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Essays On Accelerated Failure Time Models For Recurrent Event Data, Emmanuel Masavo Djegou

Doctoral Dissertations

Recurrent event data arise in many fields such as medicine, reliability, insurance, and economics, where the same event may occur repeatedly for a subject. Accelerated Failure Time (AFT) models provide an intuitive framework for relating covariates to event times and offer a useful alternative to proportional hazards models, allowing direct prediction of event timing under right censoring. However, existing AFT extensions for recurrent events, such as accelerated gap time (AGT) models, often fail to account for interventions between events and may not capture complex temporal patterns.

In this work, we first propose a class of semiparametric AGT models incorporating an …

Do Lineage-Based Inheritance Norms Matter In Kinship Care Arrangements? Exploring Inheritance Paths In Grandparent Kinship Care Practice In Ghana, Hajara Bentum, Alhassan Abdullah, Vicki Banham, Kwadwo Adusei-Asante

Research outputs 2022 to 2026

Kinship lineage and inheritance norms in Ghana play a significant role in shaping family decisions. Research has shown that kinship lineage and inheritance norms determine kin membership for children by specifying whether they belong to their maternal or paternal family, as well as whether they can inherit properties of their biological father or mother. The notion of kinship membership has shaped parenting and child welfare practices in Ghana, including child maintenance payments and parental neglectful behaviours. This research explored whether kinship-based inheritance norms could influence decisions about selecting a grandmother (maternal vs. paternal grandmother) as a child’s caregiver. We interviewed …

Brilliant Little Things: Drama-Based Mindfulness To Support Pre-Service Teacher Wellbeing, Christina C. Gray, John O’Rourke

Research outputs 2022 to 2026

Wellbeing is increasingly recognised as a critical concern in teacher education, yet pre-service teachers remain vulnerable to stress, burnout, and early attrition. This study examines Brilliant Little Things, an arts-based wellbeing initiative embedded within a drama education program. Using a phenomenological approach, the research draws on interviews, reflective journals, group chat posts, photographs, and artwork to explore how drama-based mindfulness practices can support the wellbeing of drama educators. Findings reveal how the production fostered reflection, connection, and emotional insight, offering a space for mindfulness and community. Narratives highlight the value of creative, relational pedagogies in strengthening resilience. This research contributes …

Compassionate Communities, Māori Ageing And End-Of-Life: A Systematic Review, Melissa Carey, Kathleen Mason, Levi Fox, Tess Moeke-Maxwell, Merryn Gott

Research outputs 2022 to 2026

Background: Māori people in Aotearoa New Zealand and Australia experience significant healthcare inequity as they age and towards the end of their lives. Compassionate community approaches to ageing and end-of-life care are increasing in popularity throughout the world. However, this approach has arisen from Eurocentric knowledge systems and not from First Nations people and their communities. Objectives: This research aimed to gain insight into what the Compassionate Communities approach means for First Nations people and identify implications for Māori in Aotearoa New Zealand and Australia. A systematic literature review explored the intersection of Compassionate Communities and First Nations peoples’ perspectives …

The Effects Of A Work-Strengths Affirmation Intervention On Death Anxiety, Begüm Orhan, Margaret M. Nauta

Faculty Publications – Psychology

Meaning Management Theory suggests that engaging with meaning-related resources helps individuals constructively regulate consciously experienced death anxiety. Consistent with that theory, we tested whether a single-session, online work-strengths affirmation intervention reduces college students’ (N = 201) death anxiety. Participants completed baseline measures of death anxiety, meaning in life, and self-esteem. One week later, they were randomly assigned to complete either a work-related strengths reflection exercise or a neutral writing task. We assessed outcomes immediately post-intervention and two weeks later. The intervention did not significantly reduce death anxiety in the full sample. Exploratory analyses showed small, immediate reductions among participants …

Intravenous Infusion Of Nicotinamide Adenine Dinucleotide (Nad+) Versus Nicotinamide Riboside (Nr): A Retrospective Tolerability Pilot Study In A Real-World Setting, Kirsten Reyna, Greer Heinzen, Nikita Patel, Marie Ritter, Alexandra Siojo, Henry Legere, Rachele Pojednic

Research outputs 2022 to 2026

Background: Nicotinamide adenine dinucleotide (NAD⁺) is a cofactor for NAD⁺-dependent enzymes that regulate DNA repair, cellular metabolism, and immune function. Supplementation with NAD⁺ and its precursors is commonly used to prevent age-related disease and extend healthspan. Commercial clinical and wellness settings increasingly provide intravenous (IV) NAD⁺ and nicotinamide riboside (NR) despite limited evaluation of safety and effectiveness. These considerations are important, as NAD⁺ and its precursors differ in reported side effects, cellular uptake, and metabolism. This study sought to compare commercially administered NAD⁺ IV and NR IV in humans by evaluating infusion …

When Does Alzheimer's Disease Start? Plasma Aβ42/40 Assays Show Steep Changes At Aβ-Pet Centiloid 15, Mean Age Of 66 Years, Rodrigo Cánovas, Timothy Cox, Vincent Doré, Pierrick Bourgeat, Jurgen Fripp, Azadeh Feizpour, Rosita Shishegar, Christopher J. Fowler, Simon M. Laws, Tenielle Porter, Stephanie Rainey-Smith, Leslie M. Shaw, Randall J. Bateman, Yan Li, Ovod Vitaliy, Michael W. Weiner, John C. Morris, Tammie L.S. Benzinger, Suzanne E. Schindler, Akinori Nakamura, Takeshi Iwatsubo, Takeshi Ikeuchi, Takashi Kato, Paul Maruff, Hamid R. Sohrabi, Christopher C. Rowe, Ralph Martins, Colin L. Masters, James Doecke

Research outputs 2022 to 2026

Objective: Sporadic late-onset Alzheimer's disease (AD) is characterized by a long pre-clinical phase where amyloid-beta (Aβ) and tau begin to accumulate in the brain. The primary objective was to determine the age at which AD starts by finding the average population age when both positron emission tomography (PET) Aβ (Aβ-PET) and plasma Aβ42/40 become abnormal. Methods: Two high performance immunoprecipitation-mass spectrometry (IP-MS) assays (WashU/C2N and Shimadzu) were tested on samples from 1,450 participants who were diagnosed as cognitively unimpaired (CU), mild cognitive impairment (MCI), or AD-dementia across 4 international cohorts. Natural history modeling and trajectory analyses of the combined Aβ-PET …

Providing Help In Europe: Are In-Household Care And Outside-Household Support Associated With Grandparental Child Care?, Roosa Maria Savela, David A. Coall, Mirkka Danielsbacka, Antti O. Tanskanen

Research outputs 2022 to 2026

Grandparental child care is a vital form of social support that can enhance family well-being. Prior studies have found that older adults who provide support to one individual are more likely to offer help to others within their families and social networks. However, little research has examined whether helping others is associated with grandparental child care. Using data from the Survey of Health, Aging and Retirement in Europe, covering 27 countries, and using multinomial regression models, we show that (a) support provided to individuals outside the household is associated with increased grandparental child care, whereas (b) family care provided within …

Bulletin Of Yale University School Of Nursing 2026-2027, Yale School Of Nursing

Yale School of Nursing Bulletins and Catalogues

Series 122, Number 16

September 5, 2026

Promoting The Concept Healthy Ageing For Use In Gerontological Health And Social Care Policy And Practice, Claire Donnellan

Research outputs 2022 to 2026

Aims: The concept of healthy or successful ageing dates back to the 1960s, where its goal is more realistic in today's ageing society as a result of effective interventions to control and reduce disability and health risks. The aim of this paper is to outline the importance of defining ageing, the semantics and indicators used, and to identify common challenges for health professionals' understanding and application of a healthy ageing approach in their everyday clinical practice. Design and Methods: This discursive paper demonstrates how realistic ageing indicators are for highlighting the variation and impact of challenges associated with ageing. It …

Patients’ And Health Professionals’ Perspectives On Transforming The Burden Of Haemodialysis (Hd) Treatment To An Opportunity: An In-Depth Qualitative Investigation, Haseeba Shouket, Eyal Gringart, Deirdre Drake, Ulrich Steinwandel

Research outputs 2022 to 2026

Most patients with End Stage Kidney Failure (ESKF) in Pakistan must undergo maintenance haemodialysis (HD) to survive. Session duration and the often lifelong nature of this treatment, along with other factors associated with HD, make it difficult to tolerate. This study took a positive psychological perspective and considered that HD sessions’ duration, which has been a major challenge for HD patients, can be turned to an opportunity for patients’ meaningful engagement. Such meaningful engagement can positively transform Pakistani patients’ experience of HD and extend into their lives outside HD. Twenty-four HD patients and six healthcare professionals were interviewed to explore …

Flourishing In Hong Kong: An Analysis Of Wellbeing-Related Outcomes In The Global Flourishing Study, Lanxi Huang, Xu, Maggie Yue Zhao, Hanchao Hou, Aaron Jarden, Tim Lomas, Brendan Case, R. Noah Padgett, Ying Chen, Richard G. Cowden, Byron R. Johnson, Tyler J. Vanderweele

Research outputs 2022 to 2026

Using population-based data from Hong Kong (N = 3,012) drawn from Wave 1 of the Global Flourishing Study, this study examines the distribution of multidimensional flourishing and explores sociodemographic variation across psychological, social, physical, and economic domains. Overall, respondents reported relatively strong happiness and life satisfaction and financial wellbeing, alongside less favourable social connectedness. Patterns of flourishing varied across age, gender, education, employment, and religious affiliation, highlighting meaningful heterogeneity within the population. Early older adults tended to show more favourable wellbeing profiles, whereas younger adults and nonreligious individuals displayed comparatively lower scores across several domains. Educational attainment and employment status …

The Career Choices Of Final Year Nursing Students In The United Kingdom: A Qualitative Study., Kevin Hambridge, Frazer Underwood, Gosia Bettache, Matt Carey, Halil Kaya, Lisa Burrows, Rachel Tims, Christian Brailsford

School of Nursing and Midwifery

Aim: The aim of this study is to explore the career choices of final year under-graduate nursing students in the United Kingdom. Background: Worldwide there is a decreasing number of nurses and in the United Kingdom there is a decreasing amount of nursing students. There is sparce evidence relating to the career's choices of nursing students and reasons for those choices. Obtaining a deeper comprehension of these choices may aid healthcare employers, in partnership with universities, to design the future nursing workforce. Design: A qualitative design was used. Methods: Twenty-one final year under-graduate nursing students from across a range of …

Barriers To Mental Healthcare In Rural Agricultural Communities, Monica Salonga

Research Honors

Mental health diagnoses have become increasingly concerning in the United States (US). In 2024, 60 million adults in the United States experienced a mental illness, and over 14 million adults stated they had suicidal thoughts (Reinert et al., 2025). The Center for Disease Control (CDC) reports around 4,000 suicide-related deaths in the United States every year (CDC, 2025). One population that suffers from disproportionate rates of suicide is farmers and farm families. Farmers are ranked #4 in the United States regarding suicide rates (Miller & Rudolphi, 2022). Between 2003 and 2018, there were 1,935 suicide-related deaths committed by farmers (Miller …

The Experience Of Homelessness Among Older Adults In Bhutan - A Narrative Inquiry Study, Phuntsho Om

Theses: Doctorates and Masters

A shift in the demographics of homelessness started to occur in the 1900s, with a significant increase in the number of middle-aged or elderly men and women being recognised as a part of the homeless population. The rising urgent global concern of homelessness of older adults necessitates a deeper understanding of the lived experience and holistic well-being of these marginalised adults. This thesis aimed to explore the phenomenon of homelessness of older adults in Bhutan, which is an often neglected topic in both national and international gerontological research.

Employing narrative inquiry within the constructivist approach as articulated by Pino Gravidia …

International Comparison Of Oral Hypofunction Among Community-Dwelling Older Adults In Three Asian Countries: A Cross-Sectional And Multi-National Study, Ryosuke Yanagida, Kohei Yamaguchi, Kazuharu Nakagawa, Chantaramanee Ariya, Patcharaphol Samnieng, Megan F Liu, Nai-Chia Teng, Ting-Yi Renn, Rieko Moritoyo, Sirinthip Amornsuradech, Kanako Yoshimi, Haruka Tohara

Journal of Dental Sciences

Background/purpose: In aging Asian societies, oral hypofunction among older adults has gained importance, with most epidemiological studies conducted in Japan. We aimed to compare oral function in community-dwelling older adults in Japan, Taiwan, and Thailand.

Materials and methods: Community-dwelling older adults aged ≥ 60 years who participated in Yokohama, Taipei, and Phitsanulok health surveys (May 2022–September 2024) were included. Age, sex, body mass index (BMI), and denture use data were recorded. Using the Japanese Society of Gerodontology diagnostic framework, seven oral hypofunction components were evaluated: oral hygiene, oral dryness, occlusal force, tongue–lip motor function, tongue pressure, masticatory function, …

African American Attitudes Toward Supporting Older Adults: Differences By Lifecourse Stage, Nekehia T. Quashie, Sarah E. Patterson, Michelle A. Stage, Neil K. Mehta

Public Health Faculty Publications

African Americans express stronger norms of familism compared to other racial and ethnic groups in the United States. Frequently overlooked is whether attitudes toward family and/or government support for older adults vary by lifecourse stage (young adult, midlife, and older adults) and type of support among African Americans. Using data from the 2001-2003 National Survey of American Life Adult Reinterview (n=1696, aged 18-90), multinomial logistic regression analyses were used to examine whether attitudes toward family, equal family and government, or government responsibility for financial, household chores, and personal care support to older adults vary by lifecourse stage. Findings showed that …

Creating Community Through Walking The Talk For Dementia, Kate Irving, Fernando Aguzzoli Peres, Walter D. Dawson, Jonathan Adrián Zegarra-Valdivia, Lingani Mbakile-Mahlanza, Iracema Leroi, Sherril B. Gelmon

Institute on Aging Publications

Objectives

Creating community is not only therapeutic—it has been described as essential. This study explores a process of community-building among people with lived and professional experience in the dementia field, during Walking the Talk for Dementia (WTD), a week-long, immersive event on the Camino de Santiago in Spain. Absence of community can lead to fragmented support for both people living with dementia and their care partners and for those working in the field. Achieving a sense of community, however, can be complex.

Methods

A qualitative evaluation was conducted with 79 participants from 27 countries, incorporating pre-, during and post-event reflections. …

Senolytic-Resistant Senescent Cells Have A Distinct Sasp Profile And Functional Impact: The Path To Developing Senosensitizers, Utkarsh Tripathi, Masayoshi Suda, Vagisha Kulshreshtha, Bryan T Piatkowski, Allyson K Palmer, Nino Giorgadze, Christina Inman, Nathan Gasek, Ming Xu, Kurt O Johnson, Tamar Pirtskhalava, Selim Chaib, Larissa P G Langhi Prata, Yi Zhu, Renuka Kandhaya-Pillai, Stefan G Tullius, Saranya P Wyles, Rambabu Majji, Hari Krishna Yalamanchili, David B Allison, Tamar Tchkonia, James L Kirkland

Faculty, Staff and Students Publications

The senescent cell (SC) fate is linked to aging, multiple disorders and diseases, and physical dysfunction. Senolytics, agents that selectively eliminate 30%-70% of SCs, act by transiently disabling the senescent cell antiapoptotic pathways (SCAPs), which defend those SCs that are proapoptotic and pro-inflammatory from their own senescence-associated secretory phenotype (SASP). Consistent with this, a JAK/STAT inhibitor, Ruxolitinib, which attenuates the pro-inflammatory SASP of senescent human preadipocytes, caused them to become "senolytic-resistant". Administering senolytics to obese mice selectively decreased the abundance of the subset of SCs that is pro-inflammatory. In cell cultures, the 30%-70% of human senescent preadipocytes or human umbilical …

Genome-Wide Gene-Sleep Interaction Study Identifies Novel Lipid Loci In 732,564 Participants, Raymond Noordam, Wenyi Wang, Pavithra Nagarajan, Heming Wang, Michael R Brown, Amy R Bentley, Qin Hui, Aldi T Kraja, John L Morrison, Jeffrey R O'Connel, Songmi Lee, Karen Schwander, Traci M Bartz, Lisa De Las Fuentes, Mary F Feitosa, Xiuqing Guo, Xu Hanfei, Sarah E Harris, Zhijie Huang, Mart Kals, Christophe Lefevre, Massimo Mangino, Yuri Milaneschi, Peter J Van Der Most, Natasha L Pacheco, Nicholette D Palmer, Varun Rao, Rainer Rauramaa, Quan Sun, Yasuharu Tabara, Dina Vojinovic, Yujie Wang, Stefan Weiss, Qian Yang, Wei Zhao, Wanying Zhu, Md Abu Yusuf Ansari, Hugues Aschard, Pramod Anugu, Themistocles L Assimes, John Attia, Laura D Baker, Christie Ballantyne, Lydia Bazzano, Eric Boerwinkle, Brain Cade, Hung-Hsin Chen, Wei Chen, Yii-Der Ida Chen, Zekai Chen, Kelly Cho, Ileana De Anda-Duran, Latchezar Dimitrov, Anh Do, Todd Edwards, Tariq Faquih, Aroon Hingorani, Susan P Fisher-Hoch, J Michael Gaziano, Sina A Gharib, Ayush Giri, Mohsen Ghanbari, Hans Jörgen Grabe, Mariaelisa Graff, C Charles Gu, Jiang He, Sami Heikkinen, James Hixson, Yuk-Lam Ho, Michelle M Hood, Serena C Houghton, Carrie A Karvonen-Gutierrez, Takahisa Kawaguchi, Tuomas O Kilpeläinen, Pirjo Komulainen, Henry J Lin, Gregorio V Linchangco, Annemarie I Luik, Jintao Ma, James B Meigs, Joseph B Mccormick, Cristina Menni, Ilja M Nolte, Jill M Norris, Lauren E Petty, Hannah G Polikowsky, Laura M Raffield, Stephen S Rich, Renata L Riha, Thomas C Russ, Edward A Ruiz-Narvaez, Colleen M Sitlani, Jennifer A Smith, Harold Snieder, Tamar Sofer, Botong Shen, Jingxian Tang, Kent D Taylor, Maris Teder-Laving, Rima Triatin, Michael Y Tsai, Henry Völzke, Kenneth E Westerman, Rui Xia, Jie Yao, Kristin L Young, Ruiyuan Zhang, Alan B Zonderman, Xiaofeng Zhu, Jennifer E Below, Simon R Cox, Michelle Evans, Myriam Fornage, Ervin R Fox, Nora Franceschini, Sioban D Harlow, Elizabeth Holliday, M Arfan Ikram, Tanika Kelly, Timo A Lakka, Deborah A Lawlor, Changwei Li, Ching-Ti Liu, Reedik Mägi, Alisa K Manning, Fumihiko Matsuda, Alanna C Morrison, Matthias Nauck, Kari E North, Brenda Wjh Penninx, Michael A Province, Bruce M Psaty, Jerome I Rotter, Tim D Spector, Lynne E Wagenknecht, Ko Willems Van Dijk, Lifelines Cohort Study, Million Veteran Program, Cashell E Jaquish, Peter Wf Wilson, Patricia A Peyser, Patricia B Munroe, Paul S De Vries, W James Gauderman, Yan V Sun, Han Chen, Clint L Miller, Thomas W Winkler, Dabeeru C Rao, Susan Redline, Diana Van Heemst

Faculty, Staff and Student Publications

Background and aims: Deviations from the population mean in sleep duration have been associated with increased risk for developing dyslipidemia and atherosclerotic cardiovascular disease, but the mechanism of effect is poorly characterized. We performed large-scale genome-wide gene-sleep interaction analyses of lipid levels to identify genetic variants underpinning the biomolecular pathways of sleep-associated lipid disturbances and to suggest possible druggable targets.

Methods: We collected data from 55 cohorts with a combined sample size of 732,564 participants (87 % European ancestry) with data on lipid traits (high-density lipoprotein [HDL-c] and low-density lipoprotein [LDL-c] cholesterol and triglycerides [TG]). Short (STST) and long (LTST) …

Lost Before Forgetting: Objective Driving Metrics Track Navigation Deficits Tied To Preclinical Alzheimer's Disease, Yiqi Zhu, Ramkrishna K Singh, Semere Bekena, David C Brown, Chen Chen, Matthew Blake, Jean-François Trani, Ganesh M Babulal

2020-Current year OA Pubs

BACKGROUND AND OBJECTIVES: Navigation is a complex, multisensory process in which subtle changes may emerge before the onset of symptomatic Alzheimer's disease (AD). This study investigated whether navigation abilities were associated with amyloid and tau pathology in cognitively normal older adults.

RESEARCH DESIGN AND METHODS: Among 285 cognitively unimpaired older adults, navigation and objective driving behaviors were assessed using the self-reported Santa Barbara Sense of Direction Scale (SBSOD) and a datalogger, respectively. Amyloid and tau burden were quantified using PET-MRI 2 years post-initial driving data collection. Linear mixed-effects models were used to evaluate the associations between biomarker status and longitudinal …

Biological Aging Acceleration In Major Depressive Disorder: A Multi-Omics Analysis, Breno Satler Diniz, Shangshu Zhao, Gabin Drouard, Eero Vuoksimaa, Miina Ollikainen, Eric J Lenze, Ming Xu, Richard H Fortinsky, George A Kuchel, Jaakko Kaprio, Chia-Ling Kuo

2020-Current year OA Pubs

Major depressive disorder (MDD) is linked to a higher risk of premature aging, but the mechanisms underlying this association remain unclear. Using data from two population cohorts (UK Biobank and Finnish Twin Cohort), we evaluate the relationship between systemic and organ-specific proteomic and epigenetic aging acceleration and MDD. A lifetime history of MDD was associated with accelerated proteomic aging at both systemic and organ-specific levels-including the brain-in both cohorts, with stronger associations than those observed with systemic epigenetic aging. Systemic and brain-specific proteomic aging acceleration were linked to higher risks of incident MDD and a greater risk of Alzheimer's disease, …

The Association Between Major Depressive Disorder, Plasma Biomarkers Of Alzheimer's Disease, And Mild Behavioral Impairment Among Older Adults, Yiqi Zhu, Jean-Francois Trani, Ramkrishna K Singh, Semere Bekena, Jonathan Williams, Eric J Lenze, Ganesh M Babulal

2020-Current year OA Pubs

INTRODUCTION: Plasma biomarkers and mild behavioral impairment (MBI) are associated with dementia risk, but their relationships with major depressive disorder (MDD) are understudied. This study aimed to examine associations between plasma biomarkers of Alzheimer's disease (AD) and MBI among older adults with and without MDD.

METHODS: Older adults aged ≥65 were recruited from longitudinal studies of depression and AD (

RESULTS: Older adults with MDD were more likely to endorse MBI. After adjustment, Aβ42/Aβ40 and p-tau217/np-tau217 positivity were associated with MBI among those with MDD but not among those without.

DISCUSSION: Neuropsychatric symptoms (NPS) and biomarkers are AD risk factors. …

Alzheimer's Disease Stage 1 And 2: Biology, Diagnostics, And Treatment, Suzanne E. Schindler, Sarah M. Hartz, Et Al.

2020-Current year OA Pubs

No abstract provided.