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DALIT DEFECTION TO THE BJP IN COMMUNIST PARTY-RULED KERALA: CASTE AND THE LIMITS OF REDISTRIBUTION WITHOUT RECOGNITION
No full textThis dissertation seeks to answer the question: why have many of India’s formerly “untouchable” castes (Dalits) begun supporting a rightwing ethnonationalist movement led by the Bharatiya Janata Party (BJP)? This trend is paradoxical given that the BJP’s followers, who are disproportionately upper caste, have traditionally stigmatized Dalits and defended the caste system as a natural aspect of Hinduism. In Kerala, Dalit support for the BJP is additionally perplexing given the state’s history of Left Front governments, which have long enjoyed Dalit support due to their far-reaching redistributive reforms. Drawing on 200 interviews, nine months of ethnography, an extensive household survey and archival research in the Indian state of Kerala, my dissertation argues that explaining Dalit defection from Left to Right requires attention to the limits of unidimensional attempts to address multidimensional inequalities.
My most important finding is that Dalits are defecting to the BJP because caste-blind economic redistribution policies by leftist political parties have failed to ameliorate major sources of Dalits’ marginality. Land reform, which Kerala’s communist parties (CPs) advanced aggressively while in power, ended up excluding the vast majority of Dalits. Additionally, the modest housing plots Dalits received during the land reform period are increasingly inadequate, especially for expanding families. The BJP addresses these grievances by embedding grassroots cadres in Dalit colonies to serve as front-line providers of housing and sanitation services. Often, they redeploy BJP-controlled central-government funds at the state and local level. Sometimes, they even serve as middlemen for Kerala state government welfare schemes, then attribute credit to the BJP. My second major finding is that many Dalits who defect to the BJP have experienced profound discrimination in the left parties. Dalits who feel they should have been promoted to higher ranks based on seniority remain in subordinate positions and are assigned the least desirable party work. The BJP takes advantage by making Dalits officeholders in the party and accusing the communists of neglecting Dalits and even of discriminating against them because of their caste.
Theoretically, I make sense of these findings by drawing on Nancy Fraser’s concept of bivalent oppression to advance a novel Gramscian theory of “bivalent hegemony”. Fraser distinguishes between two valences of inequality: material “maldistribution” and cultural “misrecognition,” and defines communities suffering from both as “bivalent collectivities.” I argue that in order to succeed in incorporating bivalently oppressed groups such as India’s Dalits, political parties and movements must ensure both recognition and racial/ethnic redistribution–meaning redistribution that takes into account historic maldistribution rooted in non-class oppression. When they fail to do both, as in the Kerala case of “redistribution without recognition,” they risk fracturing their base and, ultimately, hegemonic decline. Political challengers, including ethnonationalists, can exploit the unmet grievances of bivalent collectivities to forge new cross-racial/ethnic identities that can form the basis of new ruling coalitions. However, these right-wing hegemonies are also vulnerable if and when they fail to redress either valence of oppression.
In making these arguments, the present work contributes to a growing global scholarship on how ethnonationalists recruit marginalized groups. While this literature has shed light on why economically poor, yet racially dominant groups come to support ethnonationalism, we know far less about why bivalently oppressed groups would support these political currents. In this context, examining rising Dalit support for the BJP assumes added global importance
HEARING LOSS AND HEALTHCARE SATISFACTION AND NEEDS
No full textSatisfaction with healthcare is a patient-centered metric that reflects whether care experiences align with an individual’s values, needs, and expectations. Higher satisfaction with care is associated with treatment adherence, reductions in emergency room visits, and generally improved healthcare utilization patterns. Patient-provider communication, a key determinant of satisfaction with care, may be affected by hearing loss which is common among older adults. As the United States population continues to age and the proportion of older adults increases, understanding the association of hearing loss with satisfaction with care and whether addressing hearing loss can improve satisfaction with care is important.
First, we sought to characterize the association between hearing loss with unmet health needs and satisfaction with care among older adults. In a nationally representative sample of Medicare beneficiaries (N=10,422), we estimated that those with a lot of trouble hearing had 50% higher odds of reporting no usual source of care, 85% higher odds of reporting not obtaining needed medical care in the past year, and 56% higher odds of reporting not filling a needed prescription in the past year not due to cost (Chapter 2). Next, we further analyzed the association between hearing loss and dissatisfaction with the quality of care over the past year. In another nationally representative sample of Medicare beneficiaries (N=11,441), we found those with a little trouble hearing and a lot of trouble hearing had 50% and 77% higher odds of being dissatisfied with the quality of their health care over the previous year relative to those without any trouble hearing, respectively (Chapter 3).
Next, we studied whether the association between hearing loss and dissatisfaction with care was modifiable by the presence of a companion during healthcare visits in observational data (Chapter 4). Among Medicare beneficiaries over 65 years of age (N=9698), a lot of trouble hearing was associated with higher odds of dissatisfaction with quality of care (Odds Ratio [OR]= 1.293; 95% Confidence Interval [CI]= 1.043-1.603), dissatisfaction with information provided by the doctor (OR=1.371; 95% CI = 1.097-1.714), and dissatisfaction with provider’s concern for a participant’s overall health (OR=1.411; 95% CI = 1.146-1.738) compared to those without any trouble hearing. In models stratified by reported accompaniment to healthcare visits, this association was no longer present among accompanied participants while the association remained, and the magnitude of the estimate was larger among unaccompanied participants.
Lastly, we executed a prospective pilot trial to explore the impact of an initiative addressing hearing loss on improving satisfaction with care scores (Chapter 5). The initiative consisted of training providers and staff on hearing loss awareness and best-practice communication, screening inpatients for hearing loss, and providing handheld amplifiers to those with hearing loss. Using a parallel cluster design we compared the change in satisfaction with care scores, measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey that is used by the Centers for Medicare and Medicaid Services in value-based reimbursement schemes, pre- and post- initiative on two geriatric inpatient units in a large academic medical center over 6-months. No effect of the initiative was detected but concerns with the outcome instrument and compliance may have contributed to null findings.
Taken together, our results suggest hearing loss is a modifiable risk factor associated with poorer satisfaction with care and unmet needs healthcare needs at the population-level. However, addressing satisfaction with care at the hospital-unit and individual-level may be more complex. These results have implications for considering hearing loss in initiatives such as the Age-Friendly Health Systems model aimed at improving the healthcare environment and experience for older adults
A COVID-19 CASE STUDY: MISINFORMATION, POLARIZATION, AND PROBLEMATIC RESCOURCE ALLOCATION
Get PDFOne of the many woes of the COVID-19 infodemic was the polarization and misinformation that surrounded vaccination. However, many vaccine-hesitant individuals eagerly embraced monoclonal antibody therapy, as it did not engender such divisive attitudes. The over-reliance of these therapies in certain states led to a nationwide shortage during the period between September 2021-December 2021. In response, National Institutes of Health (NIH) released allocation recommendations, placing unvaccinated individuals in the highest risk tier. This created a situation that was detrimental to collective public health efforts as it allowed individuals to forego the preventative measure, which would also protect those around them, and granted them nearly unfettered access to the rescue therapy, which is only useful after infection- allowing them to circulate the virus. In this thesis I will propose a two-pronged solution consisting of an acute resolution, which will address the problematic incentive structure created by the prioritization guidelines, and a structural resolution, which will target the issue of misinformation
Freedom in a World of Catastrophe: Political Existentialism Reconsidered
No full textIn Freedom in A World of Catastrophe: Political Existentialism Reconsidered, I turn to three figures whom I call philosophers of the catastrophic, three characters in search of an exit. Their work, their lives, engaged with the catastrophic in countless forms. These include the domination of sexually asymmetric society, the disposability of the old, racism, war, colonialism, the atom bomb, isolation, torture, and so on. I argue that they will give us the right spirit, and a compelling, if today forgotten, philosophy of solidarity and the dialectics of coalition-building. I want to remember them, for in their work we shall see a great deal of resources, still untapped, to understand ourselves as social beings, and beings who possess the tools and strategies to break out of our catastrophic malaise. Speak, memory. Speak at the end of the world.
First, I examine the relevant works of Simone de Beauvoir: The Ethics of Ambiguity, The Second Sex, the Coming of Age, as well as her memoirs and anti-colonial writing. I argue that Beauvoir, far from being a political individualist is rather deeply concerned with the potential for building political alliances across differences and for the ever-possible horizon of a revolutionary future.
Second, I argue that Sartre provides a most useful social ontology which may be used as a critique of different social forms as they appear to be politically advantageous. Through an examination of his Critique of Dialectical Reason, we see that being-among does not always mean being-with, and sometimes thinking that we are working in concert hinders our collective political actions.
Third, I argue that Fanon offers the most detailed account of a materialist social ontology, identifies the limits of individual political action, and points the way toward overcoming political defeats through a complex dialectic grounded in the hope of a new world, and of the coming of new human beings.
Finally, my conclusion offers the outlines of a materialist concept of hope, grounded in the work of Beauvoir, Sartre, and Fanon. I suggest that hope can be understood precisely in terms of the development, formation, and strengthening of collective projects and confederate actions
The Role of Family in the Mental Health of Gay Men: Perceived Sexual Behavior Stigma from Family and Depressive Symptoms
No full textGay, bisexual, and other men who have sex with men (GBMSM) are disproportionately affected by depression in the United States (U.S.). Two notable correlates of depression among GBMSM are sexual behavior stigma and a lack of family support. The interplay of these is sexual behavior stigma from family, a correlate of depression not previously characterized. Understanding the relationship between perceived sexual behavior stigma from family and clinically significant depressive symptoms may identify this as a potential intervention point for the prevention and mitigation of depressive symptoms. Data were obtained from the 2021 American Men’s Internet Survey, an annual, cross-sectional, web-based behavioral survey of U.S. GBMSM. The independent variable, perceived sexual behavior stigma from family, was measured as ever experiencing perceived exclusion from family events or perceived discrimination from family members. The dependent variable, clinically significant depressive symptoms, was classified as a score of 10 or above on the Patient Health Questionnaire-9 (PHQ-9), a self-administered surveillance tool for depressive symptoms. The association between perceived sexual behavior stigma from family and clinically significant depressive symptoms, adjusting for sociodemographic factors, was estimated using multivariable Poisson regression. In these analyses, about one in five GBMSM reported clinically significant depressive symptoms, comparable to estimates from previous research. An estimated one in two GBMSM in this study reported ever perceiving sexual behavior stigma from family. Those who had ever perceived sexual behavior stigma from family reported clinically significant depressive symptoms two times more than those who had not. The significant prevalence of clinically significant depressive symptoms among GBMSM estimated and reported here reinforces the need for tailored surveillance to GBMSM populations, specifically, high-risk groups including youth, racial and ethnic minorities, those experiencing low socioeconomic status and low social capital, those with HIV or other STIs, and those engaging in substance use. Surveillance of clinically significant depressive symptoms allows for the diagnosis and treatment of depression. The association of perceived sexual behavior stigma from family and clinically significant depressive symptoms highlights the possibility for intervention research into addressing perceived sexual behavior stigma from family to prevent or mitigate clinically significant depressive symptoms in GBMSM
Substrate Modification to Probe the Catalytic Properties of Iodotyrosine Deiodinase and Developing an Alternative Reducing System for Catalysis
No full textWhile the function of the flavin-dependent reductive dehalogenase iodotyrosine deiodinase (IYD) is well characterized in humans, the rate determining steps of catalysis and all factors governing substrate specificity remained to be determined. Solvent kinetic isotope studies identified a limited isotope sensitivity of kcat and kcat/Km, though protonation of the iodotyrosine phenolate to a nonaromatic keto species was expected to be rate determining. Instead, substrate electronics dominated catalysis as iodotyrosine substrate analogues bearing electron-donating substituents in the ortho position increase kcat and kcat/Km by up to 100-fold while electron-withdrawing substituents suppress those values by up to 25-fold. Thus, stabilization of this protonated, nonaromatic keto intermediate is crucial for catalysis.
The iodotyrosine substrate carboxylate forms numerous hydrogen bonds to neighboring lysine and tyrosine residues, as well as the N3 of flavin as identified from the crystal structure of IYD. The substrate amine forms hydrogen bonds to a neighboring glutamic acid residue, as well as the C4 carbonyl of flavin. Deiodination of substrates lacking the α-amine and carboxylate of iodotyrosine was severely suppressed (250-2000-fold effect on kcat/Km) with α-amine modified compounds also binding very poorly to IYD. These ligands lacked the ability to stabilize the flavin semiquinone upon reduction of IYD, whereas a tyrosine scaffold comprised of both the α-amine and carboxylate is able to. While dehalogenation is indicative of one-electron transfers, nitroreduction via a FMN-dependent nitroreductase proceeds through a hydride transfer. Though nitrotyrosine is not reduced by wild type enzyme, modification of the nitrotyrosine zwitterion allowed for its reduction with no flavin semiquinone observed. These results indicate that the hydrogen bonding network between substrate and the N3-O4 interface of flavin is critical for stability of the flavin semiquinone and maintaining the capacity for single-electron transfer from flavin. The importance of these interactions was further confirmed by a mutant enzyme with swapped lysine and glutamic acid residues not being able to process the enantiomer of iodotyrosine, as the substrate α-amine and carboxylate are out of hydrogen-bonding distance of flavin N3 and O4. Thus, the substrate specificity of IYD is dictated in part by the influence of substrate on flavin.
Nicotinamide analogues with N-alkyl substituents (benzyl, ribityl, acetamide) have been synthesized to be used in developing a reduction system for IYD that avoids dithionite. However, these efforts have been stymied by a lack of steady-state turnover of IYD or nitroreductase NfsB for reaction initiated by a nicotinamide analog, despite them being able to stoichiometrically reduce IYD anaerobically and be iteratively oxidized by iodotyrosine. Poor association of nicotinamide analogues resulting in competition with excess of the tightly binding may cause lack of turnover, and thus the next generation of nicotinamide analogues being synthesized contain modalities that will enhance association to the active site of IYD
WORST CASE: A COLLECTION OF SHORT STORIES
No full textIn four short stories, four separate women are thrown into their worst-case scenarios. From botching a child’s blood transfusion to giving birth in the middle of the night alone, killing a motorcyclist while driving on the wrong side of the road abroad, or trying to catch a narcotics thief amongst nursing peers, their lives will never be the same. And their reactions and choices lead to consequences that tease at the concepts of morality, duty, and faith—whether that faith is in God, family, a tightknit work team, or oneself
SCIENTIFIC SENTIMENT: UNITING FACTS AND FEELINGS IN SCIENCE NEWS
No full textThis thesis explores the dynamic intersection of human emotions and the objective realm of hard-hitting science news. In an era characterized by a continuous flow of information, the dichotomy between emotional resonance and factual accuracy within science reporting is an important one. The works within this volume shed light on the potential for emotionally resonant narratives to enhance public engagement and comprehension of complex scientific concepts. Ultimately, this thesis underscores the importance of recognizing the shared humanity that underpins both the emotional experiences of real life and the pursuit of scientific knowledge, proposing a harmonious coexistence
PROJECTIONS AMONGST GREAT POWERS: TRAJECTORIES WITHIN BOUNDED DETERRENCE AND OBSERVATIONS ON MISCALCULATION – U.S., CHINA, AND CUBAN CRISIS AS CASE STUDIES
No full textThis research seeks to examine the likely misperceptions, miscalculations, and misjudgments in the present environment surrounding Taiwan’s contested future which are likely to cross the nuclear threshold of either the United States or People’s Republic of China. This is illustrated primarily through the lens of the bounded deterrence model in order to investigate all possible nuclear deterrence outcomes of a given conflict, while offering an extension of theory based upon a four-part continua of bounded deterrence variables. This research investigates the present local deterrence environment and trends; deterrence dispositions of the United States, People’s Republic of China, the Republic of China, and numerous regional countries at present and foreseeable future; all possible nuclear deterrence outcomes between the United States and People’s Republic of China and implications; and the investigation of the seminal case study of the Cuban missile crisis as it pertains to today. Lastly, the research offers recommendations to ameliorate the possibilities of these misperceptions, miscalculations, and misjudgments from escalating to nuclear war. Namely, there are many “near misses” to nuclear war, notwithstanding the increasingly likely possibility of conventional conflict over Taiwan’s political future. The probability of conventional conflict over Taiwan turning into a nuclear war is greater than traditional American foreign policy wisdom recognizes. Therefore, the United States must be precisely clear in its intentions and to communicate in ways that not only the United States believes to be clear in maintaining deterrence, but that effectively transmits the necessary knowledge to the intended audience. Unless these trends of misjudgment and miscalculation are sorted and resolved, the concern McNamara had about the Cuban missile crisis is now thoroughly likely to be revisited in some future Taiwan crisis
Impact Evaluation of Intervene K-12 Tutoring on Grade 9 Mathematics Achievement in Hartford Public Schools
Get PDFThis study was a quasi-experimental design (QED) that examined the impact of Intervene K-12 tutoring on mathematics achievement for Grade 9 ELL students identified by HPS as having experienced considerable learning disruptions as a result of the COVID-19 pandemic and having recently arrived in the United States. Achievement gains for treatment students, who received tutoring services, were compared to those of comparison students, who did not receive tutoring. Comparison students were selected by using propensity-score matching (PSM) techniques in order to identify students who were most similar to treatment students. The main outcome variables of interest were end-of-course (EOC) and Final Algebra I exam scores, as well as spring 2023 PSAT mathematics scores, while beginning-of-course (BOC) Algebra I exam scores and spring 2022 PSAT mathematics scores were used as prior mathematics achievement variables. Multiple regression analyses were used to examine the impact of Intervene K-12 tutoring on mathematics achievement gains.
The results of the impact analyses showed generally positive mathematics achievement trends for Intervene K-12 tutoring students. Treatment students outgained matched comparison students on the EOY Algebra I exam by more than 7 points. Similarly, treatment students outgained comparison students on the spring PSAT math assessment by 5 points although these impacts did not reach statistical significance. The effect size of the EOC Algebra I score impact was nearly 0.40 SDs, indicating a medium-to-large practical impact of tutoring on student mathematics achievement