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Feasibility, Acceptability And Process Evaluation Of A Physical Activity Intervention In Toddler Aged Children: The Tap-A-Long Study, Luke M. Sudarsky Oct 2022

Feasibility, Acceptability And Process Evaluation Of A Physical Activity Intervention In Toddler Aged Children: The Tap-A-Long Study, Luke M. Sudarsky

Masters Theses

Recent literature has suggested the importance of physical activity in early childhood such as during the toddler years (12 months - 3 years.) Despite this, most toddlers are not physically active. There is a need to determine the types of physical activity programs that would interest toddlers within the settings they spend a significant amount of time in (e.g., childcare center). Currently, data on the feasibility, implementation, and process evaluation of physical activity interventions in toddler age children attending childcare centers is lacking within the literature. Therefore, the purpose of the Toddler Activity Pilot (TAP-A-LONG) study was to examine the …


The Political Economy Of Intimate Partner Violence And Crisis Management: An Institutional Ethnography In Rural Vermont, Anna L. Mullany Oct 2022

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 Oct 2022

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 Sep 2022

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 …


Development Of A Predictive Model For Frailty Utilizing Electronic Health Records, Kye Poronsky Jun 2022

Development Of A Predictive Model For Frailty Utilizing Electronic Health Records, Kye Poronsky

Masters Theses

Frailty is a multifaceted, geriatric syndrome that is associated with age-related declines in functional reserves resulting in increased risks of in-hospital death, readmissions and discharge to nursing homes. The risks associated with frailty highlights the need for providers to be able to quickly, and accurately, assess someone’s frailty level. Previous studies have shown that bedside clinician assessment is not a reliable or valid way to determine frailty, meaning that a more reliable, valid and concise method is needed. We developed a prediction model using discharge ICD-9/ICD-10 diagnostic codes and other demographic variables to predict Reported Edmonton Frail Scale scores. Participants …


Preterm Birth And Subsequent Risk Of Type 2 Diabetes Among Postmenopausal Women In The Women’S Health Initiative, Aaron Holman-Vittone Jun 2022

Preterm Birth And Subsequent Risk Of Type 2 Diabetes Among Postmenopausal Women In The Women’S Health Initiative, Aaron Holman-Vittone

Masters Theses

Type 2 diabetes (T2D) is increasing in the United States, currently affecting 11.3% of the nation. The Developmental Origins of Health and Disease Hypothesis suggests that environmental stresses in utero and in early stages of life, such as preterm birth (age), can lead to development of adulthood diseases, including T2D. However, research on the association between preterm birth and T2D is sparse and predominantly based on European ancestry populations. We examined this association in postmenopausal women (N = 85,356) from the Women’s Health Initiative, a nationwide prospective cohort. Logistic regression models were used to examine the association between self-reported preterm …


The Relationship Between Pm2.5 And Chronic Respiratory Disease In Senegal, Bailey Glenn Jun 2022

The Relationship Between Pm2.5 And Chronic Respiratory Disease In Senegal, Bailey Glenn

Masters Theses

Chronic respiratory diseases such as asthma and chronic bronchitis have significantly increased in prevalence in Africa over the past 10 years. Recent studies have demonstrated that exposure to air pollution may be associated with an increased risk of chronic respiratory diseases. However, such studies have predominantly been conducted in western societies or often used urbanicity as a proxy for exposure to air pollution. Therefore, we evaluated the association between PM2.5 exposure and asthma/chronic bronchitis in Senegal. A cross-sectional study was conducted for the time period of 3 October 2010 to 28 April 2011 using annual concentrations of PM2.5 …


Three Dimensional Spatio-Temporal Cluster Analysis Of Sars-Cov-2 Infections, Keith W. Allison Jun 2022

Three Dimensional Spatio-Temporal Cluster Analysis Of Sars-Cov-2 Infections, Keith W. Allison

Masters Theses

The COVID-19 pandemic has heightened the need for fine-scale analysis of the clustering of cases of infectious disease in order to better understand and prevent the localized spread of infection. The students living on the University of Massachusetts, Amherst campus provided a unique opportunity to do so, due to frequent mandatory testing during the 2020-2021 academic year, and dense living conditions. The South-West dormitory area is of particular interest due to its extremely high population density, housing around half of students living on campus during normal conditions. Using data gathered by the Public Health Promotion Center (PHPC), we analyzed the …


The Impact Of A Lifestyle Intervention On Risk Factors Of Cardiovascular Disease And Type Ii Diabetes Among At-Risk Hispanic Women, Kathryn A. Wagner Jun 2022

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 Jun 2022

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 Jun 2022

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 Jun 2022

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 Mar 2022

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 Mar 2022

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 Mar 2022

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 Mar 2022

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 …