Health Management and Informatics electronic theses and dissertations (MU)
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The items in this collection are the theses and dissertations written by students of the Department of Health Management and Informatics. Some items may be viewed only by members of the University of Missouri System and/or University of Missouri-Columbia. Click on one of the browse buttons above for a complete listing of the works.
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Item Evolution, transmission, and clinical impacts of SARS-CoV-2 and influenza viruses(University of Missouri--Columbia, 2023) Tang, Cynthia; Wan, Xiu-Feng[EMBARGOED UNTIL 12/1/2024] Influenza and coronaviruses are leading causes of human respiratory diseases, causing substantial global impact. The ongoing evolution of SARS-CoV-2 and influenza viruses continues to trigger waves of outbreaks worldwide. Thus, understanding the natural history of influenza and SARS-CoV-2 viruses is crucial for effective prevention and rapid response to outbreaks. This dissertation explores the evolution, transmission, and clinical impacts of influenza and SARS-CoV-2 viruses and revealed four major findings. 1) the contemporary influenza B viruses showed genetic adaptations to cell and egg cultures, potentially impacting vaccine strain selection and vaccine development. 2) Rural communities were an important source for emerging SARS-CoV-2 variants and SARS-CoV-2 transmission. 3) We developed a machine learning model to predict COVID-19 outcomes, primarily hospitalization, intensive care unit admission, and long COVID. 4) Co-infections between SARS-CoV-2 and influenza viruses were highly prevalent in Central Missouri during the 2021-2022 flu season with differing rates between Delta and Omicron variants, and a link between influenza vaccination and reduced co-infections was also identified. Overall, these findings provided deeper insights into how an influenza and SARS-CoV-2 viruses emerge, evolve, and spread in humans and revealed how the intricate interplay between host, virus and environmental attributes affect disease severity of SARS-CoV-2 infection. Thus, these studies can enhance vaccine strain selection, refine strategies to address potential future pandemics, and advance the development of personalized medicine for seasonal outbreaks.Item Understanding genome composition of eusocial hymenopteran insects(University of Missouri--Columbia, 2022) Nguyen, Hung Nhat; Elsik, Christine G.Genome sequencing of the Western honey bee (Apis mellifera), a model for the biology and evolution of eusocial behavior, has revealed unusual genome compositional characteristics, including a low but heterogeneous GC content, bimodal GC content distribution, and a biased tendency of genes to be located in low GC regions. In this dissertation, we sought to determine whether those features are specific to Apis or shared with other insects and the biological meaning of those features. Chapter 1 reviews the major concepts that tie my dissertation research together, highlighting the importance of recombination, GC composition, and their relationship to the evolution of eusociality. In chapter 2, we analyzed the distributions of GC contents in GC compositional domains among twenty-seven insect species with different levels of social complexity to study whether the striking features previously known in the A. mellifera genome are common among Hymenoptera or other eusocial insects. In chapter 3, we investigated the biological context of the GC content distribution by partitioning the GC compositional domains into groups based on GC composition and then performed Gene Ontology (GO) analysis on the gene content of domains within the groups. Chapter 4 investigated the compositional features of the protein-coding content of the genome of Aculeata species (ants, bees, and wasps) by analyzing GC compositional domains in the syntenic regions between their orthologs.Item Integrated clinical decision support : assessing opportunities and outcomes(University of Missouri--Columbia, 2019) Green, Timothy A.; Shyu, Chi-RenMedical calculators play an important role as a component of specific clinical decision support (CDS) systems that synthesize measurable evidence and can introduce new medical guidelines and standards. Understanding the features of calculators is important for calculator adoption and clinical acceptance. Some medical calculators can fulfill the role of CDS for Meaningful Use purposes. However, there are barriers for clinicians to use medical calculators in practice. This research presents a novel classification system for medical calculators and explores clinician use and perceived usefulness of medical calculators. Additionally, we examine the effects of an EHR integrated decision support tool on management of pain in an inpatient setting. Metadata on 766 medical calculators implemented online were collected, analyzed, and categorized by their input types, method of presenting results, and advisory nature of those results. Reference rate, publication year, and availability of references were collected. We surveyed a population of resident and attending physicians at a medium-sized academic medical center to discover the prevalence of medical calculator use, how they were accessed, and what factors might influence their use, for example, EMR integration. We also conducted a retrospective evaluation of an EHR integrated CDS module focused on pain management, leveraging a novel approach to digital workflow evaluation within the EHR, focusing on patient-centric outcome measurements.Item Use of patient generated health data in ischemic heart disease(University of Missouri--Columbia, 2019) Shahreen, Maniza; Mosa, Abu Saleh Muhammad[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI--COLUMBIA AT REQUEST OF AUTHOR.] Health care technologies are constantly being improved to provide the best care for the patients. Health care services around the world is having an increasing number of patients with various clinical complexity or chronic diseases. Many of the patients need regular feedback and/or guidelines from their providers based on the complexity of their health condition. Nowadays many patients are using various devices to self-monitor their day to day health conditions like blood pressure, blood glucose, pulse rate etc. Health data generated by patients at home can be a good source of information for clinical decision-making process. These data can be accessible to the providers through systems like EMR, thus allowing them to act on any severe conditions, change/provide medications as needed. However, we know very little about the use of patient generated health data at the point-of-care. The purpose of this research is to understand the state-of-the-art of using patient generated data for clinical decision making. This will create the framework for studying patients and providers perspective on the meaningful use of patient generated health data.Item Healing centered yoga : an adjunct clinical intervention pilot study : trauma and chemical dependency(University of Missouri--Columbia, 2019) Saxon, Heather; Enriquez, Maithe; Houston, BrianIntroduction: Healing Centered Yoga (HCY) is a multidisciplinary practice and program offered as an adjunct clinical intervention for individuals experiencing complex, acute, and/or treatment-resistant trauma and related stress. Research on the contemplative practices, including yoga and its relationship to trauma, physiologic regulation and overall wellbeing has grown exponentially. However, with poor reporting, colonization of yoga, lack of community-partnered studies as well as lack of understanding regarding the evolutionary, neurophysiological and neurobiological mechanisms of trauma and yoga, clinical applications have been difficult or limited. Methods: Facilitate Healing Centered Yoga (HCY): An Adjunct Clinical Intervention Program and Practice for Healing Trauma[copyright] as an academic-community partnership. Using a pre/post design, analyze: a) autonomic nervous system reactivity and body awareness; b) perception of choice and connection; c) involuntary and voluntary cognitive and neurophysiologic processes and coping strategies associated with stress responses; d) trends among individual and aggregate numbers of trauma exposure. Results: Adult female participants (n=25) experiencing residential-based treatment for chemical dependency recovery enrolled in the study. Trends in feasibility are low, acceptability is high, other results are mixed with data analysis in process for manuscript. Conclusion: The overall trends of this study reflect 1) high acceptability to the priority population; 2) low feasibility affecting therapeutic efficacy, but with opportunities to increase feasibility with changes to the program; 3) successful community-partnered study with mutually perceived co-learning and shared power; 4) trends in trauma and chemical dependency as comorbid.