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Hydro-Normativity: Water Management and Urban Public Health in the Cape Colony and Natal, 1830-1905
No full textAs nineteenth-century settler port cities on the South African coast grew, so did their need for clean water supplies and effective wastewater disposal. Yet a variety of urban residents - including humans, plants, and animals -approached or responded to the water problem according to their own standards and ideas. In other words, everyone attended to what I call “hydro-normativity," or the ways individuals and communities use and manage
water according to their ideals, standards, and constraints. Building on environmental history, African history, and the history of science, technology, and medicine, this dissertation examines the relationship between municipal administrators, residents, and the
environment in coastal urban spaces through the colonial legacies of water management and infrastructure in three prominent ports: Cape Town, Port Elizabeth, and Durban. It
argues that different styles of water management, influenced by an actor’s hydro-normativity, shaped the construction and implementation of municipal infrastructure in
South Africa and influenced the region’s water management methods into the present day. The chapters together establish that municipal administrators, residents, and their coastal
environments together created a particular culture of water use and control along the urban southern African coast, determining how clean and waste waters were viewed, used, and managed into apartheid and beyond
Effects of School Culture on Learner Well-being and Academic Achievement
Get PDFThis dissertation investigates the enduring impact of colonial and postcolonial educational policies on school culture, focusing on their effects on learner well-being and academic achievement in India. The literature reviews explore the historical underpinnings of the Indian education system, emphasizing the exam-centric culture resultant from British colonial rule, and the significance of social emotional learning (SEL) in fostering positive teacher-student relationships and school culture. The problem under investigation is twofold: firstly, assessing the influence of colonial legacies on school culture and its effects on stakeholder perceptions within a high-income private school in Metro City, India; and secondly, evaluating the impact of a targeted SEL intervention aimed at enhancing teacher-student dynamics within the same context. The hypothesis posits that addressing the negative aspects of school culture through SEL can significantly improve relational trust and stress management among teachers, thereby enhancing the educational experience. Employing a mixed-methods approach, the needs assessment and intervention studies integrate quantitative data and qualitative data within a sample of teachers, students, school leaders and parents. Results from the needs assessment indicate a critical need for balancing academic achievement with holistic learner development, while findings from the intervention study reveal improvements in empathy, stress management, and relational trust among teachers. This study's implications extend to the potential for SEL interventions to improve educational practices and outcomes in diverse settings, advocating for future research and program development in this area
HOW STATES PROMOTE AND GOVERN HEALTH INFORMATION EXCHANGES AND ENGAGE THEM TO SUPPORT PUBLIC HEALTH
Get PDFWe interviewed 52 states and territories to understand how state governments have engaged with state and sub-region health information exchanges (HIEs) within their jurisdictions. We investigated the ways states participate in governance of these HIEs, strategies states use to promote exchange activity, and ways the state departments of health are leveraging HIEs for public health purposes. We found significant state involvement in HIE activity, some prompted by the response to the Covid pandemic. Yet, approaches among the states differ significantly. Here we introduce the four papers which are the output of the research. For purposes of this student’s dissertation, this is a “three paper format”.
While the papers were authored primarily by the student, coresearchers include Laura Young, CEO of San Diego Health Connect, and Lisa Bari, CEO of Civitas Networks for Health, both of whom were important partners in conducting the research.
Advised by Professor Laura Morlock of the Johns Hopkins Bloomberg School of Public Health
Developing a physiologic model of placental malaria in mice
Get PDFPregnant women in malaria-endemic regions are at greater risk than to non-pregnant adults for complications associated with malaria infection, in part because of malaria infection of the placenta. Consequences of placental malaria include maternal anemia, miscarriage, and low birth weight. Placental malaria is associated with local inflammation and cell death as well as systemic progesterone suppression, but the interaction of these two systems is poorly defined. Current preclinical mouse models of placental malaria involve injection of inbred mice with high concentrations of infected red blood cells during late pregnancy. These models fail to recapitulate maternal-fetal tolerance, the natural route of infection, and the outcomes of placental malaria from infections at early to mid-gestation.
To address these limitations, outbred CD-1 dams were infected with transgenic Plasmodium berghei expressing luciferase or mock-infected by mosquito bite challenge at either embryonic day (E) 6 (i.e., early gestation before placenta formation) or E10 (i.e., mid-gestation after placentation) and compared with non-pregnant female mice. Morbidity (i.e., weight loss) and mortality were monitored daily until mice either succumbed to infection or were euthanized at 8 days post-infection (dpi). Birth outcomes were assessed within 12 hours of delivery or immediately after euthanasia. Parasite sequestration was assessed by IVIS in the spleen, liver, uterus, placenta, and fetuses collected ay 8 dpi. Placentas were also assessed by microscopy for parasite sequestration and histopathology. ELISA was used to measure progesterone and corticosterone levels in the serum and the placenta. Immunological changes in response to malaria infection were assessed in spleen and placenta of dams by cytokine multiplexing and flow cytometry.
Survival of E10, but not E6, infected dams was significantly reduced as compared with non-pregnant females. Among pregnant dams infected at either E6 or E10, death occurred 1-2 days after delivery for all mice that survived to delivery. Malaria infection in pregnancy caused gestational age-dependent maternal morbidity, with E6, but not E10, infected dams showing significant weight loss over the course of gestation. Pregnancy did not impact peripheral parasitemia burden. Placental malaria was confirmed by imaging and quantifying luciferase-labeled parasites, which were present not only in the liver and spleen, but also in the placenta, uterine wall, and fetal tissue of malaria-infected dams. Adverse perinatal outcomes differ by gestational age at infection. E6 dams experienced pregnancy loss, while E10 dams delivered stillborn pups. Maternal malaria caused diverse systemic inflammation, with only IL-4, CXCL1, CXCL2, CCL3, CCL4, and CCL5 being differentially expressed in placentas from malaria- compared with mock-infected E10 dams. Progesterone was significantly reduced in the serum but not the placenta of malaria-infection E10 dams. Serum and placental corticosterone were significantly elevated in malaria-infected E10 dams. Serum progesterone concentration negatively correlated with 23 cytokines in the spleen, 23 of which were increased in malaria-infected E10 dams. Placental corticosterone positively correlated with 3/6 differentially expressed cytokines (CXCL1, CXCL2, and CCL4) in the placenta. Preliminary immunophenotying revealed changes in subsets of NK cells, CD4+ T cells, and B cells particularly in the placenta, but not in the spleen, of malaria- compared with mock-infected dams.
Mosquito bite infection of outbred dams with malaria parasites resulted in evidence of placental malaria including placental sequestration of parasites, combined with endocrinological changes, and adverse perinatal outcomes dependent on the gestational age of infection. Maternal malaria infection altered both systemic and placental immune responses to cause adverse perinatal outcomes
Ineffective Use of Technology in Early Childhood
No full textAll 50 of the United States have adopted at least one version of the International Society for Technology in Education (ISTE) standards. Maryland public schools require all students to take at least one technology or computer science course to graduate high school; however, teachers do not need to complete a technology course to earn their teaching license. The COVID-19 pandemic created an urgency to use technology for students to access instruction. Now that public schools have transitioned back to traditional in-person learning, teachers need to leverage the appropriate use of technology with their students. Teachers’ technology beliefs, self-efficacy, and perceived technology usefulness impact the utilization of technology.
This dissertation is comprised of a mixed methods approach with in-service teachers completing a technology self-efficacy survey and both in-service and pre-service teachers participating in interviews discussing their belief about technology integration and their perceived usefulness. The results produced the need for a crosswalk aligning the kindergarten math common core standards (CCSS) with the Next Generation Science Standards (NGSS) and ISTE student standards
Variances in Child Welfare Practice in the United States: Examining the Role of Vague Legislation and Discretion in Child Welfare
Get PDFChildren and families in the child protection system experience significant variances in
experiences and outcomes across the nation. Race and socio-economic status have all been shown to influence these variances but there has been little research to highlight
these variations occurring based on geographical location or courtroom assignment. Additionally, the influence of the legislative and judicial branches on child protection is not widely researched. This research paper examines how the role of vague legislation, bureaucratic discretion, and unrestrained judicial power within the child protection system fuels this inequity for families. This research finds that vague legislation results
in extraordinary discretion for the bureaucracy and the judiciary. Findings also suggest
that the lack of federal guidance for core concepts in child welfare is creating a fragmented system that fails to implement successful programming nationwide. Finally, this paper highlights the large role judges play in these cases, as well as the consequences of judges having untethered discretion within child protection courtcases
MULTIMORBIDITY, DEPRESSION AND FRAILTY AMONG OLDER ADULTS IN LOW-INCOME SETTINGS
Get PDFBackground: Multimorbidity, characterized by the coexistence of two or more chronic conditions, is highly prevalent worldwide. We examined the intersection of physical multimorbidity, depressive symptoms, and frailty among older adults in low-income settings across Nepal, Uganda, and Peru. We first identified subgroups of physical multimorbidity and analyzed their association with depressive symptoms using latent class analysis (LCA). Second, we assessed how frailty modifies the relationship between multimorbidity and depression in Peruvian older adults. Third, we aimed to qualitatively explore experiences from older adults and community health workers (CHWs) in Peru regarding health needs.
Methods: We analyzed data from 4,161 participants aged 60 years and older from Nepal, Peru, and Uganda. Using LCA, we identified classes of physical multimorbidity based on eight chronic conditions: COPD, asthma, chronic bronchitis, heart disease, diabetes, arthritis, hypertension, and obesity. Depression was assessed using the Patient Health Questionnaire-9. Subsequently, physical frailty phenotype was used to stratify the relationship between multimorbidity classes and depression in Peru. For the qualitative component, interviews were conducted with older adults and CHWs from low-resource settings in Peru.
Results: Among the full sample, we identified three classes of multimorbidity: 'apparently healthy,' 'respiratory disease,' and 'cardiometabolic.' The 'cardiometabolic' and 'respiratory' classes had significantly higher odds of depressive symptoms. In Peru, three classes were recognized again, with only the 'complex/multisystem' class showing a significantly higher prevalence of depression. The presence of frailty markedly intensified the association between multimorbidity and depression. Emerging themes included the desire for functional independence, the impact of socioeconomic factors such as food insecurity, elder abuse, family disputes, and financial burdens from healthcare costs.
Discussion: Interventions should integrate both physical and mental health components. Additionally, by identifying frailty as a critical factor in individuals with complex multimorbidity, we argue for the integration of frailty assessments, which can lead to more personalized care for older adults. Qualitative insights reveal that health needs of older adults encompass more than just medical care. Participants stressed the importance of being able to engage in meaningful activities that affirm their sense of usefulness and value. Public health interventions should consider these broader determinants of health
BEFORE THE HAJJ: THE ḤAGGĀT FEASTS IN PRE-ISLAMIC EPIGRAPHIC SOURCES
Get PDFThe Islamic Hajj descends from a constellation of religious practices in the ancient Near East, called ḥag(gat) (plural ḥaggāt, ḥaggim, or ḥaggin). At present, there has been no systematic examination of ḥaggāt outside of those in Jewish, Christian, and Arabic sources. This dissertation rectifies this by providing collated critical editions of the forty six pre-Islamic inscriptions that directly reference ḥaggāt, complete with transliteration, translation, and commentary. It argues that ḥaggāt were primarily feasts, rather than pilgrimages (although pilgrimages could be made to attend), and examines them via archaeological and anthropological scholarship on feasting. It begins by surveying the past 130 years of theoretical work on feasting before then treating the Dadanitic texts, Katumuwa Stele, Ancient South Arabian inscriptions, and Safaitic texts. These sources attest to ḥaggāt between the eighth century BC to the third century AD, spanning modern Saudi Arabia, Yemen, Jordan, Syria, and Turkey. While ḥaggāt could vary, overall they were (semi-)annual religious feasts that could last several days and were performed in order to receive blessing from deities. As theoretical work on feasting highlights, the ḥaggāt served as tools that people, kingdoms, and deities utilized to vie for political power. Yet more humanely, some ḥaggāt may have functioned as systems of social welfare wherein more animals were slaughtered than could be eaten, resulting in meat being distributed also to those of lower socioeconomic status. Three broad categories of ḥaggāt may also be delineated. First, decentralized local ḥaggāt took place at non-formal sites lacking permanent cultic architecture. These could be held ad hoc and do not seem to require great travel to attend. Second, localized ḥaggāt took place at established regional cultic centers that contained some degree of formalized, permanent architecture. Participants in these seem to have been mostly local residents albeit a limited number of people could perform pilgrimages to attend. Third, interregional ḥaggāt occurred at major cult sites. These attracted a large contingent of participants from greater distances and may be called “pilgrimage-feasts.” Such feasts would gradually increase in wealth as pilgrims brought offerings from surrounding regions, serving to increase further the cult’s prestige over time
The influence of pet ownership on asthma: a nested study in the ECATCh trial
Get PDFBackground
Although pet removal has usually been used as an add-on measure during the treatment of asthma, there is limited high-quality evidence focus on investigating the impact of pet ownership and interaction intensity during an asthma treatment.
Objective
To examine whether the pet ownership and interaction intensity are associated with asthma characteristics and asthma control outcomes among children from inner-city Baltimore with allergic asthma. To access whether pet ownership modify the relationship between trial’s group assignment and main outcome.
Methods
155 children ages 5–17 with allergen-sensitized asthma in inner-city Baltimore and participated in Environmental Control as Add-on Therapy in Childhood Asthma (ECATCh) were evaluated, surveyed, and inspected for asthma characteristics indicators, pet ownership, and human-animal interaction intensity during home visit at baseline, 3 and 6 months, and clinical visits at baseline, 2, 4, and 6 months. The association between pet ownership and pet interaction intensity with asthma characteristics indicators were analyzed through linear and logistic regression models.
Results
Pet ownership was not associated with controller medication treatment step at 6 months (0–6, as-needed albuterol to high-dose ICS + LABA), regardless of sensitization status. Higher interaction intensity between pets and human was associated with trends of lower percent predicted FEV1 (Estimates: -0.23 for adjusted contact score, p:0.03), lower percent predicted FEF 25-75 (Estimates: -0.23 for adjusted contact score, p:.06), and lower FEV1/FVC (Estimates: -0.12(%) for adjusted contact score, p:.03) at baseline, higher ER visits at baseline (Estimates: 0.43 for adjusted higher tertile, p: .09), and higher 6 months treatment steps (Estimates: 0.072 for adjusted higher binary, p: .07). No association with other indicators (Baseline treatment steps, unplanned doctor visit, hospitalization, PEFR, FEV1 percentage change) were found. Interaction intensity did not show obvious modification effects on the relationship between baseline group assignments and medication treatment step at six months.
Conclusion
Interaction intensity, but not pet ownership itself, is associated with worse asthma characteristics and treatment outcomes
REPEAT-DERIVED RNAS AND THEIR ROLE IN THE HUMAN BRAIN
No full textComprising ~50% of the human genome, repeat sequences, herein referred to as repeats, are DNA sequences that occur in multiple copies. A subset of repeats, termed retroelements, can be transcribed into RNA, reverse-transcribed into DNA and mobilize to new sites in the genome. Repeats reside among host genes and rely on host machinery for their transcription thereby producing repeat-derived RNAs, a subset of the transcriptome. In humans, the healthy brain has the highest expression of repeat-derived RNA compared to other somatic tissues, but it remains unclear how repeat-derived RNAs influence the brain’s transcriptome. The functional impact of repeat expression in the brain is an active area of research, and repeat-derived RNAs have been shown to influence the healthy transcriptome through rewiring transcriptional networks, chromatin remodeling, alternative splicing, and translational repression. Alternatively, and perhaps most notably, repeat-derived RNAs contribute to disease through the seeding of epigenetic states in chromatin, the production of structured RNA and catalytically active ribozymes, the generation of cytoplasmic ssDNA and RNA/DNA hybrids, the production of viral-like proteins, and the generation of somatic mutations. An increasing number of human neurodevelopmental and neurodegenerative conditions are associated with changes in repeat expression, including Aicardi-Goutieres syndrome (AGS), Rett syndrome (RTT), Amyotrophic Lateral Sclerosis (ALS), Alzheimer’s disease (AD), multiple sclerosis (MS), schizophrenia (SZ), and with relevance to this dissertation, aging and X-linked Dystonia Parkinsonism (XDP). This dissertation aims to define, explore, and characterize how repeat-derived RNAs contribute to the brain in the absence and presence of disease