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What I Talk About When I Talk About Charity Scott, Elizabeth Weeks

Scholarly Works

This essay pays tribute to Professor Charity Scott’s transformative impact on health law, legal education, and medical-legal partnerships. Reflecting on personal experience and Scott’s pioneering work, It highlights Scott’s integrity, compassion, and dedication to improving individual and community well-being through law. Scott’s role in establishing the Health Law Partnership (HeLP) and advancing the medical-legal partnership model is situated within the broader evolution of health justice, social determinants of health, and interprofessional collaboration. The essay underscores her legacy as a scholar, mentor, and innovator whose work continues to shape health law and inspire future generations of advocates, educators, and practitioners

An Optical Aptamer-Based Carbon Nanosensor For Cortisol Detection, Jessica Kretli Zanetti

Dissertations and Theses

Cortisol is a hormone related to numerous biological functions. This hormone is primarily associated with regulating the body’s stress response, including its effects on metabolism, immune function, and energy balance. Additionally, it plays a critical role in maintaining physiological homeostasis during periods of physical or psychological stress. Consequently, it is critical to monitor levels of this hormone to understand different vital processes it can impact. This work presents the development of an optical aptamer-based carbon nanosensor for the detection of cortisol. The sensor utilizes single-walled carbon nanotubes (SWCNTs) functionalized with a specific DNA aptamer to achieve high specificity and sensitivity. …

Using Mechanical Interventions To Enhance Drug Transport To Bone Tumors, Michelle Gelbs

Dissertations and Theses

Bone metastasis occurs when cancer cells spread from a primary site to a secondary location in bone. Current treatments for metastatic bone tumors typically involve systemic chemotherapy, bisphosphonates, radiotherapy, or surgery; however, due to morphological changes in the tumor microenvironment and elevated interstitial fluid pressure, tissue penetration of therapeutic agents is often more limited in cancerous tumors compared to normal tissue. Weight-bearing mechanical loading applied to bone, as well as other mechanical stimulations such as vibration, have been shown to cause loading-induced bone deformations that increase convective transport via interstitial fluid flow. We hypothesize that mechanical loading can increase the …

Optimizing Transcranial Focused Ultrasound: Calibration, Neuro Navigation, And Bold Fmri Evidence Of Neuromodulation, Amilcar J. Malave

Dissertations and Theses

This thesis presents the development, calibration, and initial implementation of transcranial focused ultrasound (tFUS) for neuromodulation in a human study. The primary objectives were to design a system capable of delivering precise and safe ultrasound stimulation to targeted brain regions and to conduct preliminary trials to assess its effects on brain activity. A custom calibration device was developed to ensure accurate measurement of acoustic pressure, addressing challenges such as voltage alterations caused by changes in system impedance. Additionally, a neuro-navigation tool was created to facilitate precise targeting of the right subgenual anterior cingulate cortex (right sgACC), enabling accurate placement of …

On The Understanding Of The Coastal-Urban Nexus Of Weather, Air Quality And Energy, Harold Gamarro

Dissertations and Theses

Urban environments exhibit complex interactions between atmospheric processes, building energy consumption, and air quality, particularly during periods of seasonal extremes such as summer ozone peaks and winter heating. Accurate representation of these interactions in urban modeling is crucial for understanding and addressing air pollution and energy management challenges in cities. This research presents a comprehensive study that advances urban atmosphere simulations by integrating building energy dynamics, air quality, and robust multi-source observational evaluation. Leveraging the Weather Research and Forecasting (WRF) model, coupled with a multilayer building environment parameterization (BEP) and a building energy model (BEM), with an improved boundary layer …

Analysis Of Energy Savings And Feasibility Of Retrofitting New York City Midrise Multifamily Buildings With Air Source Heat Pump Technology, Samuel Chussid

Dissertations and Theses

Motivated by reducing impacts of climate change due to greenhouse gas emissions, many dense urban cites throughout the United States have set into law ambitions decarbonization policies that will require buildings to replace fossil fuel space and water heating systems with electric powered alternatives. In many cities, especially in the northeast, fossil fuel space and water heating systems are used in a vast majority of buildings and significantly contribute to citywide carbon emissions. In New York City (NYC), it is estimated that over 40 percent of citywide emissions come from space heating and water heating systems that run on fossil …

The Racial Disparities Of The Gamma-Secretase/Notch Pathway And Inhibition In Triple Negative Breast Cancer, Jobin Joseph

Dissertations and Theses

Triple Negative Breast Cancer (TNBC) continues to be a formidable challenge in oncology, characterized by its aggressive phenotype and limited treatment options. Alarming racial disparities in TNBC outcomes persist, with underrepresented populations experiencing disproportionately higher rates of mortality and poorer prognoses. This master's thesis aims to delve into the molecular intricacies that contribute to these disparities, with a specific focus on gamma secretase activity, a key regulator of cellular processes.

The research methodology encompasses a multi-faceted approach, amalgamating clinical data analysis with extensive in vitro and in vivo experimentation. The study employs cutting-edge molecular profiling techniques and gene expression analysis …

Therapist Engagement With Patient Nonverbal Behavior: Exploring These Interactions As A Mechanism Of Change In Virtual And In-Person Short-Term Psychotherapy, Elliana Sheriwn

Dissertations and Theses

The individual (intrapsychic) and dyadic (interpersonal) implications of nonverbal behavior have kindled interest among psychologists for decades. Many researchers and clinicians have studied nonverbal communication in the context of attachment and moment-to-moment interactions between parent and infant (Stern, 1977; Beebe et al., 2000). Theorists have also explored nonverbal behavior in the clinical setting as a dynamic relational dimension co-created by patient and therapist (Freedman and Lavendar, 1995). Although the extant literature highlights how nonverbal communication can inform psychotherapy outcome (e.g., by fostering empathy and building rapport), the topic of therapist engagement with patient nonverbal behavior—specifically, how these interactions serve as …

Effects Of The Cb1 Receptor Antagonist, Am251, On Maternal Behavior In Long-Evans Rat Dams, Jennifer Aguilera-Fonseca, Karla Colley, Eddie Galarza, Atoria Hamm, Joe Morse, Rachel Ntor, Destiny Pichardo, Vincent P. Markowski

McNair Scholars Program

No abstract provided.

Ecological Factors Influencing The Evolution Of Jamestown Canyon Virus In The Northern United States, Ellie Bourgikos

Public Health Theses

Jamestown Canyon virus (JCV) is a re-emerging arthropod-borne virus in the midwest and northeast United States, infecting mosquitoes and white-tailed deer in a seasonal transmission cycle. Its spread may contribute to thousands of asymptomatic human infections, with 194 total cases of neuroinvasive disease diagnosed. However, very little is known about the virus’s evolutionary history, transmission patterns, and lineage distribution. For this project, we sequenced 689 JCV samples collected from mosquito pools in the northern U.S., increasing the availability of this species’ genomes. Using maximum likelihood estimation on surveillance data, we found that JCV is maintained through the overwintering of single-brood …

Effect Of The Lifestyle, Exercise, And Nutrition (Lean) Weight Loss Intervention On Anxiety Among Breast Cancer Survivors, Faiad Alam

Public Health Theses

Background: Lifestyle interventions can be an important tool in improving quality of life (QOL) among breast cancer survivors. Anxiety has been improved in some, but not all, exercise or lifestyle interventions that have investigated this component of QOL. Therefore, we sought to examine the impact of the 6-month Lifestyle, Exercise, and Nutrition (LEAN) intervention vs. usual care on anxiety among women who completed treatment for breast cancer. Methods: A total of 151 breast cancer survivors participated in the LEAN study, and 116 participants were included in this secondary analysis. State anxiety was assessed via the state anxiety portion of the …

A History Of Cioms (Council For International Organizations Of Medical Sciences) And The Creation Of Multinational Consensus For Human Subjects Research Ethics, Abigail Belle Cheung

Public Health Theses

N/A

Unveiling Chagas Disease: An In-Depth Analysis Of Epidemiological Patterns In High Burden Latin American Nations, Nicole Del Castillo

Public Health Theses

Background: Chagas Disease, endemic to 21 countries in Latin America, is transmitted by triatominae insects infected with parasites known as Trypanosoma cruzi.1–3 It is the most prevalent tropical disease in Latin America, affecting about 6 million individuals across the Americas.1 This literature review aims to summarize unique epidemiological patterns over a 9-year time period from 2010 to 2019 across three nations in South America that experienced the highest Chagas Disease burden in 2019: Bolivia, Venezuela, and Argentina.4

Methods: For this rapid literature review, one independent reviewer extracted all data for publications reviewed within a 9-year time period: 2010 to 2019. …

The Roads Less Traveled: A Metaresearch Analysis Of Local Histories In Racial Health Equity Research, Devin Trévion Brown

Public Health Theses

While it is important that racial health equity research receive growing attention in theUnited States, doing so must involve a thorough recognition and interrogation of the role that structural racism plays in creating different outcomes for Black communities. History aids in making clear the process through which race can become biology as structural racism is embodied by members of Black communities. Guided by Táíwò’s conceptualization of “resource distribution and accumulation” as well as Carter’s discussion of “racialized local biologies”, this cross-sectional meta-research analysis sought to investigate when and how racial health equity research after 2020 utilized local history to understand …

“How Long On Top Of The Hill?”: The Legacy Of Community Mental Health Programs, Institutionalized Relationships, And The Stifling Of Black Power (New Haven, 1963-1971), Sophie Elizabeth Edelstein

Public Health Theses

In the early 1960s, the Community Mental Health Centers Act aimed to overhaul the infrastructure of the mental health care system, transitioning patient care from dilapidated state psychiatric institutions to self-sufficient, comprehensive mental health centers within communities. Many academic medical centers viewed this federal legislation as an opportunity to gain access to an additional patient population for training and economic purposes. From New York City to Boston to New Haven, institutional aspirations for community control were burgeoning, and community psychiatry became a conduit for institutions to extend their reach into local communities under the guise of progressive mental health reform. …

Examining Factors Associated With Covid-19 Disruptions To Tuberculosis Services, Tejaswini Dharmapuri Vachaspathi

Public Health Theses

Background: The COVID-19 pandemic posed unprecedented challenges to global health systems, significantly impacting the delivery of essential health services, including tuberculosis (TB) care. It is important to analyze the factors associated with the reductions in TB notifications during the pandemic, with a focus on high TB burden countries, to inform strategies for making TB programs more resilient to health system shocks.

Methods: Amongst 98 selected high-burden countries, a GLM analysis was employed to examine the association between ‘missed’ TB case notifications from 2020 to 2021, and various country-level factors including: COVID-19 mortality estimates, lockdown stringency index, GDP per capita, health …

Bmi's Early Echo: Deciphering Adolescent Body Mass Indicator On Adulthood Breast Cancer, Tianyu Feng

Public Health Theses

This study aimed to explore the association between body mass index (BMI) during adolescence and the risk of breast cancer in adulthood among a Chinese female population. We conducted a nested case-control study within a prospective cohort comprising 62,487 Chinese women aged 25-55 years. Adolescent BMI was retrospectively collected via interviewer-administered questionnaires and analyzed as the primary exposure variable. Breast cancer incidence served as the primary outcome. Propensity Score Matching (PSM) was employed to adjust for confounding variables, such as socioeconomic status, lifestyle factors, and adult BMI.Of the 9,163 participants eligible for analysis, 57 breast cancer cases were identified during …

Wearable Passive Air Sampling And Crohn's Disease In Pregnancy, Hazel Ann Fajardo

Public Health Theses

Inflammatory Bowel Disease (IBD) is an immune dysregulation in the gut caused by genetic predisposition and environmental triggers. IBD represents two chronic intestinal inflammatory disorders: ulcerative colitis and Crohn’s Disease (CD), both presenting with multiple gastrointestinal symptoms and complications that affect a patient’s quality of life. Throughout the years, patterns of IBD and CD across the globe vary with trends for IBD prevalence increasing since the 1950s, in North America, Europe, and Australia. Rising incidences in developing regions are seen in Asia and Latin America, and newly industrialized countries in Asia, Africa, and South America, in the 21st century. Several …

Comparing Immunogenicity And Relative Effectiveness Of Siil-Pv (Pneumosil) To Incumbent Streptococcus Pneumoniae Vaccines And Higher-Valent Vaccines In Development, Laura Anne Fitch

Public Health Theses

Background. Streptococcus pneumoniae is an important cause of severe bacterial infections among children worldwide, and is the most common pathogenic cause of community-acquired pneumonia globally.1 There are currently multiple licensed pneumococcal conjugate vaccines that reduce both the risk of nasopharyngeal colonization (NP) and risk of developing IPD, in part by prompting an increase in serum antipolysaccharide immunoglobulin G (IgG) concentration.2 SIIL-PV (Pneumosil) is a vaccine developed by Serum Institute of India and PATH to protect against Streptococcus pneumoniae serotypes most common in LMICs, and at a lower comparative cost to its competitors.3 As this vaccine is relatively new, it is …

Exploring The Associations Between Stereotypes Of Aging And Dementia And Self-Reported Health In Parent-Adult Child Dyads, Yunke Gu

Public Health Theses

Stereotypes and stigma about Alzheimer’s Disease continue to emerge, as the number of populations affected by the disease in society is escalating. The sociocultural context sets the stage for the significant impact that Alzheimer’s has on family dynamics, especially for the adult children who provide over half of informal caregiving. Our study aims to adopt a dyadic approach, examining the interrelated experiences of adult child caregivers and their parents with ADRD. 126 dyads were included in this secondary data analysis. Measures included depressive symptoms and self-reported physical and mental health, stereotypes of aging and of person with memory loss. Results …

Prep-Aring For Prevention: Mental Health, Internalizations, And Contextual Factors As Barriers To Prep Uptake Among Sexual Minority Men And Nonbinary Individuals, Amanda Glatter

Public Health Theses

Pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention in the last ten years, as it is highly effective at preventing infection. PrEP is a strong preventive option for those at risk of HIV, but only 30% of those who could benefit from it were prescribed PrEP in the United States in 2021.2 The purpose of this study is to investigate how mental health, internalizations, and greater contextual factors unique to sexual minority men and nonbinary individuals (SMMNI) impact PrEP knowledge, uptake, and adherence. Survey data from the #MVMNT (Men’s Voices on Mapping, Networks, and Technology) project was utilized to examine the …

A Geospatial Review Of Covid-19 Testing Sites In Kentucky, Jose Marco Hernandez

Public Health Theses

The COVID-19 pandemic has accentuated healthcare access disparities, especially impacting underserved rural and urban areas. This paper investigates the accessibility of COVID-19 testing centers across Kentucky, focusing on spatial and demographic disparities. Using geospatial techniques, the study comprehensively examines testing site distribution and accessibility challenges to inform strategies addressing healthcare disparities. Adopting an observational cross-sectional design, the study utilizes 2020 US Census tract data to assess testing center accessibility in Kentucky's 120 counties. Geospatial analysis, including GIS techniques, maps testing center distribution, evaluates travel time, and examines demographic influences. Statistical tests explore associations between socio-economic factors and testing accessibility. Findings …

Comparing Hpv Vaccination Uptake In Democrat And Republican Us States Using Presidential Elections Voting Patterns In 2016 And 2020, Omar Guerrero

Public Health Theses

Abstract Objective: To investigate the association between state-level voting patterns and Human Papillomavirus (HPV) vaccination coverage in teenagers in the US. Methods: States were categorized as either Democratic or Republican based on the 2016 and 2020 Presidential election results. A paired t-test was conducted to examine the difference between vaccination coverage between the two groups. A multivariable linear regression model was conducted to examine how state-voting patterns are associated with HPV vaccination coverage after adjusting for confounding (percentage of people living in poverty, percentage of uninsured people, percentage of non-white population, and the percentage of people living in rural areas …

Measuring The Differential Effect Of Internalized Homonegativity On Hiv Prevention Outcomes By Sexual Orientation Disclosure Status Among Ymsm Across Two Us Cities, Liv Gotte

Public Health Theses

Human Immunodeficiency Virus (HIV) is highly preventable with the right resources. Nonetheless, young men who have sex with men (YMSM) face disproportionately high rates of HIV acquisition, indicating barriers to effective implementation of prevention strategies. To better understand these implementation barriers, this research explores the relationship between internalized homonegativity and HIV prevention outcomes with a focus on the mediating effect of sexual orientation disclosure to healthcare professionals among YMSM. The data used in this research were collected in a previous prospective cross-sectional study that enrolled YMSM seeking HIV prevention care in two U.S. cities ( Nashville, TN and Buffalo, NY) …

Evaluation Of One Health Education Materials: A Scoping Review And Quality Assessment, Sydney Jones

Public Health Theses

The increasing risk of zoonotic spillover, driven by climate change and evolving human behaviors, requires a systematic shift in pandemic prevention strategies towards a One Health approach. Central to this approach is effective health communication intended to translate knowledge into actionable recommendations for the most vulnerable populations. This thesis aims to systematically evaluate the quantity and quality of existing One Health communication materials through a scoping review and two distinct methods of quality evaluation: the CDC Clear Communication Index and content analysis. Among 82 communication materials identified in the scoping review, the median overall CDC Clear Communication Index score was …

Representation In The Endocrinology Literature And The Effect Of Double-Blinded Review, Gal Hodish

Public Health Theses

Background: There is an open question as to whether authorship in peer-reviewed scientific journal articles is representational. Part of this discrimination has been attributed to bias in the review process of manuscripts, with the suggestion that a double-blind review process ensures equitable outcomes due to complete deidentification of both authors and reviewers. Methods: We performed an automated review of 4,191 manuscripts published at three endocrinology journals with comparable impact factor (two single-blind journals; one double-blind journal) in the years 2010-2023; manuscripts were included in the analysis if they were published from institutions based in the United States. Gender and race/ethnicity …

Real-World Rollout Of Injectable Antiretrovirals For Hiv Prevention And Treatment: Understanding Predictors Of Early Adoption, Liza Koshy

Public Health Theses

Background: Data is limited on implementation of long-acting injectable (LAI) HIV treatment (ART) and prevention (PrEP). We sought to characterize “early adopters” of LAI ART and PrEP in terms of social determinants of health, using a health equity lens. Methods: A retrospective cohort included patients prescribed ART or PrEP through a large Northeast urban health system (January 2021-September 2023). Separate analyses used electronic health record data for: 1) prevention (LAI vs. oral PrEP) and 2) treatment (LAI vs. oral ART). Group differences were examined using ANOVA, chi-square tests or Fisher’s exact tests. Bivariate logistic regression modeled associations between LAI ART …

Diagnostic Evaluation For Abnormal Uterine Bleeding At Emergence Departments In The United States, Wanyi Huang

Public Health Theses

Objectives: To examine the pattern of diagnostic evaluation for abnormal uterine bleeding (AUB) in a national sample of women seeking care at emergency departments (ED) and to identify potential influencing factors with a focus on race and ethnicity.

Methods: We identified 1,049 (unweighted, or 7,900,653 weighted) women without previous cancer diagnosis who visited ED for non-pregnancy related AUB from the National Hospital Ambulatory Medical Care Survey during 2014-2021. The primary outcomes were whether an ultrasound was provided/ordered and whether a referral/return for follow-up consultation was recommended. Multivariable logistic regressions were conducted to assess the association of race and ethnicity with …

Concentrating More Than Oxygen: Assessment Of Exposure To Environmental Contaminants Enhanced By Oxygen Concentrators, Andrew Hong

Public Health Theses

Background: Oxygen concentrators concentrate oxygen from ambient air by selectively removing nitrogen. These concentrators are typically for personal use by individuals with chronic respiratory failure from various cardio-pulmonary disorders, including chronic obstructive pulmonary disease (COPD) and heart failure. Such concentrators also could potentially concentrate harmful air pollutants and increase adverse health risks. Understanding the mechanisms of separation in an oxygen concentrator could be used to minimize exposures to harmful pollutants.Objective/Methods: The objective of this thesis was to characterize exposures to environmental contaminants in the air supplied by oxygen concentrators. The performance of oxygen concentrators was investigated, and the levels of …

Exploring Health Equity In Global Community Health Worker Compensation With Cfir Analysis, Mansoorah Kermani

Public Health Theses

IntroductionEquitable compensation of community health workers (CHWs) is fundamental to sustaining and maximizing the impact of CHW interventions worldwide. Despite their pivotal role in promoting health equity especially among underserved populations, CHWs often encounter inadequate and inconsistent compensation, undermining the sustainability and effectiveness of their efforts. This review delves into various CHW compensation models and implications that may improve CHW compensation and performance across diverse patient populations.

MethodsEmploying the Consolidated Framework for Implementation Research (CFIR), this review systematically examines empirical literature to examine six different compensation models: alternative payment methods (value-based, capitation, and shared savings), grant-based, public sector or governmental, …