Medicine and Health Sciences Commons^™

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

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 …

Sexual Health Education Among The Intellectually And Developmentally Delayed Populations: An Examination Of Medical Providers Perspective, Sarah E. Nota

Masters Theses

Sexuality is a recognized human right as it influences mental, social and emotional wellbeing. Despite this, individuals with intellectual or developmentally delays (ID/DD) rarely receive the necessary sexual education. ID/DD persons are also at an increased risk for sexual abuse, further demonstrating the strong need for education. A natural setting in which to receive unbiased and informative sexual health information is through their medical provider. The purpose of this research was to examine current clinic standards, education, and perceptions of medical providers in regards to sexual education for ID/DD adolescents. Medical providers and students within West Michigan were surveyed with …

Improving Aedes Mosquito Surveillance And La Crosse Virus Screening In Eastern Tennessee, Cassandra Urquhart

Masters Theses

La Crosse virus (LACV), transmitted by infected Aedes triseriatus, Ae. albopictus, and Ae. japonicus mosquitoes is the leading cause of pediatric arboviral encephalitis. Severe cases of LAC encephalitis occur in individuals 16-years-old or younger and may cause permanent neurological damage or fatality. No vaccines exist making mosquito control and disease prevention crucial to public health. Effective screening and surveillance practices are key components to these goals. While a number of standard mosquito surveillance methods exist, continuous testing and improved understanding of vector biology to determine the best ways to implement these methods is important. Additionally, the current standard …

A Feasibility Study Of Just-In-Time Asthma Self-Management Intervention, Phillip Charles Scruggs

Masters Theses

Quality asthma care requires not only an initial diagnosis, but long term follow up care and education on long term control. Preventable symptoms continue to reduce the quality of life for chronic asthma sufferers and place an unnecessary burden on emergency services and the health care system at large. A mobile health (mHealth) solution is proposed to effectively improve outcomes for patients while ultimately reducing the overall burden of mismanagement on the healthcare system as a whole. The Just-in-Time Asthma Self- Management and Intervention (JASMIN) system provides a way for a patient or user to track, self-manage, and interact with …

The Effects Of A Visually Appealing And Interactive Snack Activity On Fruit And Vegetable Intake Of Preschool-Aged Children, Kristen Leigh Clay

Masters Theses

Background: Previous research has shown the potential of increasing vegetable intake by incorporating the senses into interventions. However, little to no research has specifically looked at the impact that the use of the senses can have on intake of vegetables among preschool-aged children.

Purpose: The aims of this study were to examine if mean intake of vegetable snacks and/or willingness to try the vegetable snacks would be significantly higher among preschool-age children who participated in a visually appealing and interactive snack activity compared to children who received control vegetable snacks.

Methods: Two preschools were selected to participate in the study. …

Farm-To-Preschool In East Tennessee: Evaluation Of A Small-Scale Farmer’S Market At A Childcare Center On Household Fruit And Vegetable Availability And Preschoolers’ Consumption Of Fruits And Vegetables, Jade Morgan Parry

Masters Theses

Background: Most preschool-aged children do not consume an adequate amount of fruits and vegetables (F&V). Accessibility to F&V and parental influence are important factors in determining fruit and vegetable consumption in preschool-aged children. The incorporation of farmer’s markets at childcare centers as part of a farm-to-preschool program provides an opportunity to increase access to F&V and engage parents in supporting positive changes in their children’s dietary behaviors. Gaps in the farm-to-preschool literature include a lack of well-designed intervention trials that include a control group and rigorous evaluation tools.

Methods: This was a pilot study with a quasi-experimental, pre-test, post-test …

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

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

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

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 …