Medicine and Health Sciences Commons^™

Exploring Climate Policy And Health Perspectives In Samoa: A Mixed Methods Study, Erika-Ann Fumiko Kim

Public Health Theses

Background: Greenhouse gas emissions have driven human-induced climate change, bringing several impacts to small island nations in the Pacific. Samoa, a small island developing state located in the south Pacific Ocean, is at disproportionate risk from impacts of climate change such as rising surface temperatures, rising sea levels, increases in frequency and degree of heavy precipitation events, and increases in the frequency of droughts. Simultaneously, Samoan populations possess a high prevalence of non-communicable diseases such as diabetes, heart disease, and hypertension. For multiple decades, the Government of Samoa has framed climate change as a key issue that threatens the lives, …

Long-Term Cancer Survivors' Use Of Healthcare Providers, Madeleine Tessier-Kay

Public Health Theses

Abstract

Introduction: The number of long-term (>5 years post-diagnosis) cancer survivors in the United States is growing, making it critical to understand how they utilize healthcare for their past cancer diagnosis. There are limited data on patient characteristics associated with care utilization patterns. Methods: Data are reported from the 9-year post-diagnosis follow-up of the Connecticut participants (n=399) in the American Cancer Society’s Study of Cancer Survivors-I. We assessed characteristics associated with long-term primary cancer care provider (cancer specialist vs. primary care physician (PCP), shared care vs. PCP) and number of PCP visits in the past year via multinomial logistic …

Discovery Of Genetic Pleiotropy For Obesity And Inflammation And Mediation In Identified Variants Through Obesity-Related Pathways, Yiqian Wenren

Public Health Theses

Genetic data suggest that obesity and inflammation shared a portion of their genetic architectures. Meanwhile, epidemiologic data suggest a causal link between obesity and inflammation. Therefore, we hypothesized that there are variants in the human genome that display pleiotropy for obesity and inflammation and that the effects of at least some of those variants could be mediated by obesity-related pathways. To test these hypotheses, we conducted univariate genome-wide association analyses of obesity-related traits (BMI and WHRadjBMI) and inflammation (CRP) in the UK Biobank (n= 291,396 Caucasian subjects), searched for overlapping signals, fine-mapped the regions to identify putative causal SNPs, and …

Nicotine Dependence And Alternative E-Cigarette Use Behaviors: Dripping And Vape Tricks, Harmanpreet Bhatti

Public Health Theses

Background: E-cigarette use among youth is concerning due to the risk of exposure to hazardous chemicals and future combustible cigarette use. Alternative e-cigarette use behaviors, or dripping (i.e., applying drops of e-liquids directly onto heated coils) and vape tricks (i.e., blowing shapes or large clouds of visible exhaled aerosol), may also increase this risk. However, little is known about the risk of nicotine dependence among adolescents who engage in these behaviors. Therefore, the aim of this study was to determine the association between these alternative e-cigarette use behaviors and nicotine dependence among adolescents.

Research Design: Cross-sectional data were collected from …

Postpartum Weight Trajectories In A Cohort Of 127 Samoan Women: Does Breastfeeding Protect Against Postpartum Weight Retention?, Grace Castillo

Public Health Theses

Rising global obesity rates impact every aspect of health, including maternal-fetal health. Samoa has a disproportionate burden of obesity, with more than half of Samoan women entering pregnancy obese. Given Samoan women’s high parity (4), postpartum weight retention (PPWR) may be a significant source of weight gain over women’s lifetimes. Little is currently known about PPWR among Samoan women, so this analysis sought to document PPWR trajectories, assess factors – like breastfeeding -- associated with PPWR. Data of 127 mother-infant dyads from the 2017 Foafoaga O le Ola cohort were used in analysis. Researchers collected demographic and lifestyle data, as …

Predictors Of Intense End-Of-Life Care Among Children And Young Adults With Advanced Hematologic Malignancies, Sophia Mun

Public Health Theses

Background: Studies suggest that children, adolescents, and young adults (AYAs) with advanced cancer receive intense end-of-life (EOL) care. This is particularly true for patients with hematologic malignancies. Yet, it is unclear who is at highest risk for receiving intense care.

Methods: We used the Premier Healthcare Database to perform a population-based analysis of patients aged 0-39 years at death with hematologic malignancies who died between 2010-2017. We defined intense EOL care as: receipt of cardiopulmonary resuscitation (CPR), intubation, hemodialysis, or tracheostomy within the last 30 days of life; more than one emergency room (ER) visit within the last 30 days …

Associations Between Cannabis Use, Medication Status And Panic-Anxiety Disorder Symptoms Among Us Adults, Diane Tran Ma

Public Health Theses

The existing body of literature focuses on the onset of panic disorders or other side effects as an association with cannabis use, but does little to address how possible concomitant cannabis use affects symptom presentation in already-diagnosed patients. The present project aims to take a closer look at adults with a lifetime history of DSM-5 diagnosed anxiety disorders, their prescribed (non-cannabis) medication use, cannabis use frequency, and associated symptom severity.

In general, we find that cannabis use is associated with higher panic-anxiety symptom severity across panic disorder without agoraphobia, generalized anxiety disorder, and people with combined anxious-distress diagnoses, after controlling …