Browsing by Subject "Public Health"

Now showing 1 - 15 of 15
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    Added Sugars: Why It is Added to Food and the Challenges of Labeling it
    (2016-03) Goldfein, Kara
    Avoiding too much sugar is an accepted dietary guidance throughout the world. The U.S. Nutrition Facts panel includes information on total sugars in foods. A focus on added sugars is linked to the concept of discretionary calories and decreasing consumption of added sugars as a means to assist a consumer to identify foods that are nutrient-dense. On March 14, 2014, the U.S. Food and Drug Administration proposed that including “added sugars” on the nutrition facts panel would be another tool to help consumers. This thesis discusses the functions of sugar in food and shows that the methods used to replace added sugars in foods can result in no reduction in calorie content or improvement in nutrient density. Without clear benefit to the consumer for added sugars labeling, this thesis highlights the complex business obstacles, costs, and consumer confusion resulting from the proposed rule.
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    Assessing The Influence Of The Neighborhood Environment On Evaluative And Emotional Subjective Well-Being
    (2020-03) Das, Kirti
    Comprehending and promoting well-being has been regarded as a key goal in academic research and policy making given its significant role in creating and maintain healthy, productive societies. As urban planners focus on designing and maintaining living environments, they have the potential to enhance the well-being of residents and provide opportunities for all to flourish. It is therefore critical for planners to understand how the built environment influences well-being. Despite the theoretical importance in linking planning to subjective well-being (SWB), the attention to SWB in planning is relatively recent. There remain significant gaps in the planning literature including inadequate research on the emotional aspects of SWB and omission of key SWB determinants in analysis due to a lack of interdisciplinary perspectives. In this dissertation, we hope to fill these gaps in the planning literature, add to the understanding of how attributes of the neighborhood influence the evaluative and emotional dimensions of SWB, and explore analysis methods best suited to study the neighborhood-SWB relationship. To this end, two detailed literature reviews were conducted to identify an extensive list of SWB determinants to include in the analysis. Original data were collected via a survey conducted in the Minneapolis-St Paul Twin Cities area from October 17, 2016 to October 25, 2017. The data collection effort was part of the Sustainable Healthy Cities project funded by the National Science Foundation. We find that evaluative and emotional SWB have varied determinants, both at the personal and neighborhood level. We also find evidence to support that relationships between neighborhood attributes and evaluative and emotional SWB can be asymmetric. Specifically, there is a typology of neighborhood attributes in terms of how they impact SWB when these attributes perform poorly/absent, at all levels of performance, and only at a high performance. The typology is also sensitive to modeling techniques as well as data coding schemes. Across all models used the nature of the relationships between neighborhood attributes and SWB is found to vary based on the SWB measure used. Given the sensitivity of findings to SWB measures used, analysis modeling and coding, directions for future research are discussed.
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    The Association Between Reported Dietary Β-Carotene Intakes, Serum β-Carotene, Anthropometric Factors, And Dietary Fat In United States Adults
    (2020-09) Crusan, Ambria
    Obesity prevalence continues to increase in the United States (US), therefore, understanding preventative measures is increasingly important for population health. The US has one the world’s highest rates of overweight and obesity with at least 70% of adults categorized as overweight or obese, with an increasing prevalence of morbid obesity. Obesity is of concern because increasing rates are positively correlated with multiple comorbidities. The 2015-2020 Dietary Guidelines for Americans recommend adults consume approximately 2 cups of fruits and 2.5 cups of vegetables daily, as research has tied consumption to a reduced risk for many chronic diseases. Presumably, these recommendations are made because low serum carotenoid status, a marker of fruit and vegetable intake, is associated with increased cardiometabolic disease risk. Investigating the associations between the carotenoid β-carotene (BC) and obesity are pivotal in understanding obesity as a diet-related condition. This work is the first to assess multiple factors that might influence the association between dietary BC and serum BC concentrations utilizing population-based data collected in the US. Secondary data analysis of the 2003-2006 NHANES dataset, which utilized cross-sectional survey methods to obtain a unique collection of nationally-representative, health- and nutrition-related data on non-institutionalized civilians in the US, was conducted. Weighted variables were created in SAS statistical software to accommodate the complex survey design. There is a normal distribution across sex, ethnicity, age, and body mass index (BMI), however, we natural log transformed serum BC concentrations, reported dietary BC, high-sensitivity C-reactive protein (hsCRP), and reported dietary lycopene due to skewing. Pearson correlation and partial correlation coefficients were used to assess variable correlation. Multivariable linear regression estimated relationships between serum BC concentrations and inflammation, reported dietary BC intake, BMI, total reported dietary fat intake, and total reported dietary fatty acid (FA) intakes. Notable associations were present between serum BC concentrations and BMI, hsCRP, reported dietary BC intakes, android body fat percentage, gynoid body fat percentage, saturated FAs, monounsaturated FAs, and polyunsaturated FAs. The findings of this project suggest a protective effect of increased serum BC concentrations against low-grade, systemic inflammation often associated with adipose tissue dysfunction present in obese individuals. The association present between serum BC and anthropometric factors related to higher adiposity, suggests individuals with an increased BMI and/or body fat percentage may have a greater risk of lower serum BC concentrations despite dietary BC intake. Additionally, dietary FA, polyunsaturated FA alpha-linolenic acid, is associated with increased BC in circulation. Moreover, the inverse association present between serum BC and other specific fatty acid classes suggests there may be multiple post-digestion factors affecting serum BC concentrations.
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    Cluster Evaluation of the Community-Based Public Health Initiative: 1996 Annual Report and Final Summary.
    (1996) Schmitz, Connie C.; Johnson, Carol McGee; Himmelman, Arthur T.; Wunderlich, Marijo
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    Community Pharmacists’ Awareness of Intimate Partner Violence: An Exploratory Study
    (University of Minnesota, College of Pharmacy, 2013) Barnard, Marie; West-Strum, Donna; Holmes, Erin; Yang, Yi; Swain, Kristen Alley
    Background: Intimate partner violence (IPV) is a serious public health problem, impacting more than 12 million people in the United States each year. The only know effective health care intervention is routine screening for IPV exposure; however, this intervention has been poorly adopted. Expansion of screening efforts to the community pharmacy setting provides an opportunity to have a substantial impact on the health and well-being of pharmacy patients. However, little is known about pharmacists’ knowledge, attitudes, and behaviors related to IPV. Objective: The objective of this study was to conduct an exploratory investigation of community pharmacists’ current level of knowledge, attitudes, behaviors, and intentions related to IPV and to IPV screening. Methods: A cross-sectional study using an online questionnaire was conducted. Surveys were distributed via email. Descriptive analyses of survey responses were conducted. Results: A total of 144 community pharmacists completed the survey. Results indicated most (67.4%) had no IPV education/training. Participants were significantly more willing to conduct screening with targeted patients compared to all patients. (X2=129.62; df=36; p<0.0001). There was strong agreement with interest in and willingness to participate in continuing education. Conclusions: Most respondents indicated relatively low levels of IPV knowledge and training and very little current IPV screening activity. Continuing education on IPV should be considered for pharmacists to increase knowledge and awareness of IPV.
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    Entering Silence: The Discourse of Noise Pollution
    (2019-12) Holien, Andrew P
    In this discourse analysis, I argue that the discourse of noise pollution in the United States is inadequate and that it belies the severity of noise as a latent public health crisis; moreover, I argue that the discourse often fails to examine the corrosive influence of noise on our collective capacity to think, reflect, and cultivate our interior lives.
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    From Vice to Nice: Race, Sex, and the Gentrification of AIDS
    (2017-04) Esparza, Rene
    My dissertation, From Vice to Nice: Race, Sex, and the Gentrification of AIDS, tracks the agency of white gay leaders in shaping urban politics in the 1980s vis-à-vis the racialization of public health discourses and practices. In the context of state indifference spurred by the HIV/AIDS epidemic, these leaders embraced racialized norms of sexual hygiene to articulate their Americanness. Because early in the epidemic, the racially coded language of public health represented the gay community as a threat to white Americans, gay community activists learned that meeting institutionalized-defined standards of moral health and sexual hygiene was a precondition for their social membership. However, in testifying on behalf of the gay community’s moral cleanliness, these leaders sublimated fears of perverse spaces, atypical gender roles, and deviant sexualities onto communities of color. Under neoliberalism, I argue that these racialized norms of sexual hygiene stood as yardsticks for Americanization. I underscore that racialized norms of sexual hygiene provided for the anesthetization and co-optation of gay radical politics and, in turn, gave form to what Lisa Duggan calls “homonormativity,” the normalization of white, middle-class class gay and lesbian politics of sexual respectability. Specifically, through a case study of the Twin Cities of Minneapolis and St. Paul, I uncover how homonormativity converged with wider agendas and policies encompassing the “cleaning-up” of public urban spaces such as low-income neighborhoods and vice districts, and the policing of its racial denizens such as “crack-addicted” single black mothers, Hmong refugees, and Native American sex workers. Using multiple methods, including archival research, ethnographic fieldwork, and discourse analysis, I illustrate that public health constructions of normative gender, sexuality, and domestic space became powerfully intertwined with private development so that both institutions worked in the service of promoting the economically prosperous potential of post-industrial inner-cities as centers of business, culture, and tourism. Gentrification, I conclude, does not simply denote the privatization of public urban spaces. It also reflects attempts at the privatization of non-normative sexuality in the service of reorganizing white heteronormativity.
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    Moving toward sustainability: A look beyond donor-dependent network structures
    (2020-12) Errecaborde, Kaylee
    This dissertation research delves into the rise of the multilateral, multinational Global Health Security Agenda in 2014, and the subsequent global push toward collaborative, “One Health,” governance as a solution to emerging threats at the interface of human, animal and environmental health. Using interpretive methods, the research examines the systems factors that influenced the development of structures for two collaborative networks–Multisectoral, One Health, Coordinating Mechanisms (MCMs)–in Thailand and Vietnam. Two primary questions were addressed: (1) how are MCMs established and institutionalized within national governments, and (2) how do structures frame the boundaries of MCM collaboration, either supporting or challenging efforts toward sustained government networks. In-depth interviews and document analysis of two comparative case studies in Thailand and Vietnam revealed that two systems factors, the influence of international donors and the capacity of MCM member organizations, were interdependent starting conditions for MCM development. These factors created paradoxical tensions that influenced MCM structures at the start of collaboration, creating challenges and opportunities for sustainable networks beyond donor funding. It was observed that MCM leaders, if aware, may be able to manage these interdependent tensions in support of network sustainability. As donor influence and funding is reduced over time, it requires a redistribution of tensions during the process of collaboration to support adapted network structures. The transfer and re-distribution of tensions can occur via new and adapted network policies, the development of transformational funding mechanisms, and leader support for critical connectors–key actors or champions within the network. If leaders are empowered to view the MCM as a dynamic structuration process that requires the balancing and transferring of tensions, they may be better placed to maintain fluid collaborative junctures and sustain new inter-organizational pathways. However, these leaders face considerable challenges, including shifting government positions, reorganization, position vacancies and retirements, all of which create barriers to allowing leaders the competencies–knowledge, skills and attitudes, to manage and support structural adaptation over time. This research provides theoretical and practical insights into the development of sustainable networks that are supported, but not defined, by donor-led conditions at the start of collaboration.
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    Multidisciplinary Investigation Of Rural Intersection-Related Crashes And Crash Injuries: Characteristics, Risk Factors And Prevention
    (2021-06) Tian, Disi
    Introduction: Rural intersections disproportionally contribute to crashes in rural United States (U.S.). Few available studies have examined potential causal associations between important intersection-relevant exposures and crash outcomes. Additionally, the efficacy of an advanced Rural Intersection Conflict Warning System (RICWSs), implemented at high-risk rural two-way stop-controlled intersections, has been largely unknown. Methods: This multidisciplinary study included: 1) an ecological epidemiologic analysis to identify the magnitude of and risk factors for rural intersection-related crash rates (per 100 million Annual Average Daily Traffic — AADT) by the level of injury severity, among various intersection characteristics; 2) a quasi-experimental epidemiologic investigation to evaluate the efficacy of the RICWSs for crash reductions, among 56 intersection risk-sets, each containing one RICWS treatment and three relevant control intersections; and 3) a driving simulator study to evaluate how different RICWS designs impacted drivers’ behaviors among 120 participants. The study population involved a representative sample of rural intersections in Minnesota (n = 4,172). Adjusted crash rate-ratios were obtained from the Generalized Estimating Equations (GEE), while adjusting for relevant confounders. Potential causal associations between RICWSs and various crash rate outcomes (per intersection per year) were determined, using Difference-in-Difference (DID) and Difference-in-Difference-in-Difference (Triple-D) analytical methods. Various regression models, applying the GEE, enabled efficacy determination of each RICWS design and an aggregated RICWS treatment effect, averaged across all simulated RICWS designs, among different levels of drivers' ages, mainstream traffic volume, and intersection visibility. Results: Rural intersection-related crash rates were significantly associated with various important intersection relevant risk factors by the level of injury severity. Minnesota RICWSs demonstrated a potential significant protective effect against targeted right-angle crashes, continuously, over time, post-treatment (p < 0.05). The original RICWS design potentially improved gap acceptance performance among drivers; however, it also increased the risk of stop-sign violations (Risk Ratio = 2.2, 95% Confidence Interval (CI) = 1.03 to 4.64). Conclusions: This study serves as a basis to provide insight into prioritizing the prevention of rural intersection-related crashes and associated injuries. It has significant research relevance to mitigate the overall mortality and morbidity of motorists, including the working population, on the U.S. rural roads.
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    Site Visiting the Seven Consortia in the Community-Based Public Health Initiative (CBPH): Reflections on Year Two.
    (1994) Schmitz, Connie C.; Johnson, Carol McGee; Wunderlich, Marijo; Himmelman, Arthur T.
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    Use of Wearable Technology and Social Media to Improve Physical Activity and Dietary Behaviors among College Students: A 12-week Randomized Pilot Study
    (2018-06) Pope, Zachary
    Introduction: College students are at risk for poorer health behaviors. Therefore, this study evaluated the combined effectiveness of the Polar M400 smartwatch and a theoretically-grounded, Facebook-delivered health education intervention at improving college students’ health behaviors/outcomes versus comparison. Intervention use/acceptability and validation of Polar M400 health metric data were also assessed. Methods: Thirty-eight college students (28 female; X̅age=21.5±3.4 years) participated in this two-arm randomized 12-week pilot trial. After screening, participants were randomized into two groups: (a) experimental-received Polar M400 and a twice-weekly Social Cognitive Theory (SCT)- and Self-Determination Theory (SDT)-based, Facebook-delivered health education intervention; and (b) comparison-enrolled only in separate, but content-identical, Facebook group. ActiGraph Link accelerometers and the National Cancer Institute’s ASA24 food recall measured PA and dietary behaviors, respectively. Health-related SCT and SDT psychosocial constructs were measured using psychometrically-validated questionnaires while the YMCA 3-Minute step test and bioelectrical impedance assessed cardiorespiratory fitness and body fat percentage, respectively. Results: Retention rate was 92.1%, with an intent-to-treat analysis performed. Baseline comparisons revealed only one significant difference between groups for whole grain consumption (p=0.03). For PA, a trend toward a significant main effect for time was observed for moderate-to-vigorous PA, F(2, 72)=2.6, p=0.08; partial eta-squared=0.07, with experimental and comparison groups demonstrating 4.2- and 1.6-minute/day increases, respectively, over time. For secondary outcomes, both groups demonstrated non-significantly decreased weight from baseline to 12 weeks (experimental: -0.6 kg; comparison: -0.5 kg). Further, significant main effects for time were observed for self-efficacy, social support, and intrinsic motivation (all p<0.01; partial eta-squared range: 0.18-0.38) as both groups improved over time. Finally, both groups demonstrated consistently decreased daily kcaloric consumption during the intervention. Intervention adherence was high (~86%), with health education tips implemented multiple times weekly. Validation of the Polar M400 versus the ActiGraph Link suggested moderate validity/reliability for steps per day measurements, with poor validity/reliability observed for Polar M400 daily activity time measurements. Discussion: The current study’s observations indicated initial efficacy of an intervention combining a smartwatch and theoretically-grounded, social media-delivered health education intervention on improving college students’ health behaviors/outcomes. Yet, this intervention may not provide greater benefit than comparison. Future studies should build upon noted limitations.