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Articles 1 - 30 of 68
Full-Text Articles in Medicine and Health Sciences
Exploring The Associations Between Sexism, Physical Behaviors, And Psychosocial Correlates Of Physical Activity In Young Women, Melanna Cox
Doctoral Dissertations
Physical behaviors (PB), defined as physical activity (PA) and sedentary behavior (SB), tend to be less favorable in women than in men. Low self-efficacy (SE) and social support (SS), and gender norms hinder women’s PB. Benevolent sexism, a theory on gender norms, could explain the gender disparity. PURPOSE: To 1) assess the associations among benevolent sexism endorsement (BSEN), experiences with benevolent sexism (EBS), PB, SE, and SS, 2) evaluate if BSEN or SE mediate the relationship between EBS and PB, and 3) develop a questionnaire that measures a woman’s sexist experiences in PA. METHODS: Study 1: Women (N=186) completed a …
Impact Of Child/Parent Characteristics On Ultra-Processed Food Intake In Preschool-Aged Children, A Latent Class Analysis Of Obesity-Related Factors And Obesity Risk, And The Qualitative Impact Of 9-11 Year Old's Perception Of Unhealthy Food Marketing, Jennifer E. Carroll
Doctoral Dissertations
Childhood overweight/obesity is an epidemic in the US. Modifiable risk factors, such as intake of foods that are highly processed, are heavily marketed to children. Exposure to food advertisements, along with home environment factors, family meal styles, and digital media habits shapes children’s preferences, tastes, and habits. Predictors of ultra-processed food (UPF) intake in children are unclear and the potential effect of ad exposure on UPF intake is unknown. It is also unknown if there are distinct response patterns among a collection of potentially obesity-related factors, and if distinct groups affect child BMI. Additionally, more qualitative research is needed to …
Weight Bias In Pre-Professional Health Students, Heather A. Wemhoener
Weight Bias In Pre-Professional Health Students, Heather A. Wemhoener
Doctoral Dissertations
Weight bias includes negative attitudes or judgements towards people in larger bodies. It is associated with poor health outcomes. Weight bias is highly common in the United States, and pre-professional health students are known to exhibit it. Given its impact, finding effective interventions to reduce weight bias is important. The first paper reviewed literature on existing interventions for weight bias reduction. The search revealed three main intervention types: targeting attributions, increasing empathy, and targeting social consensus. Interventions, regardless of strategy, yielded mixed results for weight bias reduction, and, in some cases, increased bias. The second paper tested a novel intervention …
"The Land That Feminism Forgot": Birthzillas, Madwives, And The Politics Of Chilbirth, Amber Vayo
"The Land That Feminism Forgot": Birthzillas, Madwives, And The Politics Of Chilbirth, Amber Vayo
Doctoral Dissertations
“The Land that Feminism Forgot” is an in-depth exploration of the politics of childbirth that draws together qualitative and quantitative evidence to theorize the connections between treatment in childbirth and maternal mortality. Situating the qualitative research in the larger national context, the second chapter offers a State Reproductive Autonomy Index that provides an overview of the reproductive policy landscape at the national level. The dissertation then explores the role of institutionalized childbirth, medical mistrust, and obstetric violence in the U.S.’s longstanding maternal mortality crisis and offers policy suggestions in key public health areas. Through 120 qualitative interviews with people who …
Evidence Assisted Learning For Clinical Decision Support Systems, Bhanu Pratap Singh Rawat
Evidence Assisted Learning For Clinical Decision Support Systems, Bhanu Pratap Singh Rawat
Doctoral Dissertations
Clinical decision support systems (CDSS) provide intelligently filtered knowledge and patient-specific and population information to the clinicians, nursing staff and healthcare professionals. CDSS can significantly improve the quality, safety, efficiency and effectiveness of health care. Over the last decade, American hospitals have adopted electronic health records (EHRs) widely resulting in a massive collection of clinical notes such as admission notes, physician notes, nursing notes and discharge summaries. For the past couple of decades, most of the work in CDSS has been focused on developing knowledge-based systems using structured data such as medications and ICD codes. In contrast, the EHR notes …
Bifidobacterial Metabolism Of Fucosylated Human Milk Oligosaccharides Influences Structure And Function Of The Infant Gut Microbiome, Liv R. Dedon
Doctoral Dissertations
Human milk contains human milk oligosaccharides (HMOs) that are indigestible and pass intact through the infant gastrointestinal tract where they are available for microbial metabolism. HMOs incorporate the same monosaccharide building blocks but vary structurally in primary sequence of monomeric components. Primary sequences are further diversified by degree of polymerization, branching, and secondary modifications such as fucosylation. Fucosylated HMOs (fHMOs) are highly abundant and can account for over 30% of total HMOs. Infant-colonizing Bifidobacterium longum subsp. infantis (B. infantis) possesses a specialized gene cluster conveying the ability to metabolize fHMOs. This study presents an in-depth analysis of B. …
The Political Economy Of Intimate Partner Violence And Crisis Management: An Institutional Ethnography In Rural Vermont, Anna L. Mullany
The Political Economy Of Intimate Partner Violence And Crisis Management: An Institutional Ethnography In Rural Vermont, Anna L. Mullany
Doctoral Dissertations
Intimate partner violence (IPV) is a significant public health issue affecting one in four women in the United States. Tasked with addressing IPV, crisis centers can significantly impact women’s health outcomes and approaches to perpetrator accountability and community education. Informed by eight months of field work at a rural crisis center and 40 in-depth interviews, this dissertation investigated how the lives of Vermont women experiencing violence and crisis center work are both shaped by larger social, political, and economic relations within capitalism. Dorothy Smith’s method of institutional ethnography provides an investigative pathway for centering survivor experiences and examining crisis center …
Mixture Models For Interval Censored Outcomes, Yibai Zhao
Mixture Models For Interval Censored Outcomes, Yibai Zhao
Doctoral Dissertations
Silent events such as the first detectable HIV infection, the onset of Type 2 diabetes and prostate cancer progression are often ascertained by diagnostic tests and/or self-reports that are scheduled periodically. In such applications, we only observe the time to the event of interest to lie between the times of last negative and the first positive tests, resulting in interval-censored observations. In addition, in some medical studies, a substantial proportion of participants may experience the events before the study, so-called prevalent cases, or participants may never experience the event, that is regarded as non-susceptible cases (or indolent cancer or long-term …
Interplay Of Environmental Pollutants And Folate In The Etiology Of Autistic Traits Analysis Using Multipollutant Approaches, Michael T. Mascari
Interplay Of Environmental Pollutants And Folate In The Etiology Of Autistic Traits Analysis Using Multipollutant Approaches, Michael T. Mascari
Doctoral Dissertations
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a spectrum of communication deficits and repetitive behaviors. The challenges in learning, thinking, and problem-solving abilities of people with ASD can be debilitating. There is currently no cure for ASD. Many environmental pollutants are suspected to contribute to the etiology of ASD and its associated traits, whereas folate and folate supplements have been shown to exhibit both protective and adjuvant roles. Little is known about the interplay of multiple environmental pollutants and folate in the etiology of ASD. Additionally, statistical approaches that consider the effects of pollutant mixtures instead …
The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner
The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner
Doctoral Dissertations
Cardiovascular disease and type 2 diabetes are global epidemics affecting approximately 127 and 21 million people in the U.S., respectively. Women who are overweight, obese or who develop glucose intolerance during pregnancy represent high-risk groups for the development of cardiovascular disease and type 2 diabetes. Hispanic women are both more likely to begin their pregnancies as overweight or obese and have a higher prevalence of type 2 diabetes, compared to non-Hispanic whites. However, prior lifestyle interventions have largely been limited to non-Hispanic whites. Therefore, this research assessed how culturally tailored lifestyle modification may affect cardiovascular disease and type 2 diabetes …
Endocrine Disrupters And Adverse Health Outcomes Among Post-Menopausal Women, Gabriela Vieyra
Endocrine Disrupters And Adverse Health Outcomes Among Post-Menopausal Women, Gabriela Vieyra
Doctoral Dissertations
Globally, chronic diseases that require ongoing medical attention, and limit daily living activities, are the leading cause of disability and mortality. The older population in the U.S. is rapidly growing, and the risk of chronic diseases is higher in this population, specifically older women. In 2018, 51.3% of women compared to 41.8% of men had two or more chronic conditions. Thus, the Women’s Health Initiative (WHI) study, Chapter 1, focused on preventing leading causes of death, disability, and frailty in older women. Phthalates are synthetic industrial compounds, Chapter 2, commonly added to daily used consumer goods, nutritional and dietary supplements, …
Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones
Quality Of Life For Women With Chronic Lyme Disease: A Socioeconomic Investigation, Dale M. Jones
Doctoral Dissertations
This is a mixed methods investigation of how chronic Lyme disease, including Lyme-like diseases and co-infections, affects the quality of life of women who have chronic Lyme. Both quantitative and qualitative methods were used during three phases of research: a 91-question survey instrument followed by focus group discussions and written narratives. The research considered the socioeconomic impact on quality of life in five areas: obtaining a diagnosis, relationships and personal support systems, struggles with the medical system, the ability to work, and access to treatment. There were 500 responses to the survey, of which 373 were analyzed; 11 participants in …
Elucidating Mechanisms Influencing Maternal Postpartum Health: The Protective Benefits Of Breastfeeding And Associations With Allostatic Load, Experiences Of Stress, And Resiliency, Bi-Sek J. Hsiao
Doctoral Dissertations
Research has established breastfeeding as protective of maternal health, but little is known about the ways breastfeeding interacts with chronic stress pathways and interfaces with stressors such as discrimination and neighborhood deprivation, which are salient in the experiences of many marginalized communities. This research addresses these knowledge gaps through secondary analyses of prospective cohort data generated by the Community Child Health Research Network through Community Based Participatory Research processes. Analytical samples were derived from 2510 postpartum women from five regions in the U.S. who self-identified as Black, Hispanic, or White. Study 1 investigated and found an inverse association between breastfeeding …
Sperm Epigenetics Mediates The Effects Of Paternal Preconception Phthalate Exposures And Aging On Reproductive Outcomes And Embryonic Programming, Oladele Amos Oluwayiose
Sperm Epigenetics Mediates The Effects Of Paternal Preconception Phthalate Exposures And Aging On Reproductive Outcomes And Embryonic Programming, Oladele Amos Oluwayiose
Doctoral Dissertations
Infertility, which is the inability to achieve clinical pregnancy within 12 months of unprotected sexual intercourse, affects 15% of all couples globally. Emerging evidence shows, just as females, males are equally likely to contribute to couple infertility, suggesting the relevance of male factor in couple reproductive success. The potential factors thought to drive male infertility include male preconception environment and aging. Thus, this dissertation focused on two (DNA methylation and small non-coding RNAs (sncRNAs)) of the three major potential epigenetic mediators that occur during spermatogenesis and sperm maturation prior to conception using human and mice model. First, to explore the …
Decision-Analytic Models Using Reinforcement Learning To Inform Dynamic Sequential Decisions In Public Policy, Seyedeh Nazanin Khatami
Decision-Analytic Models Using Reinforcement Learning To Inform Dynamic Sequential Decisions In Public Policy, Seyedeh Nazanin Khatami
Doctoral Dissertations
We developed decision-analytic models specifically suited for long-term sequential decision-making in the context of large-scale dynamic stochastic systems, focusing on public policy investment decisions. We found that while machine learning and artificial intelligence algorithms provide the most suitable frameworks for such analyses, multiple challenges arise in its successful adaptation. We address three specific challenges in two public sectors, public health and climate policy, through the following three essays. In Essay I, we developed a reinforcement learning (RL) model to identify optimal sequence of testing and retention-in-care interventions to inform the national strategic plan “Ending the HIV Epidemic in the US”. …
Oxybenzone And The Mammary Gland: Impact Of An Environmental Pollutant On Health, Disease & Ethical Decision-Making, Klara Matouskova
Oxybenzone And The Mammary Gland: Impact Of An Environmental Pollutant On Health, Disease & Ethical Decision-Making, Klara Matouskova
Doctoral Dissertations
The environmental pollutant and common sunscreen compound oxybenzone is a benzophenone type UV light chemical filter used in industrial and consumer goods. This chemical widely contaminates human tissues, non-human species, and environmental matrices. In this dissertation, oxybenzone is investigated for its effects on the mouse mammary gland in the offspring following perinatal exposure; after perinatal and prepubertal exposures as a dual environmental insult during two sensitive times of development; and in adults after exposure during pregnancy & lactation as an environmental factor potentially increasing the tissue susceptibility to mammary tumors. Chapter 1 introduces the mammary gland. Chapter 2 reviews UV …
Factors Associated With The Perception Of Diet Quality: Analysis Of The National Health And Nutrition Examination Survey (Nhanes) 2007-2018, Kiara Y. Amaro-Rivera
Factors Associated With The Perception Of Diet Quality: Analysis Of The National Health And Nutrition Examination Survey (Nhanes) 2007-2018, Kiara Y. Amaro-Rivera
Doctoral Dissertations
Perceived diet quality is a potential modifiable factor that could explain dietary choices. Research has shown that some individuals tend to misperceive the healthfulness of their diet, rating it more or less healthy than it actually was when compared to dietary recommendations. In particular, overestimation of diet quality has been associated with lower intention to change dietary behaviors. Using the National Health and Nutrition Examination Survey (NHANES) dataset, this dissertation explores factors associated with the perception of diet quality among U.S. adults. In Chapter 1, we derived dietary patterns using latent class analysis and explored their association with perceived diet …
Applied Infectious Disease Forecasting For Public Health, Graham Gibson
Applied Infectious Disease Forecasting For Public Health, Graham Gibson
Doctoral Dissertations
Infectious disease modeling has emerged as a powerful data driven tool for monitoring outbreaks, assessing intervention strategies, and allocating public health resources. This thesis addresses a variety of challenges faced in real-world infectious disease forecasting. We first present methods for aggregating forecasts made at different spatial scales, where explicitly modeling the spatial dependency would be computationally prohibitive. We then extend the mechanistic model framework to create an operational forecasting model capable of handling real-world COVID-19 surveillance system issues. Finally, we propose a new framework for merging mechanistic and statistical approaches to infectious disease forecasting. This framework allows modelers to construct …
High-Dimensional Feature Selection And Multi-Level Causal Mediation Analysis With Applications To Human Aging And Cluster-Based Intervention Studies, Hachem Saddiki
Doctoral Dissertations
Many questions in public health and medicine are fundamentally causal in that our objective is to learn the effect of some exposure, randomized or not, on an outcome of interest. As a result, causal inference frameworks and methodologies have gained interest as a promising tool to reliably answer scientific questions. However, the tasks of identifying and efficiently estimating causal effects from observed data still pose significant challenges under complex data generating scenarios. We focus on (1) high-dimensional settings where the number of variables is orders of magnitude higher than the number of observations; and (2) multi-level settings, where study participants …
Investigating The Developmental Impacts Of 3,3’-Dichlorobiphenyl (Pcb-11) In Zebrafish (Danio Rerio), Monika A. Roy
Investigating The Developmental Impacts Of 3,3’-Dichlorobiphenyl (Pcb-11) In Zebrafish (Danio Rerio), Monika A. Roy
Doctoral Dissertations
The environmental pollutant 3,3’-dichlorobiphenyl (PCB-11) is a lower-chlorinated polychlorinated biphenyl (PCB) congener present in air and water samples. Both PCB-11 and its metabolite, 4-PCB-11-Sulfate, are detected in humans, including in pregnant women. The work conducted for this dissertation takes a developmental toxicology approach and uses zebrafish (Danio rerio) to investigate PCB-11’s potential impacts to the liver and pancreas. Chapter 1 introduces PCBs and the current knowledge gaps. Chapter 2 investigates PCB-11 interactions in short-term 4-day exposures with the Aryl hydrocarbon receptor (Ahr) pathway in both 0-20 mM individual and mixture exposures with other Ahr agonists. In Chapter 3, …
Sleep, Reproduction, And Pregnancy, Joshua R. Freeman
Sleep, Reproduction, And Pregnancy, Joshua R. Freeman
Doctoral Dissertations
Sleep, and particularly sleep timing, prior to conception may be important for reproductive and pregnancy health. Evidence of a biological mechanism relating sleep to reproductive health from laboratory studies suggests that sleep may influence the hypothalamic-pituitary-ovarian (HPO) axis. The role of sleep in the HPO axis may also impact many reproductive outcomes including reproductive hormones, ovulation, pregnancy, live birth, pregnancy loss, and adverse pregnancy outcomes. However, epidemiological evidence for associations between sleep, especially sleep timing, and these reproductive health endpoints is limited with most studies typically assessing shift work, and not sleep patterns directly. To address these gaps, we evaluated …
Mental Health And Adiposity: The Effects Of Racial Discrimination And Social Relationships, Nicole D. Fields
Mental Health And Adiposity: The Effects Of Racial Discrimination And Social Relationships, Nicole D. Fields
Doctoral Dissertations
Excess adiposity is associated with increased risk of cardiovascular disease, type 2 diabetes, and premature mortality. It is well-documented that Black women are disproportionately affected by excess adiposity. Research has focused on lifestyle factors, such as diet and physical activity, to explain the higher prevalence of obesity among Black women compared to white women; however, there is much less research on the association between psychological distress and adiposity, which may be important for understanding racial disparities. To date, no studies have examined the social context by which mental health and physical health are related. Black women in U.S. society live …
Policing And Health: Police Encounters As A Fundamental Cause Of Racial Health Disparities, Richard S. Carbonaro
Policing And Health: Police Encounters As A Fundamental Cause Of Racial Health Disparities, Richard S. Carbonaro
Doctoral Dissertations
Structural racism has taken many forms throughout American history and to this day continues to drive social, economic, and health inequalities. Mass incarceration is a modern tool of social marginalization with well documented and deep-rooted racial inequalities. Research has continually shown that mass incarceration negatively impacts the health of disadvantaged communities. Even police stops, the most common and mundane form of criminal justice contact has been linked with deleterious health outcomes at the individual and community level. In this dissertation, I identify specific social and biological mechanisms connecting encounters with the police and health outcomes. In the first chapter, I …
Tai Chi And Mindfulness Training To Improve Balance In People With Multiple Sclerosis: A Community-Based Intervention Study, Julianna Eve
Tai Chi And Mindfulness Training To Improve Balance In People With Multiple Sclerosis: A Community-Based Intervention Study, Julianna Eve
Doctoral Dissertations
Introduction: Tai Chi and meditation have led to improved quality of life, and reduced fatigue and depressive symptoms in people with multiple sclerosis (MS). Tai Chi interventions have successfully improved balance, however the few studies evaluating meditation impact on motor skill improvement have reported conflicting results. Benefits of meditation on improving alertness and attention have been reported, but it is unknown whether these benefits might extend to physical balance. Objective: determine the impact of an 8-week Tai Chi or Mindfulness Based Stress Reduction (MBSR) intervention on physical balance, psychosocial wellbeing, and sensorimotor function; and whether benefits are retained after …
Hospital Assessment And Response To Environmental Pollution As A Population Health Need: Identifying Prevalence And Predictors In Community Benefit Practices, Sarah Valentine
Doctoral Dissertations
Hospitals have a growing role in improving population health. Environmental pollution is an important determinant of health with disproportionate effects on Communities of Color. This warrants hospital action. To advance such action, it is important to take stock of current hospital engagement with environmental pollution and to identify factors associated with such engagement. I investigated the following. To what extent do New York State (NYS) non-profit hospitals assess, identify, and respond to environmental pollutants as part of community benefit practices? Do factors previously reported as associated with hospital engagement of social determinants predict engagement with environmental pollution as a community …
Geographical Disparity Of Adverse Childhood Experiences And Chronic Diseases In Saudi Arabia, Fahad Alhowaymel
Geographical Disparity Of Adverse Childhood Experiences And Chronic Diseases In Saudi Arabia, Fahad Alhowaymel
Doctoral Dissertations
Background: Adverse childhood experiences (ACEs) have been linked to numerous negative physical and mental health outcomes and have been shown to increase risk for chronic diseases in adulthood. In Saudi Arabia, few studies have examined ACEs prevalence and their relation to chronic diseases across geographical settings. Purpose: The purpose of this study was to examine ACEs prevalence and association with chronic diseases across the provinces of Saudi Arabia, and to determine the moderating effect of geographical setting on the ACE-chronic disease relationship. Methods: A cross-sectional design was used with an existing Saudi national dataset from the National Family Safety Program …
Redox Signaling In The Zebrafish Embryo And Implications For Endocrine Pancreas Morphogenesis, Archit Rastogi
Redox Signaling In The Zebrafish Embryo And Implications For Endocrine Pancreas Morphogenesis, Archit Rastogi
Doctoral Dissertations
The glutathione (GSH) system evolved to combat oxygen toxicity in nearly all living organisms, and serves as the predominant cellular redox buffer in vertebrates. This dissertation explores the roles of GSH during embryogenesis using the zebrafish (Danio rerio). The first agnostic in vivo characterization of GSH utilization in the embryo revealed strict spatiotemporal GSH profiles in developing organ systems. Interruption of these GSH profiles by exogenous xenobiotics led to organ specific adverse developmental outcomes; pancreatic β-cells were found to be especially susceptible and developed atypical morphologies following redox active xenobiotic exposures. Pancreatic β-cells lacked expression of Nrf2a (Nuclear …
Rare Diseases In The United States: Establishing Prevalence, The Insurance Experience, And Orphan Drug Expenditures In Medicare Part D, Tai Pasquini
Doctoral Dissertations
In the United States, there are an estimated 30 million people living with one or more rare diseases. Each rare disease impacts fewer than 200,000 people. Small patient populations create research and medical challenges. Patients and the healthcare system experience high costs. To adequately address patient needs and prepare our healthcare system, it is critical that we conduct research that contextualizes the U.S. rare disease experience. This dissertation includes three related studies that look at the U.S. rare disease experience. The first paper investigates the availability and data quality of rare disease prevalence estimates and the healthcare infrastructure that could …
Cross-Cutting Narratives Of Opioid Use Disorder Among Pregnant Women And Mothers: Implications For Humanistic Care, Alice Fiddian-Green
Cross-Cutting Narratives Of Opioid Use Disorder Among Pregnant Women And Mothers: Implications For Humanistic Care, Alice Fiddian-Green
Doctoral Dissertations
Opioid-related fatalities in the U.S. have increased drastically. Pregnant women and mothers with opioid use disorders (OUD) are a rapidly growing and vulnerable population. Using a critical narrative approach, this dissertation examines how the syndemic of trauma, substance use, and mental health conditions influences opioid use and treatment trajectories among pregnant women and mothers across the lifecourse. The goal of this dissertation was to examine three discursive resources that shape the social construction of perinatal and maternal opioid use across all strata of social life: macro-level (news media), meso-level (scientific), and micro-level (individual) narratives. Informed by 18-months of ethnographic observation, …
Improving Chinese Mothers’ Health Literacy: A Wechat Intervention, Qiong Chen
Improving Chinese Mothers’ Health Literacy: A Wechat Intervention, Qiong Chen
Doctoral Dissertations
The health literacy and eHealth literacy of women during the reproductive age is crucial, as it can affect their health and the health of their children. Promoting health literacy is essential to achieve mothers’ empowerment by improving access to and capacity of using health information effectively. However, functional, interactive, and critical health literacy and eHealth literacy have never been assessed among Chinese women. The first study during this dissertation assessed functional, interactive, and critical health literacy and eHealth literacy among 421 of Chinese mothers with children under 3 years old. The results revealed overall less than optimal level of health …