Digital Commons Network^™

Child And Adolescent Exposure To Environmental Chemicals And Mental Health Outcomes: A New Haven Study, Yunyue Shi

Public Health Theses

Child and adolescent mental health disorders, including anxiety, depression, and behavioral problems, contribute significantly to the global health burden. Exposure to toxic air contaminants such as semi-volatile organic compounds (SVOCs)—especially polycyclic aromatic hydrocarbons (PAHs) and phthalates—during critical developmental periods can have detrimental impacts on children’s brain development and function. This study aimed to identify potential associations between children and adolescents’ chemical exposure and mental health outcomes. The objectives were: 1) to characterize the distribution of individual environmental chemical exposures among children and adolescents using Fresh Air samplers and 2) to determine the association between chemical exposures, particularly PAHs and phthalates, …

The Synergistic Intersection Of Two Public Health Crises: Increased Risk Of Fatal Opioid Overdose Following Extreme Temperature Events, Anna Stouffer

Public Health Theses

Background: The opioid crisis and climate change are two severe public health crises. There may be a synergistic relationship between the two, as extreme temperatures events (both hot and cold) may alter behavior and cause physiological stress that makes fatal opioid overdose more likely. Methods: We analyze the association between fatal opioid overdose and extreme temperature exposure using a case-crossover design and a distributed lag non-linear model, which allows us to look at the odds of death 0-6 days after temperature exposure. We used death records from North Carolina and daily county-level temperature exposures. The analyses were conducted on data …

Examining The Relationship Between Pcv13, Respiratory Viruses, And Invasive Pneumococcal Disease In Massachusetts Children, Kaitlin Soden

Public Health Theses

The landscape of the burden of invasive pneumococcal disease (IPD) in Massachusetts children has been shaped by both the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in 2010 as well as the relationship with respiratory viruses, like influenza and COVID-19. The implementation of non-pharmaceutical interventions (NPIs) and dramatic decline in non-COVID circulating respiratory viruses during the initial waves of the COVID-19 pandemic provided a unique opportunity to evaluate the relationship between respiratory viruses and IPD in Massachusetts children. Using weekly surveillance data for IPD, influenza, and COVID-19 in Massachusetts children 5 years of age and younger from the Massachusetts …

Long-Term Exposure To Ambient Pm2.5 & Intentional Self-Harm, Caroline Elise Sutton

Public Health Theses

A growing body of literature is finding that air pollution exposure may contribute to disease onset of certainbrain disorders, including mental disorders such as depression, through mechanisms of neuroinflammation and oxidative stress1. However, even as there is increasing attention on the impacts of air pollution and mental illnesses, most studies focus on mental illness outcomes that might not represent severe or life-threatening symptoms (such as self-harm)2–7 , while a majority of studies focused on intentional self-harm assess the relationship between short-term air pollution exposure (as opposed to chronic and cumulative exposure) and self-harm outcomes8–13 . Given the barriers to treatment …

“I Don't Work For The Prison. I Don't Work For The Hospital Either. I’M Yours. Who Else Here Is Yours?” A Qualitative Analysis Of Facilitators And Barriers Of Launching Enhanced Perinatal Programs In Seven State Prisons, Karenna Thomas

Public Health Theses

The United States incarcerates women at the highest rate globally (Fair & Walmsley, 2022), while simultaneously failing to provide incarcerated individuals with adequate reproductive health care. Perinatal programs, including a combination of one-on-one and group prenatal and postpartum education, labor and birth support with a doula, separation support, and lactation care have been implemented as an alternative to standard care in around 21 states (Wilson et al., 2022). While the efficacy of these programs among incarcerated individuals has been established (Bard et al., 2016; Barkauskas et al., 2002; Schroeder & Bell, 2005; Shlafer et al., 2018; Shlafer, Saunders, Boraas, et …

Cost-Effectiveness Of Helicobacter Pylori Screenings In Asian Americans In The United States, Qin Wang

Public Health Theses

Background: Gastric cancer remains a significant public health concern, particularly for Asian Americans in the United States, who are at higher risk. Helicobacter pylori (H. pylori) infection is a known risk factor for gastric cancer (GC) and peptic ulcer disease (PUD), and its eradication has proven effective in preventing both conditions. Due to the lack of clinical standards in H. pylori screening for this high-risk group of Asian Americans, we explore whether population-based screening using carbon-13 urea breath test (C-UBT) and/or endoscopy is cost-effective in the United States for Asian Americans. Methods: We built a cohort state-transition Markov model to …

Birth Characteristics, Outdoor Artificial Light At Night, Ambient Air Pollution And The Risk Of Hepatoblastoma In Young Children, Peiyi Wang

Public Health Theses

Objective: The etiology of hepatoblastoma, the predominant malignant liver tumor in infancy and early childhood, is unclear. We assessed possible associations between birth characteristics, outdoor artificial light at night (ALAN), ambient air pollution (measured by particulate matter PM2.5), and the risk of hepatoblastoma.

Methods: Leveraging a population-based linkage of statewide birth records and cancer registry data in California, we conducted a case-control study that included 356 hepatoblastoma cases diagnosed at the age of 0-6 years during 1988-2015 and 17,800 controls frequency-matched by birth year. Restricted cubic spline transformation was employed to evaluate non-linear associations. Multivariable logistic regression models were used …

Assessment Of Suicide Risk In Emergency Department Settings For Adults In Nepal: Validation Of The Nepali Ask Suicide-Screening Questions, Pei Wang

Public Health Theses

Objectives: Suicide is a severe public health crisis around the globe. Low-middle-income countries (LMICs) bear 77% of the global suicide burden. Screening is a significant component of suicide prevention, but there is a dearth of suicide screening tools, especially in LMICs. This study focused on validating the Ask Suicide-Screening Questions (ASQ) within an adult Emergency Department (ED) population in Nepal. Although the validation occurred in an ED setting, the Nepali ASQ is designed with the flexibility to be useful in a variety of healthcare contexts, extending its applicability beyond just emergency care.Methods: We systematically translated and adapted the 4-item ASQ, …

Cost-Effectiveness Analysis Of Alternative Infant And Neonatal Rotavirus Vaccination Schedules In Malawi, Catherine Wenger

Public Health Theses

Rotavirus is the leading cause of cases and deaths related to diarrhea-related hospitalizations among children under five worldwide, especially in low- and middle- income countries. Although vaccination is proven to be the best strategy for preventing rotavirus, its impact has been suboptimal in LMICs.

The primary aim of this study was to evaluate the impact of and cost- effectiveness of the current Rotarix rotavirus vaccine, two alternative vaccine delivery schedules, and the next-generation vaccine (RV3-BB) in Malawi.

The cost-effectiveness of rotavirus vaccine strategies in Malawi was evaluated using moderate-to-severe and non-severe rotavirus cases derived from a mathematical model ofrotavirus transmission …

Prevalence Of Perinatal Depression In Us Residents: Analysis Based On Nhanes 2017-2020 Pre-Pandemic, Yian Wu

Public Health Theses

Objective:Perinatal depression, affecting over 10% of pregnant and postpartum women globally, is a significant but often underrecognized mental health issue. Untreated symptoms can persist for years, highlighting the need for early intervention. This study, using the most recent National Health and Nutrition Examination Survey (NHANES) data available, aims to assess trends in perinatal depression prevalence and mental health care utilization in US. Methods: NHANES data from 2017 to March 2020 were analyzed, focusing on pregnant and postpartum women who had given birth within the last 24 months as the target population. The Patient Health Questionnaire (PHQ-9) was used to assess …

The Influence Of Social Convoy On The Improvement Of Depressive Symptoms In A 3-Year Longitudinal Study: The Potential Role Of Urban-Rural Division, Qianyi Xu

Public Health Theses

Objective: This longitudinal study aims to delve into the complicated relationship between social convoy and the improvement of depressive symptomatology, while also investigating the potential mediating role of household registry status.Methods: The study utilized data from 2,511 participants from the China Health and Retirement Longitudinal Study (CHARLS), specifically from the 2015 survey (Wave 3) and the 2018 survey (Wave 4). The selected sample comprised Chinese adults aged 45 and older who exhibited depressive symptoms in 2015 and for whom comprehensive data on various social convoy components and sociodemographic variables were available. Logistic regression models were applied to assess the associations …

Assessing The Correlation Between Per- And Polyfluoroalkyl Substances (Pfas) Exposure And Cancer Incidence In The U.S., Xiaoqing Zhang

Public Health Theses

AbstractThe study seeks to understand the relationship between key PFAS contaminants and their potential to cause cancer in the United States. It also aims to find out how different PFAS exposures affect different types of cancer and how food can increase or decrease the risk of getting cancer. The study used secondary data from the government and other reliable sources. The process looked at PFAS exposure, food malnutrition, and cancer rates in the population by using both descriptive and inferential statistics. After looking at socio-economic factors and their health effects on the public, the results showed that PFOS, PFHxS, and …

Randomized Trial Of Exercise Vs. Usual Care On Inflammatory And Metabolic Biomarkers In Women With Breast Cancer Taking Aromatase Inhibitors, Lingxiao Zhang

Public Health Theses

ABSTRACT

Background: The Hormones and Physical Exercise (HOPE) study demonstrated efficacy of exercise in reducing AI-associated arthralgia in breast cancer survivors. Yet, the underlying mechanism for this relationship remains unclear. Prior research among breast cancer survivors highlights improvements in metabolic and inflammatory biomarkers related to exercise. This secondary analysis of HOPE examined the potential role of metabolic and inflammatory biomarkers in mediating the effect of exercise vs. usual care on AI-associated arthralgia.

Methods: Our analysis included 80 participants (42 exercise arm, 38 usual care) enrolled in the HOPE study. The intervention was a year-long exercise program that included both supervised …

The Impact Of The Covid-19 Pandemic On Cancer Prevention Behaviors In Selected Gen Z Population (Ages 18-25), Lan Zhang

Public Health Theses

Background: The COVID-19 pandemic has resulted in negative changes in health behaviors related to cancer. Recent studies in adults have identified factors leading to harmful/unhealthy lifestyle changes during the pandemic. However, little is known about the factors that predict worse cancer-related health behaviors among young adults.

Methods: The data used for this analysis were from a cross-sectional online survey conducted in Connecticut in 2021 regarding participant’s lifestyle behaviors during the COVID- 19 pandemic. Participants were recruited through social media networks of community partners and organizations within the Yale Cancer Center (YCC) catchment area. Participants included local minority and low socioeconomic …

Resilience In Self-Perception Of Aging Among Chinese Older Adults Under The One-Child Policy, Minyang Zhang

Public Health Theses

This study examines the resilience of self-perception of aging (SPA) among older Chinese adults affected by the One-Child Policy (OCP), based on data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Implemented in 1979, the OCP reshaped family dynamics. It potentially influences aging perceptions among the elderly. Utilizing the stereotype embodiment theory, this research assesses if deep-rooted cultural attitudes towards aging could mitigate the psychological effects of these demographic changes. Results suggest that despite significant societal shifts, the SPA among Chinese elderly remains stable. That indicates a minimal direct impact of the OCP on aging perceptions. The finding underscores …

Do Rental Assistance Programs Relieve Overcrowding In U.S. Children?, Frank Zhu

Public Health Theses

Introduction: Crowded living conditions are associated with many negative health outcomes, with significant implications for children, as they are particularly shaped by their home environment and more likely to live in crowded conditions, given their larger household size. How rental assistance programs may shape and improve household crowding has not been previously explored. Methods: This study leveraged data from NHANES linked with HUD administrative rental assistance records. We examined changes in crowding measures in U.S. children using linear and logistic regression models stratified by different rental assistance program types. Results: There was a statistically significant 40 percentage point reduction in …

Remotely Sensed Assessments Of Malnutrition In South Sudan, Rebecca Chausse

Public Health Theses

South Sudan is consistently considered the hungriest country in the world further exasperated by armed conflict and extreme climate events such as drought and flooding. This thesis includes a remote sensing analysis of thermal activity to assist in identifying areas with higher or lower Integrated Food Security Phase Classification (IPC) scales in certain contexts. Key Findings reveal a statistically significant negative correlation between U.S. dollar price of cereals and tubers and observed thermal activity (p-value=0.0280703, rho=-0.6727273), indicating that an increase in one variable may coincide with a decrease in the other within Rumbek Centre and Gogrial West. These findings may …

Trauma-Informed Digital Health Interventions: A Scoping Review, Amelea Lowery

Public Health Theses

Background: Trauma exposure is a pervasive issue around the world and the impacts of trauma can be long lasting and detrimental to individual and population health outcomes. Trauma responses can influence and determine an individual or community’s approach in seeking supportive resources. Given the critical role of supportive resources and the prevalent use of technology and internet use, it is essential to understand how digital health interventions contribute to addressing trauma explicitly. This scoping review aims to explore the landscape of trauma-informed digital health interventions for adults, assess their outcomes, and identify their measurable impacts across various settings.Methods: A scoping …

A Simulation-Based Approach For Power And Sample Size Estimation In Stepped Wedge Cluster Randomized Trials With Time-To-Event Outcomes, Xintong Lu

Public Health Theses

Stepped wedge cluster randomized trials (SWCRTs) have become increasingly popular across various disciplines, particularly in public health and medical research, as they allow evaluation of interventions rolled out sequentially across multiple clusters. However, time-to-event outcomes in SWCRTs pose significant methodological challenges. Traditional closed-form solutions for power and sample size estimation often fail to capture the complexities introduced by the implementation of staggered treatment and the discrete nature of outcome measurements. In this paper, we propose a simulation-based RShiny platform aimed at addressing these limitations by offering a more accurate and flexible approach to determining power and sample size in SWCRTs …

Exploring The Role Of Bacteroidales In Human Health: A Comprehensive Literature Review On Their Associations With Selected Diseases, Tingyue Wang

Public Health Theses

Bacteroidales are a vital group of gut bacteria that significantly contribute to human health by maintaining gut balance. However, their abundance is often altered in various diseases, indicating a strong association with disease progression and immune responses. This review categorizes Bacteroidales into clusters based on metabolic phenotypes, suggesting similarities in their metabolic pathways.

To explore the relationship between Bacteroidales species and human health, we conducted a comprehensive literature review. We compiled a list of 16 Bacteroidales species and performed targeted searches in PubMed using keywords related to inflammation and immunity. This process helped us identify relevant diseases, focusing on those …

Resilience In Self-Perception Of Aging Among Chinese Older Adults Under The One-Child Policy, Minyang Zhang

Public Health Theses

This study examines the resilience of self-perception of aging (SPA) among older Chinese adults affected by the One-Child Policy (OCP), based on data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Implemented in 1979, the OCP reshaped family dynamics. It potentially influences aging perceptions among the elderly. Utilizing the stereotype embodiment theory, this research assesses if deep-rooted cultural attitudes towards aging could mitigate the psychological effects of these demographic changes. Results suggest that despite significant societal shifts, the SPA among Chinese elderly remains stable. That indicates a minimal direct impact of the OCP on aging perceptions. The finding underscores …

Aiming For The Goal: Contribution Dynamics Of Crowdfunding, Joyee Deb, Aniko Öry (Oery), Kevin R. Williams

Cowles Foundation Discussion Papers

We study a dynamic contribution game where investors seek private benefits that are offered in exchange for contributions and a single, publicly-minded donor values project success. We show that donor contributions serve as costly signals that encour-age socially-productive contributions by investors who face a coordination problem. Investors and the donor prefer different equilibria but all benefit in expectation from the donor’s ability to dynamically signal his valuation. We explore various contexts in which our model can be applied and delve empirically into the case of Kickstarter. We calibrate our model and quantify the coordination benefits of dynamic signaling in counterfactuals.

(Special Section, Hymns Beyond The Congregation Ii): Whither Christian Soldiers? Metaphor And Momentum In The Midtwentieth-Century Reception Of A Victorian Hymn, Jonathan Hicks

Yale Journal of Music & Religion

There are few more explicit documents of the interconnection of hymnody, mobility, and coloniality than the 1939 film Stanley and Livingstone. Directed by the American duo of Henry King and Otto Brower, much of the picture was filmed “on location” in the British-controlled territories of Kenya, Uganda, and Tanganyika (now part of Tanzania). The film tells the real-life story of a New York journalist (Stanley) searching for a Scottish missionary (Livingstone) and eventually finding him in a town on the north-eastern shore of Lake Tanganyika. One scene in particular—where Stanley finds Livingstone leading his hosts in a rendition of …

(Special Section, Hymns Beyond The Congregation Ii): “We’Ll Understand It Better By And By:” Nomenclature, Negotiation, And Naming Our Neighbors, Emmett G. Price Iii

Yale Journal of Music & Religion

Hymns, whether composed for religious contexts or as expressions of spiritual reflection, are historically revered for their redemptive nature. For generations, Black Hymnody has cried out for Christological interventions to end shambolic and systemic oppression against Black people. The vicious murder of George Perry Floyd, Jr. on May 25, 2020 reverberated and initiated, as a catalyst, an overdue global awakening that sparked a catalytic moment for conversations too long deferred. Conversations that question how we experience and name things; how we negotiate trauma; and how we engage one another as neighbors. In many ways, the redemptive nature of hymns has …

Polluted Soundscapes And Contrepoison In Sixteenth-Century France: The Sonic Warfare Leading To The First War Of Religion, John Romey

Yale Journal of Music & Religion

In the decades leading up to and during the first years of the Wars of Religion, Huguenots and Catholics waged audible battles over sonic territories using songs as spiritual weapons. Huguenots memorized and communally sang metrical psalms in the vernacular as sonic markers of the Reformed faith. Catholics interpreted these same sounds as pollution in need of eradication. Artus Desiré, for example, responded by producing polemical contrepoison, musical antidotes created by composing new countertexts to Marot’s Psalm tunes to “cleanse” them of their perceived heresy. While scholars have long recognized both the destructive nature of iconoclastic attacks on religious …

King’S Vibrato: Modernism, Blackness, And The Sonic Life Of Martin Luther King, Jr., Joshua Lazard

Yale Journal of Music & Religion

A book review is presented for King's Vibrato: Modernism, Blackness, and the Sonic Life of Martin Luther King, Jr., authored by Maurice O. Wallace, by Joshua Lawrence Lazard.

Buddhist Music As A Contested Site: The Transmission Of Teochew Buddhist Music Between China And Singapore, Jie Zhang

Yale Journal of Music & Religion

In the Chaozhou City Gazetteer of Buddhism & Chaozhou Kaiyuan Monastery Gazetteer published in 1992, the then Abbot of the Kaiyuan Monastery, Shi Huiyuan 释慧原 heavily condemned the Qing Dynasty (1644–1911) monk Shi Kesheng 释可声 (date unknown) for "starting the sins among laities in the Chaozhou region who dared transgressing (the Buddhist doctrines) and became chant leaders in a flaming mouth ceremony.” Why was the Abbot so upset with a fellow monk back in history? What did Kesheng do, and what were the implications of him starting this "transgression"? This article investigates the history of the international traffic of Buddhist …

(Special Section, Hymns Beyond The Congregation Ii): Spiritual Concert-Fundraisers, Singing Conventions, And Cherokee Language Learning Academies: Vernacular Southern Hymnbooks In Noncongregational Settings, Jesse P. Karlsberg, Kaylina M. Crawley, Sara S. Hopkins

Yale Journal of Music & Religion

Noncongregational settings were integral to hymnody in the postbellum settler colonial context of the southern United States during the late nineteenth and early twentieth centuries. The incorporation of hymn singing into a wide range of noncongregational settings served Black, white, and Native populations in navigating unsettled racial dynamics during this period across the US South and its diasporas. This essay features three case studies examining hymn collections intended or repurposed for a range of noncongregational uses: spiritual collections connected with the performing ensembles of black institutions, a shape-note songbook that attempted to bridge singing convention and congregational contexts, and a …

Mirativity In English Response Particles: An Analysis From The Syntax/Semantics Interface, Randi Martinez

Yale Working Papers in Grammatical Diversity

Responses to questions can provide significant insight about linguistic structure and meaning. In this paper, I propose an analysis of the structure of assertions and various responses to assertions, bringing together semantic and syntactic considerations. The analysis incorporates a Speech Act Phrase (SAP, Speas & Tenny 2003), which is taken to encode illocutionary force. I present novel data on a polar response particle (PRP) form that has not yet been considered in the literature, namely, the English yeah-huh/nuh-uh responses. I show that these are polarity-based responses that signal disagreement and mirativity. I discuss the syntactic and discourse-related restrictions for yeah-huh/nuh-uh …

Note From The Editor: Transitions In The Managing Editor Position, Jeffers Engelhardt

Yale Journal of Music & Religion

Editor-in-Chief Jeffers Engelhardt announces a change in personnel within the Managing Editor position at the Yale Journal of Music & Religion.