Digital Commons Network^™

Relationship Between Food Craving And Food Selection, Elizabeth Marie Raiff

Public Health Theses

Objective: The primary aim of this study was to determine the influence of craving on food selection.

Research Methods and Procedures: A total of 95 viable participants completed the food craving inventory

(FCI), a restaurant meal selection questionnaire, and various demographic questions. Linear regression

modeling was used to analyze the relationship between FCI craving score and various forms of caloric intake.

Logistic regression models were utilized to analyze the relationship between “high-craving” status and food

selection.

Results: No significant findings resulted from modelling the relationship between craving category FCI scores

and craved caloric intake using Pearson’s coefficient. Likewise, no significant …

Cost Effectiveness Of A Produce Prescription Intervention, Danielle Raso

Public Health Theses

In this study, we examined the effectiveness, cost, and cost-effectiveness of a produce prescription program. The program analyzed in this study is run by Community Health and Social Services (CHASS) Center, a Federally Qualified Health Center (FQHC) in Detroit, Michigan. The prescription produce intervention begins with eligibility screening and referral by patients’ physicians at clinical visits for eligibility. Eligible patients are then given “prescriptions” for free fruits and vegetables that they can exchange at participating farmers markets or farm stands. Farmers markets also host cooking demonstrations and distribute healthy recipes. Finally, coordinators and volunteers follow up with patients and provide …

Evidence-Based Interventions For Antimicrobial Resistance In Conflict-Afflicted Lmics, Noora M. Reffat

Public Health Theses

Introduction: Although control strategies for antimicrobial resistance (AMR) have been described in high-income settings, interventions to curb the emergence and spread of AMR in conflict-afflicted low- and middle-income countries (LMICs) have not been systematically explored.

Objective: The objective of this review was to identify and assess the effectiveness of various control strategies in curbing the emergence and spread of AMR in conflict-afflicted LMICs.

Methods: A systematic scoping review of the literature was conducted using Embase, PubMed, and Scopus to identify primary literature reporting on AMR in Pakistan, Lebanon, Jordan, or Turkey published in the last decade (Jan. 2010 – Jan. …

How Discrimination, Social Support, And English Proficiency Impact Depression In South Asian Immigrants: The Mediators Of Atherosclerosis In South Asians Living In America Study, Shireen Roy

Public Health Theses

Objectives: Discrimination, low social support, and low English proficiency negatively impact the mental health of immigrants. More work is needed to investigate the relationship between these factors and depression in South Asian immigrants. We examined the cross-sectional associations between chronic discrimination, low social support, low English proficiency, and depression in South Asians using data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.

Methods: We fit logistic regression models to evaluate the associations between discrimination, social support, English proficiency, and depression in a sample of 887 South Asian adults. We also explored how discrimination, social support, …

The Relationship Between Race And Gender And Healthcare Outcomes For Patients In The Intensive Care Unit, Ria Rungta

Public Health Theses

Objective: Although racial and gender disparities in healthcare treatment have been widely studied, relatively few studies have focused on the critically ill population and have had conflicting results. In this study, we sought to assess the associations between a patient’s race and gender and their ICU mortality, length of stay, and any observed delays in the discharge process.

Methods: We utilize a large single-center database called MIMIC-III to analyze the association be- tween a patient’s race and gender and the outcomes of hospital mortality, ICU length of stay, and delays in discharge process. All analysis is conducted using R. Multivariable …

Are Food Baskets Helpful For Refugees With Chronic Illnesses In Sub-Saharan Africa?, Anthony Russell

Public Health Theses

ABSTRACT

Refugees are among some of the most vulnerable populations in our world today. Food insecurity appears to be a consistent state among many refugee populations regardless of length of refugee status and setting. The primary study aims were to: a) identify factors influencing refugees’ ability to manage their chronic illnesses; b) describe food insecurity and dietary intake among refugees with chronic illnesses; c) understand the role food baskets play for this population.

A cross-sectional mixed methods study was conducted in two phases. Phase 1 consisted of 10 in-depth interviews with older adult refugees to identify factors influencing their management …

Nitrous Oxide: Use In Labor & Delivery And Steps Toward Healthcare Sustainability, Bethany Sanchez

Public Health Theses

Objective: This study explores trends in procurement for 3 hospitals in Connecticut over a four-year period to better understand how much N2O is released. N2O use and frequency of conversion to epidural after N2O, as well as emergency cesarean section after N2O use is also examined. A plan for N2O destruction technology testing is outlined.

Background: Nitrous Oxide (N2O) is a well-documented greenhouse gas (GHG) and ozone-depleting agent. N2O use continues to be unregulated, and concurrently it has also become more widely adopted for use in labor and delivery in the US, though it has been popular in Europe and …

The Effects Of Rental Assistance On Housing Stability, Quality, Autonomy And Affordability, Rebecca G. Schapiro

Public Health Theses

In light of the current affordable housing crisis in the United States, this paper examines how rental assistance is associated with four housing outcomes: housing stability, quality, autonomy, and affordability to expand the current knowledge base on benefits of rental assistance. We use data from the first four waves (2017-2019) of the JustHouHS Study, a cohort study of low-income adults designed to examine the intersection of housing, mass incarceration, and health in New Haven, Connecticut. We use Generalized Estimating Equations to examine how rental assistance is associated with participants’ housing stability, quality, autonomy, and affordability. Participants receiving rental assistance had …

The Effect Of Childhood Maternal Trauma Experienced Before The Age Of 18 On Young Adolescent Children Ages 8-15, Alyssa Schneider

Public Health Theses

Childhood trauma is a pervasive and prevalent issue, and one that impact the entirety of the familial unit. Furthermore, maternal childhood trauma, or childhood trauma that was experienced by individuals that are now mothers, has the potential of being passed down and having far-reaching impacts for their children. This is known as the intergenerational transmission of trauma. However, this has primarily been studied in infants and children. As such, this study aimed to elucidate the effects of maternal childhood trauma on young adolescent children using a diary study method with the children and assessing childhood trauma in the mothers. It …

Confidentiality In The Clinic: A Qualitative Analysis Of Adolescent Girls’ Experiences Of Confidentiality In Sexual And Reproductive Health Care, Karen Teekadai Singh

Public Health Theses

Purpose: Adolescents in Connecticut can legally consent to sexual and reproductive health (SRH) care themselves and their parents do not have the right to view their confidential SRH treatment records. A qualitative study capturing information about adolescent girls’ experiences when receiving SRH care was conducted to explore how confidentiality and privacy play out in the clinic from the perspective of adolescents, the facilitators and barriers to adolescents’ confidentiality and privacy in SRH care, and the influence of family members or other guardians on adolescent patients’ confidentiality and privacy.

Methods: A secondary analysis of 31 interviews with adolescent girls was conducted. …

Glycemic Variability And Indices Of Glycemic Control Among Pregnant Women With Type 1 Diabetes Based On Use Of Constant Glucose Share Technology, Julie Sklar

Public Health Theses

Pregnant women with type 1 diabetes (T1D) experience increased glycemic variability as a result of changing insulin sensitivity and resistance throughout gestation. Therefore, strategies that help pregnant women with T1D manage their glycemic control are of great interest. We examined whether remote monitoring of Continuous Glucose Monitor (CGM) data by friends and family affects glycemic variability during pregnancy compared to CGM use alone in a pilot non-randomized trial (n = 28). During preconception or the first trimester, women with T1D were placed in one of two groups based on device compatibility: (1) CGM Alone (n = 13): women without iPhone, …

Neighborhood And Environmental Factors And The Relationship To The Willingness To Use And Actual Uptake Of Pre-Exposure Prophylaxis (Prep) Uptake, A Rapid Scoping Review, Steven Susana-Castillo

Public Health Theses

PrEP (Pre-Exposure Prophylaxis), which appeared on the market after FDA approval in 2012, is more than 90% effective against HIV transmission via sexual contact and more than 60% effective against HIV transmission via intravenous drug use. Current interventions focus on individual behavior or clinical guidelines, however, there has been little focus on the environmental factors affecting PrEP willingness and uptake. To investigate the relationship between neighborhood, environmental factors and PrEP willingness and uptake in the United States, a rapid scoping review was conducted with three electronic databases of articles (January 2012 – March 2020). Of the 2,016 citations screened, 11 …

You Win Some, You Lose Some: An Analysis Of Medicare For All’S Differential Impact On Hospital Finances, Leah Sussman

Public Health Theses

Background: High health care costs have led to an unprecedented number of policy proposals to reform the United States health care system. Proponents of Medicare For All (M4A) argue that a single-payer system would reduce costs by allowing the government to obtain better prices from providers. M4A would have varying effects on sources of hospital revenue, increasing some payment while decreasing others. This paper explores the differential effects of M4A on hospital income.

Methods: This paper uses data from CMS’s Healthcare Cost Report Information System (HCRIS) to create a baseline model reflecting hospital revenues and costs under current hospital payment …

Medical Student Mistreatment And Burnout: An Intersectional Approach, Bethelehem Getachew Teshome

Public Health Theses

Importance

While prior studies have described mistreatment in an undergraduate medical setting by sex, sexual orientation, and race/ethnicity, no studies have examined the degree of mistreatment and symptoms of burnout experienced by students with multiple marginalized identities with national data.

Objective

To describe the association between mistreatment, burnout, and having multiple marginalized identities during undergraduate medical education.

Design

This cohort study utilized data from the Graduate Questionnaire administered annually by the Association of American Medical Colleges.

Setting

This study utilized student responses from the 140 U.S. medical schools accredited by the Association of American Medical Colleges’ Liaison Committee on Medical …

Major Depression Among Immigrants: Findings From The Nis-2003, Trang Tran

Public Health Theses

Lawful permanent residents (LPRs) are immigrants who come to the US through a variety of countries and circumstances. Most studies focus on subsets of immigrant populations, however, this study utilized data from the 2003 New Immigrant Survey, a nationally representative, cross-sectional survey of LPRs (n = 8,573). Participants were grouped into three main visa categories (i.e. Refugees/Asylees/Parolees, Legalization, Family/Employment/Diversity) and the objective was to examine the association between visa status and depression outcomes among adult survey respondents. We used bivariate analyses to measure the relationship between sociodemographic variables and visa status. Approximately 98% of the Legalization category originated from Latin …

Tobacco Use, Knowledge Of Tobacco Risks, And Perception Of Smoking Behaviors Among Urban And Rural Youth In South Sulawesi, Indonesia, Ryan Andrew Sutherland

Public Health Theses

This observational study surveyed knowledge, practice, and attitudes (KAP) of N=959 youth 13 – 18 years of age in South Sulawesi, Indonesia and assessed how age, sex, familial smoking status, friend group smoking status, teacher smoking status, parental education, parental employment, exposure to tobacco-related advertisements, access to internet-connecting technological devices (INT-D) and television, and monthly pocket money were associated with youths’ perceptions of tobacco users and smoking, knowledge of tobacco health risks, and smoking status. This study also examined how urban or rural environment and schooling — access or lack of access to formal education — shaped youths’ decisions to …

Meteorological Determinants Of Mosquito Populations In Connecticut, Melpomene Vasiliou

Public Health Theses

As climate change continues at an alarming rate, it is important to quantify and characterize its wide-ranging impacts at both the global and more localized scales. This study aims to build on this body of evidence that details the local impacts of climate change that have already begun to and will increasingly harm human health. The study explores time trends in Connecticut’s mosquito abundance, as well as potential meteorological determinants of abundance for one key species. Secondary analysis using computational techniques was performed on mosquito abundance data provided by the Connecticut Agricultural Experiment Station (CAES). Simple linear regression was performed …

Promoting Ecosystem And Human Health Under Climate Change ——An Integrated Analysis Of Sustainable Olive Cultivation In Cyprus, Ningjing Wang

Public Health Theses

Achieving agricultural sustainability has become a high priority to ensure society’s current and future food needs without compromising ecosystem health, economic profitability, and human well-being. Organic agriculture has been proposed as an alternative to conventional farming for meeting sustainable goals. However, empirical evidence linking organic farming, human health, and sustainability in the context of climate change is scarce. In addition, previous studies comparing organic and conventional agriculture have not considered the variation in farming practices within the same management regime.

In this study, a multi-criteria sustainability assessment framework with ten indicators has been developed and proposed for sustainable olive cultivation …

Evaluating The Appropriateness Of Oral Antibiotic Therapy Following Discharge For Patients With Urinary Tract Infection, Sera Yoo

Public Health Theses

Introduction: Inappropriate use of antibiotics is common in healthcare settings, with urinary tract infections (UTI) being one of the most common indications for antibiotic prescriptions. This study evaluated the appropriateness of oral antibiotic therapy among adult patients with suspected UTI who were admitted to Yale New Haven Hospital during January 2018. We hypothesized that 60% of antibiotics were inappropriate, and that inappropriate therapy was associated with Clostridioides difficile infection, hospital readmission and/or mortality.

Methods: We conducted a retrospective cohort study of adult patients who were admitted to Yale New Haven Hospital from January 1, 2018 to January 31, 2018. Data …

Hiv Testing During Antenatal Care In Eastern & Southern Africa: How Do Adolescents And Young Women Fare?, Claire Young

Public Health Theses

Background

To validate Elimination of Mother to Child HIV Transmission (eMTCT), pregnant women must receive antenatal care (ANC) HIV testing. Given challenges for adolescent girls in ANC, we hypothesized that adolescents were less likely to receive ANC HIV testing in Eastern and Southern Africa (ESA).

Methods

For 10 ESA countries, we use 2015-2018 Demographic and Health Surveys (DHS) to study 46,056 women attending ANC and giving birth in the last three years. We used age-stratified (15-19, 20-24, and 25-49 years of age at time of delivery) crude and adjusted logistic regressions to assess predictive factors for ANC HIV testing, both …

Solid Fuel-Related Indoor Air Pollution And Poor Sleep Quality In Adults Aged 45 Years And Older; A National Longitudinal Study In China, Haiqing Yu

Public Health Theses

Background: Sleep disorders are a common public health issue in an aging society. Outdoor air pollution has been linked to poor sleep quality, but few studies have investigated the relationship between indoor air pollution derived from solid fuel combustion and sleep quality in elderly.

Objective: To evaluate the association between indoor air pollution due to cooking solid fuels and sleep quality among adults aged 45 years and elderly in China.

Methods: We analyzed data from the China Health and Retirement Survey (CHARLS), a national survey of ~17,000 residents aged over 45 from 150 counties/districts in China. Participants were restricted to …

The Impact Of Cognitive Decline On Decision-Making Among Older Persons In China, Quan Yuan

Public Health Theses

Decision-making among the older population is of importance as older persons make critically consequential decisions on daily errands, household financials, and care-seeking that affect the remainder of their lives. Despite the increasing prevalence rate of cognitive impairment in developing countries, many questions surrounding the impact of cognitive impairment on decision-making among older persons remain unexplored. Therefore, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study helps bridge the gap in the existing literature by examining the effect of cognitive decline on decision-making among the older population in China. We first investigate the association between an individual's cognitive …

Intimate Partner Violence, Colorism, And Stress Coping In Barbados, Nkandu Yumbe

Public Health Theses

Persons who experience intimate partner violence (IPV) have higher rates of chronic disease. This is thought to be due, in part, to the adoption of health risk coping behaviors, as well as the detrimental biological response to chronic stress associated with violence. The role of colorism (perceived skin tone discrimination) in the experiences of victims of IPV, their stress and stress coping behaviors has not previously been examined. The objective of this study was to explore the intersecting experience of black skin, coping strategies and stress among women with IPV histories in Barbados. Women above the age of 18, who …

Accelerometer-Measured Physical Activity And Sedentary Time Among Samoan Adults And Associations With Type 2 Diabetes And Hypertension, Parmida Zarei

Public Health Theses

Objectives: (1) To describe accelerometer-measured physical activity among Samoan adults; (2) to determine associations between physical activity and type 2 diabetes and hypertension; and (3) to assess adherence to global physical activity recommendations.

Participants: Three hundred eighty-five Samoan adults aged 30-72 years.

Setting: Participants were recruited from 23 villages on the Samoan island of ‘Upolu (eight urban, seven peri-urban, and eight rural).

Measurements: Self-reported demographic information including age, census region of residence, and occupation was collected. Anthropometric measurements including weight and height were taken in light island clothing, and body mass index was calculated. Sedentary time, light-intensity physical activity, and …

Speech, Innovation, And Competition, Greg Day

Scholarly Works

Critics contend that concentrated power in digital markets has generated threats to free speech. For a variety of reasons, market power is naturally thought to concentrate in digital markets. The consequence is that “big tech” is said to face little competition; Facebook controls 72 percent of the social media market while the parent of YouTube (72 percent of the video market) is Google (92 percent of the search market). This landscape has potentially vested private companies with unprecedented power over the flow of information. If Facebook, for example, decides to ban certain types of speech or ideas, it would potentially …

The Folly Of Credit As Pandemic Relief, Pamela Foohey, Dalie Jimenez, Christopher K. Odinet

Scholarly Works

Within weeks of the coronavirus pandemic appearing in the United States, the American economy came to a grinding halt. The unprecedented modern health crisis and the collapsing economy forced Congress to make a critical choice about how to help American families survive financially. Congress had two basic options. It could enact policies that provided direct and meaningful financial support to people, without the necessity of later repayment. Or it could pursue policies that temporarily relieved people from their financial obligations, but required that they eventually pay amounts subject to payment moratoria later.

In passing the CARES Act, Congress primarily chose …

Stopping The Resurgence Of Vaccine-Preventable Childhood Diseases: Policy, Politics, And Law, Hillel Y. Levin, Stacie Patrice Kershner, Timothy D. Lytton, Daniel Salmon, Saad B. Omer

Scholarly Works

Mandatory vaccination programs in the United States are generally successful, but their continued success is under threat. The ever-increasing number of parents who opt their children out of vaccination recommendations has caused severe outbreaks of vaccine-preventable diseases. Public health advocates have pushed for changes to state laws, but their efforts have generally been unsuccessful. We suggest that their lack of success is due to public health advocates’ failures to contend with the features of the political system that impede change and to propose reforms that are ethically defensible, efficacious, and politically feasible. Based on our earlier public health studies, ethical …

Analysis Of Mechanical Deformation Eect On The Voltage Generation Of A Vertical Contact Mode Triboelectric Generator, Nabid Aunjum Hossain, Mir Jalil Razavi, Shahrzad Towfighian

Mechanical Engineering Faculty Scholarship

One of the associated factors that controls the performance of a triboelectric generator (TEG) is the mechanical deformation of the dielectric layer. Therefore, a good contact model can be a prominent tool to find a more realistic and efficient way of determining the relationships between the contact and electrical output of the generator. In this study, experiments are conducted on a vertical contact mode triboelectric generator under an MTS machine. The open-circuit voltages are measured at different loads imposed by the MTS by controlling the cyclic displacement of the top tribo layer of the generator. A finite-element-based theoretical model is …

Taking A Joke Seriously: When Does Humor Affect Responses To The Slurring Of People With Intellectual Disabilities?, Jennifer Katz, Dimitri Wing-Paul

Psychology

The use of humor may affect how bystanders respond to slurs. Undergraduates (N = 192) completed a measure of prejudice towards people with intellectual disabilities and were randomly assigned to read a scenario in which a peer uses a slur either as part of a joke (humor condition) or a statement (control condition). Participants responded to measures of intent to assertively respond and their evaluation of the speaker. Humor inhibited intent to nonverbally disagree and to verbally confront. Bystanders’ own prejudicial attitudes moderated the effects of humor on intent to verbally confront and negative evaluation. In the humor condition, compared …

Retroperitoneal Hematoma, Christopher Mondie, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

Retroperitoneal hematoma is defined as bleeding into the retroperitoneal space. This clinical entity is often occult and under-recognized by clinicians and is a cause of significant morbidity and mortality. Often patients do not manifest clinically apparent signs and symptoms until a substantial amount of blood loss has occurred. It is not uncommon for patients to present in frank hemorrhagic shock due to an underlying retroperitoneal hematoma. The retroperitoneal space lies directly posterior to the peritoneal cavity. An organizational schema dividing the retroperitoneal space into three different “zones” is widely prevalent in the surgical literature. The central-medial zone (Zone I) falls …