Digital Commons Network^™

Light At Night And Cancer Incidence: A Gis-Based Study In The Us, Linshuoshuo Lyu

Public Health Theses

Aims: Light at night (LAN) can cause circadian disruption and was found to be a potential risk factor for several cancers. This study aims to confirm the adverse effect of LAN on hormone-related cancers and explore the association between LAN and the prevalence of various cancer types under an ecological study design. Methods: County-level age-adjusted cancer incidence data was obtained from the CDC Cancer Statistics (2016 to 2020), while LAN data (1996 to 2000) was obtained from the satellite imagery of Version 4 Defense Meteorological Satellite Program. Linear mixed effect regression models (LMMs) were performed to assess the relationship of …

Drivers Of Global Waterborne Disease Transmission Following Extreme Precipitation Events: A Systematic Review, Claire Latendresse

Public Health Theses

Precipitation events such as hurricanes, typhoons, and heavy rainfall can have devastating impacts on water and sanitation infrastructure around the world and have led to large-scale waterborne outbreaks. As climate change amplifies the frequency and intensity of extreme weather events, it is also triggering an increase in waterborne disease transmission. This master’s thesis consists of a systematic review of academic literature pertaining to extreme precipitation events and the pathways by which they trigger waterborne outbreaks.

A systematic review of the literature in PubMed was conducted to identify waterborne disease outbreaks associated with extreme precipitation. The initial search yielded 3,248 results …

A Geospatial Analysis Of Demographic Characteristics And Environmental Burdens In Communities Near Superfund Sites, Long Island, New York, Fintan Mooney

Public Health Theses

Nassau and Suffolk Counties of Long Island, New York, have over 30 federal Superfund sites, which may contribute to increased health inequities in nearby communities due to potential drinking water contamination and air pollutant emissions. We assessed the proximity to Superfund sites on Long Island in relation to community demographics and the presence of other environmental burdens. Data were obtained from the 2022 United States Environmental Protection Agency’s Environmental Justice Screening and Mapping Tool (EJScreen) and included proximity to Superfund sites (operationalized through the EJScreen distance weighting score), presence of other environmental hazards, and sociodemographic variables from the U.S. Census …

Characterizing Populations Living Near Concentrated Animal Feeding Operations: Implications For Health Equity And Environmental Justice, Leah Salzano

Public Health Theses

Current literature has highlighted that concentrated animal feeding operations (CAFOS) are associated with adverse health outcomes among populations living in close proximity to the farms and that, in certain states, vulnerable populations may be disproportionately exposed to CAFOs. However, none of the existing studies have assessed the sociodemographic makeup of areas highly exposed to CAFOs across a diverse geographic range. Using locations of CAFOs across six states with robust operations, we conducted logistic regression models assessing the likelihood of high exposure vs. low exposure at the census tract level for each 10% increase in sociodemographic variables (percent unemployed, percent minority, …

Association Of Diurnal Temperature Range With Pediatric Influenza Hospitalization Rates In The United States, 2009 – 2019, Khang Duy Tran

Public Health Theses

Introduction: Climate change may have a negative impact on respiratory illnesses, such as influenza. Diurnal temperature range (DTR), an indicator of climate change, is the difference between the maximum and minimum temperature within a day or a week. As the climate warms, global DTR decreases, though there might be regions where DTR increases instead. Previous literature conducted in non-U.S. regions found both positive and negative associations between DTR and influenza infections. A group especially vulnerable to the effects of DTR are children less than 5 years of age due to their less-developed thermoregulation capability. This study thus aimed to explore …

The Potential Link Between Pfas And Colorectal Cancer: A Narrative Review, Amina Mutalib

Public Health Theses

Background: Currently, there is information on the detrimental impacts of exposure to pollutants such as per- and polyfluoroalkyl substances (PFAS) but there is still limited information on the impact PFAS has on colorectal cancer.Aim: To review and examine the evidence available in the existing published literature showing an association between exposure to PFAS and colorectal cancer. Methods: In this narrative review using searches of PubMed, SCOPUS and Google Scholar, publications between 2003 and 2023 were identified to ensure the inclusion of all recent development in this area of research. Inclusion criteria included a focus on the association between PFAS/PFOS and …

Evaluating Environmental Risk Factors For Community-Associated C. Difficile Infection In New Haven County, Connecticut, 2016-2021, Hannah Liat Litwak

Public Health Theses

Background: Clostridioides difficile infection (CDI) is classified as an urgent threat to public health and has been increasing in incidence and severity. CDI is commonly considered hospital- acquired; however, rates of community-associated CDI (CA-CDI) have been increasing and now make up more than 50% of cases reported. Risk factors for CA-CDI exposure are poorly understood and inadequately studied. This study uses regression to evaluate if community characteristics are associated with CA-CDI incidence at the census tract level in New Haven County. The goal is to determine if where someone lives in proximity to these potential risk factors may contribute to …

“Am I Sick Or Just Discarded?”: Psychiatry, Health Care Reform, And The Rise Of Geriatrics In America, 1931-1954, Sophie E. Edelstein

Harvey M. Applebaum ’59 Award

Between 1931 and 1941, the United States population over the age of sixty-five increased by over 35 percent. These individuals, however, did not receive increased support. Rather, American politicians and society at large labeled the elderly a ‘burden,’ and passed off their care to the overworked medical personnel of state and federal mental institutions. Sparked by clinical exposure to the influx of elderly patients to mental institutions, Massachusetts psychiatrist David Rothschild identified an erroneous assumption in care practices for senile patients. In many cases, physicians preemptively diagnosed those admitted to state and federal institutions with some form of senile dementia, …

Evolutionary Dynamics Of Rapid, Microgeographic Adaptation In An Amphibian Metapopulation, Adam Zachary Andis Arietta

Yale Graduate School of Arts and Sciences Dissertations

Wild organisms can rapidly adapt to changing environments, even at fine spatial scales. This fact prompts hope that contemporary local adaptation may buffer some of the negative anthropogenic impacts to ecosystems. However, there are limits to the pace of adaptation. Understanding the adaptive potential—and limitations—of individual species at fine-resolution is an important task if we hope to accurately predict the repercussions of future climate and landscape change on biodiversity. My dissertation takes advantage of an uncommonly long-observed and closely-studied system to paint a comprehensive picture of evolution over time in association with shifts in ecological contexts. In this dissertation, I …

Critical Theory In Revolt: Angela Davis, Rudi Dutschke, Hans-Jürgen Krahl And The Frankfurt School, 1964-1972, Cecilia Sebastian

Yale Graduate School of Arts and Sciences Dissertations

This dissertation charts an alternative history of Frankfurt School Critical Theory through its critical reception and appropriation by students involved in anti-authoritarian, anti-capitalist, and anti-imperialist social movements in the United States and West Germany in the 1960s and 1970s. There, many student readers of the tradition, including those named in the title, found opportunities to refine and critique their mentors’ ideas about capitalism and the state, racism and fascism, technology and mass culture, and the nexus of theory and praxis. They resisted the domestication of Critical Theory into the purely academic discourse of philosophy, sociology, and political theory, and instead …

A Silent Injustice: Air Pollution As A Contributing Factor Of Covid-19 Health Disparities, Spencer Johnson

The Yale Undergraduate Research Journal

COVID-19, the disease caused by SARS-CoV-2 has had a disproportionate impact on Black communities throughout the United States. This paper suggests that air pollution may be a factor for why Black individuals experience markedly poorer health outcomes after contracting COVID-19. It establishes that not only are Black Americans exposed to disproportionate amounts of air pollution, but also that many air pollution-related ailments are the exact ones that have been clinically proven to make COVID-19 more fatal. AV Whe UniWed SWaWeV diVcXVVeV ZhaW a ³neZ noUmal´ entails for healthcare practice and public health policy, this paper makes the case for why …

Co-Distribution Of Ambient Light At Night And Incidence Of Human Cancers And Covid-19, Yidan Meng

Public Health Theses

Introduction and BackgroundThere are increasing concerns about the effects of artificial lights on human health, including hormone-related disease and immune functions. In January 2020, the outbreak of COVID-19 disrupted everyone’s life, and people who infected have various severity. Thus, we want to analyze whether people exposed to different ambient light at night (LAN) levels make them more susceptible to COVID-19 for our summer research. Besides the effects of LAN on immune functions, we also discussed the association of LAN and multiple cancers in seven states of Northeastern U.S. We used similar statistical and geographic analysis methods and separate them into …

Investigation On The Association Between Unconventional Oil And Gas Development And Traffic Accident Rates In Ohio, Hubian Wang

Public Health Theses

The oil and gas drilling activities had greatly developed in Ohio in past decade. Unconventional natural gas development is a newly developed technology, which requires more heavy-truck trips in the drilling process. Limited studies investigated the association between drilling activities and increased rate of traffic accidents. Ecological study was conducted to analyze the association. Number of unconventional wells were obtained as exposure variable from Ohio department of natural source, and the data of traffic crashes were collected as outcome variable from Ohio department of public safety. Other variables including sociodemographic data and spatial distribution of primary roads were examining as …

Caesarean Delivery Among Women Of Color Is Associated With Risk Of Early Childhood Developmental Delays In Brazil, Haley Case

Public Health Theses

Background. Poverty, racism, and other sources of oppression threaten children’s nurturing environments and associated early childhood development (ECD). Women of Color and their children are disproportionately exposed to risk factors for poor ECD in Brazil. There is a growing body of evidence supporting the claim that unnecessary cesarean section (CS) is associated with poor maternal health outcomes and ECD delays. There is an existing gap in the literature on risk factors, including obstetric factors, of poor ECD among children of Women of Color in Brazil.

Objective. The objective of this thesis was to investigate factors, including obstetric characteristics of CS …

Association Between Opening A Jail And Sexually Transmitted Infections In Rural Counties Across The United States, Tyler Harvey

Public Health Theses

Abstract

Objective

To estimate the effect of openings jail in rural counties on county-level chlamydia, gonorrhea, and syphilis prevalence rates.

Methods

We used county-level data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (2005-2017) to obtain chlamydia, gonorrhea, and syphilis rates, and the American Correctional Association’s National Jail and Adult Detention Directory (2013-2014) to locate rural jail openings. Using a generalized synthetic control method, we estimated the effect of opening jails in 41 rural counties between 2010 and 2012 across the United States on sexually-transmitted infections.

Results

We found an average treatment effect for chlamydia prevalence …

Targeting The Inequality In Quality Improvement, Raquel Maria Davis

Public Health Theses

Objective. To use Casalino et al.’s (2007) proposed causal pathways of how pay-for-performance (P4P) can exacerbate racial/ethnic health care disparities as a framework for analyzing the literature and determine the adequacy of the evidence.

Data Sources/Study Setting. Existing literature (gray and peer-reviewed) on pay-for-performance and racial/ethnic health disparities identified from the Ovid Medline database.

Conceptual Framework. Casalino et al.’s four casual pathways include: “Pathway 1: Reduction in income for physicians in poor minority communities,” “Pathway 2: ‘Color-blind’ quality improvement programs,” “Pathway 3: ‘Teaching to the test’ might disproportionately affect minorities,” and “Pathway 4: Avoiding patients perceived as likely to lower …

Prep Uptake, Adherence, And Persistence: Qualitative Interviews With Women Experiencing Ipv, Ipv Service Providers, And Healthcare Providers, Amy Janet Caplon

Public Health Theses

Background: Intimate partner violence (IPV) has been associated with HIV susceptibility and

acquisition. Studies have found that women who had experienced IPV were at least three times more likely to have a diagnosis of HIV. Women are interested in taking PrEP, however barriers to uptake, adherence, and persistence are not widely known, and present knowledge excludes experiences of healthcare providers and IPV service providers. In this qualitative study, we examined the perceived facilitators and possible solutions to PrEP uptake, adherence, and persistence. This was done using a sample of women experiencing IPV, Reproductive Health Providers, PrEP Providers, and IPV service …

Association Of Age On Diagnosis And Treatment Of Locally Advanced And Metastatic Prostate Cancer, Chi Zhang

Public Health Theses

Background Prostate cancer is an aging-related disease. As the result of the radiation are of STAMPEDE trial came out, major shifts in the use of local therapy (LT) are expected for men newly diagnosed with locally advanced and metastatic disease. This study aims to determine the role of patient age on LT.

Methods We identified 6882 and 37382 locally advanced and metastatic prostate cancer diagnosed in 2004-2014 using the National Cancer Database (NCDB). We used logistic multivariable regression to determine the role of age in the receipt of prostate and/or pelvic radiation or radical prostatectomy after adjusting for demographic and …

Multi-State Analysis Of Unconventional Oil And Gas Development And Rates Of Sexually Transmitted Infections In The United States, Nicholaus Peter Johnson

Public Health Theses

Background

Advances in unconventional oil and gas development (UOGD), including hydraulic fracturing and horizontal drilling, have helped position the United States as a world leader in the production of both crude oil and natural gas hydrocarbons. This significant increase in production would not have been possible, however, without the assemblage of a workforce that is predominantly young, male, and mobile. This is significant given that a number of studies have associated similar types of mobile workforces – especially those employed by resource extractive industries – with impacts on the sexual health of the host communities in which these workers operate …

Declines In Human Papillomavirus (Hpv) – Associated High-Grade Cervical Neoplasia By Sociodemographic Factors After Introduction Of Hpv Vaccines In Connecticut, Usa 2008-2017, Mike Yepes

Public Health Theses

Abstract

Background: In 2006, the FDA approved the first vaccine against human papillomavirus. Trends in HPV-related sequalae are an effective method of analyzing HPV vaccine impact. Our primary objective was to measure trends in cervical neoplasia based on sociodemographic characteristics including race, ethnicity, and socioeconomic status.

Methods: Since 2008, Connecticut has required reporting of cervical intraepithelial neoplasia labeled grade 2+ and adenocarcinoma in situ. CIN 2+ diagnoses trends were modeled by area-based measures of age, race, ethnicity, and socioeconomic status using negative binomial regression and change-point analysis. Incidence rate measurements were adjusted to reflect inclusion of women who had completed …

Clustering Of Suicide In Brazilian Indigenous Children And Youth: Implications For Interventions, Thomas Lazzarini

Yale Medicine Thesis Digital Library

CLUSTERING OF SUICIDE IN BRAZILIAN INDIGENOUS CHILDREN AND YOUTH: IMPLICATIONS FOR INTERVENTIONS.

Thomas Lazzarini, Crhistinne Gonçalves, Julio Croda, Albert Ko, Walter Benites, Liliane da Silva, Kristen McLean, Jason Andrews, Daniel Henrique Tsuha, and Robert Rohrbaugh. Department of Psychiatry, Yale University, School of Medicine, New Haven, CT.

Abstract: The purpose of this study was to conduct a retrospective cohort study as well as a qualitative study to better understand the current context of suicide among the indigenous population living on the reservations surrounding Dourados, Brazil. Critical questions included: What are the most important suicide risk factors? Which communities have the highest …

The Role Of Folate In The Association Between Perinatal Air Pollution Exposure And Birth Outcomes In Lanzhou, China, Rebecca Ann Wong

Public Health Theses

Background: China’s rapid economic and industrial development over the past few decades has been accompanied by tremendous increases in air pollutant emissions and come at a serious cost to the environment and public health. Recent research has revealed an increased risk of adverse birth outcomes associated with perinatal air pollution exposure. Although the mechanisms by which air pollutants contribute to adverse birth outcomes have not yet been established, folate intake has been shown to counteract several of the hypothesized biological pathways.

Hypothesis: Dietary folate intake and folic acid supplementation modify the association between perinatal air pollution exposure (PM10, NO2, SO2) …

The Effect Of Union Status On Injury Risk And Severity In A Manufacturing Cohort, Khaled Abdulrahman Altassan

Public Health Theses

Objective: This study aimed to investigate the effect of union status on risk of injury among a cohort of aluminum manufacturing workers.

Methods: This cohort study included all hourly employees at 19 U.S. plants, which were in operation between 2000 and 2007. Workers were classified into unionized and non-unionized groups. The final dataset combined a human resources database, which includes information about job history and socio-demographic information, and an incident management system, which includes information on work-related injuries. Injuries were classified by severity into four mutually exclusive categories: injuries requiring first aid, medical treatment, work restriction, and lost work time. …

Sociodemographic Differences In Human Papillomavirus Vaccine Impact: A Systematic Review, Alexandra Nichole Montano

Public Health Theses

IMPORTANCE: The majority of literature related to disparities in human papillomavirus (HPV) vaccination has been focused on sociodemographic differences in vaccine uptake. Now nearly ten years after the introduction of the vaccine, and with a better understanding of disparities in uptake, a small but growing body of evidence is beginning to examine the impacts of the vaccination campaign. Monitoring disparities in the impact of the vaccine is crucial in order to better understand the full implications of the vaccine and to properly guide future programs and recommendations.

OBJECTIVE: To systematically review the literature on the impact of the human papillomavirus …

Describing The Health Care Needs Of School-Age Children In Sub-Saharan Africa In Order To Develop A Model Of A Nurse-Run School-Based Health Clinic, Bonnie Tong

Yale School of Nursing Digital Theses

Objective: Rural Kenya is affected by health disparities and poor health outcomes among school-age children. This paper identifies gaps in health care among school-aged children in rural Kenya, in order to identify a health care model to meet those gaps.

Design: The results of a systematic review on the health care needs were triangulated with field notes from interviews of stakeholders in a rural Kenyan village. Needs were then compared with currently available health care resources to identify gaps.

Sample: Multiple databases were searched to identify relevant articles published between the years 2000- 2014. Interviews were conducted with health workers, …

Influenza And Asthma Hospitalizations In Nyc From 2002-2012, Pauline Trinh

Public Health Theses

INTRODUCTION: The literature has focused primarily on rhinoviruses as the major determinant of asthma exacerbations. The association between other respiratory viruses such as influenza and asthma exacerbations is not well characterized and further understanding can better inform prevention strategies to reduce influenza-related asthma.

OBJECTIVES: The primary objective of this study is to determine whether asthma hospitalizations of children and adults in the five boroughs of New York City is correlated with influenza hospitalizations temporally and spatially and whether these correlations differ by county or age.

METHODS: A times series regression analysis was performed using influenza hospitalizations as the explanatory series …

Estimating The Incidence Of Japanese Encephalitis In Divisions Of Bangladesh, Craig Michael Rothenberg

Public Health Theses

Japanese Encephalitis (JE) is a mosquito-borne viral disease responsible for 30,000 to 50,000 reported cases and up to 15,000 reported deaths every year. The disease is a significant public health concern in Bangladesh, but there is no regular surveillance or immunization for JE in the country. The objective of this study is to determine whether a practical model to estimate the incidence of JE in Bangladesh can be developed using data on population, environmental characteristics, and/or vector distribution for JE-endemic countries in Asia and the Western Pacific. Information on JE incidence, area, land cover, climate, population characteristics, land elevation, and …

Hpv Vaccine Effectiveness In New Haven County, Connecticut Women Age 18-39, 2008-2012, Jennifer Lynn Berry

Public Health Theses

Background: HPV vaccines have demonstrated high efficacy in clinical trials against cervical lesions and infections by HPV vaccine types 16 and 18. Together these two types are responsible for approximately 70% of cervical cancer. Data on HPV vaccine effectiveness in general populations is limited.

Methods: Surveillance data monitoring high-grade cervical lesions in Connecticut was used. Medical records were reviewed and patients were interviewed to ascertain HPV vaccine history. Patients' biopsy specimens were typed to determine the presence of vaccine or non-vaccine type HPV. Odds ratios were determined using logistic regression, adjusting for age at diagnosis, grade of cervical lesion, race/ethnicity, …

Geospatial Analysis Of Violent Crime And Premature Mortality From Chd, Sarah Elise Conderino

Public Health Theses

Background: Cardiovascular disease (CVD) is the leading cause of death in the United States and many of these deaths are preventable. Studies have shown that neighborhood-level characteristics may contribute to health outcomes, but no study has yet examined whether neighborhood crime contributes to early mortality from CVD.

Objective: We examined geographic trends in the association between neighborhood crime rates and premature mortality from coronary heart disease (CHD) using New Haven, CT USA as a model city.

Methods: Neighborhoods in New Haven were established by existing census tracts. CHD deaths were identified from the Connecticut Master Death Files and violent crime …

Incorporating Satellite Derived Cloud Climatologies To Improve High Resolution Interpolation Of Daily Precipitation., Adam M. Wilson, Benoit Parmentier, Brian Mcgill, Rob Guralnick, Walter Jetz

Yale Day of Data

Conservation of biodiversity demands comprehension of evolutionary and ecological patterns and processes that occur over vast spatial and temporal scales. A central goal of ecology is to understand the factors that control the spatial distribution of species and this has become even more important in the face of climate change. However, at global scales there can be enormous uncertainty in environmental data used to model species distributions. Even ‘simple’ metrics such as mean annual precipitation are difficult to estimate in areas with few weather stations and available data sets do not quantify uncertainty in these surfaces. We are developing a …