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Full-Text Articles in Medicine and Health Sciences

Distributing Condoms And "Hope": Race, Sex, And Science In Youth Sexual Health Promotion, Chris A. Barcelos Nov 2016

Distributing Condoms And "Hope": Race, Sex, And Science In Youth Sexual Health Promotion, Chris A. Barcelos

Doctoral Dissertations

This project uses discursive, visual, and ethnographic approaches situated in a critical feminist methodology to understand how ways of knowing about youth sexuality and reproduction influence community health work. I understand the “problem” in this inquiry as the discursive contexts that limit critical ways of knowing about young people’s sexual subjectivities and practices and about the design of policies and programs. Although race, class, gender, and sexuality are understood in the public health literature as important social determinants of health, there is a lack of research that applies a critical, feminist lens to these constructs. I draw on three years …


Gestational Weight Gain And Maternal Health Among Hispanic Women, Megan W. Harvey Nov 2016

Gestational Weight Gain And Maternal Health Among Hispanic Women, Megan W. Harvey

Doctoral Dissertations

More than 70% of women do not gain within their target range of gestational weight gain (GWG), as recommended by the Institute of Medicine (IOM) in 2009. Risks associated with inadequate GWG include small-for-gestational age, low birthweight, pre-term birth, and difficulty establishing breastfeeding. Risks associated with excessive GWG include large-for-gestational-age, macrosomia, and delivery complications. There are also long-term consequences for maternal and fetal metabolic processes. Higher pre-pregnancy BMI, lower education level, and higher parity are known risk factors for excessive GWG. There are also possible racial / ethnic differences, and Hispanic women, in particular, may be at high risk for …


Mobile Produce Markets: A Strategy For Increasing Access To Fruits And Vegetables Among Low Income Urban Residents, Bi-Sek J. Hsiao Nov 2016

Mobile Produce Markets: A Strategy For Increasing Access To Fruits And Vegetables Among Low Income Urban Residents, Bi-Sek J. Hsiao

Masters Theses

Mobile produce markets (MPM) are a community-based strategy to improve produce access in areas with few fruits and vegetables (FV) retail options. The purpose of this thesis is to assess the functionality of MPM in low-income urban neighborhoods. This thesis includes three studies. Study 1 investigates FV availability in areas around MPM locations (n=13). We found limited fresh FV availability in stores, but high prevalence of 100% juice, and canned FV and beans. Study 2 applied questionnaire data from MPM shoppers (n=143) to assess MPM experiences. Chi Square was used to compare shopping behaviors between older (≥ 60) and younger …


A Comparison Of Techniques For Handling Missing Data In Longitudinal Studies, Alexander R. Bogdan Nov 2016

A Comparison Of Techniques For Handling Missing Data In Longitudinal Studies, Alexander R. Bogdan

Masters Theses

Missing data are a common problem in virtually all epidemiological research, especially when conducting longitudinal studies. In these settings, clinicians may collect biological samples to analyze changes in biomarkers, which often do not conform to parametric distributions and may be censored due to limits of detection. Using complete data from the BioCycle Study (2005-2007), which followed 259 premenopausal women over two menstrual cycles, we compared four techniques for handling missing biomarker data with non-Normal distributions. We imposed increasing degrees of missing data on two non-Normally distributed biomarkers under conditions of missing completely at random, missing at random, and missing not …


Macronutrients And The Risk Of Premenstrual Syndrome, Serena C. Houghton Jul 2016

Macronutrients And The Risk Of Premenstrual Syndrome, Serena C. Houghton

Doctoral Dissertations

Premenstrual syndrome (PMS) affects 8-20% of reproductive-aged women, impacting work, family, and social interactions. Limitations in available PMS treatments, including side effects and limited medication efficacy, indicate the need for improved prevention. Modifiable risk factors for prevention of PMS include dietary factors. Several micronutrients have been identified as risk factors, but there has been little evaluation of macronutrients. Thus, the research aim was to examine prospectively whether macronutrient consumption was associated with PMS development among a subset of women enrolled in the Nurses’ Health Study II cohort. Chapter 1 evaluates the association of fat intake and PMS risk. Among 3,638 …


Feasibility Of A Combined Physical Activity And Sleep Education Intervention For Girls Living In A Low Socioeconomic Status Urban Community, Cory J. Greever Jul 2016

Feasibility Of A Combined Physical Activity And Sleep Education Intervention For Girls Living In A Low Socioeconomic Status Urban Community, Cory J. Greever

Doctoral Dissertations

Declining sleep duration and poor sleep quality is a public health epidemic disproportionately effecting elementary age girls living in low socioeconomic status urban communities. The Girls Dancing and Sleeping for Health (Girls DASH) program was designed to test the feasibility, acceptability, and efficacy of a combined physical activity and sleep education program in this population. In combination with baseline data from a previously conducted intervention in elementary age urban girls living in a low SES community in Springfield, MA, results from a cross-sectional analysis indicated that greater screen time was positively associated with parental reports of child’s sleep quality. Additionally, …


Transformative Learning Facilitated Dialogue: As A Tool For Social Change An Autoethnography, Leslie A. Saulsberry Jul 2016

Transformative Learning Facilitated Dialogue: As A Tool For Social Change An Autoethnography, Leslie A. Saulsberry

Doctoral Dissertations

It is my goal, through this autoethnography, to take you through a reflective journey and present to you my personal theory of how facilitated dialogue in the context of transformative learning, critical reflection, systems thinking, shared vision, and holarchy can create a paradigm shift in our personal consciousness, decisions, behaviors, practice, and social policies—social change. My objective is to show how each theory is like a stepping-stone in the path towards social change. The purpose of this living work is to offer an alternative way of creating a healthy and whole society by exploring how facilitated dialogue can lead to …


Sleep Patterns, Urinary Levels Of Melatonin And Subsequent Weight Change In The Women’S Health Initiative Observational Study, Nicole M. Barron Jul 2016

Sleep Patterns, Urinary Levels Of Melatonin And Subsequent Weight Change In The Women’S Health Initiative Observational Study, Nicole M. Barron

Masters Theses

Results from prospective studies examining associations between sleep duration and weight gain have been mixed. Melatonin has been hypothesized to mediate the association between sleep duration and weight/body composition. In cross-sectional studies, aMT6s has been shown to be inversely associated with weight/body fat percentage. We examined associations between baseline sleep duration, insomnia status, aMT6s levels with weight/body fat percentage through 6 years, utilizing a subset 690 women who participated in a breast cancer case-control study nested within the WHI-OS. Multi-variable and mixed-effects regression was used to calculate beta-coefficients and 95% confidence intervals. Cross-sectional analyses showed urinary aMT6s levels were inversely …


A Comparative Sustainability Study For Treatment Of Domestic Wastewater: Conventional Concrete And Steel Technology Vs. Vegetated Sand Beds (Vsb’S) And Their Relative Differences In Co2 Production, Alicia M. Milch Jul 2016

A Comparative Sustainability Study For Treatment Of Domestic Wastewater: Conventional Concrete And Steel Technology Vs. Vegetated Sand Beds (Vsb’S) And Their Relative Differences In Co2 Production, Alicia M. Milch

Masters Theses

Conventional wastewater treatment in the U.S. is an energy dependent and carbon dioxide emitting process. Typical mechanical systems consume copious amounts of energy, which is most commonly produced from fossil fuel combustion that results in the production of CO2. The associated organic load is also metabolized by microorganisms into CO2 and H2O. As the desire to reduce CO2 output becomes more prominent, it is logical to assess the costs of conventional treatment methods and to compare them to alternative, more sustainable technology. Vegetated Sand Bed (VSB) and Reed Bed (RB) systems are green technologies …


Antidepressant Use And Risk Of Colorectal Cancer In The Women's Health Initative, Jenna F. Kiridly Jul 2016

Antidepressant Use And Risk Of Colorectal Cancer In The Women's Health Initative, Jenna F. Kiridly

Masters Theses

Colorectal cancer is the third most common cancer among U.S. women; 63,610 new cases were estimated to have occurred in 2015. Prior studies found a reduced risk of colorectal cancer among antidepressant (AD) users, however, none adjusted for depression, which is itself linked to increased colorectal cancer risk and could confound this relationship. We assessed the relationship between ADs and AD drug classes with risk of colorectal cancer in a prospective cohort of 145,190 women between the ages of 50-79 without a previous history of cancer at enrollment. Current AD use was assessed at baseline. Over an average follow-up of …


The Adoption Of Harm Reduction By Abstinence Program Staff: A Qualitative Analysis, Morgan Coe Jul 2016

The Adoption Of Harm Reduction By Abstinence Program Staff: A Qualitative Analysis, Morgan Coe

Masters Theses

Opioid overdose fatalities have quadrupled in the United States since the turn of the century, and are becoming increasingly recognized as a nationwide epidemic. While naloxone (narcan) has long been the standard treatment for overdose in clinical settings, it has not been issued to opioid users or their family members in the U.S. until relatively recently. As naloxone distribution and overdose training become more widespread, they are being incorporated into more and more abstinence-oriented settings including detoxes, halfway houses, and outpatient methadone and suboxone treatment programs. This qualitative study explored whether the staff at such programs found that training their …


Essays On Household Health Expenditures, National Health Insurance And Universal Access To Health Care In Ghana, Evelyn Kwakye Mar 2016

Essays On Household Health Expenditures, National Health Insurance And Universal Access To Health Care In Ghana, Evelyn Kwakye

Doctoral Dissertations

Access to quality health services is essential for maintaining a healthy population and economic development hence the growing global consensus that universal health coverage is necessary. Ghana attempts to expand access by making basic health services free at the point of delivery through its National Health Insurance Scheme (NHIS). Prior studies indicate NHIS increases demand for health services, but questions remain about its impact on out of pocket payments, quality of services, and the financial viability of the program. Hence, this dissertation analyzes the financial risk in health care seeking, the effect of NHIS on out of pocket payments and …