The Repeating Book: In Search of the Creole Text in the Caribbean

Ph.D.In my dissertation, I argue that Caribbean thought and literature exhibit exceptional characteristics that make them unique, sharing features that make them what I call the “creole text.” Orlando Fals Borda’s Historia Doble de la Costa (1979-86) and Antonio Benítez Rojo's La Isla que se Repite (1989) guide my analysis. Historia Doble de la Costa is a much lesser-known book, it is a tetralogy that navigates between a poetic and a historicist discourse which, for lack of a better term, can be described as a social history whose structure duplicates its pages as if it contained two books, one of them a history from below, with parallel texts on facing pages. Historia Doble de la Costa also repeats itself because each of its four volumes repeat elements of the others to narrate the histories of the different subregional islets of the Colombian Caribbean. Through drawing on Benitez Rojo idea of “repetition”, I show that this repetition characterizes textual creolity in general, such as in C.L.R. James's The Black Jacobins (1938), Fernando Ortiz's Contrapunteo Cubano del Tabaco y el Azúcar (1940), Lydia Cabrera's El Monte (1954), George Lamming's The Pleasures of the Exile (1960), Édouard Glissant's Le Discours Antillais (1981), Manuel Zapata Olivella's Changó, el Gran Putas (1983), among others. I maintain that the creole text is cannibalistic in the sense that it is a textual assemblage that combines different fields of knowledge, approaches, intellectual traditions, formats and writing styles in an undisciplined manner. This anthropophagous attitude constitutes an artistic amalgam, unclassifiable, with a tendency towards excessiveness and the baroque, generating polyphony. In this way, the creole text opens up, including not only the oral record and myth, but also narrating the agency of subjects previously considered passive objects, in particular, the historical experience of the African diaspora

Impact of an Open Access Scheduling System on No-Show Rates in an Urban Federally Qualified Health Center

D.N.P.No-show medical appointments lead to health disparities and threaten the financial survival of Federally Qualified Health Centers (FQHCs). Open access scheduling eliminates long lead times, a common reason for no-show visits. Preventive health screenings and chronic disease management were drastically reduced during the COVID-19 pandemic, requiring innovative methods to increase access to care. The purpose of this quality improvement (QI) project was to measure the impact of an open access scheduling system on no-show rates in an urban FQHC. A pre-post observational design compared two days per week of no-show data for a span of 10 weeks between two family medicine physicians’ schedules. No-show data from the pre-intervention group (N = 175) was collected from October 17, 2022–December 20, 2022 and compared to no-show data from the open access post-intervention group (N = 82) collected from October 16, 2023–December 19, 2023. No-show rates were significantly lower in the open access post-intervention group (3.5%) compared to the traditional pre-intervention group (36%),

Racial and Ethnic Disparities in Vaccination Coverage across Thirteen States: A County-Level Analysis

M.S.Despite significant strides in vaccine development and dissemination during the COVID-19 pandemic, limited and patchy vaccine uptake highlights a critical public health challenge for future pandemics. However, the inadequacy of detailed data has hampered our ability to understand the ethnic and racial disparities in COVID-19 vaccinations Previous research has primarily focused on national or state-level disparities, highlighting the need for county-level analyses. This study aims to bridge this gap by analyzing disparities at the county level, providing a more accurate assessment of COVID-19 vaccination inequities. Specifically, we investigate the geographic distribution of COVID-19 vaccination disparities for Black and Hispanic populations, whether there are disparities between urban and rural counties, and whether significant differences exist in racial/ethnic disparity in vaccination rates when analyzed at the county level compared to state and national rates. Data was collected from 13 state health departments between June 22, 2021, and July 22, 2021, and included COVID vaccination counts disaggregated by county and race/ethnicity group. The findings reveal significant spatial heterogeneity in both Black and Hispanic vaccination disparity. Urban areas exhibited higher levels of Black disparity. Rural areas exhibited higher levels of Hispanic disparity. It was also determined that state-level analyses significantly obscure true disparities, highlighting the importance of county-level data. The findings from this study underscore the importance of targeted interventions tailored to specific geographic contexts and emphasize the imperative forpolicymakers and public health officials to prioritize the collection and utilization of granular county-level data to effectively address racial and ethnic disparities in vaccination efforts, thereby fostering more equitable health outcomes for all communities

Budgeting the Blaze: An Analysis of the Relationship Between Prescribed Burns and Wildfire Suppression Costs

M.P.P.Federal wildland firefighting agencies spend billions each year to contain and manage wildfires. These costs have grown exponentially as wildfire seasons have grown more severe. Unfortunately, climate scientists anticipate that the frequency and scope of these disasters will continue to grow over the next several decades as temperatures increase. It is crucial to understand how fuel reduction strategies can mitigate these effects. This thesis paper draws upon wildfire incident data from the National Geographic Area Coordination Center (GACCC) and prescribed fire data from the US Forest Service to examine the impact of prescribed burns in previous years on reducing wildfire suppression costs. This relationship analysis occurs on a county-level basis across the continental United States. Additionally, the wildfire data covers the years 2020 through 2023, and the prescribed fire data covers the years 2015 through 2023. This leaves 2,243 observations of counties that experienced wildfires and 3779 county observations that were treated with a prescribed burn. By evaluating the economic effects of prescribed burns by year on future wildfire suppression costs, this paper seeks to add to the existing literature on mitigation and serve as a reference for better financial management of the growing wildfire crisis

Exploring Mechanisms by Which CodY Regulate the Activity of the Sae Two-Component System to Control Virulence in Staphylococcus aureus

Ph.D.Staphylococcus aureus is a ubiquitous Gram-positive bacterium that colonizes up to 30% of the human population. As an opportunistic human pathogen, the bacterium is a leading cause of skin and soft tissue infections, endocarditis, and bacteremia. Drug resistance compounds the problem, and the lack of an efficacious vaccine emphasizes the need for new therapies to combat staphylococcal infections. One exciting approach is to target the regulation of virulence genes. Virulence genes are often regulated by multiple factors that respond to different environmental cues. Some of the factors act directly on virulence genes; others control virulence indirectly by controlling the expression or activity of other regulators. My dissertation research focuses on CodY, an amino acid- and GTP-responsive global transcriptional regulator of many metabolic pathways, and the mechanism by which it funnels nutrient depletion signals through a major regulator of virulence-the SaeR/S two-component system. Previous work by others and I in the Brinsmade lab and elsewhere showed that overexpressing the sensor kinase gene saeS and the response regulator gene saeR does not increase the expression of the Sae regulon genes. To explain this surprising result, my thesis provides experimental support for the hypothesis that CodY controls the cellular fraction of activated SaeR (SaeR~P) to adjust the expression of virulence factor genes. In Chapter II, I show that transcriptional regulation of the sae locus is dispensable for CodY-dependent upregulation of the Sae regulon. Moreover, CodY-deficient S. aureus strains have higher SaeS kinase activity, correlating with increased membrane branch- chain fatty acids derived from isoleucine. In chapter III, I show that CodY regulates SaeS kinase activity during periods of nutrient sufficiency by repressing the genes that code for enzymes and proteins that catalyze branched-chain fatty acid synthesis. Additional work herein focuses on the molecular mechanism by which the branched-chain fatty acids alter the SaeS signaling complex. My work contributes to the elucidation of a novel method of post-transcriptional virulence regulation by branched-chain fatty acids. Understanding the molecular basis of this regulation is an important first step in characterizing potentially new anti-virulence targets with therapeutic potential

Random Utilities and How to Find Them

Ph.D.In this dissertation, I study the random utility model. The random utility model is an extension of the classic paradigm of economics which assumes that decision makers choose according to some underlying preference. The random utility model extends this paradigm by allowing for heterogeneity across either a population of decision makers or across time for the same decision maker. This heterogeneity is modeled as there being a distribution over preferences inducing a distribution over choices. In Chapter 1, I study when an analyst is able to recover the underlying distribution over preferences from choice data. I provide fully characteristic conditions under which we are able to recover the underlying distribution over preferences. In Chapter 2, I readdress the problem of testing the random utility model. While axiomatic tests of the random utility model have been known, only recently has a hypothesis test for the random utility model been developed which can be applied to real data. However, this hypothesis test is not computationally feasible in many reasonable applications. I provide an alternative hypothesis test, applicable to real data, that offers large computational improvements over the current standard methodology. In Chapter 3, I study the random utility model in a dynamic setting where a decision maker's past choices can impact their preference today. First, I broach the problem of aggregation. In general, if a decision maker's preference depends on their history of choices, the time average of their choices does not coincide with the random utility model. I provide characteristic conditions for when the random utility model is an accurate model of time aggregated choice. Second, I develop a test for this type of dynamic random utility when we have time disaggregated but population level data. I provide a fully characteristic axiomatic test as well as a hypothesis test for history dependent random utility for this type of data

The Relationship Between Food Insecurity and Unmet Need for Modern Contraceptives: A Country-Level Analysis

M.P.P.Though access to modern contraceptive methods (MCMs) has improved globally over the past several decades, there remains a high level of unmet need among women of reproductive age (ages 15-49), particularly in low- and lower-middle income countries (LMICs). While little past research exists that examines the impact that food insecurity has on unmet need for MCMs, what does exist suggests that food insecure women are less likely to have pregnancy intentions than women who are food secure, but simultaneously less likely to be using any form of contraception. I use country-level panel data on 122 countries between 2015 and 2022 to investigate the relationship between moderate-to-severe food insecurity (MSFI) on unmet need for MCMs among women of reproductive age. Because most past research has explored the relationship at a hyper-local level and/or taken a qualitative approach to the question, this paper represents a geographic expansion on previous work. My study findings support my hypothesis, suggesting a positive relationship between MSFI and unmet need for MCMs on a global scale that is stronger among LMICs

Under One Roof: The Relationship Between Grandparent Co-Residence and Adolescent Mental Health

M.P.P.Multigenerational living is on the rise in the United States, with more children living in multigenerational households than in previous decades. However, the bulk of the literature on multigenerational living focuses on the financial and health impacts for adult generations. The outcomes of children in multigenerational households are not well-documented, despite the fact that 10% of children under 18 resided in multigenerational households in 2023. Mental health outcomes among children and youth are of particular concern in the United States, where the prevalence of depression among adolescents has been increasing at a faster rate than any other age group since 2009. This study investigates the relationship between living in a multigenerational household and depression among children using a sample of 4,834 middle and high school survey respondents from Waves 1 and 2 of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Grandparent co-residence is measured in Wave 1 (1994-95) and measures of depression incidence and symptom severity are constructed from Wave 2 (1996) responses to Center for Epidemiologic Studies Depression Scale (CES-D) instrument questions. I estimate the association between living with one or more grandparents and depression incidence and symptomatology using regression analysis in which I control for demographics, parental relationships, household structure, violence exposure and religiosity. I find no statistically significant relationship between grandparent co-residence and depression in this sample, although results indicate an inverse association between strength of parental relationships and depression incidence and symptomatology. Future research should involve a larger sample of longitudinal data in order to further shed light on the relationship between household structure and adolescent mental health