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EXAMINING ASSOCIATIONS BETWEEN SOCIAL INFRASTRUCTURES, HOUSEHOLD FOOD SECURITY STATUS, AND NUTRITION EQUITY IN THE UNITED STATES
No full textBackground
In 2021, over 13.5 million households (10%) in the United States (U.S.) reported experiencing food insecurity. Black, Indigenous, and People of Color (BIPOC) populations experience food insecurity the deepest. These disparities, in part, result from structural racism in the U.S. which has led to the racialization communities, resulting in differential access and availability of resources needed to achieve food security.
Objectives
To understand the relationships between different social infrastructures (the Supplemental Nutrition Assistance Program (SNAP), social networks, and charitable food support), household food security, and the advancement of nutrition equity in racialized communities in the U.S.
Methods
This multiple methods study was conducted using nationally representative data from the Survey of Income and Program Participation (SIPP) 2018 Panel and data from a sample of low-income and predominantly Black residents living in Buffalo, New York in 2021 – 2022. We quantitatively assessed the association between household food insecurity and changes in SNAP benefit amounts (an increase, a decrease, a total loss of SNAP, or consistent SNAP receipt) in 2018 compared to 2017. We then quantitatively assess the associations between household food insecurity and social network characteristics. Semi-structured in-depth interviews were conducted with people living in a racialized area of Buffalo, New York in May – July 2022.
Results
Among a nationally representative sample of SNAP households (n=10 million households), compared to people who received a SNAP increase in 2018, those that totally lost SNAP had 58% lower odds of household food insecurity (OR=0.42; 95% CI= 0.18 – 1.02; p=0.057), but there was no statistically significant relationship found among people who received a SNAP decrease or consistent SNAP. Among a sample of predominantly low-income and Black residents living in Buffalo, New York (n=232) residents having 7 or more close social network members was associated with a 60% lower odds of experiencing food insecurity for each additional close member in the network (OR=0.40, 95% CI=0.18 – 0.87), but no relationship was detected when there were fewer than seven close members in the network (OR=0.92, 95% CI= 0.67 – 1.27). Further, every additional person that provided any food support was associated with 56% higher odds of experiencing food insecurity (OR=1.56, 95% CI=1.15 – 2.13), but no association was detected between reciprocity and household food security (OR=0.88, 95% CI=0.69 – 1.12). Finally, through in-depth interviews with 40 predominantly low-income and Black residents in Buffalo we found people commonly used the SNAP and food pantries to meet food needs over receiving support from social network members. Poverty, challenges accessing and affording healthy food, and the inability to reciprocate support to others undermined the advancement of nutrition equity. Historical and ongoing acts of disempowerment and disinvestment also hindered the advancement of nutrition equity.
Conclusions
Our findings suggest that social infrastructures are important resources people use to meet food needs. Yet, these infrastructures both individually, and as a collective, do not address the root cause of food insecurity—poverty—and, therefore, cannot fully promote the advancement of nutrition equity as currently structured. Future research and policies should focus on mechanisms to expand social infrastructures, not further restrict them, so food security and nutrition equity can be actualized by all people
THE ROLE OF PROJECT MANAGEMENT IN SPONSORED RESEARCH
Get PDFProject management provides guidance, direction, and tools for projects ranging in scope and complexity. The role of applying project management principles to sponsored research planning is a crucial factor in the success of most research, as well as an effective method to remain within the scope, schedule, and budget of the project. Project management techniques may be allusively applied to research as informal practice by the Principal Investigators (PI), rather than a Project Manager (PM). It is critical to understand that project management principles may not be applicable to all research ventures as the ambiguity and undefined goals surrounding some research are not conducive to the practices and procedures of project management.
This study evaluates the role of project management in research through an in-depth literature review, as well as a survey questionnaire to the research community to evaluate to what extent is project management presently applied to research. The evidence gathered shows that project management is currently being applied by research professionals to a great extent for research projects leading to better results, and with better impact on timelines, and budgets. Consequently, researchers face a number of challenges such as administrative burdens, and lack of resources in staffing, capital, and technology. Two principal approaches to implementing a sound research management strategy are flexibility and an analysis of the requirements to identify the best approach. It is found that PIs are mostly taking on this decision, and ultimately driving the research planning, execution, and oversight, as well as conducting the research and evaluating results. PIs are overburdened, and applying project management principles may help alleviate project planning and execution
Trigeminal innervation and tactile responses in mouse tongue
No full textThe mammalian tongue is richly innervated with somatosensory, gustatory and motor fibers. These form the basis of sophisticated sensorimotor functions such as the determination of object shape and texture during active touch. Despite high tactile acuity and sensitivity revealed by human behavioral and microneurography studies, the neural basis of tongue mechanosensation remains largely mysterious. In particular, the relationships between electrophysiological responses and anatomical innervation patterns of distinct sensory neuron types remain unclear. Here we found that sensory neurons in the trigeminal ganglion (TG) innervated both fungiform papillae and filiform papillae of the tongue, unlike gustatory afferents from the geniculate ganglion which innervate only the fungiform papillae that contain taste buds. Myelinated lingual afferents in the mouse fungiform and filiform papillae did not form corpuscular sensory end organs but rather had only free nerve endings. In contrast, in the ferret tongue we found sensory end organs in filiform papillae with shapes that resembled Krause end bulbs. Single-unit recordings from TG in anesthetized mice revealed two types of lingual low-threshold mechanoreceptors (LTMRs) with conduction velocities in the Aδ range or above and distinct tactile properties: intermediately adapting (IA) units and rapidly adapting (RA) units. IA units were sensitive to static indentation, while RA units were sensitive to tangential forces applied by stroking. Lingual LTMRs were not directly responsive to rapid cooling or chemicals that can induce astringent or numbing sensations when applied to their receptive fields. Genetic labeling of lingual afferents in the tongue revealed at least two types of nerve terminal patterns, involving dense innervation of individual fungiform papillae by multiple putatively distinct afferents, and relatively sparse innervation of filiform papillae. Together, our results suggest a simple model that links the functional and anatomical properties of tactile sensory neurons in the tongue
Crystalglobulin-associated nephropathy presenting as MGRS in a case of monoclonal B-cell lymphocytosis: a case report
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Abstract
Background
Crystalglobulin-associated nephropathy (CAN), a rare subtype of monoclonal gammopathy, usually associated with multiple myeloma and occasionally monoclonal gammopathy of uncertain significance (MGUS), is characterized by occluding monoclonal pseudothrombi within renal glomerular capillaries and/or interstitial arterioles. Ultrastructurally, these pseudothrombi are unique for having a crystalline substructure. We describe a case of an adult patient with monoclonal B-cell lymphocytosis (MBL) and acute renal failure whose kidney biopsy revealed a rare diagnosis of CAN.
Case presentation
A 63-year old male presented with a 2-month history of edema, arthralgia and malaise. He had acute kidney injury with hematoproteinuria on urine analysis. Serum and urine protein electrophoresis were both negative. A renal biopsy however revealed features of CAN. Organomegaly, bone pain and lymphadenopathy were absent. A repeat serum electrophoresis was positive for IgA kappa and a free light chain assay showed elevated free kappa light chains. Flow cytometry done subsequently revealed a diagnosis of MBL, chronic lymphocytic leukemia (CLL) type.
Conclusion
CAN in association with MBL/CLL has not been previously described in literature, and our case highlights yet another instance of monoclonal gammopathy of renal significance (MGRS) where a small B-cell clone resulted in extensive renal pathology without systemic manifestations.
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RUSSIAN INFLUENCE CAMPAIGNS AGAINST ESTONIA
No full textThe current crisis between Russia and Ukraine is being exacerbated by the leveraging of the ethnic Russian population in the Lugansk and Donetsk regions by the government of the Russian Federation. Since the collapse of the Soviet Union in 1991, newly established countries were formed along historically ethnic lines. Because of forced migration by the former Soviet government, many new nations had to incorporate ethnic Russian populations into citizenship programs. Significant research has examined the impact of non-aligned ethnic populations on the prevailing new governments. This study has found various successes and failures at integration across a variety of nations. Historic and current trends of the Russian Federation influencing Russian ethnic populations present a problem for governments. The Baltic country of Estonia (population 1.220 million) is uniquely susceptible to Russian influence because 24.8% of its residents are ethnic Russian or speak only the Russian language. When factoring in other ethnic groups, only 68.7% of the national inhabitants are Estonians. To investigate this problem, historical research based on empirical data already established was used to identify media trends to analyze the Bronze Soldier incident in 2007 along with removal of the T-34 monument located near Narva in 2022. By reviewing these two case studies, an understanding was gained of the impact Russian Federation soft power influencing operations have in the media on the Russian speaking population living in Estonia. In the results of this research, an unexpected observation was also uncovered on the Russian Federation’s capabilities that might have future implications
Oral History of Tom L. Beauchamp
No full textThis interview with Tom L. Beauchamp, PhD, was conducted by Suzanne Snider on June 6 and 7, 2022 and February 6, 2023, in Washington, DC as part of Moral Histories: Voices and Stories from the Founding Figures of Bioethics, an oral history project of the Johns Hopkins Berman Institute of Bioethics. Beauchamp is Professor Emeritus of Philosophy at Georgetown University and Senior Research Scholar Emeritus at the Kennedy Institute of Ethics at Georgetown. Prof. Beauchamp’s areas of expertise include foundational approaches to bioethics, ethics of human subjects research, ethics of the use of animals, informed consent, and business ethics.On Day 1, Beauchamp spends significant time speaking about his family’s longtime presence in the South and growing up in a working class, predominantly White neighborhood in Dallas, Texas. Beauchamp names the Little Rock, Arkansas school segregation crisis as a turning point for his burgeoning commitment to civil rights issues, and ultimately bioethics. Beauchamp narrates his academic trajectory, starting with Southern Methodist University (SMU) where he participated in sit-ins to confront racial segregation and studied under influential philosophical theology professors. He then attended a graduate program in religious studies and philosophy at Yale University. He earned his philosophy doctorate at Johns Hopkins University and went on to a teaching career at Georgetown University.Beauchamp describes his recruitment to the newly-established Kennedy Institute of Ethics by physician-bioethicist André Hellegers. He explains that conversations around paternalism in medicine, genetics, informed consent, and abortion were at the heart of the Institute’s founding. He shares the similarities and differences between the Kennedy Institute and The Hastings Center, which formed within a few years of each other. Beauchamp recounts an invitation from philosopher Stephen Toulmin to write about justice for the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission), and later being recruited to join the staff of the Commission.On Day 2 of the interview, Beauchamp describes his friendship with André Hellegers and their frequent lunches, which eventually resulted in Beauchamp’s appointment at the Kennedy Institute. He describes his job as “staff philosopher” to the National Commission and working on the Commission’s Belmont Report, which specified ethical principles for responsible conduction of research on human subjects. He speaks to the global reception of the Belmont Report. While working on the Belmont Report, Beauchamp worked on the Principles of Biomedical Ethics with co-author James Childress. Beauchamp describes how the two texts and writing processes informed each other. He talks about meeting Ruth Faden, his collaborator and wife, at Georgetown and spending four years co-writing a book about informed consent with her. Beauchamp speaks about the role of advocacy and activism within bioethics. He reflects on his private consulting work for Eli and Lilly Company, a pharmaceutical company, and the importance of industry having input from bioethics experts. He speaks to the expansion of bioethics by the late 70s, including voices from the public health domain. Beauchamp talks about his interest in, and his edited book about, animal ethics. Beauchamp describes his extensive writing on the philosopher David Hume and describes his current project: a biography about Ruth Faden.On Day 3, Beauchamp speaks more about his work on the Belmont Report and collaboration with James Childress. He describes how criticisms of Principles of Biomedical Ethics, including feedback from philosophers such as Dan Clouser and Bernard Gert, improved the theoretical scope of future editions. He reflects on converting to Judaism after marrying Ruth Faden. Beauchamp speaks about bioethics emerging nationally, noting the work done by Dan Clouser at Hershey and Ruth Macklin at Case Western Reserve University. He narrates his participation in early conversations about the founding of the American Society of Bioethics and Humanities and talks about the Haverford conference initiated by Sam Gorovitz in the mid-70s.This interview may be of interest to those wishing to learn more about: bioethics as it relates to philosophy and theology; the founding of the Kennedy Institute of Ethics and other bioethics origin stories from the early 1970s; Southern Methodist University (SMU), Yale University, and Johns Hopkins University; the South and political formation; business ethics; the history of the National Commission and the Belmont Report; the creation of the principle-based approach to biomedical ethics; informed consent; and the work and life of André Hellegers
Advances in Systems Science and Machine Learning for Public Health Applications
No full textIn recent decades, there has been a growing trend in using computational methods to capture the dynamics and nature of complex real-world tasks, especially in the public health field. On the one hand, these tasks often operate as a system, presenting challenges for traditional analytic methods that assume independent factors. Therefore, this thesis explores the use of systems science methods to capture the complexity of public health problems in a logical and quantitative manner. Furthermore, with the rise of big data, there is a need for advanced machine learning techniques to identify trends or relationships in health outcome studies, which is also explored in this thesis.
We begin by exploring smoking cessation interventions and propose a general procedure for applying systems science methods to the studies of implementation processes. We demonstrate one case example of using microsimulation to study factors related to willingness to quit smoking. Additionally, we propose prediction models to track participants' progress in a smoking cessation intervention, serving as an initial and crucial step in constructing an agent-based model.
In the second project, we utilize social network approaches, including network theory and opinion dynamics, to quantify peer influences among social systems composed of individuals with serious mental illness attending group smoking cessation therapies.
For our third study, we work with Boston Birth Cohort and focus on applying advanced machine learning approaches to child health outcome research. Specifically, we apply Bayesian statistical methods to explore the association between in-utero co-exposure to toxic metals and childhood overweight or obesity. We also investigate whether adequate maternal micronutrients can be protective against these outcomes.
In the final application of this thesis, we further explore the field of child obesity by examining the dynamics of longitudinal BMI growth patterns. We employ k-means clustering and latent class growth analysis to identify distinct BMI trajectories across different childhood stages and investigate the underlying causes and effects of these developmental trajectories. This comprehensive examination of child obesity highlights the importance of understanding the complex nature of this public health issue and provides insights for potential intervention strategies.
Overall, this thesis demonstrates the broad applicability of systems science approaches and machine learning methods in capturing the complexity of public health research topics, providing insights for potential intervention strategies, and advancing the understanding of these important public health issues
ESSAYS ON MEDICARE’S HOSPITAL READMISSIONS REDUCTION PROGRAM AND THE UTILIZATION OF REVASCULARIZATION PROCEDURES
No full textMedicare’s Hospital Readmissions Reduction Program (HRRP) is a national pay-for-performance (P4P) program that was established by the Affordable Care Act (ACA) that imposes financial penalties on hospitals whose 30-day excess readmission rates for six conditions and procedures are above that of the national mean. Evaluations of the HRRP have shown decreases in 30-day readmission rates attributable to the program. While many of these evaluations have consistently shown decreases in the readmission rates of patients with acute myocardial infarctions (AMI), the mechanisms underlying these observed changes as well as their unintended effects are not fully understood. Revascularization procedures are mainstays in the treatment of AMI and coronary artery disease (CAD) more generally. Penalties may have influenced providers to alter their provision of revascularization procedures to patients in accordance with both clinical and financial incentives. This research aims to address three questions on the effects of HRRP penalties on the utilization of revascularization procedures for AMI patients. First, it investigates whether the HRRP increased the utilization for Medicare AMI patients and several subpopulations within that group. Later on, it replicates the foregoing analysis but focuses on Medicare-Medicaid dual-eligible beneficiaries who are more likely to be lower-income and with poorer health status. Finally, it investigates whether there are any spillover effects on the utilization of elective revascularization procedures on non-AMI patients. Using inpatient discharge data from the Healthcare Cost and Utilization Project from seven states in 2009, 2011, 2013, and 2015, we find that HRRP penalties are associated with increases in the utilization of revascularization procedures for AMI patients, more noticeably for ST-elevation myocardial infarction (STEMI) patients in states who have higher average penalties among penalized hospitals. Utilization also increased for dual-eligible beneficiaries in states that have higher percentages of dual-eligibles among their Medicare beneficiaries. Finally, we also find that higher HRRP penalties are associated with increases in the utilization of diagnostic and therapeutic coronary procedures. These suggest that HRRP penalties may have influenced treatment choices for AMI and non-AMI patients. Future research should continue exploring these relationships and their ultimate effect on patient outcomes
"The Greatest Master There Is": Forms and Functions of Fear in Niccolò Machiavelli's Work
No full textThe name of Niccolò Machiavelli is frequently associated with fear. One of the most famous and often quoted of all Machiavelli’s ideas is to be found in chapter XVII of The Prince, where he argues that it is better for princes to be feared than loved by their subjects as fear, not love, provides the best guarantee of safety to power. No wonder then that scholars have mainly, if not exclusively, focused on that argument to explain Machiavelli’s thoughts on fear. However, such thoughts are scattered throughout The Prince, not just in chapter XVII, and bring to the surface a relatively wide array of forms and functions of fear, which change according to textual circumstances and theoretical contexts. Moreover, and perhaps most importantly, the same is true of other of Machiavelli’s works written both before and after his dismissal from the Florentine chancery in 1512. In other words, Machiavelli’s oeuvre is punctuated by views of and references to fear that have been overlooked or even ignored in scholarship, although attesting to the importance he bestows on this passion as a political and military driving force.
The dissertation aims to fill this gap in the extant literature by devoting to Machiavelli’s take on fear the due attention it deserves. To this end, the dissertation examines most of Machiavelli’s production in a chronological way and through a close-reading approach. More specifically, the dissertation prioritizes primary sources over secondary literature and focuses on the lexical level: it analyzes those passages containing fear-related words and clarifies their conceptual implications, without losing sight of the context in which these words appear. This methodological choice relies on the fact that Machiavelli tends to employ the same words to express, emphasize, and strengthen his main ideas on a given subject. Therefore, to concentrate on Machiavelli’s frequent use of fear-related words offers valuable insights into how he conceives of this passion. By doing so, the dissertation accomplishes another important goal: it shows the lines of continuity and discontinuity in Machiavelli’s view of fear, which thus turns out to be a psycho-political mosaic made of old and new tiles
NONLOCAL FILTRATION EQUATIONS AND FRACTIONAL CURVATURE FLOWS
No full textIn this thesis, we record the joint work done by the author and Pak Tung Ho concerning the fractional Nirenberg problem with a symmetric assumption, which is addressed through fractional curvature flows on the Riemannian sphere Sn. Furthermore, we present the author’s work on nonlocal filtration equations related to the Heisenberg group Hn. The classical Nirenberg’s problem is to find a conformal metric of an n-dimensional Riemannian manifold such that its scalar curvature is a given function f. A geometric flow has been introduced to study Nirenberg’s problem by Struwe for n = 2 and has been generalized to n ≥ 3 by Chen and Xu on the sphere Sn. Using the scalar curvature flow, Leung and Zhou proved an existence result for prescribing scalar curvature when the given function f possesses certain reflection or rotation symmetry on the Riemannian sphere Sn in their paper. This led naturally to the study of the prescribing fractional order curvature problem with the same symmetric hypothesis on Sn, which has been proved by the author and Pak Tung Ho. Motivated by the extensive investigations of nonlocal filtration equations, utilizing the integral operators instead of the Laplacian operator on the Euclidean space Rn, we work on the same type of equations on the Heisenberg group Hn. We established the existence, uniqueness and large-time behavior of the corresponding solutions. Furthermore, an interesting result stated that a uniform Hölder regularity, as the function value tends to zero, holds for the porous medium type of equations, which can also be adapted to obtain uniform Hölder regularity on Rn