Digital Commons Network^™

Age-Based Differences In The Usefulness Of Resources: A Multi-Study Investigation Of Work And Well-Being Outcomes, Lale Muazzez Yaldiz

Dissertations and Theses

The labor force is aging globally. It is projected that the number of older workers will increase in the workforce in the near future. At the same time, it is estimated that workplaces will grow more age-diverse, where younger and older workers will work side-by-side more often than they used to. These demographic shifts in the workforce necessitate a further understanding of the differences between the values, needs and motivation, and work outcomes of employees of different ages. To this end, few studies to date have investigated whether job-related resources are differentially useful for the work and non-work outcomes of …

Burden Of Lipohypertrophy Among Insulin Dependent Diabetes Mellitus Patients In China: An Analysis Of Outcomes And Impact Of Pen Needle Reimbursement Policy, Arthi Chandran

Dissertations and Theses

Background

Diabetes is a global epidemic and with an aging population accompanied by rapid urbanization China ranks highest in disease prevalence and associated burden. Independent of diabetes type, insulin is an eventual and costly requirement for disease management. The consequences of insulin administration however are poorly understood. Lipohypertrophy (LH) is one such consequence. It is hypothesized that method of insulin delivery and poor delivery technique are significant risk factors for this condition which is believed to alter insulin pharmacodynamics. Subsequently, insulin pen needles are a critical component of care however access to pen needles varies across China.

Objective

The objective …

The Urban Food Desert As A Model For The Urban Health Care Desert: Fundamental Causes And Economic Considerations, Estevan A. Garcia

Dissertations and Theses

Introduction: A “health care desert” is a part of the country where needed medical, behavioral, mental, dental, and/or pharmaceutical health care services are extremely limited or altogether unavailable. This terminology is based on the concept of a “food desert,” which describes an area where people have limited access to affordable and healthy foods, and which, together with the negative health consequences of eating lower-quality foods, is well described in public health literature. The application of this terminology to an urban environment with ready access to transportation has been limited and is controversial. However, the recent increase in urban hospital closures …

Quantifying Spatial Potential Access Equity In An Agent Based Simulation Model Of Buprenorphine Treatment Policy In The United States, Alexandra Elizabeth Nielsen

Dissertations and Theses

Opioid dependence and opioid related deaths are a public health problem which the United States Centers of Disease Control have declared an epidemic. While opioid agonist therapy for opioid addiction has been accepted as the most effective treatment for opioid dependence among academics, and office based buprenorphine treatment has been available in the Unites States for over 10 years, OB buprenorphine faces many barriers to widespread adoption. Empirical data on the geographic distribution of physicians able to prescribe buprenorphine and the prescribing patterns of those physicians show considerable unevenness in access and utilization of treatment services.

Federal-level policies have recently …

Framing Physical Activity: Weight Control Frames And Physical Activity Motivation, Kristin Spurkland

Dissertations and Theses

Public health institutions and popular media frequently frame weight loss and weight control as primary benefits of physical activity. This exploratory, descriptive study examined how respondents rated statements exemplifying three physical activity frames: a weight control frame, a medical frame, and an active embodiment frame. An anonymous, online survey was conducted in March 2018; respondents rated frame statements in terms of inspiring motivation to engage in physical activity, and in terms of perceived credibility. They also provided anthropometric data and physical activity data. Data were analyzed for the entire sample as well as stratified by multiple variables, including body mass …

Effects Of Fan Cooling At Room Temperature On Indoor 20-Km Cycling Time Trial Performance, Matthew Bloom

Dissertations and Theses

Aim: The primary purpose of this study was to examine effects of a fan-induced airflow at standard room temperature (20-23°C) on 20-km cycling time trial performance. A secondary purpose was to investigate two fan speeds and whether a difference in performance existed with increased fan speed in intermediate duration indoor cycling tests.

Methods: Seven trained cyclists completed three 20-km cycling time trials under three conditions in a randomized crossover design. The 3 conditions were: 1) control (no fan), 2) low speed fan, and 3) high speed fan.

Results: A tendency for modest decreases in time to completion (TTC) were noted …

Differential Well-Being In Response To Incivility And Surface Acting Among Nurses As A Function Of Race, Lauren Sarah Park

Dissertations and Theses

Demand for healthcare services is rising dramatically as the proportion of older adults in the United States increases, and the success of these healthcare organizations depends on cooperation among patients, doctors, and nurses. These interpersonal interactions come with costs associated with managing one's emotions in ways that are in line with completing job tasks effectively, especially as past research has demonstrated that nurses are likely to experience and respond to incivility, and nurses of minority backgrounds even moreso. This study examines the effect of experiencing incivility on engaging in surface acting, or simulating emotions that are not actually felt; how …

Sexual Expression And Social Connectedness Among Community-Dwelling Older Adults, In The United States, Neal J. Blangiardo

Dissertations and Theses

Sexuality is a central aspect of human identity for all people, including older persons. Sexual expression continues across the lifespan, despite the cultural fallacy of the sexlessness of older adults. Older adults live active sexual lives which involve relationships, social roles, and an array of sexuality-related needs.

This dissertation examines the relationship between sexual expression and social connectedness, in older community-dwelling adults. Research on sexuality in this community predominately focuses on genital sexual expression, has not explored the non-genital dimension of sexual expression, and little is known about the role of social relationships that can play in supporting sexual expression. …

A New Benchmarking Methodology To Monitor Industry's Investment In Community-Based Obesity Prevention And Food Access Initiatives: Gaps And Opportunities, Olivia Barata Cavalcanti

Dissertations and Theses

Background:

Despite increased public health efforts and investment in obesity prevention, obesity continues to be a growing problem in the United States.¹ Excess weight increases the risk for a series of correlated diseases, such as type 2 diabetes, hyperinsulinemia, hypertension, dyslipidemia, joint abnormalities, polycystic ovarian syndrome, nonalcoholic fatty liver disease, sleep disturbances and a decreased life span.^2–9

Traditional interventions to improve nutrition or decrease obesity have not achieved the desired success so far because obesity is a complex problem, involving a vast number of factors, sectors and actors that influence individuals’ energy balance.^10,11 To achieve change in …

Mobile Alcohol Primary Prevention: Feasibility With Urban Communter College Students, Janice Chisholm

Dissertations and Theses

The first year and possibly as early as the first two to six weeks of college are marked with personal and social transitions that may help to define academic and other behavior for new college students, including alcohol use patterns.1 Evidence suggests that alcohol use by college students negatively affects learning, retention, and graduation,2,3 and is associated with alcohol related unintentional injury, deaths, sexual violence, suicide and other problems.4 Young adults entering college have been found to increase their usage during the transition from high school, particularly for students with certain social characteristics (male sex, history of conduct issues, peer …

Incidence, Risk Factors, And Prediction Of Gastrointestinal And Intracranial Bleeding In A Cohort Of Older Veterans Prescribed Oral Anticoagulants, Angela Laurio

Dissertations and Theses

ABSTRACT

Incidence, Risk Factors, and Prediction of Gastrointestinal and

Intracranial Bleeding in a Cohort of Older Veterans Prescribed Oral Anticoagulants

by

Angela L. Laurio

Advisor: Marianne (Mimi) C. Fahs, PhD, MPH

Objectives:

The objectives of this dissertation were to: (1) describe and compare the incidence and odds of gastrointestinal and intracranial bleeding in veterans age 50 to 89 who were prescribed warfarin, direct oral anticoagulants, or no oral anticoagulants; (2) identify risk factors for gastrointestinal and intracranial bleeding among older veterans prescribed oral anticoagulants, and to calculate the relative risk of bleeding over time through time-to-event analysis; and (3) develop …

Rates Of Developmental And Behavioral Screening Of Young Children: Implications For Health Care Policy And Practice, Shirley Berger

Dissertations and Theses

Background: The skills and capacities developed during early childhood are the foundation for a child’s future academic functioning, economic productivity, and lifelong health and mental health. When young children have developmental delays or disabilities, early identification and intervention lead to better outcomes; however, only a minority are identified before school entry. Primary care is an important setting for identification of developmental and behavioral conditions as most young children attend well-child visits regularly and parents expect developmental guidance from pediatricians. Two key pediatric preventive services are recommended: developmental monitoring/surveillance at every well-child visit and developmental screening at 9 months, 18 months, …

Exploring The Association Of Victimization And Alcohol And Marijuana Use Among American Indian Youth Living On Or Near Reservations: A Mixed Methods Study, Lindsay Nicole Merritt

Dissertations and Theses

Adolescent substance use research has yet to consider victimization as a potential risk factor contributing to alcohol and marijuana use among American Indian youth living on or near reservations, despite the presence of traumatic experiences, childhood adverse events, racism, and discrimination. Contribution to this lack of attention may be due to little being known about American Indian youth victimization. Even less is known about its association with alcohol and marijuana use in general and for those youth living on or near reservations in particular.

This study utilizes mixed methods with a nationally representative sample of American Indian youth living on …

Fungal Endophytes In A Seed-Free Host: New Species That Demonstrate Unique Community Dynamics, Brett Steven Younginger

Dissertations and Theses

Fungal endophytes are highly diverse, cryptic plant endosymbionts that form asymptomatic infections within host tissue. They represent a large fraction of the millions of undescribed fungal taxa on our planet with some demonstrating mutualistic benefits to their hosts including herbivore and pathogen defense and abiotic stress tolerance. Other endophytes are latent saprotrophs or pathogens, awaiting host plant senescence to begin alternative stages of their life cycles. Most, however, are likely plant commensals with no observable benefits to their hosts while under study. Yet, when considering the context-dependence that may determine plant resistance to pathogen attack, the consortium of endophytes present …

Is Therapy Going To The Dogs? Evaluating Animal Assisted Therapy For Early Identified At-Risk Children, Leah Faith Brookner

Dissertations and Theses

This study explores the historical context of human-animal relationships and examines the important ways that humans benefit from various types of interactions with domesticated animals. Therapeutic approaches that incorporate animals have been shown to have multiple benefits, including improved physical and mental health. Although this area of study is still largely overlooked in scientific fields of study, including social work, Animal Assisted Therapy (AAT) has become increasingly prevalent in various mental health settings. Despite its popularity and anecdotal support, research on the benefits of AAT with children is minimal; there are no studies examining the ways in which this approach …

Health Risks In Medical Homes And Their Effects On Emergency Department And Inpatient Expenditures: A Focus On Patient-Centered Primary Care Homes In Oregon, Kweku Nyameyepa Wilson

Dissertations and Theses

The fragmented approaches to delivering health care services in the United States, along with the associated structural inefficiencies and unsustainable increases in health care costs affecting all payers, compel the need for reform. Various federal and state-level delivery system reform models have emerged in response.

The Medical Home (MH) is one of such reform models. In 2004 a national initiative entitled "The Future for Family Medicine Project" identified the lack of emphasis on comprehensive primary care, especially for chronic care patients, and proposed the introduction of MHs to improve comprehensive primary care delivery for every patient. Oregon's MH variant, the …

Assessment Of Technology Adoption Potential Of Medical Devices: Case Of Wearable Sensor Products For Pervasive Care In Neurosurgery And Orthopedics, Liliya Stepanivna Hogaboam

Dissertations and Theses

Information and communication technologies hope to revolutionize the healthcare industry with innovative and affordable solutions with a focus on pervasive care. Wearable sensors products can provide monitoring in a natural environment with a constant stream of information, enriching healthcare practices and enabling better pervasive care.

Wearable sensor technologies could monitor patients' mobility, gait, tremor, daily activity and other health indicators in real time that could allow for simple, non-invasive, tracking of spine care that may lead to increased patient engagement, integration, feedback, post-surgery analysis, monitoring of patient's condition, patient's data extraction and analysis and possibly aiding in better diagnosis, intervention, …

Obesity, Type 2 Diabetes, And Dietary Acculturation Among Foreign-Born Blacks In New York City, Margrethe F. Horlyck-Romanovsky

Dissertations and Theses

Background: Black immigration to the US quadrupled between 1980 and 2000, and between 2000 and 2013 it further increased by 56%. The US Census estimates that by 2060, 16.5% of the US Black population will be foreign-born. Half of all foreign-born Blacks (FBBs) in the US, or more than 1.9 million people, are from the Caribbean, and of those, 682,000 were born in Jamaica alone. Besides the Caribbean, there are 1.36 million immigrants from sub-Saharan Africa. In New York City, non-Hispanic black Caribbean and West African immigrants constitute 19% and 4%, respectively, of the total foreign-born population. Research is limited …

Water Transport In The Lateral Line Canal Of The Intertidal Fish Xiphister Mucosus (Girard 1858) And Its Significance To Evaporative Water With Preliminary Observations Of The Metabolic Consequences Of Water Loss, Whitney Anne Gayer

Dissertations and Theses

The lateral line canal system is a sensory organ found in all teleost fish that has a wide range of morphological variation. Variation in morphology may often be the result of evolutionary necessity where the need for function dictates form. Xiphister mucosus is an amphibious Stichaeid fish that inhabits the rocky intertidal zone of the northeastern Pacific Ocean. The rocky intertidal is considered an extreme environment where crashing waves and ebbing tides may require the specialization of adaptations for surviving the many abiotic stressors encountered there.

The lateral line trunk canal of Xiphister is regarded as unique among teleosts with …

Acceptability Study And Pilot Rct Of A Guide To Understanding Reproductive Health For Ladeez (Gurhl) Code: An Hiv Risk Reduction App Intervention For Black And Latina Young Women In New York City, Sonia K. Gonzalez Gladstein

Dissertations and Theses

Background: Young Black and Latina women suffer from higher sexually transmitted disease (STD) incidences than White women, increasing their susceptibility to contracting human immunodeficiency virus (HIV). The adoption and widespread usage of mobile devices has contributed to the public’s ability to access available information at all hours, including information on sexual and reproductive health (SRH). Despite a growing body of mobile health literature, there is limited understanding of how mobile-based sexual and reproductive health interventions for use by young adult Black and Latina women could improve sexual health knowledge and connection to clinical care.

Methods: This pilot randomized controlled trial …

Wnt Secretion Proteins Modulate Rankl-Induced Expression Of Aire In Thymic Epithelial Cells, Daniel Pollack

Dissertations and Theses

Thymic epithelial cells (TEC) are essential for a proper adaptive immune response by regulating thymocyte development and establishing central tolerance. In the thymus, TECs differentially express Wnt proteins, which activate canonical and non-canonical Wnt signaling pathways. Wnt signaling is thought to regulate cell survival, proliferation, and development although the direct molecular mechanisms in TECs have yet to be elucidated. The inducible inhibition of canonical Wnt signaling with Dkk1 leads to a rapid loss of TEC progenitors as well as a decline in mature Aire-expressing mTECs. Therefore, we explore the role of Wnt ligands potentially responsible for stimulating and/or regulating Wnt …

Knockdown Of Heparan Sulfate Via Ndst1 Knockout Does Not Inhibit Mouse Aortic Endothelial Cell Alignment In-Vivo, John Diaz De Leon Iii

Dissertations and Theses

Atherosclerotic plaque localizes in predictable areas such as arches and bifurcations which are characterized by disturbed flow patterns and the resulting damage and dysfunction to the endothelium. Endothelial cells (ECs) under sustained laminar flow align in the direction of flow; however, under disturbed flow conditions, ECs sustain damage to their glycocalyx (GCX) which results in unaligned and rounder cells. An investigation into the role of NDST1 sulfation of heparan sulfate (HS), a key component of many proteoglycans which make up the GCX, was conducted. The descending aortas (DAs) of transgenic mice with conditional knockouts (KOs) of NDST1 in vascular ECs …

Electrode And Headgear Design For Accurate Tdcs, Henry Bernstein

Dissertations and Theses

Stimulating the brain with a low current that is focused on specific regions of the brain has been shown to modify brain function and treat various neurological diseases. Transcranial direct current stimulation (TDCS) has been an effective and life changing alternative treatment for a vast range of neurological conditions including depression, epilepsy, stroke rehabilitation, addiction and chronic pain but only if it is administered correctly. During TDCS, a weak constant current is applied to precise locations on the scalp to modulate brain activity. Those locations can be determined by the cumbersome 10-20 EEG measurement system, transcranial magnetic stimulation or neuronavigation. …

Synthesis Of 1,4-Triazolyl Combretacoumarins As Potential Anticancer Agents, Tashrique A. Khandaker

Dissertations and Theses

Coumarins are natural compounds that have various physiological and therapeutic properties, making them pharmacologically important. Combretastatin A-4 (CA-4) is a microtubule-binding agent that has potent cytotoxic effects against human cell lines. In CA-4 the trimethoxyarene moiety plays a crucial role in its carcinopreventive effect. Thus, we decided to synthesize novel, potential anti-cancer agents called 1,4-triazolyl combretacoumarins, by coupling different coumarins and the functionally relevant group of CA-4 i.e, the trimethoxyarene moiety, via a 1,2,3-triazolyl ring using a copper-catalyzed [3 + 2] azide-alkyne cycloaddition (CuAAC) reaction, which is a very atom-economical reaction. The coupling partners, 4-azidocoumarins, required for making these …

Whether, When, And How: Fertility Intentions And Age In The U.S., Andrea Melnikas

Dissertations and Theses

Thinking about, planning for, and having children is a deeply personal experience influenced by myriad factors at individual, intrapersonal, community and larger social levels. Examining fertility intentions is of interest to researchers from numerous social science disciplines in part because these intentions are potentially tied to larger demographic and economic shifts. In recent years in the U.S. the mean age at first birth has been increasing, with more women of older ages (age 35 and older) giving birth, due to both delays in childbearing that accompanied larger social trends such as increased educational and career opportunities and a decrease in …

Reducing Arsenic Exposure From Private Well Water In The United States: The Use, Effect, And Potential Of Testing Requirements, Sara Flanagan

Dissertations and Theses

Over 45 million Americans drink from unregulated private well water of unknown quality. Arsenic is the most concerning groundwater contaminant for health because of its toxicity and widespread natural occurrence. Most residential wells in arsenic-affected areas have not been tested for arsenic; the success of community programs and efforts to motivate testing is limited by a range of psychological, situational, and socioeconomic barriers. However, testing only acts as screening and does not reduce exposure without effective and consistent actions to follow. Given the limitations in relying on individual well owners to be aware, willing, and capable of testing their water, …