Digital Commons Network^™

Evaluation Of Genetic Testing For Thoracic Aortic Disease, Adrian Ricardo Acuna Higaki

Yale Medicine Thesis Digital Library

AimsThoracic aortic disease (TAD), including aneurysms and dissections, present a significant global health challenge due to its typically asymptomatic nature until the onset of critical complications that come with high morbidity and mortality. Effective risk stratification is crucial for early identification and management of patients and their families who are at heightened risk of disease progression. This study aims to evaluate the effectiveness of current genetic testing guidelines for patients with thoracic aortic aneurysms. Methods The study evaluated genetic tests for TAD from 2012 to 2023 in patients aged 18 and older with a thoracic aorta diameter greater than 4 …

Provider-Patient Alliance And Trauma Among Pregnant Patients With Opioid Use Disorder, Molly Doernberg

Yale Medicine Thesis Digital Library

The goal of this project was to compare the provider-patient relationship among pregnant patients with opioid use disorder (OUD) who did or did not have a history of moderate to severe trauma. The hypothesis was that patients with a trauma history would self-report worse relationships with their providers. This was an exploratory analysis of data from 169 patients enrolled in the Support Models for Addiction Related Treatment (SMART) trial. Trauma history, defined as probable post-traumatic stress disorder (PTSD), was determined by a score ≥31 on the PTSD Checklist for DSM-5 (PCL-5). The provider-patient relationship, collected at 26±4 weeks of pregnancy, …

Superficial Cervical Plexus Block And Quality Of Recovery After Thyroidectomy: A Randomized Controlled Trial, Anita Jegarl

Yale Medicine Thesis Digital Library

Purpose: To investigate the effect of the superficial cervical plexus block (SCPB) on the quality of recovery of patients undergoing thyroidectomy with an Enhanced Recovery After Surgery protocol

Methods: This double-blind randomized controlled trial recruited adult patients undergoing thyroidectomy to be randomized to receive pre-incisional bilateral SCPB with either 0.25% bupivacaine or saline. All enrolled participants completed a baseline Quality-of-Recovery 40 (QoR-40) survey prior to surgery, and another QoR-40 survey on postoperative day (POD) 1. Their electronic health records were reviewed to obtain information on secondary outcomes such as intraoperative analgesics administered, post-anesthesia care unit (PACU) duration of stay, incidence …

Effect Of Hormone Exposure And Menopausal Status On Microvascular Dysfunction And Vasospasm, Haleigh Tianna Larson

Yale Medicine Thesis Digital Library

EFFECT OF HORMONE EXPOSURE AND MENOPAUSAL STATUS ON MICROVASCULAR DYSFUNCTION AND VASOSPASM

Haleigh T. Larson and Samit M. Shah. Section of Cardiology, Department of Internal Medicine, Yale University, School of Medicine, New Haven, CT

Background: Cardiovascular disease (CVD) is the leading cause of mortality among women in the United States. Ischemic heart disease (IHD) represents a sizeable fraction of CVD that affects women, and ischemia with no obstructive coronary artery disease (INOCA) affects approximately two-thirds of women with IHD. INOCA is characterized by myocardial ischemia symptoms, such as chest pain, without significant epicardial coronary artery obstruction. Up to 50% of …

Yale Medicine Magazine December 2025, Issue 175, Yale University. School Of Medicine

Yale Medicine Magazine - alumni bulletin and magazine

This is the December 2025 issue of Yale Medicine Magazine, issue 175. Prepared in cooperation with the alumni and development offices at the School of Medicine. Earlier volumes are called Yale School of Medicine alumni bulletins, dating from v.1 (1953) through v.13 (1965) and Yale Medicine: alumni bulletin of the School of Medicine, v.1 (1965) through v. 52, no.1. (Autumn 2017).

Ecarrots: Prison Control And Profits From Correctional Tablets, Justin Iverson

Scholarly Works

In recent years, tablets have gained tremendous popularity behind bars for their ability to expand access to educational and rehabilitative services for people in prison. However, there are downsides to tablet implementation, including high costs at the expense of a captive population and shifting power dynamics resulting in possible volatility. This Article examines the use of correctional tablets in jails and prisons as mechanisms for administrative control and profit-making in an era of beleaguered correctional budgets. It also considers legal and policy implications related to the disproportionately negative impact of the introduction of tablets on people in poverty, increased dependency …

Copyright, Ebooks, And The Future Of Digital Lending, Mary Lafrance

Scholarly Works

Public libraries face a digital lending crisis. Even as library patrons demand greater access to digital materials, eBook publishers have subjected libraries to onerous licensing terms. These include prices substantially higher than those charged to the general public, as well as stringent constraints on license duration and/or loan volume, forcing many libraries to repurchase their eBooks every one or two years. Some publishers are releasing new books only in digital formats, making it even more costly for libraries to maintain robust collections. eBook publishers also compel libraries to use specific digital lending platforms which pose risks to patron privacy. At …

"A Plain Denial”: Reclaiming Equal Protection In American Juvenile Law, Addie C. Rolnick, David S. Tanenhaus, Justin Iverson, Danielle L. Silvestri

Scholarly Works

Juvenile courts are based on the premise that children are different from adults and should therefore be treated differently. Children may be treated more informally by courts, punished for different purposes, and brought before the court for different behaviors. Since In re Gault, the Supreme Court has been clear that there are limits to how different juvenile courts can be. Juveniles are entitled to many of the same procedural protections as adult criminal defendants, although the Court has preserved some procedural differences where it has determined that their benefit is outweighed by the need to preserve the informality, flexibility, …

Keynote Address: Envisioning Wage Justice, Ruben J. Garcia

Scholarly Works

In this Keynote address for the Minnesota Journal of Law & Inequality’s Symposium, “Not Just Wages,” held at the University of Minnesota Law School on April 11, 2025, I discuss the evolving concept of wage justice, using the lens of Critical Wage Theory and its origins in pioneering theories of race, labor and justice. The Article outlines the legal frameworks that have defined the content of wage justice in the twenty-first century, particularly for marginal workers. This Article raises the alarm about the impact of political change on low-wage workers, using case studies and analysis of administrative agency enforcement of …

Restorative Justice In Legal Education, Lindsey Pointer, Aparna Polavarapu, Alanna Ojibway

Scholarly Works

No abstract provided.

A Faster Way To Yes: Re-Balancing American Asylum Procedures, Michael Kagan

Scholarly Works

The United States asylum system, like many other asylum systems, is under immense pressure to process asylum applications faster. The primary response to this pressure is negative, namely to deny asylum claims quickly by categorizing them as manifestly unfounded. In the United States, this is done through the “credible fear” process. This negative orientation leads to a structural imbalance in which denials can be fast and easy for the system, but approvals take time and extensive effort. Using domestic and international comparative examples, this Article proposes re-balancing the asylum system by establishing a process for expedited approvals of clearly eligible …

A Right To Be Born?: What Dobbs Could Mean For Artificial Reproductive Technologies, Stewart Chang

Scholarly Works

No abstract provided.

Presumed Guilt: Epistemic Closure In Pregnancy Prosecutions, M. Eve Hanan

Scholarly Works

Criminal law and reproductive justice scholars are calling attention to the increase in prosecutions for pregnancy outcomes in the United States. Trace amounts of controlled substances in newborns are prosecuted as child abuse. Miscarriages are prosecuted as illegal abortions or homicides. This area of criminal law existed side-by-side with Roe v. Wade for late-term pregnancy outcomes. The Dobbs decision has further emboldened these prosecutions by removing the protections of the Due Process Clause from the pre-viability phase of the pregnancy.

Using a case study of a woman who was pressured to plead guilty to manslaughter and sentenced to eight years …

Interoperable Legal Ai For Access To Justice, Drew Simshaw

Scholarly Works

The access-to-justice gap is growing, affecting individuals with both civil and criminal needs in the United States. Though these challenges are multifaceted, procedural barriers in the U.S. legal system can often inhibit access-to-justice efforts. The resulting inequities undermine fairness for those interacting with courts and jeopardize the legitimacy of the broader legal system. Legal technology driven by artificial intelligence (Al) has been heralded for its potential to combat these challenges on three access-to-justice fronts that are often conceptualized in isolation: a consumer (i.e., self-help) front, a legal-service-provider front, and a court front. Progress on each of these fronts is apparent, …

Structural Originalism: A Second Amendment Case Study, Ian C. Bartrum

Scholarly Works

“Originalism” is having a national moment, even if it is not entirely clear what the word means. What should we be originalist about? The leading academic approach asks us to parse the communicative content of text ratified in a very different linguistic culture; then construct a modern legal meaning consistent with our semantic speculations. Too often the result enforces policy judgments made in a radically different moral and technological world. This makes very little sense.

In this paper I recommend a more perspicuous and coherent use of constitutional history, which I call “structural originalism.” Rather than saddle ourselves with the …

From Clinic To Court: Feminist Organizing And The Fight For Birth Control In Griswold V. Connecticut, Lynn Q. Lee

Kaplan Senior Essay Prize for Use of Library Special Collections

In 1961, Planned Parenthood League of Connecticut (PPLC) Director Estelle Griswold and Yale School of Medicine Department of Obstetrics and Gynecology Chair Dr. Charles Lee Buxton were arrested. Charged with opening an illegal birth control clinic in New Haven, the two embarked on a four-year battle to overturn Connecticut’s decades-old anti-birth control law. The resulting Supreme Court case, Griswold v. Connecticut (1965), was the culmination of decades of advocacy, coalition building, and cultural conflict over reproductive rights in one of the nation’s most restrictive states.

Griswold v. Connecticut established the constitutional right to marital privacy, creating the protection needed for …

A Maintenance Repair And Overhaul Model For Operational Sustainability; Incorporating Processes And Risks., Linn Guinn, Mary M.H. Woody, Eva Maleviti

Publications

Maintenance, Repair, and Overhaul (MRO) companies are integral to the aviation industry, with the core responsibility of ensuring aircraft remain safe and airworthy. Their role is critical in maintaining the industry’s high standards of performance and safety. To remain competitive, MROs must provide a wide range of services—including inspections, periodic checks, engine overhauls, avionics repairs, fuselage and cabin modifications, and interior refurbishments— while consistently meeting regulatory and safety requirements. Beyond technical compliance, MROs must adopt a quality-driven, continuous improvement approach to manage risks effectively. This requires the integration of processes, programs, and systems aligned with international standards to strengthen resilience, …

Enforced Colorblindness, Goldburn P. Maynard Jr.

Washington and Lee Law Review

The time for race consciousness is over, and the era of enforced colorblindness is upon us. The dawn of this new age is troubling because it closes the door on effective strategies to achieve racial justice, including efforts to grant federal reparations. This Article analyzes the areas in which courts have invalidated race-conscious measures, with a particular focus on recent racial equity efforts by the Biden Administration. Rather than treating the loss of race consciousness exclusively as a loss to the movement for equality, this Article argues for a silver-lining approach. While court-led efforts to remedy the effects of slavery …

Political Disinformation In The Anthropocene, Jeffrey Omari

Washington and Lee Law Review

The Anthropocene is the name that scientists have given to our current geological epoch, which references the overwhelming influence of human agency on the Earth and its ecological systems. Adopted as a theoretical tool across multiple academic disciplines, social scientists often employ the term to address deep-rooted political and socioeconomic problems and the symptoms of global inequalities and injustices. Meanwhile, legal scholars have employed the term to address the global environmental harms of human agency and to examine how normative frameworks must fundamentally change and adapt to the times ahead. At the same time, recent scholarship also notes that democracies …

Can Employers Save Us From Student Loans? Credentialism, Arms Races, And Debt Forgiveness, Tammy Harel Ben Shahar, Omer Kimhi

Washington and Lee Law Review

America is drowning in student loan debt. About 45 million Americans owe the astounding sum of $1.75 trillion in outstanding student debt, and many of them default on their payments. While most agree that something must be done, attempts to alleviate the problem have met political backlash and legal challenges. In June of 2023, the Supreme Court struck down the Biden administration’s comprehensive student loan debt forgiveness plan, and recently the administration initiated the politically contested “Saving on a Valuable Education” plan (“SAVE”). Amidst this political tug of war, this Article aims to offer a critical and nuanced analysis of …

The Fiction Of Equitable Distribution: Military Divorce, Disability, And The “Dire Plight” Of The Former Military Spouse, Zoe Speas

Washington and Lee Law Review

Division of retired pay is one of the most emotionally fraught elements of military divorce. For the servicemember, retired pay compensates decades of service to his country. For the civilian spouse, it remunerates the same decades of domestic labor that enabled such service. Federal restrictions on division of military retirement have spawned confusion and litigation for more than thirty years. Today, former spouses remain extremely vulnerable to this unique and “dire plight.”

In civilian divorce, state courts apply state law to fairly distribute marital assets. Military retirement and disability benefits, however, fall within the scope of the Uniformed Services Former …

The “Dire Plight” Contextualized: Comment On “The Fiction Of Equitable Distribution: Military Divorce, Disability, And The ‘Dire Plight’ Of The Former Military Spouse” By Zoe Speas, Catlin Meade

Washington and Lee Law Review

For forty years, military spouses have sacrificed their economic security and personal well-being to support their servicemember spouse’s military career, only to be thrust into a “dire plight” if their marriage ends in a community property state. The legislative policy that put them in this untenable position has not served federal interests: the military currently faces a recruiting crisis and military spouses’ economic security has not improved since the USFSPA. It is time for Congress and the DoD to reexamine the incentives and benefits provided to servicemembers and their families. Congress and the Court must end the USFSPA’s groundless, inequitable, …

The Crumbley Precedent: When Florida Parents Should Face Involuntary Manslaughter Charges In School Shootings, Sophie Hayman

Nova Law Review

No abstract provided.

Implementation Of Teamstepps® In A Peri-Operative Environment In An Urban Medical Center, Chris Chantler

Yale School of Nursing Digital Theses

Problem and Context: Preventable Patient Harm (PPH) continues to occur frequently in healthcare. Failures in communication, poorly functioning teams, and a lack of shared mental models (SMMs) continue to challenge healthcare organizations. The purpose of this PI project was to improve communication and teamwork, among team members in a Peri-Operative setting. TeamSTEPPS® was selected as the training curriculum. Multiple parameters, including perceptions of teamwork, and safety metrics were evaluated pre and post-intervention.

Intervention: TeamSTEPPS® was selected as the training curriculum. TeamSTEPPS® is a highly adaptable curriculum designed to address these gaps and to improve team function in the healthcare setting. …

Reducing Opioid Use Following Posterior Spinal Fusion Procedures: A Pilot Project, Kevin Matthew Cornett

Yale School of Nursing Digital Theses

Importance: Opioid misuse and mortality remain a prevalent problem in the United States and there is a high rate of chronic opioid-use after spinal fusions. Current guidelines recommend the optimization of non-opioid analgesics as a primary pain control strategy with opioids acting as a secondary agent. Objective: To pilot an analgesic decision tree (ADT) featuring non-opioid analgesics to reduce postoperative pain, opioid consumption, and the incidence of adverse events during the first 48 hours after patients undergo a posterior spinal fusion. Methods: A literature review of opioid-sparing analgesics was conducted and a protocol developed as an interdisciplinary collaboration. The ADT …

Implementing A Screening Algorithm For Depression Diagnosis, Management And Referrals In Primary Care, Jorge Correia

Yale School of Nursing Digital Theses

Depression is a major cause of mortality, morbidity, disability, and economic costs in theUnited States. Everyday millions of Americans navigate our complex healthcare field to find the best solution to their problem. Due to a shortage of specialized psychiatric providers, often these people must rely on the primary care settings to get the help they need. However, the lack of knowledge in screening and management of mood disorders causes many of these patients to fall through the cracks or get substandard quality of mental health care. The goal of this quality improvement project was to develop and implement a screening …

Changing The Paradigm For Newly Graduated Nurses’ Intent To Leave Through An Emeritus Rn Virtual Mentoring Program In An Acute Care Hospital Setting, Lacy Eynon

Yale School of Nursing Digital Theses

The U.S. nursing shortage presents a critical challenge to healthcare organizations, withwide-reaching implications for patient safety and financial sustainability. High nurse turnover contributes to increased staffing costs, estimated at $56,300 average cost per nurse replaced. This shortage directly impacts patient outcomes including increased rates of medical errors, patient mortality and decreased overall quality of care. Supporting early-career nurses through mentorship programs is a promising strategy to improve professional development and retention, thereby addressing clinical and economic consequences workforce shortages. This DNP Project developed and implemented an Emeritus RN Virtual Mentoring Program utilizing experienced emeritus nurses to mentor nurses with less …

Readmission Reduction Of 1st Year Transplant Recipients, Kristin Freed

Yale School of Nursing Digital Theses

Abstract Readmission Reduction of 1st Year Transplant Recipients Clear communication with patients at their health-literacy level improves patient outcomes, fosters trust, and is associated with readmission reduction. Readmission of transplant recipients are correlated with morbidity, medical errors, higher healthcare economic costs, and indicative of decreased survival post- transplant. Literature suggests that up to 72% of transplant recipients may have low health literacy increasing risk of readmission. The Agency of Healthcare Research and Quality created the REALM-SF assessment as a tool for medical providers to evaluate a patient’s health literacy status in a timely manner. This Doctor of Nursing Practice (DNP) …

New Leader Mentoring: Guiding Nursing Leaders Of The Future, Renee Marie Hammond

Yale School of Nursing Digital Theses

Nursing leaders throughout our health care system are retiring or leaving at an alarming rate – over 60% of the nursing leader workforce is expected to leave in the next five years. Retention of new nurse leaders is crucial to retention of clinical nurses, morale, and patient outcomes. Development of a formal mentorship program between new nurse leaders and experienced nurse leaders is essential to reducing the intent to leave of leaders. The Aims of this project are to develop a mentorship program for new nurse leaders using an adaptation of the American Organization for Nursing Leadership Core Competencies, to …

Empowering Emerging Air Medical Leaders Through A Novel Professional Development Program Adapting National Nursing And Healthcare Management Competencies To A Multi-State Air Medical Service, Christopher Hardman

Yale School of Nursing Digital Theses

Empowering Emerging Air Medical Leaders through a Novel Professional Development Program Adapting National Nursing and Healthcare Management Competencies to a Multi-State Air Medical ServiceHigh turnover in the nursing workforce has led to clinicians with limited experience being promoted to leadership roles without proper training or support. Nurse leaders directly impact clinical outcomes and retention. The financial burden of turnover is significant, as health systems must continually replace employees. Despite this, limited evidence exists on effective professional development and retention strategies in non-traditional, non-hospital settings. This DNP project sought to adapt and implement a novel professional development program, derived from the …