Medicine and Health Sciences Commons^™

Homestead Vegetable And Poultry Production And Related Practices: An Assessment In Nepal, Shiva Bhandari

Theses and Dissertations

Consumption of nutrients-rich foods like diverse vegetables, eggs, and meat throughout a year remains a challenge in low- and middle-income countries due to poor availability, accessibility, and affordability. One important way to overcome the challenge is to promote households’ own production of these foods and encourage individuals to consume. Improving household production of the foods necessitates understanding whether active participation and performance of frontline workers in the communities and performing improved production-related practices can translate into improved production of nutrients-rich foods. This study had two specific aims. The first aim was to examine demographic, socio-economic, and programmatic determinants of active …

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

The Relationship Of Hair Glucocorticoid Levels To Immunological And Virological Outcomes In A Large Cohort Of Combination Antiretroviral Therapy Treated People Living With Hiv, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Shuaifeng Liu, Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Background

Existing literature mostly investigated the relationship of acute or short-term glucocorticoid exposure to HIV disease progression using cortisol levels in serum, saliva, or urine. Data are limited on the relationship of long-term glucocorticoid exposure to HIV disease progression. This study examined whether hair glucocorticoid levels, novel retrospective indicators of long-term glucocorticoid exposure, are associated with two common indicators of HIV disease progression (CD4 count and HIV viral load) among a large cohort of combination antiretroviral therapy treated Chinese people living with HIV (PLHIV).

Methods

A total of 1198 treated PLHIV provided hair samples for glucocorticoid (cortisol and cortisone) assay …

Evaluation Of A Community-Based Performance Arts Programme For People Who Have Experienced Stroke In The Uk: Protocol For The Shaper-Stroke Odysseys Study, Carolina Estevao, Maria Baldellou Lopez, Rachel E. Davis, Lucinda Jarret, Tayana Soukup, Ioannis Bakolis, Andy Healey, Jean Harrington, Anthony Woods, Nikki Crane, Fiona Jones, Carmine Pariante, Daisy Fancourt, Nick Sevdalis

Faculty Publications

INTRODUCTION: Stroke survivors, once in the community, face challenges with their long-term rehabilitation care and present higher levels of loneliness, depression and anxiety than the rest of the population. A community-based performance arts programme, Stroke Odysseys (SO), has been devised to tackle the challenges of living with stroke in the UK. In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. METHODS AND ANALYSIS: Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. …

Specificity Matters: Unpacking Impact Pathways Of Individual Interventions Within Bundled Packages Helps Interpret The Limited Impacts Of A Maternal Nutrition Intervention In India, Shivani Kachwaha, Phuong H. Nguyen, Lan Mai Tran, Rasmi Avula, Melissa F. Young, Sebanti Ghosh, Thomas Forissier, Jessica Escobar-Alegria, Praveen Kumar Sharma, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

BACKGROUND: To address gaps in coverage and quality of nutrition services, Alive & Thrive (A&T) strengthened the delivery of maternal nutrition interventions through government antenatal care (ANC) services in Uttar Pradesh, India. The impact evaluation of the A&T interventions compared intensive ANC (I-ANC) with standard ANC (S-ANC) areas and found modest impacts on micronutrient supplementation, dietary diversity, and weight-gain monitoring. OBJECTIVES: This study examined intervention-specific program impact pathways (PIPs) and identified reasons for limited impacts of the A&T maternal nutrition intervention package. METHODS: We used mixed methods: frontline worker (FLW) surveys (n = ∼500), counseling observations (n = 407), and …

Study Protocol: Randomised Controlled Hybrid Type 2 Trial Evaluating The Scale-Up Of Two Arts Interventions For Postnatal Depression And Parkinson’S Disease, Tayana Soukup, Rachel Davis, Maria Baldellou Lopez, Andy Healey, Carolina Estevao, Daisy Fancourt, Paola Dazzan, Carmine Pariante, Hannah Dye, Tim Osborn, Rebecca Bind, Kristi Sawyer, Lavinia Rebecchini, Katie Hazelgrove, Alexandra Burton, Manonmani Manoharan, Rosie Perkins, Aleksandra Podlewska, Ray Chaudhuri, Fleur Derbyshire-Fox, Alison Hartley, Anthony Woods, Nikki Crane

Faculty Publications

INTRODUCTION: Research on the benefits of 'arts' interventions to improve individuals' physical, social and psychological well-being is growing, but evidence on implementation and scale-up into health and social care systems is lacking. This protocol reports the SHAPER-Implement programme (Scale-up of Health-Arts Programmes Effectiveness-Implementation Research), aimed at studying the impact, implementation and scale-up of: Melodies for Mums (M4M), a singing intervention for postnatal depression; and Dance for Parkinson's (PD-Ballet) a dance intervention for Parkinson's disease. We examine how they could be embedded in clinical pathways to ensure their longer-term sustainability. METHODS AND ANALYSIS: A randomised two-arm effectiveness-implementation hybrid type 2 trial …

Social Determinants Of Health And Depression Among African American Adults: A Scoping Review Of Current Research, Brooks Yelton, Daniela B. Friedman, Samuel Noblet, Matthew C. Lohman, Mark M. Macauda, Mayank Sakhuja, Katherine H. Leith

Faculty Publications

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for …

The Mediating Effect Of Depression On The Relation Between Interpersonal Needs And Suicidal Ideation Among Chinese Transgender Women, Ruijie Chang, Chengbo Zeng, Shan Qiao Ph.D., Huwen Wang, Chen Xu, Xiaoyue Yu, Tiecheng Ma, Ying Wang, Xiaoming Li Ph.D., Yong Cai

Faculty Publications

Background: Transgender women are at high risk of depression and suicidal ideation. The interpersonal theory of suicide proposes that suicidal ideation could be a consequence of high interpersonal needs (thwarted belongingness and perceived burdensomeness). The current study tests this theory and investigates whether depression could mediate the relationship between interpersonal needs and suicidal ideation among transgender women in Shenyang, China.

Methods: A total of 198 transgender women were recruited by snowball sampling. A cross-sectional study was conducted through a structured questionnaire. Suicidal ideation, depression, and interpersonal needs were assessed. Path analysis was used to carry out the research goals and …

Challenges For Estimating The Global Prevalence Of Micronutrient Deficiencies And Related Disease Burden: A Case Study Of The Global Burden Of Disease Study, Sonja Y. Hess, Alexander C. Mclain, Edward A. Frongillo Jr., Ashkan Afshin, Nicholas J. Kassebaum, Saskia J. Osendarp, Reed Atkin, Rahul Rawat, Kenneth H. Brown

Faculty Publications

Information on the prevalence of micronutrient deficiencies is needed to determine related disease burden; underpin evidence-based advocacy; and design, deliver, and monitor safe, effective interventions. Assessing the global prevalence of deficiency requires a valid micronutrient status biomarker with an appropriate cutoff to define deficiency and relevant data from representative surveys across multiple locations and years. The Global Burden of Disease Study includes prevalence estimates for iodine, iron, zinc, and vitamin A deficiencies, for which recommended biomarkers and appropriate deficiency cutoffs exist. Because representative survey data are lacking, only retinol concentration is used to model vitamin A deficiency, and proxy indicators …

Shaper-Pnd Trial: Clinical Effectiveness Protocol Of A Community Singing Intervention For Postnatal Depression, Carolina Estevao, Rebecca Bind, Daisy Fancourt, Kristi Sawyer, Paola Dazzan, Nick Sevdalis, Anthony Woods, Nikki Crane, Lavinia Rebecchini, Katie Hazelgrove, Manonmani Manoharan, Alexandra Burton, Hannah Dye, Tim Osborn, Rachel E. Davis, Tayana Soukup, Jorge Arias De La Torre, Ioannis Bakolis, Andy Healey, Rosie Perkins, Carmine Pariante

Faculty Publications

INTRODUCTION: Postnatal depression (PND) affects approximately 13% of new mothers. Community-based activities are sought after by many mothers, especially mothers that prefer not to access pharmacological or psychological interventions. Singing has shown positive effects in maternal mood and mother-child bonding. The Scaling-Up Health-Arts Programmes: Implementation and Effectiveness Research-Postnatal Depression study will analyse the clinical and implementation effectiveness of 10-week singing sessions for PND in new mothers. This protocol paper will focus on the clinical effectiveness of this trial. METHODS AND ANALYSIS: A total of 400 mothers with PND (with a score of at least 10 on the Edinburgh Postnatal Depression …

The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr.

Faculty Publications

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample.

Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Prolonged Time From Diagnosis To Breast-Conserving Surgery Is Associated With Upstaging In Hormone Receptor-Positive Invasive Ductal Breast Carcinoma, Natalie Hills, Macall Leslie, Rachel Davis, Marielle Crowell, Hiroyasu Kameyama, Hallgeir Rui, Inna Chervoneva, William Dooley, Takemi Tanaka

Faculty Publications

BACKGROUND: Time to surgery (TTS) has been suggested to have an association with mortality in early-stage breast cancer. OBJECTIVE: This study aims to determine the association between TTS and preoperative disease progression in tumor size or nodal status among women diagnosed with clinical T1N0M0 ductal breast cancer. METHODS: Women diagnosed with clinical T1N0M0 ductal breast cancer who had breast-conserving surgery as their first definitive treatment between 2010 and 2016 (n = 90,405) were analyzed using the National Cancer Database. Separate multivariable logistic regression models for hormone receptor (HR)-positive and HR-negative patients, adjusted for clinical and demographic variables, were used to …

Relation Of Breastfeeding Duration With Blood Pressure And Arterial Stiffness, Lohita Kollipara, Abbi Lane-Cordova, Xuewen Wang

Senior Theses

Background: The purpose of this analysis was to investigate the effects of differing breastfeeding duration on vascular function.

Methods: A study was designed to explore the breastfeeding patterns of 79 participants who delivered a singleton fetus 6 months-3 years ago and were aged 18-45 years old. Participant breastfeeding and dietary habits were self-reported using surveys. Breastfeeding groups were established by following the American Association of Pediatric guidelines on breastfeeding duration: Women who did versus did not breastfeeding for 6 months continuously. Blood pressure was measured using a standard oscillometric cuff, while SphygmoCor® technology was used to measure pulse wave velocity. …

Evaluating The Health Impact Of Centeringpregnancy Program Versus Traditional Prenatal Care In Midland Obstetric Clinics And Validating Selected Item On Birth Certificate, Oluwatosin A. Momodu

Theses and Dissertations

The primary focus of this dissertation is to evaluate the health impact of the CenteringPregnancy (CP) program versus traditional prenatal care (TPNC) on important maternal outcomes of pregnancy. This is looked at in two outcomes-gestational weight gain (GWG) and pregnancy induced hypertension (PIH). The specific aims are to examine the: (1) effects of CenteringPregnancy program versus traditional prenatal care on gestational weight gain (GWG); (2) effects of CenteringPregnancy program versus traditional prenatal care on pregnancy induced hypertension (PIH).

Birth certificate (BC) data were linked to hospital discharge records of women who delivered in midland’s obstetric clinics of South Carolina between …

Food Choice Decision-Making Among School-Going Adolescents Amidst The Nutrition Transition In Urban Accra, Ghana, Krystal Krsna Rampalli

Theses and Dissertations

Like many countries of the world, Ghana is experiencing a nutrition transition and rising non-communicable diseases. Adolescents are susceptible to diet-related health risks as they experience significant physical and psychological changes, which are happening in tandem with food environment changes, including widespread proliferation of large portion and package sizes of energy-dense, nutrient-poor foods. Both local and multinational food and beverage companies have encouraged consumption of their products through various marketing tactics targeted directly to adolescents. Some of these tactics include the use of characters or celebrity endorsement, promotional discounts, and appeal to sociocultural values, including messages about body size preferences. …

The Assessment Of An Extended Set Of Socio-Economic Determinants To Explain Anxiety And Uncertainty, Insufficient Quality And Food Intake Of Afghan Refugees, Mohammad Reza Pakravan-Charvadeh, Hassan Vatanparast, Edward A. Frongillo Jr., Mahasti Khakpour, Cornelia Flora

Faculty Publications

OBJECTIVES:

In this study, socio-economic factors associated with Afghan refugee households' food insecurity, anxiety and uncertainty, insufficient quality and food intake were determined.

DESIGN:

Household Food Insecurity Assess Scale measurement was applied to assess food insecurity, anxiety and uncertainty, insufficient quality and insufficient food intake. Descriptive analysis and multivariable regression models were used to determine the associated factors.

SETTING:

The study was carried out in urban areas of Tehran province in Iran. PARTICIPANTS: To collect data, interviews were conducted among 317 Afghan households. The questionnaire was administered via face-to-face interviews to either the breadwinner of the selected households or a …

Advancing Use Of Nutrition Knowledge To Improve Practice By Policy And Program Communities In India During A Political Transition, Edward A. Frongillo Jr., Jessica L. Escobar-Alegria

Faculty Publications

Models are needed for how to advance use of knowledge by programs and policy officials to make evidence-based decisions about nutrition. How to advance use of nutrition knowledge in India from 2011 to 2015 during a political transition was investigated through studying a knowledge initiative led by the International Food Policy Research Institute. Semistructured interviews were conducted with 37 diverse participants, and 1091 news articles, 318 Twitter and 175 Facebook posts, 12 YouTube events, 65 knowledge products, and 130 engaging events were assessed. Open-axial coding, content and themes analysis, triangulation, and process tracing were used. The knowledge initiative analyzed the …

A Structural Study Of The Cytoplasmic Chaperone Effect Of 14-3-3 Proteins On Ataxin-1, Seppe Leysen, Rebecca Jane Burnley, Elizabeth Rodriguez, Lech-Gustav Milroy, Lorenzo Soini, Carolyn J. Adamski, Larissa Nitschke, Rachel Davis, Tomas Obsil, Lucas Brunsveld, Tom Crabbe, Huda Yahya Zoghbi, Christian Ottmann, Jeremy Martin Davis

Faculty Publications

Expansion of the polyglutamine tract in the N terminus of Ataxin-1 is the main cause of the neurodegenerative disease, spinocerebellar ataxia type 1 (SCA1). However, the C-terminal part of the protein - including its AXH domain and a phosphorylation on residue serine 776 - also plays a crucial role in disease development. This phosphorylation event is known to be crucial for the interaction of Ataxin-1 with the 14-3-3 adaptor proteins and has been shown to indirectly contribute to Ataxin-1 stability. Here we show that 14-3-3 also has a direct anti-aggregation or "chaperone" effect on Ataxin-1. Furthermore, we provide structural and …

Maternal Resources For Care Are Associated With Child Growth And Early Childhood Development In Bangladesh And Vietnam, Sulochana Basnet, Edward A. Frongillo Jr., Phuong Hong Nguyen, Spencer Moore, Mandana Arabi

Faculty Publications

BACKGROUND:

Suboptimal child growth and development are significant problems in low- and middle-income countries. Maternal resources for care may help to improve growth and development. This study examined the association of maternal resources for care on child length, motor development and language development of children 12-23.9 months old.

METHODS:

We used baseline data from the Alive & Thrive household surveys collected in Bangladesh (n = 803) and Vietnam (n = 635). Resources for care were represented by maternal education, knowledge, height, well-nourishment, mental well-being, decision-making, employment, support in chores and perceived support. The regression analyses were adjusted for household wealth …

Relationship Between Food Insecurity And Smoking Status Among Women Living With And At Risk For Hiv In The Usa: A Cohort Study, Lila A. Sheira, Edward A. Frongillo Jr., Judith Hahn, Kartika Palar, Elise D. Riley, Tracey E. Wilson, Adebola Adedimeji, Daniel Merenstein, Mardge Cohen, Eryka L. Wentz, Adaora A. Adimora, Ighovwerha Ofotokun, Lisa Metsch, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Objectives People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.

Design Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015.

Setting Nine participating sites across the USA.

Participants 2553 …

Adaptation Of The Agency For Healthcare Research And Quality’S ‘Hospital Survey On Patient Safety Culture’ To The Bosnia And Herzegovina Context, Šehad Draganović, Guido Offermanns, Rachel E. Davis

Faculty Publications

OBJECTIVES: Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING: Nine hospitals. PARTICIPANTS: Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel …

Water Insecurity Is Associated With Lack Of Viral Suppression And Greater Odds Of Aids-Defining Illnesses Among Adults With Hiv In Western Kenya, Jason M. Nagata, Joshua D. Miller, Craig R. Cohen, Edward A. Frongillo Jr., Elly Weke, Rachel Burger, Pauline Wekesa, Lila A. Sheira, A Rain Mocello, Phelgona Otieno, Lisa M. Butler, Elizabeth A. Bukusi, Sheri D. Weiser, Sera L. Young

Faculty Publications

Reliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June …

Water Insecurity Is Associated With Lack Of Viral Suppression And Greater Odds Of Aids-Defining Illnesses Among Adults With Hiv In Western Kenya, Jason M. Nagata, Joshua D. Miller, Craig R. Cohen, Edward A. Frongillo Jr. Ph.D., Elly Weke, Rachel Burger, Pauline Wekesa, Lila A. Sheira, A. Rain Mocello, Phelgona Otieno, Lisa M. Butler, Elizabeth A. Bukusi, Sheri D. Weiser, Sera L. Young

Faculty Publications

Reliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June …

Covid-19 Disrupted Provision And Utilization Of Health And Nutrition Services In Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, And Administrative Data, Phuong H. Nguyen, Shivani Kachwaha, Anjali Pant, Lan M. Tran, Monika Walia, Sebanti Ghosh, Praveen K. Sharma, Jessica Escobar-Alegria, Edward A. Frongillo Jr., Purnima Menon, Rasmi Avula

Faculty Publications

BACKGROUND: The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. OBJECTIVES: This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic. METHODS: We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children < 2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests. RESULTS: Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼ 30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (< 10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼ 40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼ 20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%). CONCLUSIONS: COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.

Applying Health Stigma Framework To Examine The Mechanisms Of Hiv-Related Stigma On Clinical Outcomes, Chengbo Zeng

Theses and Dissertations

Background: HIV clinical outcomes including CD4 count, viral suppression, and health-related quality of life (HRQoL), are important indicators reflecting immunologic functioning, treatment efficacy, and overall health quality. However, due, in part, to HIV-related stigma, many people living with HIV (PLWH) experience suboptimal clinical outcomes. The Health Stigma Framework introduced the potentially distinct mechanisms underlying internalized, anticipated, enacted stigma and health outcomes through psycho-behavioral pathways. Based on this framework, this dissertation investigated the impacts and mechanisms of HIV-related stigma on clinical outcomes among PLWH in Guangxi, China from a longitudinal perspective. Methods: Data at baseline, 6-, 12-, 18- month follow-ups …

Neighborhood Socioeconomic Status, Green Space, And Walkability And Risk For Falls And Fracture Among Postmenopausal Women: The Women’S Health Initiative, Marilyn Elizabeth Wende

Theses and Dissertations

The purpose of this study was to assess whether neighborhood socioeconomic status (SES), walkability, and green space impacts fall and fracture incidence among postmenopausal women, and to assess important modifiers for these relationships, such as fall history, physical activity, physical impairment, race/ethnicity, and rurality. Data from the Women’s Health Initiative study from 1993 to 2012 (N=161,808) was used.

SES had a significant relationship with falling after adjustment (intermediate vs low SES OR=0.99, p=0.0309; high vs low SES OR=0.99, p=0.1192). Study arm participation and fall frequency at baseline significantly modified this relationship. Walkability had a significant relationship with falling incidence after …

Perspective: The Importance Of Water Security For Ensuring Food Security, Good Nutrition, And Well-Being, Sera L. Young, Edward A. Frongillo Jr., Zeina Jamaluddine, Hugo Melgar-Quinonez, Rafael Perez-Escamilla, Claudia Ringler, Asher Y. Rosinger

Faculty Publications

Water security is a powerful concept that is still in its early days in the field of nutrition. Given the prevalence and severity of water issues and the many interconnections between water and nutrition, we argue that water security deserves attention commensurate with its importance to human nutrition and health. To this end, we first give a brief introduction to water insecurity and discuss its conceptualization in terms of availability, access, use, and stability. We then lay out the empirical grounding for its assessment. Parallels to the food-security literature are drawn throughout, both because the concepts are analogous and food …

A Contextual Evaluation Of The Fresh Fruit And Vegetable Program In South Carolina And Related Child Health Behaviors, Kathryn Irene Hoy

Theses and Dissertations

Children in vulnerable communities are at increased risk for poor diet.1,2 The Fresh Fruit and Vegetable Program (FFVP) is a United States Department of Agriculture (USDA) child nutrition program that increases vulnerable children’s access to and consumption of fruits and vegetables.3,4 FFVP is inherently flexible,5 has few regulations, and helps identify and develop best practices for individual schools to increase fruit and vegetable consumption among low-resource children.6 Flexibility built into the FFVP at the federal level naturally results in a variation of program adoption and implementation at both the state and school-levels.7 These variations affect outcomes in complex health promotion …

Navia: A Program For The Visual Analysis Of Complex Mass Spectra, Daniel Quetschlich, Tim K. Esser, Thomas D. Newport, Francesco Fiorentino, Denis Shutin, Siyun Chen, Rachel Davis, Silvia Lovera, Idlir Liko, Phillip J. Stansfeld, Carol V. Robinson

Faculty Publications

MOTIVATION: Native mass spectrometry is now a well-established method for the investigation of protein complexes, specifically their subunit stoichiometry and ligand binding properties. Recent advances allowing the analysis of complex mixtures lead to an increasing diversity and complexity in the spectra obtained. These spectra can be time consuming to tackle through manual assignment and challenging for automated approaches. RESULTS: Native Mass Spectrometry Visual Analyser (NaViA) is a web-based tool to augment the manual process of peak assignment. In addition to matching masses to the stoichiometry of its component subunits it allows raw data processing, assignment and annotation and permits mass …