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Attitudes And Interactions Of Indigenous And Non-Indigenous People With Wildlife In The Northern Talamanca Mountains Of Costa Rica, Carolina Saenz-Bolaños

Doctoral Dissertations

In this study I investigated wildlife and human use of landscapes in the northern Talamanca Mountains of Costa Rica (Pacuare-Barbilla sector), including three contiguous protected areas (a national park, a forest reserve, and an indigenous territory), as well as surrounding unprotected areas. I describe and compare perceptions of wildlife by different social actors in the Pacuare-Barbilla sector, collecting information with a questionnaire as an instrument. I also inventoried and monitored the abundance and distribution of a variety of wildlife species occurring throughout the area using camera traps. The species with greater abundance or only occurrence in the national park were …

Reducing Patient Risk For Suicidal Behaviors With A Safety Bundle Of Best Practices With Non-Psychiatric Patients, Olayemi Akindele

Student Scholarly Projects

Practice Problem: Suicide is a public health condition that affects people globally. The increased suicidal behaviors of patients in a medical-surgical unit demanded an effective screening protocol to identify high-risk patients.

PICOT: In patients 18 years and older on a medical-surgical unit, does the implementation of the Columbia Suicide Severity Rating Scale (C-SSRS) tool and application of a Safety Bundle of Best Practices (SBBP) increase early identification of suicide risk with decreased patient self-harm behaviors, compared to the current standard practice of no assessment tool or safety bundle of best practices within 12 weeks?

Evidence: Ten studies served as evidence …

Patient Satisfaction With Noise, Robert W. Kentner Ii

Student Scholarly Projects

Practice Problem: Noise on hospital units can interfere with patient rest, timely recovery, and statisfacton with care. Improvements in the reduction of hospital noise levels lead to improved patient satisfaction and improved rest. Patients were surveyed on their satisfaction with noise during the day and at night.

PICOT: In Acute Care Patients (P), does the implementation of a noise reduction program (I) compared to no noise reduction program (C), affect patient satisfaction with noise (O) over a six-week period (T)?

Evidence: Studies show that many hospitals have noise levels that exceed the World Health Organization’s recommended standards for noise …

Does Knowing The Mental Health History Of A Mass Shooter Heighten Stigma And Negative Attitudes Toward Mental Illness?, Lianna Artessa

PCOM Psychology Dissertations

Mass-shooting incidents are an ongoing epidemic that continues to take countless lives. Despite the prevalence of gun-related mass-shooting events, the research on this phenomenon is scarce. Following these events, individuals often receive news from differing media outlets and programs. The current media portrayal of mass-shooting events often appears to support a widely accepted connection between mass shootings and mental illness. This portrayal may reflect an existing and perhaps growing misunderstanding and negative stigma toward individuals diagnosed with a psychiatric disorder. This experimental study sought to determine the degree to which individuals’ attitudes toward and opinions of a perpetrator of a …

Do Faces Facilitate Or Distract Children From Attending To Threats?, Sarah A. Skidmore

Senior Honors Projects, 2010-2019

Threatening stimuli may produce an attentional bias in humans, capturing and holding attention to a greater extent than other types of stimuli. Humans rely on others to alert their attention to threats in their environment, and social stimuli, such as faces, have privileged processing compared to nonsocial stimuli. We wanted to explore whether task-irrelevant fearful or neutral faces facilitate, distract, or have no effect on the detection of threatening or neutral images (spiders and frogs, respectively). Three- to-five-year-old children (N=37) completed a visual search task in which they searched for threatening or neutral animals. Consistent with previous literature, we found …

A Discussion Regarding Various Animals' Abilities To Make Music And Move Rhythmically To Songs, Emilie R. Bufford

Capstone Projects and Master's Theses

This project involves exploring the presence of music and rhythmic abilities in specific animal species. The main subjects are whales, sea lions, gorillas, elephants, birds, and mice. The goal of this project was to compare their abilities to those of humans, and overall, determine whether such abilities are considered musical. Cases where animals demonstrate the ability, both learned and innate, to move to a beat are analyzed, along with animals who demonstrate musical vocal abilities naturally in the wild. The previously unknown frequencies of whales, mice, and elephants, are brought to light. These findings bring up the possibility of even …

Hiv-1 And Helminth Co-Infection In Adults In Kenya, Cameron Page

Yale Medicine Thesis Digital Library

BACKGROUND: As part of rapidly expanding HIV-1 Care Programs in sub-Saharan Africa, many HIV-1 infected individuals are being identified who do not yet qualify for ART. These individuals may benefit from treatment of co-infections, such as soil-transmitted helminths. Treatment of helminth infection in HIV-1 infected individuals may improve health and nutrition and may slow progression to AIDS. In this setting, access to both medical care and diagnostic testing is limited. Determining correlates of helminth infection in HIV-I infected individuals may allow clinicians to better target empiric anti-helminth therapy in HIV-1 infected individuals. METHODS: To describe the prevalence and correlates of …

Evaluation Of A Social Support Measure That May Indicate Risk Of Depression During Pregnancy, Lori Spoozak

Yale Medicine Thesis Digital Library

The objective of this study was to evaluate the psychometric properties of the Kendler Social Support Interview modified for administration to pregnant women and to assess the relationship between social support and depression in the first trimester of pregnancy. Subjects were administered the Modified Kendler Social Support Interview (MKSSI) and the Composite International Diagnostic Index to diagnose depression. Principal components analysis was employed to construct the MKSSI score. Cronbachs coefficient alpha and principal factor analysis were run for items included in the MKSSI score. The relationship between a depressive diagnosis and the MKSSI score and subscales was assessed by logistic …

Intussusception Of The Appendix: New Trends And Comprehensive Analysis Of 140 Case Reports, Barbara Wexelman

Yale Medicine Thesis Digital Library

INTUSSUSCEPTION OF THE APPENDIX: NEW TRENDS AND COMPREHENSIVE ANALYSIS OF 140 PUBLISHED CASE REPORTS. Barbara A. Wexelman, Cassius Ochoa Chaar, and Walter Longo. Section of Colorectal Surgery, Department of Surgery, Yale University, School of Medicine, New Haven, CT. Statement of Purpose: This paper uses 139 published case reports to understand the demographic, diagnostic, and treatment trends of intussusception of the appendix. Methods: Using the PubMed literature search engine to find all English references of intussusception and appendix, and reviewing those that contained actual case reports of intussusception of the appendix, we analyzed the demographics, presentation, diagnostic methods, surgical treatment, and …

Electrical Stimulation And Glutamate In The Hippocampus Of Epilepsy Patients, Gabriel Widi

Yale Medicine Thesis Digital Library

Electrical brain stimulation has been proposed as a promising treatment option for patients with medically resistant epilepsy disorder. Glutamate levels in the epileptogenic human hippocampus are elevated interictally and increase with seizures. Fifty Hz stimulation is a candidate therapeutic stimulation that is also used for clinical cortical mapping. We examined the effects of 50 Hz stimulation on glutamate efflux in the hippocampus of patients with medically refractory epilepsy. Subjects (n = 10) underwent intracranial EEG (icEEG) evaluation for possible therapeutic resection. Electrical stimulation was delivered through implanted hippocampal electrodes (n = 11) and microdialysate samples were collected every 2 mins. …

Influence Of A Serotonin Transporter Promoter Polymorphism (5-Httlpr) On Corticolimbic Abnormalities In Bipolar Disorder An Integrated Genetics And Functional Mri Study, Maulik Shah

Yale Medicine Thesis Digital Library

Bipolar disorder (BD) is associated with abnormalities of the subgenual anterior cingulate cortex (sgACC) and the amygdala, components of a corticolimbic neural system that subserves emotional regulation. The short s allele - as opposed to the long l allele - of a serotonin transporter promoter (5-HTTLPR) polymorphism is associated with more severe course features of BD and impaired functional connectivity between the sgACC and amygdala in healthy control (HC) individuals. This study tests the hypothesis that the s allele influences the dysfunction in the sgACC-amygdala neural system in BD. Twenty-six euthymic BD participants (17 s carriers, 9 ll) and 43 …

Outcomes In Patients With End-Stage Renal Disease And Colonic Diverticular Disease, Louis Salamone

Yale Medicine Thesis Digital Library

Purpose: To evaluate clinical presentation and outcomes of patients with end-stage renal disease (ESRD) or renal transplantation and symptomatic colonic diverticular disease Methods: A retrospective review of all patients with the primary diagnosis of diverticulitis or diverticulosis and end-stage renal disease treated at Yale-New Haven Hospital from January 1, 1985 to December 31, 2005 was performed. Patient factors evaluated including age, gender, comorbidities, nature of ESRD, and immunosuppression if any, along with the diagnosis of diverticulosis or diverticulitis, complicated vs. uncomplicated and outcomes including morbidity, mortality and LOS. Patients were evaluated to determine predictors of poor outcome. Simple summary statistics …

Depression And Resilience During The First Six-Months Of Internship, Rachel Laff

Yale Medicine Thesis Digital Library

Consistent with prior studies, the prevalence of depression in interns is significantly higher than the general population. There is a significant amount of suicidal ideation among interns during the first three-months of internship. It appears that international medical graduates are significantly less depressed than U.S. medical graduates during the first six-months of internship. A prior history of depression, longer work hours, female gender, and a lack of confidence in coping with challenges are associated with the development of depression during the first six-months of internship. Of greatest concern, very few interns with clinically significant levels of depression are seeking treatment. …

Efficacy Of Formal Screening For Depression In Pediatric Type 1 Diabetes Clinic, Jeffrey Winer

Yale Medicine Thesis Digital Library

This study was undertaken to examine the efficacy of screening for depression in a pediatric diabetes clinic and how the yield of such screening compares with established screening protocols aimed at identifying early microvascular complications and associated autoimmune diseases. Two-hundred-fifteen children and adolescents 8-18 years old in the Yale Pediatric Diabetes Center were screened for depression using the Children's Depression Inventory (CDI), with information including gender, age, duration of diabetes, HbA1C, and results of other screening protocols compiled. A total of 8.4% of our cohort had CDI scores ≥13 indicative of clinically-significant depressive symptoms, with a range of 0-34. Depression …

Anatomy, Physiology And Management Of Patients With Diffuse Pulmonary Arteriovenous Malformations, Tamara Lazic

Yale Medicine Thesis Digital Library

Diffuse pulmonary vascular malformations (PAVMs) are a small and understudied, but nevertheless important subset of the PAVM population of patients, associated with significant mortality and morbidity. A review of literature was undertaken to investigate the current understanding of diffuse PAVMs. This review demonstrated that no additional attempts to define diffuse PAVMs and describe their natural history was made before or after the in 2000 report by Faughnan et al {{51 Faughnan,M.E. 2000; }}. To further expand the findings from 2000, we performed a retrospective review of 36 patients (21 female, 15 male) with diffuse PAVMs from a cohort of 821 …

Localized Biliary Ischemia In Patients With Hepatic Arteriovenous Malformations, A Newly Recognized Syndrome Occurring In Hereditary Hemorrhagic Telangiectasia Diagnosis And Management, Rasha Khoury

Yale Medicine Thesis Digital Library

The clinical manifestations of hepatic arteriovenous malformations (HAVMs) were elucidated. A review of the literature was undertaken to better understand how HAVMs specifically affect the biliary system. A retrospective review of the 50 patients with HAVMs seen at the Yale University HHT Center was done, including clinical manifestation, intervention and outcome analysis. Of 50 adults with HAVM, median age was 64 (range 17-73) and 84% were female. Initially 74% were classified as Type 1, symptomatic heart failure, 16% as Type 2, portal hypertension, and 10% as Type 3, biliary abnormalities. In Type 1 conversion to Type 3 was associated with …

Differences In The Central Neural Activation Under Emotional Stress Across The Menstrual Cycle, Nayalya Lopushnyan

Yale Medicine Thesis Digital Library

The present study had several goals. First, we aimed to investigate the potential differences in the activation of the corticolimbic structures during emotional stress in healthy women across the menstrual cycle using stress imagery. Second, we searched for differences in the subjective anxiety under emotional stress across the menstrual cycle and tried to correlate the perceived level of anxiety to activation of the specific corticolimbic structures. Third, we attempted to compare central neural activation of women in follicular and in luteal phases of the menstrual cycle separately to that of men during emotional stress to investigate potential differences in neural …

Reproductive Desires And Intentions Among Hiv-Infected Individuals In Chennai, India, Elizabeth Houle

Yale Medicine Thesis Digital Library

Despite the personal and cultural importance of childbearing in India, limited information exists on the extent of childbearing desires and intentions among HIV-infected individuals in this setting. The purpose of this study was to measure the extent of childbearing desires among HIV-infected individuals in Chennai, India, thereby testing the hypothesis that HIV significantly influences the desire to have children. Three hundred HIV-infected individuals were interviewed about childbearing desires and intentions during routine visits for HIV care at an HIV specialty care clinic in Chennai, South India. Sixteen percent of participants expressed desire for childbearing, and 9% expressed intention to have …

The Association Between Pediatric Overweight And Ankle Injuries: A Case-Control Analysis, Ellen Margaret House

Yale Medicine Thesis Digital Library

Pediatric obesity has become a worldwide pandemic and trauma is the leading cause of pediatric morbidity and mortality. Our hypothesis is that being overweight increases the likelihood of acute ankle injuries in children. Our study consisted of a case-control analysis in an urban pediatric emergency department with subjects between 5-19 years of age. Cases consisted of children presenting with acute ankle injury; controls had chief complaints of fever, headache, or sore throat. Demographic information, physical activity score, heights, and weights were obtained on all participants; injury severity was calculated for the cases. Age and gender specific body mass index percentiles …

Clinical And Demographic Predictors Of Short-Term Recovery From Arthroscopic Partial Meniscectomy, Peter Fabricant

Yale Medicine Thesis Digital Library

Patients undergoing orthopaedic surgery are concerned with returning to activities of daily living (recovery) in addition to the long-term result of their surgery (end result). As evidence of predictors of rate of short-term recovery is limited to date, this study seeks to determine which patient clinical and demographic factors can serve as prognostic indicators for rate of short-term recovery from arthroscopic partial meniscectomy in the year following surgery and how they may differ from previously published associations with long-term outcome. Clinical (depth of meniscal excision, involvement of one or both menisci, extent of meniscal tear, extent of osteoarthritis) and demographic …

The Use And Safety Of Vascular Occlusion Techniques: A Survey Of Practicing Surgeons, Ryan Kelly

Yale Medicine Thesis Digital Library

Vascular occlusion techniques can be divided into two categories ¡V transfixion and non-transfixion. Transfixion techniques are defined by the passage of suture material or staples through the vascular tissue. Non-transfixion techniques are defined as suture, metal, or polymer material placed solely around the vascular tissue. The purpose of this study was to survey surgeons in various specialties to determine which vascular control technique they believe is safest and most appropriate to manage medium-sized arteries 6-10mm in diameter. A survey was distributed to surgeons in the following specialties: general surgery, urology, thoracic surgery, vascular surgery, obstetrics and gynecology, and colon and …

Community Based Epidemiological Study Of Chagas Disease In Rural Peru, Paul Walker

Yale Medicine Thesis Digital Library

The purpose of this study was to evaluate the epidemiology of Trypanosoma cruzi infection, to valuate the TESA blot, and to characterize cardiac findings of patients with Chagas disease in a rural setting near Arequipa, Peru. The study site was the town of Quequeña, Peru with a population of 774 with 236 inhabitants under the age of 18 according to the 2005 census conducted by Peru. A fumigation/insect collection campaign was done in December of 2006 to quantify household infestation levels, document housing characteristics, and GPS household locations. Of the 602 people surveyed to be living in Quequeña, blood samples …

The Effect Of Teleradiology On Interpretation Times For Ct Pulmonary Angiography Studies, Scott Thomas Olcott Kennedy

Yale Medicine Thesis Digital Library

The purpose of this study was to evaluate the impact of a teleradiology service on the timely interpretation of computed tomography (CT) pulmonary angiography studies. A survey of clinical and imaging physicians was performed to develop achievable goals for interpretation of CT pulmonary angiography studies. Percentages of studies given preliminary written reports within these thresholds were compared for 1,102 pulmonary angiography CT studies from three months before teleradiology was implemented to three months after. Identical control data were matched over the same periods for 1,638 CT brain studies. Data are reported as averages and percentages. Statistical significance was evaluated with …

Melioration And The Behavioral Addiction Process: An Experimental Analysis, Jared Micah Dinehart

Theses and Dissertations

Melioration can be a factor contributing to behavioral addiction. In this study, 76 university undergraduates operated a "money machine" by selecting between choices that corresponded to maximization and melioration. Participants initially made choices consistent with a strategy of melioration and demonstrated significantly greater variability in choice behavior when visual cues were presented aimed at exposing the internality (or consequence) of the choice situation. Removal of the visual cues resulted in a return to lower responding. Visual cues may aid in interrupting the behavioral addiction pattern by limiting exclusive use of a melioration choice strategy. Methods of restructuring and experimentation with …