Medicine and Health Sciences Commons^™

: Examining How Factors Associated With Patients, Physicians, Hospitals, And Surrounding Communities Affect Primary And Repeat Cesarean Delivery Through A Social-Ecological Lens, Christina Ventura-Dipersia

Dissertations and Theses

Background: Childbirth is one of the most common reasons for hospitalization in the U.S., and Cesarean delivery (i.e., surgical childbirth) is costlier and has a higher likelihood of birth-related complications, maternal rehospitalization, and postpartum medical care utilization than vaginal delivery. The rate of Cesarean delivery in the United States (U.S.) has increased in recent years by over 60%, from 20.7% of all births in 1996 to 32.9% of all births in 2011. As Although this increasing trend of Cesarean delivery incidence has also been seen in other countries, the rate of Cesarean delivery has been rising more steadily within …

The Case For Not Giving Birth, Amanda D'Ambrosio

Capstones

Racism in medicine and a broken healthcare system has led to a maternal mortality crisis in the United States, one that disproportionately harms Black mothers. Though lawmakers and medical professionals have introduced legislation to expand healthcare and combat discrimination in clinical settings, reproductive justice leaders encourage new mothers to lean on their communities as a solution to the crisis.

Insured And In Debt, Virginia Jeffries

Capstones

Many Americans with employer-sponsored health insurance are still going into debt to pay medical bills.

http://virginia-jeffries.com/cap/

Putting A Face To Cancer, Lenn Robbins

Capstones

About one month after I began my studies at the Craig Newmark Graduate School of Journalism, I was diagnosed with a rare form of cancer, Langerhans Cell Histiocytosis (LCH). Three years and three relapses later, I have my MA, I defiant will to fight this disease and the hope that by chronicling my experience I might help others. If this project helps just one person, it's been worth the ride.

https://lennrobbins.wixsite.com/facetocancer

Nyc Is A Hotspot For Bedsores Among The Elderly And Immobile, Kara J. Brown

Capstones

New York City is a hotspot for bedsores in nursing homes, according to data provided by the federal government. The Big Apple is home to nine of the 10 nursing homes in the state with the highest rates of long-stay, high-risk patients suffering from bedsores. Nationwide, those 10 nursing homes are among the worst in the nation—the top 2%—for their high bedsore rates, the data shows. Residents considered high risk are, according to Medicare, those who are impaired in bed mobility or transfer, who are comatose, or who suffer from malnutrition.

More than one out of every four residents at …

More Than A Century After Problem Emerged, Manhole Explosions Still Injuring Dozens In New York City, Gaspard Le Dem, Gabriel Sandoval

Capstones

Since the early days of electrification, New York City has been rattled by manhole explosions –– underground blasts that injure residents, damage buildings, force evacuations, cause power outages and traffic disruptions.

Consolidated Edison, the city's largest electric provider, has for decades blamed manhole issues on bad weather and road salt that erodes underground wires. But some experts and former utility workers say lack of maintenance is at the root of the problem.

Meanwhile, city and state officials have failed to rein in the problem through weak laws and loose oversight. As a result, unsuspecting drivers and pedestrians continue to be …

Students With Mental Health Disabilities Suffer From Discrimination Across College Campuses, Abigail Nequa Napp

Capstones

Over the course of several months, we investigated and reported on how colleges and universities have been discriminating against students with mental health disabilities. We FOIA'd the Department of Education for a history of pending and resolved cases (from 2008 - November 2019) to uncover violations committed by colleges. In several instances, institutions discriminated and punished students instead of accommodating their mental health disabilities as required by law. We also reviewed recent lawsuits involving students against universities that focused on punitive leave of absence policies as well as wrongful death suits. This revealed further inefficiencies, deficiencies and tragedy in the …

Gay Social Networking Apps Are Fueling Crystal Meth Use, Moises A. Mendez Ii

Capstones

Selling crystal meth on gay social networks is a problem nobody is talking about; two men tell their stories. The LGBT+ community has a long standing relationship with the use of drugs. From the 70s to present day, there has been a popular drug used – currently, it's crystal meth. Adam and Christopher have dealt with their addiction to crystal meth for many years and the introduction of gay dating apps like Grindr, Scruff and Jack'd posed new problems for them when they were trying to stay sober.

https://medium.com/@moises.mendez/gay-social-networking-apps-are-fueling-crystal-meth-use-ac34f38fa636

Healing The Black Mind, Vanessa Etienne

Capstones

Due to an oppressive history, the African American community is more likely to have issues regarding mental health, but less likely to pursue professional treatment for it. However, as the perception of mental health care in the Black community starts to shift, many are finding unconventional ways to approach healing. http://vanessaetienne.tilda.ws

Dirty Water: The Newburgh Water Crisis, Shantal Riley

Capstones

Dirty

Dirty Water: the Newburgh water crisis

Summary

This project covers the ongoing water crisis in the City of Newburgh, New York. It tells the story of the contamination of the city’s drinking water by chemicals known as PFAS – short for perfluoroalkyl and polyfluoroalkyl substances.

Valued for their resistance to water and oil, the chemicals are found in carpets, furniture, clothes, non-stick cookware, food packaging and a range of industrial products. They’re nicknamed “forever chemicals” because they don’t break down in the environment. They’re also found in fire foam, which was used at Stewart Air National Guard Base. Located …

Acceptability Of A Vaginal Ring To Prevent Hiv And Pregnancy: Integrating Multiple Qualitative Methods, Dana Watnick

Dissertations and Theses

Heterosexual vaginal sex can simultaneously put women at risk for unintended pregnancy and sexually transmitted infections, such as HIV, disproportionately impacting poor women around the world. Both unintended pregnancy and HIV are persistent public health concerns associated with negative outcomes for mothers, families and communities. The current mix of prevention tools available to women to protect against unintended pregnancy and HIV is limited. Multipurpose Prevention Technologies (MPTs) are innovative products that simultaneously offer protection against pregnancy and HIV. However, MPTs will only be effective in reducing unintended pregnancy and incident HIV if women are willing to use them. With an …

An Exploratory Study Of How Millennials Approach And Communicate Mental Health In The Workplace, Johanna I. Seitenbach

Student Theses and Dissertations

Depression is the leading cause of disability worldwide, affecting more than 300 million people. As more millennials take on leadership positions, it is important to understand how companies are currently addressing mental health in the workplace and compare this to how millennials approach the subject. The quantitative analysis completed through this study helped to determine what a mentally healthy workplace looks and feels like for millennials. Companies are increasingly investing in mental health initiatives for several reasons: to increase brand recognition, to improve company culture, to mitigate potential lawsuits, and to increase employee engagement and retention. This survey assessed how …

Off-Label, On Brand: How Psychiatric Drugs Reached Unsuspecting Youths, Charles J. May, Danielle Hyams, Larisa Karr

Capstones

This capstone project takes a deep dive into the world of off-label medicine, specifically focusing on psychiatric drugs for children. Off-label medicine is common practice, but not many people understand the potential dangers of this practice if doctors are not forthcoming and honest with their patients about potential side effects. Throughout this report, we detail the experiences of youths who took antipsychotics and antidepressants for off-label purposes, and the life-changing side effects the experienced as a result.

https://medium.com/@charlie.may/off-label-on-brand-how-psychiatric-drugs-reached-unsuspecting-youths-cdcb22315789

What Happened To This Child? Identifying Factors That Influence The Identification And Categorization Of Child Maltreatment In The United States, Erika Tullberg

Dissertations and Theses

Background: Research has shown that adverse childhood experiences are strongly linked with health outcomes over the life course, and that child maltreatment – generally defined as physical abuse, sexual abuse, emotional maltreatment and neglect – can have an immediate, negative impact on child health and development and a longer-term impact on adolescent and adult health, including the leading causes of morbidity and mortality in the U.S. With such significant consequences, the accurate identification of child maltreatment is critical.

Child welfare caseworkers are charged with protecting the safety and fostering the well-being of children who have been identified as maltreated or …

Hypertension And Hiv In An Urban Slum Setting, Port-Au-Prince, Haiti, Olga Tymejczyk

Dissertations and Theses

Background: Rapidly growing urban slum settings increasingly face co-occurring communicable and non-communicable health crises, against the backdrop of extreme poverty, and social and environmental vulnerability. In Haiti, sparse data suggest a growing burden of hypertension and cardiovascular disease (CVD), along with substantial prevalence of HIV, increasingly recognized as a major CVD risk factor. As life-saving antiretroviral treatment (ART) is extended to more people living with HIV (PLWH), their risk of CVD increases with longer life expectancy and possibly cumulative ART exposure. Pregnant HIV-positive women may face additional cardiovascular vulnerability, due to the risk of gestational hypertension and pre-eclampsia. Integration of …

Trends In The Timeliness Of Hiv Diagnosis And Antiretroviral Treatment Initiation Before, During And After The “Treat All” Recommendation – New York City, 2006 - 2015, Mckaylee Robertson

Dissertations and Theses

BACKGROUND: Voluntary HIV testing followed by immediate antiretroviral treatment (ART) initiation (universal testing and treatment) has become an integral part of strategies to eliminate HIV and control the HIV/AIDS epidemic. Minimizing the time from HIV infection to ART initiation is essential for universal test and treatment to be optimally effective. In New York City, an epicenter of the HIV epidemic, the ‘treat all’ recommendation, immediate treatment for all people diagnosed with HIV, was made in late 2011, and efforts to ‘treat all’ were contemporaneous with large scale HIV testing initiatives in NYC. The overarching goal of this dissertation was to …

Extreme Obesity Among Adults In The United States: Spatial Variation And The Association With Mortality, Carrie Mills

Dissertations and Theses

Objectives: The purpose of this dissertation was to create small area estimates to describe and explore the county-level spatial variation of extreme obesity among adults in the United States and to assess the county-level association and spatial variation of extreme obesity and mortality.

Methods: The Behavioral Risk Factor Surveillance System was used in conjunction with data from the Census Bureau to estimate county-level model-predicted prevalence of extreme obesity using multilevel regression and poststratification. Spatial dependence of estimates was assessed using global Moran’s Index, and local Moran’s Indices were used to identify clusters of higher and lower rates of extreme obesity …

Burdern Of Chronic Health Conditions And Healthcare Utilization Among Mobile Populations In Sub-Saharan Africa, Elizabeth M. Ortiz

Dissertations and Theses

Background: Much of public health research in sub-Saharan Africa on mobile occupations, such as truck drivers and sex workers, has focused on HIV risk. However, evidence is emerging to suggest that the HIV epidemic among these groups is coupled with a high prevalence of chronic health conditions (CHC), specifically hypertension, diabetes, and obesity. For people living with HIV, increased risk of CHC may also be linked to HIV-related chronic inflammatory cascade. In Africa, there has been little research on CHC risk factors or patterns of healthcare utilization among mobile populations. Therefore, the objectives of this study are to examine the …

Patient And Provider Perspectives On Sexual History Taking During Gynecological Care: A Pilot Study In An Academic Family Medical Setting In New York City, Ashley M. Chastain

Dissertations and Theses

Background: In the United States (US), women face a number of serious issues concerning sexual health. Current surveillance data indicates that overall rates of bacterial sexually transmitted infections (STIs) are increasing rapidly. While rates of new diagnoses have decreased, the risks of acquiring HIV are still relatively high for some females, specifically Black/African-American women. In New York City (NYC), where this dissertation research was conducted, similar HIV/STI rates exist among females of reproductive age (aged 15-44). Among women in the US, there are also high estimated rates of other sexual health problems, such as sexual anxiety, sexual dysfunction, and intimate …

The Development Of Face Morphing Task To Assess Self Other Differentiation, Esen Karan

Dissertations, Theses, and Capstone Projects

Self-Other Differentiation (SOD) refers to a developmental process of acquiring a consolidated, integrated, and individuated sense of self. SOD develops at a) perceptual (e.g., facial perception) and b) representational (e.g., traits, mental states, and beliefs) levels. Impairments in representational SOD (R-SOD) are associated with many forms of psychopathology, particularly borderline personality disorder (BPD) and narcissistic personality disorder (NPD). Few studies to date have examined the perceptual aspects of SOD (P-SOD), which are hypothesized to develop from infancy onwards in tandem and in interaction with R-SOD. Given that the human face is one of the key characteristics that humans use to …

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …

Clinical Characteristics And Neuroanatomical Predictors Of Acute Antidepressant Outcome For Patients With Comorbid Depression And Mild Cognitive Impairment, Jeffrey N. Motter

Dissertations, Theses, and Capstone Projects

Background: Older adults presenting with both a depressive disorder (DEP) and cognitive impairment (CI) represent a unique, understudied population. The classification of cognitive impairment severity continues to be debated though it has recently been subtyped into late (LMCI) versus early (EMCI) stages. Previous studies have found associations between treatment outcome and both cortical thickness and white matter hyperintensities (WMH), though report inconsistent directionality and affected regions. In this study, we examined baseline clinical characteristics and neuroanatomical features as prognostic indicators for older adults with comorbid DEP and CI participating in an open antidepressant trial. EMCI is hypothesized to have greater …

The Lived Experience Of Spirituality In The Lives Of Caribbean Men, Camille A. O. Hamilton

Dissertations, Theses, and Capstone Projects

This is a qualitative phenomenological study exploring the lived experience of spirituality in the lives of English-speaking Caribbean men, aged 40-60 years old, living with chronic illness and residing in the United States. In this study Caribbean men living with chronic illness are asked to reflect on their lived experiences and evolution of the experienced phenomenon of spirituality. A purposive sample of eleven English-speaking men from the Caribbean, living with chronic illness were recruited and interviewed for this study. Max van Manen’s 1997 Methodological Structure of Human Science Research was used as the phenomenological guide. The exploration uncovered 4 essential …

Exploration Of The Inhibitory Properties Of The Nucleoside Antibiotic Salicyl-Ams And Analogues Targeting Siderophore Biosynthesis In Mycobacterium Tuberculosis, Glennon Bythrow

Dissertations, Theses, and Capstone Projects

Mycobacterium tuberculosis (Mtb) is a resilient, obligate bacterial pathogen responsible for pulmonary tuberculosis disease (TB), that has upheld a significant impact on global public health throughout history. The World Health Organization (WHO) approximates nearly 10 million new TB cases arose in 2017 alone, accounting for 1.6 million deaths. There has been a notable rise in TB cases produced by multidrug‑resistant (MDR) and extensively drug-resistant (XDR) strains of Mtb. This, along with the intrinsic resistance of Mtb to many standard drugs and poor patient compliance, is deeply impacting global control of TB. Among the several strategies currently in …

Inference Of Language Functional Network In Healthy, Cancerous And Bilingual Brains By Fmri And Network Modeling, Qiongge Li

Dissertations, Theses, and Capstone Projects

We study the underlying mechanism by which language processing occurs in the human brain using inference methods on functional magnetic resonance imaging data. The data analyzed stems from several cohorts of subjects; a monolingual group, a bilingual group, a healthy control group and one diseased case. We applied a complex statistical inference pipeline to determine the network structure of brain components involved with language. This healthy network reveals a fully connected triangular relationship between the pre-Supplementary Motor Area (pre-SMA), the Broca's Area (BA), and the ventral Pre-Motor Area (PreMA) in the left hemisphere. This "triangle'' shows consistently in all the …

Outcomes In Children With Additional Disabilities Following Cochlear Implantation: A Systematic Review, Rebecca M. Tuchman

Dissertations, Theses, and Capstone Projects

Background: Thirty percent of children with hearing loss have an additional disability. These children may be difficult to test according to standard audiologic behavioral test protocols. Additionally, progress within this population may present differently than in children with no additional disability. Currently, no evidence-based protocol exists for assessing cochlear implant benefit and outcomes in this population.

Objective: The purpose of this investigation is to perform a systematic review on the outcomes of cochlear implantation in children with additional disabilities. Specifically, this study focused on areas of function assessed, outcome measures used, and evidence of benefit observed.

Methods: A comprehensive search …

Emotion Processing Deficits In Psychopathy: Does Cueing To Relevant Facial Features Increase Cognitive And Emotional Empathy?, Shawn E. Fagan

Dissertations, Theses, and Capstone Projects

Psychopathy is a multifaceted disorder characterized by a lack of cognitive and emotional empathy. The traditional model of psychopathy divides the disorder into two factors: Factor 1 consists of the interpersonal and affective traits of psychopathy while Factor 2 measures antisocial behaviors and lifestyle choices. The attention-to-the-eyes hypothesis argues that psychopathic individuals have impaired emotion recognition (specifically for fear) due to deficits in orienting attention to salient facial features like the eyes. Psychopathic individuals also display blunted autonomic responding to emotional stimuli, though whether this is due to attention-orienting deficits remains to be clarified. The present project investigated whether empathy-related …

Eugenics In The 21st Century, Jessica Linn Chin

Dissertations, Theses, and Capstone Projects

Eugenics is the science of enhancing the human population through the management of breeding and hereditary traits. This thesis explores the history of eugenics and shows how eugenic practices continue in the 21^st century with advancements in technology and positive eugenic goals that can result in adverse effects on the human body and society. When Sir Francis Galton coined the term eugenics in 1883, he intended to improve British society with the use of positive eugenics. Galton used positive eugenics to encourage people with good mental and physical qualities to produce more children. He avoided negative eugenics, which involved …

Impact Of Religiosity And Level Of Acculturation On Cultural Alignment: An Exploration Of Terror Management Mechanisms Among Muslim American Women, Farah T. Goheer

Dissertations, Theses, and Capstone Projects

ABSTRACT

Impact of Religiosity and Level of Acculturation on Cultural Alignment: An Exploration of Terror Management Mechanisms among Muslim American Women

by

Farah Taha Goheer, M.A.

Advisor: Joel Sneed, Ph.D.

Background: Terror management theory (TMT) is based upon the notion that human beings require ongoing psychological protection from the unyielding, existential threat of death. A large body of evidence has shown that human beings manage death-related terror by aligning with and endorsing the dominant views of their cultural worldviews. Notably, as immigrants experience a new culture, worldviews become rearticulated to incorporate elements of host and heritage cultures. However, it is …

The Social Cost Of Pain: Rejection Sensitivity, Social Rejection, And Cannabis Use In Young Adults, Naomi Dambreville

Dissertations, Theses, and Capstone Projects

Cannabis has been implicated in relieving distress and social pain, an important area of research in young adult samples, given the saliency of peer and social networks to addiction. Cannabis, via opioid pathways, has been shown to reduce, or potentially buffer, the effects of social pain and rejection. Thus, cannabis may be protective against the painful feelings of social stress, particularly for heavier or more frequent users. However, findings are not wholly positive, as other research indicates cannabis may blunt affective responses and impair social processing. The effects of cannabis use in young adults are understudied, as well as its …