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Epidemiology And Innate Immune Monocyte Function Of Staphylococcus Aureus Carriers And Non-Carriers In A Medical School Community: A Pilot Study, Catherine Molina Dailey

Yale Medicine Thesis Digital Library

Purpose: The purpose of this study was to examine host risk factors and measure innate immune function in order to assess their potential associations with carriage of Staphylococcus aureus (S. aureus). Nearly a third of individuals worldwide are carriers of S. aureus. These bacteria usually exist as harmless commensal organisms of the skin or mucosa, most frequently in the anterior nares. Some people are persistently colonized with S. aureus while other people are intermittently or never colonized. If S. aureus gains access to underlying tissues or to the bloodstream, it can cause serious life-threatening infections, and colonization with S. aureus …

Long-Term Patterns Of An Estuarine Pathogen Along A Salinity Gradient, David Bushek, Susan E. Ford, Iris Burt

Journal of Marine Research

Parasitic, disease-causing pathogens can exert strong control over marine populations yet few long-term studies exist that describe these relationships. Understanding the connections to long-term large-scale processes relative to local short-term processes should facilitate better planning for disease impacts in the management of marine resources. We describe a 21-yr dataset of dermo disease (Perkinsus marinus) in eastern oysters (Crassostrea virginica) in Delaware Bay, USA. Analyses indicated (1) a strong positive association between disease and mortality that was non-linear and defined by thresholds, (2) a clear spatial gradient of increasing disease and mortality with increasing salinity, (3) an …

An Introduction To Ecology Of Infectious Diseases – Oysters And Estuaries, Eileen E. Hofmann, Susan E. Ford

Journal of Marine Research

Infectious diseases are recognized as an important factor regulating marine ecosystems (Harvell et al., 1999, 2002, 2004; Porter et al., 2001; McCallum et al., 2004; Ward and Lafferty, 2004; Stewart et al., 2008; Bienfang et al., 2011). Many of the organisms affected by marine diseases have important ecological roles in estuarine and coastal environments and some are also commercially important. Outbreaks of infectious diseases in these environments, referred to as epizootics, can produce significant population declines and extinctions, both of which threaten biodiversity, food web interactions, and ecosystem productivity (Harvell et al., 2002, 2004)...

Spatial And Temporal Variability Of Disease Refuges In An Estuary: Implications For The Development Of Resistance, Susan E. Ford, Emily Scarpa, David Bushek

Journal of Marine Research

Although the concept of genetic refuge has long been employed in ecological and paleoecological context, it has only rarely been used to identify regions where organisms are protected from diseases that affect the rest of a population. The refuges harbor individuals that have not been exposed to selective mortality and remain susceptible to the disease. They represent a reservoir of susceptibility alleles that can mix with those from resistant survivors of disease and can retard the development of resistance in the population as a whole. Two water-borne protistan parasites affect oysters along the east coast of the United States: Haplosporidium …

Predicting Disengagement From Care In An Early Psychosis Patient Cohort In The United States, Matthew Kruse

Yale Medicine Thesis Digital Library

The current study aims to assess baseline variables which may predict disengagement from care among patients with psychosis seeking treatment at an early intervention clinic in the United States. Based on literature published at sites outside the United States, we predict that duration of untreated psychosis, global assessment of functioning, forensic history, family contact, and substance abuse are predictive of disengagement during the first year of outpatient treatment. Patients were grouped according to whether or not they disengaged from care in a one year follow-up, and compared them on the above discrete and continuous variables with chi-square analysis and Student‟s …

Effectiveness And Monitoring Of Antiretroviral Therapy For Hiv-Infected Children In Accra, Ghana, Oliver Barry

Yale Medicine Thesis Digital Library

Title: EFFECTIVENESS AND MONITORING OFANTIRETROVIRAL THERAPY FOR HIV- INFECTED CHILDREN IN ACCRA, GHANA

Authors: Oliver M. Barry, Meghan Prin, Lorna A. Renner, Bamenla Goka, Jonas Kusah, Kwamena W. Sagoe, and Elijah Paintsil. Section of Infectious Diseases, Department of Pediatrics, Yale University, School of Medicine, New Haven, CT.

Despite advances in HIV diagnosis and care, many challenges remain in resource-limited settings. As scale-up of antiretroviral therapy (ART) progresses in resource-limited settings, evaluation of available first-line regimens and monitoring techniques is needed to ensure the safety and success of such efforts. This study had two specific aims. First, the study aimed to …

Development Of Resistance To An Introduced Marine Pathogen By A Native Host, Susan E. Ford, David Bushek

Journal of Marine Research

In 1957–1959, the introduced protistan parasite, Haplosporidium nelsoni, killed 90–95% of the oysters (Crassostrea virginica) in lower Delaware Bay and about half of those in the upper bay. Shortly thereafter, H. nelsoni-caused mortality in the wild population of the lower bay declined, approximating that of first-generation selectively bred oysters. For nearly three decades thereafter no further change in survival of the wild population was evident, although steady improvement was achieved by continued selective breeding. Survival of the wild population is thought to have plateaued because the great majority of oysters inhabited the upper bay where they …

Effective Population Sizes Of Eastern Oyster Crassostrea Virginica (Gmelin) Populations In Delaware Bay, Usa, Yan He, Susan E. Ford, David Bushek, Eric N. Powell, Zhenmin Bao, Ximing Guo

Journal of Marine Research

Effective population size (N_e) is an important concept in population genetics as it dictates the rate of genetic change caused by drift. N_e estimates for many marine populations are small relative to the census population size. Small N_e in a large population may indicate high reproductive variance or sweepstakes reproductive success (SRS). The eastern oyster (Crassostrea virginica) may be prone to SRS due to its high fecundity and high larval mortality. To examine if SRS occurs in the eastern oyster, we studied N_e and genetic variation of oyster populations in Delaware Bay. …

Modeling The Dispersal Of Eastern Oyster (Crassostrea Virginica) Larvae In Delaware Bay, Diego A. Narváez, John M. Klinck, Eric N. Powell, Eileen E. Hofmann, John Wilkin, Dale B. Haidvogel

Journal of Marine Research

The interactions of circulation and growth processes in determining the horizontal distribution of eastern oyster (Crassostrea virginica) larvae in the Delaware Bay estuary were investigated with a coupled circulation-individual-based larvae model that used environmental conditions from the spawning seasons (mid-June to mid-September) of 1984, 1985, 1986, 2000, and 2001. Particles, representing oyster larvae, were released at five-day intervals from areas in Delaware Bay that correspond to natural oyster reefs. The simulated larval development time was used to estimate potential larval success, determined by the percent of larvae that successfully reached settlement size (330 μm) within the planktonic larval …

Outcomes In The Urologic Management Of Neurogenic Bladder In Spinal Cord Injured Patients, Leonard Ufumwen Edokpolo

Yale Medicine Thesis Digital Library

The main objective of this study was to retrospectively report our institutionaloutcomes with the long-term management of neurogenic bladder in spinal cord injurypatients. Specifically to: (A) report the association of recurrent urinary tract infection

(UTI) with the long-term use of clean intermittent catheterization (CIC) in our population of spinal cord injury (SCI) patients. (B) Secondly, to evaluate the use of retroperitoneal

ultrasound for long-term renal tract surveillance in injured patients. (C) And thirdly, to describe our experience with the use of the lowsley retractor method for suprapubic cystostmy in patients with neurogenic bladder.

Subjects were selected from patients followed by …

Foretelling The Future Of Prognostication: A Historically Inspired Domain-Based Approach For The Elderly, John Thomas

Yale Medicine Thesis Digital Library

FORETELLING THE FUTURE OF PROGNOSTICATION: A HISTORICALLY INSPIRED DOMAIN-BASED APPROACH FOR THE ELDERLY

John M. Thomas and Terri R. Fried. Section of Geriatrics, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.

Hypothesis: 1) Physicians' decisions to discuss hospice as an option for terminally ill patients are based on a limited approach to prognostication that excludes many patients who may benefit from discussions. 2) Identifying broader domains of health most important for prognostication, as an alternative to calculating life expectancy or mortality risk, might encourage prognostication and improve physician-patient communication.

Aims: 1) To examine the association between …

A Program Evaluation Of A Mobile Clinic In New Haven, Connecticut, Britton Ashley Gibson

Public Health Theses

Background: Barriers to health care typically exist amongst poor and marginalized communities that are burdened by a number of factors, such as unemployment, lack of insurance, and homeless. These groups also hold a disproportionate disease burden due to increased risk of exposure. Thus, they are likely to go without care for treatable conditions because they are unable to access traditional health care settings. One way of overcoming these barriers to care is through the use of mobile clinics. These clinics are able to offer a variety of services within disadvantaged communities to both prevent the spread of disease and alleviate …

A Survey Assessing The Contributing Factors To Substance Abuse Treatment In U.S. Corrections Settings, Michael Soule

Yale Medicine Thesis Digital Library

In light of the dramatic rise in incarceration due to the "War on Drugs," we explored the contributing factors to substance abuse treatment (SAT) programming - in particular, evidence-based treatments like medication assisted therapy (MAT) - implementation in United States correctional settings (including jails, prisons, and community corrections facilities). We hypothesized that current funding availability would be the primary factor preventing and contributing to program implementation, but further hypothesized that an array of secondary factors such as overcrowding, geographic location, facility type, and attitudes and knowledge about MAT would also play a role. We mailed a survey to an enriched …

Medicine@Yale June 2012 Volume 8, Issue 3, 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.

Parental Perception Of Child Weight Status In Wangcheng District, Hunan Province, People's Republic Of China, Nichole Buswell

Yale School of Nursing Digital Theses

Objectives: This cross-sectional, quantitative study was designed to describe the prevalence of overweight and obesity in a sample of schoolchildren (age 9-11 years) in central southern China. It also described parental attitudes about childhood overweight, physical activity, and eating patterns. In addition, this study described parental perception of and concern about their child's weight status.

Methods: This study was conducted in June 2011 at three elementary schools located in Wangcheng District, a suburb of Changsha, the capital city of Hunan Province. Child anthropometric data were collected, after which surveys were distributed to be brought home for completion by parents/caregivers.

Results: …

Sex Trafficking In Kolkata, India: Employment Histories And Perceptions Of Risk, Madison Leigh Rose

Public Health Theses

Abstract

Sex trafficking is a significant public health and human rights concern in India. This paper aims to (1) replicate questions about predisposing factors and trafficking mechanisms previously asked of women and girls released from trafficking to a sample of women actively involved in commercial sex work; and (2) go beyond existing research by determining first-hand information on pre-trafficking employment histories and subjective perceptions of trafficking and health risks.

Interviews with 57 trafficked female sex workers in Kolkata (Calcutta), India. Most women were born in India. Bangladesh and Nepal were also reported nations-of-origin. Illiteracy was prevalent in the sample (67.9%, …

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) …

Characterization Of Bis-(3', 5')-Cyclic Dimeric Adenosine Monophosphate As A Mucosal Adjuvant And Its Relevance In A Model Of Hookworm Pathogenesis, Shawn Terryah

Public Health Theses

Most pathogens invade their human host or establish infection at mucosal surfaces. In contrast to parenteral vaccines, mucosal immunization has the potential to induce a robust immune response at mucosal surfaces capable of blocking the entry and establishment of many pathogens. Despite these advantages, very few mucosal vaccines are licensed for human use, largely because antigens administered by the mucosal route are either poorly or non-immunogenic. A strategy to overcome this problem is co-administering vaccine antigens with a mucosal adjuvant. Recently, bis-(3',5')-cyclic dimeric adenosine monophosphate (c-di-AMP) was identified as a potential mucosal adjuvant. To evaluate c-di-AMP as a mucosal adjuvant …

Obesity As A Risk Factor For Hospital Acquired Infections In Pediatric Trauma Patients: A Pilot Study, Elyor Vidal

Public Health Theses

Context

The prevalence of obesity among young Americans in the 6 to 19 year old category has tripled since the 1960's. Today, 50% of individuals in this age group are either overweight or obese (Kimm, 2002). Studies have shown that increased percentage of body fat weakens the body's immune system (Falagas, 2009). Moreover, trauma can be an immuno-compromising condition. A study by Brown et al. in 2006 showed that obese pediatric trauma patients had more sepsis (15% vs 4%, P = .007) and wound infection (26% vs. 8%, p = .03), along with other clinical complications.

Objective

This project serves …

Governance Implications Of Global Infectious Disease Epidemics Under Shared Health Governance Scheme. Lessons From Sars, Ruosi Wang

Public Health Theses

The world is becoming flat. With the progress of globalization and world integration, the past century has witnessed a growing number of emerging and reemerging diseases. It has become a common concern the world will face a deadly infectious disease pandemic and the international community needs to set up a functional system to face up the challenge. Over the past decade, outbreaks of SARS, H5N1 and H1N1 pandemic have raised concern among public health officials and the public in general on the need of global and local pandemic control. Infectious agents have been able to take advantage of the dramatic …

Palivizumab Dosing And Risk Of Rsv Infection In Premature Children, Michael J. Araas

Public Health Theses

We conducted a retrospective case-control study of children attending the Yale-New Haven Hospital Premature Infant Primary Care Clinic (YNHH-PIPCC). Subjects were prematurely born children under 24 months of age cared for at the YNHH-PIPCC between October 2000 and March 2011. They are eligible to receive monthly passive respiratory syncytial virus (RSV) immunization with palivizumab during the RSV season. All cases had laboratory-documented severe RSV disease necessitating hospital admission or outpatient visit. Controls did not have severe RSV disease during the same season as their matched case. Controls were matched to the cases by gestational age and month of birth. Risk …

Exhibiting Health: Museums As A Venue For Public Health Intervention, Jacqueline Katherine Bruleigh

Public Health Theses

Public health interventions are as broad as the field itself. Through this paper, I will highlight the missed opportunity that museums present as an intervention site for public health. I will then discuss the design, content, challenges, successes, and directions for growth of a specific exhibition (Big Food: Health, Culture, and the Evolution of Eating), as an example of successfully translating public health into the museum context, which could be used as a starting point for further interventions in this underutilized venue.

Blindness And Poverty: An Outreach-Based, Case-Control Study Assessing The Relationship Between Poverty And Visual Impairment From Cataract In Greater Accra, Central, Eastern, Western, Volta, And Ashanti Regions Of Ghana, Jonathan Legrand Curtis

Public Health Theses

Background

Blinding cataracts have been linked to poverty, and are the most common form of preventable blindness in the developing world. The WHO has identified cataract surgery as one of the top five potential public health interventions in developing countries; however, studies exploring the initial economic attributes before cataract surgery and subsequent outcomes following the sight-restorative surgery in the developing world have not been undertaken. This study assesses the baseline economic and sociodemographic attributes of a cohort of 267 cataract cases in rural villages throughout southern Ghana and compares them with 100 controls to test whether those with existing cataracts …

Epidemiology And Trends For Vibriosis In Connecticut, 1999-2010, Olivia Ellis

Public Health Theses

Background: Behavior and environment play a significant role in the acquisition of vibriosis. Vibrio data collected over the past twelve years suggests that incidence of vibriosis has increased in Connecticut. Vibriosis is a physician and laboratory reportable illness in Connecticut. Surveillance data was collected by Connecticut FoodNet and Connecticut Department of Public Health staff. These data were analyzed to evaluate the epidemiology and trends in incidence over time.

Methods: Incidence rates were stratified by demographic, geographic, bacteriologic and clinical groups and trends in the incidence and percentage of cases in these groups were analyzed over time. Because risk factors for …

Determinants Of Dengue Transmission During Epidemic And Inter-Epidemic Periods In Two Colombian Cities, Yao Fu

Public Health Theses

Dengue fever is an urban disease that has a complex epidemiology consisting of alternating periods of intense epidemics and persistence in endemic locations. No studies have compared the patterns of geographic variation and determinants of dengue transmission in neighborhoods during epidemic and non-epidemic periods. Colombia's individual-based epidemiological surveillance system provides a unique opportunity to study this topic. The goal of this study was to better understand dengue epidemiology in two of the highest dengue fever reporting Colombian cities that vary in climate, Armenia (elevation 1320-1580 m, 21-23 C) and Barranquilla (elevation 5-134m . 27-30 C). We used a novel ecological …

Occupational Exposures Of Healthcare Workers To Pertussis Within A Large Pediatric Care Network: A Retrospective Study, Danica Elizabeth Kuncio

Public Health Theses

Background

Infection control policies have a significant impact on the risk for disease transmission in healthcare settings, and adherence to guidelines dictates their effectiveness. Healthcare worker (HCW) exposure to communicable diseases can occur when guidelines have not been consistently implemented, placing the HCW at risk for infection with subsequent transmission to patients and co-workers. Respiratory pathogens are a common source of healthcare-associated infection, especially in pediatric settings and pertussis has emerged as a particularly important agent that is associated with an increasing number of both community and healthcare-associated outbreaks despite the availability of an effective vaccine. Adults, including HCWs, are …

The Health Status Of Prisoners At Three Rural Haitian Prisons, Katherine Grace Lamonaca

Public Health Theses

Background: Aside from documented high prevalence of infectious disease, little is known about the health status of prisoners in developing countries. In Haiti, prisons typically lack adequate food, clean water, and medical care. Some prisoners, however, may receive additional food from visitors during designated food delivery hours. This study sought to characterize the overall health status of Haitian prisoners as well as to begin to explore the impact of incarceration on health status. We hypothesized that prisoners who had more visitors and shorter lengths of detention would be more likely to have better overall health status, measured by having a …

Effect Of Socio-Cultural Beliefs On Late Stage Presentation Of Breast Cancer Among Ghanaian Women, Yehoda Martei

Yale Medicine Thesis Digital Library

ABSTRACT

EFFECT OF SOCIO-CULTURAL BELIEFS ON LATE STAGE PRESENTATION OF BREAST CANCER AMONG GHANAIAN WOMEN. Yehoda M. Martei; Verna Vanderpuye; and Beth A. Jones.

Yale University, School of Medicine, New Haven, CT.

New data emphasizes the increasing burden of cancer in the developing world, which has led to an increasing move to prioritize cancer care on the global health agenda. Breast cancer is the leading cause of cancer mortality among women globally. In Ghana, most women present with advanced stage breast cancer. There is currently no national screening program, and insight into why women present late stage is limited. The …

Medicine@Yale November/December 2011 Volume 7, Issue 5, 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.

Stat3 Is Important For The Emergence Of Human B Cells Predicted To Proliferate After Infection With Epstein-Barr Virus, Amanda Victoria Zeta De La Paz

Yale Medicine Thesis Digital Library

STAT3 is important for the emergence of human B Cells predicted to proliferate after infection with Epstein-Barr Virus

Amanda Z. de la Paz and Sumita Bhaduri-McIntosh. Section of Infectious Diseases, Department of Pediatrics, Yale University, School of Medicine, New Haven, CT.

Many unanswered questions surround the early changes in B cells that lead to establishment of latency and immortalization following Epstein-Barr virus (EBV) infection. Data from the Bhaduri-McIntosh lab revealed that EBV differentially infects B cells into distinct sub-populations, only one of which, those marked CD23hi CD58+ IL6-, can be predicted to proliferate as early as 3 days after exposure …