Effect Of Body Mass Index, Testosterone, And Insulin On Breast Cancer: A Mendelian Randomization Study And Investigation Of Selection Bias, Kezhen Fei

Dissertations and Theses

BACKGROUND: Female breast cancer is the most studied cancer, and the second leading cause of cancer death in women, whose aetiology is still not completely clear. The parallel increase of incident obesity and breast cancer in women worldwide raises the question of the role of adiposity, measured by body mass index (BMI), and of major anabolic hormones, such as insulin and testosterone, on breast cancer. Observational studies are open to confounding making it difficult to clearly demonstrate causal effects. Several mendelian randomization (MR) studies have shown inverse association of BMI with breast cancer. To assess selection bias in MR …

Radiation Isolation And The Impact Of Care: Nursing Knowledge And Perception Of Radiation Risks, Bae P. Chu

Dissertations and Theses

Background: The safety challenges encountered when employing ionizing radiation to treat patients and manage radiation exposure and contamination have been well established in previous research. However, little is known about nurses’ understanding of the risks associated with ionizing radiation and how they respond to their own perceptions of risk. Although a wealth of literature shows an association between radiation treatment and negative patient experiences, there remains a lack of understanding of the basis of these perceptions among nurses. Increased ionizing radiation diagnoses and treatment means that nurses are at a higher risk of radiation exposure today than thirty years ago. …

Assessment Of Spatial And Temporal Trends Of Exposure To Ambient Fine Particulate Matter And Ozone In New York/New Jersey Metropolitan Area, Subraham Singh

Dissertations and Theses

Background. Exposures to fine particulate matter (PM_2.5; particles with diameter less than 2.5 μm) and ozone (O₃) affect premature respiratory and cardiovascular mortality, morbidity and contribute to the development and progression of sub-clinical and clinical disease. Climate change affects air quality directly by modifying the thermodynamic properties of formation mechanisms and transport patterns, and indirectly, through increased emissions of PM_2.5 and O₃ precursors. The resultant changes in air quality influence human health outcomes through mechanisms of varying scale, timing, and complexity. PM_2.5 and O₃ levels have been declining due to the implementation …

Neighborhood Predictors Of E-Cigarette Retailer Density In New York City, Laena Orkin-Prol

Dissertations and Theses

Background: The rampant expansion of the e-cigarette market over the last decade in the U.S. is a threat to the health of the public—due to the e-cigarette’s appeal to young people, addictiveness, and harms of consumption. It is vital to study the distribution of e-cigarette retailers of different types in major urban centers, such as New York City (NYC), to identify if certain neighborhoods are overburdened with retailers and if intervention is required. The current research on the e-cigarette retailer environment is limited in its scope and methods used.

Objective: To investigate neighborhood attributes associated with e-cigarette retailer density in …

Factors Related To Contraceptive Use And Family Planning Decision-Making In The South Asian Community Residing In New York City, Nandini Shroff

Dissertations and Theses

Introduction: Currently, there are approximately 5.4 million South Asians residing in the United States (U.S.). The limited literature illustrates that contraceptive use is underutilized among Asians and Asian sub-groups, including South Asian Americans, compared to other racial and ethnic groups. Using Los Angeles County Health survey data, one study found that 22% of Asian Americans reported always using condom in the past 12 months compared to 37% of African Americans, 27% of Whites, and 27% of Hispanics. A study among New Jersey women revealed that compared to non-South Asian women, South Asians (SAs) were less likely to have used ever …

Investigation Of The Association Of Exposures To Fire-Related Hazards With Pulmonary Function Of Firefighters, David G. Goldfarb

Dissertations and Theses

Background. Firefighters are habitually exposed to hazardous toxicants which place them at an elevated risk for numerous adverse health outcomes. An example of this is the associations observed in other works between inhalation of combustion byproducts from urban structural fires and both acute and chronic pulmonary dysfunction. To-date, the characterization of firefighters’ exposures to dangerous chemicals in smoke from non-wildfire incidents, both directly through personal monitoring and indirectly from work-related records is scarce. Prior works investigating the association between routine firefighting and pulmonary function have relied on crude metrics such as years of service and numbers of responses to …

The Global Implementation Of Dolutegravir For Hiv Treatment, Matthew L. Romo

Dissertations and Theses

Background
Dolutegravir, an integrase strand transfer inhibitor, is now recommended by international guidelines as part of preferred antiretroviral therapy (ART) regimens for people living with HIV. In low- and middle-income countries (LMICs), HIV treatment programs are transitioning from non-nucleoside reverse transcriptase inhibitors (NNRTIs) to dolutegravir because of its superior efficacy and tolerability, and high genetic barrier to HIV drug resistance. Along with the optimism surrounding widespread dolutegravir use, key questions regarding its implementation have emerged. In this dissertation, I sought to achieve the following specific aims: Aim 1: Characterize dolutegravir uptake in LMICs and identify potential disparities related to sex …

Assessing Psychosocial Factors That Influence Water, Sanitation, And Hygiene Behavior In The Amhara Region Of Ethiopia, Kimberly Kamara

Dissertations and Theses

Background: The absence of potable drinking water from an improved source combined with inadequate sanitation and hygiene contributed to an estimated 1.9% of the global burden of disease in 2016. The estimated number of diarrheal deaths in 2016 was 1.4 million, of which 829,000 could have been prevented through improved drinking water and sanitation services, and hand-washing with soap. Despite the clear link between poor water and sanitation access and hygiene practices, 785 million people do not have access to water and two million do not have access to basic sanitation services. However, access does not automatically result in increased …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

The Associations Between Diabetes, Cardiovascular Disease And Occupational Hearing Loss In A Cross-Sectional Analysis Of Department Of Energy Nuclear Workers, With A Mendelian Randomization Of Publicly Available Data To Enhance Observational Findings, Jonathan Corbin

Dissertations and Theses

Title: The Associations between Diabetes, Cardiovascular Disease and Occupational Hearing Loss in a Cross-sectional analysis of Department of Energy Nuclear Workers, with a Mendelian Randomization of Publicly Available Data to Enhance Observational Findings

Author: Jonathan Corbin

Advisor: Ghada Soliman, MD, PhD, R.D., CDN

Introduction: Occupational Hearing Loss (OHL) is the most common workplace health condition, and the overall impact of hearing loss (HL) on health is underappreciated. Diabetes and cardiovascular disease (CVD) are two of the most common causes of death and are largely preventable and treatable. Previous research has evaluated associations between OHL and …

Factors Associated With Racial And Ethnic Disparities In Cesarean Delivery Among Women With Low-Risk Pregnancies At New York City Hospitals, 2012-2017, Ellen Brazier

Dissertations and Theses

BACKGROUND: While Cesarean delivery is a life-saving procedure when certain complications arise, it is associated with increased risks of maternal mortality and morbidity, as well as neonatal and childhood morbidities, and increased risks for women during subsequent pregnancies. Stark and persistent racial/ethnic disparities in Cesarean delivery that are not explained by clinical risks raise concerns about overuse of the procedure, as well as the contribution of potentially avoidable Cesareans to disparities in maternal mortality and morbidity. Understanding the extent to which disparities in Cesarean delivery may be attributable to differences in care during labor is critical for addressing these disparities. …

Psychedelic Use And Psychological Flexibility: The Role Of Decentering, Mystical Experiences, Ego-Dissolution, And Insight, William M. Campo

Dissertations and Theses

The purpose of this study was to investigate potential associations between psychological flexibility (PF) and characteristics of the psychedelic experience: self-perceived meaningful intention, feelings of comfort and safety, decentering, mystical experiences, ego-dissolution, and insight. The first hypothesis was that perceived meaningful intention and feelings of comfort/safety during the psychedelic experience were expected to be associated with PF, decentering, mystical experiences, ego-dissolution, and insight. The second hypothesis was that decentering, mystical experiences, ego-dissolution, and insight were expected to be associated with greater PF. Participants who used classic psychedelic substances prior to this study were recruited from social media. The sample after …

Ego-Feeling And Ego-Boundaries: An Examination Of The Work And Legacy Of Paul Federn, Samuel Selinger

Dissertations and Theses

Paul Federn was an important figure in the early development of psychoanalysis. He was, besides Sigmund Freud himself, the only founding member of the Vienna Psychoanalytic Society who was still a member when the society was disbanded by the Nazis in 1938. He was also an early pioneer in the use of psychoanalysis toward the understanding and treatment of psychosis, and was among the very first to consider the importance of the ego to psychoanalytic understanding of the mind and mental illness. This dissertation examines Federn’s key ideas-- ego-feeling and ego-boundaries-- their influence on later psychoanalytic formulations by Winnicott, Lewin, …

The Role Of Rna Helicase Rhau In Immunoglobulin Class Switch Recombination, Sabine Jean Guillaume

Dissertations and Theses

B cells alter the expression of immunoglobulin isotypes through a process known as class switch recombination (CSR). In these cells, activation induced cytidine deaminase (AID) binds Gquadruplex (G4) switch transcripts, which serve as guide RNAs to target AID to the immunoglobulin heavy chain switch (S) regions in the DNA for CSR. Sequence alignment revealed homology between the AID G4 binding domain and the RNA helicase associated with AU-rich element (RHAU) specific motif (RSM), which allows RHAU binding to G4 RNAs and subsequent unwinding of G4 RNA into single-stranded transcripts. We hypothesize that RHAU functions in CSR by binding G4 S …

Identification Of Adhd And Comorbid Disorders In Children: The Potential Role Of Minority Group Membership, Rachel H. Tayler

Dissertations and Theses

Identification of ADHD and Comorbid Disorders in Children: The potential role of minority group membership

by

Rachel Tayler, MSc, MA

Advisor: Sarah O’Neill, PhD

Attention-Deficit/Hyperactivity Disorder (ADHD) affects six million US children. Females, Latinx, and possibly Black children have lower rates of diagnosis than their Male and White non-Latinx peers. ADHD is behaviorally defined, and as such, clinicians' perceptions of symptoms and determination of diagnoses may be influenced by demographic factors such as race, ethnicity and sex.

This vignette study examined whether clinicians' implicit ethnic, racial, and sex biases affect diagnosis of ADHD and comorbid conditions. Psychiatry trainees and pediatricians …

Exosome- And Microrna-Based Therapeutic Approach For Tendinopathy, Angela Wang Ilaltdinov

Dissertations and Theses

Tendinopathy, characterized by degeneration and chronic inflammation, is a significant clinical burden. Current treatments focus on symptom management but do not sufficiently address its underlying pathology; however, stem cell-based approaches aimed at repairing diseased tissues may overcome this limitation. Therapeutic effects of stem cells may be due in part to paracrine actions, including some mediated by exosomes – extracellular vesicles secreted by cells that play a role in cell communication. MicroRNA (miRNA), small non-coding RNA carried by exosomes, are likely responsible for many exosome effects. Exosomes and miRNA therapies show promise in treating diseases such as cancer and arthritis, but …

Youtube, Cyberbullying And Covid-19, Ani Shavliashvili

Dissertations and Theses

The purpose of this research is to uncover how people discuss bullying or cyberbullying experiences via YouTube videos before and after the start of the COVID-19 pandemic. Since people were indoors during the pandemic, individuals took to social media and left comments on YouTube about bullying. Since people could not discuss bullying in-person, it was interesting to see how people shared their views on bullying and cyberbullying via YouTube, as well as how that might have changed after the start of COVID-19. The purpose of this study is to demonstrate how social media platforms like YouTube provide a safe space …

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

Contraceptive Use And Sterilization Among People With Disabilities, Gabrielle Y. Defiebre

Dissertations and Theses

Background

Approximately 20% of individuals in the United States (US) have a disability, with 1 in 4 adult women above the age of 18 having a disability. People with disabilities include individuals who may experience difficulties with mobility, cognition, independent living, vision, hearing, and/or self-care. Disabled people face physical/environmental barriers, provider-level barriers, and system-level barriers in accessing health care, including sexual and reproductive health care, and are more likely than people without disabilities to have unmet medical needs. Four recent studies have indicated that those with disabilities are more likely to have received female sterilization as a family planning service …