Digital Commons Network^™

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 …

Expanding The Boundaries Of Food Policy: The Turn To Equity In New York City, Nevin Cohen, Rositsa Ilieva

Publications and Research

Policymakers acknowledge that the food system is multidimensional and that social determinants affect diet-related health outcomes, yet cities have emphasized programs and policies narrowly connected to food access and nutritional health. Over the past fifteen years, the boundaries of food governance have expanded to include a wider range of issues and domains not previously considered within the purview of food policy, like labor, housing, and education policies. This paper illustrates the processes by which this shift occurs by presenting the case of New York City, which has broadened its food governance to a larger set of issues, requiring cross-sectoral initiatives …

Africans Who Arrive In The United States Before 20 Years Of Age Maintain Both Cardiometabolic Health And Cultural Identity: Insight From The Africans In America Study, Elyssa M. Shoup, Thomas Hormenu, Nana H. Osei-Tutu, M.C. Sage Ishimwe, Arielle C. Patterson, Christopher W. Dubose, Annemarie Wentzel, Margrethe F. Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

The overall consensus is that foreign-born adults who come to America age < 20 y achieve economic success but develop adverse behaviors (smoking and drinking) that lead to worse cardiometabolic health than immigrants who arrive age ≥ 20 y. Whether age of immigration affects the health of African-born Blacks living in America is unknown. Our goals were to examine cultural identity, behavior, and socioeconomic factors and determine if differences exist in the cardiometabolic health of Africans who immigrated to America before and after age 20 y. Of the 482 enrollees (age: 38 ± 1 (mean ± SE), range: 20–65 y) in the Africans in America cohort, 23% (111/482) arrived age < 20 y, and 77% (371/482) arrived age ≥ 20 y. Independent of francophone status or African region of origin, Africans who immigrated age < 20 y had similar or better cardiometabolic health than Africans who immigrated age ≥ 20 y. The majority of Africans who immigrated age < 20 y identified as African, had African-born spouses, exercised, did not adopt adverse health behaviors, and actualized early life migration advantages, such as an American university education. Due to maintenance of cultural identity and actualization of opportunities in America, cardiometabolic health may be protected in Africans who immigrate before age 20. In short, immigrant health research must be cognizant of the diversity within the foreign-born community and age of immigration.

Reproducibility And Sensitivity Of Thirty-Six Methods To Quantify The Sars-Cov-2 Genetic Signal In Raw Wastewater: Findings From An Interlaboratory Methods Evaluation In The U.S., Brian M. Pecson, Emily Darby, Charles N. Haas, Yamrot M. Amha, Mitchel Bartolo, Richard Danielson, Yeggie Dearborn, George Di Giovanni, Christobel Ferguson, Stephanie Fevig, Erica Gaddis, Donald Gray, George Lukasik, Bonnie Mull, Liana Olivas, Adam Olivieri, Yan Qu, Sars-Cov-2 Interlaboratory Consortium, John J. Dennehy

Publications and Research

In response to COVID-19, the international water community rapidly developed methods to quantify the SARS-CoV-2 genetic signal in untreated wastewater. Wastewater surveillance using such methods has the potential to complement clinical testing in assessing community health. This interlaboratory assessment evaluated the reproducibility and sensitivity of 36 standard operating procedures (SOPs), divided into eight method groups based on sample concentration approach and whether solids were removed. Two raw wastewater samples were collected in August 2020, amended with a matrix spike (betacoronavirus OC43), and distributed to 32 laboratories across the U.S. Replicate samples analyzed in accordance with the project's quality assurance plan …

Childhood Maltreatment And Lead Levels In Middle Adulthood: A Prospective Examination Of The Roles Of Individual Socio-Economic And Neighborhood Characteristics, Anthony Carpi, Valentina Nikulina, Xuechen Li, Cathy Spatz Widom

Publications and Research

Background Lead is a common environmental hazard because of its past use as an additive to gasoline and household paint. Some evidence suggests that children with histories of child abuse and neglect are at elevated risk for residence in communities and households with less desirable characteristics and high levels of exposure to environmental hazards and toxins.

Objectives To understand whether childhood maltreatment leads to higher levels of household dust lead and blood lead in adulthood and the extent to which characteristics of a person’s physical environment or individual level socio-economic status (SES) (based on unemployment, poverty, and receipt of public …

Workers At Long-Term Care Facilities And Their Risk For Severe Covid-19 Illness, Jessica Greene, Diane Gibson

Publications and Research

Given the high concentration of COVID-19 cases in long-term care (LTC) facilities in the United States, individuals working in these facilities are at heightened risk of SARS-CoV-2 exposure. Using data from the nationally-representative 2017 and 2018 National Health Interview Surveys on adults who reported working in LTC facilities, this study examines the extent to which LTC workers are also at increased risk or potentially at increased risk for severe illness from COVID-19 including hospitalization, intubation, or death. We used the Centers for Disease Control and Prevention’s list of conditions placing individuals in these risk categories to the extent possible. We …

The Cost Effectiveness Of Mental Health Treatment In The Lifetime Of Older Adults With Hiv In New York City: A Markov Approach, Juan J. Delacruz, Mark Brennan-Ing, Andreas Kakolyris, Omar Martinez

Publications and Research

Background

There are noticeable gaps in knowledge regarding the cost and effectiveness of integrated medical and behavioral services for older adults with HIV. Their lifespan is close to the population’s level but their quality of life has sharply declined due to depression and substance use. Mental health disorders are widespread among an aging population with HIV. Objective The aim of this study was to build a decision analytic model to evaluate medical interventions with and without mental health treatment using primary data of 139 older adults with HIV and health outcomes from the literature.

Methods

We tracked the progression of …

Gender And Racial Disparity For Hospital Emergency Service Usage In Usa: A Quantitative Analysis For Various Age Groups During 2010–2017., Subhendra N. Sarkar, Anthony F. Devito, Evans Lespinasse, Faisal Khosa

Publications and Research

Background: Annually emergency department (ED) services are utilized by more than 100 million Americans making ED usage trends important determinants of healthcare quality, outcomes and cost. Previous workers have demonstrated the existence of disparity in various healthcare services in USA although a comprehensive analysis has not been undertaken. Dahlgren and Whitehead rainbow model has offered insights for multiple factors of influence on an individual’s health and focuses on the relationships among these factors. The Commission on Social Determinants of Health (CSDH; WHO initiatives) suggests that the social and environmental factors are at the root of most of the inequalities responsible …

The Occupational Depression Inventory: A New Tool For Clinicians And Epidemiologists, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Background: Depressive symptoms induced by insurmountable job stress and sick leave for mental health reasons have become a focal concern among occupational health specialists. The present study introduces the Occupational Depression Inventory (ODI), a measure designed to quantify the severity of work-attributed depressive symptoms and establish provisional diagnoses of job-ascribed depression. The ODI comprises nine symptom items and a subsidiary question assessing turnover intention. Methods: A total of 2254 employed individuals were recruited in the U.S., New Zealand, and France. We examined the psychometric and structural properties of the ODI as well as the nomological network of work-attributed depressive symptoms. …

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. …

Exercise Behavior And Mood During The Covid-19 Pandemic In Taiwan: Lessons For The Future, Yu-Kai Chang, Chiao-Ling Hung, Sinika Timme, Sanaz Nosrat, Chien-Heng Chu

Publications and Research

The Coronavirus disease 2019 (COVID-19) pandemic and its associated governmental recommendations and restrictions have influenced many aspects of human life, including exercise and mental health. This study aims to explore the influence of COVID-19 on exercise behavior and its impact on mood states, as well as predict changes in exercise behavior during a similar future pandemic in Taiwan. A cross-sectional online survey was conducted between 7 April and 13 May 2020 (n = 1114). Data on exercise behavior pre and during the pandemic and mood states were collected. A cumulative link model was used to predict changes in exercise frequency …

Association Of Body Shape Index (Absi) With Hand Grip Strength, Nir Y. Krakauer, Jesse C. Krakauer

Publications and Research

Hand grip is a leading measure of muscle strength and general health, yet its association with body shape is not well characterized. Here, we examine correlations between grip strength, a body shape index (ABSI), and body mass index (BMI) in the 2011–2014 United States National Health and Nutrition Examination Survey cohorts. Grip strength was found to correlate negatively with ABSI (though positively with BMI), suggesting that those with a more central body profile tend to be weaker than others with the same weight. Individuals with low grip strength, as well as those with high ABSI, were more likely to die …

Coh-2000 - Community Health Interventions, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that exposes students to a range of health promotion and disease prevention and management strategies used by health specialists to address community health challenges. Through readings and videos, as well as online course assignments and discussions, students learn about planning and designing interventions to improve the health of specific priority populations and communities-at-large.

Ptsd And Depressive Symptoms As Potential Mediators Of The Association Between World Trade Center Exposure And Subjective Cognitive Concerns In Rescue/Recovery Workers, Ankura Singh, Rachel Zeig-Owens, Laura Rabin, Theresa Schwartz, Mayris P. Webber, David Appel, David J. Prezant, Charles B. Hall

Publications and Research

We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline (N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting …

Covid-19: Health As A Common Good, Alfredo Morabia

Publications and Research

No abstract provided.

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 Public Health We Need, Alfredo Morabia

Publications and Research

No abstract provided.

Resuming On-Site Services: Final Report And Recommendations Of The Cuny Libraries Covid-19 Task Force, Kathleen Dreyer, Jeffrey Delgado, Karen Okamoto, Steven Ovadia, Roxanne Shirazi, Michael Waldman, Haruko Yamauchi, Simone Yearwood

Publications and Research

This report was prepared by the CUNY Libraries COVID-19 Task Force, which formed in May 2020 with the following charge:

Authorized by the CUNY Office of Library Services and the Council of Chief Librarians, the task force is charged to survey best practices shared by libraries world-wide and to develop guidelines for CUNY Libraries site management, staff and user safety, circulation and resource sharing, and materials handling as pandemic conditions evolve.

A summary of the draft report was submitted by Interim Dean for Library Services Polly Thistlethwaite to CUNY’s Academic & Student Support Task Force on June 23, 2020. The …

Addressing The Commercial Determinants Of Health Begins With Clearer Definition And Measurement, Kelley Lee, Nicholas Freudenberg

Publications and Research

No abstract provided.

Stress Measured By Allostatic Load Varies By Reason For Immigration, Age At Immigration, And Number Of Children: The Africans In America Study, Thomas Hormenu, Elyssa M. Shoup, Nana H. Osei-Tutu, Arsene F. Hobabagabo, Christopher W. Dubose, Lilian S. Mabundo, Stephanie T. Chung, Margarethe F. . Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22–65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.

Online Grocery Shopping By Nyc Public Housing Residents Using Supplemental Nutrition Assistance Program (Snap) Benefits: A Service Ecosystems Perspective, Nevin Cohen, Katherine Tomaino-Fraser, Chloe Arnow, Michelle Mulcahy, Christophe Hille

Publications and Research

This paper examines adoption of online grocery shopping, and potential cost and time savings compared to brick and mortar food retailers, by New York City public housing residents using Supplemental Nutrition Assistance Program (SNAP) benefits. A mixed methods action research project involving the co-creation of an online shopping club, the Farragut Food Club (FFC), recruited 300 members who registered to shop online using SNAP, and received waivers on delivery minimums and provided technical assistance and centralized food delivery. We conducted a survey (n = 206) and focus groups to understand shopping practices; FFC members collected receipts of groceries over two …

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 …

Enhancing Global Health Communication During A Crisis: Lessons From The Covid-19 Pandemic, Scott C. Ratzan, Silvia Sommarivac, Lauren Rauh

Publications and Research

Background/objective: The understanding and practice of public health crisis communication are improved through the study of responses to past crises, but require retooling for present challenges. The ‘Addressing Ebola and other outbreaks’ checklist contains guiding principles built upon maxims developed from a World Health Organization consultation in response to the mad cow (bovine spongiform encephalopathy) crisis that were later adopted for Ebola. The purpose of this article is to adapt the checklist for the health communication challenges and public health practices that have emerged during the coronavirus disease 2019 (COVID-19) pandemic. The communication challenges of promoting vaccine acceptance are used …

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 …

Racism And The Political Economy Of Covid-19: Will We Continue To Resurrect The Past?, Zinzi D. Bailey, J. Robin Moon

Publications and Research

COVID-19 is not spreading over a level playing field; structural racism is embedded within the fabric of American culture, infrastructure investments, and public policy, and fundamentally drives inequities. The same racism that has driven the systematic dismantling of the American social safety-net has also created the policy recipe for American structural vulnerability to the impacts of this and other pandemics. The Bronx provides an important case study for investigating the historical roots of structural inequities showcased by this pandemic; current lived experiences of Bronx residents are rooted in the racialized dismantling of New York City’s public infrastructure and systematic disinvestment. …

Studying Public Perception About Vaccination: A Sentiment Analysis Of Tweets, Viju Raghupathi, Jie Ren, Wullianallur Raghupathi

Publications and Research

Text analysis has been used by scholars to research attitudes toward vaccination and is particularly timely due to the rise of medical misinformation via social media. This study uses a sample of 9581 vaccine-related tweets in the period 1 January 2019 to 5 April 2019. The time period is of the essence because during this time, a measles outbreak was prevalent throughout the United States and a public debate was raging. Sentiment analysis is applied to the sample, clustering the data into topics using the term frequency–inverse document frequency (TF-IDF) technique. The analyses suggest that most (about 77%) of the …