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Upstream oncology: identifying social determinants of health in a gynecologic oncology population
Full text linkIntroduction: Social determinants of health (SDoH) are the factors that affect a patient’s health quality and outcomes and contribute to health disparities. Evidence suggests that clinical care contributes only 20% to patients’ health outcomes, while the remainder is under the influence of upstream factors. The upstream approach to healthcare aims to address SDoH before they contribute to less ideal outcomes downstream. Several SDoH may contribute to outcomes for cancer patients. This Upstream Gynecologic Oncology Initiative seeks to identify which SDoH affect a population of patients with gynecologic malignancies.
Hypothesis: This study hypothesizes that women receiving care for gynecologic malignancies are affected by specific SDoH among the categories of housing, food, transportation, finances, health literacy and social support. This study aims to identify the frequency of these six social factors among the outpatient gynecologic oncology population at the University of Iowa.
Methods: This needs assessment is the first phase in a quality improvement project assessing the SDoH affecting women with gynecologic cancers. Two hundred twenty-two patients receiving outpatient care for gynecologic malignancies completed an anonymous needs assessment survey. Validated survey questions regarding housing, food, transportation, finances, health literacy and social support were used to identify needs. Responses were considered positive if any degree of need was reported.
Results: Responses demonstrated the most substantial need in the categories of social support (32%), health literacy (28%) and financial stability (24%). Less need was reported in the categories of food (11%), transportation (5%) and housing (4%). Fifty-seven percent of women reported at least one social need among the six categories screened.
Conclusion: Upstream SDoH, most notably social support, health literacy and financial stability are identified to be present and likely contributing to health quality, outcomes, and disparities within this gynecologic oncology patient population. Overall, these findings support the idea that SDoH should be assessed for each unique patient population - and for each patient receiving care for gynecologic cancer. While social support was the most frequently reported SDoH, many patients already received adequate help at home; suggesting that meaningful efforts should next be directed at improving health literacy in the population. Appreciation and assessment of SDoH potential to impact care and management should be used to design a routine screening tool for the study population and organize resources to address or mitigate the identified needs
Pilots in the First World War: How the Phenomenon of the Flying Ace Impacted the War Effort
No full textThis thesis analyzes the British and German air forces during the First World War, and the various uses of planes and the men that flew them. Pilots were valued militarily, but their uses went beyond pure battle strategy and militaristic accomplishments. From the beginning of the 20th century, Europe had been infatuated with the idea of airfare and its potential power, and Europeans were also obsessed with the heroic pilots that flew them. Some of Europe’s most famous authors including H.G. Wells and Jules Verne heavily featured pilots as their glamorous, daring and brave heroes, so when the war broke out, many young men who had grown up listening and reading about pilots wanted to join the newly created air forces. The Royal Flying Corps and the Luftstreitkräfte faced tough opposition from the more traditional military branches at the beginning of the war, but would soon rise to power as reconnaissance was realized as useful, and dogfighting became an unmatched spectacle on the Western front, akin to a boxing match or other sporting event. Aces started to become recognized military and public figures. With airpower’s growing importance in the military, pilots became famous and enjoyed privileges that no other branch had. Government propaganda agencies realized pilots’ popularity and worked to use the image of the chivalrous knight in the sky for morale and recruitment purposes, in opposition to the anonymous and nameless face in trench warfare. This image turned flying into the ultimate game, and ignored the stressful reality of life as a fighter pilot. My thesis reconciles the alluring image of the flying ace with the alcoholism, debauchery, and danger that became so prevalent throughout the war, and the impact that the new technology had on the war and the men above the front lines. Using media such as film, newspapers, and memoirs, government propagandists were able to create a romanticized image of the flying ace that they could align with their own nation’s image in order to boost military and homefront morale
Big Data Drive: The Rhetoric of Biometric Big Data
Full text linkIn this essay, we seek to develop a concept of “big data drive.” Influenced in part by Lacan’s theory of drive, we study the drive toward biometric big data. Biometric big data (BBD) refers to the data collected around facial recognition, eye recognition, thumb prints, and other types of technology whose task is to identify a specific being through unique bio characteristics. “Big Data Drive” refers to the energies that pulsate around Big Data, as both a signifier and fetishized object, to promise “something more” that may never be fulfilled
The Impact of Ignition Interlock Laws on DUI Arrests
Full text linkWe study the impact of Ignition Interlock Laws (IILs), an increasingly popular public policy aimed at reducing drunk driving, on driving under the influence (DUI) arrests. While past studies have found that IILs reduce alcohol-impaired motor vehicle fatalities and short-term recidivism rates, little evidence exists on how IILs impact DUI arrests as a more direct indicator of DUI prevalence. Using state-level monthly panel data from the Uniform Crime Reporting Program, we find that DUI arrests decrease in response to IIL adoption, though more substantively and significantly when all DUI offenders are required to use them for a period after their conviction. The results suggest deterrence may be at least partially responsible for this effect, contrary to what a previous analysis of motor vehicle fatalities concluded. Our results add to the understanding of how IILs work, as policy makers continue to address the over 100 million episodes of driving while potentially under the influence of alcohol that are reported annually
Duties to a Future Self
Full text linkIn this paper, I will evaluate the notion of having duties to one’s future self. In doing so, I will discuss both ethical theories and metaethical theories. More specifically, I intend to utilize a prima facie duty-based ethical account and a psychological reductionist view of personal identity to argue that one can have duties to future selves. Relationships with our friends ground a number of objective agent-relative duties to them. I will argue that our relationships to our future selves are similar to our relationships to friends in significant ways and, as such, also ground objective agent-relative duties
The Use of Wienerisch in Der Rosenkavalier: A Dialect Analysis
Full text linkThis thesis analyzes the use of Viennese (Wienerisch) in Der Rosenkavalier—an opera composed by Richard Strauss with libretto by Hugo von Hofmannsthal. This analysis will be used to discuss how proper representation can help make characters more relatable and enjoyable for the participating audience, as well as give proper insight into the background of a character and how that may influence their motives throughout the performance. To support this analysis, a brief historical and sociolinguistic analysis of Viennese is introduced. A phonetic comparison, by way of specific scene examples, of Nico Castel’s 2002 International Phonetic Alphabet (IPA) transcription and translation, phonetic transcription based on David Adams’ traditional Standard German Diction Rules for Singers, and the performers’ choice in the use of Viennese is also introduced. Scenes are compared from performance examples by The Royal Opera Covert Garden (1985), Film with the Vienna State Opera Chorus and Orchestra (1994), Festspielhaus Baden-Baden (2009), and The Metropolitan Opera (2017)
The Erotic Hunt: Gender and Space in Early-Ninth-Century Carolingian Verse
No full textThis essay analyzes descriptions of royal and imperial Carolingian women on hunts in both the Paderborn Epic and Ermold’s Carmen in honorem Hludowici Caesaris. It compares these early ninth-century verses to their main classical model, Virgil’s Aeneid, and considers how the latter’s ambiguous depictions of Dido and Venus might have inflected the Carolingian’s poems’ depictions of women. Recognizing that the poets’ panegyrical intentions appear at odds with these ambiguous Virgilian exempla, the article investigates the royal hunt as a poetic stage, considering how the chase offered a public space in which to present positive depictions of women. The essay ultimately argues that these poems, rather than straightforward praise of women or of female leadership, confine their acclaim to particular women leading in specified ways and in specified spaces and construct the hunt as an ideal space for such exercise of power
How Does the Brain Predict Who\u27s Speaking?
Full text linkWhile sitting in a noisy environment you may have trouble understanding your conversation partner. However, listening to a familiar voice of a friend may be easier compared to listening to an unfamiliar voice. Past research studies support this phenomenon with evidence of stronger speech-evoked brain activity while listening to a familiar speaker. Additionally, previous studies have developed the concept of the Predictive Coding Theory. This theory states that the brain predicts what will occur in its sensory environment based on its internal representations of the world. The incoming sensory inputs update the predictions. There has been an emphasis on the physiological evidence of neurocognitive processing in this theory. One in which is dominated by top-down processing, and the other uses sensory sampling. In this study, we claim that gamma band oscillations use sensory sampling and beta band oscillations use top-down processing and predicting. However, there is no evidence on what neural substrates are involved while tracking a speaker’s identity in noise. Our goals were to investigate the cortical oscillations produced and their location in the brain when there is a speaker identity cue versus no cue. We measured cortical EEG data of 13 normal-hearing participants in speech-in-noise. The speaker identity cues increased beta band oscillations in the inferior frontal gyrus region of the left hemisphere. However, without a speaker identity cue, greater gamma band oscillations were found in the supratemporal gyrus in both hemispheres. The results had significant differences amongst both conditions. With these results, we support the Predictive Coding Theory and the physiological evidence of cortical oscillations. While the brain tracks a familiar voice in noisy environments it uses predictive top-down processing indicated by beta waves. However, if the brain cannot predict the speaker, then sampling of auditory features occurs, indicated through gamma oscillations. This allows the brain to be open to all potential voices