Medicine and Health Sciences Commons^™

Sex-Based Differences In Periprocedural Outcomes Of Left Atrial Appendage Occlusion With The Watchman Device, Andrew Jake Arakaki

Public Health Theses

Background/Purpose: Left atrial appendage occlusion (LAAO) is a procedure recommended for individuals with non-valvular atrial fibrillation (NVAF) who have contraindications for long-term anticoagulation. The WATCHMAN is the only FDA approved LAAO device and has been commercially available since 2015. To date, there have been no studies evaluating sex-based differences in safety and outcomes of LAAO with the WATCHMAN device. In this study we sought to determine if there were differences in baseline characteristics, medical history, and periprocedural outcomes of WATCHMAN implantation between women and men.

Methods: Using data from the National Cardiovascular Disease Registry (NCDR) - Left Atrial Appendage Occlusion …

Association Between Maternal Depressive Symptoms And Hypertension Among African American Mothers In The Intergen Study, Xiaosong Gao

Public Health Theses

Purpose: The purpose of this paper is to examine the association between maternal depressive symptoms and hypertension among African American mothers from the InterGEN study.

Data Source: The Intergenerational Blood Pressure (InterGEN) Study was a longitudinal study which enrolled 250 African American mother-child dyads based in Southwest and Central Connecticut.

Methods: We used logistic regression models to examine the association between depressive symptoms and hypertension, and adjusted for educational level, employment in the past 6 months, and Race-Related Events Score (RRES). We used growth curve modeling to examine the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) …

Ethnic Differences And Risk Of Early-Onset Hodgkin Lymphoma, Connor Ashton Graham

Public Health Theses

Ethnic differences in the risk of early-onset Hodgkin lymphoma (HL) have been understudied. We evaluated potential associations between birth characteristics and early-onset HL in the California Linkage Study of Early-onset Cancers, a population-based case-control study that included a large number of non-Hispanic white and Hispanic subjects. This analysis included 2,819 HL cases (non-Hispanic white: 1651, Hispanic: 1168) diagnosed at the age of 0-37 years in California during 1988-2015 and 140,950 controls matched on race/ethnicity and year of birth. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from multivariable logistic regression models. Among non-Hispanic whites, a birthweight of ≥4,000g …

Impact Of A 6-Month Exercise Intervention On Cognitive Function Among Ovarian Cancer Survivors: The Women’S Activity And Lifestyle Study In Connecticut (Walc), Jonica Yu Kao

Public Health Theses

Purpose: Cancer survivors often exhibit symptoms of impaired cognitive abilities after chemotherapy treatment. Physical activity has been shown to be promising in improving cognitive function among survivors for various types of cancer. However, very few studies have addressed this concern among the ovarian cancer patient population specifically.

Methods: The study randomized 111 physically-inactive ovarian cancer survivors into a 6-month exercise intervention (n=59) or an attention-control group (n=52). The FACT-Cog scale was self-reported to understand survivor perceptions of cognitive abilities at baseline and at 6 months. Generalized linear models (GLMs) were executed to examine the effect of the intervention versus attention-control …

Immunotherapy For Advanced Cancer Patients With Autoimmune Disease, Huaqi Li

Public Health Theses

Purpose

Immunotherapy (IT) has been shown to improve cancer survival but there is limited evidence regarding use in patients with advanced cancer and pre-existing autoimmune disease (AI). We sought to address these knowledge gaps and determine IT utilization patterns and overall survival (OS) for these patients.

Patients and Methods

This retrospective cohort study used data from Flatiron Health’s nationwide oncology database. Patients diagnosed with advanced cancer where there was ≥ 1 FDA approved IT were included. Baseline demographics were analyzed using χ2 and t-tests. Patterns of IT use were assessed using logistic regression. OS was estimated using Kaplan-Meier and Cox …

Prevalence, Awareness And Control Of Hypertension And Diabetes Among Hiv Positive And Negative Patients At The Military Hospital Of Douala, Cameroon, Duane Killian Madziva

Public Health Theses

Background: With anti-retroviral therapy (ART) prolonging the survival of people of living with HIV/ AIDS, other chronic co-morbidities such as hypertension, and diabetes are becoming an increasing problem. Studies on hypertension and diabetes in Sub-Saharan Africa are still limited, even with the growing concern of Africa’s dual burden of chronic and infectious diseases. As such, we aimed to determine the prevalence, awareness and control of hypertension and diabetes among people living with and without HIV/ AIDS in Cameroon. Methods: This was a hospital-based cross-sectional study conducted at the Military Hospital of Douala, Cameroon. Participants aged 21 – 65 years were …

Racial/Ethnic And Sociodemographic Disparities In Lipid Screening And Risk Factor Awareness Among Pregnant Women Receiving Prenatal Care, Reed Mszar

Public Health Theses

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality with younger women being disproportionately affected by traditional risk factors including dyslipidemia. Despite recommendations for lipid screening in early adulthood, many younger women currently do not undergo screening. Prenatal and early pregnancy care represent underutilized opportunities for lipid screening and ASCVD risk assessment. We aimed to assess the prevalence and variations in pregnant women reporting a prior lipid screening and an awareness of high cholesterol as a risk factor for ASCVD.

METHODS: We administered a survey to 234 pregnant women receiving prenatal care at one of the …

Covid-19 Risk Among Temporary Protected Status Beneficiaries, Diana Estefania Estrada Alamo

Public Health Theses

The current federal response of the United States to the COVID-19 pandemic has created conditions and resulted in unintended consequences that may be disproportionately increasing the risk of COVID-19 infection and sequelae for immigrant populations. This investigative thesis explores whether states with a greater percentage of Temporary Protected Status beneficiaries experience more COVID-19 related deaths as compared to the rest of the United States. Using a multiple linear regression model for statistical analysis, covariates under consideration include the number of COVID-19 confirmed cases, tests performed, hospitalizations reported, as well as the population density of each state and the proportion of …

Glycemic Variability And Indices Of Glycemic Control Among Pregnant Women With Type 1 Diabetes Based On Use Of Constant Glucose Share Technology, Julie Sklar

Public Health Theses

Pregnant women with type 1 diabetes (T1D) experience increased glycemic variability as a result of changing insulin sensitivity and resistance throughout gestation. Therefore, strategies that help pregnant women with T1D manage their glycemic control are of great interest. We examined whether remote monitoring of Continuous Glucose Monitor (CGM) data by friends and family affects glycemic variability during pregnancy compared to CGM use alone in a pilot non-randomized trial (n = 28). During preconception or the first trimester, women with T1D were placed in one of two groups based on device compatibility: (1) CGM Alone (n = 13): women without iPhone, …

Accelerometer-Measured Physical Activity And Sedentary Time Among Samoan Adults And Associations With Type 2 Diabetes And Hypertension, Parmida Zarei

Public Health Theses

Objectives: (1) To describe accelerometer-measured physical activity among Samoan adults; (2) to determine associations between physical activity and type 2 diabetes and hypertension; and (3) to assess adherence to global physical activity recommendations.

Participants: Three hundred eighty-five Samoan adults aged 30-72 years.

Setting: Participants were recruited from 23 villages on the Samoan island of ‘Upolu (eight urban, seven peri-urban, and eight rural).

Measurements: Self-reported demographic information including age, census region of residence, and occupation was collected. Anthropometric measurements including weight and height were taken in light island clothing, and body mass index was calculated. Sedentary time, light-intensity physical activity, and …