Digital Commons Network^™

Exploring The Challenges And Interventions For Type 1 Diabetes In Young Children, Patra Chisom Ezeamii, Nenrot Gopep, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Domestic Violence And Mental Health: A Complementary Perspective, Olayemi Aloba, Jacob Gakpo, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

Does The Use Of Audits Decrease The Infection Rate In A Medical Care Setting?, Kylie Borchert, Kristel K. Bakker

Annual Research Symposium

Nosocomial infections are a significant health concern in medical settings. Reports of low compliance rates with hand hygiene standards, guidelines of which are outlined and mandated by the CDC and WHO, are frequent. Factors contributing to nonadherence include lack of knowledge and an unclear understanding of correct techniques (4). Evidence shows that improved hand hygiene can reduce infection rates (1), especially when healthcare providers are included in interventions that aim to improve compliance (4).

Survey Of Prairie Lakes For Microplastics In Eastern South Dakota, Vanessa Ocansey, Basbo Ayelazono, Kristel K. Bakker

Annual Research Symposium

Microplastics are plastics that have been worn down into small fragments that invade aquatic environments and have cultivated themselves into most corners of the world. They are defined as being less than 5 mm in size and categorized as either primary (manufactured small) or secondary (broken down from larger plastics) (Calcutt, Jo, et al., 2018). Microplastics have been found in ocean surface water and deep-sea benthic zones as well as freshwater systems. They can be harmful to organisms, ecosystems, and human health, though the full extent of their impact is not yet known.

Consumer Financial Data And Non-Horizontal Mergers, Linda Jeng, Jon Frost, Elisabeth Noble, Chris Brummer

Fordham Journal of Corporate & Financial Law

This Article explores the potential competitive implications of non-horizontal mergers where they involve extensive consumer data, including consumer financial data. As data become increasingly central to firm strategy, mergers between data-rich firms, while potentially leading to positive outcomes, can also create market power in ways not entirely accounted for by traditional antitrust theory. The Article considers some of these implications. It introduces new metrics for valuing data sets held by merging firms that could help competition authorities evaluate market impacts more effectively. The Article then suggests potential tools to mitigate anti-competitive effects of data-rich mergers. It advocates for further research …

Forgiveness Of Self And Others: A Group Approach To The Treatment Of Ptsd And Other Trauma Related Experiences, Jarrod A. Mask

Psychology Doctoral Specialization Projects

Forgiveness is often misinterpreted as the act of forgetting what happened or offering one’s offender the ability to redeem themselves for their wrongdoings. This is simply not the case. Rather, forgiveness is the process of the individual making the unprovoked choice to release their resentment in their own voyage towards living a free and happy life without being imprisoned from the emotions un-forgiveness produces. Forgiveness, as it may be a necessary process for the individual is to attain a sense of peaceful acceptance and liberation from their pain, is not an easy process. Providing a peer-based support system in the …

The Thing With Feathers: An Introduction To Hope-Efficacy Affective Reappraisal Training (Heart), David Bishop

Psychology Doctoral Specialization Projects

Hope is an essential cognitive state as it relates to motivation and aspirations and allows one to feel efficacious in pursuing desired outcomes in life. When used ineffectively, it may also have negative effects on well-being and quality of life in the disappointment that follows from unmet expectations. Hopelessness (aka despair), on the other hand, occurs when one loses hope, and when one is unable to recover from despair, the consequences may be extreme. Despair may result in negative impacts to well-being and mental health and may also present in individuals’ behaviors. Those who experience extreme, severe, and frequent despair …

Demonstration Of An Enhanced Dosing Pattern For Debulking Large And Bulky Unresectable Tumors Via Differential Hole-Size Spatially Fractionated Radiotherapy, Joshua Misa, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Purpose/objective

We propose a novel lattice deployment for spatially fractionated radiotherapy (SFRT) treatments. In this approach, a larger diameter high-dose sphere is centrally placed in the bulky tumor mass and surrounded by smaller diameter high-dose spheres.

Materials/methods

Thirty SFRT patients (10 head and neck [HN], 10 abdominal/pelvis, and 10 chest/lung cases) treated with an MLC-based crossfire method were retrospectively analyzed. Eleven differential hole-size lattice patterns were benchmarked against the clinically delivered SFRT plans (1 cm diameter cylinders, 2 cm spacing) and the standard uniform lattice pattern (1.5 cm diameter spheres, 3 cm spacing). These patterns varied in core diameter (C: …

In Vitro Α/Β Ratio Variations In Cervical Cancer, With Consequent Effects On Equivalent Dose In 2 Gy Fraction In High-Dose-Rate Brachytherapy, Cameron Thayer-Freeman, Brien Washington, Denise Fabian, Dennis C. Cheek, William St. Clair, Mark E. Bernard, Wei Luo

Radiation Medicine Faculty Publications

Purpose: To determine the distributions of published α/β values measured in vitro and the resulting uncertainties in the equivalent dose in 2 Gy fractions (EQD ₂ ) when applied to high-dose-rate brachytherapy (HDR-BT) for cervical cancer.

Methods and Materials: An analysis of 98 published α/β values from 31 papers was conducted, spanning 23 cervical cancer cell lines. Values were further divided into squamous cell carcinoma and adenocarcinoma histologies. Probability distributions were fit to histograms using the bootstrapped Kolmogorov-Smirnov goodness-of-fit test. Both average and most probable α/β values for cervical cancer were determined. The probability distributions were then applied to three …

All The World’S A Stage: The Implementation Of Creative Arts Therapy Utilizing Psychodrama In Prison Populations, Rachael A. Yeager

Psychology Doctoral Specialization Projects

Incarceration rates continue to increase in the United States every year. Federally, the FIRST STEP ACT was passed to assist in rehabilitative programming and to reduce recidivism rates. Psychology programs intervene in areas such as trauma, a highly prevalent concern amongst adults in custody, and utilize evidence-based recidivism programming. Creative Arts Therapies (CATs) have been implemented in prisons in the United States, while Psychodrama is a psychotherapeutic technique generally utilized in European and Asian countries. The World’s Stage (TWS) is a treatment modality that provides psychoeducation on trauma and trauma responses in a Cognitive Behavioral Therapy format and integrates the …

Roll The Reel: The Evolution Of Racial Issues In Sports Law, Aaron Hernandez, Danielle R. Gershen

Marquette Sports Law Review

No abstract provided.

Sports Law In Law Reviews And Journals, Joseph A. Delia, Sydney A. Hardy

Marquette Sports Law Review

No abstract provided.

The Arena Tax: Subsidiary Athletics Departments And The Limits Of University Property Tax Exemptions, Matthew Razzano

Marquette Sports Law Review

No abstract provided.

Survey Of Recent Mandamus Decisions Of The Texas Supreme Court, Douglas S. Lang

SMU Annual Texas Survey

No abstract provided.

Who Belongs And Why It Matters: Belonging At An Oregon Elementary School, Kelly Smith

Educational Leadership Professional Doctorate Dissertations

Student sense of belonging is at the foundation of student outcomes with impacts reaching far beyond the walls of the elementary school classroom. This study investigates factors that shape students’ sense of belonging at an Oregon elementary school where Youth Truth survey data over the past three years have revealed a lack of sense of belonging amongst students. Correlates to the low sense of student belonging were identified via a root cause analysis process with students, staff and families. As a result of the root cause analysis, a theory of improvement was developed with input from students, staff and families. …

Rising Tides Lift All Boats: Significant Disproportionate Identification Of Latine Students In The Eligibility Category Of Specific Learning Disability, Erica Gordon

Educational Leadership Professional Doctorate Dissertations

The study explored the complex problem of practice (POP) of significant disproportionate identification of Latine multilingual learner (ML) students in the special education eligibility category of specific learning disability (SLD). The study employed improvement science as its methodological framework. Integral partners and a leadership team from a rural Oregon district reviewed the literature and used a root cause analysis to identify six causes behind these outcomes. Iterative plan-do-study-act (PDSA) cycles test with concise data collection, enabling real-time adjustments and improvements within the improvement cycle was used to implement two change ideas. These prioritized change ideas resulted in the implementation of …

Beyond Vulnerability: Climate Change And The Moral Authority Of Youth, Amber Acquaye

Yale Medicine Thesis Digital Library

Young people worldwide demand a voice in climate governance, yet their perspectives remain largely excluded from the moral frameworks that shape climate policy. This exclusion not only marginalizes children’s lived experiences and ethical reasoning but also perpetuates paternalistic norms and dangerous marginalization. To counter this, this thesis study shows that youth are not just passive stakeholders but moral agents whose perspectives yield a more just and comprehensive understanding of climate responsibility. Recognizing their ethical insights is crucial for medicine, especially pediatrics and child psychiatry, given how climate change amplifies health risks like respiratory illnesses, heat-related conditions, and eco-anxiety. Understanding how …

Effect Of Constraining Underdilated Transjugular Intrahepatic Portosystemic Shunts, Ishan Ayyalasomayajula

Yale Medicine Thesis Digital Library

Transjugular intrahepatic portosystemic shunt (TIPS) placement remains a primary treatment option for managing the sequelae of portal hypertension. However, the degree of decompression must be balanced to avoid complications of overshunting, such as hepatic encephalopathy (HE), liver failure, and heart failure. Currently, the most utilized device for TIPS creation, the Viatorr endoprosthesis shunt can be dilated to between 8 and 10 mm. However, dilating to the minimal size can decrease the hepatic-venous pressure gradient (HVPG) below goal. However, shunts that were underdilated at placement can self-expand to their minimal diameter. Placing a constraining stent around the endograft theoretically precludes such …

Quantitative Assessment Of Facial Ptosis In Face Transplantation, Sam Boroumand

Yale Medicine Thesis Digital Library

As a transformative surgical procedure, face transplantation restores form and function to patients with severe facial disfigurements, yet the long-term aging dynamics of transplanted tissues remain poorly characterized. This study aimed to investigate the progression of facial ptosis in transplanted facial allografts over time, addressing a critical gap in the understanding of long-term outcomes following face transplantation. Specific aims include quantifying ptosis progression using cephalometric measurements, identifying regional variations in the degree of ptosis across the face, and comparing changes between face transplant recipients and a non-face transplanted control cohort to contextualize findings.

To assess these aims, standardized frontal headshots …

“A Double-Edged Sword”: Influence Of The 21st Century Cures Act On The Childhood Cancer Care Experience, Mona Clappier

Yale Medicine Thesis Digital Library

The 21st Century Cures Act yielded policy change that allows patients toimmediately access components of their electronic health record (EHR) via an online portal. For children, adolescents, and young adults (AYAs) with cancer and their families, this federal mandate has profound implications. We sought to explore how immediate EHR portal access influences the childhood cancer care experience. We conducted semi-structured interviews with key informants, including parents of children with cancer, AYAs with cancer, and pediatric oncology healthcare professionals, at three National Cancer Institute-designated comprehensive cancer centers. Interviews were recorded, transcribed, and thematically analyzed. Across 84 participants, 71% self-identified as women …

Effectiveness Of Interventions For Depressive Symptoms After Spinal Cord Injury: A Systematic Review, Robert Cotter

Yale Medicine Thesis Digital Library

Our aims were to summarize and evaluate evidence regarding the efficacy ofinterventions for depressive symptoms in adults living with spinal cord injury (SCI) and comorbid major depressive disorder or significant depressive symptoms to inform the development of clinical practice guidelines. Articles published since 2013 and available in Medline, The Cochrane Library, Embase, Scopus, CINAHL, or PsycINFO were evaluated. Databases were searched in June 2022 and updated November 2023. Inclusion criteria: age 18 years or older, traumatic SCI, and clinically significant depression (Population), mental health interventions including behavioral, pharmacological, and complementary and alternative medicine (Intervention), inclusion of a control group (Comparator), …

Exploring Health Professional Student-Led Interventions To Address Gaps In Common Non-Communicable Disease (Ncd) Screening, Management, And Self-Care Education In Ghana., Brian Amu Fleischer

Yale Medicine Thesis Digital Library

BackgroundNon-communicable diseases (NCDs) are expected to become Africa's leading cause of death by 2030. In Ghana, with its limited healthcare resources, hypertension is already the leading cause of death, contributing to 15.3% of total deaths. Student-run free clinics (SRFCs) have become essential components of healthcare systems worldwide, offering primary medical care to underserved populations. This study explores the feasibility of health professional student-led interventions in addressing gaps in NCD screening, early management, and self-care education in Ghana.

MethodsThis research employed an exploratory sequential design, combining qualitative and quantitative phases. Six focus group discussions (FGDs) with 48 health professional students at …

Predictors Of Adverse Outcomes In Adolescent Idiopathic Scoliosis And The Impact Of A Quality Improvement Initiative, Astrid C. Hengartner

Yale Medicine Thesis Digital Library

Posterior Spinal Fusion (PSF) is a common surgical intervention for severe cases of adolescent idiopathic scoliosis (AIS). However, prolonged hospital stays due to delayed ambulation and extended transition from intravenous (IV) to oral analgesics are significant concerns. In this study, we investigate the risk factors for delayed ambulation and prolonged transition to oral analgesics, and their respective impacts on hospital length of stay (LOS). Additionally, we explore the impact of a multidisciplinary Quality Improvement (QI) spine conference initiative on perioperative outcomes for patients undergoing PSF for AIS.This retrospective cohort analysis was carried out on 126 adolescents who underwent elective PSF …

Trends In Missing Race And Ethnicity Data In A National Surgical Database, Kevin Gao Hu

Yale Medicine Thesis Digital Library

Accurate data collection on race and ethnicity is critical to detecting and characterizing disparities in surgical care. This study explores the prevalence and impact of missing race and ethnicity data in the National Surgical Quality Improvement Project Pediatric (NSQIP Pediatric) database. NSQIP Pediatric from 2016-2020 was assessed for patients who were missing data for race (RM), ethnicity (EM), or both (BM). Changes in proportion of RM, EM, and BM patients were assessed with Cochran-Armitage tests. Surgical outcomes were modeled using linear mixed-effects models, treating CPT codes as random effects. Models were bootstrapped with 1000 iterations for each outcome. Of 596,571 …

The Effects Of New Onset Medicare Eligibility At Age 65 On Access To Surgical Care At A Large Non-Profit Health System, A Single-Center Regression Discontinuity Analysis, Amanda R. Jankelovits

Yale Medicine Thesis Digital Library

ASSOCIATION OF MEDICARE ELIGIBILITY ON SURGICAL CARE ACCESS, A REGRESSION DISCONTINUITY DESIGN

Amanda Jankelovits, Julian Zhao, Hugo He, Hung-Mo Lin, Robert B. Schonberger, Department of Anesthesiology, Yale University, School of Medicine, New Haven, CT

The widespread onset of Medicare eligibility at age 65 has expanded access to healthcare, particularly among those previously uninsured. However, disparities in healthcare coverage still exist, especially for underrepresented minorities and low-income individuals. In this analysis, we utilize a regression discontinuity design to understand the effects of new onset Medicare eligibility at age 65 on access to surgical care at a large non-profit health system, focusing …

Maternal Prenatal Anxiety And Child Epigenetic Aging: A Longitudinal Analysis From Childhood To Mid-Adolescence, Shashwat Kala

Yale Medicine Thesis Digital Library

The developmental origins of health and disease posits that in utero exposures and early life experiences increases susceptibility to a host of pathologies. Maternal psychopathology, specifically maternal prenatal anxiety, has been studied as an in utero stressor that can affect childhood development and epigenetic aging. In the current study, we analyzed the longitudinal effects of maternal prenatal anxiety on epigenetic aging, assessed sex-specific effects, and tested the contribution of cellular heterogeneity to these findings. Using the longitudinal Basal Influences on Baby Development (BIBO) cohort, we performed a mixed model for repeated measures to determine how prenatal and postnatal anxiety (State-Trait …

Exploring The Journey To Heart Failure Diagnosis In Uganda, Teimur Kayani

Yale Medicine Thesis Digital Library

This study sought to explore the healthcare journeys of patients recently diagnosed with heart failure (HF) in Uganda. Using a semi-structured guide developed in collaboration with Ugandan colleagues, we conducted in-depth interviews with 19 patients diagnosed with HF within the past three months across four regional referral hospitals in Uganda. Interviews were conducted in the participant’s preferred language (English, Luganda, Lugbara, Lugisu, or Swahili) using trained research assistants (RAs) and were recorded, transcribed verbatim, and thematically analyzed using the socioecological framework (SEM) to capture individual, interpersonal, community, and systemic-level barriers to HF care.Findings revealed a total of 11 themes spread …

International Structural Magnetic Resonance Imaging Of Cortical Thickness In Older Adults With Bipolar Disorder, Rebecca Brynn Marks

Yale Medicine Thesis Digital Library

The presentation of bipolar disorder (BD) seems to change over the course of a lifetime. In older adults, BD seems to pose novel challenges including decreased cognitive functioning, psychiatric and medical comorbidities, increased susceptibility to medication side effects, and possibly even a shift toward more depressive symptoms. Despite these clinical findings, research into older adults with BD has lagged behind that of adolescents and young adults. As the global population ages, so too do individuals with BD. In fact, it is predicted that by 2030, 50% of patients with BD will be over the age of 60. This emphasizes why …

Individual-Level Variables Associated With Non-Medical Opioid Use Among Us Adults In 2021-22, Max Moss

Yale Medicine Thesis Digital Library

Recent changes to the US opioid overdose epidemic have been driven by the spread of illicitly-manufactured opioids and complex patterns of multi-substance use. This study provides updated analyses of opioid use epidemiology among US adults, which are needed to guide new research and interventions. We conducted a cross- sectional study of data from the National Survey on Drug Use and Health, 2021-22. Using nationally-representative estimates weighted to 255,053,169 adults, multivariable logistic regression models determined odds of mutually exclusive past-year opioid use categories (non-medical use of pharmaceutical opioids [NMUPO], heroin use, or both) across demographic, socioeconomic, and clinical variables. Prevalence of …

Pre-Admission Sleep Of Patients In The Intensive Care Unit: A Retrospective Observational Study, Siddhi Nadkarni

Yale Medicine Thesis Digital Library

The medical intensive care unit (ICU) can be a challenging place for patients to get adequate sleep. Multiple environmental and pathophysiological factors can cause sleep deprivation in the ICU, which have been associated with adverse short and long-term outcomes. Although various factors have been hypothesized to impact quality of sleep in the ICU, research on the nature of patients’ pre-ICU sleep is very limited. Understanding the role that pre-ICU sleep plays in sleep quality in the ICU has the potential to inform public health measures to improve sleep and risk stratify critically ill patients. The objective of this study is …