Medicine and Health Sciences Commons^™

Depression And Anxiety Among Plurisexual Teens In The U.S., Olivia Goodwin

Public Health Theses

Background: Little research focuses on the mental health consequences of stigma for plurisexual teens, with even less research comparing cisgender plurisexual youth to nonbinary plurisexual youth.Aims: To assess whether having both a marginalized sexual orientation and a marginalized gender identity is associated with greater risk or greater resilience in depression and anxiety outcomes among teens in the US. Methods: Data was analyzed from the 2022 LGBTQ Teen Survey. Inclusion in the study required being an English speaker living in the US, being 13-18 years old, and identifying as cisgender and plurisexual (n=1547) or gender nonbinary and plurisexual (n=1867). Statistical tests …

Longitudinal Associations And Trajectories Of Cognitive Decline By Blood Pressure Categories, Namuunaa Juramt

Public Health Theses

Objectives: This study aimed to examine the cross-sectional, longitudinal associations and trajectories between cognitive decline and blood pressure (BP) categories defined by the 2017 American College of Cardiology/American Heart Association guideline and to explore sex differences in cognitive decline trajectories in each BP category.Design, setting, and participants: The Atherosclerosis Risk in Communities study is a longitudinal cohort study (1987-2018). 10,456 of 15,792 participants (female 55.5%) were included in the analysis with a median follow-up time of 22.2 years. Exposures: Blood pressure (BP) was measured at 6 of the study visits and was categorized as normal BP (Systolic BP [SBP] < 120 and Diastolic BP [DBP] < 80 mmHg; n = 930), elevated BP (SBP 120-129 and DBP < 80mmHg; n = 853), hypertension stage 1 (SBP 130-139 mmHg, or DBP 80-89 mmHg; n = 1,142), and hypertension stage 2 (SBP >=140 …

Psychological Resilience In U.S. Military Veterans: Results From The 2019-2020 National Health And Resilience In Veterans Study, Michael Georgescu

Public Health Theses

Psychological resilience is the most common response following exposure to traumatic life events. To date, most research has focused on factors associated with adverse post-trauma mental health outcomes rather than understanding those associated with psychological resilience. In particular, little is known about factors associated with resilience in veterans, despite their high rates of trauma exposure, such as combat and military sexual trauma. To address this gap, we used a discrepancy-based psychiatric resilience (DBPR) analytic approach to operationalize resilience and to identify modifiable health and psychosocial factors associated with resilience in a nationally representative sample of U.S. veterans (N = 4,069). …

Protection Against Cholera From Killed Whole-Cell Oral Cholera (Kocv) Vaccines: Systematic Review And Meta-Regression Of Randomized Control Trials And Observational Studies, Helena Hojeong Kwon

Public Health Theses

Introduction: Although killed whole-cell oral cholera vaccines (kOCVs) are widely used as a part of cholera control strategy, mixed evidence around the vaccine induced protection remains.Objectives: The primary objective of this systematic review was to update estimates of kOCV protection: vaccine efficacy and effectiveness. A secondary objective was to estimate the waning dynamic of kOCV protection by duration of follow-up. Methods: On August 15th, 2022, we searched for randomized control trials and observational studies that reported kOCV protection in low- and middle-income countries on PubMed, EMBASE, Scopus, ISI Web of Science, and The Cochrane Review Library with a start date …

“Recovery Is About Change, So You Have To Change Everything” Exploring The Evolution Of Recovery Capital Among Women In Substance Use Disorder Treatment, Elizabeth Jadovich

Public Health Theses

Recovery capital is an emerging framework in the field of addiction that aims to understand substance use disorder recovery holistically by considering an individual’s access to resources across the four domains of human, physical, social, and community capital. The underrepresentation of women’s experiences in substance use research as well as the limited understanding of substance use disorder treatment’s effect on recovery capital development poses specific challenges to women’s development and maintenance of recovery capital resources while in treatment. This secondary qualitative analysis of data collected from the larger RENEW study explores the experiences of 19 women actively enrolled in substance …

A Dna-Extraction-Free Method For The Molecular Detection Of Streptococcus Pneumoniae Carriage In Saliva, Tzu-Yi Lin

Public Health Theses

Pneumococcal carriage is a prerequisite for pneumococcal disease and surveillance of carriage is crucial for evaluating and informing vaccination strategies. In recent years, molecular methods have improved the sensitivity of pneumococcal carriage detection as compared to the gold standard culture-based method. However, nucleic acid extraction from samples collected is resource-intensive, limiting scalability for extensive surveillance, particularly in low-resource settings. We previously developed a saliva-based PCR test for SARS-CoV-2, having identified that nucleic acid extraction can be omitted and replaced with a simple enzymatic lysis or heat treatment step without compromising the accuracy and efficiency of testing. Here, we compared pneumococcus …

Elucidating Metformin As A Scavenger Of 4-Hne, An Endogenously Produced Aldehyde Associated With Alzheimer’S Disease Progression, In Hek293t Cells, Miren Lopez Lascurain

Public Health Theses

Metformin, a first-line therapy for Type 2 Diabetes Mellitus (T2DM), has been shown to have numerous health benefits in neurodegenerative disease progressions, including Alzheimer’s disease (AD). Vasiliou et al. have recently proposed that metformin is able to scavenge endogenously produced aldehydes such as 4-hydroxy-2-nonenal (4-HNE), which are thought to contribute to the progression and development of AD. Preliminary in vitro and in silico studies demonstrate that metformin scavenges 4-HNE leading to adduct formation. Therefore, this study sought to determine if metformin adducts 4-HNE in a living system. We hypothesize that metformin can scavenge 4-HNE in HEK 293T cells and will …

"Hair-Esteem Toolkit For Black Girls": The Development Of A Self-Esteem Toolkit For Black Adolescent Girls Centering Hair As A Tool For Empowerment, Sydney Hussett-Richardson

Public Health Theses

Background: For Black adolescent girls, hair is a strong staple of gender and ethnic identity, influencing intrapersonal and interpersonal interactions. Gendered racism and Eurocentric beauty standards pathologize Black girls and their hair, leading them to experience high rates of hair harassment and discrimination. These experiences negatively impact the self-esteem of Black girls, which has important implications for a host of health behaviors. The purpose of this study was to explore the relationship between self-esteem and hair among Black girls and integrate findings into a culturally relevant digital toolkit to promote and develop hair-esteem and self-esteem among Black girls.Methods: This study …

The Ethical And Legal Considerations Of Ai-Driven Healthcare In Infectious Diseases, Natalie Makableh

Public Health Theses

Artificial intelligence (AI) has been rapidly growing in the healthcare sector, with the potential to improve patient outcomes, increase efficiency, and reduce costs. However, as with any technological advancement, AI-driven healthcare presents ethical and legal challenges that must be addressed to ensure the responsible and beneficial use of the technology. To the best of our knowledge this is the first study to examine the ethical and legal considerations of using AI technology in healthcare, with a particular focus on infectious diseases. With the growing use of AI in healthcare, it is crucial to evaluate its potential benefits and challenges in …

Variation In First-Line Therapy By Biomarker Expression Status In Patients With Advanced Non-Small Cell Lung Cancer, Yimeng Li

Public Health Theses

Background: Patients diagnosed with advanced non-small cell lung cancer (NSCLC) have a poor prognosis. To inform evidence-based care, this study aims to describe and quantify the first-line treatment variation of patients with NSCLC. Methods: A retrospective cohort study was conducted using Flatiron databases to analyze the treatment patterns of 18,979 patients with advanced NSCLC diagnosed between 1/1/2016 and 6/30/2020. Patients were categorized into groups by biomarker findings and performance status. The first-line treatment variations were measured using the Herfindahl-Hirschman Index (HHI), which provides an indication of the degree of variation in treatment. Bootstrapping was assisted in calculating 95% confidence intervals …

Assessment Of Environmental Injustice: Spatial Analysis Of Pennsylvania Drilling Waste Facilities And Community Demographics, Avery Naperala

Public Health Theses

Background: Unconventional oil and gas drilling practices have led to the production of technologically-enhanced naturally occurring radioactive materials (TENORM) and chemical waste products, with insufficient toxicological data to understand the health impacts of exposures to these waste materials (U.S. Energy Information Administration, n.d.; US EPA, 2015b; ALNabhani et al., 2016; Elliott et al., 2017). Environmental injustices occur when disadvantaged populations experience a disproportionate burden of exposure to environmental disamenities, such as waste facilities (US EPA, 2015a). This study aims to assess whether disparate exposure to drilling waste facilities is occurring in Pennsylvania based on several socioeconomic factors, as well as …

The Impact Of The Covid-19 Pandemic On Non-Typhoidal Salmonella Incidence And Exposures In Connecticut, 2015-2022, Adeline Morris

Public Health Theses

Background: During 2020, Salmonella incidence decreased by 22% in the United States.1 At the same time, many common activities were reduced or restricted, including travel and eating food prepared at restaurants or events, which are known risk factors for Salmonella infection. Methods: A descriptive analysis using Salmonella surveillance data collected in Connecticut between 2015 to 2022 was performed to characterize the changes in travel and outside food exposures. Frequencies of exposures were compared before the pandemic, during the pandemic, and after the vaccine was implemented and restrictions eased. Rate ratios of observed to expected cases were calculated to explore trends …

Early Life Growth Patterns Among Infants Of Mothers With Diabetes, Hedy Ludwig

Public Health Theses

AbstractObjective: Exposure to diabetes during pregnancy increases the risk of insulin resistance, obesity, and cardiometabolic disease in offspring. Limited research exists regarding early postnatal growth patterns among moderate preterm and term infants. This study aims to evaluate growth patterns during the early postnatal period among term and moderate preterm infants of mothers with and without diabetes during pregnancy. Methods: In a prospective longitudinal analysis using data from Yale New Haven Hospital (YNHH), characteristics from term and moderate preterm infants were compared between diabetes exposure groups (n=148). Percent change in weight from birth to hospital discharge was compared between diabetes exposure …

Impact Of The Covid-19 Outbreak On Mental Health And Public Practices In Rural Communities In China, Wenxin Liang

Public Health Theses

Coronavirus disease (COVID-19) has significant impact on people’s mental health. However, no nationwide study has investigated the mental health among rural residents during the COVID-19 outbreak in China. This study was aimed to investigate the impact of the COVID-19 outbreak on the mental health and public practices for controlling and preventing the COVID-19 in rural communities in China. An anonymous online survey was sent to participants through WeChat, the most widely used Chinese social-networking app, from March 2 to 11, 2020. We recruited 4607 individuals from 11 representative provinces in mainland China. The analytical sample was 2159 rural residents. The …

Menopausal Status, Age At Menopause, And Associations With 1-Year Angina Burden Among Women In Recovery From Acute Myocardial Infarction Enrolled In The Virgo Study, Tamara Dorothy Mehta

Public Health Theses

Background: Current knowledge is limited on the association between early age at menopause (AAM) and angina during recovery from acute myocardial infarction (AMI) in young women. We assessed the differences in 1-year angina burden post-AMI among women in pre/peri-menopause phases compared to post-menopausal women stratified by their AAM. Methods: Among patients in the VIRGO study, 1,948 women were categorized into four groups: a reference group of those in their pre/peri-menopause phase (n=917), post-menopausal women who reached AAM at 40 years or younger (n=337), AAM between 41-49 years (n=476), and AAM between 50-55 years (n=218). Angina burden was assessed from Seattle-Angina …

Sexual Show-And-Tell: Correlates Of Sex Communication And Active Modes Of Consent, Samantha Nardella

Public Health Theses

Sexual consent communication is a critical component in ensuring healthy and satisfying sexual experiences. The communication of consent can take many forms and be affected by a variety of factors, ranging from gender and sexual orientation, to type of sexual behavior and familiarity with a partner. The current study sought to examine the ways in which different factors affected how one communicated consent in their last sexual encounter. College students (N = 211) completed an online cross-sectional survey examining engagement in sexual behaviors, feelings in sexual encounters, and aspects of their most recent sexual experience. Individual- and situational-level correlates were …

Epidemiology Of Human Hookworm (Necator Americanus) Infection In Rural Ghana: Investigating Host-Parasite Factors That Mediate Infection, Savanna Randi

Public Health Theses

Abstract

Introduction: Hookworms are soil-transmitted helminths (STHs) that cause significant morbidity in high-risk populations, posing a global health concern in locations of rural poverty [1-5]. While there have been ventures by the World Health Organization to eliminate hookworms in Africa by 2030, there is variability in the effectiveness of current chemotherapy regimens. Studies have shown that benzimidazole anthelmintics have reduced effectiveness, and people living in endemic areas are quickly reinfected [6]. Critical gaps remain in understanding parasite-host interactions within communities, further challenging successful disease control. A study initiated in 2022 investigated the epidemiology of human hookworm infection in Beposo, Ghana. …

Antibiotic Prophylaxis For Prevention Of Surgical Site Infections In Orthopedic Surgery, Edwin Ruiz Fuentes

Public Health Theses

Background: In the past decades, there has been an increase in the proportion of orthopedic surgical site infections (SSIs) caused by gram-negative bacilli in various healthcare settings. SSI prevention guidelines suggest that gentamicin can be added to prophylactic antibiotic treatment to target gram-negative bacilli. However, the effectiveness of this strategy remains to be confirmed in orthopedic surgery.

Methods: A retrospective cohort study was conducted to investigate the association between antibiotic prophylaxis with adjunctive gentamicin and SSI rates in orthopedic surgeries. 5,571 patients who underwent hip, knee, spine, and hip fracture surgeries between January 2019 and July 2021 at Yale-New Haven …

Associations Between Patient Sociodemographic Factors And Risk-Aligned Prostate Cancer Clinical Management, Madison Jewel Novosel

Public Health Theses

Although definitive treatment is associated with improved survival for aggressive prostate cancer and is supported by clinical practice guidelines, a significant number of patients do not receive definitive treatment. To identify gaps in practice, we sought to evaluate sociodemographic factors associated with treatment of localized prostate cancer across clinically relevant risk strata. We performed a retrospective study of patients with prostate cancer using the National Cancer Database. A total of 954,591 patients diagnosed with localized prostate (cT1-4N0M0) cancer from 2010 to 2020 were included in the analysis. We used descriptive statistics and multivariable logistic regression to evaluate factors associated with …

Examining The Impacts Of Stress And Negative Affect On Eating And Weight Outcomes: A Meta-Analysis, Taylor Spadory

Public Health Theses

Overweight and obesity have become incredibly pressing public health issues in the United States. Rising rates of prevalence pose grave risks to population health and underscore the need for a greater understanding of the underlying mechanisms that contribute to increased eating and weight gain. While stress and negative affect (NA) have been recognized as possible predictors, the literature is inconsistent and experimental studies have produced mixed results. Therefore, we conducted a comprehensive quantitative meta-analysis to assess the prospective effects of stress and NA on eating and weight outcomes, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We …

From Theory To Practice: Zoonotic Spillover, One Health And The Role Of Local Indigenous Communities, Pranav Prabhu Savanur

Public Health Theses

This paper discusses the impact of zoonotic spillovers on public health and the need for a One Health approach to preventing future pandemics. Zoonotic spillovers occur when pathogens are transmitted from animals to humans, facilitated by anthropogenic land changes, migration or trade, increased human-animal contact, and poor biosafety. However, anthropogenic land use change is the primary driver for zoonotic spillovers. Most emerging infectious diseases in humans are of zoonotic origin, and the impact of these spillovers on public health is significant. The paper emphasizes the need to prevent spillover events for primary pandemic prevention, which requires a coordinated and collaborative …

The Makings Of Creativity And Empathy: Maps Of Maternal Representations, Anielle M. Fredman

Dissertations and Theses

ABSTRACT

The Makings of Creativity and Empathy: Maps of Maternal Representations

by

Anielle M. Fredman

Advisor: Sasha Rudenstine, Ph.D.

The present study investigates the relationship between maternal fantasy of the child and their relationship, and children’s unconscious processes. In addition, the study aims to ascertain the link between maternal representations and aspects of the child’s intrapsychic world, including ego functioning, object relations, and processes of separation-individuation.

Maternal fantasy was measured in an original way with a tripartite typology of Positive, Mixed-Complex, and Contradictory Representations, applied to the Parent Development Interview-Revised Short (Slade et al., 2004), adapted from the Working Model …

Use Of Bioheat Modeling To Characterize And Optimize Implantable Medical Devices And Neuromodulation Technologies, Adantchede Louis Zannou

Dissertations and Theses

Medical device development includes prototyping, benchtop characterization, preclinical studies, and clinical trials. Understanding the limitations and potential adverse effects of medical devices prior to their administration in humans is a crucial first step. Optimizing medical devices is essential to employing technology and improving patients care. Computational modeling is widely adopted as a powerful tool to predict stimulation/recording parameter optimization, rapid electrode/device prototyping, investigating novel mechanism of action, and testing working principles of any medical devices. Many implantable neuromodulation technologies including Spinal Cord Stimulation (SCS), which provide substantial therapeutic benefit for patient population with lower back pain, produces heat via the …

Mechanically Driven In Vivo Osteocyte Ca2+ Signaling: Aging And Pharmacologic Effects, James Padgett

Dissertations and Theses

Bone’s ability to respond and adapt to mechanical loading declines significantly with age which is a major contributor to bone fragility. It is widely accepted that osteocytes are the key cells responsible for orchestrating the development of the “ideal” skeleton. This ability is attributed to osteocyte’s role as the primary mechanosensing cell that is responsible for maintaining the skeleton’s integrity throughout life. Recent work from our laboratory has shed light into how osteocytes respond to mechanical loading in vivo. The breakthrough approaches that enabled these discoveries were development of: (1) the first ever reporter mouse model with a genetically encoded …

Patient Engagement, Involvement, Or Participation -- Entrapping Concepts In Nurse-Patient Interactions: A Critical Discussion, Teresa Jerofke-Owen, Georgia Tobiano, Ann C. Eldh

College of Nursing Faculty Research and Publications

The importance of patients taking an active role in their healthcare is recognized internationally, to improve safety and effectiveness in practice. There is still, however, some ambiguity about the conceptualization of that patient role; it is referred to interchangeably in the literature as engagement, involvement, and participation. The aim of this discussion paper is to examine and conceptualize the concepts of patient engagement, involvement, and participation within healthcare, particularly nursing. The concepts were found to have semantic differences and similarities, although, from a nursing perspective, they can be summoned to illustrate the establishment of a mutual partnership between a patient …

Case Reports From Women Using A Quantitative Hormone Monitor To Track The Perimenopause Transition, Maria Meyers, Richard J. Fehring, Mary Schneider

College of Nursing Faculty Research and Publications

The fertility tracking of menstrual cycles during perimenopause with a quantitative hormone monitor is a novel undertaking. Women in regular menstrual cycles have been tracking their fertility using different biomarkers since the 1960′s. Presently, there are newer electronic hormonal devices used to track fertility that provide more exact and objective data to help delineate the fertile time frame of a woman’s cycle. These devices measure quantitative levels of estrogen, the luteinizing hormone, progesterone, and follicle-stimulating hormone, all of which occur at varying levels during the menstrual cycle. As women advance toward menopause, their cycles vary in length, and their hormones …

A Swimming Program For Children With Autism Spectrum Disorders: Assessing Critical Parameters From Caregivers’ Perspectives, Abir K. Bekhet, Norah L. Johnson, Tana Karenke, Amy V. Van Hecke

College of Nursing Faculty Research and Publications

One in 54 individuals is diagnosed with autism spectrum disorders (ASD). Swimming can impact the physical and mental well-being of persons with ASD, which in turn may improve their caregivers’ well-being. The purpose of this qualitative evaluation study is to assess the necessity, acceptability, feasibility, fidelity, and beginning effectiveness of a 12-session swimming training program (STP) at an indoor university pool designed to teach persons with ASD how to swim, and to teach caregivers precautions for safety around water. Participants included 7 boys, and 3 girls with ASD [mean age 7.05 years (SD 1.17)] and their caregivers. Results indicated that …

The Influence Of Early Childhood Parental Feeding Behaviors On Self-Regulation & Food Decision-Making In Young Adults, Natasha Singareddy

CMC Senior Theses

This study used data from a diverse set of undergraduates from the Claremont Colleges to examine the relationship between cognitive control (impulsivity and response inhibition) and self-regulatory ability as an indicator of sustained early childhood parental feeding behaviors in adulthood. In addition, the current study explored if early childhood parental feeding behaviors predicted food decision-making in adulthood as a result of perceived taste and nutritional value of food items. It was hypothesized that heightened impulsivity and impaired response inhibition as measures of cognitive control would correlate to poorer self-regulation, in turn reflecting a particular mode of early childhood parental feeding …

Treatment Of Anxiety By Transcutaneous Vagus Nerve Stimulation: A Retrospective Chart Review, Rhea Gandhi

CMC Senior Theses

Surgical vagus nerve stimulation (VNS) was FDA cleared for depression (2005) and epilepsy. (1997). In the surgical procedure, a pacemaker is implanted below the collarbone (clavicle) and connected to the vagus nerve in the neck. Transcutaneous vagus nerve stimulation (tVNS) is a non-surgical alternative to VNS and there is evidence supporting its effectiveness for several conditions. Advantages include lower cost and fewer adverse side effects.

Anxiety is tied to excess or unopposed sympathetic nervous system activity, while the parasympathetic nervous system, especially the vagus nerve, is relatively underactive. This study aimed to investigate a potential impact of regular tVNS stimulation …

Understanding The Journey Of Human Prenatal Cd4+ Plzf+ T Cells To The Small Intestine, Tomi Oyedeji Olaniyan

CMC Senior Theses

The fetal immune system has a variety of needs that differ from those of the adult immune system. One such difference is fetal T cell composition and how they migrate from the thymus to peripheral lymphoid organs and mucosal tissue such as the small intestine (SI). Previous research shows that the majority of memory T cells in the prenatal SI are CD4+ PLZF+ T cells but the mechanisms involved in the homing of these cells in the small intestine have not yet been determined. In our experiment, I found evidence to support the claim that IL-7 drives the acquisition of …