Digital Commons Network^™

Development Of A Comprehensive Sexual Education Curriculum For A Private, Independent Day School For Students Pre-K Through 8th Grade, Haja I. Kamara

Public Health Theses

This paper describes the development of a comprehensive sex education (CSE) curriculum for The Country School (TCS), a coeducational, independent school in Madison, CT that serves approximately 200 students in Pre-Kindergarten through 8th grade. CSE describes a wide array of sex education programs and curricula that are scientifically accurate, culturally and age-appropriate, gender-sensitive and life skills-based. The goal for this project is multi-pronged: adapt existing health education programming, build out a new health and wellness program with a distinct scope and sequence for each grade level that includes resources and supports for ongoing parent education and professional development. To inform …

Impact Of A 6-Month Exercise Intervention On Cognitive Function Among Ovarian Cancer Survivors: The Women’S Activity And Lifestyle Study In Connecticut (Walc), Jonica Yu Kao

Public Health Theses

Purpose: Cancer survivors often exhibit symptoms of impaired cognitive abilities after chemotherapy treatment. Physical activity has been shown to be promising in improving cognitive function among survivors for various types of cancer. However, very few studies have addressed this concern among the ovarian cancer patient population specifically.

Methods: The study randomized 111 physically-inactive ovarian cancer survivors into a 6-month exercise intervention (n=59) or an attention-control group (n=52). The FACT-Cog scale was self-reported to understand survivor perceptions of cognitive abilities at baseline and at 6 months. Generalized linear models (GLMs) were executed to examine the effect of the intervention versus attention-control …

The Hiv Care Continuum And Barriers To Viral Suppression Among Men Who Have Sex With Men In Greater Kuala Lumpur, Malaysia., Lauren Haerin Kim

Public Health Theses

Background: Men who have sex with men (MSM) now account for nearly half of all new HIV cases in Malaysia. There has been little research, however, characterizing the HIV care continuum among MSM living with HIV in Malaysia. This study describes the HIV care continuum and examines factors associated with HIV viral non-suppression among newly diagnosed MSM living with HIV in Kuala Lumpur, Malaysia.

Methods: We enrolled 163 MSM living with HIV who were in care at a major university hospital in Kuala Lumpur, Malaysia. Participants completed a self-administered questionnaire. Electronic medical chart review also provided data on engagement in …

Evaluating The Association Between Severe Acne And Pancreatic Cancer Risk, Rachel Vania Lee

Public Health Theses

Objective: Inflammation is a suggested mediator in pancreatic carcinogenesis. Severe acne may be a proxy of inflammation; however, the association between severe acne with pancreatic cancer is unstudied. Here, we explored the association between self-reported severe acne and pancreatic cancer risk for the purpose of hypothesis generation.

Methods: In a hospital-based case-control study, we used information from personal interviews with 939 confirmed cases of pancreatic adenocarcinoma and 440 controls to assess history of teenage and adult acne. We evaluated the association between severe acne and pancreatic cancer risk by estimating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using …

Acknowledgment Of Sexual Violence And Mental Health Among College Students, Francesca Maviglia

Public Health Theses

A significant number of individuals who experience a form of sexual violence that could be classifiable as rape or sexual assault do not label their experience as such. Studies found that rape acknowledgement status can impact a survivor’s postassault experiences and recovery process. This study examined how a sample of 236 college students who experienced some form of sexual violence labeled their experience. The association between different degrees of acknowledgement and posttraumatic stress and depression symptoms was tested. 162 (68.6%) of respondents did not label their experience as unwanted; the remaining 74 (31.4%) varied in their labeling of the experience …

Assessing The Functional Impact Of Pfrh5 Genetic Diversity On Erythrocyte Invasion Pathway Utilization In Plasmodium Falciparum, Adam Joseph Moore

Public Health Theses

Malaria is still responsible for over 405,000 deaths and 228 million cases of disease globally each year, with the large majority of these cases being caused by the Plasmodium falciparum parasite subspecies1. The RTS,S P. falciparum malaria vaccine, the only malaria vaccine ever licensed, is currently being rolled out in three African countries as part of a pilot implementation program and targets a major circumsporozoite protein (PfCSP). After three doses and a seven-year follow up, the vaccine showed a 7% efficacy on average with a -56.8% efficacy for patients in regions with above average exposure to P. falciparum2. While the …

Live Birth Bias In Epidemiological Study Of Timing Specific Exposure Effect During Pregnancy And Child Health: A Simulation Study, Ngoc Tram Nguyen

Public Health Theses

In reproductive and perinatal epidemiological studies, measurement of child health outcomes that can only be ascertained in live born children may be incomplete since only 60 – 70% of fertilized eggs result in live births and early pregnancy loss is often undetected. Studies assessing outcomes among live born children are subject to live birth bias, a phenomenon previously proposed as a form of collider-bias in which conditioning on live-birth status induces a non-causal association between exposure and outcome. In this study, we expanded a previously proposed common structure of this bias to evaluate its impact on the estimation of time-specific …

Drug Use And Severe Outcomes Among Patients Hospitalized With Influenza Over Three Seasons, Christina Elizabeth Parisi

Public Health Theses

Influenza is a significant public health problem in the United States and around the world, causing considerable morbidity and mortality annually. Drug use is also a significant issue that is associated with numerous health complications and conditions. However, the relationship between severe influenza outcomes and drug use is not well understood. The objectives of this investigation are to compare the prevalence of demographic and behavioral factors associated with severe influenza outcomes between persons who use drugs (PWUDs) and non-PWUDs hospitalized with influenza and, by controlling for those factors we find are significant, determine if there is an association between severe …

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 …

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 …

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. …

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 …

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 …

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 …

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 …

Environmental Law, Travis M. Trimble

Scholarly Works

Notable cases decided in the United States Court of Appeals for the Eleventh Circuit in 2019 all arose out of disputes that originated under the Clean Water Act (CWA). The Eleventh Circuit held that, in preparing an Environmental Impact Statement (EIS) in connection with its decision to issue a dredge and fill permit under Section 404 of the CWA, the Corps of Engineers (Corps) was not required to consider potentially negative environmental effects resulting from activity made possible by the permit where the agency had no authority independently to regulate the effects. The court also held that the Environmental Protection …

Interpersonal Communication: A Mindful Approach To Relationships, Jason S. Wrench, Narissra M. Punyanunt-Carter, Katherine S, Thweatt

Milne Open Textbooks

Interpersonal Communication: A Mindful Approach to Relationships helps readers examine their own one-on-one communicative interactions using a mindfulness lens. The writing team of Jason S. Wrench, Narissra M. Punyanunt-Carter, and Katherine Thweatt incorporates the latest communication theory and research to help students navigate everyday interpersonal interactions. The 14 chapters in this book cover topics typically taught in an undergraduate interpersonal communication course: family interactions, interpersonal dynamics, language, listening, nonverbal communication, and romantic relationships, as well as exploring emerging areas such as self-compassion, body positivity, friendships, and “the dark side”. The writing takes on a purposefully informal tone to engage readers. …

Rna Sequencing Of Human Peripheral Nerve In Response To Injury: Distinctive Analysis Of The Nerve Repair Pathways., Andrew S. Welleford, Jorge E. Quintero, Nader El Seblani, Eric Blalock, Sumedha Gunewardena, Steven M. Shapiro, Sean M. Riordan, Peter Huettl, Zain Guduru, John A. Stanford, Craig G. Van Horne, Greg A. Gerhardt

Manuscripts, Articles, Book Chapters and Other Papers

The development of regenerative therapies for central nervous system diseases can likely benefit from an understanding of the peripheral nervous system repair process, particularly in identifying potential gene pathways involved in human nerve repair. This study employed RNA sequencing (RNA-seq) technology to analyze the whole transcriptome profile of the human peripheral nerve in response to an injury. The distal sural nerve was exposed, completely transected, and a 1 to 2 cm section of nerve fascicles was collected for RNA-seq from six participants with Parkinson's disease, ranging in age between 53 and 70 yr. Two weeks after the initial injury, another …

Mems Biosensor For Water-Immersed Application, Kun-Lin Lee

Dissertations and Theses

Although many air-based sensing mechanisms exist, not all of them can be applied in the water-based environment. In order to obtain a cell-based biosensor, the sensing method needs to be reliable and repeatable in a liquid environment. Therefore, this study is focused on transforming existing air-based sensors to water-immersed applications. This study includes two types of sensors.

First, commercial quartz resonators are used to investigate live-cell activity in water-based toxic solutions. I perform toxicity tests using quartz crystal microbalance (QCM). The QCM used in the study has a resonant frequency of 10 MHz and consists of an AT-cut quartz crystal …

Macro - And Microstructure Evaluation And Field Applications Of Concrete With Recycled Glass Pozzolan, Marija Krstic

Dissertations and Theses

Concrete is the most used material in the world, second only to water. Conventional concrete is produced with Portland cement (PC). The production of cement is an energy intensive operation that has raised significant environmental concerns, since one ton of cement generates an equal ton of CO₂. In the USA about 90 million tons of cement are used annually, with 3 million tons used in New York. Most contemporary concrete applications for buildings and infrastructure use high-performance concrete (HPC) mixtures which are produced by replacing a percentage of cement with supplementary cementitious materials (SCMs), consisting mainly of fly-ash …

Diffuse Damage Repair Mechanism In Bone, Leila Mehraban Alvandi

Dissertations and Theses

Bone microdamage is a result of fatigue, creep or ‘wear and tear’ caused by physiological activities and largely contributes to bone fragility. Bone, unlike engineered materials, has the ability to repair the microscopic cracking or microdamage through targeted, osteoclast-mediated bone remodeling. This capability is crucial for preservation of its structural integrity and quality; failure of the skeleton to effectively repair microdamage leads to accumulation of damage, which is one of the main contributors to bone fragility. Linear microcracks (50-100 µm) and diffuse damage (Dif.Dx) (sub-micron) are the two types of microdamage. Recent studies show that Dif.Dx repairs without bone remodeling, …

Characterization Of Bone Pathology In Sickle Cell Disease And Therapeutic Strategies, Mykel D. Green

Dissertations and Theses

Sickle cell disease (SCD) is a genetic hemoglobinopathy that has grown into a global health concern. While the advances in medical treatment and management of SCD during childhood have drastically improved the overall survival of children, the transition from pediatric to adult services is significantly inadequate in comparison. Life expectancies of patients with SCD in first world countries such as the United States are shortened to averages of 42 and 48 years for men and women, respectively. Despite the increasing number of people living with SCD, remarkably, few detailed studies have described the clinical course and complications of the disease …

Ice Algae Resource Utilization By Benthic Macro- And Megafaunal Communities On The Pacific Arctic Shelf Determined Through Lipid Biomarker Analysis, Chelsea Wegner Koch, Lee W. Cooper, Jacqueline M. Grebmeier, Karen Frey, Thomas A. Brown

Geography

We studied ice algae utilization by benthic fauna from the northern Bering and Chukchi Seas using highly branched isoprenoid (HBI) biomarkers. We assessed whether various food acquisition strategies influence the observed HBI signatures. The proportion of phytoplankton to ice algae-sourced HBIs was determined through the H-Print approach that is presumed to reflect the percentage of sea ice organic carbon (iPOC) incorporated into tissues, relative to phytoplankton organic carbon. Cluster analysis separated 3 groups based on location and feeding strategy that were significantly influenced by annual sea ice persistence. Ice algae utilization was most significant in the northeast Chukchi Sea, where …

Microbial Degradability Of Terrigenous, Marsh-Exported, And Estuarine Colored Dissolved Organic Matter In Long Island Sound, John R. Supino

Dissertations and Theses

The Long Island Sound is one of the world's most urbanized estuaries, polluted from excess nutrients which impact the quality of water through increased biological productivity. Dissolved organic matter (DOM) is a sensitive indicator of anthropogenic pollution and nutrient enrichment in coastal waters as well as an important part of the carbon cycle and serves as a primary food source for aquatic food webs. Additionally, the colored portion of DOM (CDOM) impacts coastal optical properties, ocean color, and light attenuation. High levels of CDOM have been shown to inhibit the growth of phytoplankton and limit photosynthesis, damaging the food chain …

Understanding How Sequence Differences Among Glutamate Transporters Might Contribute To Their Differential Function In Glutamate Clearance In C. Elegans, Irving Estevez

Dissertations and Theses

In the nervous system, high circuit resolution requires efficient post-signaling clearance of the neurotransmitter. Glutamate-mediated neurotransmission involves the release of glutamate (Glu) into the synaptic cleft by the presynaptic cell and binding to glutamate receptors (GluR) on the postsynaptic cell, leading to activation of a signal transduction cascade. Neurotransmission is eventually terminated by Glu uptake via glutamate transporters (GluT). Inefficient Glu clearance is detrimental to precise rapid signaling, can lead to blurring of circuit resolution by inadvertent Glu spillover to nearby circuits, and may even be neurotoxic. While classical views depict synapses as insulated by glia, recent technological advances show …

Does Neighborhood Socioeconomic Status Moderate The Association Between Adhd And Overweight/Obesity?, Ayanna N. Gilmore

Dissertations and Theses

This study aimed to examine whether neighborhood-level socioeconomic status (NSES) moderated the Attention-Deficit/Hyperactivity Disorder (ADHD)-overweight/obesity association. Participants (N=568; mean (SD) age = 20.74 (3.20) years; 70.8% female) were part- time or full-time students attending the City College of New York. They were recruited through an online platform and participated in the study in exchange for course credit. Eligible participants were required to self-report their height, weight, from which body mass index (BMI) was calculated. Participants were categorized as Low BMI (Underweight or Typical BMI) or High BMI (Overweight or Obese BMI). Participants self-reported current ADHD symptoms using the ADHD-EF Index …

Does Overweight/Obesity Moderate The Association Between Adhd And Internalizing Difficulties In Young Adults?, Breanna Badripersaud

Dissertations and Theses

This study’s objective was to investigate if ADHD symptoms and BMI are associated with internalizing impairments of depression, anxiety, stress and lower self-esteem in college students. It was predicted that higher ADHD symptoms would be associated with elevated depression, anxiety, stress, and low self-esteem, especially if BMI fell in the overweight/obese range. Undergraduate students [N= 580; Mean (SD) age= 20.7 (3.10)] from an urban campus completed an online survey comprising self-report measures of demographics, height/weight, attention and hyperactivity/impulsivity (Barkley Deficits Executive Functioning Scale ADHD- Executive Function Index), depression, anxiety, stress (all using the Depression Anxiety and Stress Scale) and self- …