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Operationalizing Culture: Refugees, Migration, And Mental Health In The Wake Of The Vietnam War, Helena Bui

The Yale Undergraduate Research Journal

!e end of the Vietnam War led to the migration of hundreds of thousands of Vietnamese refugees to the United States a"er political and economic upheaval. As another result, the refugees’ years of warfare, trauma, death, and injury began to manifest as unprecedented mental health issues that American physicians and researchers sought to understand. In this paper, I argue that American medical professionals— in good faith—operationalized [Vietnamese] culture to help themselves and their colleagues understand the mental health issues of Vietnamese refugees. Yet this operationalization acted as a double-edged sword. Viewing Western mental health discourse through the lens of Vietnamese …

A Comparison Of The Evolution, Structure, And Function Of Sars-Cov And Sars-Cov-2 Spike Proteins, Tai Michaels

The Yale Undergraduate Research Journal

As the COVID-19 pandemic has developed into the largest pandemic of the twenty-first century, it has become apparent that this disease, caused by the SARS-CoV-2 virus, is unlike anything the modern world has faced before. Not only has the disease infected more than 16 million people worldwide, but its rapid spread has drawn global attention to the gaps in our understanding of its pathogenesis and the development of vaccines and treatments. One of the most important topics of research in the disease is the viral spike (S) protein which facilitates binding and entering host cells and plays a key role …

Western And Chinese Medicine In The History Of Community-Based Care In San Francisco’S Chinatown, Grace Chen

The Yale Undergraduate Research Journal

In fear-inciting epidemic, disease has often led to the disproportionate injury of minority communities through lack of equal access to medical care and implementation of prejudiced policies disguised as public health. In the United States, the use of infectious disease as a vehicle for the targeted suppression of Chinese Americans is no new phenomenon, from the discriminatory reactions to the 1900 San Francisco plague outbreak to the escalation of racial violence in the ongoing coronavirus pandemic. Here, I explore how Chinese immigrants in the late 19th and early 20th centuries responded to inadequate public health care in San Francisco, including …

2020 Annual Report, Bank Of Korea

Documents

No abstract provided.

Yale Medicine Magazine July 2021, Issue 167, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the July 2021 issue of Yale Medicine Magazine, issue 167. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965) and Yale Medicine: alumni bulletin of the School of Medicine, v.1 (1965) through v. 52, no.1. (Autumn 2017).

Guidelines For Influenza Vaccination Uptake In Pregnant Women: A Cluster-Randomized Controlled Trial, Jenna R. Moscarelli

Yale School of Medicine Physician Associate Program Theses

Influenza is a contagious respiratory illness caused by influenza viruses. Influenza infection during pregnancy poses unique risks to pregnant women and infants, including severe symptoms and adverse pregnancy outcomes. However, many pregnant women do not receive the influenza vaccination. Reasons for low vaccine uptake are multifactorial, with the lack of a healthcare provider’s recommendation being a critical barrier. In this cluster-randomized controlled trial, we will examine the effect of a structured vaccine recommendation program for obstetric providers on the mean proportion of pregnant women who receive the influenza vaccination. Specifically, this trial will use a custom provider education program based …

Normalizing Community Mask-Wearing: A Cluster Randomized Trial In Bangladesh, Jason Abaluck, Laura H. Kwong, Ashley Styczynski, Ashraful Haque, Md. Alamgir Kabir, Ellen Bates-Jeffries, Emily Crawford, Jade Benjamin-Chung, Salim Benhachmi, Shabib Raihan, Shadman Rahman, Neeti Zaman, Peter J. Winch, Md. Maqsud Hossain, Hasan Mahmud Reza, Stephen P. Luby, Ahmed Musfiq Mobarak

Cowles Foundation Discussion Papers

Background: A growing body of scientific evidence suggests that face masks can slow the spread of COVID-19 and save lives, but mask usage remains low across many parts of the world, and strategies to increase mask usage remain untested and unclear. Methods: We conducted a cluster-randomized trial of community-level mask promotion in rural Bangladesh involving 341,830 adults in 600 villages. We employed a series of strategies to promote mask usage, including free household distribution of surgical or cloth masks, distribution and promotion at markets and mosques, mask advocacy by Imams during Friday prayers, role modeling by local leaders, promoters …

The Impact Of Community Masking On Covid-19: A Cluster Randomized Trial In Bangladesh, Jason Abaluck, Laura H. Kwong, Ashley Styczynski, Ashraful Haque, Md. Alamgir Kabir, Ellen Bates-Jeffries, Emily Crawford, Jade Benjamin-Chung, Shabib Raihan, Shadman Rahman, Salim Benhachmi, Neeti Zaman, Peter J. Winch, Md. Maqsud Hossain, Hasan Mahmud Reza, Abdullah All Jaber, Shawkee Gulshan Momen, Faika Laz Bani, Aura Rahman, Tahrima Saiha Huq, Stephen P. Luby, Ahmed Mushfiq Mobarak

Cowles Foundation Discussion Papers

Background: Mask usage remains low across many parts of the world during the COVID- 19 pandemic, and strategies to increase mask-wearing remain untested. Our objectives were to identify strategies that can persistently increase mask-wearing and assess the impact of increasing mask-wearing on symptomatic SARS-CoV-2 infections. Methods: We conducted a cluster-randomized trial of community-level mask promotion in rural Bangladesh from November 2020 to April 2021 (N=600 villages, N=342,126 adults). We cross-randomized mask promotion strategies at the village and household level, including cloth vs. surgical masks. All intervention arms received free masks, information on the importance of masking, role modeling by community …

Curse Of Democracy: Evidence From 2020, Yusuke Narita, Ayumi Sudo

Cowles Foundation Discussion Papers

Countries with more democratic political regimes experienced greater GDP loss and more deaths from Covid-19 in 2020. Using five different instrumental variable strategies, we find that democracy is a major cause of the wealth and health losses. This impact is global and is not driven by China and the US alone. A key channel for democracy’s negative impact is weaker and narrower containment policies at the beginning of the outbreak, not the speed of introducing policies.

Immune-Metabolic Regulation By The Transsulfuration Pathway, Aileen Heeyeon Lee

Yale Graduate School of Arts and Sciences Dissertations

Pro-longevity interventions such as caloric restriction (CR) and methionine restriction (MR) can improve metabolic health. However, despite decades of extensive studies, the mechanisms that underlie the benefits of these dietary interventions are still being characterized. Particularly, the effect of these diets on immune cells in mediating their metabolic benefits has been largely unexplored. This work aimed to expand our understanding of how these dietary interventions may regulate immune responses and identify novel immunomodulatory pathways that could be harnessed during inflammatory and metabolic pathologies.In line with other studies in animal models, we identified that the transsulfuration pathway (TSP) was induced in …

Mechanisms Of Resistance Against B Cell Targeting Treatments For Myasthenia Gravis, Ruoyi Jiang

Yale Graduate School of Arts and Sciences Dissertations

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder caused by autoantibodies that disrupt neuromuscular transmission by targeting components of neuromuscular junctions, such as the acetylcholine receptor (AChR, 90% of patients) and muscle specific kinase (MuSK, 10% of patients). Treatments that address the underlying causes of MG target the cells responsible for producing these autoantibodies. Two such treatment strategies are predominantly used: (1) surgical resection of the thymus (a reservoir for auto-antigen specific B cells in patients with AChR MG) and (2) systemic therapy targeting subsets of autoantibody-producing B cells. The thymus is a known anatomic reservoir for B cells that …

Developing Tradition: A History Of Intercultural Health Governance In Mexico, 1940-2000, Joshua Mentanko

Yale Graduate School of Arts and Sciences Dissertations

This is an intellectual and social history of efforts by the Mexican state to order and transform medical pluralism for developmentalist ends in the highlands of Chiapas state between 1940 and 2000. Focusing on state employees, bilingual and indigenous doctors and midwives, and Mexican and foreign anthropologists, it grounds the emergence of “interculturalidad” – or the project of integrating indigenous traditional medicine into state and non-state health institutions – in a broader history of economic development and modernization and indigenous resistance to and negotiation of capitalist and national integration projects. It shows how efforts to integrate traditional medicine have not …

Discovery Of Host-Microbiota Interactions, Connor Rosen

Yale Graduate School of Arts and Sciences Dissertations

The microbiota, comprising the trillions of microorganisms that colonize barrier tissues, exert profound effects on host health and disease. Microbial effects on host physiology have been illuminated by a wealth of sequencing-based approaches that enumerate bacterial species, strains, genes, and products (collectively, “multi-omics” approaches) at different tissue sites and in different human populations. Microbes may influence local physiology at their site of residence, as well as having systemic effects including perturbation of organism-wide metabolism, with wide-ranging consequences. The molecular mechanisms by which microbes mediate both local and systemic effects, however, remain mostly unclear. This is in part due to technological …

Three Essays On Political Responses To Opioid Use In The United States, Lilla Orr

Yale Graduate School of Arts and Sciences Dissertations

In the first two decades of the 21st century, opioid use in the United States has grown to unprecedented levels. Approximately half of the U.S. adult population has been prescribed an opioid based pain reliever, 1.7 million people have an opioid use disorder, and nearly 50,000 people die of opioid related overdoses each year. Public attitudes and drug policy have transformed in the wake of this staggering loss of life. These changes are often attributed to the racial, socioeconomic, and geographic profile of those most affected by the overdose and addiction epidemic, as well as the perceived culpability of physicians, …

Medicine@Yale January/February 2021 Volume 16, Issue 1, Yale School Of Medicine Office Of Communications

Medicine@Yale - development newsletter

Medicine@Yale : advancing biomedical science, education and health care was a print and online newsletter which published news about academics, research and philanthropy for alumni, donors, faculty, students and the general public. It was initially published 6 times a year and then changed to a quarterly schedule. The first issue came out June/Jul. 2005. The final issue was published in May/June 2022, vol. 17, issue 1. Published by Yale School of Medicine, Office of Communications.

Was New York City A Source Of Global Sars-Cov-2 Spread?, Cole Jensen

Public Health Theses

Coronavirus disease 2019 (COVID-19) was first diagnosed in the United States on January 15, 2020, in the state of Washington. Shortly after that, on February 29, 2020, the first case of COVID-19 was reported in New York City. From January 2020 through July 2020, there were 223,107 cases of COVID-19 that led to 18,787 COVID-19 related deaths in New York City alone. During this time, many left New York City to avoid contracting the virus or to return home. This travel seeded much of the transmission within the United States. We aimed to identify any international transmission of severe acute …

Assessing Changes In The Epidemiology Of Cutaneous Leishmaniasis In Southwest Colombia Following The Peace Accord With Fuerzas Armadas Revolucionarias De Colombia (Farc), Matthew Stephen Benczkowski

Public Health Theses

The Colombian Conflict persisted for over 50 years, recently coming to an end in November 2016 after the signing of Colombia’s Peace Agreement between the government and FARC guerrilla group. Internal armed conflict is often entangled with the exacerbation of health outcomes, including promoting the spread of infectious diseases like cutaneous leishmaniasis (CL). CL is a vector-borne parasitic disease localized to the human tegument that decreases quality of life through lesions leading to scars and associated stigmatization. This study assessed changes in demographic and clinical characteristics of patients with CL in Southwest Colombia before and after the signing of the …

The Utility Of A Maximum Entropy Species Distribution Model For Ixodes Scapularis In Predicting The Public Health Risk Of Lyme Disease In Ontario, Canada, Holly Alexandra Burrows

Public Health Theses

Introduction: Lyme disease is an emerging public health threat in Ontario, Canada due to the range expansion of the tick vector, Ixodes scapularis. Tick abundance and density are important predictors of human Lyme disease risk and are typically measured using active tick surveillance (dragging). New cost-effective tools are needed to augment current surveillance activities.Objective: The objective of this study was to evaluate the ability of a Maximum entropy species distribution model to predict I. scapularis density and abundance in three regions of Ontario – Ottawa, Kingston, and southern Ontario – in order to determine its utility in predicting the public …

Is Now The Time For Supervised Consumption In New Haven? Assessing The Complexities Of Global Examples, National Efforts, And City Contexts To Support The Progress Of Local Harm Reduction, Mariah Frank

Public Health Theses

The overdose crisis has been an issue of public health and safety in the U.S. over the past 30 years, as a wave of increased addiction and overdoses beginning in 1990 brought it to public attention and political salience.1 The impact of the current overdose crisis is felt deeply across the state of Connecticut and locally in the City of New Haven. Statewide data show that people in Connecticut are more likely to die from a drug overdose than they are from a car accident, firearm death or homicide, Alzheimer’s, influenza/pneumonia, diabetes, kidney disease, or septicemia (data not including deaths …

Exploring Thai Physicians’ Perceptions Of And Willingness To Prescribe Pre-Exposure Prophylaxis (Prep), Brandi E. Moore

Public Health Theses

Background: Oral pre-exposure prophylaxis (PrEP) is a daily medication that can prevent HIV infection. PrEP may further support HIV prevention initiatives in Thailand, particularly as it becomes more accessible in the country’s government clinics and hospitals. While studies have explored perceptions of PrEP for at-risk people in Thailand, there has been limited investigation into Thai physicians’ opinions of and willingness to prescribe PrEP. Methods: Using convenience sampling, this cross-sectional study recruited 132 Thai physicians to complete an anonymous, online survey. The survey assessed physicians’ concerns about PrEP, experience with PrEP, and willingness to prescribe PrEP. Bivariate and multivariable logistic regressions …

Too Fast, Too Furious: Slaughterhouse Line Speeds In The Era Of Covid-19, Zoe Novic

Public Health Theses

Since 1998, the United States Department of Agriculture (USDA) has allowed meat companies to increase slaughter line speeds in order to increase production of meat and poultry. The USDA grants approvals known as “line speed waivers” that bypass the requirements of current speed and inspection regulations. During the Covid-19 pandemic, slaughterhouses became epicenters of Covid-19 outbreaks, which called into question safety regulations established at these facilities. The USDA continued to grant line speed waivers despite evidence that faster line speeds result in increased worker injuries, animal welfare violations, environmental protection violations, food safety violations, and higher risk of Covid-19.

In …

Why Not Here? An Examination Of Statewide Hospital Use Among Patients With Idu-Associated Diagnoses And Procedures In Lawrence And Lowell Ma, 2005-2019, Frank Wu

Public Health Theses

This study sought to investigate the factors that led residents with IDU-associated diagnoses and procedures to seek care outside their home cities of Lawrence and Lowell, Massachusetts. Endocarditis diagnoses were found to be no different between hospitals in and out of Lawrence and Lowell, however, echocardiograms (CI = -0.19, -0.14; p-value = <0.001), skin and soft tissue infections (CI = 1.11, 1.23; p-value = <0.001), and irrigation and drainage procedures (CI = 0.15, 0.21; p-value = <0.001) were all found to be significantly different. These changes in hospital use highlight the need to account for patient-resident mobility during the creation of future similar studies.

Evaluating Clinician Features And Reporting Decisions On Performance In The Merit-Based Incentive Payment System, Christopher Robert Han

Yale Medicine Thesis Digital Library

The Merit-Based Incentive Payment System (MIPS) is the largest change to physician reimbursement in decades. We sought to examine clinician participation and performance of clinicians to better understand the relationship between clinician features and reporting decisions on MIPS scores and payment adjustments.

Using publicly available data from the Centers for Medicare and Medicaid Services (CMS), we examined 2018 clinician participation and performance in the MIPS. We analyzed aggregate MIPS score performance as well as payment adjustment results stratified by clinician specialty, reporting affiliation, practice size, and the CMS special status designating rural or health profession shortage area (HPSA). Using linear …

Refugee Health, Healthcare, And Resettlement In New Haven, Connecticut: A Historical Study With Contemporary Implications, Ezra Lichtman

Yale Medicine Thesis Digital Library

Nationally, there is no single clinic model for the provision of healthcare to refugees, and the field of refugee health is perpetually in flux. However, in the New Haven area, there is a well-established system of resettlement, health screening, and healthcare integration for newly arrived refugees. A local agency secures housing, provides education and social opportunities, and coordinates medical visits. And Yale-New Haven Hospital holds adult and pediatric screening clinics for refugees. The origins of this local system lie in the late 1970s and 1980s, when Soviet Jewish and Southeast Asian refugees began to relocate to New Haven in large …

Changes To Worship And Perceptions Of The Covid-19 Pandemic By Religion In The Us, Allison Elizabeth Bailey

Public Health Theses

COVID-19 is a recently emerging infectious disease that spreads easily through respiratory droplets and can cause severe illness and death. Individuals can be both infectious and asymptomatic, which makes it difficult to identify those who are at-risk of spreading the disease to others. In the US, shortly after the World Health Organization (WHO) declared COVID-19 a pandemic disease, states began to issue lockdown orders encouraging residents to stay inside to reduce the spread of the virus. As a result, many Americans were not able to attend religious gatherings or worship services for several months. A cross-sectional study surveyed religious Americans …

Utilizing Covid-19 Models In Humanitarian Crisis Settings, Duane Barksdale

Public Health Theses

Since the emergence of the COVID-19 pandemic in late 2019, several researchers and decision-makers have turned to statistical modeling to inform predictions of the severity of the burden of infection and disease in various settings. While it is understood that no model can perfectly describe the transmission of a novel and highly transmissible pathogen, there still lies the potential for models to be useful tools for local and international decision makers to act proactively to mitigate the burden of disease. In Syria, these challenges are compounded by humanitarian crises resulting from the ongoing civil war in the region. This conflict …

Without A Trace: Is Technology The Next Stage In Contact Tracing’S Evolution?, Madeline Bender

Public Health Theses

Contact tracing has become both a buzzword and a priority during the COVID-19 pandemic. Though it was deployed nationwide in the U.S., its success varied regionally. This special project thesis, in the form of a longform journalism article, traces the public health practice back to its roots to explore who contact tracers are, what they do, and what factors contributed to tracing’s limited success in 2020–21, centering around concepts of stigma and privacy. With this foundation, it assesses the promise and perils of incorporating technology into contact tracing during the COVID-19 pandemic.

Impact Of Serial Point Prevalence Covid-19 Testing On Severe Disease Outcomes In Connecticut Nursing Home Residents, Lauren Marie Campbell

Public Health Theses

Introduction: COVID-19 is a respiratory disease caused by infection with the virus, SARS-CoV-2. Transmission of the virus can occur in both symptomatic and asymptomatic cases making controlling the spread challenging. Point prevalence testing in long term care facilitates has been found to be a useful strategy in detecting cases and managing COVID-19 outbreaks. The impact of this control strategy on severe outcomes of disease in residents of these facilities has not been fully characterized.Methods: Active surveillance of COVID-19 in long term care facilities in Connecticut began in April 2020, with point prevalence surveys beginning in May 2020. Data was collected …

Developing A Framework For Civilian-Military Public Health Operations Involving Non-State Armed Groups, Andrew James Chambers

Public Health Theses

Introduction: The interface of military forces, civilian actors and non-state armed groups (NSAGs) during a public health emergency within an active conflict is a situation fraught with legal and ethical challenges not adequately addressed in established doctrine or international guidance documents. Ongoing public health crises in Yemen and Afghanistan represent the real-world consequences of threats to population health and security if these critical gaps are not addressed. Methods: A list of five diverse medical scenarios was developed as an initial attempt to produce a practical, historically-informed framework for use in future civilian-military (CIV-MIL) training events and guidance. Ten virtual interviews …

The Epidemiology Of Covid-19 Hospitalizations In Connecticut, July – December 2020, Geena Chiumento

Public Health Theses

Background. Hospitalizations due to COVID-19, caused by infection with SARS-CoV-2, have disproportionately impacted many throughout the United States, particularly elderly folks, communities of color, and individuals residing in low-income neighborhoods. Objective. This study aims to describe the epidemiology of COVID-19-related hospitalizations in Connecticut in order to elucidate trends in incidence as well as health disparities. Methods. All first-time hospitalizations due to laboratory-confirmed COVID-19 from July 1 to December 31, 2020, including patients’ geocoded residential addresses, were obtained from the Connecticut Department of Public Health. Patients residing in the community were compared to those residing in congregate settings. Community patients were …