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- All Subjects: Basic Reproductive Number
- All Subjects: Obesity
Description
According to the Centers for Disease Control and Prevention (CDC), type 2 diabetes accounts for 90-95% of diabetes (29.1 million) cases and manifests in 15-30% of prediabetes (86 million) cases, where 9 out of 10 individuals do not know they have prediabetes. Obesity, observed in 56.9% of diabetes cases, arises from the interactions among genetic, biological, environmental, and behavioral factors that are not well understood. Assessing the strength of these links in conjunction with the identification and evaluation of intervention strategies in vulnerable populations is central to the study of chronic diseases. This research addresses three issues that loosely connect three levels of organization utilizing a combination of quantitative and qualitative methods. First, the nonlinear dynamics between insulin, glucose, and free fatty acids is studied via a hypothesis-based model and validated with bariatric surgery data, demonstrating key metabolic factors for maintaining glucose homeostasis. Second, the challenges associated with the treatment or management, and prevention of diabetes is explored in the context of an individualized-based intervention study, highlighting the importance of diet and environment. Third, the importance of tailored school lunch programs and policies is studied through contagion models developed within a social ecological framework. The Ratatouille Effect, motivated by a pilot study among PreK-8th grade Arizona students, is studied and exposes the importance of institutionalizing practical methods that factor in the culture, norms, and values of the community. The outcomes of this research illustrate an integrative framework that bridges physiological, individual, and population level approaches to study type 2 diabetes and obesity from a holistic perspective. This work reveals the significance of utilizing quantitative and qualitative methods to better elucidate underlying causes of chronic diseases and for developing solutions that lead to sustainable healthy behaviors, and more importantly, the need for translatable multilevel methodologies for the study of the progression, treatment, and prevention of chronic diseases from a multidisciplinary perspective.
ContributorsLe Murillo, Anarina (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Li, Jiaxu (Thesis advisor) / Phillips, Elizabeth D. (Committee member) / Towers, Sherry (Committee member) / Arizona State University (Publisher)
Created2016
Description
The 2009-10 influenza and the 2014-15 Ebola pandemics brought once again urgency to an old question: What are the limits on prediction and what can be proposed that is useful in the face of an epidemic outbreak?
This thesis looks first at the impact that limited access to vaccine stockpiles may have on a single influenza outbreak. The purpose is to highlight the challenges faced by populations embedded in inadequate health systems and to identify and assess ways of ameliorating the impact of resource limitations on public health policy.
Age-specific per capita constraint rates play an important role on the dynamics of communicable diseases and, influenza is, of course, no exception. Yet the challenges associated with estimating age-specific contact rates have not been decisively met. And so, this thesis attempts to connect contact theory with age-specific contact data in the context of influenza outbreaks in practical ways. In mathematical epidemiology, proportionate mixing is used as the preferred theoretical mixing structure and so, the frame of discussion of this dissertation follows this specific theoretical framework. The questions that drive this dissertation, in the context of influenza dynamics, proportionate mixing, and control, are:
I. What is the role of age-aggregation on the dynamics of a single outbreak? Or simply speaking, does the number and length of the age-classes used to model a population make a significant difference on quantitative predictions?
II. What would the age-specific optimal influenza vaccination policies be? Or, what are the age-specific vaccination policies needed to control an outbreak in the presence of limited or unlimited vaccine stockpiles?
Intertwined with the above questions are issues of resilience and uncertainty including, whether or not data collected on mixing (by social scientists) can be used effectively to address both questions in the context of influenza and proportionate mixing. The objective is to provide answers to these questions by assessing the role of aggregation (number and length of age classes) and model robustness (does the aggregation scheme selected makes a difference on influenza dynamics and control) via comparisons between purely data-driven model and proportionate mixing models.
This thesis looks first at the impact that limited access to vaccine stockpiles may have on a single influenza outbreak. The purpose is to highlight the challenges faced by populations embedded in inadequate health systems and to identify and assess ways of ameliorating the impact of resource limitations on public health policy.
Age-specific per capita constraint rates play an important role on the dynamics of communicable diseases and, influenza is, of course, no exception. Yet the challenges associated with estimating age-specific contact rates have not been decisively met. And so, this thesis attempts to connect contact theory with age-specific contact data in the context of influenza outbreaks in practical ways. In mathematical epidemiology, proportionate mixing is used as the preferred theoretical mixing structure and so, the frame of discussion of this dissertation follows this specific theoretical framework. The questions that drive this dissertation, in the context of influenza dynamics, proportionate mixing, and control, are:
I. What is the role of age-aggregation on the dynamics of a single outbreak? Or simply speaking, does the number and length of the age-classes used to model a population make a significant difference on quantitative predictions?
II. What would the age-specific optimal influenza vaccination policies be? Or, what are the age-specific vaccination policies needed to control an outbreak in the presence of limited or unlimited vaccine stockpiles?
Intertwined with the above questions are issues of resilience and uncertainty including, whether or not data collected on mixing (by social scientists) can be used effectively to address both questions in the context of influenza and proportionate mixing. The objective is to provide answers to these questions by assessing the role of aggregation (number and length of age classes) and model robustness (does the aggregation scheme selected makes a difference on influenza dynamics and control) via comparisons between purely data-driven model and proportionate mixing models.
ContributorsMorales, Romarie (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Mubayi, Anuj (Thesis advisor) / Towers, Sherry (Committee member) / Arizona State University (Publisher)
Created2016