Digital Commons Network^™

Exploring Climate Policy And Health Perspectives In Samoa: A Mixed Methods Study, Erika-Ann Fumiko Kim

Public Health Theses

Background: Greenhouse gas emissions have driven human-induced climate change, bringing several impacts to small island nations in the Pacific. Samoa, a small island developing state located in the south Pacific Ocean, is at disproportionate risk from impacts of climate change such as rising surface temperatures, rising sea levels, increases in frequency and degree of heavy precipitation events, and increases in the frequency of droughts. Simultaneously, Samoan populations possess a high prevalence of non-communicable diseases such as diabetes, heart disease, and hypertension. For multiple decades, the Government of Samoa has framed climate change as a key issue that threatens the lives, …

Modeling The Effects Of Climate Factors On The Incidence Of Future Campylobacter Infections In Connecticut, Hannah Lemanske

Public Health Theses

Background & Introduction: Campylobacter is one of the most common foodborne bacteria in the United States, accounting for 48 million infections each year. Campylobacter infections can arise from consuming contaminated food, especially poultry, water, or contact with infected animals. Due to its strong seasonality, cases peaking in the summer and declining in the winter, potential relationships between climate and campylobacter have been analyzed.Methods: Weekly campylobacter surveillance data was obtained from the Connecticut Department of Public Health for 2000 through 2018. Historical and projected temperature and precipitation data were also gathered from the National Oceanic and Atmospheric Administration. A statistical analysis …

Evaluating The Cost-Effectiveness Of Varied Vaccination Strategies For Ebola Virus Disease In The Democratic Republic Of The Congo, Rachel Amanda Lobe-Costonis

Public Health Theses

Introduction: The 2018 outbreak of Ebola virus in the Democratic Republic of Congo was the first to occur in the context of an ongoing complex humanitarian emergency. Despite optimism for an effective response given the efficacious one-dose Merck vaccine (ERVEBO), the immense challenges to public health efforts caused by the ongoing armed conflict posed unprecedented complications to the recommended ring vaccination strategy. In the end, contract tracing efforts for ring vaccination reached only 82% of individuals at best estimate, and the outbreak lasted 89 weeks with a total cost of $734 million. In comparison, transmission dynamic modeling has shown the …

Epidemiology Of Covid-19 Hospitalizations In New Haven And Middlesex Counties, Connecticut, July - September 2021, Caroline Mary Mcwilliams

Public Health Theses

Abstract:Background. This thesis explores the epidemiology of COVID-19 hospitalization among residents of New Haven County and Middlesex County, Connecticut from July - September 2021 with an emphasis on quantifying racial/ethnic and SES disparities. Two previous studies, the first conducted from March - May 2020 and the second conducted from July - December 2020, used COVID-NET Surveillance data from New Haven and Middlesex counties to explore the same questions. This thesis will compare findings with these previous studies to better understand how the epidemiology of COVID-19 hospitalization and racial/ethnic and SES disparities have changed in New Haven and Middlesex counties. Methods. …

Factors Associated With Failure To Complete Multi-Dose Vaccine Series Among U.S. Children Ages 19–35 Months, National Immunization Survey-Child, 2019, Sarah Yukari Michels

Public Health Theses

Background: Most early childhood immunizations require 3-4 doses to achieve optimal disease protection. Failure to complete multi-dose vaccine series is an important driver of undervaccination. Our objective was to evaluate factors associated with starting but not completing all multi-dose series in the combined 7-vaccine series.

Methods: Using 2019 National Immunization Survey-Child data, U.S. children ages 19-35 months with provider verified vaccination data were classified in one of three vaccination patterns: (1) completed the combined 7-vaccine series, (2) missing ≥1 vaccine series (i.e., selective vaccination), or (3) all series initiated, but did not complete all multi-dose series (i.e., missing ≥1 dose(s)). …

The Behavioral Immune System: A Public Health Perspective: How Our Partisan Perceptions Of Sickness Influenced Population Health During The Pandemic, Senyte Pierce

Public Health Theses

Researchers propose that people have a disease-avoidance mechanism called thebehavioral immune system, which is intended to identify and prevent possible interactions with harmful infections. This thesis is intended to explain this phenomenon, one well researched in the fields of behavioral and evolutionary psychology, to public health professionals, who can use its hypothesized components to understand better how to support population health and wellbeing. In addition, the COVID-19 pandemic will serve as a case study to understand the limitations of the BIS as it relates to socio-cultural events and personal political identification. The behavioral immune system keeps individuals healthy by monitoring …

Novel Applications Of Music And Digital Media In Global Health Intervention And Education Initiatives During The Covid-19 Pandemic: A Case Study Of Bts And Army, Mariko Fujimoto Rooks

Public Health Theses

The Korean musical group BTS (full name Bangtan Seoyeondan/방탄소년단) is one of the world’s most commercially and artistically successful entertainment acts. BTS is primarily known for their domination of both Western and Korean musical markets, impressive digital media presence, major role in supporting the South Korean economy, and highly mobilized 400,000 member fandom known as ARMY. BTS and their parent company HYBE’s artistic creation and marketing model has long focused on creating “Music and Artists for Healing,” or using music and various forms of primarily digital content to connect with and improve health outcomes for fans. In response, ARMY have …

Prescriptive Faith: Carceral Health Beyond The Prison Walls, Shamar S. Smalls

Public Health Theses

Individuals who are exposed to the carceral system—specifically, solitary confinement are uniquely vulnerable to psychological and physical health conditions. However, the relationship between solitary confinement and physical health conditions are relatively underexamined, compared to mental health disorders. This analysis examines the potential for a risks’ association between solitary confinement and cardiovascular disease risk factors. Additionally, this study examines the relationship between spirituality as a self-efficacious coping measure for health-related outcomes. A cross-sectional analysis of 302 survey participants with a prior history of incarceration in a housing study (New Haven, CT) with a prior history of incarceration from Fall 2017 – …

Using A Dynamic Model To Assess Maintenance Of Deer Tick Virus Via Horizontal Transmission In Ixodes Scapularis Populations, Hannah Jane Sproch

Public Health Theses

IntroductionDeer Tick Virus—a lineage of Powassan Virus—is an emerging tick-borne flavivirus associated with high rates of morbidity and mortality. Although DTV infection is rare, there has been an observed increase in the number of human cases in recent decades, necessitating more public health attention. Ixodes scapularis ticks are known to be the primary vector of DTV. However, the enzootic cycle has yet to be fully characterized and there is evidence that horizontal transmission alone may be insufficient for DTV maintenance; it is hypothesized that vertical and co-feeding transmission are also necessary for sustained transmission.

MethodsA dynamic model was developed to …

Occupational And Socioeconomic Risk Factors Of Noise-Induced Hearing Loss, Rongcan Sun

Public Health Theses

Hazardous noise (>85 dBA) is among the most common occupational exposures and responsible for the majority of noise-induced hearing loss. Noise-induced hearing loss impacts many aspects of a person’s life, including workplace safety, daily routine, economic consequences, and quality of life. However, studies on the relationship between occupational noise exposure and hearing loss were usually done in specific industries rather than the general population. In addition, studies focused on associations between socioeconomic factors and hearing loss rarely take the type of occupation into consideration. In this study, we aim to evaluate both occupational noise exposure and socioeconomic status as …

Nutrition And Hookworm Infection: A Causal Analysis Of The Literature, Mengting Su

Public Health Theses

Hookworm infection is one of the neglected tropical diseases, particularly in low and middle-income countries, but we know relatively little about causal evidence related to malnutrition. This is mainly due to the relatively small research community compared to those investigating the impact of hookworm infection on host nutritional status and disease complications. Causal inference is critical in epidemiology and biomedical research because it can be a powerful tool in enlightening prevention efforts and developing etiology models. The application of causal criteria to address complex epidemiological research questions is indeed helpful in proposing more interventions to improve the health and well-being …

Synergistic Epidemic: A Case Study Of Covid-19 And Substance Use Disorder In New London, Ct, Mary Tate

Public Health Theses

The onset of the COVID-19 pandemic in March 2020, complicated the already ineffectual delivery of health care for historically hard-to-reach populations. Those who face housing insecurity, substance use disorders, unemployment, or uncertain immigration and insurance status were abandoned, as the mainstream U.S healthcare system struggled to cope under the pressure of the novel virus. While parallel public health crises were put on hold to deal with COVID-19, the pandemic collided with and exacerbated the ongoing opioid crisis. Using New London, CT as a case study, this project set out to address a gap in literature on the potential syndemic effect …

Quantitative Real-Time Pcr Assays For The Detection Of Leptospira, Alice Zhao

Public Health Theses

Leptospirosis is an infectious zoonotic disease caused by bacteria of the genus Leptospira. The genus is comprised of 40 pathogenic species divided among P1 (19) and P2 (21). Leptospirosis incurs a disproportionately large burden of disease in urban slum regions of developing countries that lack adequate sewage disposal, water treatment, and sanitation infrastructure. While P1 species have been identified in cases of human infection, it is unclear if all Leptospira species are capable of infecting humans, especially P2 species. Among P1 species, L. interrogans has been described as the most frequent specie to cause disease in both animals and humans, …

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

In …

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

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

Public Health Theses

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

Overseen And Overlooked: Knowledge Production And Care In Public Health Surveillance, Krzysztof Wojciech Chwala

Public Health Theses

At the beginning of the COVID-19 pandemic, contact tracing was implemented as a public health measure to prevent the further spread of disease. In this thesis, I analyze contact tracing as a case study of public health surveillance. I argue that public health does not sufficiently study the social components and consequences of its surveillant activities, and as a result is hyperopic; it sees health-related phenomena at a distance with clarity, but has not brought its own logics under view. To remedy this, I utilize perspectives from the field of surveillance studies, which studies surveillance as social and cultural phenomena. …

Determining Polymorphisms In Tnf Production As They Relate To Infection With Ebov, Nirvana K. Dominguez Singh

Public Health Theses

This is a theoretical proposal done as an intellectual exercise. The purpose of this project is to practice and familiarize oneself with the process of applying for a grant from the National Institute of Health to conduct research on human subjects. This proposed study plans to sequence blood samples from infected individuals, exposed and uninfected individuals, and unexposed individuals from the 2018 outbreak in the Democratic Republic of Congo to determine the presence of polymorphisms in TNF production as they relate to Ebolavirus infection. It is hypothesized that certain polymorphisms in the regulation and production of TNF that cause a …

Global Routine Immunization Policies For Refugees, Jad A. Elharake

Public Health Theses

BackgroundIn 2020, approximately 26 million refugees resettled in a new country—fleeing their homes due to conflict, persecution, violence, and human rights violations. Refugees often migrate from developing countries with limited access to adequate health care, routine immunizations, and public health resources. Because of low immunization coverage and potentially underlying health conditions, including stress, trauma, overcrowding during transit, poor hygiene and sanitation services, and malnutrition, refugees face a greater risk of contracting vaccine-preventable diseases (VPDs). This presents a key public health challenge and ethical imperative to serve the health needs of refugees resettling each year.

ObjectiveThe purpose of our study was …

How Knowledge, Perception, And Identity Influence Covid-19-Related Concerns In The Built Environment, Abigail Ginader

Public Health Theses

Background: There is increasing research exploring how different diverse and intersecting identities based on race, gender, ability/disability, sexual orientation, and age interact with space to influence an individual’s inclusiveness and comfort in a space. This is particularly salient in the context of COVID-19 which has shown large health inequities and increased risk for certain vulnerable subgroups (e.g., older individuals, individuals of color).Objective: To assess end users’ perception of COVID-19 safety in the built environment of museums. Methods: A cross-sectional study design was used. An electronic survey was distributed between January and February 2021. Repeated measures ANOVA, multivariate Poisson regression, and …