In with a runny nose, Out in a body bag: Why is it so difficult for Black women to leave the hospital alive?

In the Black community, there is an unspoken understanding about Black people going to the doctor with a runny nose, and leaving in a body bag. A recent article published by The Oprah Magazine demonstrates that racism is rampant in the United States healthcare system, and it is taking the lives of Black women at an alarmingly disproportionate rate (Stallings, 2018). When seeking medical treatment, many Black women are at the mercy of doctors who possess an implicit bias against Black women. Simply put, implicit bias describes the phenomenon in which people behave and treat others based on negative preconceptions they have about other people, even though they are not intentionally trying to do so. Because of this implicit bias, Black women have every reason to be scared of medical professionals, and their distrust is justifiable. A growing body of research and testimony gives evidence of Black women’s mistreatment due to their race, and the disparity in quality of care between Black and non-Black women widens, especially for pregnant Black women. In this presentation, I will investigate the current injustices against Black women in the healthcare system and address the health disparities that are exclusive to Black women. I will hypothesize what steps need to be taken to abolish the health disparities that Black women face when seeking medical attention

In with a runny nose, Out in a body bag: Why is it so difficult for Black women to leave the hospital alive?

In the Black community, there is an unspoken understanding about going to the doctor with a runny nose, and leaving in a body bag. A recent article published by The Oprah Magazine demonstrates that racism is rampant in the United States healthcare system, and it is taking the lives of Black women at an alarmingly disproportionate rate (Stallings, 2018). When seeking medical treatment, many Black women are at the mercy of doctors who hold an implicit bias against Black women. Simply put, implicit bias describes when people behave and treat others based on negative preconceptions they have about other people, even though they may not be trying to do so intentionally. Because of this implicit bias, Black women have every reason to be scared of medical professionals; their distrust is justifiable. A growing body of research and testimony gives evidence of Black women’s mistreatment due to their race, and the disparity in quality of care between Black and non-Black women widens, especially for pregnant Black women. In this research report, I investigate the current injustices against Black women in the healthcare system and address the health disparities that are unique to Black women. I have also incorporated personal anecdotes from family members and friends with firsthand experience of poor treatment by medical professionals. I include these anecdotes because they speak to the realities of medical racism, and its effects, including on people that I am very close to. Some of these women like my mother, Keisha Carter, and my grandmother, Vicki Carter, had no desire to remain anonymous. Others, who I refer to as Toni, Ann, and Jackie, wanted to remain anonymous to protect their privacy. In addition, I discuss some comments from medical professionals who have personally seen their co-workers acting discriminatorily towards Black female patients. I also propose steps that need to be taken to lessen the healthcare disparities that Black women face when seeking medical attention

Three essays in economic history

This dissertation consists of three essays on topics in economic history. The first two chapters focus on historical place-based policies in the United States. Chapter One studies the United States Army's role in shaping the spatial distribution of the population. Chapter Two studies the construction of the Interstate Highway System (IHS) in the city of Detroit. Chapter Three examines mechanisms for financing creativity in the British publishing industry. In Chapter One, I link the location of US Army forts to spatial patterns in population density across counties on the American frontier. Fort establishment predicts initial increases in density, indicative of their role as man-made factors in explaining the origins of local spatial patterns. Long after fort abandonment, increased density persists at fort locations, indicating path dependence. Long-run persistence is driven by if, and when, a fort county was connected to the nineteenth century railroad network. Chapter Two studies the political economy behind site selection for urban segments of the IHS and measures effects of construction on neighborhoods in Detroit. Using variation at the census-tract level, I show that interstates were routed through neighborhoods with low property value to minimize land acquisition costs and future losses to the city's tax base. Following construction, interstates led to short-run declines in property values, population density, and the percentage of a neighborhood's black residents. In the long run, property values declined further in tracts with an interstate, and tracts closest to construction remained less dense with lower shares of black residents. Chapter Three uses book-level data on Romantic Period English literature to investigate crowdfunding as a mechanism for financing creativity in the publishing industry. We show that new authors and female authors faced substantially greater demand uncertainty in the industry, compared to both established and male authors, and these authors are more likely to crowdfund their works. Subsequently, while crowdfunded works have lower average payoffs, crowdfunded titles written by females, and targeting a female audience, are relatively more successful than their traditionally-published counterparts, consistent with demand in excess of expectations

Understanding and treating selective mutism in children : a guide for counselors

Selective mutism is a clinical disorder in which a child remains silent in chosen situations despite the ability for speech. Though there are cases of selective mutism in adults, the major population in which this disorder is diagnosed is in children. This paper will focus on these children who meet the criteria for a diagnosis of selective mutism. There are three major theoretical schools of thought regarding selective mutism. The first deals with hostility and control; the second, anxiety and social phobia; and the third, family communication in regard to the onset and maintenance of this disorder. This paper explores the causes of selective mutism from each of these perspectives

Impact of School-Based, Linguistically Relevant Literacy Interventions for Spanish-English Bilingual Students

In the fall of 2015, the National Center for Education Statistics reported 9.5% or 4.8 million students were English Language Learners (ELLs) (“The Condition of Education,” 2018).  ELLs often face challenges in school when accessing an English only curriculum. Researchers in education believe that early literacy instruction can mitigate academic disparities (Baker et al., 2012, p. 738); however, there needs to be more research on whether the instruction should be provided in the child’s native language or in English (p. 738).  There were two methods of literacy intervention for ELLs in this systematic review: sequential intervention and paired intervention. Sequential intervention provides intervention in the student’s native language before transitioning to English. Meanwhile, paired intervention provides intervention in English and Spanish.

The Ethics of Eliminating Harmful Species: The Case of the Tsetse Fly

Wildlife species harmful to humans are often targets of control and elimination programs. A contemporary example is the tsetse fly, a vector of sleeping sickness and African animal trypanosomosis. Tsetse flies have recently been targeted by a pan-African eradication campaign. If it is successful, the campaign could push the entire tsetse family to extinction. With the emergence of effective and efficient elimination technologies, ethical assessment of proposed elimination campaigns is urgently needed. We examine the ethics of tsetse fly elimination by considering arguments predicated on both the instrumental and the intrinsic values of the species at local and global scales. We conclude that, although global eradication of tsetse flies is not ethically justified, localized elimination campaigns targeting isolated populations are ethically defensible. We urge assessments of this kind be conducted regularly and in context, so that all relevant factors underlying decisions on species elimination are routinely laid bare for evaluation

GABA and lactate preconditioning increases cell division in annual killifish cell line during anoxia

Annual killifish (Austrofundulus limnaeus) live in temporary ponds in Venezuela and experience drastic changes in their environment that cause their ponds to dry up. This species survives by producing drought- and anoxia-tolerant embryos that are deposited in the mud. Embryos survive these conditions by entering metabolic dormancy (diapause) until environmental signals break their dormancy and they continue developing. In order to survive anoxia, embryos rely exclusively on anaerobic metabolism, which leads to abundant lactate accumulation. Previous research has shown that the production and degradation of the neurotransmitter γ-aminobutyric acid (GABA) is crucial for long-term anoxia survival. This study explores the role of lactate and GABA metabolism in anoxia tolerance. To test this, we exposed embryo-derived cells (WS40NE) in anoxia to three treatments: anoxia preconditioning, lactate preconditioning, and GABA supplementation. For all treatments, cell survival was monitored, and extracellular lactate levels were measured. Compared to the control, cells exposed to lactate and GABA proliferated at a higher rate, whereas the anoxia preconditioned treatment proliferated at a lower rate. Rate of lactate accumulation was dependent on time spent in anoxia as well as whether cell media was changed. Media changes led to higher rates of lactate production compared to cells in static media. Understanding survival of cells during anoxia may give insight to how human conditions, such as strokes, can be avoided or damage can be reversed

Finding AGN in Deep X-ray Flux States with Swift

We report on our ongoing project of finding Active Galactic Nuclei (AGN) that go into deep X-ray flux states detected by Swift. Swift is performing an extensive study on the flux and spectral variability of AGN using Guest Investigator and team fill-in programs followed by triggering XMM_Newton for deeper follow-up observations. So far this program has been very successful and has led to a number of XMM-Newton follow up observations, including Mkn 335, PG 0844+349, and RX J2340.8-5329. Recent analysis of new Swift AGN observations reveal several AGN went into a very low X-ray flux state, particularly Narrow-Line Seyfert 1 galaxies. One of these is RX J2317-4422, which dropped by a factor of about 60 when compared to the ROSAT All-Sky Survey.Comment: 6 pages, 3 figures, Proceedings of the "10 Years of Swift" Meeting held in Rome in December 2014. Submitted to Po

Should All Patients With Pulmonary Hypertension Undergoing Non-Cardiac Surgery Be Managed by Cardiothoracic Fellowship-Trained Anesthesiologists?

Objectives To identify differences in practice patterns and outcomes related to the induction of general anesthesia for patients with pulmonary hypertension (PH) performed by anesthesiologists who have completed a cardiothoracic fellowship (CTA group) vs those who have not (non-CTA group). Design Retrospective study with propensity score matching. Setting Operating room. Participants All adult patients with PH undergoing general anesthesia requiring intubation at a single academic center over 5 years. Interventions Patient baseline characteristics, peri-induction management variables, post-induction mean arterial pressure (MAP), and other outcomes were compared between CTA and non-CTA groups. Methods and main results: Following propensity scoring matching, 402 patients were included in the final model, 100 in the CTA group and 302 in the non-CTA group. Also following matching, only cases of mild to moderate PH without right ventricular dysfunction remained in the analysis. Matched groups were overall statistically similar with respect to baseline characteristics; however, there was a greater incidence of higher ASA class (P = .025) and cardiology and thoracic procedures (P < .001) being managed by the CTA group. No statistical differences were identified in practice patterns or outcomes related to the induction of anesthesia between groups, except for longer hospital length of stay in the CTA group (P = .008). Conclusions These results provide early evidence to suggest the induction of general anesthesia of patients with non-severe PH disease can be comparably managed by either anesthesiologists with or without a cardiothoracic fellowship. However, these findings should be confirmed in a prospective study