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Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

Plasma Proteins That May Cause Parkinson’S Disease And Multiple Sclerosis: A Mendelian Randomization Study, Brigid A. Staley

Dissertations and Theses

Multiple sclerosis (MS) and Parkinson’s disease (PD) are progressively disabling neurologic disorders that profoundly affect quality of life and shorten life expectancy. There is no cure for either disease, and current treatments only alleviate symptoms and may cause serious side effects. The causes of MS and PD are not well understood. Previous epidemiologic studies have documented numerous environmental risk factors for both diseases. However, these studies are inherently prone to bias from confounding which may generate spurious results. The lack of unbiased evidence on environmental causes of MS and PD has been a critical barrier to fully understanding their pathophysiology. …

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

The House We Built In Challenging The Status Quo: House And Ballroom Community Leadership And Health Justice, Jennifer Lee

Dissertations and Theses

Background: The House Ballroom Community (HBC), an underground queer subculture, has been leading actions in large urban cities throughout the Unites States to address health inequities exacerbated by stigma, systemic neglect, and economic disparities, such as the HIV/AIDS epidemic. The HBC is an inventive and dynamic space that posits new leadership paradigms for health equity and health justice, where collective actions and their resulting social impact center the embodied knowledge of their members to create social change.

Methods: Community-based participatory research (CBPR) was a fundamental method and framework for each of the studies (Aims 1, 2, and 3). The meaningful …

Medical Cannabis In New York State, David Steven Younger

Dissertations and Theses

Background: In July 2014, New York State became the 23rd state to legalize marijuana (“cannabis”) for medical consumption under the New York State Medical Marijuana Program (“Program”). Three years later, during his Executive budget address, the NYS Governor, Honorable Cuomo, directed the Department of Health in consultation with other NYS agencies, to evaluate the experience, consequences and effects of legalized marijuana in neighboring states and territories, and to review the health, criminal justice and economic impacts of regulating marijuana use. That report concluded that the positive effects of a regulated marijuana market outweighed the potential negative impacts.

Objective: This dissertation …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

Development Of A Hospital Readmission Reduction Program For Patients Discharged To Skilled Nursing Facilities: An Application Of Artificial Intelligence And Machine Learning Techniques, Anna Stachel

Dissertations and Theses

Background

Hospital readmissions within 30 days after discharge have drawn national policy attention as they are a reflection of suboptimal patient care. Readmissions are costly, accounting for more than $17 billion in potentially avoidable Medicare expenditures - nearly 78% of readmissions may be avoidable. Rich electronic data from medical records, growing computing capacities, and open source machine learning algorithms offer new opportunities to predict patients at high risk for readmission and prevent readmission through focused interventions. Prediction models might also serve to provide a more nuanced context of patient characteristics that lead to variations in readmission rates. Furthermore, transitional care …

What’S For Lunch? Examining The Factors Associated With Food Choices And Food Insecurity Among Cuny College Students- A Mixed Methods Study, Rachel G. Taniey

Dissertations and Theses

Background: The growing rates of food insecurity in college students points to the need to examine food choices within the context of a socio-ecological framework with an emphasis on the contribution of financial constraints and limited food access on food-based decisions.

Methods: A mixed-methods study design using both primary and secondary data analysis was developed for this dissertation. Primary data examining undergraduate college students was collected on three CUNY campuses including: semi-structured in-depth interviews (N=33), computerized 24-hour dietary recalls using the ASA24 program (N=45), three focus groups (N=26) with students who utilize on-campus food assistance programs, and key informant interviews …

Exploration Of The Complex Relationship Among Multilevel Predictors Of Prep Use Among Men Who Have Sex With Men In The United States, Kristina M. Rodriguez

Dissertations and Theses

Background: Men who have sex with men (MSM) remain the group most heavily affected by HIV in the United States (US), with MSM of color further disproportionately represented. In July 2012, the US Food and Drug Administration (FDA) approved the use of tenofovir disoproxil fumarate plus emtricitabine (TDF-FTC, Truvada) for use as pre-exposure prophylaxis (PrEP) in HIV-negative adults who are at high-risk of HIV infection. Despite its effectiveness, PrEP prescriptions are reaching only a small proportion of those who could benefit from the drug and prescription rates vary both by race and geographic region. The goal of this dissertation was …

Leveraging Eelectronic Health Records To Develop Cardiovascular Risk Profiles For Primary Prevention With Youth Living With Hiv In Multidisciplinary Adolescent Hiv Care Settings, Sitaji Gurung

Dissertations and Theses

Background: HIV infection has shown to be associated with increased risk for, and earlier occurrence of cardiovascular disease (CVD). Emerging evidence suggests that detectable viral load (VL) and CD4 ≤ 200 contribute substantially to increased risk of CVD. Cigarette smoking is prevalent in at least 40% of those with HIV, and significantly more common compared to the general population. As many as 33% of adolescents are overweight, and this excess weight leads to lipid abnormalities, and increases in metabolic syndrome. With the newer formulation of antiretroviral therapy (ART) agents available as a component of single tablet regimens (STR), it is …

Novel Hepatitis C Virus (Hcv) Community Viral Load Measures, Hcv Incidence And Prevalence, And Hcv Prevention By Methadone Maintenance, Ashly E. Jordan

Dissertations and Theses

Abstract

Introduction

The incidence of Hepatitis C virus (HCV) infection has increased in the current opioid epidemic in the United States; current estimates are that 2-3 million Americans have HCV infection. The ongoing and increasing HCV epidemic among people who use drugs (PWUD) is occurring in the context of known HCV prevention and highly efficacious and well-tolerated curative HCV treatment. The development of direct acting antivirals (DAAs) with cure rates approaching 100% dramatically changed the treatment landscape. This provides both the potential for improved individual- and population-level treatment effectiveness, and also the potential for population-level HCV ‘cure as prevention' (CasP) …