Digital Commons Network^™

Psychosocial Mechanisms Of Historical Trauma Transmission In Native American Communities: A Rapid Scoping Review, Rucha Kandlur

Public Health Theses

For centuries Native American communities have been subjected to persistent oppression. The effects of the historical events of colonization have transcended generations and continue to affect the lives of the current generation, removed from direct exposure to the traumatic events. The intergenerational transmission of trauma has widely been studied in Holocaust survivors, with only recent explorations in other marginalized populations incurring similar forms of trauma. Additionally, explorations in intergenerational trauma transmission have largely focused on biological mechanisms rather than the psychosocial mechanisms. The purpose of this study is to examine existing evidence regarding psychosocial mechanisms of intergenerational transmission of historical …

The Impact Of Covid-19 On Backyard Poultry-Associated Salmonella In Connecticut, Laura Kasper

Public Health Theses

Introduction: Salmonellosis is the second leading bacterial foodborne illness in the United States, and is mainly characterized by symptoms of gastroenteritis and their consequences in afflicted individuals. Salmonella accounts for 1.35 million infections, 26,500 hospitalizations and 420 deaths in the United States every year. Live poultry act as a reservoir of Salmonella and causes an annual national outbreak. There has yet to be a published study on the impact of COVID-19 lockdowns on the incidence of Salmonella and on the percentage of cases tied to the national poultry outbreak. Methods: Active public health surveillance of Salmonella in Connecticut is conducted …

The Impact Of Economic Intimate Partner Violence On Women’S Sexual And Reproductive Health In Asia & The Pacific, Marina Katague

Public Health Theses

Intimate partner violence is a human rights violation and serious threat to global public health. Economic intimate partner violence is a unique form of abuse whose effects on health need clarification. Data from the 2011-2012 UN Multi-country Study on Men and Violence, comprised of cross-sectional samples in China, Papua New Guinea, and Sri Lanka were collected on ever-partnered women aged 18-49 years. The sample averaged some (1.14) economic violence exposure across summed behaviors (range 0-12; standard deviation=2.04). Multivariable regressions were run to assess the relationship between severity of IPV abuse types and 14 sexual and reproductive health outcomes. Adjusted analyses …

Factors Associated With Early Childhood Development Outcomes For Children Of Adolescent And Young Adult Mothers In Brazil, Lily Benson Kofke

Public Health Theses

Objectives: A descriptive analysis to explore the risks for early childhood development (ECD) delays among children of adolescent and young adult mothers in Brazil. Methods: A secondary analysis of cross-sectional data of a representative sample of children under age 2 and their mothers from community health centers in Brasília, Brazil. The Denver Developmental Screening Test II was used to assess overall and domain-specific ECD (personal-social, fine motor, gross motor, and language). Mothers were subset into two groups based on age. Bivariate analyses and multivariable logistic regressions were used to examine the associations between maternal age and risk of ECD delay, …

An Exploration Of Race Differences In Network Exposures To Mass Incarceration, Jessica Lee

Public Health Theses

A growing literature suggests that mass incarceration impacts not only the individual who is incarcerated, but also their partners, family members, and children. However, few studies have examined race differences in network exposure to mass incarceration. This study explores associations between race and various measures of network exposure to incarceration: relationships, interactions with the criminal legal system, and housing. We draw on data from the 2017-2018 baseline survey from the Justice, Housing, and Health Study. Descriptive statistics show that Black respondents are more likely to experience each event we examined compared to whites, except for parental incarceration and receiving threats …

The Associations Between Circadian Genetic Factors And Cancer Survival, Bingqing Li

Public Health Theses

The circadian rhythm controls a range of important biological behaviors with a 24-hour cycle. The mammalian biological clock is a layered network of vibrators with a master clock locating in the neurons of suprachiasmatic nucleus (SCN) in the hypothalamus and a set of core and related circadian genes. Several lines of evidence from previous studies suggested the relationships between tumorigenesis and circadian rhythm disruption. However, the effects of circadian genetic factors in cancer survival remains uncertain. Therefore, it is important to review and explore the circadian genetic factors which might be linked to cancer survival. This paper aimed to evaluate …

Gene-Gene Interactions Contributing To Asthma Susceptibility, An Exploration Using Uk Biobank Dataset, Yuyuan Lin

Public Health Theses

Background: Previous studies have attempted to identify gene-gene interactions for asthma. However, most of these studies suffered from lack of replication or insufficient statistical power. In this study, we aimed to explore the gene-gene interactions affecting asthma susceptibility and tried to replicate the results. Both the discovery and replication datasets were nested in UK Biobank data.

Methods: Nested case-control design was used. In the discovery analysis (N= 306,859, cases = 35,483, controls = 271,376), Univariate genome-wide association analysis was performed to prioritize loci for the interaction analysis. Pairwise search for epistasis was conducted among 5,389 SNPs. Replication of the top …

Public Health And Natural Gas Policy In Connecticut, Cheyenne Liberti

Public Health Theses

Due to its adverse impacts on public health via contributions to global climate change and emissions of toxic substances throughout the life cycle, natural gas use should be eliminated as quickly as possible in Connecticut. This project aims to 1) identify the policies and programs concerning all stages of the natural gas life cycle, in and affecting Connecticut; 2) evaluate the capacity of these policies and programs to mitigate public health hazards, promote environmental justice, and achieve rapid elimination of natural gas use; and 3) recommend policy and program alternatives that would accomplish these goals in a more timely manner. …

The Impact Of Ww’S Multi-City Fvrx Program On Children, Damaris Lopez Mercado

Public Health Theses

Introduction and background: Higher F&V intake are associated with healthier BMI in children, but cost of F&V has been found to be a barrier to access for some families. To mitigate this barrier, Wholesome Wave (WW) implemented a six-month F&V incentive program that included a $25 weekly financial incentive for families to spend on F&V in three U.S. cities. The primary objectives of this paper are to assess whether this program significantly impacted child F&V consumption and child anthropometry from baseline to end-of-program and to assess whether F&V intake and food insecurity and end-of-program are significant predictors of healthy child …

Analyzing The Restriction Of Mass Gatherings And School Closures/Reopening In China And Iran During The Covid-19 Pandemic With A Public Health Ethics Framework, Esther Luo

Public Health Theses

The COVID-19 pandemic has undoubtedly elevated the status of public health. Concurrently, public health ethics has been brought to the forefront of the field and its practices in several ways. Over the past year, SARS-CoV-2 has affected nearly every country. In both high and low resource settings, policymakers turned to public health to ease the tension placed on health care systems by COVID-19. Governments implemented measures ranging from lockdown orders to mask mandates, all with the primary goal of curbing the spread of SARS-CoV-2. The effectiveness of these interventions has become a salient topic in public health research, and much …

Determinants For Approval And Reimbursement Of Orphan Products In China, Wenlan Mao

Public Health Theses

Rare disease definition varies among countries/regions. China has published The First National List of Rare Diseases, including 121 kinds of rare diseases in 2018. It was the first time that China has defined rare diseases officially. China has also started releasing a range of encouraging regulations regarding orphan drug development and approval in recent years. Nevertheless, the FDA has introduced Orphan Drug Act in the 1980s, Japan has launched a government-led support initiative in the 1990s, and the European Parliament has adopted the Orphan Regulation in 2000. Among the 121 rare diseases, 58 of them have approved treatments in the …

Co-Distribution Of Ambient Light At Night And Incidence Of Human Cancers And Covid-19, Yidan Meng

Public Health Theses

Introduction and BackgroundThere are increasing concerns about the effects of artificial lights on human health, including hormone-related disease and immune functions. In January 2020, the outbreak of COVID-19 disrupted everyone’s life, and people who infected have various severity. Thus, we want to analyze whether people exposed to different ambient light at night (LAN) levels make them more susceptible to COVID-19 for our summer research. Besides the effects of LAN on immune functions, we also discussed the association of LAN and multiple cancers in seven states of Northeastern U.S. We used similar statistical and geographic analysis methods and separate them into …

Economic Evaluation Of The Preventing Childhood Obesity Through Mindfulness-Based Parent Stress Intervention, Jingyi Meng

Public Health Theses

This study analyzed the intervention cost of a novel early childhood obesity prevention program -- Preventing Childhood Obesity Through a Mindfulness-Based Parent Stress Intervention (PMH+N) conducted by Yale Stress Center. The randomized clinical trial started from 11/01/2018 and will enroll 240 participants in total. Parents were included in the trial if they had: a child in the 2- to 5-year age group, a body mass index (BMI) over 28 kg/m2, high levels of perceived stress as assessed by the Perceived Stress Scale (PSS) (score >25) and were able to read and write in English. For 12 weeks, about 13 parents …

Impact Of Health Care Access On Delayed Or Missed Adolescent Vaccinations For Tdap, Meningococcal, And Hpv Vaccines Among U.S. Adolescents, Nis-Teen 2018, Maura Iko Nakahata

Public Health Theses

Background: Adolescent vaccination coverage varies considerably between Tdap, meningococcal, and HPV vaccines. While evidence suggests that health care access affects vaccination coverage, evidence does not explain whether access drives delayed or no vaccination. This study evaluates whether measures of health care access are associated with delayed vaccination or not being vaccinated by age 17 years for Tdap, meningococcal, and HPV vaccines when controlling for sociodemographic factors as proxies for vaccine hesitancy. The secondary objective assesses whether health care access measures had consistent associations across the different vaccines. Methods: Using current ACIP recommendations, ‘on-time’, ‘delayed’, and ‘missed’ status by age 17 …

(De)Constructing The Grocery Store: An Ethnographic Examination Of Spatial Characteristics And Their Implications For Social Inclusion, Madeline Hoai Chau Nguyen

Public Health Theses

I acknowledge that this research was conducted on land stolen from the Mattabesic, Paugusett, and Schaghticoke tribes which is currently occupied by a Western colonial power.

This study examines the physical characteristics of the interior of New Haven grocery stores and how these are designed to socially include or exclude racial minorities. Drawing upon critical race theory and using ethnographic research methods, I analyze similarities and differences amongst selected independent American and Asian grocery stores and how they communicate their cultural values to various social groups. Even if it is not explicit, white supremacist values are embedded in these spaces. …

Impact Of Covid-19 On Participants Of A Fruit And Vegetable Program, Christabelle Ong

Public Health Theses

Objective: To investigate the impact of COVID-19 on the participants of a multi-city fruit and vegetable incentive program.Design: A six-month cohort study was conducted. Pre-program and post-program data were collected using an online survey platform. Setting: Eight cities across the United States. Participants: A total of 822 individuals were recruited through local site partners to participate in a fruit and vegetable incentive program (n=822; 79.4% women, 20.6% men; median age: 57 years old). Intervention: Participants received $50 monthly fruit and vegetable vouchers, a sneaker gift card or gift basket, and access to a weight loss app. Main Outcome Measures: The …

The Role Of Histone Demethylase Kdm6a In Mouse Coronavirus Infection, Sonam Patel

Public Health Theses

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of acute respiratory coronavirus disease 2019 (COVID-19), a disease that erupted into a global pandemic in March of 2020.2 Recently, a genome wide CRISPR screen was performed on SARS-lineage coronaviruses and two additional recombinant viruses; the screen revealed host genes essential to coronavirus pathogenesis and entry.7 The screen identified KDM6A, a histone demethylase, as an important pro-viral gene.7 Building upon this observation, in this thesis, I explore the role of Kdm6a in murine hepatitis virus (MHV), a type of mouse coronavirus. MHV is the prototypical model for studying SARS-CoV-2 …

An Examination Of The Multilevel Determinants Of Homelessness, Ashley Brooke Roehrig

Public Health Theses

Objectives: This project aimed to explore factors contributing to homelessness within Fairfield County, Connecticut in order to understand how to develop prevention services that best match the population’s needs.

Methods: This project draws on data collected from a qualitative study done by Supportive Housing Works, where researchers conducted 2 focus groups and 44 semi-structured interviews with individuals experiencing homelessness or housing instability in Bridgeport, CT. Participants were recruited by posting flyers, as well as referrals from programs such as Prospect House, and other Opening Doors Fairfield County (ODFC) partner agencies. Eligible participants had to be registered with the Homeless Management …

An Agenda-Setting Report: Biome Monitoring For Human Health, Peter Roumeliotis

Public Health Theses

In light of the COVID-19 pandemic and the increasing frequency with which zoonotic diseases of pandemic potential have emerged in recent decades, it is vital to seek new methods of preventing disease outbreaks before they occur. Novel information age technologies have the potential to change the game for infectious disease outbreak monitoring. This paper addresses the overall opportunity that exists for biome surveillance as a means for health monitoring, particularly the way that the domains of technological and biological sciences can unite to prevent the next pandemic before it gets a chance to take hold. This report outlines the numerous …

The Impact Of The Covid-19 Pandemic On People With Disabilities: Pandemic-Related Stress And Contribution To The Disability Community As Predictors Of Posttraumatic Growth, Megan Marie Roy

Public Health Theses

People with disabilities (PWD) face many existing barriers and unjust conditions that contribute to negative psychosocial outcomes. PWD have also been disproportionately impacted by the COVID-19 pandemic, which has introduced unique sources of stress and trauma in the disability community. However, scant research attention has been paid toward its effects on the mental health of PWD, especially factors that may buffer risk or foster positive psychological outcomes. Therefore, this study investigates the impact of pandemic-related stress on posttraumatic growth (PTG), or the perceived psychological benefits accrued as a result of struggle with a major life challenge or crisis (Tedeschi & …

Association Between Maternal Stress And Parental Responses To Child Development As Measured By Hpa Axis Biomarkers, Crystal Maureen Ruiz

Public Health Theses

Background. This study aims to assess the association between perceived stress and maternal responses to child developmental behavior, utilizing hypothalamic-pituitary-adrenal (HPA) axis biomarkers to measure maternal stress: cortisol, cortisone, DHEA and testosterone.

Methods. This study was conducted using data collected from a randomly selected sample of mother-infant dyads from the Bachpan cohort. This analysis focuses on data collected at baseline and 36 months postpartum. Of the women who screened positive for depressive symptoms at baseline (n=889) and provided responses to the 36-month questionnaire assessing perceived stress, a sub-sample (n=90) provided hair cortisol concentration (HCC) samples and completed a questionnaire concerning …

Implementation, Prevalence, And Referral Rates Of Patient-Reported Outcomes Of Distress And Depression Screening In Oncology Care, Emily Erin Saadi

Public Health Theses

Clinical depression and distress are prevalent in cancer patients and are often unrecognized by clinicians. However, patient-reported outcomes, or PROs, can facilitate provider assessment of oncology treatment plans by detecting depressive and distress symptoms early in a patient’s cancer trajectory. Since PROs capture patients’ subjective experience, they provide invaluable insight into patient satisfaction, quality of life, and mental health. In April 2019, leadership at Smilow Cancer Hospital at Yale New Haven Health implemented a new, electronic workflow that widely disseminated PHQ-9 and NCCN Distress questionnaires to patients seen in three Smilow Cancer Hospital Care Centers. The objective of this pilot …

“We Are Left Alone”: A Qualitative Study Of Life Satisfaction Of Older Adults In Rural Nepal, Anna Elisabeth Schwartz

Public Health Theses

Considering that the aging population in the Southeast Asian region is rapidly growing, there is an increasing need to promote the subjective well-being of older adults. However, few studies have investigated mechanisms of life satisfaction in developing countries in the Southeast Asian region. This research gap needs to be addressed, since aging and life satisfaction are complex processes that are experienced differently in various sociocultural contexts. The purpose of this study is to understand meanings of life satisfaction and experiences of aging through the perspectives of older adults who live in Jumla, Nepal. We conducted semi-structured, in-depth interviews with twenty …

Associations Between Restorative Justice Policies And Mental Health Among Women Survivors Of Intimate Partner Violence, Laurel Ann Sharpless

Public Health Theses

Introduction: Intimate partner violence (IPV) can impact the mental health of survivors; however, little is known about the role of state-level restorative justice policies. Restorative justice policies are survivor-centered justice approaches focused on repairing harm between the survivor and perpetrator while ensuring perpetrator accountability, which may buffer the mental health outcomes among IPV survivors. Furthermore, the impact of restorative justice policies on mental health may be influenced by the degree of state-level support for policy implementation through administrative guidelines or program funding. This study examined: (1) the relationship between IPV exposure and women’s perceived mental health and assessed state restorative …

Sex Difference In Identification Of Predictive Tumor Tissue Metabolites Associated With Colorectal Cancer Prognosis, Xinyi Shen

Public Health Theses

Colorectal cancer (CRC) is the third major cause of cancer-related deaths in the United States in 2020. Sex-related differences in CRC stage, prognosis, and metabolism have become increasingly popular in cancer research. Males have poorer survival for CRC, but females with right-sided colon cancer (RCC) have aberrant metabolism correlated with poor survival. Delay in knowing the condition of CRC in female patients would result in poor prognosis, which could be avoided by predicting prognostic outcomes. Random Survival Forest (RSF) is ideal for exploration and making predictions using metabolomics data with high dimension, strong collinearity, and heterogeneity, which CPH models could …

Health-Related Quality Of Life In Endometrial Cancer Survivors, Michelle Sodipo

Public Health Theses

Background: Endometrial cancer is the most common cancer of the female reproductive organs and one of few cancers in the United States with rising incidence and mortality rates. Few studies have examined factors that influence health-related quality of life (HRQOL) of endometrial cancer survivors after active treatment and existing studies have been limited in sample size. In this study, we examined sociodemographic and clinical factors associated with HRQOL and symptom burden in a national sample of endometrial cancer survivors.

Methods: We evaluated 331 endometrial cancer survivors from the longitudinal American Cancer Society’s Study of Cancer Survivors-I who completed self-administered questionnaires …

Long-Term Cancer Survivors' Use Of Healthcare Providers, Madeleine Tessier-Kay

Public Health Theses

Abstract

Introduction: The number of long-term (>5 years post-diagnosis) cancer survivors in the United States is growing, making it critical to understand how they utilize healthcare for their past cancer diagnosis. There are limited data on patient characteristics associated with care utilization patterns. Methods: Data are reported from the 9-year post-diagnosis follow-up of the Connecticut participants (n=399) in the American Cancer Society’s Study of Cancer Survivors-I. We assessed characteristics associated with long-term primary cancer care provider (cancer specialist vs. primary care physician (PCP), shared care vs. PCP) and number of PCP visits in the past year via multinomial logistic …

Genetic Determinants For Cancer Risks With Racial Differences And Asthma, Yinqiao Wang

Public Health Theses

Over the past decade, many studies have found disproportionally higher prostate cancer among men of African ancestry, and testicular cancer incidences among men of European ancestry, compared with men from other ethnicity/race groups. However, genetic determinants that could potentially explain this observation are unclear. This study collected single nucleotide polymorphisms (SNPs) related to the two cancer types and compared the frequencies of each risk allele of SNPs among men of African or European ancestry from several genetic databases. When comparing the frequencies of risk alleles that are associated with prostate and testicular cancers, significant differences were found between those of …

Investigation On The Association Between Unconventional Oil And Gas Development And Traffic Accident Rates In Ohio, Hubian Wang

Public Health Theses

The oil and gas drilling activities had greatly developed in Ohio in past decade. Unconventional natural gas development is a newly developed technology, which requires more heavy-truck trips in the drilling process. Limited studies investigated the association between drilling activities and increased rate of traffic accidents. Ecological study was conducted to analyze the association. Number of unconventional wells were obtained as exposure variable from Ohio department of natural source, and the data of traffic crashes were collected as outcome variable from Ohio department of public safety. Other variables including sociodemographic data and spatial distribution of primary roads were examining as …

Determining The Relationship Between Sars-Cov-2 Infection And Streptococcus Pneumoniae In Clinical Saliva Samples, Anne Watkins

Public Health Theses

Background. Streptococcus pneumoniae is a commonly found upper respiratory tract colonizer that can progress to more severe disease forms such as pneumonia. Interactions with respiratory viruses other than SARS-CoV-2 have been previously identified such that S. pneumoniae may sometimes enhance disease or occur as a secondary or co-infection. With the recent emergence of SARS-CoV-2 there is limited data available describing this specific pathogen relationship that could play a role in the breadth and severity of the pandemic. Methods. Inpatients and healthcare workers testing positive for SARS-CoV-2 March 2020-August 2020 were tested for S. pneumoniae through saliva culture enrichment and RT-qPCR …