Digital Commons Network^™

Cleft Lip And Depression In Adults: A Multi-Ancestry Mendelian Randomization Study, Anne Lyon Havlik

Public Health Theses

Background: Clefting of the lip with or without cleft palate (CLP) is the most common congenital craniofacial abnormality globally, affecting one in 700 live births. Traditional observational studies suggest an increased risk of adult depression among subjects with CLP, but these studies are subject to residual confounding.Objective: We aimed to address residual confounding by evaluating the association between the genetically-predicted risk of CLP on the risk of adult depression in a Mendelian randomization framework. Methods: We used single-nucleotide polymorphisms strongly associated with CLP as genetic instruments. Genetic associations with adult depression were extracted from separate studies. Three ancestry groups were …

Pre-Admission Depression And 6-Month Post-Discharge Sleep Disorders In Elderly Covid-19 Survivors, Yixiao Zhang

Public Health Theses

ABSTRACTObjective: This study aims to evaluate the association between depression at baseline and presence of three sleep disorder symptoms (fatigue, daytime sleepiness, and insomnia) following 6-month hospital discharge in elderly COVID-19 survivors. It also aims to identify which other baseline patients’ characteristics or post-discharge factors may be associated with these sleep disorder symptoms. Methods: The participant datasets were obtained from VALIANT, a prospective longitudinal study of community-living adults aged ≥ 60 years who were admitted with COVID-19 to hospitals within the Yale New Haven Health System (YNHHS) from June 2020 - June 2021. Multiple logistic regression models were performed to …

Copd And Asthma: Genome-Wide Associations And Genetic Pleiotropy, Yixuan Yang

Public Health Theses

This study aimed to describe the overlap between genetic variants that are independently associated with COPD and asthma, then dissect the cross-phenotype associations to characterize patterns of pleiotropic effects. The COPD and asthma datasets were separately extracted from an aging population consisting of white European subjects from the UK Biobank database. Genome-wide association tests were performed separately with the COPD and asthma data to first investigate significant genetic variants independently associated with each of the two phenotypes. With the GWAS summary statistics, several significant genetic loci that exhibit potential pleiotropic effects on COPD and asthma on a genome-wide significant level …

Interrupted Time Series Analysis To Evaluate Regional Greenhouse Gas Initiative Health Impacts, Julia Sweatman

Public Health Theses

Abstract

Background & Aims: Fossil fuel combustion emits a spectrum of ambient air pollutants, with the most harmful health effects seen from particulate matter 2.5 μm or less in diameter (PM2.5). Pricing carbon can reduce PM2.5 emissions and yield co-benefits for public health. The Regional Greenhouse Gas Initiative (RGGI) is a cooperative carbon pricing initiative among twelve states aiming to curb carbon dioxide emissions from the power sector. This preliminary analysis explores methodological approaches to quantify the health benefits associated with PM2.5 changes after RGGI was first implemented in 2009.

Methods: An interrupted time series analysis was performed to compare …

Impact Of Covid-19 On Women Living With Hiv Who Are Survivors Of Intimate Partner Violence, Xinyi Zhang

Public Health Theses

Background: As the COVID-19 pandemic continues to evolve, there is a concern about elevated intimate partner violence (IPV) risk. Women living with HIV (WLWH) faced disproportionately high rates of IPV compared to women without HIV. The intersections of the co-occurring pandemics of COVID-19 and IPV present unique challenges to WLWH in different ways. Currently, we have limited evidence on the impact of COVID-19 on the experience of IPV among WLWH. Methods: This is a cross-sectional analysis of COVID-19 impact using baseline data from an ongoing, prospective, micro-longitudinal cohort study on HIV care engagement among WLWH who have experienced lifetime IPV. …

Genome-Wide Association Studies Of Depression And Alzheimer’S: Identifying Pleiotropic Snps, Yara Ahmed Kamel Abdelsalam

Public Health Theses

Background: Alzheimer’s disease (AD) has been rising globally, making it important to understand risk factors. Depression has been identified as a risk factor in epidemiological studies and meta-analysis. The possible mechanism could be pleiotropic. This study sought to identify the pleiotropic SNPs associated with depression and AD so that can understand the relationship between the two diseases more evident.Methods: The sample was from the UK biobank population, using the White European subpopulation. Depression was defined using self-reported depression status and electronic medical records. Proxy AD was defined by biological mother and father’s AD status. Two univariate association analysis was conducted …

Analyzing Pediatric Department Documentation Of Patient Social Needs With Icd-10 Z-Codes, 2019-2020, Oluwatofunmi Jummie Akinwunmi

Public Health Theses

The 10th revision of the International Classification of Diseases (ICD-10) allows healthcare professionals to document social needs with ICD-10 Z-codes. Data derived from documentation of ICD-10 Z-codes can be leveraged to identify at-risk populations for targeted intervention. However, there remains concern for underutilization of these codes particularly in the pediatric population. We sought to examine the documentation of ICD-10 Z-codes in the pediatric outpatient setting of the largest Connecticut hospital network by specialty type and age group. We examined deidentified electronic health records of pediatric outpatient patients from 2019-2020. We used descriptive statistics to measure the proportion of patients with …

Exploring The Perceptions Of Genetics, Genetics Testing, And Science In People Of African Descent, Maame-Owusua Boateng

Public Health Theses

Background: Historical injustices towards Black populations in the United States have impacted how communities interact with medicine and public health such as medical experimentations, scientific racism, medical racism, and eugenics. Black communities are underrepresented in human genomics projects compared to those that identify as white or of European ancestry. Prior research has demonstrated that Black people are less likely to know about the availability of genetic testing for diseases and have less confidence in the benefits of genetic testing. These disparities make it imperative to understand the perspectives of people of African descent. Methods: The Black Genome Project is an …

Racism-Related Stress And Health Behaviors And Outcomes Among Emerging Adult Sexual Minority Men Of Asian Heritage, Lauren Li-Min Chin

Public Health Theses

Rationale: Acts of racial discrimination impart racism-related stress on the individual and have been linked to decreased psychological well-being and physical health. While there are numerous studies of other groups of sexual minority (SM) men of color in this area, little research has focused on HIV-negative, Asian-identifying SM men. Objectives: This study investigates whether racism-related stress is associated with substance use, general and oral health outcomes, and attitudes towards PrEP in a sample of emerging adult Asian SM men. The study also evaluates whether these behaviors affect the relationships between racism-related stress and the other outcomes. Methods: This secondary data …

Prostate Cancer Clinical Characteristics And Treatment Among Asian-American Persons In The United States: An Analysis Of The National Cancer Database 2004-2020, Farah Jeong

Public Health Theses

Introduction: Given the considerable cultural diversity within the Asian population, numerous factors can significantly impact health status and management. Objective: This study examined the differences in demographic characteristics, clinical characteristics, and treatment status among each Asian American patient with PCa compared to non-Hispanic White and non-Hispanic Black patients by analyzing PCa dataset from National Cancer Database (NCDB) 2004-2020 data. Methods: Patients (n=860,669) with localized PCa diagnosed between 2004 and 2020 who identified as White, Black, Chinese, Japanese, Filipino, Korean, Vietnamese, Asian Indian, or Pakistani within NCDB were extracted and stratified by risk level: low-risk and intermediate/high-risk. The effect of racial …

Psychosocial Experiences And Genetic Knowledge In Individuals With Pathogenic And Uncertain Tp53 Variants In The Prospective Registry Of Multiplex Testing (Prompt) Cohort, Dana Kahle

Public Health Theses

Germline mutations in the TP53 gene confer increased risk of diverse malignancies in children and adults in the Li Fraumeni cancer susceptibility syndrome, a rare condition with estimated prevalence of about 1 in 3,555 in the population. The Prospective Registry of Multiplex Testing (PROMPT) study is a registry of individuals undergoing genetic testing for inherited cancer susceptibility using multi-gene panels regardless of test results and agreeing to participate in questionnaire studies about their experience. The purpose of this study was to investigate how the psychosocial experience of genetic testing and level of genetic understanding and knowledge differs for those who …

Barriers And Facilitators For Implementing The Who Safe Childbirth Checklist In Mozambique: A Qualitative Study Using The Consolidated Framework For Implementation Research (Cfir), Anqi He

Public Health Theses

High maternal and neonatal mortality rates persist in Mozambique, with the issues of stillbirth remaining understudied. Most maternal and neonatal deaths in the country are due to preventable and treatable direct childbirth-related complications that often occur in low-resource settings. The World Health Organization (WHO) introduced the Safe Childbirth Checklist (SCC) in 2015 to reduce adverse birth outcomes. The SCC, a structured list of evidence-based practices, targets the main causes of maternal and neonatal deaths and stillbirths in healthcare facilities. Despite successful implementation in over 15 countries, the SCC has not been adopted in Mozambique. This study aimed to identify potential …

A First Look Into Cognitive Impairment In The Republic Of Armenia: A Population With A History And Present Reality Of Collective Trauma, Patelle Jivalagian

Public Health Theses

The Republic of Armenia, a largely homogenous population burdened with a history of collective trauma, presents a unique opportunity to explore aging and cognition. The population survived a genocide in 1915 but, continues to face threats to existence today due to geopolitics. Studying the Armenian population can provide insight about the role of mental health in cognitive impairment. This study aimed to examine characteristics associated with cognitive impairment at mobile clinics across 6 provinces in Armenia and provided a first look into the national health profile of the likelihood of dementia progression in Armenia.Participants consisted of 262 subsample of older …

A Dna-Extraction-Free Method For The Molecular Detection Of Streptococcus Pneumoniae Carriage In Saliva, Tzu-Yi Lin

Public Health Theses

Pneumococcal carriage is a prerequisite for pneumococcal disease and surveillance of carriage is crucial for evaluating and informing vaccination strategies. In recent years, molecular methods have improved the sensitivity of pneumococcal carriage detection as compared to the gold standard culture-based method. However, nucleic acid extraction from samples collected is resource-intensive, limiting scalability for extensive surveillance, particularly in low-resource settings. We previously developed a saliva-based PCR test for SARS-CoV-2, having identified that nucleic acid extraction can be omitted and replaced with a simple enzymatic lysis or heat treatment step without compromising the accuracy and efficiency of testing. Here, we compared pneumococcus …

Identifying Aberrant Metabolism And Underlying Biology In Colorectal Cancer Tumors Between Early- And Later-Onset Samples, Allison Paige Janak

Public Health Theses

Early-onset colorectal cancer (EO-CRC) occurring in individuals under age 50 is rapidly increasing globally. In comparison, later-onset colorectal cancer (LO-CRC) incidence has decreased or remained stable over recent years. Despite these increases in EO-CRC incidence, the etiology of EO-CRC is largely unknown. This study aimed to compare the metabolomes of EO-CRC (N=53) and LO-CRC (N=314) patients from a cohort of 367 patients using patient matched samples of stages I-IV tumor and healthy colon tissue. Hydrophilic interaction liquid chromatography mass spectrometry (HILIC-MS) and reversed phase liquid chromatography mass spectrometry (RPLC-MS)-based untargeted metabolomics were applied to identify features present in the samples, …

Knowledge, Attitudes, And Practices (Kap) About Lassa Fever Prevention And Control: A Survey Of Three Rural Communities In Central Liberia-Epidemiology Of Microbial Diseases, Joseph Gibson Jepru Lewis

Public Health Theses

Introduction: Since the discovery of Lassa fever in 1969 in Nigeria, the disease has become endemic in many West African countries. An estimated 500,000 cases of Lassa fever virus occur each year, leading to approximately 5,000 deaths annually. Liberia continues to record outbreaks almost every subsequent year in regions once considered non-endemic. With no effective vaccines, many studies have underscored the importance for residents in Lassa-endemic regions to have good knowledge and good prevention practices in place to prevent Lassa fever.

Methods: A cross-sectional data extracted from a longitudinal, observational, cohort study conducted using voluntary participant self-reported and study visits …

Assessment Of Environmental Injustice: Spatial Analysis Of Pennsylvania Drilling Waste Facilities And Community Demographics, Avery Naperala

Public Health Theses

Background: Unconventional oil and gas drilling practices have led to the production of technologically-enhanced naturally occurring radioactive materials (TENORM) and chemical waste products, with insufficient toxicological data to understand the health impacts of exposures to these waste materials (U.S. Energy Information Administration, n.d.; US EPA, 2015b; ALNabhani et al., 2016; Elliott et al., 2017). Environmental injustices occur when disadvantaged populations experience a disproportionate burden of exposure to environmental disamenities, such as waste facilities (US EPA, 2015a). This study aims to assess whether disparate exposure to drilling waste facilities is occurring in Pennsylvania based on several socioeconomic factors, as well as …

The Impact Of The Covid-19 Pandemic On Non-Typhoidal Salmonella Incidence And Exposures In Connecticut, 2015-2022, Adeline Morris

Public Health Theses

Background: During 2020, Salmonella incidence decreased by 22% in the United States.1 At the same time, many common activities were reduced or restricted, including travel and eating food prepared at restaurants or events, which are known risk factors for Salmonella infection. Methods: A descriptive analysis using Salmonella surveillance data collected in Connecticut between 2015 to 2022 was performed to characterize the changes in travel and outside food exposures. Frequencies of exposures were compared before the pandemic, during the pandemic, and after the vaccine was implemented and restrictions eased. Rate ratios of observed to expected cases were calculated to explore trends …

Indirect Effects Of Covid-19 Vaccination Against Sars-Cov-2 Omicron: Rapid Review & Meta-Analysis, Brett Anthony Martini

Public Health Theses

Background: First identified in Wuhan, China in late 2019, the infectious viral disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of lives worldwide and poses the largest public health crisis in the past century. The development and deployment of vaccines have been a key public health measure to mitigate the subsequent harm associated with the viral infection. Despite the mRNA vaccine platform being in development for 15+ years, the mass vaccination campaigns were the first large-scale use of this technology, leaving much to be learned about their effectiveness and longevity. Mass vaccination campaigns influence …

Antibiotic Prophylaxis For Prevention Of Surgical Site Infections In Orthopedic Surgery, Edwin Ruiz Fuentes

Public Health Theses

Background: In the past decades, there has been an increase in the proportion of orthopedic surgical site infections (SSIs) caused by gram-negative bacilli in various healthcare settings. SSI prevention guidelines suggest that gentamicin can be added to prophylactic antibiotic treatment to target gram-negative bacilli. However, the effectiveness of this strategy remains to be confirmed in orthopedic surgery.

Methods: A retrospective cohort study was conducted to investigate the association between antibiotic prophylaxis with adjunctive gentamicin and SSI rates in orthopedic surgeries. 5,571 patients who underwent hip, knee, spine, and hip fracture surgeries between January 2019 and July 2021 at Yale-New Haven …

Achieving Success[Ion] In Healthcare Leadership: Building An Immersive Nurse Manager Residency Program, Natalie Marie Fucito

Yale School of Nursing Digital Theses

Succession in nursing leadership is essential to the success of the profession. Successful nurse leaders prove cost effective to organizations by promoting key patient outcome indicators and attributes associated with a decrease in staff nurse turnover. Professional development opportunities and mentorship prove successful in retaining nurse managers to advance healthcare leadership. However, literature shows that new nurse managers lack those professional development and mentoring experiences that contribute to their success in this crucial role. In an era where volatility, uncertainty, complexity and ambiguity remain constants for new healthcare leaders, a change in traditional professional development programs is key to sustaining …

Svb Financial Group Systemic Risk Report—Fr Y-15, Dan Beck

Documents

No abstract provided.

Lessons Learned: Patrick Honohan, Maryann Haggerty

Journal of Financial Crises

Patrick Honohan, an economist, was governor of the Central Bank of Ireland and a member of the Governing Council of the European Central Bank (ECB) from September 2009 until November 2015. Early in his tenure, he led a team that investigated the causes of the Irish banking crisis that broke out in 2008 during the Global Financial Crisis. Resolving the problems of bank failure and over-indebtedness that emerged in that crisis dominated his term of office. In late 2010, Ireland had to request financial assistance from the “troika” of the International Monetary Fund (IMF), the European Commission, and the European …

Malaysia: Reserve Requirements, Afc, Bailey Decker

Journal of Financial Crises

Bank Negara Malaysia (BNM) unpegged the ringgit in July 1997, days after Thailand floated the baht. Ringgit depreciation and adverse investor sentiment worsened, contributing to a domestic liquidity shortage and capital flight. Malaysia experienced market instability in the early months of 1998, particularly pressure on its exchange rate, foreign currency reserves, and interest rates. At the same time, disruptions in the domestic money market and loan intermediation process caused an increase in lending rates, which resulted in debt servicing problems and weakened financial stability. To facilitate lending and productive economic activity, BNM twice lowered the statutory reserve requirement (SRR) at …

Jamaica: Reserve Requirements, Gfc, Corey N. Runkel

Journal of Financial Crises

In October 2008, the Global Financial Crisis (GFC) and liquidity shortages rocked American and European markets, causing investors to exit liquid Jamaican-dollar assets. The Bank of Jamaica (BOJ) feared a “disorderly depreciation” in the Jamaican-dollar (JMD) exchange rate to the US dollar (BOJ 2009, 44). In response, the BOJ raised required reserve ratios for cash and other liquid assets, the first increases since 2002. The BOJ raised reserve ratios three times—in December 2008, January 2009, and February 2009—because the central bank could not change its requirements by more than 200 basis points per month. The BOJ raised the requirement for …

India: Reserve Requirements, Gfc, Sharon Nunn, Carey K. Mott

Journal of Financial Crises

As international funding sources dried up during the Global Financial Crisis of 2007–2009 (GFC), businesses in India sought funds from domestic financial institutions, straining banks and lifting short-term lending rates. The liquidity pressure, coupled with sharp asset price corrections and rupee depreciation, restricted credit expansion in India. The Reserve Bank of India (RBI) responded with a suite of liquidity measures, including cuts to its two reserve requirement ratios, the cash reserve ratio (CRR) and the statutory liquidity ratio (SLR). The RBI cut the CRR over the course of four months from October 2008 to January 2009, lowering the ratio from …

Czech Republic: Reserve Requirements, 1997, Benjamin Hoffner

Journal of Financial Crises

In the first quarter of 1997, fiscal and current account deficits in the Czech Republic put pressure on the koruna’s pegged exchange rate as capital flowed out of the domestic economy. Although the Czech National Bank (CNB) committed to tight monetary policy to protect the peg, on April 11, the CNB announced a lowering of the minimum reserve requirement (RR) ratio from 11.5% to 9.5%, effective May 8. The RR ratio (RRR) reduction (RRR) reflected a compromise with the government, which had petitioned the central bank to ease monetary policy. To improve the balance of payments, the government also implemented …

Ecuador: Blanket Guarantee, 1998, Bailey Decker

Journal of Financial Crises

After a series of exogenous shocks hit the Ecuadorian economy in 1997–1998, foreign creditors reassessed their emerging-market risk and reduced external credit lines to Ecuador, thus draining liquidity. The closure of a small bank called Solbanco in April 1998 triggered deposit runs at other banks. Banks sought assistance from the Central Bank of Ecuador (Banco Central del Ecuador, or BCE). By the end of September 1998, the BCE had issued emergency loans to 11 financial institutions, totaling nearly 30% of the money base. The crisis accelerated in August 1998 when Banco de Prestamos, the sixth-largest bank, was closed; the existing …

Blanket Guarantees Survey, Christian M. Mcnamara, Carey K. Mott, Greg Feldberg, Andrew Metrick

Journal of Financial Crises

This paper surveys 10 blanket guarantee (BG) programs across 13 Key Design Decisions. The defining characteristics of these programs in terms of their inclusion in our BG series are (a) that they guaranteed a broader range of liabilities beyond deposit accounts and (b) that the guarantees covered existing liabilities in addition to newly issued ones. Each case represents an effort to eliminate creditors’ incentive to withdraw funding from institutions by guaranteeing that the funding will be paid back even if the institutions are unable to do so themselves. The main themes that emerge are: (a) the inability of blanket guarantees …

The Financialization Of Recession Response, Aaron Klein

Journal of Financial Crises

This paper analyzes economic policy responses to the COVID-19-induced recession, focusing on the American policy response. Despite widespread political distrust between the two parties sharing control of the government and the timing of the upcoming presidential election, America’s political system was able to enact a massive policy response that reduced the severity of the recession. This political response happened faster than any automatic policy response would have, based on the delays in data reporting. The economic policies enacted continued America’s trend toward financialization of fiscal policy. The Federal Reserve and America’s private banking and financial systems were heavily relied upon …