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The influence of ecological interactions and environmental context on shellfish mariculture and restoration outcomes in North Carolina
Get PDFFoundation species define habitats, meaning their disappearance ensures the loss of entire ecosystems. Oysters, a benthic foundation species, declined by ~85% in the 20th century, but restoration and mariculture have been undertaken in North Carolina (NC) and beyond to recoup ecological and financial losses. Oysters’ expanded emphasis, while encouraging, belies their condition—NC oysters have suffered severe die-offs in recent years. Ecological theory suggests that promoting natural environmental processes and positive ecological interactions should yield better reestablishment outcomes. Here, I apply the theoretical to the practical in four studies testing how ecological interactions and environmental context influence NC restoration and mariculture practices. In Chapter 1, I tested whether oysters’ spatially distinct pre- and post-settlement bottlenecks along an estuarine salinity gradient can be bypassed by transplanting oysters up-estuary shortly after settlement. I found that transplanting juvenile oysters from high salinity waters with high recruitment and low survival to lower salinity waters with low recruitment and high survival tripled oyster biomass, serving as a possible restoration template at the estuarine scale. In Chapter 2, I tested how shellfish relay, the periodic harvest of oysters from otherwise closed areas, presents as an ecological disturbance. I found that relaying was a pulse disturbance to adult oysters, but severe external oyster mortality likely hampered relayed reefs’ resilience afterwards. In Chapter 3, I examined how nitrogen cycling varies by oyster mariculture method and location. I found that farmed oyster-influenced denitrification is highly site-specific and temporally variable, meaning that “one-size-fits-all” estimates of the mariculture industry’s removal of bioavailable nitrogen as an ecosystem service are likely inaccurate. Finally, in Chapter 4, I asked whether situating oyster farms next to seagrass meadows might reduce oysters’ pathogenic loads via cross-habitat facilitation. A lack of difference in oyster disease-causing pathogen loads between farms bordering seagrass meadows and bare flats suggests that this theoretical benefit, while observed in other systems, does not reliably extend to NC oysters. Guided by ecological evidence, each chapter proposes adjustments to active restoration and mariculture practices, which could aid coastal communities in their establishment and maintenance of productive and sustainable ecosystems.Doctor of Philosoph
Promoting Positive Social Skills Within Early Care and Education (ECE) Contexts: Integrating Quantitative and Qualitative Analyses for Policy Considerations
Get PDFAdaptive social functioning is critical for young children’s success across developmental domains both in childhood and long-term. Extant studies suggest that exposure to high quality early care and education (ECE), which can serve as a supportive context for development, may lead to social skills growth in preschool-aged children. The two papers in this dissertation aimed to contribute to our understanding of how ECE quality may predict social skills development across multiple levels of influence and how investments from discretionary funds awarded to ECE programs may align with those predictive aspects of quality. In Paper 1, I examined process and structural quality predictors of social skills growth in a high-quality, universal preschool program at scale. In Paper 2, I investigated how ECE providers invested discretionary grant funds from COVID-19 Child Care Stabilization Grants, whether those investments differed by provider and program characteristics, and whether those investments align with known predictors of children’s social skills development. Taken together, the findings of these two papers suggest that process quality and structural quality are interrelated constructs that must be considered both independently and jointly by scholars exploring social skills development in ECE settings. The findings from Paper 1 demonstrate that structural quality factors predict social skills development in preschool, while the findings from Paper 2 show that when ECE providers are awarded discretionary funds to improve their programs, they invest in structural quality over process quality overall. In summation, the evidence suggests that structural quality features of ECE programs should not be overlooked in consideration of program quality and impacts on child outcomes.Doctor of Philosoph
WHAT DRIVES BANK CREDIT LINES? WHOLESALE FUNDING AND BANK LIQUIDITY CREATION
Get PDFLiquidity creation is one of the primary functions of banks, and bank credit lines are the single largest source of it. Existing theories of banks’ supply of credit lines have highlighted the central role of traditional retail deposits. In this paper, I revisit those results and find little evidence to support those claims. Instead, I document that sources of non-retail funding – wholesale funding – have been an important driver of banks’ contingent commitments. I show that banks with greater wholesale funding ratios lend more using off-balance sheet commitments. Causal estimates rely on two identification strategies (1) membership dates of banks to the Federal Home Loan Bank (FHLB) system in a staggered difference-in-differences (DiD) exercise and (2) shift-share instrument design. Estimates from these exercises suggest a 1% increase in wholesale funding leads to 0.3-0.4% increase in contingent commitments. I rule out reverse causality in a standard DiD design using an exogenous regulatory change – introduction of FIN 46 – which materially impacted banks’ supply of credit lines. These results run contrary to the prevailing deposit-based theories of banks’ commitment lending and have important implications for banks’ "specialness" in commitment lending, aggregate liquidity risk, and post-2008 decline in bank credit lines.Doctor of Philosoph
Racial and ethnic inequities in perinatal mental health care in the US: The impact of medical mistrust and residential segregation
Get PDFPostpartum depressive symptoms (PDS) affect one in eight people in the US, with racially minoritized individuals experiencing higher rates of PDS than White Americans, yet lower access to screening and care. Healthcare gaps likely result from discriminatory practices and policies, but little research has explicitly examined this using measures of interpersonal and structural racism. Using population-based, longitudinal data from seven US jurisdictions in the Postpartum Assessment of Health Survey (2020) this dissertation examines racial and ethnic inequities in postpartum depressive symptoms and care and potential mechanisms behind these patterns. First, I examined patterns of self-reported PDS, perinatal mood and anxiety disorder (PMAD) diagnosis, and receipt of postpartum mental health care by racial and ethnic identity. Of 4,542 people who delivered live births, 11.8% reported PDS. Among them, 25% received a PMAD diagnosis and 50% received mental health care. Diagnosis did not differ by race and ethnicity, but racially minoritized individuals – particularly Asian, Native Hawaiian, or Pacific Islander, Southwest Asian, Middle Eastern, or North African; Black; and Hispanic respondents were significantly less likely to receive mental health care than their White counterparts. I next assessed patterns of medical mistrust and its relation to gaps in PMAD diagnosis and mental health care. Among 454 individuals with PDS, the highest medical mistrust based on identity (MMBI) was observed among individuals who were single, Black, Hispanic, had less than a college degree, and had public insurance. However, MMBI was not significantly associated with diagnosis or care. To explore structural mechanisms behind inequities in postpartum mental health care, I examined whether the racial residential segregation of one’s county was related to receipt of PMAD diagnosis and mental health care and explored the role of health professional shortages. Among 560 individuals with PDS, those living in counties with higher concentrations of racially minoritized populations were less likely to receive postpartum mental health care than those in counties with a greater concentration of White individuals, though healthcare provider shortages were not related. Findings highlight stark racial and ethnic inequities in postpartum depression management in the US that may largely stem from structural causes like residential segregation.Doctor of Philosoph
What Can Explain the Temporal Asymmetry of Moral Responsibility?
Get PDFIt is common sense that, while we can be morally responsible for our past actions, we cannot be morally responsible for our future actions. Why? Because they have not been performed yet. Ordinary morality, accordingly, is committed to a temporally grounded asymmetry with respect to moral responsibility. Call this idea ASYMMETRY. While it seems obvious to most that ASYMMETRY is true, little ink has been spilled on why it is true. In this paper, I will examine several natural candidates of potential explanations of ASYMMETRY. I will first consider the view that the past but not the future is determinate. I will then turn to commonly proposed conditions under which an agent acquires responsibility for an action at a time and conditions under which an agent retains responsibility over time. As I will argue, none of them can adequately explain ASYMMETRY.Master of Art
Biological Variation in Non-communicable Disease Risk and Associations with Economic Status of Women in China, Cambodia, and Cebu, Philippines
Get PDFThe present study investigates the relationship between biological non-communicable disease risk factors and relative economic status. Using cross-sectional data from women aged 18+ from the China Health and Nutrition Survey (2015), the Cebu Longitudinal Health and Nutrition Survey (2012), and the World Health Survey+ Cambodia (2023), this project aimed to quantitatively assess differences in biological variables between datasets and relationships between independent continuous biological variables, systolic blood pressure, HbA1c, high-density lipoprotein cholesterol, triglycerides and weight-to-height ratio, and relative household income and asset-based wealth within data sets. Then, qualitatively assessing how relationships varied across space and time. Generalized linear models were employed, adjusting for sociodemographic factors that influence economic and biological factors. Results suggest that women in China, Cambodia, and Cebu, Philippines, were experiencing different stages of epidemiological and nutrition transitions. Differential relationships to economic status were observed, with more significant associations between biological outcomes and wealth than community-level income inequality.Master of Art
MAINSTREAMING THE EUROPEAN RADICAL RIGHT: A QUANTITATIVE ANALYSIS OF THE ELECTORAL AND NORMATIVE CONSEQUENCES OF MAINSTREAM RIGHT ACCOMMODATION FROM 2014-2020
Get PDFThe rise of the European radical-right has elicited the need for response from mainstream political parties to combat the electoral threat that these challenger parties pose. This paper critically analyzes the dominant strategic approach of the mainstream right, accommodation on the issue of immigration, addressing not only the electoral effects but also the normative consequences. Using a quantitative analysis of party positioning on the issue of immigration from 2014 to 2019, based on the CHES expert survey data, as well as individual-level survey data drawn from the European Social Survey Wave 10, this study analyzes how accommodating behavior by the mainstream may influence individual attitudes towards immigration. The main finding is that while accommodation can be electorally effective in preventing voter defection to the radical right, the strategy also has normative consequences, leading to more restrictive attitudes towards immigrants for individuals across the political spectrum.Master of Art
The Impacts of Hidradenitis Suppurativa on Education and Employment: A Scoping Review Protocol
Get PDFObjective: The objective of this scoping review is to understand the extent and type of evidence regarding the impacts of hidradenitis suppurativa (HS) on education and employment status.
Introduction: HS, an inflammatory skin condition affecting the apocrine glands and hair follicles, entails substantial burdens to patients, including severe pain and resulting physical impairments pose a significant mortality risk. A better understanding of the impacts of HS on educational attainment and employment status may shape care guidelines for patients with HS.
Inclusion criteria: Studies that will be included in the scoping review are those that investigate patients with HS specifying education- or employment-related variables and outcomes. Studies concerning patients with HS but lacking education or employment related data, and studies concerning all other dermatological conditions will be excluded.
Methods: A comprehensive search will be conducted on PubMed, Scopus, CINAHL, ProQuest Health & Medical Collection, and Academic Search Premier. No date limits will be applied, only articles in English languagewill be included, and search terms will include HS and education- and employment-related terms. A minimum of two, independent reviewers will use Covidence to screen articles. Results will be presented using tabulated and thematic displays.
Results: Results will ideally inform care for HS to ensure educational attainment and employment.
Conclusions: Gaps and limitations in the relationship between HS, education, and employment, and future research directions will be presented
Chronic conditions and adherence to COVID-19 preventive measures in Pitt County, North Carolina
Get PDFIntroduction Individuals with chronic conditions have increased risk of severe COVID-19 infection. Few studies have been conducted in the United States regarding their engagement in recommended preventive behaviors. This study examines the associations between chronic conditions and adherence to COVID-19 preventive measures and vaccination intent in a community-based study conducted during the COVID-19 pandemic. Methods A cross-sectional study was conducted July-December 2020 among residents in Pitt County, North Carolina. Online surveys collected information on demographics, physical health and health behaviors, and COVID-19 preventive behaviors, including vaccination intent. Logistic regression estimated associations between any chronic condition (vs. none) and adherence to each preventive measure (always/most of the time vs. half the time or less), adjusting for age, race, gender, smoking, and alcohol. Analyses were repeated with increasing number of chronic conditions. Results Among 671 participants, adherence to preventive measures was often >90%. Intent to vaccinate showed evidence of a statistically significant dose response relationship with each additional number of chronic conditions (adjusted odds ratio [OR]=1.19; 95% confidence interval [CI]: 1.03, 1.37). An increased odds of wearing a facemask in public was also found for any chronic condition, though this did not reach statistical significance (adjusted OR=1.69; 95% CI: 0.97, 2.95). We did not find significant associations between having a chronic condition and adherence to other preventive measures such as avoiding large crowds or distancing six feet apart. Conclusion Adoption of preventive measures is an essential public health tool during epidemics/pandemics, particularly in the absence of vaccines. Our findings have implications for future public health messaging during a large-scale epidemic based on whether someone is likely engaged with and more trusting of the health care system (those with chronic conditions) versus those who are not
Racial and Ethnic Disparities in Receipt of ERBB2-Targeted Therapy for Breast Cancer, 2010-2020
Get PDFImportance: Among older women (aged ≥50 years) with ERBB2 (formerly HER2 or HER2/neu)-positive breast cancer, research has shown racial and ethnic disparities in access to ERBB2-targeted therapies, with Black women receiving treatment at lower rates than their White counterparts. Objective: To examine racial and ethnic disparities in receipt of ERBB2-targeted therapies and changes in receipt over time. Design, Setting, and Participants: This retrospective cohort study used Surveillance, Epidemiology, and End Results-Medicare linked data from January 1, 2010, to December 31, 2020. Beneficiaries who were diagnosed with ERBB2-positive breast cancer between 2010 and 2019, were aged 66 years or older at diagnosis, were continuously enrolled in Medicare Parts A and B in the 12 months before and after diagnosis, and had localized or regional stage disease at diagnosis were included. Data were analyzed from February through September 2024. Exposure: Race and ethnicity defined as non-Hispanic Black or African American, Hispanic, or non-Hispanic White. Main Outcome and Measures: The primary outcome was receipt of ERBB2-targeted therapies in the 12 months after diagnosis of ERBB2-positive breast cancer. Modified Poisson regression was used to evaluate the probability of receiving ERBB2-targeted therapy by race and ethnicity. Results: Among 12 765 beneficiaries with ERBB2-positive breast cancer (median [IQR] age, 74 [69-80] years; 99.2% female), 8.1% were of Black, 6.9% Hispanic, and 85.0% White race and ethnicity, and 54.2% received ERBB2-targeted therapy. The overall proportion who received ERBB2-targeted therapies increased from 41.3% in 2010-2011 to 64.3% in 2018-2019. Compared with White patients, Black patients had a lower likelihood of receiving ERBB2-targeted therapies in 2010-2011 (adjusted risk ratio [ARR], 0.81; 95% confidence limit [CL], 0.68-0.97), as did Hispanic patients (ARR, 0.75; 95% CL, 0.62-0.92). Racial and ethnic disparities in receipt of ERBB2-targeted therapies narrowed over time, with no significant differences observed across racial and ethnic groups in 2018-2019 for Black patients (ARR, 0.97; 95% CL, 0.87-1.08) and Hispanic patients (ARR, 1.05; 95% CL, 0.95-1.16). Conclusions and Relevance: These findings suggest a narrowing of racial and ethnic disparities in receipt of ERBB2-targeted therapies over time among older Medicare beneficiaries with ERBB2-positive breast cancer. Future research is needed to understand the practices that contributed to the narrowing of racial and ethnic disparities and to develop implementation strategies to effectively improve the quality and equity of breast cancer care