Digital Commons Network^™

Trust And A Respect For Persons: Public Health As A Profession Of Relationships, Michael Anthony Perrin

Public Health Theses

The purpose of this thesis is to explore the concept of empathy, or “the ability to share someone else’s feelings," in public health, examining the concept’s effect on both the ethical mandates of the profession and the validity of community-engaged research results. The ethical guidelines of the profession, as outlined by the American Public Health Association and other prominent public health researchers, were used to inform such an exploration, as was personal experience and Yale public health researcher insights. A case study of homelessness public health research was conducted. Interviews and surveys were conducted with prominent homelessness community advocates with …

Barriers To Care For Cardiovascular Risk Factor Management, Morgan Anne Pratte

Public Health Theses

Introduction: Hypertension, high cholesterol, diabetes, obesity, and smoking are established risk factors for cardiovascular disease (CVD), and the presence of several risk factors is associated with worse health outcomes. Access to healthcare has a major influence on the management and treatment of these modifiable conditions. The objective of this study is to examine barriers to care among non-elderly adults with multiple risk factors for CVD, and to furthermore identify socio-demographic disparities within this group.

Methods: Analyses utilized data from a subset of 39 U.S. states and territories that implemented the optional healthcare access module in the 2013 Behavioral Risk Factor …

Time In Ghana And Dietary Patterns In Liberian Refugees, Wilhelmenia Lee Ross

Public Health Theses

Previous research suggests acculturation (i.e. exposure and assimilation to local culture) is associated with changes in dietary patterns among immigrants. This study investigates this association in a refugee population using time in refugee settlement as a proxy for acculturation. A cross-sectional survey was conducted among a convenience sample to: (i) identify dietary patterns in Liberian refugees and Ghanaians living in or near a refugee settlement; (ii) compare adherence to these dietary patterns between groups; and (iii) investigate the association between acculturation and dietary patterns in Liberian refugees. Time in refugee settlement was assessed by self-report; food consumption was assessed by …

Determinants Of Perceived Insufficient Milk And The Infant Feeding Practices Of New Mothers In León, Nicaragua, Cara Safon

Public Health Theses

Breastfeeding has been shown to improve maternal and child health. In Nicaragua, the primary risk of death and disability-adjusted life years among children under 5 years of age is suboptimal breastfeeding. Although the Nicaraguan Ministry of Health promotes exclusive breastfeeding from within the first half hour through the first 6 months of life, less than a third of children in the country under 6 months are exclusively breastfed. As part of a larger, mixed-methods study, 21 semi-structured, in-depth interviews were conducted with new mothers recruited from 3 primary health centers between June and August 2015 in order to identify the …

Perspectives For Adolescent Engagement: The Bright Bodies Program, Athena Theodora Samaras

Public Health Theses

While responses to the obesity epidemic have largely encompassed top-down approaches with a focus on health-related outcome evaluation, for successes to be sustained, a greater emphasis is needed on local initiatives and intervention process evaluation. Pediatric weight management programs in the healthcare and community settings represent local initiatives that have had considerable health-related impacts, yet are often limited by high attrition rates. Because adolescence is marked by substantial weight shifts and the formation of long-lasting health habits, it represents a critical point for implementing obesity prevention and treatment. Accordingly, this study sought to assess factors that promote adolescent participant engagement …

Food Insecurity In San Pedro, Ecuador: The Association Of Food Insecurity With Dietary Diversity And Bmi, Etna Tiburcio

Public Health Theses

Background: Limited research has examined the association between food insecurity and both dietary diversity and body mass index (BMI) in rural, Ecuador.

Methods: A cross-sectional analysis was conducted on a sample of 237 patients and family members visiting a primary care community clinic. To determine food security level, the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) was employed. Outcome was measured using the Household Dietary Diversity Score (HDDS) and BMI was deduced using measured height and weight. These measures were then evaluated in their associations with food security level, adjusting for wealth stratum for the HDDS variable.

Results: As …

Intermediate Assessment Of The Khushi Baby Crct: Implementation Of A Novel Mhealth Solution For Vaccination Record Keeping In Rural Udaipur, Rajasthan, India., Preethi Ganesh Venkat

Public Health Theses

Background: Khushi Baby (KB) is a mobile health platform that tracks child immunizations using a mobile application and a Near Field Communication (NFC) necklace worn by the child. Quantitatively assessing intermediate indicators of the KB program’s progress is important, especially when considering the program’s scalability.

Objectives: This study seeks to quantitatively examine three key intermediate outcomes of the KB cluster Randomized Controlled Trial (cRCT), using group comparisons of mothers’ survey responses, that are indicative of whether the necklace is discussed, visible, and liked by users. Two data collection tools were compared in this study: the NFC sticker and the NFC …

The Effect Of Spatiotemporally-Dependent Air Pollution Exposure On Birthweight In The Lanzhou Birth Cohort, Dennis Wang

Public Health Theses

Introduction: Low birthweight serves as a proxy risk factor for a number of conditions later in development. Of China’s urban centers, Lanzhou has long been considered one of the worst-affected cities by air pollution.

Objectives: This study uses spatial heterogeneity in air pollution exposure across addresses in Lanzhou and temporal heterogeneity resulting from the differential timing of pregnancy in the Lanzhou Birth Cohort to investigate the association between PM10 exposure and birthweight.

Methods: The study population consisted of 4,865 mother-child pairs from the Gansu Provincial Maternity and Child Care Hospital. Participants completed an epidemiological questionnaire and patient data were collected …

The Role Of Folate In The Association Between Perinatal Air Pollution Exposure And Birth Outcomes In Lanzhou, China, Rebecca Ann Wong

Public Health Theses

Background: China’s rapid economic and industrial development over the past few decades has been accompanied by tremendous increases in air pollutant emissions and come at a serious cost to the environment and public health. Recent research has revealed an increased risk of adverse birth outcomes associated with perinatal air pollution exposure. Although the mechanisms by which air pollutants contribute to adverse birth outcomes have not yet been established, folate intake has been shown to counteract several of the hypothesized biological pathways.

Hypothesis: Dietary folate intake and folic acid supplementation modify the association between perinatal air pollution exposure (PM10, NO2, SO2) …

Pirnas Variants And Lung Cancer Risk: A Post-Gwas Study, Rui Ye

Public Health Theses

Background: Lung cancer is the most frequently diagnosed cancer and one of the top cause of cancer death worldwide. The recent discovery of PIWI-interacting RNAs (piRNAs), one type of non-coding RNAs, has been shown to be involved in tumorgenesis pathways of various types of cancer types by accumulating evidences. However, the role of piRNAs in lung cancer development is underexplored.

Methods: Genotype and phenotype data were obtained from a genome-wide association study of lung cancer risk (3,702 cases and 3,739 controls) and 1,173 imputed piRNAs variants were analyzed by association analysis for lung cancer risk. A secondary expression analysis is …

All-Source Exposures To Arsenic For Residents Living Near Historic Gold Mine Areas In Northwest Romania, Zhen Zhang

Public Health Theses

Background: Roşia Montană gold mine is the site of historic mining operations since Roman times. Contamination of nearby communitiesby historic mining activities is of serious concern.

Objective: The study objective is to investigate whether living in the vicinity of historic gold mining increases risk of arsenic exposure from the surrounding environment, and if dietary intake from home gardens is associated with reduced risk of arsenic exposure.

Methods: We performed assessments in 64 participants from 57 households within the target communities. All study participants gave written informed consent. The study was approved by the institutional review boards of the regional public …

Property Rights And Governance Strategies: How Best To Deal With Land, Water, Intellectual Property, And Spectrum, Richard A. Epstein

Colorado Technology Law Journal

No abstract provided.

Predictors Of Prenatal Care Satisfaction Among Pregnant Women In American Samoa, Oluwaseyi A. Adeyinka

Public Health Theses

Objectives: Women of reproductive age in American Samoa have a high-risk for pregnancy complications, due to their high levels of overweight and obesity. Prenatal care can mitigate this risk; however, many women do not seek care. The low rate of prenatal care utilization may stem from a low-level of prenatal care satisfaction. By understanding the predictors of prenatal care satisfaction in America Samoa, targets for improvement may be identified, with the ultimate goal of increasing prenatal care utilization.

Methods: A cross-sectional survey was distributed to women (n=174) in the waiting areas of the clinic at the Lyndon B Johnson Tropical …

Predictors Of Nutritional Status Among Young Samoan Children, Courtney C. Choy

Public Health Theses

The nutrition transition is associated with the rising burden of non-communicable diseases in low-and middle-income countries and in Samoa, young children are particularly vulnerable to malnutrition in various forms. In this present study, we documented the current prevalence and co-existence of child nutritional status outcomes within this population and by census region. We then examined the role of selected child, maternal, and household characteristics as potential predictors of child nutritional status. A cross-sectional, community-based design was used to collect data from singleton pairs of a non-pregnant mother and child between 24 to 59 months olds in the Samoan island of …

Predictors Of Breast Density In Hispanic And Latino Women Living In The Northeast Region Of The United States, Emma Claye

Public Health Theses

Introduction: Breast density, the fibroglandular, non-fatty tissue in the breast, has been shown to be a significant risk factor for breast cancer. Little is currently known about the predictors of breast density among the understudied but increasing population of Hispanic and Latino women in the United States.

Objectives: The objective of this study is to identify predictors of breast density among Hispanic and Latino women in Connecticut and to determine if these differ from those described in other populations. Because the hormonal milieu is somewhat different in Hispanic/Latinas compared with White women, we are interested in how these variables impact …

Investigating Fear, Shyness, And Discomfort Related To Menstrual Hygiene Management In Rural Cambodia, Gabrielle Joy Daniels

Public Health Theses

Over the last decade, increasing attention has been given to understanding girls' menstrual hygiene management (MHM) experiences in school. However, little has been done to understand girls' MHM experiences in other contexts, such as the home environment. The purpose of this study was to explore the knowledge, attitudes, and practices of MHM and menstrual related experiences among rural Cambodians, with an expanded scope to include both the home and school environments, and five participant perspectives. Our study was conducted in eight rural secondary schools and eight rural villages from two Cambodian provinces, Banteay Meanchey and Kratie. Our target participants included …

Hands Up: A Systematized Review Of Policing Sex Workers In The U.S., Fabian Luis Fernandez

Public Health Theses

This work lays the foundation for a study of criminalization and its effects on the health of street-based sex workers in the U.S. seeking to: 1) conduct a systematized review of sources from across the country settling on seventeen that describe experiences of harassment, false arrests, theft, physical abuse, sexual assault, HIV criminalization, survival tactics, reporting practices, and positive relations with law enforcement and 2.) compare the U.S. literature to international research, reflecting on the ways that public health researchers remain complicit in sustaining these harmful institutions by failing to consider diversity, the criminalized context of sex work, the links …

Neighborhood-Level Socioeconomic Status And County Fairs And The Risk Of Shiga Toxin-Producing Escherichia Coli Incidence In Connecticut, 2012 To 2014, Gili Hrusa

Public Health Theses

Abstract

Background: Shiga toxin-producing E. coli (STEC) is a reportable illness. It is associated with a spectrum of clinical manifestations that range from watery and/or bloody diarrhea to hemolytic uremic syndrome (HUS), a life threatening condition which causes acute renal failure in both children and adults. A study in Connecticut (CT) by Whitney et al. (2015) found a strong association between higher socioeconomic status (SES) and Shiga toxin-producing E. coli incidence. In the same study, there was a weaker association demonstrated between rurality and STEC incidence as well. The primary aim of this study is to investigate the relationship between …

Vitamin D Status And Age Of Menarche:, Alexandra Hua

Public Health Theses

Early age of menarche (AOM) increases risk for chronic disorders, including cardiovascular disease and related mortality, type 2 diabetes, and breast cancer. Vitamin D deficiency may be linked to earlier onset of menstruation, but there is limited research examining vitamin D and its association with AOM. The objective of this study was to examine the association between vitamin D levels and AOM by analyzing the National Health and Nutrition Examination Survey (NHANES) data from 2001-2010. We hypothesized that that vitamin D deficiency is associated with earlier age of menarche in adolescent and early adult females in the United States. Cross-sectional …

What Can We Learn From Healthy Positive Weight Deviants In Samoa?, Sophia Hua

Public Health Theses

Introduction: Over 90% of females and over 80% of males in Samoa are either overweight or obese. The continuing economic and nutrition transition in Samoa has contributed to a sharp rise in prevalence. Excess weight affects both the younger and older generation of Samoa. With little evidence of decreasing prevalence in overweight or obesity, the country needs to make weight loss/prevention of weight gain a public health priority. This paper will look at the behaviors of healthy positive weight deviants in Samoa to inform targetable changes the population can make.

Setting/Participants: 3,475 participants were eligible for this study from four …

Lifetime Residential Water Source And Thyroid Cancer Risk: A Connecticut Based Case-Control Study, Hannah Grace Kaneck

Public Health Theses

While incident thyroid cancer diagnoses continue to increase at a rate faster than any other cancer in the US, questions about environmental exposures’ link to small malignancy increases persist. Nitrate consumption as a predictor for thyroid cancer has become a topic of interest due to their ubiquitous contamination of water and food supplies. No epidemiological studies have looked at the correlation of residential water source over an entire lifetime and its relation to thyroid cancer. A Connecticut based case-control study conducted in 2010-2011, including 462 histologically confirmed incident thyroid cancer cases and 498 Connecticut based controls used multivariate unconditional logistic …

Socioeconomic Rights Adjudication In Canada: Can The Minimum Core Help In Adjudicating The Rights To Life And Security Of The Person Under The Canadian Charter Of Rights And Freedoms?, Ania Kwadrans

Journal of Law and Social Policy

Violations of the minimum core economic and social rights (ESR) deprive society’s most vulnerable individuals and groups of the very resources that are essential to life and basic well-being. States have an obligation to ensure that meaningful remedies are available for such infringements. Though articulating a minimum core for ESR poses challenges, and critics of the concept find it beyond the institutional competence of courts, it remains an important tool for adjudication. The minimum core focuses the inquiry on the underlying goals of human rights: the protection of vulnerable and marginalized groups from the most serious forms of deprivation and …

Dietary Patterns And Thyroid Cancer Risk: A Population-Based Case-Control Study, Jiaxin Liang

Public Health Theses

Thyroid cancer (TC) incidence has increased greatly during the past decades with a few established risk factors. The relationship between diet factors and TC remains unclear. Limited literature has investigated the association and with inconsistent findings. We examined the association between dietary pattern and risk of TC in a population based case-control study conducted in Connecticut (2010-2011). 390 historically confirmed incident TC cases and 436 population-based controls that completed baseline dietary history questionnaires were included in the analyses. We identified 3 distinct dietary patterns (“Starchy Foods and Desserts”, “Fruits and Vegetables”, “High Protein and Fat”) through principal components analysis. Multivariate …

Stress, Social Support, And Low Birth Weight: The Birth To Twenty Cohort, Esther Lim

Public Health Theses

The role that psychosocial factors play in determining birth weight has been thought to play an analogous role as physical insults during pregnancy. In particular, maternal social support and stress have been studied separately with respect to their association with low birth weight (LBW), with more recent studies examining their interaction. The latter case has found that the level of social support reported by participants can modify the association between perceived levels of stress and LBW status. However, much of the research conducted to study and establish this relationship has mostly taken place within the high income countries (HIC) of …

French Proficiency At The Secondary And Post-Secondary Levels, Kirsten Wienckowski

Senior Honors Theses and Projects

As a general rule, It is claimed that the four years of foreign language courses taken In high school are equivalent to the first four semesters of foreign courses taken at the university level. In fact, most universities grant college credit for scoring well on the foreign language Advanced Placement (AP) and International Baccalaureate (IB) exams taken by students following the completion of thelr study of a foreign language In high school. This claim prompts an exploration of proficiency levels achieved by students studying French at the secondary and post-secondary levels through evaluations of the French AP, 18, College Level …

A Comparison Of Four Methods Of Dental Age Estimation And Age Estimation From The Risser Sign Of The Iliac Crest, Rebekah A. Goltz

Senior Honors Theses and Projects

Age estimation techniques are of medicolegal importance for estimating the age of living asylum seekers. as well as for unidentified human remains from forensic cases. As there are many techniques for age estimation, this study compares four different methods using dental radiographs of modern subadults (under 18 years) to determine which is more accurate for the modern sample. Additionally, this study explores age estimation from apophyseal fusion in the pelvis using the Risser method of the iliac crest compared to estimates of dental age. This study additionally compares the accuracy of four dental age estimation methods, including: Schour and Massler …

Food And Slave Communities In The Antebellum South, Jessica Rose

Dissertations and Theses

No abstract provided.

The Importance Of The Prioritization Of Human Development Through Governmental Policies, Barbara Marie Fertitta

Dissertations and Theses

This thesis examines the prioritization of human development through governmental policies. Education and gender equality are two of the most fundamental indicators of human development that have far reaching impacts on other human development indicators. This thesis uses the case studies of Ghana and Pakistan to compare and contrast how each respective government has prioritized different aspects of human development and the impact it has had on their country as well as their security. I propose that higher levels of human development increase levels of security and that when there is low physical security, human development levels are also low. …

The Effects Of Grameen-Model Microfinance Institutions And Self-Help Group Microfinance On Women’S Economic Empowerment In Rural India, Forrest Weaver

Dissertations and Theses

Women in rural India suffer from pervasive gender inequality and disempowerment. One road to equality is economic empowerment through microfinance. Economic empowerment consists of an increase in savings, income, ownership of property or a microenterprise, and access to social services and training. I compile studies of two most common types of microfinance models used in India in order to determine if there is a general trend indicating that microfinance as a whole has a positive impact on women’s economic empowerment. The two types of microfinance examined are Grameen-model microfinance institutions (MFIs) and Self-Help groups (SHGs) through the SHG-Bank linkage model. …

The Incongruence Of Development Assistance: An Overview Of World Bank Policies, Elizabeth Garcia-Polanco

Dissertations and Theses

In post-conflict countries were instability has intensified, it becomes apparent how inadequate development assistance can be and why even after large sum of investments development assistance has not been able to completely alleviate poverty. For agencies like the World Bank that provide first hand assistance, we question whether there are prerequisites needed in order for their policies to be effective and whether these policies are targeting the core reasons for the countries’ poverty dilemma. African countries continue to hold intricate predicaments that may at times be too complicated to be analyzed without sufficient resources provided by the international community. While …