Medicine and Health Sciences Commons^™

Precarity Beyond Food: How The Closure Of An Independent Grocery Store Shed Light On The Limitations Of Food Access Efforts In Syracuse, New York, Katherine Louisa Ravene Mott

Theses - ALL

On September 11, 2017, the owner of an independent grocery store in Syracuse, New York’s Near Westside neighborhood announced that the store would close within the month. The Near Westside is often characterized by its high levels of concentrated poverty for African American and Hispanic neighborhood residents. Nojaim Brothers Supermarket opened in 1919 and persisted for 97 years amidst an unfavorable political and economic landscape marked by the creation of both chain grocery stores and supermarkets as well as the effects of urban renewal and disinvestment. I argue that Nojaim’s endurance can be attributed to the embeddedness of the grocery …

Cytochrome P450 Monooxygenase-Mediated Lipid Metabolism In Obesity And Colon Tumorigenesis, Weicang Wang

Doctoral Dissertations

Colon cancer is a major public health issue: it is expected to have 140,250 new cases and 50,630 deaths during 2018, making colon cancer the third most common type of cancer and the second leading cause of cancer death in the United States. Obesity is associated with enhanced colonic inflammation, which is a major risk factor of colorectal cancer. Currently, more than 35% of adults and nearly 17% of children are obese. Considering the obesity and colon cancer epidemic in the United States, there is an urgent need to identify novel therapeutic targets for obesity and colon cancer. Here, using …

A Quality Improvement Project To Determine The Incidence And Prevalence Of Obstructive Sleep Apnea, Best Practice Anesthesia Guidelines, And The Incidence Of Perioperative Cardiac And Respiratory Complications After The Implementation Of The Stop-Bang Questionnaire, Bradly Diamond, Gregory Guerrier, Cody Holliman, Robert Marrero, Tyler Nelson

Doctoral Projects

Patients with obstructive sleep apnea (OSA) are at risk for perioperative respiratory and cardiovascular compromise (Opperer et al., 2016). Unfortunately, almost 90% of patients with moderate-to-severe OSA are not diagnosed and unaware of their disorder; however, they remain at increased perioperative risks (Singh et al., 2015). The STOP-BANG questionnaire was developed to meet the need for a reliable, concise, and efficient screening tool for OSA risk. The facility at which this project was conducted did not utilize a prescreening OSA risk tool. The facility not using a prescreening OSA risk tool is especially important because the State of Mississippi currently …

Impact Of Best Practice Guideline Statement On Anesthesia Practice In Rural Mississippi Hospitals With Obese Patients Undergoing Total Knee Arthroplasty, Steven Hodnett

Doctoral Projects

The aim of this best practice guideline (BPG) was to be a resource for anesthesia providers practicing with obese patients undergoing total knee arthroplasty (TKA) and to measure the knowledge of these providers. After dissemination of an executive summary to anesthesia providers in two hospitals in rural Mississippi, an anonymous online survey was provided via Qualtrics software for voluntary participation. The survey consisted of 10 questions. The data collection period was five weeks. Respondents are noted at N=2, and the data was reviewed and categorized into one of three domains (i.e., knowledge, practice, and safety). In the domain of knowledge, …

Extreme Obesity Among Adults In The United States: Spatial Variation And The Association With Mortality, Carrie Mills

Dissertations and Theses

Objectives: The purpose of this dissertation was to create small area estimates to describe and explore the county-level spatial variation of extreme obesity among adults in the United States and to assess the county-level association and spatial variation of extreme obesity and mortality.

Methods: The Behavioral Risk Factor Surveillance System was used in conjunction with data from the Census Bureau to estimate county-level model-predicted prevalence of extreme obesity using multilevel regression and poststratification. Spatial dependence of estimates was assessed using global Moran’s Index, and local Moran’s Indices were used to identify clusters of higher and lower rates of extreme obesity …

Identifying Pediatric Obesity In The Retail Health Setting And Implications For Quality, Jodie Nicole Guardi

College of Science and Health Theses and Dissertations

Pediatric obesity has reached an epidemic status. The purpose of this study was to examine the prevalence of overweight and obese patients, as well as how often and how accurately a diagnosis was coded. The population for this study included children ages 3-18. This cohort presented to retail health clinics in a large urban health system for school or sports physicals from June 1, 2017 to November 30, 2017. Method. A retrospective chart review was conducted. Statistical analysis was performed to determine if there was a relationship between obesity and age, ethnicity, race, and gender. Results. The study identified 15.9% …

Diabetes, Bonsitu Hubena

Nursing Student Class Projects (Formerly MSN)

Diabetes is a serious chronic disease that can affect different body systems. There are two categories of diabetes. In Type 1 diabetes, insulin production is diminished or absent due to autoimmune attack on the beta cells in the pancreas. Type 2 diabetes occurs as a result of insulin resistance due to beta cell failure. Although the cause is unknown, some of the contributing factors of diabetes include environmental, genetics, race, and family history. In addition, research has shown a significant linkage between obesity and diabetes. Therefore, it is important to understand the factors that predispose individuals to diabetes as well …

The Role Of Secretory Phospholipase A2 Group Iia In Obesity And Metabolism, Michael S. Kuefner

Theses and Dissertations (ETD)

Secretory phospholipase A2 group IIA (PLA2G2A) is a member of a family of secretory phospholipases previously implicated in inflammation, atherogenesis, and antibacterial actions. These enzymes hydrolyze glycerophospholipids at the sn-2 position releasing lysophospholipids and fatty acids. Though studies have shown PLA2G2A is pro-inflammatory and promotes atherosclerosis, no research has analyzed the role of this enzyme in obesity and metabolism. Studies in the past 5-10 years utilizing various knock- out or over-expression mouse models have analyzed the role of different secretory phospholipase A2s (sPLA2) in metabolic diseases. From these studies, it is known that at least seven of the 11 sPLA2 …

Obesity Suppresses Pigment Epithelium-Derived Factor And Alters Pro-Tumorigenic Signaling Pathways In Prostate Cancer, Nizar Ahmed Khamjan

Theses and Dissertations

Background: Pigment epithelium-derived factor (PEDF), a multifunctional protein, is a potent tumor suppressor and anti-angiogenic factor. PEDF has been identified as a novel regulator of lipid metabolism via binding and activating adipose triglyceride lipase, which stimulates lipolytic pathways. PEDF-deficient mice develop prostatic hyperplasia that progresses to cancer when these mice are fed a high fat diet (HFD). PEDF expression is decreased in prostate cancer (PCa) patient tissues. Conversely, PEDF treatment inhibits PCa growth in mouse models. Recently, our lab has demonstrated that excess oleic acid (OA) treatment, an in vitro obesity model, suppresses secreted PEDF expression in PCa cell lines …

Type 2 Diabetes (T2d), Janice Loney

Nursing Student Class Projects (Formerly MSN)

ABSTRACT

Type 2 diabetes (T2D) is a devastating disease predisposing individuals to a myriad of serious health complications such as: heart disease, stroke, retinopathy, neuropathy, renal disease, dementia, amputation and early death. Diabetes care has a major economic impact worldwide, as a future family nurse practitioner (FNP) patient education on T2D risk factors, disease process and medical management are vital to halt this growing epidemic. A literature search was conducted and five peer reviewed articles were chosen addressing T2D pathophysiology, risk factors, effects of self-care behaviors and emerging treatment options.

Focused efforts from the literature reviews indicate education and adherence …

A Behavioral Weight Loss Program For Low-Income Adults With Obesity And Hiv, Sophai Thach

Dissertations

Problem: Obesity, having a body mass index (BMI) of 30 kg/m² or greater, increases the risk for cardiovascular disease. For people living with HIV (PLWH), this increases their risk for myocardial infarctions by 50% and causes this life-threatening event to occur at a younger age compared to those who are not diagnosed with HIV.

Methods: With obesity disproportionately affecting people with low income, this study aims to evaluate the effects of a 12-week behavioral weight loss program that utilizes journaling as a self-monitoring tool, weekly educational classes, and individualized goal-setting on PLWH with obesity who live in …

The Tampa Gym Study: An Ethnographic Exploration Of Gyms, Female Gym-Goers And The Quest For Fitness In Tampa, Fl, Danielle Reneé Rosen

USF Tampa Graduate Theses and Dissertations

The Tampa Gym Study was an ethnographic examination of veteran women exercisers, their workout routines, and their attitudes towards the workouts that they undertake in two Tampa area gyms. The study’s principle objective was to study “fitness culture” in these facilities and the manner in which that culture is embodied in the language women use to describe themselves and their exercise behaviors.

The obesity crisis in the United States has been significantly responsible for an increase in membership in gyms and fitness facilities nationwide. The “culture of fitness” as it is embodied in these facilities has impacted women and their …

Macrophages And Associated Inflammation Differentially Impact Obesity, Colorectal Cancer And Obesity-Enhanced Colorectal Cancer, Jackie Bader

Theses and Dissertations

Colorectal Cancer (CRC) is the third-most common malignancy for men or women, with chronic inflammation considered as a primary risk factor. Obesity is also considered a chronic inflammatory disease and is associated with increased CRC incidence. Further, obesity and CRC occur in men and women differently with the highest incidence of either disease found in men, suggesting that female sex hormones may play a protective role in inflammatory diseases. Macrophages can promote inflammation and are a driving force in obesity-associated metabolic dysfunction. Conversely, macrophages also contribute to pro-tumoral responses including, proliferation, angiogenesis and tissue remodeling. This heterogeneity of macrophage behavior …

The Contribution Of Adipose Tissue From Ovariectomized Mice To Colon Cancer, Meredith Smith Carson

Theses and Dissertations

Obesity is considered a major public health concern worldwide due to the increased incidences of metabolic dysfunction and cancer risk. The obese state is, in part, attributable to the overconsumption of calorie-dense foods commonly seen in a standard Western diet, which aids in the progression of chronic, lowgrade inflammation. The role of estrogen varies depending on menopausal status, where estrogen deficiency coupled with increased visceral fat associated with post-menopause leads to increased secretions of pro-inflammatory adipokines and cytokines. However, the presence of estrogen in a premenopausal state has been shown to attenuate the pro-inflammatory response, which has been demonstrated when …

The Plant-Based And Soul-Full Study (Pass): Examining How Owners Of Local Vegan Soul Food Restaurants Promote The Consumption Of Vegan Foods In The African American Community, Anthony Crimarco

Theses and Dissertations

Background: Obesity remains a prevalent public health epidemic and African American (AA) adults are disproportionately affected by obesity more than any other ethnic group. There are also disparities in obesity by location, with the South having the highest rates compared to other geographic regions in the United States. Addressing poor dietary habits is important for improving obesity rates among AAs, but there has been limited research that has focused on specifically developing culturally-tailored interventions. With a recent number of soul food restaurants serving exclusively vegan meals opening up across the country to appeal to AAs and others interested in eating …

Childhood Obesity: Getting Back To The Basics, Fanny Powell

DNP Qualifying Manuscripts

Childhood obesity is an epidemic that affects the nation. The Centers for Disease Control and Prevention (CDC) (2015) states that over the past thirty years, the prevalence of childhood obesity has more than doubled in younger children and quadrupled in adolescents (CDC, 2015). Although obesity is a multifactorial health issue that is affected by genetics, metabolic factors, socioeconomic factors, and lifestyle choices (Stanford, 2018), a majority of pediatric obesity is as a result of consuming more energy than the body utilizes. There are both immediate and long-term consequences of obesity that negatively affect a child’s health which may carry over …

Relationship Between Binge Eating Disorder And Circadian Chronotype, Leon B. Jons

Theses & Dissertations

Binge eating disorder (BED) is a common condition in the general population and is more common in individuals with obesity. The later timing of food intake has been associated with an increase incidence of obesity. The purpose of this study was to evaluate the relationship between circadian chronotype and BED in a population of individuals with obesity. The sample consists of a retrospective review of 170 subjects presenting to an obesity medicine clinic who had been clinically evaluated for BED and chronotype.

No significant correlation was found between BED and a late chronotype in this population. In a secondary analysis …

Eat Better Move More: Educational Program Teaching Healthy Eating Habits To Low-Socioeconomic Elementary School Students, Megan March

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obesity is a growing problem and has shown no signs of improvement over the past decade, with an estimated one in five children between the ages of six and seventeen are overweight. This problem is even more prevalent in ethnic minorities and socioeconomically disadvantaged families. The purpose of this study was to examine the effects of the EBMM program nutrition module on 4th and 5th grade student’s food choices. The study was conducted at an elementary school in Northwest Arkansas. A convenience sample of 4^th and 5^th grade students was chosen to participate in the study. Nursing students …

The Prevalence And Context Of Adult Female Overweight And Obesity In Sub-Saharan Africa, Ifeoma Ozodiegwu

Electronic Theses and Dissertations

Adult women bear a disproportionate burden of overweight and obesity in Sub-Saharan Africa (SSA). Precise information to understand disease distribution and assess determinants is lacking. Therefore, this dissertation aimed to: (i) analyze the prevalence of adult female overweight and obesity combined in lower-level administrative units; (ii) analyze the effect modification of educational attainment and age on the association between household wealth and adult female overweight and obesity; (iii) synthesize qualitative research evidence to describe contextual factors contributing to female overweight and obesity at different life stages. Bayesian and logistic regression models were constructed with Demographic and Health Survey (DHS) data …

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Increasing Utilization Of Cognitive Behavioral Therapy To Reduce Morbid Obesity In A Primary Care Setting, Erin J. Mccue

Doctoral Projects

Background: Obesity among adults is characterized by a body mass index (BMI) of 30 or higher. The impairment and disability resulting from obesity indicates a significant health problem that is often seen in primary care settings. Research indicates that cognitive behavioral therapy (CBT) is an underutilized, but extremely beneficial intervention that may support individuals in achieving weight loss. Adults suffering from obesity with or without comorbid conditions such as psychiatric disorders (e.g. anxiety and depression) have benefitted from CBT.

Purpose: To implement the increased utilization of CBT in the adult population with obesity and depression or anxiety in a primary …

A Need For A Culturally Congruent Obesity Intervention At A Community Safety-Net Clinic, Claudia D. Rivera-Salas

Doctoral Projects

Background: Obesity is an epidemic in the United States which causes numerous chronic conditions and disproportionally impacts underserved populations. The removal of barriers that prevent active lifestyles such as unaffordable facilities and inaccessibility are of primary importance in promoting a healthy lifestyle.

Objectives: Collaboration with community organizations to increase access to culturally congruent nutrition and exercise classes for underserved Latino/Hispanic patients of a Midwestern safety-net clinic to reduce obesity, increase physical activity, and improve dietary habits.

Methods: Assessment of current practices revealed the need for project development. Six-week nutrition education class and exercise classes were held for eligible patients which …

The Business Cycle And Health: An Analysis Of How Macroeconomic Conditions Impact Health Outcomes In The U.S., Talitha Kumaresan

Honors Theses

The U.S. spends about twice as much per person on healthcare, yet the disease burden remains higher in the U.S. than in comparable countries (Sawyer and Cox 2018; Sawyer and Gonzales 2017). Although health status is perceived to be an outcome of individual decision making, the business cycle also affects health. While the effect of macroeconomic shocks on health outcomes has been studied extensively, results remain inconclusive. This analysis uses longitudinal data over 30 years and panel data models to examine the effect of macroeconomic conditions on obesity, diabetes, hypertension, depression, congestive heart failure, and heart attack or myocardial infarction. …

Investigation Of The Role For Methyl-Cpg Binding Protein 2 Variant Mbd2_V2 In Cancer Stem Cells And Obesity-Associated Cancers, Emily A. Teslow

Wayne State University Dissertations

Obesity is a risk factor for both TNBC and PCa, and pro-inflammatory features associated with obesity, including upregulated production of ROS, promote CSCs. Previously published work from the Bollig-Fischer laboratory established that TNBC CSCs could be inhibited by neutralizing ROS in culture with H2O2 targeted antioxidants. In this report, antioxidant treatment resulted in the downregulation of mRNA splicing variant MBD2_v2. MBD2_v2 was highly expressed in CSCs versus bulk TNBC cells and supported self-renewal in vitro. As obesity is coupled with increased ROS, we hypothesized that obesity could drive CSCs via MBD2_v2 expression. The work presented in this thesis addressed this …

Sugar-Sweetened Beverages: A Survey To Assess Adults Knowledge, Attitudes, And Consumption Patterns Of Sugar-Sweetened Beverages, Jeff Schafer

All Graduate Theses, Dissertations, and Other Capstone Projects

Sugar-sweetened beverages (SSBs) have a direct impact on the general health of the country when looking at the rising obesity levels (CDC, 2017a). The USDA’s dietary guidelines suggest that the daily intake of added sugar should be limited to 6 teaspoons for women and 9 teaspoons for men (Hughes, 2017). However, the average American consumes 20 teaspoons of sugar daily (Hughes, 2017). These extra calories are converted into fat and stored in the body. Data collected throughout the years indicates a rise in the number of Americans living with a weight above healthy recommendations, which is termed, obese. Obesity is …

Nutrition Education For The Underserved Youth Within The Greater Twin Cities Area Through The Insports Foundation, Paige D. Deters, Allison Kaper, Maura Romanshek

All Electronic Theses and Dissertations

It has been examined that poor access to nutritious foods and limited opportunities for physical activity is prevalent among children from underserved families. These deficiencies contribute to increasing childhood obesity rates and emphasize the need for early interventions. Establishing nutritional literacy and understanding the importance of an active lifestyle in early childhood can lead to long-term health benefits and reduction in chronic disease later in life (HHS & USDA, 2015; Tsai et al., 2011; Wang et al., 2011). The InSports Foundation serves as a comprehensive non-profit organization that addresses many of these issues by providing children from underserved families with …

Correlation Of Body Mass Index Percentile And Craniofacial Morphology: A Retrospective, Cross-Sectional Study, Adam G. Danze

Student Theses, Dissertations and Capstones

Introduction: Obesity rates are rising exponentially in many countries around the world, particularly in the United States. This epidemic is affecting people of all ages, and little to no progress has been made it slow it down. Lack of physical activity and increased consumption of energy rich foods and caloric intake have been recognized as contributing factors for the concerning increase in the prevalence of obesity in child and adult populations. The high prevalence of obesity is believed to be a complex interplay of genetic, environmental, socioeconomic, cultural, and psychological factors. Childhood obesity is occurring at progressively younger ages, leading …

So You Think You Can Exercise: The Gap Between Exercise Confidence And Physical Activity Among Samoan Adults, Diksha Brahmbhatt

Public Health Theses

Samoa is experiencing one of the highest prevalence of overweight and obesity in the world, placing its population at increased risk of developing several noncommunicable diseases including type 2 diabetes and cardiovascular disease. The role of physical activity in reducing the burden of these diseases and overweight is well-established. Exercise self-efficacy or confidence is a predictor, if not determinant, of recreational physical activity. The purpose of this study, therefore, is to assess the relationship between exercise confidence and levels of recreational physical activity among Samoan adults. We confirm that exercise confidence is correlated with time spent exercising. However, despite considerable …

Postpartum Weight Trajectories In A Cohort Of 127 Samoan Women: Does Breastfeeding Protect Against Postpartum Weight Retention?, Grace Castillo

Public Health Theses

Rising global obesity rates impact every aspect of health, including maternal-fetal health. Samoa has a disproportionate burden of obesity, with more than half of Samoan women entering pregnancy obese. Given Samoan women’s high parity (4), postpartum weight retention (PPWR) may be a significant source of weight gain over women’s lifetimes. Little is currently known about PPWR among Samoan women, so this analysis sought to document PPWR trajectories, assess factors – like breastfeeding -- associated with PPWR. Data of 127 mother-infant dyads from the 2017 Foafoaga O le Ola cohort were used in analysis. Researchers collected demographic and lifestyle data, as …

Naktide Targeted To Adipocytes Ameliorates Western Diet Induced Obesity, Rebecca D. Pratt

Theses, Dissertations and Capstones

Obesity has become a worldwide epidemic and is a major risk factor for metabolic syndrome. It is believed that cellular oxidant stress plays a key role in both the development and maintenance of obesity as well as its associated comorbidities such as diabetes, cardiovascular disease, and nonalcoholic steatohepatitis (NASH). We have previously reported that systemic administration of pNaKtide, which targets the Na/K-ATPase oxidant amplification loop was able to decrease oxidative stress and adiposity in mice fed a high fat and fructose supplemented western diet (WD). As adipocytes are believed to play an active role in the development of obesity and …