional Models On Causal Inference, Rong Jiao
Dissertations & Theses (Open Access)
Statistical analysis has experienced significant progress on association study, but it remains elusive to understand the etiology and mechanism of complex phenotypes. As a major analytical platform, association analysis may hamper the theoretic development of biomedical science and its application. Thus, many researchers suggest making the transition from association to causation. The mainstream of research in genetics and epigenetics data analysis focuses on statistical association or exploring statistical dependence between variables. Despite significant progress in dissecting the genetic architecture of complex diseases by genome-wide association studies (GWAS), the signals identified by association analysis can only explain a small proportion of …
Physical Activity Among Preschool-Aged Children: Considerations For Waking Activity Patterns And Health, Erin Dooley
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 …
Examining The Relation Between Social Capital And Physical Activity Across Life Stages, Leigh Ann Ganzar
Examining The Relation Between Social Capital And Physical Activity Across Life Stages, Leigh Ann Ganzar
Dissertations & Theses (Open Access)
Physical inactivity in adults increases the risk for adverse health outcomes, including non-communicable diseases and premature death. Children who are not sufficiently physically active face increased risk for non-communicable disease risk factors, mental health issues, and poor academic performance. Despite these risks, the majority of people do not achieve sufficient physical activity levels. Social capital is an aspect of the social environment that can shape physical activity behavior throughout different life stages. The three studies of this dissertation sought to assess the association between social capital, from both the cohesion and network perspectives, and physical activity behavior in different life …
Additional Graduate Degrees Associated With Promotion Among Primary Care Clinical Faculty, Michael A. Hansen
Additional Graduate Degrees Associated With Promotion Among Primary Care Clinical Faculty, Michael A. Hansen
Dissertations & Theses (Open Access)
Introduction: Many young and ambitious physicians purposefully seek out meaningful careers in academic medicine, yet there are no evidence-based findings to assist these individuals in how to succeed in advancing their careers in this unique work environment. For early and mid-career faculty, a growing number of trainings and opportunities are available but with little insight as to which choices may have the biggest impact. One common perception is the need for additional advanced training, such as a Master of Public Health. Aims and Method: This study sought to provide evidence-based information about additional training by quantifying the benefit of added …
Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang
Quantifying The Financial & Clinical Impact Of Annual Vs. Biennial Mammography Screening, Danmeng Huang
Dissertations & Theses (Open Access)
Current guidelines for screening mammography recommend different start ages and intervals for women with average cancer risk. Longer intervals between mammograms allow more time for a tumor to grow, to become symptomatic and clinically detectable, and more likely to be at advanced stage. Existing literature on the associations between mammography screening frequency and risk of more advanced breast cancer have mixed results. Studies have showed that advanced breast cancer costs more to treat, but real-world cost estimates following different mammography screening frequencies are unavailable. To fill the gaps, this dissertation aimed to quantify the clinical and financial impact following annual …
Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez
Epidemiological Evaluation Of The National Sickle Cell Screening Program In The Republic Of Uganda, Arielle G. Hernandez
Dissertations & Theses (Open Access)
Sickle cell anemia contributes substantially to childhood morbidity and mortality in sub-Saharan Africa, where there are scarce health resources and inadequate awareness among healthcare providers and the community. Without early diagnosis and initiation of preventive treatments, most infants will die of acute complications before their fifth birthday. Information on the mortality associated with sickle cell anemia is excluded from global statistical summaries due to the lack of accurate data, making sickle cell anemia an invisible killer of children on the African continent. Information from long-term large-scale sickle cell screening efforts is not yet available in Africa; therefore, a mixed-methods study …
The Associations Between Fat And Clinical Outcomes Among Lung Cancer Patients: Dietary Intake And Genetic Determinants, Fang Yu Lin
Dissertations & Theses (Open Access)
Higher dietary fat intake and alterations in fatty acid metabolism may affect cancer development and progression. This dissertation conducted a series of studies examining whether dietary fat intake and genetic variants in fatty acid metabolism genes have an impact on clinical outcomes among non-Hispanic whites newly diagnosed with non-small cell lung cancer (NSCLC). First, a cohort of 2,262 NSCLC patients was prospectively examined for intakes of total, saturated, monounsaturated, and polyunsaturated fat in relation to overall survival and recurrence. Dietary fat intake at diagnosis was assessed with a previously validated food frequency questionnaire and categorized by Dietary Reference Intakes. Multivariable …
External Environmental Dimensions And Financial Performance Of Major Teaching Hospitals In The U.S, Karima Lalani
External Environmental Dimensions And Financial Performance Of Major Teaching Hospitals In The U.S, Karima Lalani
Dissertations & Theses (Open Access)
Background: Teaching hospitals have a unique mission to not only deliver graduate medical education, but to also provide both inpatient and ambulatory care, and to conduct clinical and medical research; therefore, they are under constant financial pressure, and it is important to find out what types of external environmental components affect their financial performance. No recent studies have been comprehensively conducted for all major teaching hospitals in the U.S. to examine if there is an association between the external environmental dimensions based upon Resource Dependence Theory (Munificence, Uncertainty, Complexity) and the short-term financial performance, measured by days cash on hand …
Access To Antibiotics Without Prescription For Travelers And Colombian Citizens At Community Pharmacies In Bogota, Colombia, Marie Kasbaum
Access To Antibiotics Without Prescription For Travelers And Colombian Citizens At Community Pharmacies In Bogota, Colombia, Marie Kasbaum
Dissertations & Theses (Open Access)
The misuse of antibiotics has been shown to exacerbate the global antibiotic resistance crisis, which could have major consequences on public health worldwide (Auta et al., 2018). In Bogotá, Colombia, the non-prescription sale of antibiotics still occurs in pharmacies despite national regulations requiring a prescription from a physician or health agency before dispensing antibiotics to a patient (Vacca et al., 2011). The purpose of this study was to investigate the non-prescription sale of antibiotics in community pharmacies to foreign travelers and Colombian citizens in Bogotá, Colombia. Trained Simulated Clients (SCs) gathered experimental data in pharmacies distributed throughout 20 geographic districts …
Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson
Examining Differences In Physical Activity By Socio-Demographics, Employment, And Social Support Among U.S. Adolescents, Ashleigh Marie Johnson
Dissertations & Theses (Open Access)
The overall decline in physical activity levels during adolescence supports the examination of intrapersonal-, interpersonal-, and behavior-level factors that may influence physical activity behavior among this population. The three papers within this dissertation aimed to examine associations of socio-demographics and socio-environmental factors with physical activity among U.S. adolescents. Papers 1 and 3 used data from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Paper 1 examined differences in adolescent physical activity by gender and race/ethnicity, and examined modification by grade and socioeconomic status (SES). Paper 3 examined the association of parent- and adolescent-reported parental social support with adolescent …
Nonlinear Functional Models On Causal Inference, Rong Jiao
Nonlinear Functional Models On Causal Inference, Rong Jiao
Dissertations & Theses (Open Access)
Statistical analysis has experienced significant progress on association study, but it remains elusive to understand the etiology and mechanism of complex phenotypes. As a major analytical platform, association analysis may hamper the theoretic development of biomedical science and its application. Thus, many researchers suggest making the transition from association to causation. The mainstream of research in genetics and epigenetics data analysis focuses on statistical association or exploring statistical dependence between variables. Despite significant progress in dissecting the genetic architecture of complex diseases by genome-wide association studies (GWAS), the signals identified by association analysis can only explain a small proportion of …
Understanding The Relatlonships Between Survivorship Care Plans And Survivor Level Outcomes Among Breast And Colorectal Cancer Survivors, Jessica Danielle Austin
Understanding The Relatlonships Between Survivorship Care Plans And Survivor Level Outcomes Among Breast And Colorectal Cancer Survivors, Jessica Danielle Austin
Dissertations & Theses (Open Access)
PURPOSE: Cancer survivors have complex journeys following the completion of active treatment. The Institute of Medicine and other high-profile organizations have recommended and mandated the use of a survivorship care plan (SCP) despite mixed evidence supporting the impact of SCPs on key survivor-level outcomes. The purpose of this dissertation was to understand the complex relationship linking the delivery of SCPs and to relevant survivorlevel outcomes. STUDY GROUP: This dissertation focuses on breast and colorectal cancer survivors because they comprise nearly 30% of the entire cancer survivor population in the US and are the two most prevalent cancers in men and …
Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal
Characterizing Risk & Burden Of Lower Cranial Neuropathy (Lcnp) As Late Effect Among Oropharyngeal Cancer Survivors, Puja Aggarwal
Dissertations & Theses (Open Access)
Background: Lower cranial neuropathy (LCNP) is a rare but potentially disabling late effect of radiotherapy (RT) and other head and neck cancer therapies. Survivors who develop late LCNP may experience profound functional impairment with deficits in swallowing, speech, and voice. The aims of this research were: 1) to quantify the cumulative incidence of late LCNP and identify clinical predictors of late LCNP; 2) to investigate the impact of late LCNP on severity of cancer treatment-related symptoms, general functional impairment (GFI), and single item scores of the most severe symptoms; and 3) to quantify the association of late LCNP with swallowing-related …
Hepatitis C Infection In Men Who Have Sex With Men, Jing Zhao
Hepatitis C Infection In Men Who Have Sex With Men, Jing Zhao
Dissertations & Theses (Open Access)
Hepatitis C virus (HCV) infection is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. Current treatment rates and efficacy are inadequate to manage the disease burden caused by HCV; thus, efforts are needed to control HCV transmission. Besides the well-known transmission routes, which are health-care-associated transmission and transmission through injecting drugs, HCV could also be transmitted by sexual contact, especially among men having sex with men (MSM). MSM also have higher drug use prevalence than the general population, which may contribute to HCV infection by sexual disinhibition and other risky behavior. Since 2000, there have been emerging reports …
Ashtanga For Addiction: A Qualitative Web-Based Open-Ended Survey To Assess Outcomes From Ashtanga Yoga Practice In Individuals In Long-Term Recovery From Substance Abuse Disorder, Shaun M. Jones
Dissertations & Theses (Open Access)
Over 72,000 people die from overdose or secondary health issues related to substance use disorder (SUD) annually. Studies support mind-body interventions in reducing stress, anxiety, depression, and craving symptoms. There is a growing body of literature supporting yoga as a mind-body intervention for individuals recovering from SUD. These interventions promote improved physical awareness, greater awareness of mental states, non-reactivity, and reduced perception of pain, allows for more successful coping with cravings. Ashtanga yoga (AY) is a tradition of yoga wherein students work on a one-on-one basis with highly qualified teachers following an invariant sequence of yoga postures. AY is characterized …
Climate Change And Chagas Disease In The Americas: A Qualitative Systematic Review, Brittany N. Graves
Climate Change And Chagas Disease In The Americas: A Qualitative Systematic Review, Brittany N. Graves
Dissertations & Theses (Open Access)
While many studies have found associations between climate change and factors affecting Chagas disease transmission, the future impact of climate change on the global spread of Chagas disease remains debatable. A qualitative, systematic review was conducted to assess the impact of climate change on Chagas disease transmission in the Americas (Central America, South America, and North America). The literature search was performed in January 2019 using the keywords climate, Chagas, and “trypanosoma cruzi” and the electronic databases PubMed, Scopus, and Ovid. Searches retrieved records from 1982 through 2019. The initial electronic database search identified a total of 191 record documents …