Digital Commons Network^™

Economics Of Fixed-Dose Combination Drugs Approved In The United States, Jing Hao

Doctoral Dissertations

Patent is the most important form of intellectual property protection for new drugs. Patent extension and market exclusivity currently serve as major regulatory incentives to promote new drugs. Combination drug, or fixed-dose combination (FDC) are formulations that contain two or more active ingredients in a single pill. FDCs, especially combinations of singe drugs that are already in the market, are common strategy for brand-name drug companies to extent the patent and exclusivity life. The substitution of single drug products that soon have generic alternatives with newer, brand-name combinations lead to potential increases in pharmaceutical expenditures and raises concerns on economic …

Impact Of A Preschool Workplace Intervention On Classroom Teachers’ Physical Activity Levels And Quality Of Life, Ogechi O. Nwaokelemeh

Doctoral Dissertations

PURPOSE: To examine the feasibility and efficacy of a three-month, cluster-randomized workplace PA intervention on PA levels and wellbeing measures in preschool classroom teachers. METHODS: Ten preschool centers were randomized into two groups; short-bouts of structured PA (SBS-PA, n=5) or traditional unstructured PA (TRAD-PA, n=5). The SBS-PA intervention consisted of 10-minute structured, teacher-led PA routines implemented within the classroom setting, followed by 20 minutes of unstructured playtime. The TRAD-PA intervention consisted of supervised 30-minute of unstructured free playtime. Both interventions were implemented during the morning and afternoon designated gross-motor playtime for 30 min/session, five days/week for three months. Participants’ …

Impact Of Exercise During Pregnancy On Maternal Outcomes Among A High-Risk Population, Carrie Nobles

Doctoral Dissertations

Prior observational research has suggested an association between increased physical activity during pregnancy and improved maternal outcomes including a reduced risk of gestational diabetes mellitus (GDM). Despite this, randomized controlled trials of prenatal exercise are sparse and only one had been conducted in a high-risk population. Therefore, we examined the association between physical activity during pregnancy and risk of adverse pregnancy outcomes in the Behaviors Affecting Baby and You (B.A.B.Y.) Study, a randomized controlled trial of a 12-week exercise intervention among a diverse group of inactive pregnant women at high-risk for GDM. The first project examined the effect of participation …

Factors Affecting The Quality Of Services Provided To Female Survivors Of Sexual Violence In Nairobi, Kenya: Perspectives From Health Practitioners, Leso Munala

Doctoral Dissertations

This study examined the experiences of practitioners facing the challenges of providing services to female survivors of sexual violence in Kenya. Specifically, the study examined how health practitioners understand their experience in responding to the needs of sexual violence survivors, how they view these women, in what ways they are helping them to heal, and in what ways the health system fails to help these women. In-depth interviews were conducted with 28 health practitioners, from eight post-rape care facilities located in Nairobi, Kenya. The questions focused on the practitioners’ workload, challenges and rewards, the emotional impact of working with survivors, …

Identifying Menstrual Symptom Patterns In Young Women Using Factor And Cluster Analysis, Felicia A. Quintana-Zinn

Masters Theses

Approximately 80% of reproductive age women experience physical or emotional symptoms prior to onset of menses. Of these women, approximately 20% experience symptoms severe enough to interfere with social functioning and life activities and meet criteria for premenstrual syndrome (PMS). More than 100 different symptoms are associated with PMS, the most common of which include breast tenderness, headache, anger, and depression. Symptom groupings tend to be stable within an individual but can vary distinctly between women. Potential differences in the etiology of symptoms suggest that PMS should not be considered a single condition in research or clinical studies, but rather …

The Effects Of Ovarian Hormones And Exercise On Gene Markers Of Cardiac Dysfunction, Anisha S. Patel

Masters Theses

Heart disease is the leading cause of death in women in the United States. Premenopausal women appear to have better cardiac function and lower risk of heart disease compared to male postmenopausal female counterparts. Ovarian hormone loss influences blood pressure homeostasis and causes systemic inflammation, which may result in chronic stress on the heart. Two key physiological changes in cardiac dysfunction are reemergence of the fetal gene pattern and myocardial remodeling. Physical activity has been linked to improved cardiac function. The purpose of this study was to investigate the effects of ovariectomy on early markers of cardiac dysfunction and fibrosis …

Urinary Phthalate Metabolite Concentrations And Cancer Mortality In Nhanes, 1999-2006, A B. Kaiser

Masters Theses

Four in ten people in the US will be diagnosed with cancer during their lifetime. Environmental exposures are important determinants of cancer risk, causing as many as 19% of cancers worldwide. Phthalates are a group of chemicals used to increase the flexibility of plastics and vinyl in household materials such as food packaging, plastic toys, wood finishes and adhesives. Some phthalates may act as endocrine disruptors with hypothesized links to endometriosis, breast cancer, and reproductive outcomes. However, no research yet exists on phthalate exposure and all-cancer mortality. We investigated the relationship between seven urinary phthalate metabolites among 5,205 adults in …

Examining Implementation Of The Massachusetts Act Relative To Safety Regulations For School Athletic Programs (Sessions Laws: Chapter 166 Of The Acts Of 2010): A Multiple-Case Study, Mitchell L. Doucette

Masters Theses

Background/Purpose: Reducing the incidence and negative consequences of concussion among youth athletes is a public health priority. Fifty states have adopted legislation addressing the problem of sports-related concussions among youth-athletes. In 2010, Massachusetts adopted legislation based on Washington State’s Lystedt Law, enacting state-wide requirements for high school athletic programs. This study explored how the legislation has been implemented within Massachusetts schools and school-districts and identified factors influential to local implementation.

Methods: A qualitative multiple-case study approach was utilized. US Census data concerning the household median income and population size of the school-district’s representative town(s) were used to purposively recruit cases. …

Does Change In Physical Activity Predict Mental Health Outcomes In Pre-Adolescent African American Girls?, Sarah A. Burkart

Masters Theses

Pediatric obesity is a significant clinical and public health issue for African American girls in which low physical activity (PA) is a contributor. The mother-daughter relationship (MDR) has rarely been examined in the context of improving health behaviors such as PA and mental health outcomes (MHO) within this population. PURPOSE: To examine if change in PA following a 12-week culturally-tailored mother-daughter PA intervention predicts change in MHO variables (self-esteem, depressive symptoms, body image dissatisfaction) and MDR in pre-adolescent African American girls. METHODS: Mothers (n=27; age=36.0±17.0 years; body mass index (BMI)=34.0±7.4 kg/m²) and daughters (n=27; age=9.0±1.4 years; BMI=20.3±5.7 kg/m …

The Effects Of Menopausal Vasomotor Symptoms And Changes In Anthropometry On Breast Cancer Etiology, Victoria Hart

Doctoral Dissertations

One of the strongest predictors of breast cancer risk is mammographic density; however, incomplete understanding of the mechanisms relating density to risk has limited its use as a marker for breast cancer susceptibility. Hormone fluctuations during the menopausal transition may influence declines in mammographic density and may also trigger the onset of menopausal vasomotor symptoms (VMS), which have been associated with lower breast cancer risk. The effects of hormone changes on density, VMS, and breast cancer risk are complicated by external factors such as changing body mass and hormone therapy use during the menopausal transition. We evaluated the association between …