Digital Commons Network^™

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

Public Health Theses

Abstract

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

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

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

Public Health Theses

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

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

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

Public Health Theses

Background

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

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

Yale Medicine Thesis Digital Library

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

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

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

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

Public Health Theses

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

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

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

Public Health Theses

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

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

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

Public Health Theses

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

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

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

Public Health Theses

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

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

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

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

Yale School of Nursing Digital Theses

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

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

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

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

Public Health Theses

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

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

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

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

Public Health Theses

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

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

Public Health Theses

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

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

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

Yale Day of Data

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

Antimicrobial Resistance To 14 Antimicrobials In Marine Coastal Waters Around Northern Ireland: Use Of The Novel Relative Resistance Index As A Marker Of Ecological Status, Peter J. A. Moore, Juluri R. Rao, B. Cherie Millar, Colin E. Goldsmith, Wilson A. Coulter, John E. Moore

Journal of Marine Research

Relatively little work has been published on the incidence of antibiotic resistance (ABR) in the marine microbiological environment, which is of importance to animal (fish, mammals, birds) health, zoonotic transmission, distribution of ABR bacteria with oceanic drift, and ultimately human health. A study was performed to determine the diversity of total ABR (intrinsic and acquired resistance) in marine bacteria in shallow coastal waters surrounding Northern Ireland through the use of a novel Relative Resistance Index (RRI) as a surrogate marker for ecological change, particularly in comparing marine water in commercial versus non-commercial sites. Total antibiotic resistance was observed to varying …

School-Related Exposure To Nitrogen Dioxide And Asthma Severity In Children Enrolled In The Study Of Traffic, Air Quality And Respiratory Health (Star), Rashele P. Yarborough

Yale Medicine Thesis Digital Library

Asthma is an inflammatory disease of the airways characterized by shortness of breath, chest tightness, wheezing and cough. It is one of the most common chronic diseases in children in developed countries, and the prevalence of pediatric asthma has been increasing in recent decades. Both indoor and outdoor air pollution have been identified as risk factors for asthma incidence, prevalence and severity. One of the major gaseous air pollutants, nitrogen dioxide (NO2), is generally related to combustion processes and research has been done to assess its role in asthma outcomes. Unfortunately, studies investigating the relationships between NO2, asthma and respiratory …

Hpv Type Distribution In New Haven County, Ct Among Women With Cin2+ Diagnoses From 2008-2010, Chelsea Anne Russ

Public Health Theses

Background

The human papillomavirus is a necessary cause of cervical cancer leading to >12,000 cervical cancer diagnoses and >4,000 deaths in the United States in 2007. In 2006, the first HPV vaccine was approved by the US FDA, which prevents the acquisition of high-risk types of HPV (16/18) that cause 70% cervical cancer cases in the US and 50% of precancerous lesions. Our objectives were to examine HPV type distribution among women with cervical intraepithelial neoplasia 2/3 (CIN2+) by area-based measures of race, ethnicity, and poverty and individual level characteristics.

Methods

In 2008, the Connecticut Department of Public Health (DPH) …

Depression Treatment In Hiv-Infected And Uninfected Veterans: Do Treatment Rates Vary By Hiv Status?, Kristen Sueoka

Yale Medicine Thesis Digital Library

Background: Despite a higher prevalence of depression among HIV-infected veterans, previous research has shown that infectious disease (ID) providers report substantially less comfort with depression treatment than do general medicine (GM) providers. We examined whether HIV-infected veterans who are treated by ID providers are less likely to have their depressive symptoms treated compared to uninfected controls managed by GM providers. Methods: We used survey, service utilization, and pharmacy data on veterans from the Veterans Aging Cohort Study (VACS), a prospective cohort study of HIV-infected and age-, race- and site-matched uninfected subjects at 8 Veterans Affairs Healthcare Centers. We used the …

Agroecology And The Struggle For Food Sovereignty In The Americas, Avery Cohn, Jonathan Cook, Margarita Fernández, Rebecca Reider, Corrina Steward

Yale School of the Environment Publications Series

A collaborative project of the International Institute for Environment and Development (IIED), the IUCN Commission on Environmental, Economic and Social Policy (CEESP) and the Yale School of Forestry & Environmental Studies (Yale F&ES)

Invertebrate Larval Availability During Summer Upwelling And Downwelling On The Inner Continental Shelf Off New Jersey, Hongguang Ma, Judith P. Grassle

Journal of Marine Research

This study examined the effects of wind-driven, cross-shelf circulation on invertebrate larval supply to benthic habitats on the inner continental shelf off Tuckerton, New Jersey, USA. Study sites were located along an inshore/offshore transect in the LEO-15 research area at Beach Haven Ridge, a 12–20 m deep, shore-oblique sand ridge. Meroplankton was sampled using Moored, Automated, Serial Zooplankton Pumps which were programmed to take 250-l samples, ~1 m above the bottom, every 4 h. Upwelling and downwelling conditions were characterized using wind data from the nearby meteorological tower at the Rutgers University Marine Field Station, and bottom temperatures from LEO-15 …

Structure Of The Internal Boundary Layer Over A Patch Of Pinnid Bivalves (Atrina Zelandica) In An Estuary, Vladimir Nikora, Malcolm O. Green, Simon F. Thrush, Terry M. Hume, Derek Goring

Journal of Marine Research

Measurements of tidal-current boundary-layer flow over an experimental 2-m by 2-m patch of pinnid bivalves (Atrina zelandica) in a northern New Zealand estuary are presented. Previous work demonstrated a link between "mesoscale" (order 100 m) patchiness of the benthic biota and time-averaged boundary-layer dynamics. The aim in this new experiment was to describe the three-dimensional structure of turbulence at the patch scale (order 1 m). Flow over three densities of Atrina was investigated: 340 individuals per 4 m², 50 individuals per 4 m² and zero individuals. An internal boundary layer (IBL) grows downstream from the …

The Role Of Colonization In Establishing Patterns Of Community Composition And Diversity In Shallow-Water Sedimentary Communities, Paul V. R. Snelgrove, J. Frederick Grassle, Judith P. Grassle, Rosemarie F. Petrecca, Karen I. Stocks

Journal of Marine Research

To determine whether pattern and diversity in benthic sedimentary communities are set primarily at colonization or by post-settlement biological interactions, we collected faunal cores and conducted reciprocal sediment transplant experiments at a sandy and a muddy site at 12 m depth, ~3 km apart off New Jersey. Multivariate analyses of cores collected at these sites in September 1994 indicated differences in the taxa determining local pattern, with the bivalve Spisula solidissima and the polychaete Polygordius sp. being dominant at the sandy site, and oligochaetes, several polychaete species and the bivalve Nucula annulata dominant at the muddy site. Individual cores from …

Enzymatically Hydrolyzable Amino Acids In North Sea Sediments And Their Possible Implication For Sediment Nutritional Values, B. Dauwe, J. J. Middelburg, P. Van Rijswijk, J. Sinke, P. M. J. Herman, C. H. R. Heip

Journal of Marine Research

The nutritional value of peptidic material in five North Sea sediments that differ in organic matter quality has been investigated with an enzymatic approach measuring the digestibility (rate constant k of proteolysis by protease) and the proportion of bioavailable fraction of amino acids (%EHAA-i:THAA). The bioavailable fraction in sediments varied between 14-50% EHAA-i:THAA and was generally lower than in potential source organisms such as algae (40-43%), plankton (~80%) and bacteria (57-72%). The rate of proteolysis of the amino acids varied among stations (k = 0.3-3.1 h^-1) with a systematic decrease when going from labile to more refractory …

Observations Of The Influence Of Diurnal Convection On Upper Ocean Dissolved Gas Measurements, Craig L. Mcneil, David M. Farmer

Journal of Marine Research

An important example of the interaction between biological productivity and near-surface oceanography is the role of nocturnal convection and diurnal restratification in modifying the environment in which photosynthetic activity takes place. In situ time series measurements of dissolved oxygen reveal the effects of photosynthetic activity, respiration and redistribution by mixing. Moored thermistor time series and frequent CTD casts show that restratification during the day is confined to a warmer shallow surface layer where most of the biological production is expected to occur. The depth and rate of mixing is measured with neutrally buoyant floats which track the vertical excursions of …

Internal Tidal Bores In The Nearshore: Warm-Water Fronts, Seaward Gravity Currents And The Onshore Transport Of Neustonic Larvae, Jesus Pineda

Journal of Marine Research

Nearshore temperature fluctuations are associated with energetic cross-shore two-way flows that influence the onshore transport of neustonic larvae. Water temperature near the surface and bottom at two nearshore stations off southern California (6 and 15 m water depth, respectively) can drop sharply and subsequently rise. Two or more consecutive drops and rises can occur at diurnal or semidiurnal periodicities. The temperature increases may be accompanied by energetic seaward bottom currents together with sharp-edged warm-water fronts. (Warm-water fronts are defined here as linear seasurface features dividing parcels of water of different temperature.) Shoreward-moving surface fronts divided bodies of water of different …

Water Characteristics, Mixing And Circulation In The Bay Of Bengal During Southwest Monsoon, V. S. N. Murty, Y. V. B. Sarma, D. P. Rao, C. S. Murty

Journal of Marine Research

Influence of the freshwater influx, the wind forcing and the Indian Ocean monsoon drift current on the property distributions and the circulation in the Bay of Bengal during southwest monsoon has been quantified. At the head of the Bay, waters of low salinity, affected by the freshwater influx, occupy the upper 90 m water column. The isohaline 34.0 × 10⁻³ separating these waters from those of underlying saline waters shoals southward gradually and outcrops around 14N, 10N and 6N in the western, central and southeastern regions of the Bay respectively. The wind-stress-curl-induced upwelling effect is confined to depth limits …

Upwelling And Outwelling Effects On The Benthic Regime Of The Continental Shelf Off Galicia, Nw Spain, E. López-Jamar, R. M. Cal, G. González, R. B. Hanson, J. Rey, G. Santiago, K. R. Tenore

Journal of Marine Research

The benthic regime off the Galician coast of NW Spain was surveyed to assess biogenic enrichment from coastal upwelling and detritus outwelling from the rías, large coastal embayments: the Rías Altas along the northern and the Rías Bajas along the western coast, which have intense mussel aquaculture. Sediment samples were collected from 1984 to 1986 and used for geological, microbiological, and macrofaunal studies. Sub-bottom acoustic profiler records and grab and core samples identified two main mud deposits on the western shelf that were aligned north to south and parallel with the coastline. The major axis of the mud deposit, which …

Diel Migration And Feeding Patterns Of The Chaetognath, Sagitta Friderici, Off The West Coast Of South Africa, Venetia Stuart, Hans M. Verheye

Journal of Marine Research

The vertical distribution patterns of adult and juvenile Sagitta friderici were investigated over a 48 h period, using samples collected at different depth strata with an RMT 1 × 6 net. Juvenile chaetognaths were generally found at depths of less than 50 m throughout the day and night, and exhibited limited diel migration patterns. Adults, on the other hand, migrated more extensively and were generally found below 50 m during the day and scattered throughout the water column or near the surface at night. Using the mean depths at each sampling time, the migration patterns of adult chaetognaths closely followed …

Forestry Research: A Provisional Global Inventory, Francois Mergen, M. A. Judd, J. Putnam

Discussion Papers

No abstract provided.

The Effects Of The Filter-Feeding Clam Mercenaria Mercenaria On Carbon Cycling In Experimental Marine Mesocosms, Peter H. Doering, Candace A. Oviatt, John R. Kelly

Journal of Marine Research

The metabolism and the fate of ¹⁴C labelled carbon was examined in 4 outdoor mesocosm (13 m³) tanks containing both benthic and pelagic compartments. Mesocosms with (16/m²) and without the clam, Mercenaria mercenaria were compared. System production, net and gross sedimentation of particulate carbon and benthic remineralization of dissolved inorganic nitrogen were all greater in mesocosms with clams. A filtration rate model, dependent on clam size and temperature, explained between 74–114% of the increased gross sedimentation in clam tanks relative to controls.The higher production in the clam tanks was at least in part due to …

Seasonal Lags Between Organic Carbon Deposition And Mineralization In Marine Sediments, David T. Rudnick, Candace A. Oviatt

Journal of Marine Research

The fate of phytoplankton detritus in the muddy sediments of shallow marine ecosystems was studied by labelling the water column of a 13 m³ microcosm with radiocarbon bicarbonate from January to July. By the end of the study, more than 9% of the original inorganic label was found as organic carbon in the top 10 cm of sediment. The accumulation of labelled organic carbon in the sediment totalled 14.5 gC/m². We estimate that this amount represented 15% of daytime net primary production and roughly half of the labelled organic carbon that was deposited on the sediment. The …