Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 15 of 15

Full-Text Articles in Medicine and Health Sciences

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis Dec 2022

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …


Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell Dec 2022

Healthcare Service Utilization And Life Satisfaction In South Africa, Tamara Chavez-Lindell

Doctoral Dissertations

South Africa has achieved improvements in many health measures over the past 30 years, yet significant disparities in healthcare utilization and health outcomes persist. There is evidence that healthcare utilization has a strong influence on health outcomes and life satisfaction. Unfortunately, rural areas tend to have poorer accessibility and utilization of health services, leading to disparities in health outcomes. In rapidly urbanizing countries such as South Africa, identification of disparities and predictors of public healthcare utilization and life satisfaction may provide information that can be used to guide development of programs aimed at improving population health outcomes, quality-of-life, and overall …


Perinatal Health In North Dakota: Emerging Issues, Grace N. Njau Dec 2022

Perinatal Health In North Dakota: Emerging Issues, Grace N. Njau

Doctoral Dissertations

Preterm birth, newborn screening refusal, and postpartum depression represent three emerging areas of concern that have not been previously investigated in North Dakota. Their potential impact creates significant social, behavioral, and economic burdens. Although various studies have investigated preterm birth and postpartum depression, to the best of my knowledge, newborn screening refusal in the United States has not been previously investigated. In alignment with the role of Title V of the Social Security Act (Maternal and Child Health) Programs to conduct ongoing statewide needs assessments, the objectives of this study was to investigate and identify predictors of preterm birth, newborn …


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 …


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 …


Design And Development Of The Urban Population Health Observatory To Improve Disease Surveillance And Response, Whitney Brakefield May 2022

Design And Development Of The Urban Population Health Observatory To Improve Disease Surveillance And Response, Whitney Brakefield

Doctoral Dissertations

Chronic and infectious diseases have a profound impact on the quality and length of life of populations that suffer from these conditions. Scientists, physicians, and health officials are seeking innovative approaches to decrease the morbidity and mortality of deadly diseases. Incorporating artificial intelligence and data science techniques across the health science domain could improve disease surveillance, intervention planning, and policymaking. In this dissertation, we describe the design and development of the Urban Population Health Observatory (UPHO), an explainable knowledge-based multimodal big data analytics platform. A common challenge for conducting multimodal big data analytics is integrating multidimensional heterogeneous data sources, which …


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 …