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Evaluating The Implications Of Class And Regional Stereotypes On Attributions Of Blame During Hurricane Helene: A Reflexive Content Analysis Of Tiktok, Abby Ong

Public Health Theses

Background and Objectives: Hurricane Helene devastated entire towns across the Southern and Appalachian U.S. Following the hurricane, people who lived in impacted regions were derided for their perceived failures in evacuating. Utilizing Bernard Weiner’s attribution theory of social motivation, this study sought to analyze potential implications of regional stereotypes on how people blamed or supported disaster victims. Primary objectives were to: (1) to analyze content regarding residents’ decisions to evacuate or not evacuate during the storm, (2) to document attributions of blame or support and how those experiencing the disaster and outside observers responded to these attributions, and (3) to …

Factors Associated With Non-Transport For Ems Incidents Of Pediatric Head Injuries, Margaret Zhang

Public Health Theses

Background/Purpose:Emergency Medical Services (EMS) is a valuable resource for evaluating, treating, and coordinating care for individuals who have sustained a traumatic brain injury (TBI). Among adults with a TBI, there is frequent refusal of EMS transport. This raises a public health concern because it can put a burden on resource utilization and reveal misperceptions regarding risk following head injuries. Less is known about whether similar patterns of non-transport exist among children with TBIs. The purpose of this study is to describe the epidemiology of pediatric head injuries attended by EMS and to identify factors associated with non-transport for these patients. …

Enhancing Research Utilization Among Health Policymakers: Lessons From An Executive Certificate Program In Liberia, Felicia Annan-Mills

Public Health Theses

Evidence-based decision-making in health policy is a systematic and transparent approach to policymaking and program design using research evidence and other similar sources. It is essential for developing effective health policies and ensuring that programs align with political priorities and community needs and have strong empirical support for their efficacy and impact. Global health agencies like the World Health Organization and the West African Health Organization have developed guidelines for evidence-based decision-making in health for organizations to use as guiding tools in their policymaking. Regardless, there is still a gap in applying research evidence to practice programs for many countries …

The Role Of Climate Change In The Pandemic Agreement Negotiations, Cristina Arnes Sanz

Public Health Theses

Introduction: For over three years, Member States of the World Health Organization (WHO) have been negotiating a treaty to prevent, prepare for, and respond to future pandemics. The Pandemic Agreement is anticipated to be adopted at the World Health Assembly in May 2025. Growing scientific evidence underscores the effects of climate change on infectious diseases, including those that could lead to pandemics. This thesis examines how climate change has been addressed in the drafting and negotiations of the Pandemic Agreement.

Methods: All the references related to climate change in the transcripts of the publicly broadcast Intergovernmental Negotiating Body (INB) meetings …

The Village Determinants Of Self-Rated Health And Mental Health: A Multilevel Analysis Of Environments In Rural Honduran Villages, Marnen Elizabeth Decker

Public Health Theses

I investigated the associations of village structural, behavioral, and social environments with self-rated health and mental health among adults residing in remote rural villages in the mountainous Copán region of Honduras. I estimated nested multilevel logistic models with 17,318 adults in 174 villages. All models controlled for individual characteristics to distill true village-level effects, and nested structure was employed to facilitate direct comparison across models. Both poor self-rated health and mental health were inversely associated with village size and positively associated with coffee cultivation. Poor self-rated health was also positively associated with friend/adversary tie ratio, and poor self-rated mental health …

Association Between Primary Covid-19 Vaccine Type And Booster Uptake Among Incarcerated People In Connecticut: A Retrospective Cohort Study, Michael Condon Elhardt

Public Health Theses

Importance: Booster doses of the COVID-19 vaccine are critical for maintaining protection against SARS-CoV-2, especially in high-risk settings such as correctional facilities. Understanding how initial vaccine type influences booster uptake can inform vaccination strategies in these and other underserved populations.Objective: To assess whether the type of COVID-19 vaccine received for the primary series—either viral vector (Janssen/Jcovden) or mRNA (Moderna/Spikevax or Pfizer-BioNTech/Comirnaty)—was associated with timing or likelihood of booster completion among incarcerated individuals. Design: Retrospective cohort study using survival analysis methods. The study period spanned from February 2, 2021, to May 31, 2023. Setting: Connecticut Department of Correction (DOC) facilities, including …

Evaluating The Impact Of P. Falciparum Genetic Diversity On Pfrh5 Blood Stage Vaccine Protection Through A Multi-Method Approach, Alyssa Agarwal

Public Health Theses

Malaria remains a major global health threat as control efforts have stalled in recent years. Recently, theWHO began recommending two vaccines, RTS,S/AS01 and R21, both of which target the pre-erythrocytic stage of malaria. However, these vaccines are only partially protective and do not protect against the blood-stage of malaria where clinical disease begins. Therefore, a more broadly protective vaccine is still needed. Plasmodium falciparum reticulocyte-binding protein homolog 5 (PfRH5) is a leading candidate for next-generation blood-stage malaria vaccines with the most advanced formulation, RH5.1/Matrix-M, recently entering Phase 2b clinical trials. However, historically, malaria vaccine development has been challenged by the …

Modeling Impacts Of Water Improvements On Typhoid In Urban South Asia, Chessley Blacklock-Votava

Public Health Theses

Introduction: Typhoid fever represents a significant burden of disease in urban areas across South Asia. While the recent implementation of routine typhoid conjugate vaccinations (TCVs) has demonstrated significant protective effectiveness against disease, it fails to mitigate environmental transmission through contaminated water, which individuals without access to improved water sources (IWS) may be infected by. Objectives: The primary aim of this study is to estimate the potential reductions to typhoid fever incidence that populations could experience when increasing proportions of the population that have IWS across three high-burden cities in South Asia. The relationship between this reduction and the proportion of …

Scale-Up Of Access To Medication For Opioid Use Disorder For People Who Inject Drugs On Parole In Ukraine: A Modeling Analysis, Brendan Caver

Public Health Theses

Background: Human Immunodeficiency Virus (HIV) and opioid-use disorder have long beendescribed as a syndemic; the two health issues go hand-in-hand to exacerbate each other (Perlman & Jordan, 2018). While the HIV pandemic has improved greatly in many regions such as the United States over the past several decades, it continues to become worse in Eastern Europe and Central Asia. HIV prevalence and opioid dependence are particularly high in carceral settings, but access to opioid agonist therapy (OAT) is extremely limited. This paper shows the results of a modeling analysis undertaken to see the impact of opioid agonist therapy (OAT) scale-up …

How To Increase The Public’S Awareness Of Car-T Therapy? A Pilot Mixed Methods Study, Pei-Chun Cha

Public Health Theses

Background: Chimeric Antigen Receptor (CAR) T-cell therapy is a combination of antibody and T cell receptor (TCR), which allows T-cells to recognize and attack cancer cells. It has shown effectiveness in treating hematological malignancies, but has been less effective for solid tumors. Clinically, it is the first FDA-approved gene therapy as it uses lentivirus to modify the genome of T cells that are infused back into patients. Preclinically, laboratory research is being conducted to enhance this treatment through multiple genetic modifications. Concurrently, integrating community research to understand the public’s awareness of CAR-T is essential for making this therapy more widely …

Cost-Effectiveness Of New Monoclonal Antibody And Maternal Immunization For The Prevention Of Respiratory Syncytial Virus (Rsv) Disease In Infants: A Systematic Review, Yuwei Che

Public Health Theses

AbstractIntroduction: Respiratory syncytial virus (RSV) remains a major cause of morbidity and mortality among infants and young children worldwide. Given the lack of specific therapeutic treatments for RSV that are suitable for universal use, the development of effective prevention strategies is of paramount importance. Previously, palivizumab was utilized for long-term prophylaxis of RSV infections; however, it was only recommended for specific populations due to its high cost and limited overall effectiveness. In 2023, the U.S. FDA approved RSVpreF maternal vaccine (Abrysvo™, Pfizer), and nirsevimab (Beyfortus™, Sanofi and AstraZeneca) for the prevention of RSV to newborns. Two newly developed interventions have …

Assessing The Costs Of Illness Attributable To Leptospirosis, Alyssa Chetrick

Public Health Theses

Leptospirosis, caused by the spirochetes of the genus Leptospira, is a zoonotic bacterialdisease endemic to tropical regions and lower middle income countries (LMICs). Leptospirosis causes an estimated 1 million cases and more than 58,900 deaths annually.(Costa et al., 2015; Torgeson et al., 2015) In addition to human health, leptospirosis significantly impacts animal health and the livestock industry, particularly through reproductive losses, increased treatment costs, and decreased milk production, which exacerbates global insecurity.(Bennet, 2015; Torgeson et al., 2015) The estimated global cost loss to productivity due to disease is estimated at Int$ 29.3 billion. (Agampodi et al., 2023) Because of its …

Empowering Mothers In New Haven: Evaluating The Impact Of A Maternal Health Program For New And Expecting Black And Brown Mothers, Ethelia Holt

Public Health Theses

The U.S. maternal mortality rate has surpassed that of other high-income countries, with mental health conditions now among the leading causes of perinatal death. These challenges disproportionately affect Black and Brown women, who are less likely to receive adequate follow-up care. The Maternal Health Program for New & Expectant Black and Brown Mothers aimed to improve maternal mental health through psychoeducation, skill-building, financial literacy, and connection to local resources.

A mixed-methods evaluation was conducted using pre- and post-program survey data (N = 7) to assess changes in mental health symptoms, knowledge, self-care, and financial habits. Descriptive statistics were the primary …

Black Lives Matter Paterson’S Harm Reduction Center Program Evaluation, Shreya Jadhav

Public Health Theses

BackgroundThe Substances and Sexual Health (SASH) Lab at the Yale School of Public Health conducts much of its work in Paterson, New Jersey. As part of a community partnership, the lab collaborated with Black Lives Matter (BLM) Paterson to conduct a program evaluation of BLM Paterson’s Harm Reduction Center. BLM Paterson, founded in 2016, offers harm reduction through a wide range of services including survival resources, referrals to treatment, and a touchpoint with the healthcare system, all within a safe, non-judgmental space for individuals to decompress and find support. Evaluation Methods This formative program evaluation assesses the impact of BLM …

Association Between Greenspace And Weight-Related Outcomes In Later Adulthood: A Longitudinal Study Using Uk Biobank Data, Jun Jiang

Public Health Theses

Overweight and obesity are escalating global health concerns, greenspace may support healthierweight, and air pollution may mitigate the effect, but its effects across population subgroups and over time remain underexplored. According to the longitudinal analysis, this study found that greenspace exposure within 300 m was more strongly associated with lower BMI and overweight risk than exposure within 1000 m; for example, the presence of greenspace within 300 m reduced the odds of overweight (OR = 0.791, 95% CI: 0.672–0.933), while the same measure within 1000 m was associated with higher odds of obesity (OR = 1.275, 95% CI: 1.08–1.505). Stratified …

Barriers And Facilitators To Covid-19 Vaccination Access Among Older Adults: A Comprehensive Needs Assessment To Enhance Vaccination Strategies, Jiye Lee

Public Health Theses

Objective: To identify system-specific barriers and facilitators to COVID-19 vaccination among older adults (≥65 years) within a large academic healthcare system and to inform future strategies to enhance vaccine uptake.

Methods: This mixed-methods study included six semi-structured interviews with healthcare leaders and staff, a large-scale survey of 42 clinical leaders across 52 ambulatory sites (20 responses), and analysis of administrative data from Yale New Haven Health (2020–2024). Interviews and survey responses were thematically analyzed. Quantitative data on vaccination rates for COVID-19 and influenza were analyzed by age group and year using descriptive statistics and t-tests.

Results: The semi-structured interviews with …

Prevalence And Correlates Of Antipsychotic Use Without An Indicated Diagnosis Among Long-Stay Residents In Nursing Facilities In Massachusetts, Hongyi (Sophie) Liu

Public Health Theses

Background: In 2012, the Centers for Medicare & Medicaid Services (CMS) implemented initiatives to reduce unnecessary antipsychotic medication use in elderly nursing home residents to ensure quality of care. While antipsychotic use among long-stay nursing home residents has decreased nationwide, Massachusetts still exceeds the national average and ranks 6th in the U.S. This study aims to evaluate and identify both facility-level characteristics and resident-level correlates of antipsychotic use without an indicated diagnosis among long-stay residents in Massachusetts nursing homes. Methods: The study examined 30,857 long-stay residents across 345 nursing facilities in CY2023, using data from the Minimum Data Set (MDS), …

Understanding Parental Perspectives On Youth Substance Use In Urban New Jersey: A Rapid Qualitative Analysis, Mirriam Mananah

Public Health Theses

Adolescent substance use remains a significant public health issue, particularly for Black youth who face disproportionate consequences due to systemic inequities and community-level risk factors. While existing prevention programs exist, few are culturally tailored to the needs of Black families in urban environments. This thesis uses the ADAPT-ITT framework to guide the cultural adaptation of the Strong African American Families (SAAF) program, focusing on the “Assessment” phase through qualitative research.Twenty interviews were conducted with Black parents and guardians of youth aged 10–17 in Paterson and East Orange, New Jersey. Using rapid qualitative analysis, five key themes emerged: (1)Parent-Led Communication as …

Assessing Environmental And Sociodemographic Risk Factors For Leptospira Infection In A Urban Informal Settlements: A Study In Salvador, Brazil, Sebastian Alonso Salazar

Public Health Theses

Background: Leptospirosis is a neglected zoonotic disease that disproportionately affects people living in areas with poor sanitation, water contamination and rodent infestation such as urban informal settlements. More than one billion people worldwide reside in such communities, and with increasing urbanization, coupled with environmental change, the risk of Leptospira transmission continues to increase. Despite its global burden, this disease is often underreported due to diagnostic challenges and limited healthcare access, particularly in urban informal settlements. Understanding the incidence and risk factors in these settings is essential for improving public health interventions. This study aims to estimate the annual incidence of …

Innovative Approaches To Combat Triple-Negative Breast Cancer: Integrating Metabolic Modulation, Advanced Therapies, And Lifestyle Interventions, Ngozi Damilola Chidumebi Akingbesote

Yale Graduate School of Arts and Sciences Dissertations

Triple-negative breast cancer (TNBC), an aggressive and often lethal subtype of breast cancer, continues to challenge researchers and clinicians due to its poor prognosis and limited therapeutic options. This thesis explores novel therapeutic strategies that integrate metabolic modulation, advanced radionuclide therapies, and lifestyle interventions to combat TNBC effectively. The first component investigates metabolic scaling and its implications for cancer metabolism. Gene and protein expression analyses across species reveal that metabolic processes, including oxidative metabolism and detoxification, scale inversely with body mass. This foundational insight underscores the importance of systemic metabolic regulation in understanding cancer progression. In the realm of cancer …

Mental Representations Of Computational Processes, Marlene Berke

Yale Graduate School of Arts and Sciences Dissertations

Human intelligence is uniquely powerful and flexible - operating in an enormous range ofsituations, from those as everyday as driving in traffic while carrying on a conversation, to those as extraordinary as cooperating to shift a culture. Work in cognitive science over the past decades has argued that two foundational types of representations form the building blocks of human intelligence: representations of the physical world in terms of objects, forces, spaces, substances, and so on (Carey, 2009), and representations of the social world in terms of agents and their mental states, like goals, beliefs, and knowledge (Gopnik, Meltzoff, & Bryant, …

The Devil Sounds Out: Affect And Intentionality In Conservative Evangelical Anti-Rock Discourse, 1965-1990, Philip Bixby

Yale Graduate School of Arts and Sciences Dissertations

Scholars have often described the evangelical reception of rock music as a discourse that changes in a positive direction, from the full-sail rejection of rock in the 1960s to the cautious acceptance of the genre as legitimate worship music throughout the 1970s, '80s, and '90s. This dissertation surveys anti-rock texts written by conservative evangelicals from the mid-1960s to the early 1990s, observing an alternative trajectory of the discourse. The dissertation shows that an uncompromising trend of anti-rock criticism persists well into the 1980s, especially promoted by preachers and writers (for example, Jeff Godwin and Jimmy Swaggart) who sought to deny …

Essays In Macroeconomics And Finance, Francesco Beraldi

Yale Graduate School of Arts and Sciences Dissertations

This dissertation consists of three independent essays in which I study how financial markets affect macroeconomic outcomes. I combine rich micro-data and structural models with heterogeneity to shed light on how interactions among different agents influence business cycle fluctuations and the distribution of resources in the economy. I leverage this approach to address central questions covering financial intermediation, household and corporate finance, and their implications for macroeconomic policy and financial stability. Chapter 1: Banking Relationship and Loan Pricing Disconnect. In the first chapter, I study how long-term relationships between banks and firms shape loan pricing and capital allocation. I use …

Essays On Consumer Inferences, Mohin Banker

Yale Graduate School of Arts and Sciences Dissertations

Consumers infer from what they know to impute what they wish to know. For example, to estimate the quality of a new product, one may infer that a product's price reflects its quality. This dissertation is composed of three essays investigating factors that affect consumers' inferences. The first essay examines how inferences of positive information differ from inferences of negative information, and shows that positive information is generalized to new objects more than negative information, all else equal. For instance, a good restaurant affects judgments of similar restaurants more than a bad restaurant does. The second essay investigates inferences about …

Incentivizing Evidence-Based Care: Policy Levers And Delivery-System Response, Tamara Beetham

Yale Graduate School of Arts and Sciences Dissertations

This dissertation examines how state and federal policies shape the addiction treatment landscape, focusing on how the treatment delivery system responds to policy changes. Through three chapters, I evaluate policy tools designed to expand access to life-saving yet underutilized services and their potential to mitigate or reinforce disparities. The first two chapters analyze a Medicaid policy change that allowed states to access previously restricted funding, contingent on improving their addiction treatment systems. Chapter one finds that improvements in access and quality were primarily driven by facility turnover - new facility openings and closures - rather than changes within existing facilities. …

When Do Children Think Inequality Is Fair?, Pinar Aldan

Yale Graduate School of Arts and Sciences Dissertations

Psychological research suggests that from infancy, humans are highly attuned to fairness and expect resources to be fairly allocated. However, despite this early sensitivity, people ultimately learn to live with - and sometimes even justify - widespread societal inequalities. This thesis explores how children, who in principle deeply value fairness, come to tolerate economic disparities. Through four chapters, this thesis examines how individuals of different ages interpret reasons for inequality that are common in social life yet underexplored in developmental research. Chapter 2 investigates how people reason about unequal compensation in division-of-labor contexts, where individuals assume distinct, qualitatively different roles. …

Microwave Techniques For Neutrino Mass Measurement, Arina Bykadorova Telles

Yale Graduate School of Arts and Sciences Dissertations

Direct neutrino mass measurement is one of the frontiers of particle and nuclear physics, with the most recent measurements setting an upper bound of 0.45 eV/c^2 and cosmological models and observations predicting an upper bound on the sum of neutrino masses of 0.12 eV/c^2. The next generation of neutrino mass experiments require new technology to push beyond the statistical and systematic limits of current measuring capabilities. Project 8 is a collaboration seeking to make this possible by combining the well-established tritium endpoint method with a relatively new technique called CRES. CRES uses the RF emission of electrons undergoing cyclotron motion …

Investigating Non-Canonical Roles Of Atr And Chk1 Throughout The Cell Cycle, Yoon Ki Joo

Yale Graduate School of Arts and Sciences Dissertations

Chromosome Instability (CIN), which results from DNA damage in interphase and chromosome missegregation in mitosis, is considered to be a potent driver of cancer. To prevent CIN, cells harbor the DNA Damage Response (DDR) pathway, which is responsible for detecting and repairing damaged DNA. Because of their importance in preventing CIN, the core members of the DDR pathway such as Ataxia Telangiectasia and Rad3-related (ATR) and Checkpoint kinase 1 (CHK1) have been studied as promising targets in cancer therapy. However, clinical trials show that ATR and CHK1 inhibitors elicit adverse side effects with unknown reasons. Recent research suggests that one …

Investigating The Structure And Assembly Of The Hiv-2 Capsid Protein: How Does It Compare To Its More Infamous Cousin?, Matthew David Cook

Yale Graduate School of Arts and Sciences Dissertations

Several million people live with infection by human immunodeficiency virus type 2 (HIV-2). Like its pandemic-causing relative, HIV-1, infection with HIV-2 can progress to AIDS, is largely incurable, and is similarly mutation-prone, presenting a challenge for treatment. Despite this, detailed study of HIV-2 is widely lacking while most of the understanding of the virus and its proteins is borne out of comparison with HIV-1. The two are sufficiently similar that this is generally effective, but differences in infection outcomes of the two viruses must be explicable by molecular determinants. One domain of viral biology particularly worth attention in this regard …

Quantum Zeno Effects On Photon Decaying From A Microwave Cavity, Vidul Ravindra Joshi

Yale Graduate School of Arts and Sciences Dissertations

Quantum mechanics and classical physics differ fundamentally when it comes to measurement. In classical physics, measurement is nonintrusive, which means the act of measurement does not disturb the state of the system. In quantum mechanics, however, measurement is often invasive, meaning the act of measurement has a back action on the system's state. This difference is illustrated to its full extent by the quantum Zeno effect, where the evolution of a quantum system is inhibited when it is repeatedly measured. The system is repeatedly projected into an eigenstate of the measurement operator, preventing its natural evolution. In theory, the quantum …