Digital Commons Network^™

Development Of A Viral Vaccine Vector Expressing A P. Falciparum Erythrocyte Membrane Protein Domain To Target Severe Malaria, Sara Eve Crager

Yale Medicine Thesis Digital Library

There are an estimated 300-500 million cases of malaria every year, resulting in approximately 2 million deaths. Malaria mortality occurs primarily in children under the age of five, and is resultant from the development of severe malaria. Attempts to control P. falciparum malaria face rapidly escalating levels of resistance on two fronts: the parasite to anti-malarial drugs, and the mosquito vector to insecticides. Despite current prevention efforts, the global incidence of malaria continues to rise and there is a clear and urgent need for a malaria vaccine. Malaria vaccine efforts thus far have been largely unsuccessful in eliciting robust and …

Low Uptake Of Intermittent Preventive Treatment Of Malaria In Hiv-Infected Pregnant Women At An Urban Hospital In Accra, Ghana, Grace Wanjiku

Yale Medicine Thesis Digital Library

Objectives: The clinical course and complications of malaria during pregnancy are exacerbated in HIV-positive women. Furthermore, malaria during pregnancy may increase the risk of mother to child transmission (MTCT) of HIV. We assessed the uptake of WHO recommended intermittent preventive treatment (IPT) for malaria and insecticide treated bed nets (ITN) during pregnancy among HIV-negative and HIV-positive pregnant women in a malaria endemic area.

Methods: A cross sectional study of 151 women (96 HIV-negative and 55 HIV-positive) receiving antenatal and HIV care at an urban district hospital in Accra, Ghana from July to August, 2008. The women were interviewed to obtain …

Constitution Of Jamaica, Government Of Jamaica

Documents

The Constitution of Jamaica with amendments through 2011

Medicine@Yale May/June 2011 Volume 7, Issue 2, 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.

Evaluation Of Need And Feasibility Of Tuberculosis Screening In Buprenorphine Treatment Programs, Ryan Schwarz

Yale Medicine Thesis Digital Library

Background: Buprenorphine's availability in primary care settings offers increased access to treatment and linkage to primary care for opioid-dependent patients. Currently, tuberculin skin testing (TST) is recommended for patients enrolling in methadone maintenance treatment (MMT), but not for those enrolling in buprenorphine maintenance treatment (BMT).

Objectives: To compare TST screening results in enrollees in BMT and MMT programs and assess the correlates of TST positivity among these subjects.

Methods: A cross-sectional analysis of a retrospective cohort study was conducted to compare concurrent TST results among contemporaneously matched groups of MMT and BMT patients in the same community.

Results: TST positivity …

Influenza Vaccine Given To Pregnant Women Reduces Hospitalization Due To Influenza In Their Infants, Isaac Benowitz

Yale Medicine Thesis Digital Library

The aim of this study was to determine whether giving influenza vaccine to pregnant women can reduce the incidence of hospitalization due to influenza in their infants in the first year of life. This was a matched, hospital-based case-control study at Yale-New Haven Children's Hospital. Case and control subjects were all aged hospitalization, matched to cases by date of birth and date of hospitalization (both within 4 weeks before or after). We contacted parents of all subjects to collect information on the subjects' health and home setting and to get permission to review subjects' and mothers' hospital records and outpatient …

Effect Of Malaria On Hiv Viral Load And Maternal Outcomes In Hiv-Positive Pregnant Women Of Accra, Ghana, Johanna Kate Halfon

Yale Medicine Thesis Digital Library

EFFECT OF MALARIA ON HIV VIRAL LOAD AND MATERNAL OUTCOMES IN HIVPOSITIVE PREGNANT WOMEN OF ACCRA, GHANA Jana Halfon, Elizabeth Levey, Margaret Lartey, Richard Adanu, Michael Ntimi, Larysa Aleksenko, Kwamena Sagoe, Patrick Kumi, Michael Cappello, and Elijah Paintsil (Sponsored by Elijah Paintsil, Yale School of Medicine, through the Doris Duke Charitable Foundation) HIV-1 positive pregnant women co-infected with malaria face increased risk of Mother-to-childtransmission (MTCT) of HIV. Placental malaria has been implicated, whether through an increase in placental or peripheral HIV viral load or a disruption of placental architecture. But the mechanism is not well understood. There are no studies …

Ethical Considerations In Access To Experimental Drugs For Treatment Use, Sonja Rakowski

Yale Medicine Thesis Digital Library

Do dying patients have a moral claim to access experimental drugs when all else has failed? This question has been the focus of an active and evolving debate concerning the rights of terminally ill patients, the nature of the drug development process, and the scope of federal regulation, with supporters arguing that seriously ill patients should be able to decide for themselves whether and when to attempt experimental therapies and opponents arguing that the resulting state of affairs would be disastrous for patient safety and for the integrity of the drug development process. This thesis concerns the ethical considerations surrounding …

Routine Opt-Out Hiv Testing In Jails: Findings From Two Prospective Controlled Trials, Ravi Kavasery

Yale Medicine Thesis Digital Library

Background: Tens of millions of Americans enter jails annually. The Centers for Disease Control and Prevention now recommends routine HIV testing in prisons and jails. The logistics for performing routine HIV testing within jails, however, remains controversial. Specific Aims: 1) To simulate and explore the feasibility of future implementation of a routine opt-out HIV testing protocol using rapid testing methods in the often-chaotic jail setting. 2) To evaluate the optimal time to perform routine HIV testing among inmates who are competent to consent to testing, in a manner that not only maximizes public health but also attends to the safety …

The Fda Black Box Warning System: The Utmost In Drug And Patient Safety?, Andrew T. Georgi

Yale Medicine Thesis Digital Library

THE FDA BLACK BOX WARNING SYSTEM: THE UTMOST IN DRUG AND PATIENT SAFETY? Andrew Georgi (Sponsored by Paul Barash, MD, and Loreta Grecu, MD). Department of Anesthesiology, Yale University School of Medicine, New Haven, CT. Of the 7856 pharmaceutical products under the purview of the Food and Drug Administration (FDA), over six hundred have a black box warning (BBW). As the FDAs highest level of warning included on drug package inserts, this notation is reserved for those drugs that pose significant risks leading to death or serious injury. However, the types of warnings that warrant this distinction have not been …

Green Practices For Surgical Units, Gifty Kwakye

Yale Medicine Thesis Digital Library

The study aimed to identify leading practices to promote environmentally friendly and efficient efforts in surgical healthcare. Despite widespread enthusiasm for going green in the U.S. economy, little information is available to inform the medical community on the effort. We explore safe and efficient strategies for hospitals and healthcare providers to protect the environment while delivering high-quality care. As part of the study design, we performed a systematic review of the literature using relevant Pubmed search terms and surveyed a panel of hospital managers and CEOs of healthcare organizations pursuing green initiatives. Recommendations were itemized and reviewed with each panelist …

Acceptance Of Telemedicine In Pediatric Rheumatology: A National Survey Of Pediatricians, Kathleen Jo Elayda Corbin

Yale Medicine Thesis Digital Library

ACCEPTANCE OF TELEMEDICINE IN PEDIATRIC RHEUMATOLOGY: A NATIONAL SURVEY OF PEDIATRICIANS. Kathleen Jo E. Corbin, Lisa G. Suter. Section of Rheumatology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. The specific aims of this study were to characterize: 1) the impact of the pediatric rheumatology workforce shortage from the perspective of pediatric rheumatologists and general pediatricians, and 2) the acceptance of telemedicine, including both video conferencing and store and forward technology, as a potential solution for the pediatric rheumatology workforce shortage. We hypothesized that physicians practicing in settings with decreased access to pediatric rheumatology would perceive …

Acceptability Of Seasonal Influenza Vaccines Among Low-Risk Adults In An Urban Emergency Department, Kamila Sikora

Yale Medicine Thesis Digital Library

Emergency departments (EDs) are the only source of medical care for many adults and have been found to be feasible venues for vaccinating high-risk patients against seasonal influenza. Since the CDC guidelines expanded in 2008 to include any adults wishing to protect themselves and those around them from the flu, the vaccination of low-risk patients in the ED has not been evaluated. This study sought to assess the acceptability among adult patients of all ages for vaccinating against seasonal influenza in the Urgent Care area of an urban ED, which treats primarily healthy adults. A convenience sample of adult patients …

Optimal Duration Of Intrapartum Antibiotic Prophylaxis For Group B Streptococcus And Effects On Practice Patterns, Emma Longley Barber

Yale Medicine Thesis Digital Library

OPTIMAL DURATION OF INTRAPARTUM ANTIBIOTIC PROPHYLAXIS FOR GROUP B STREPTOCOCCUS AND EFFECTS ON PRACTICE PATTERNS. Emma L Barber, BS, Edmund F Funai, MD, Michael B Bracken, PhD, MPH, Guomao Zhao, BS, Irina A Buhimschi, MD, and Jessica L Illuzzi. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, United States. The 2002 CDC guidelines recommend a minimum of four hours of intrapartum penicillin G prophylaxis to assure a neonate is adequately prophylaxed against group B streptococcus (GBS). We examined the validity of this duration through the relationship between duration of prophylaxis and fetal serum …

Trade, Tastes And Nutrition In India, David Atkin

Discussion Papers

No abstract provided.

Medicine@Yale January/February 2010 Volume 6, 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.

The Cost-Effectiveness Of Alternative Hiv Intervention Portfolios In South Africa, Robert Stavert

Yale Medicine Thesis Digital Library

The Cost-effectiveness of Alternative HIV Intervention Portfolios in South Africa. Robert Stavert and Elisa Long (Sponsored by David Paltiel). Department of Epidemiology and Public Health, Yale University, School of Medicine, New Haven, Ct. A dynamic compartmental model was instantiated with recent epidemiological data from South Africa to compare the effectiveness and cost-effectiveness of different portfolios of interventions to prevent HIV infection over a twenty year time horizon. We hypothesized that portfolios which combined scaling up the delivery of highly active antiretroviral therapies (HAART), increasing availability of HIV screening and counseling, and establishing widespread circumcision campaigns would be the most effective …

Utility Of Repeat Screening For Asymptomatic Bacteriuria In Pregnancy, Sara Whetstone

Yale Medicine Thesis Digital Library

UTILITY OF REPEAT SCREENING FOR ASYMPTOMATIC BACTERIURIA IN PREGNANCY Sara Whetstone, Stephen Thung, and Jessica Illuzzi. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT. Asymptomatic bacteriuria (ASB) during pregnancy is associated with an increased risk of developing pyelonephritis. The objectives of our study were to determine the incidence of ASB throughout the first two trimesters of pregnancy and to compare the cost effectiveness of performing repeat screening with a single screening strategy for ASB to prevent pyelonephritis. In this prospective cohort study, 206 pregnant women at an urban academic obstetric clinic provided urine …

Longitudinal Evaluation Of Quality Of Life In Older Persons With Advanced Illness, Rachel Solomon

Yale Medicine Thesis Digital Library

Longitudinal Evaluation of Quality of Life in Older Persons with Advanced Illness Rachel Solomon, Paul Kirwin, and Terri Fried. Section of Geriatrics, Departments of Internal Medicine and Psychiatry, Yale University School of Medicine, New Haven, CT; VA Connecticut Healthcare System. Background: Efforts to understand and evaluate quality of life (QoL) among persons with chronic disease have resulted in the development of indices that measure QoL according to the severity of disease, symptoms, and functional impairments. By definition, inclusion of these domains presumes that QoL declines as illness progresses. However, this assumption may not reflect the subjective experience of QoL in …

Population And Health Policies, T. Paul Schultz

Discussion Papers

No abstract provided.

Rhinovirus-Associated Wheezing And Asthma In Young Children, Zofia Piotrowska

Yale Medicine Thesis Digital Library

Human rhinoviruses (HRV) are a common cause of the common cold, and are thought to be associated with asthma exacerbations in both children and adults. Recently, HRV have been identified as a major cause of hospitalization in children < 5 years old. The purpose of this study was too determine whether HRV are a cause of either wheezing and/or hospitalization in children < 2 years old. We used a PCR assay to screen for HRV infection in children < 2 years old: 1) with symptoms of upper or lower respiratory tract disease without wheezing; 2) with wheezing; 3) who were asymptomatic. A group of children who had a respiratory specimen submitted to a diagnostic laboratory for whatever reason and who tested negative for four common viruses in the clinical lab were also screened. All specimens were collected between January 1 and December 31, 2004. Phylogenetic analyses were performed on a majority of HRV isolates. Overall, 28 (17%) of 165 children with symptoms of respiratory traction infection without wheezing; 21 (26.3%) of 80 children with symptoms of respiratory tract infection and wheezing; 3 (3%) of 93 asymptomatic children and 47 (23.3%) of 202 children with specimens submitted to the diagnostic laboratory tested positive for HRV. The difference between the rate of infection in the asymptomatic group and each of the three other groups was statistically significant (p<0.01). Among children with samples submitted to the diagnostic laboratory in whom HRV was the only identified pathogen, 55% were hospitalized. This rate was similar to that observed for respiratory syncytial virus (52.7%) among children of a similar age group and time period (P=0.85). Diverse groups of HRV were circulating during the one-year study period. We conclude that HRV are important pathogens among young children < 2 years old and are responsible for a significant proportion of wheezing this age group. Among a group of children with a respiratory specimen submitted to the diagnostic laboratory in whom a rhinovirus was the only identified pathogen, a majority were hospitalized.

The Use Of Traditional Chinese Medicine And Its Possible Relationship With Adherence To Highly-Active Anti-Retroviral Therapy In Patients With Hiv/Aids In Hong Kong, Kurtland Ma

Yale Medicine Thesis Digital Library

The aim of this project was to examine the usage of traditional Chinese medicine (TCM) and its possible relation to adherence to HAART by HIV-infected Chinese male patients by answering the following questions: 1. How prevalent is TCM use among HIV-infected Chinese patients? 2. What types of TCM are used by this population? 3. What are the predictors of TCM use in this population? 4. Is there a relationship between TCM use and adherence to HAART? A total of 81 self-administered questionnaires were completed by ethnic Chinese patients who had been on HAART for at least one year at Integrated …

A Historical Analysis Of Physician Dissatisfaction, Lisa Mcdonald

Yale Medicine Thesis Digital Library

Given the growing levels of physician dissatisfaction and attrition, this study was conducted to ask what was the historical development of the events that gave rise to the problematic conditions, what are the characteristics of the current daily practice environment that create dissatisfaction, and what are the consequences of physician dissatisfaction? This research was conducted by literature review compiled from both the lay and scientific sectors, however, when possible primary sources were employed. As a science, medicine undoubtedly has improved over the last century. However, this review would suggest that developments in the last 30 years have created a contemporary …

Medicine@Yale November/December 2009 Volume 5, 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.

The Coming Transformation: Values To Sustain Human And Natural Communities, Stephen R. Kellert, James Gustave Speth

Yale School of the Environment Publications Series

No abstract provided.

Medicine@Yale May/June 2009 Volume 5, 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.

Medicine@Yale March/April 2009 Volume 5, Issue 2, 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.

Pidm Annual Report 2009/2010, Malaysia: Perbadanan Insurans Deposit Malaysia (Pidm)

Documents

No abstract provided.

Psychiatric Illness In The Next-Of-Kin Of Intensive Care Unit Patients, Janelle Katie Moulder

Yale Medicine Thesis Digital Library

The prevalence of psychiatric symptoms in next-of-kin (NOK) of intensive care unit (ICU) patients has been reported at higher than 70% when screening is performed using the Hospital Anxiety and Depression Scale (HADS). The primary purpose of this study was to assess the ability of the HADS to predict psychiatric illness, diagnosed with the aide of a validated tool, the Structured Clinical Interview for DSM-IV (SCID). In addition, we asked NOK to rate aspects of the ICU experience to determine possible associations with psychiatric diagnosis. Thirty-four NOK were enrolled in this study from July 2006 to November 2006. Subjects were …

The Climate Crisis And The Adaptation Myth, Robert Repetto

Yale School of the Environment Publications Series

No abstract provided.