UCHC Graduate School Masters Theses 2003 - 2010

The Sympathetic Arterial Innervation and Body Stress

James O'Rourke — Mon, 22 Apr 2013 09:08:34 PDT

Therapeutic Touch and Cancer Cells

Gloria A. Gronowicz — Mon, 22 Apr 2013 08:44:42 PDT

Energy medicine therapies based on a human biofield have been practiced for thousands of years and can trace their origin in Ayurveda. Our goal was to determine if Therapeutic Touch (TT), a more recently developed energy medicine practice, had any effects on cancer cells. Previous work in our laboratory demonstrated that TT significantly increased the growth of normal human osteoblasts and increased the synthesis of bone matrix proteins and mineralization in cell culture. In this study as was practiced in our previous studies, TT was performed twice a week for 10 minutes and was compared to untreated cultures and 'placebo-treated" cultures. Two different cell lines of human bone cancer, osteosarco~a, were used; Saos-2 and HOS, derived from different patients. TT significantly (p=O.01) decreased HOS proliferation determined by radioactive thymidine incorporation into the DNA, but had no significant effect on Saos-2 cells compared to untreated control and placebo-
treated groups. At 2 weeks, TT significantly decreased mineralization, determined by assaying calcium content of the cell layer of Saos-2 and HOS cells (p=O.03), compared to control and placebo-treated cultures. Additionally, Northem blot analysis indicated a TT-induced decrease in mRNA expression for several bone matrix proteins in both Saos-2 and HOS cell cultures. In conclusion, Therapeutic Touch decreased differentiation and bone formation in human osteosarcoma-derived cells and significantly decreased cell growth in the HOS but not in Saos-2 cells. These results demonstrate that a human
biofield exists, which is able to affect cell activities and may have therapeutic value in patients.

Sexual Risk and High Risk Behavior among Substance Abusing Adolescents in Hartford, Connecticut : Implications for Effective Treatment Delivery

Rosalie Simichak — Mon, 07 Feb 2011 11:07:05 PST

Substance use and high risk sexual behavior have significant health consequences for adolescents who engage in these behaviors, including HIV, STD transmission, teen pregnancy, and an array of other associated health problems. The Hartford Youth Project (HYP) established by the Connecticut Department of Children and Families, offers a system of substance abuse treatment which has proven to be effective in reducing adolescent engagement in such high risk behavior. In this study, the data generated by the HYP are examined in conjunction with data derived from a qualitative review of existing services in order to identify a sexual risk profile for substance abusing adolescents in Hartford. The majority of both HYP boys and girls (75% of boys and 56% of girls) reported sexual activity in the last three months. Among both boys and girls, more than a third of both reported that they had sex without a barrier. The large number of substance abusing youth having unprotected sexual activity places them at significant risk of HIV/STDs and pregnancy. Nearly a third of both boys and girls also reported having sex while either they or their partner were high on alcohol or drugs. Although available services have proven to be effective in addressing the issue of substance use and abuse among this population, there is clearly a gap in this service system in the area of HI V, STD and pregnancy prevention. The findings of this study highlight the importance of making services available to youth to address their population's need for such appropriate HIV, STD and pregnancy prevention services.

The Effects of Cognitive Reserve on the Rate of Cognitive Decline in Persons with Mild Cognitive Impairment

Nicholas Adams — Tue, 11 Jan 2011 05:57:22 PST

Healthy Food Availability in Hartford's Corner Stores: WIC Authorization Matters

Erin Katherine Havens — Wed, 13 Oct 2010 11:14:22 PDT

Diet is an important modifiable risk factor for obesity and related chronic diseases which are disproportionately high among low-income and racial/ethnic minority populations. A growing field of research has documented inequalities by race and income in neighborhood access to foods recommended for a healthy diet. In October 2009, the revised food package for the Supplemental Nutrition Program for Women, Infants and Children (WIC) took effect, requiring certified stores to stock fresh produce, whole grain products and other foods consistent with national dietary recommendations. This project examined 1) differences in healthy food availability (HFA) between WIC-certified and non-certified corner stores and 2) the impact of federal changes to the WIC program on HFA in corner stores. Four rounds of food inventories were completed in 52 corner stores in Hartford, CT between January 2009 and January 2010 to measure the effect of the policy change. Analyses included chi-square, t-tests, and multivariate regression models. Participation of store owners as WIC vendors positively predicts HFA in Hartford’s corner stores. Compared to non-certified stores, WIC certified stores stocked a wider variety of revised food package foods, a higher proportion of reduced-fat milk, a greater variety of produce and were more likely to carry whole grain bread than non-WIC stores. The strength of WIC-certification as a positive predictor of HFA increased following the WIC policy changes. These findings have potential implications for intervention planning in Hartford and reflect the importance of including WIC as a variable in future food environment studies.

Feasibility of Screening for Violence in the Pediatric Emergency Department Setting

Courtney M. Thomas — Tue, 17 Aug 2010 11:22:07 PDT

Attribution of the Causes of Death in People Infected with HIV and/or Hepatitis C in Connecticut, 2003-2007

Kristin Elizabeth Gerard — Tue, 17 Aug 2010 11:10:39 PDT

Introduction: This study examined the causes of death in Connecticut residents who were infected with hepatitis C and/or HIV/AIDS and died between 2003 and 2007. Disease surveillance and mortality data can provide important public health information that may be used to develop important public health programs, policies, or legislation. Underreporting of diseases in mortality data may lead to reduced public health funding. Background: Hepatitis C and HIV/AIDS are two potentially fatal infectious diseases that have been reportable in Connecticut since 1994 and 1981, respectively. Mortality data in Connecticut contain information about the causes of death in a deceased individual, which may or may not encompass all actual causes. Methods: The hepatitis C and HIV/AIDS databases were matched to death data from 2003 to 2007 using Link Plus, electronic matching software from the CDC. The match resulted in three de-identified databases: deceased hepatitis C cases, deceased HIV/AIDS cases, and deceased co-infected cases. Primary and underlying causes of death were examined. Results: HIV disease was the primary cause of death in more than half of HIV/AIDS and co-infected cases while chronic hepatitis C was the primary cause of death in 6.7% of hepatitis C cases. In hepatitis C cases where the primary cause of death was liver disease, hepatitis C was listed as an underlying cause of death in 6.2% of those cases. Similar findings were shown in HIV/AIDS cases when major cardiovascular disease was the primary cause of death. vi Conclusions: HIV/AIDS and hepatitis C are underreported on death certificates in Connecticut, especially when the person died of a condition possibly related to their infection. Hepatitis C was underreported more often than HIV/AIDS. Increased HIV and hepatitis C screening for at-risk persons, comprehensive prevention programs, education about the importance of death certificates and how to complete them, and data sharing between agency programs may help to reduce underreporting in mortality data.

An In-Depth Study of Staphylooccus aureus Infections and Cases of Colonization in the Inpatient Population at a University Teaching Hospital

Nancy Russell Dupont — Tue, 17 Aug 2010 11:01:52 PDT

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that has historically been identified in hospital-acquired infections since the mid 1900's. Epidemiologically significant trends have occurred which have identified the increasing prevalence of MRSA in the community setting. Methods: An investigation of all isolates positive for Staphylococcus aureus of the inpatient population was conducted over a nine year time period in a university teaching hospital. Additionally, a unit specific case/control study was conducted during an outbreak of MRSA in a neonatal intensive care unit. Results: From January of 1997 through December of 2005, the number of isolates identified as positive for S. aureus had increased. Additionally, the proportion of MRSA to Methicillin-sensitive Staphylococcus aureus (MSSA) had increased from 40 to 60%. A chi-square test was conducted comparing the number of isolates positive for MRSA in 1997 versus 2005 which was found to be statistically significant with a P value < 0. 001. Additionally, from January 1997 through December 31, 2001, the first greatest change in proportion of MRSA to MSSA was noted. The increase in isolates identified as positive for MRSA was found to be approximately three times as great. The comparison of isolates identified as MRSA in 1997 versus 2001 was statistically significant with a P value <0.001. A hospital-acquired case is defined as one in which the specimen positive for MSSA or MRSA was obtained 48 hours after admission to the hospital. Conversely, a community-acquired case is defined as having a culture positive for MSSA or MRSA obtained within 48 hours of admission. Using a chi-square test we found no statistically significant difference in identification of the acquisition of MSSA or MRSA as to whether the patients were adrnitted from home or another health care institution. The number of community-acquired cases identified as positive for MRSA was higher than those that were hospitalacquired. Lastly, through a case/control study of infants leading to NlCU employee screening for identification of employees for positive colonization status with MRSA, we identified the common source who served as a reservoir for transmission of this pathogen. Conclusion: Methicillin-resistant Staphylococcus aureus has emerged as a significant public health burden and serves as a warning requiring the attention of key stakeholders to implement rigorous actions to control the spread and reduce the development of multi-drug resistant organisms.

Adolescent Pregnancy Prevention in San Jose, Costa Rica : Assessment of an Educational Intervention

Alexandra Devin Mainiero — Tue, 11 May 2010 10:32:13 PDT

This thesis explores adolescent pregnancy in San Jose, Costa Rica and examines a school-based pregnancy prevention intervention. The relationships between school, gender and risk of adolescent pregnancy are also analyzed, and recommendations are made for effective pregnancy prevention programming. The Purral region of Guadalupe on the outskirts of San Jose, Costa Rica, suffers a higher rate of adolescent pregnancy compared to the rest of the country. In response to this problem, the International Health Central American Institute (IHCAI) implemented a sexual health education program in two local secondary schools in 2006. Very little information about the program is available. It is known that the program was initially evaluated through assessments of the participants’ knowledge before and after the educational sessions. There was no evaluation of the youth attitudes or behaviors, adolescent pregnancies, or long-term impact. The author worked with IHCAI in San Jose, Costa Rica to perform an assessment of the longer term effects of this sexual health education program. They developed a questionnaire to evaluate the knowledge, attitudes, and behaviors surrounding sexual health of youth in the Purral community. Researchers at IHCAI later used this survey to collect data from adolescents who had participated in the educational intervention and those who had not. This thesis analyzes the data collected by IHCAI to assess the effectiveness of the - 2 - educational intervention and the influence of other factors on the knowledge, attitudes, and behaviors of adolescents in the Purral region. The thesis begins with an overview of adolescent pregnancy, Costa Rica and the Purral region, and a description of the education intervention implemented by IHCAI. The research goal, logic model, and methods are then described. The results are reported, and the thesis then concludes with discussion of the results as well as study limitations and recommendations for future research and intervention. This thesis will be used to guide IHCAI’s continuation and expansion of adolescent pregnancy prevention programming.

OB/GYN Rates and Risk of Malpractice: Considerations for the University of Connecticut Health Center Credentialing Committee

Denise Ortiz — Wed, 24 Feb 2010 05:36:47 PST

The Effect of Eating Disorders on Work Performance

Kristie Jean Smith — Thu, 25 Jun 2009 10:19:03 PDT

The Effect of Variation in Early Summer Rainfall Patterns on Blacklegged Tick (Ixodes scapularia) Nymph Survival, and the Implications for the Transmission of Lyme Disease in Connecticut

Jennifer Scott — Thu, 25 Jun 2009 07:33:36 PDT

Access to Oral Healthcare for People with Down Syndrome in the State of Connecticut

Moises Yldefonso Salas — Thu, 18 Jun 2009 12:31:42 PDT

The Associations Between Social, Behavioral, and Health Risk Factors on a High School Student’s Decision to Pursue Post High School Plans

Richard Anthony Rodriguez — Thu, 18 Jun 2009 12:10:37 PDT

Background: Due to the relationship between SES and health, pursuing post high-school plans can lead to better future health outcomes for the student. The current paper assesses how behavioral and health risk factors, and family and social support, effect a student’s decision to pursue post high school plans. Methods: Data from the Youth Behavioral Component of the 2007 Connecticut School Health Survey were analyzed. Composite measures of exposure to/participation in violent behavior, mental and physical health, family/social support and substance abuse were created. The effects of these domains on the decision to pursue post high-school plans were assessed using logistic regression. Data were stratified by socioeconomic status. Results: Low SES students were more likely than high SES students to be doubtful for post high-school plans. Cocaine abuse emerged as the risk factor that put low SES students at the highest odds of not pursuing post high-school plans, followed by involvement in violent/aggressive behavior, and receiving less family/social support than their peers. Similar findings regarding violence and family/social support were found in the high SES group. Findings regarding substance abuse in the high SES group were not statistically significant. Discussion: Prevention programs regarding violence and substance abuse may have the added benefit of increasing the likelihood that high school students will make post high school plans. Preventing cocaine use among low SES students may be of particular importance. Violence prevention measures should be tailored to the target group. Adequate family/social support emerged as an encouraging factor for post high school plans.

Misperceptions and Barriers to Seeking Dermatologic Care in Minority Populations

Titilopemi Aina — Thu, 04 Jun 2009 11:26:06 PDT

C-Reactive Protein, Obesity, and Colorectal Cancer Mortality : a Prospective Study of the NHANES III-NDI Dataset

Alexandra Maria Hajduk — Thu, 04 Jun 2009 09:18:03 PDT

Chronic inflammation has been implicated in the pathogenesis of many chronic diseases, including colorectal cancer. Obesity has been identified as a risk factor for colorectal cancer via induction of a chronic state of low-grade bowel inflammation due to excessive release of inflammatory cytokines such as C-Reactive protein (CRP) by adipocytes. Prior studies have produced evidence of positive associations between CRP and colon cancer risk but none to date have assessed if elevated CRP is an independent risk factor when controlling for obesity. Also, controversy exists about which measure of adiposity best predicts risk of colon cancer. METHODS: We examined these questions using the National Health and Nutrition Examination Survey III (NHANES III) database linked to the National Death Index. In addition to CRP level, we studied the following four adiposity measures: body mass index, waist circumference, waist-to-hip ratio, and a new index developed by the NIH that stratifies BMI according to waist circumference. Outcome variables were: all-cause, colorectal cancer, other obesity related cancers, and all other causes. Dichotomous and Polytomous Logistic Regression were performed. RESULTS: CRP levels showed positive but weak correlations with adiposity measures. In the age-adjusted and multivariate Dichotomous Logistic Regression analyses, elevated CRP level was significantly associated with all-cause mortality (OR=1.63 95% CI 1.40-1.91; and OR=1.32, 95% CI 1.08-1.61; respectively.) Using age-adjusted and multivariate Polytomous Logistic Regression, elevated CRP level was associated with mortality from colorectal cancer (OR=2.72, 95% CI 1.30-5.72; OR= 2.44, 95% CI 1.20-4.94; respectively.) OR estimates did not change appreciably when adiposity measures were included in multivariate models. Further, none of the body measures of adiposity were significantly associated with cause-specific death in either age-adjusted or multivariate analyses. CONCLUSIONS: Our findings suggest that CRP may be an independent risk factor for all-cause and, more so, for colorectal cancer mortality. We speculate that the surprising effects related to body measures of adiposity may reflect misclassification related to the single baseline obesity measurement, taken during 1988-94, in light of the obesity epidemic that emerged during the follow-up time period. Further investigation of this relationship is warranted to determine of elevated CRP remains an independent risk factor when longitudinal adiposity history is known.

The Dental School Applicant Pool and the Oral Healthcare Workforce

Lauren Mentasti Consonni — Thu, 21 May 2009 13:58:56 PDT

One of the major challenges faced by the dental profession today is the recruitment of the most qualified dental school applicants who are capable of serving the nation’s future oral healthcare needs. The Association of Schools of Public Health (ASPH) also recognizes this challenge, describing one of the three core functions of public health as “assuring that all populations have access to appropriate and cost effective care, including health promotion and disease prevention services.” To achieve this core function, the ASPH cites “a competent public health and personal healthcare workforce” as one of the ten essential public health services. Unfortunately, the goals of both quality and equality in terms of the dental workforce and access to oral healthcare have yet to be realized. When considering access to oral health services on a national or state level, a thoughtful and thorough consideration of the dental school applicant pool is essential. According to a recent study published in the Journal of the American Dental Association, the annual number of retiring dentists will exceed the number of newly licensed dental practitioners in 2009, a trend which is projected to continue throughout the next decade. The approximately 4,400 dentists produced each year from the nation’s 57 accredited dental education programs are charged with the responsibility of meeting the oral healthcare needs of the population at large.

The Impact of Depression on Long-Term Care Needs and Utilization

John Kouch — Thu, 21 May 2009 09:38:01 PDT

Practice-Based Care Coordination: the Outcomes of Care Coordination Activities in an Inner-City Pediatric Clinic

Giorelly Jacqueline Prado — Wed, 20 May 2009 11:12:07 PDT

Analyses of Occupational Illnesses and Implementation of Preventive Strategies at Connecticut Tobacco Farms

William Carter III — Mon, 18 May 2009 07:50:00 PDT