Digital Commons Network^™

Trends In Antimicrobial Resistant Non-Typhoidal Salmonella Before And After The Food And Drug Administration’S Guidance For Industry #213, United States 2013-2020, Lily Valentina Carruthers

Public Health Theses

Background: Previous research has shown a potential link between antibiotic use among food-producing animals and antimicrobial resistant enteric pathogens. In late 2016, the Food and Drug Administration completed the implementation of its Guidance for Industry #213, through which growth promotion was removed as an indication for use of medically-important antimicrobials among food-producing animals. This study aimed to describe trends in antimicrobial resistance among human Salmonella isolates from 2013-2020 in the United States before and after the implementation of this regulation.Methods: All non-Typhoidal Salmonella isolates sent to the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) from 2013-2020 were included …

“She Trusts Us To Love Her, You Know?”: Using A Love Ethic Framework To Explore Faith Navigation And Acceptance Processes Among Mormon Mothers Of Lgbtq+ Individuals, Nandini Milind Deo

Public Health Theses

Parental acceptance is a key factor in bolstering the health and well-being of LGBTQ+ individuals across their lifespan (Needham & Austin, 2010; Ryan, 2010; Jin, 2020; Clark et al., 2021). One factor known to influence parental acceptance is family religiosity, which has typically been associated with conflict and/or rejection (Ryan, 2010; Johns & Hanna, 2012; Roe, 2017). The purpose of this study was to better understand faith navigation and acceptance processes among active Mormon mothers of LGBTQ+ individuals in an effort to inform public health engagement with highly religious parents of sexual and gender minority children. In-depth qualitative interviews were …

On The Same Page? Agreement Between Older Adults And Emergency Clinicians Regarding Desired Outcomes And Its Association With Return Hospital Visits, Hollie Dowd

Public Health Theses

Objectives. To develop a framework for as well as examine the relationship between patient-clinician agreement on what matters to older adults in the emergency department (ED) and 30-day ED return visits.Methods. A sample of 45 emergency department patients aged 70+ and their emergency clinicians were separately asked about the patient’s desired outcomes for their ED visit. Thematic analysis of interview transcripts was conducted and dyadic agreement for each of the identified themes was recorded, then a percent agreement composite score was calculated. 30-day ED return visits were tallied and additional sociodemographic and clinical data was accumulated. Descriptive, bivariate, and multivariate …

Proximity And Parental Interaction: Examining The Relationship Between Proximity Data And Mother-Infant Interaction Among Mothers With And Without Depression, Paige Farrenkopf

Public Health Theses

Background: There is a lack of data on response behaviors among young mothers in low- and middle-income countries. Emerging passive sensing technology has been increasingly allowing researchers to collect this type of day-to-day behavioral data.

Methods: We administered PHQ-9 depression surveys and the Observation of Maternal-Child Interaction (OMCI) measure to young mothers between the ages of 15-25 in the Chitwan region of Nepal, and conducted key informant interviews with all mothers selected for participation.

Results: Among 54 mother-infant dyads, we found that there was no statistically significant correlation between maternal responsiveness and proximity. When we stratified participant groups by depression …

Environmental And Health Impacts Of Biobased Polymers, Liora Fiksel

Public Health Theses

The use of biopolymers is predicted to grow in the coming years as the world searches for solutions to its sustainability problems. Pursuing biobased materials is widely thought of as the sustainable response to moving away from petroleum-based materials and the plastic-waste issue; however, its potential environmental and human health impacts are being questioned. Notably, the controversies related to biopolymers' renewable feedstocks include adding pressure to the food economy, land use, occupational hazards, and environmental pollution with potential human exposure and adverse health effects. Other resource burdens include energy and water. Many biopolymers are designed to biodegrade, compost, or be …

Stigma, Cisgenderism, And The Pathologization Of Transness, Baqar Husain

Public Health Theses

Cisgenderism is the culture and system, constituted by both ideology and practice, that denies, denigrates, or pathologizes self-identified gender identities that do not align with assigned sex at birth. Medicine and law are jointly deterministic of the wellbeing of transgender people. This analysis seeks to explore how stigma, operationalized by cisgenderism, manifests in legal and medical structures to negatively impact the wellbeing of transgender people. Thus, this analysis begins with the definition of key terms necessary to understanding concepts related to sex, gender, and gender variance. After delineating how stigma operates, the recent history of transness is outlined and is …

Mindfulness And Psychological Stress In Black Male Caregivers, Alyssa Misun Kim

Public Health Theses

Background: Mindfulness practices are under-studied in Black communities despite theireffectiveness in improving mental health. When specifically examining Black male caregivers of people living with Alzheimer’s disease or dementia, not much is known about how mindfulness can affect their stress in their role as a caregiver and their identity as a Black male. Therefore, the purpose of this study is to examine mindfulness, self-rated stress, and depressive symptoms among Black male caregivers and non-caregivers and determine whether mindfulness can serve as a protective buffer against psychological stress in each of these groups. Methods: 18 Black male caregivers and 29 non-caregivers completed …

Epidemiology Of Covid-19 Hospitalizations In New Haven And Middlesex Counties, Connecticut, July - September 2021, Caroline Mary Mcwilliams

Public Health Theses

Abstract:Background. This thesis explores the epidemiology of COVID-19 hospitalization among residents of New Haven County and Middlesex County, Connecticut from July - September 2021 with an emphasis on quantifying racial/ethnic and SES disparities. Two previous studies, the first conducted from March - May 2020 and the second conducted from July - December 2020, used COVID-NET Surveillance data from New Haven and Middlesex counties to explore the same questions. This thesis will compare findings with these previous studies to better understand how the epidemiology of COVID-19 hospitalization and racial/ethnic and SES disparities have changed in New Haven and Middlesex counties. Methods. …

A National Assessment Of Racial And Ethnic Disparities In Cleft Lip Repair, Connor J. Peck

Public Health Theses

AbstractPurpose: This study examined the impact of patient race/ethnicity on the likelihood of experiencing delays to surgery, post-operative surgical complications, and prolonged hospital length of stay (LOS) following primary cleft lip (CL) repair. Methods: Patients who underwent CL repair were identified in the 2006-2012 Kids’ Inpatient Database. Primary outcomes were defined as treatment after 6-months-old, presence of any surgical complication, LOS >1 day, and total hospital charges. Multivariable analyses were performed to adjust for sociodemographic and clinical characteristics that might account for differences in outcomes. Results: There were 5927 eligible patients with cleft lip: 3724 White, 279 Black, 1316 Hispanic, …

Evaluation Plan For A Mortality Surveillance System In Northwest Syria, Hanna Peterson

Public Health Theses

AbstractIntroduction: Cause-specific population mortality data is one of the most useful metrics used to monitor and evaluate the severity of a crisis. However, the unique context of fragile and protracted armed conflicts creates obstacles for establishing a mortality surveillance system. When CRVS are not feasible, VA can be used to generate high-quality mortality rate estimates. There is currently little documentation of implementation and evaluation of mortality surveillance systems in conflict settings, and guidance for both is extremely limited. This thesis aims to contribute to these two knowledge gaps by providing an evaluation plan for a mortality surveillance system in Northwest …

A Qualitative Analysis Of Paternal Perspectives On Breastfeeding Support Among Black Fathers In Connecticut, Jasmine Teresa Rios

Public Health Theses

Background: Despite the persistence of racial and ethnic disparities in breastfeeding in which Black mothers breastfeed at lower rates, little is known about Black fathers’ experiences with breastfeeding and breastfeeding support services (e.g., maternity hospital-based care, lactation specialty care). This thesis reports Black fathers’ perceptions of breastfeeding, influencers of breastfeeding, and breastfeeding support services in Connecticut using a qualitative, community-based participatory approach.Methods: The study’s focus group guide was co-developed with community partners and adapted from the Barrier Analysis Tool to identify breastfeeding facilitators, barriers, and service improvement areas. Per study design, all participants were fathers to a child under three …

Navigating A Patchwork Maze: Individuals’ Experience Of Administrative Burden When Accessing Homeless Assistance Services, Leah Robinson

Public Health Theses

Despite significant efforts to address the issue of homelessness in the United States over the past several decades, over 500,000 individuals still experience homelessness on any given night. A large portion of this persistent and high rate of homelessness can likely be attributed to the shortage of affordable housing options, the eviction crisis, and limited financial support for rental assistance found throughout the country. However, administrative burdens may also contribute to the high rate of homelessness being seen.Our study explores this question by examining 28 individuals’ experience of administrative burden when navigating the landscape of homeless assistance services in New …

Effects Of Depression And Discrimination During Pregnancy On Postpartum Healthcare Utilization Among Women In Detroit, Mi And Nashville, Tn, Janet A. Rojina

Public Health Theses

Objectives: This study seeks to document how both depression and discrimination during pregnancy may impact postpartum healthcare utilization (e.g. attendance of the 6-week postpartum appointment and maternal emergency room (ER) visits within 6 months after birth) among women in Detroit, MI and Nashville, TN. We also investigate how race may be associated in the relationship between depression during pregnancy and healthcare use. Methods: Descriptive, stratified, and logistic regression (univariate and multivariate) analyses were conducted using SAS 9.43. Data was drawn from the Expect with Me (EWM) study, a multisite prospective longitudinal matched-cohort that included 951 pregnant women from Detroit, MI …

Prescriptive Faith: Carceral Health Beyond The Prison Walls, Shamar S. Smalls

Public Health Theses

Individuals who are exposed to the carceral system—specifically, solitary confinement are uniquely vulnerable to psychological and physical health conditions. However, the relationship between solitary confinement and physical health conditions are relatively underexamined, compared to mental health disorders. This analysis examines the potential for a risks’ association between solitary confinement and cardiovascular disease risk factors. Additionally, this study examines the relationship between spirituality as a self-efficacious coping measure for health-related outcomes. A cross-sectional analysis of 302 survey participants with a prior history of incarceration in a housing study (New Haven, CT) with a prior history of incarceration from Fall 2017 – …

Occupational And Socioeconomic Risk Factors Of Noise-Induced Hearing Loss, Rongcan Sun

Public Health Theses

Hazardous noise (>85 dBA) is among the most common occupational exposures and responsible for the majority of noise-induced hearing loss. Noise-induced hearing loss impacts many aspects of a person’s life, including workplace safety, daily routine, economic consequences, and quality of life. However, studies on the relationship between occupational noise exposure and hearing loss were usually done in specific industries rather than the general population. In addition, studies focused on associations between socioeconomic factors and hearing loss rarely take the type of occupation into consideration. In this study, we aim to evaluate both occupational noise exposure and socioeconomic status as …

Synergistic Epidemic: A Case Study Of Covid-19 And Substance Use Disorder In New London, Ct, Mary Tate

Public Health Theses

The onset of the COVID-19 pandemic in March 2020, complicated the already ineffectual delivery of health care for historically hard-to-reach populations. Those who face housing insecurity, substance use disorders, unemployment, or uncertain immigration and insurance status were abandoned, as the mainstream U.S healthcare system struggled to cope under the pressure of the novel virus. While parallel public health crises were put on hold to deal with COVID-19, the pandemic collided with and exacerbated the ongoing opioid crisis. Using New London, CT as a case study, this project set out to address a gap in literature on the potential syndemic effect …

Musculoskeletal Outcomes Among Older Adults Following Hospitalization For Covid-19: A Pilot Study, Clara Ming Hei Wong

Public Health Theses

Background Older individuals are at high risk for musculoskeletal impairment following hospitalization due to decreased neuromuscular function and bone mineral density (BMD) arising from illness itself, and external factors such as immobilization and changes in nutritional status. To address the knowledge gap regarding the longitudinal impact of COVID-19 on musculoskeletal outcomes, this thesis aimed to study the relationship between COVID-19 severity and physical functional, incidence of falls and fractures in older adults. Secondarily, in a subset of patients we examined the relationship between COVID-19 severity and osteoporosis- and sarcopenia-related measures. Methods This study analyzed data from the VALIANT study and …

Residential And Race/Ethnicity Disparities In Heat Vulnerability In The United States, Mitchell Manware

Public Health Theses

Adverse health outcomes caused by extreme heat represent the most direct human health threat associated with the warming of the Earth’s climate. Socioeconomic, demographic, health, land cover, and temperature determinants contribute to heat vulnerability; however, nationwide patterns of residential and race/ethnicity disparities in heat vulnerability in the United States are poorly understood. This study aimed to develop a Heat Vulnerability Index (HVI) for the United States; to assess differences in heat vulnerability across geographies that have experienced historical and/or contemporary forms of marginalization; and to quantify HVI by race/ethnicity. Principal components analysis (PCA) was used to calculate census tract level …

Creating A Welcoming, Inclusive, And Affirming Primary Care Environment For Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex And Asexual Patients, Samantha Korbey

Yale School of Nursing Digital Theses

The LGBTQIA+ community has long faced disparities in healthcare which have had significant consequences including increased cancer risk factors and poorer health outcomes when compared to the cisgender, heterosexual community. Interventions are needed to increase the knowledge and cultural competency of providers, to create welcoming and safe spaces for LGBTQIA+ patients, and to encourage disclosure of sexual orientation and gender identity (SOGI).

The purpose of this DNP project was to adapt, implement, and evaluate an evidence-based model for creating an affirming, inclusive, culturally competent, and safe primary care environment for LGBTQIA+ patients within a family practice center. This quality improvement …

Enhancing The Assessment Of Suicidal Ideation In The Long-Term Care Environment: A Quality Improvement Project, Carissa Ann Tufano

Yale School of Nursing Digital Theses

Abstract Despite high rates of depression and risk factors for suicide, there is a knowledge deficit and lack of protocol surrounding the assessment of suicidal ideation in the long-term care setting. Although studies examining suicide in the long-term care setting are lacking, the prevalence of suicidal ideation is high. This DNP quality improvement project addressed this problem by creating a suicide assessment and management inservice for frontline clinical staff at a skilled nursing facility in Connecticut. The inservice integrated use of an adapted suicide assessment algorithm and a suicide screening tool, the P4 Screener. A SAMHSA toolkit was utilized as …

Efficient Estimation Of Average Derivatives In Npiv Models: Simulation Comparisons Of Neural Network Estimators, Jiafeng Chen, Xiaohong Chen, Elie Tamer

Cowles Foundation Discussion Papers

Artificial Neural Networks (ANNs) can be viewed as \emph{nonlinear sieves} that can approximate complex functions of high dimensional variables more effectively than linear sieves. We investigate the computational performance of various ANNs in nonparametric instrumental variables (NPIV) models of moderately high dimensional covariates that are relevant to empirical economics. We present two efficient procedures for estimation and inference on a weighted average derivative (WAD): an orthogonalized plug-in with optimally-weighted sieve minimum distance (OP-OSMD) procedure and a sieve efficient score (ES) procedure. Both estimators for WAD use ANN sieves to approximate the unknown NPIV function and are root-n asymptotically normal …

Orderly Resolution Of The Former Hypo-Alpe-Adria-Gruppe Concluded Successfully. The New European Resolution Regime Has Proven Itself., Republic Of Austria: Financial Market Authority

Documents

No abstract provided.

Linguistic Variation From Cognitive Variability: The Case Of English 'Have', Muye Zhang

Linguistics Graduate Dissertations

In this dissertation, I seek to construct a model of meaning variation built upon variability in linguistic structure, conceptual structure, and cognitive makeup, and in doing so, exemplify an approach to studying meaning that is both linguistically principled and neuropsychologically grounded. As my test case, I make use of the English lexical item ‘have' by proposing a novel analysis of its meaning based on its well-described variability in English and its embed- ding into crosslinguistically consistent patterns of variation and change.

I support this analysis by investigating its real-time comprehension patterns through behavioral, electropsychophysiological, and hemodynamic brain data, thereby incorporating …

Lessons Learned: Richard “Jake” Siewert, Mercedes Cardona

Journal of Financial Crises

Siewert served as counselor to US Treasury Secretary Timothy Geithner from 2009 to 2011 during the Global Financial Crisis of 2007–09 (GFC). He had previously served in the Clinton administration, including as a special assistant to the president for economic affairs, at the National Economic Council, and as deputy White House press secretary. He also handled the press secretary duties from September 30, 2000, to January 20, 2001. This “Lessons Learned” is based on an interview with Mr. Siewert.

The Effect Of A Financial Crisis On Household Finances: A Case Study Of Iceland’S Financial Crisis, Axel Hall, Andri S. Scheving, Gylfi Zoega

Journal of Financial Crises

Iceland experienced a financial crisis in 2008–2009 when its banking system collapsed, the currency lost half its value, most businesses became technically insolvent, house prices fell, and household debt increased due to indexation to foreign currencies or the price level. This paper tells the story of the crisis and maps the losses to households using a dataset from tax returns that includes all taxpayers in the country and contains the value of housing, mortgage debt, disposable income, and net worth. For relative losses in net worth, the results show that families with children, especially those with parents aged between 24 …

A Game-Theoretic Analysis Of Childhood Vaccination Behavior: Nash Versus Kant, Philippe De Donder, Humberto Llavador, Stefan Penczynski, John E. Roemer, Roberto Vélez

Cowles Foundation Discussion Papers

Whether or not to vaccinate one’s child is a decision that a parent may approach in several ways. The vaccination game, in which parents must choose whether to vaccinate a child against a disease, is one with positive externalities (herd immunity). In some societies, not vaccinating is an increasingly prevalent behavior, due to deleterious side effects that parents believe may accompany vaccination. The standard game-theoretic approach assumes that parents make decisions according to the Nash behavioral protocol, which is individualistic and non-cooperative. Because of the positive externality that each child’s vaccination generates for others, the Nash equilibrium suffers from a …

Lessons Learned: Richard "Jake" Siewert, Mercedes Cardona

Documents

Cardona, Mercedes (2021) "Lessons Learned: Richard “Jake"Siewert," The Journal of Financial Crises: Vol. 3 : Iss. 4, 45-48. Available at: https://elischolar.library.yale.edu/journal-of-financial-crises/vol3/iss4/8

Organizational Structure And Pricing: Evidence From A Large U.S. Airline, Ali Hortaçsu, Olivia R. Natan, Hayden Parsley, Timothy Schwieg, Kevin R. Williams

Cowles Foundation Discussion Papers

We study how organizational boundaries affect pricing decisions using comprehensive data from a large U.S. airline. We document that the firm’s advanced pricing algorithm, utilizing inputs from different organizational teams, is subject to multiple biases. To quantify the impacts of these biases, we estimate a structural demand model using sales and search data. We recover the demand curves the firm believes it faces using forecasting data. In counterfactuals, we show that correcting biases introduced by organizational teams individually have little impact on market outcomes, but coordinating organizational outcomes leads to higher prices/revenues and increased deadweight loss in the markets studied.

Lessons Learned: Matthew Kabaker, Yasemin Esmen

Journal of Financial Crises

During the Global Financial Crisis of 2007-09, Matthew Kabaker was senior adviser to Treasury Secretary Timothy F. Geithner and Treasury deputy assistant secretary, capital markets. He helped design the Treasury’s policy response to the financial crisis; design and implement the Dodd-Frank financial reforms; and address housing finance reform, including reforms at Fannie Mae and Freddie Mac. Mr. Kabaker also served on the Treasury’s Financial Stability Policy Council and Housing Policy Council. This Lessons Learned summary is based on an interview with Mr. Kabaker.

Us Community Development Capital Initiative (Cdci), Adam Kulam

Journal of Financial Crises

The United States Department of the Treasury responded to the Global Financial Crisis with an economy-wide stimulus package called the Troubled Assets Relief Program (TARP). Within the portion of TARP’s budget dedicated to bank investments, about $570.1 million was disbursed to community development financial institutions (CDFIs)—specifically, banks and credit unions (depositories)—in a program called the Community Development Capital Initiative (CDCI). Through the CDCI, Treasury provided capital to CDFI depositories, encouraged them to lend to small businesses, and promoted other community-oriented goals. The CDFI depositories issued either preferred shares or unsecured subordinated debentures to Treasury at low (2%) interest rates for …