Digital Commons Network^™

Shared Burden, Potential Space: A Qualitative Study Of How Psychodynamic Therapists Work With Intergenerational Transmission Of Historical Trauma, Shaun J. Halper

Dissertations and Theses

The intergenerational transmission of trauma (ITT) has been investigated since the 1960s, beginning with research on the descendants of Holocaust survivors. Few qualitative studies, however, have taken up how psychodynamic therapists experience their treatments with adult patients with ITT. This study uses Interpretive Phenomenological Analysis (APA) to analyze adult ITT treatments from the perspective of psychodynamic psychotherapists. Ten licensed clinicians in the NYC tri-state area participated in semi-structured interviews, which were organized around three research aims: how clinicians conceptualized and identified ITT, what effective clinical interventions they used, and how they understood the impact of therapist-patient sameness or difference (regarding …

Examining The Spatial Variability Of Summer Heat In New York City Using Landsat Land Surface Temperature, Ryan Kabir

Dissertations and Theses

Extreme heat is the leading weather-related cause of death in the United States, and in New York City (NYC) approximately 370 heat-related deaths occur annually on average. The spatial distribution of surface heat exposure across NYC is highly uneven, low-income neighborhoods and communities of color consistently face higher temperatures, yet the intraurban spatial structure of land surface temperature (LST) during heatwave events has not been systematically characterized at high resolution. The New York City Panel on Climate Change Fourth Assessment (NPCC4) identifies this as an explicit research gap, noting that its own projections, based on global climate models downscaled to …

Civil War Memory In New York City, 1861-1902, Kevin J. Sugrue

Dissertations and Theses

This thesis examines how New York City experienced, understood, and later remembered the American Civil War, from the outbreak of war (1861) through the dedication of major monuments at the turn of the twentieth century (1902). Although New York was the Union’s largest city and its most significant source of troops, casualties, industrial output, financial capital, and press coverage, the city’s wartime experience was deeply conflicted. As a Democratic stronghold and home to large populations of recent immigrants and working-class laborers, New York’s support for the Union was broad but conditional, fractured by class, ethnicity, race, and political allegiance. These …

Dna Barcoding Complements Citizen Science Identifications In An Arthropod Survey At Governors Island, New York, Malky Gestetner

Dissertations and Theses

Arthropods are declining worldwide, threatened by habitat loss, climate change, and growing urbanization. Efforts to monitor arthropod biodiversity are crucial for conservation policies and for maintaining the ecosystem services provided by these animals in urban environments. Surveys of arthropods have been attempted in many New York neighborhoods, but no formal assessment has been conducted on Governors Island, which harbors 72-acres of parkland within a short boat ride away from Manhattan. This is a deficiency which this study helps to address. Following student-led collection efforts within four Governors Island sites, DNA barcoding was employed to complement specimen identification based on morphology …

Reproducing The French-Canadian Settler Collective In Ontario Through French Language Rights, Monique Woolnough

Journal of Law and Social Policy

Much of settler colonial theory and studies in Canada has focused on the dominant British settler colonial power, with an emerging spotlight on Quebec. Little attention has been paid to French-Canadian settler colonialism in French-Canadian minority provinces such as Ontario. This research aims to make visible this gap in attention and begin to fill in its contours by understanding how the French-Canadian settler colonial project operates in Ontario through law. Through the application of Indigenous, settler colonial, socio-legal and critical feminist and race theories to a review of narrative themes in the jurisprudence of courts and tribunals interpreting Ontario’s French …

Establishing A Rigorous And Standardized Volunteer-Led Hypertension Screening Program: An Implementation Science Approach Using Cfir, Alexander Boakye

Public Health Theses

Hypertension, or high blood pressure, is a common condition characterized by elevated blood pressure. It is a major risk factor for global cardiovascular disease-related illness and death [1]. Uncontrolled hypertension raises the risk of heart attack, heart failure, kidney disease, stroke, and cognitive decline [2-4]. Although routine blood pressure screening, patient education, and early linkage to care are proven strategies for detecting and managing hypertension, awareness, treatment, and control rates remain suboptimal in the United States and worldwide [5,6]. Community-based hypertension programs involving trained non-clinical personnel have shown effectiveness in increasing screening participation and improving blood pressure control, especially among …

Dietary, Physical Activity, Mental Health And Substance Use Among Adolescents In American Samoa: A Cross-Sectional Study, Arwen Chen

Public Health Theses

Adolescent mental health is an important public health concern in American Samoa, but limited research has examined how modifiable health behaviors relate to mental health outcomes in this population. This cross-sectional study examined associations of dietary patterns, sugar-sweetened beverage (SSB) consumption, and physical activity with depressive symptoms, anxiety symptoms, and substance use among 449 high school students in American Samoa. Depressive symptoms, anxiety symptoms, substance use, diet, and physical activity were assessed using self-reported survey measures, including the Patient Health Questionnaire-9 for Adolescents (PHQ-9A), Generalized Anxiety Disorder-7 scale (GAD-7), Dietary Screener Questionnaire (DSQ) items, and the Physical Activity Questionnaire for …

Stigma, Coping & Resilience Among Hiv+ Pwid In St. Petersburg, Rf, Gabrielle Bogut

Public Health Theses

Russia and the other countries that comprised the Soviet Union constitute the one region in which the HIV epidemic continues to expand. Unlike most other regions, more than a quarter of HIV cases in Russia resulted from unsafe injection among people who inject drugs (PWID), and St. Petersburg is among the cities with the highest rates and case counts of HIV. Our study sought to identify actionable psychosocial characteristics influencing receipt of antiretroviral therapy (ART) in PWID. This study assessed survey results from 225 HIV-positive individuals recruited from a Russian NGO that provides PWID with harm reduction services. Individuals were …

Scaling Up Long-Acting Hiv Prep: Perspectives From Health Practitioners On Implementation Of Twice Yearly Lenacapavir, Taylor Braunstein

Public Health Theses

BackgroundLenacapavir (LEN), a twice-yearly subcutaneous injectable Pre-Exposure Prophylaxis (PrEP) medication for HIV, was approved by the Food and Drug Administration (FDA) in 2025. LEN represents a significant advancement in HIV prevention, demonstrating 99.96-100% efficacy in the PURPOSE 1 and 2 clinical trials12,21. Despite its promise in HIV prevention, high list prices, complex loading regimens, and implementation uncertainties pose barriers to widespread uptake. This study examines provider perspectives on the acceptability, feasibility, and appropriateness of LEN as PrEP, as well as perceived implementation barriers and facilitators. Methods This mixed-methods, cross-sectional study recruited licensed US practitioners (RNs, NPs, PAs, MDs, DOs, and …

Multi-Level Barriers And Facilitators To Hiv Care Engagement Among Women Exposed To Intimate Partner Violence, Bernard Frempong

Public Health Theses

Background: WLWH face persistent gaps in HIV care engagement, and IPV is a critical determinant of health in this population. Few studies have examined barriers and facilitators to care by current IPV exposure and relationship status using mixed methods.Methods: We analyzed cross-sectional baseline data from 158 WLWH (M age=54.9 years [SD=10.41]) with lifetime IPV exposure enrolled in the I-CARE study in Connecticut. Participants were grouped by: (1) IPV with a current partner (n=74, 46.8%), (2) currently partnered without IPV (n=19, 12.0%), and (3) not currently partnered (n=65, 41.1%). Barriers and facilitators to HIV care engagement were assessed quantitatively and qualitatively …

Ethics Training For Community Researchers Engaged In Participatory Research: An Analysis Investigating Current Practices In Low-Income Countries, Chioma Chukwunedu

Public Health Theses

Participatory Research (PR) involves individuals affected by a research problem as active collaborators rather than passive subjects. While this approach emphasizes ethical and contextually relevant practices, existing literature suggests that ethics training for community researchers in low-income countries is inconsistently implemented and often not culturally adapted. This study examines how ethics training is currently provided to community researchers engaged in PR in low-income countries.A secondary analysis was conducted using manuscripts identified through a prior systematic review of PR studies in low-income settings. Corresponding authors of included studies were invited to complete an online Qualtrics survey regarding ethics training, participatory research …

Physiological Predictors Of Long-Term Diabetes Risk Among Asian Women With Gestational Diabetes: A Scoping Review, Haiyi Guo

Public Health Theses

Objective:To identify risk factors associated with the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM) among women in East Asia. East Asian populations were selected as the focus because previous studies suggest that women in this region may experience a disproportionately high risk of progression after GDM, even at lower body mass index levels than those typically observed in Western populations. A clearer understanding of these risk factors may help inform more targeted postpartum prevention strategies. Methods: A scoping review was conducted using PubMed, Embase, the Cochrane Library, CNKI, VIP, and SinoMed databases, covering studies published …

Intergenerational Meaning-Making In Cambodian Americans, Caitlin Gojuk

Public Health Theses

Background: Cambodian Americans face high psychological distress yet remain underrepresented in research, especially second-generation individuals. Intergenerational trauma, stigma, and family dynamics shape mental health understanding and expression. Objective: This study examines how Cambodian American young adults make sense of mental health and distress through cultural identity, family relationships, and inherited meanings of trauma. Methods: In-depth semi-structured interviews were conducted with six second-generation Cambodian American young adults residing in Massachusetts, United States. Participants completed brief measures of depression and anxiety symptoms (PHQ-8; GAD-7) to provide a descriptive context. Interviews were analyzed using inductive thematic analysis informed by relational, narrative, and ecological …

Cost-Effectiveness Analysis Of Twice-Yearly Injectable Lenacapavir Versus Daily Oral Prep For Hiv Prevention Among Men Who Have Sex With Men In China, Xueqing Guo

Public Health Theses

Men who have sex with men (MSM) remain a key at-risk population in China’s HIV epidemic while the real-world effectiveness of daily oral pre-exposure prophylaxis (PrEP) among MSM has been limited by low uptake and suboptimal drug adherence. Lenacapavir, a first-in-class capsid inhibitor administered twice yearly, emerged as a highly efficacious, long-acting prevention strategy with the potential to reduce drug burdens associated with current PrEP strategy. However, its high price ($28,000 per patient per year) raises major affordability concerns, and its economic value in China remains understudied. This study aimed to evaluate the cost-effectiveness of lenacapavir compared with daily oral …

Water Resource Governance And Health Equity In Angola, Mads Harner

Public Health Theses

AbstractBackground: Angola is confronting a set of intertwined challenges including water insecurity, increasing climate variability, and deep structural inequality that together intensify the burden of waterborne and water-related diseases (Lombana Cordoba et al., 2021; World Health Organization, 2025). Roughly half of the population does not have reliable access to safe drinking water, and gaps in sanitation and hygiene infrastructure, especially in peri-urban and rural areas, facilitate the spread of illnesses such as cholera, diarrheal diseases, and malaria (UNICEF Angola, 2025; Moreira et al., 2012). These issues are further exacerbated by drought and broader climate variability, and underlying them are historical …

Using The Behavior Change Wheel To Understand The Role Of Antimicrobial Stewardship Programs, Siqi Jiang

Public Health Theses

Objectives: This review aimed to summarize recent antimicrobial stewardship programs (ASPs) implemented in pediatric outpatient settings and analyze how these interventions influence appropriate antibiotic use.Methods: PubMed and Scopus were searched for studies published between 2016 and 2026 globally. Studies were included if they evaluated an antimicrobial stewardship intervention in a pediatric outpatient setting. Only English studies are included. Studies that describe the results of implementations and policies related to ASP are included, including randomized controlled trials, quasi-experiments, natural experiments, quality improvement studies and observational studies, and longitudinal studies. Interventions in selected articles were analyzed using the COM-B (Capability, Opportunity, Motivation-Behavior) …

Family-Related Stressors And Mental Health Among Internally Displaced Young Adults In Mozambique: A Mixed-Methods Study With Implications For Global Mental Health Interventions, Jaspreet Kandola

Public Health Theses

Mental health outcomes among displaced populations are shaped by post-displacement stressors, yet the role of family dynamics, specifically, remains insufficiently understood. This study examines how family-related stressors are associated with mental health among internally displaced young adults in Nampula Province, Mozambique. Using a convergent parallel mixed methods design, this study integrated survey data from 601 participants with qualitative data from in-depth interviews with a subsample of 16 participants. Quantitative analyses showed that family separation and concern for family members in conflict zones were associated with higher posttraumatic stress disorder (PTSD) symptoms, with family separation also linked to higher anxiety and …

Understanding The Influence Of Hiv Status On Perceived Barriers To Reproductive Care For Pregnant Haitian Women: A Framework-Guided Qualitative Analysis, Olivia Mccarthy

Public Health Theses

Background: Haiti has the highest maternal mortality rate in Latin America and the Caribbean, where pregnant women face substantial structural, social, and economic barriers to care. Women living with HIV encounter additional challenges, including stigma, breaches of privacy, and discrimination within healthcare settings. Although prior research has examined maternal health and HIV related stigma in Haiti, little is known about how HIV status differentially shapes pregnant women’s perceptions of barriers to maternal healthcare.Methods: This study draws on data from seven focus groups conducted in rural communities in Haiti’s Centre Department between 2018 and 2019. Participants included 65 pregnant women, representing …

Telehealth Adaptation Of Bright Bodies Program, A Pediatric Intensive Lifestyle Intervention For Obesity: Caregiver Experiences And Implications For Future Implementation, Xiayu "Katniss" Ni

Public Health Theses

Introduction: The Virtual Bright Bodies Program is a telehealth adaptation of Yale's evidence-based family-based intensive lifestyle intervention targeting pediatric obesity, delivered through video conferencing during and following the COVID-19 pandemic. This retrospective cross-sectional study evaluated caregiver experiences with the telehealth-adapted program among 25 caregivers of children aged 7-16 years who completed a post-program survey.

Method: Caregiver perceptions were assessed using the adapted Telehealth Satisfaction Questionnaire (TSQ, 13 items), the adapted Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ, 4 items), and the Acceptability of Intervention Measure (AIM, 4 items). Quantitative data were analyzed descriptively, followed by exploratory subgroup analyses examined whether acceptability …

Protecting Older Individuals From Age Discrimination Harming Psychological Well-Being: Role Of Neighborhood Cohesion, Tongyu Qiu

Public Health Theses

Age discrimination is known to harm older adults’ mental health, yet factors that may protect against this harm have received little attention. Prior studies have focused primarily on individual-level factors rather than community-level characteristics, such as neighborhood cohesion, which may be more amenable to large-scale interventions and policies. To our knowledge, no prior study has examined whether neighborhood cohesion buffers the association between age discrimination and worse psychological well-being in older adults. Participants aged 60 years and older were drawn from the Midlife in the United States (MIDUS) study. We hypothesized that baseline age discrimination would predict worse psychological well-being …

Perceptions Of Sexual Health Stigma Among Adolescents And Pediatric Primary Care Providers In The United States: A Qualitative Exploration, Avanti Shah

Public Health Theses

Background: In the United States (U.S.), young people aged 13–24 experience disproportionately poor sexual health outcomes. Sexual health stigma has been identified as a key barrier to uptake of sexual health services (e.g., STI/HIV testing), particularly for adolescents younger than age 18. This study aimed to describe and compare how U.S. adolescents and pediatric primary care providers perceive sexual health stigma and its potential influence on adolescent sexual health service access and utilization.

Methods: The study utilized existing data from two qualitative studies that explored pediatric primary care providers’ awareness of state laws regulating minors’ access to confidential sexual health …

Assessing Cardiovascular Disease Risk And Healthcare Access Barriers To Identify Prevention Strategies Among Market Vendors In Uganda, Yumi Yang

Public Health Theses

Background: Cardiovascular disease (CVD) accounts for 10% of all deaths in Uganda, making it the leading cause of death among non-communicable diseases (NCDs) in the country. Across sub-Saharan Africa, urban market vendors serve as key participants in the informal workforce. Research from West Africa suggests that vendors, many of whom are women, are a vulnerable population with high prevalence of CVD risk factors and structural barriers to healthcare access. However, limited research has examined this population in East Africa, and the present study is the first to characterize 10-year CVD risk and assess healthcare barriers among market vendors in Uganda.Methods: …

Examination Of Awareness And Frequency Of Behavioral Masking/Camouflaging Based On Life Experiences, Elizabeth M. Smith

Senior Honors Theses and Projects

Camouflaging behaviors are typically employed by individuals with autism spectrum disorder (ASD) to appear more in line with societal norms and avoid social ostracization. This study examined the connections between camouflaging and theatre experience, mental health diagnostic status, and levels of self-monitoring. In the study, participants completed a brief, 30- minute survey online examining camouflaging, autistic traits, self-monitoring, and life experiences across individuals of different age ranges. All participants were 18 years of age or older, completed a consent form, and received a debriefing. All responses were completely anonymous. The results showed significantly higher levels of camouflaging behaviors in participants …

Arbitration Overcorrection? Interpreting Arbitration Clauses After Morgan V. Sundance, Peter Constable Alter

Chapman Law Review

In 2022’s Morgan v. Sundance, Inc., the Supreme Court ruled that the Federal Arbitration Act (FAA) does not allow courts to “devise novel rules to favor arbitration over litigation.” Applying that principle, the Court held that the Eighth Circuit erred by grafting an arbitration-specific prejudice requirement onto the generally applicable waiver standard when deciding whether a defendant waived its right to arbitrate by proceeding in court. The Supreme Court traced this error to a misunderstanding of the FAA’s core purpose. While courts, including the Supreme Court itself, routinely interpreted the FAA as establishing a liberal “policy favoring arbitration,” the …

The Military Discharge Review Boards’ Irregular Presumption Of Regularity, Jessica Lynn Wherry

Chapman Law Review

“There is a presumption of regularity in the conduct of governmental affairs.” With these twelve words in the Department of Defense’s Code of Federal Regulations, the military discharge review boards (DRBs) have denied relief to thousands of veteran-applicants seeking a discharge upgrade. While seemingly innocuous, this administrative principle has become a nearly insurmountable barrier to relief for veterans with a less-than-honorable discharge. Veterans with a less-than-honorable discharge are generally ineligible for a range of veterans benefits, including health care and education benefits, and they have higher suicide rates compared to honorably discharged veterans.

For most veteran-applicants, the administrative path to …

China-U.S Relations: Techno‑Nationalism, Strategic Entrapment, And Taiwan., Prince Y. Munya Mr.

Dissertations and Theses

Abstract

This thesis examines how China–U.S. relations evolved from a manageable strategic rivalry into a more rigid and increasingly difficult form of competition after the Obama administration’s “Pivot to Asia.” It argues that traditional explanations such as power transition theory alone cannot fully explain the deterioration of the relationship. Instead, the study introduces the concept of techno-nationalism, where technological leadership becomes tied to national identity, economic security, and geopolitical power, particularly in areas such as semiconductors, artificial intelligence, and supply-chain security. Through historical analysis and policy tracing, the thesis develops the concept of strategic entrapment to explain how both Washington …

The Limits Of Economic Sanctions: Why Western Efforts Did Not Fully Economically Isolate Russia After 2022 Invasion Of Ukraine, Jonibek Oblokulov

Dissertations and Theses

No abstract provided.

The Complex Decision-Making Processes Of Rural Emerging Adults: Counseling Beyond Dualism, Donna M. San Antonio Dr.

Faculty Scholarship

Rural adolescents approach the transition out of high school with individual concerns about making an emotionally or financially expensive “mistake,” family concerns about young people leaving home, and national and local concerns about declining rural economies and out-migration. The literature concerning this topic considers factors that influence youth aspirations in rural areas, such as economic barriers, the way higher education is valued, and perceptions of rural places as lacking in opportunity. However, there has been little study of the myriad interpersonal, emotional, and self-identity inputs that are part of the decision-making processes of rural emerging adults, and little is known …

“Shaking The Ladder” Reveals How Analytic Choices Can Influence Associations In Nutrition Epidemiology: Beef Intake And Coronary Heart Disease As A Case Study, Colby J Vorland, Lauren E O'Connor, Beate Henschel, Cuiqiong Huo, James M Shikany, Carlos A Serrano, Robert Henschel, Stephanie L Dickinson, Keisuke Ejima, Aurelian Bidulescu, David B Allison, Andrew W Brown

Children’s Nutrition Research Center Staff Publications

Nutrition epidemiological models involve many analytic decisions, such as defining exposures, selecting which covariates to include, or configuring variables in different ways. We explored the impact of analytical decisions on conclusions in nutrition epidemiology using self-reported beef intake and incident coronary heart disease as a case study. We used REasons for Geographic and Racial Differences in Stroke (REGARDS) data, and selected covariates and their configurations from published literature to recapitulate common models used to assess associations between meat intake and health outcomes. Three model sets were designed: sets one and two used continuous and quintile-defined beef intakes, respectively, each with …

Examining Widely Held Propositions On Human Dietary Protein Needs And Benefits: A Critical Review Of The Science That Shapes Both The Data And Our Understanding Of An Essential Macronutrient, Mitchell M Kanter, Sally Aaron, Steven N Austad, Andrew W Brown, Nicholas A Burd, Wayne W Campbell, Mark Cope, Teresa A Davis, John W Erdman, Miguel Freitas, Kristen Hicks-Roof, Samuel Klein, Wantanee Kriengsinyos, Dudley W Lamming, Donald K Layman, Heather J Leidy, Kevin C Maki, Richard D Mattes, Shalene Mcneill, Daniel R Moore, Stefan M Pasiakos, Stuart M Phillips, David Raubenheimer, Wendy Reinhardt, Nancy R Rodriguez, Stephen Simpson, Hans H Stein, Luc J C Van Loon, Connie M Weaver, David B Allison

Children’s Nutrition Research Center Staff Publications

The essentiality of protein in the human diet is unequivocal. Yet researchers, clinicians, and lay people often believe numerous propositions about dietary protein despite insufficient supporting or refuting data in some instances. To address this disconnect, and to "pressure-test" current beliefs about dietary protein, the Indiana University School of Public Health-Bloomington convened a workshop in February 2025 titled "Human Dietary Protein Needs and Benefits: A Critical Assessment of Postulated Propositions." More than 20 international experts discussed (1) methodologic issues affecting data acquisition and interpretation; (2) "optimal" dietary protein intakes and effects on muscle protein synthesis rates, muscle protein accretion, …