Advancing Understanding Of Dynamic Mechanisms In Onset To Event Models: Discrete Time Survival Mediation With A Time Variant Mediator

Integrating discrete time survival and mediation analytic approaches, discretetime survival mediation models (DTSM) help researchers elucidate the impact of predictors on the timing of event occurrence. Though application of this model has been gainful in various applied developmental and intervention research contexts, empirical work has yet to consider how DTSM models operate with a mediator that has a varying effect over time. The importance of examining this situation has important impacts for application of the model, given more complex statistical models are required, and subsequent interpretation of model parameters differ from the basic DTSM model. The overarching purpose of this dissertation was to understand how the addition of a mediator with a time variant effect impacts parameter estimation and fit of the DTSM model estimated in a mixture modeling framework. This investigation was done within the context of an applied example (Study One) to simultaneously inform applied considerations in timing to onset of youth alcohol use, as well as to evaluate statistical performance of the model in a related single-cell Monte Carlo study (Study Two) and an expanded simulation study (Study Three). Results are presented with discussion of future directions for this research and considerations for application of this modeling approac

Using Geographical Information Systems to Investigate Access to School Mental Heath Services

Many youth present emotional or behavioral difficulties at levels that necessitate mental health services, yet few receive these needed services. However, school mental health services are thought to improve access to mental health services for youth and families over and above traditional community mental health centers. The purpose of the current study was to expand on existing research by examining community-level and geographic predictors of the utilization of school mental health or community mental health services. Within the context of a large, federally funded trial, I examined how community rurality, ethnic/racial makeup and drive time predicted the use of either school mental health or community mental health services while controlling for county of residence and median household income. Service utilization at schools versus the community mental health center was not predicted by the community- or geographiclevel predictors examined in the current study. However some interesting descriptive findings did emerge that may lend preliminary support to the notion that school mental health services help improve geographic accessibility for those youth that live furthest from the community mental health center. Implications for future research are discussed

The Healing Body: Recovering the Church\u27s Mission of \u3ci\u3eShalom\u3c/i\u3e

Christianity is an embodied faith. God shaped human beings from the dust of the earth in God’s own image, in relationship with God, each other, and creation, and called us “good”. Our bodies, souls, and relationships are inextricably intertwined, and full health can be defined as a state of shalom, the flourishing of our whole selves in the context of our relationships and environment. Alienation, sickness, injustice, and suffering are experienced as brokenness in our bodies, souls, relationships, institutions, and environment. Restoration of health involves identifying and healing what is broken. God affirmed the goodness and worth of our bodies by becoming incarnate as Jesus, the son of man, entering and sharing our brokenness. Through his life, ministry, death, and resurrection, Jesus revealed what salvation, restoration, and shalom look like. His proclamation of salvation was embodied and demonstrated through healing the sick, cleansing the lepers, freeing the captives, proclaiming good news to the poor, and letting the oppressed go free (Luke 4:18-19; 7:22). His bodily resurrection ensures the redemption and healing of our own bodies. Not only does Jesus offer this salvation and shalom to us as individuals; as the church, we are also sent as he was sent (John 20:20), called and empowered by the Holy Spirit to participate in Jesus’ work of reconciliation and healing and become his healing body on earth. The early church took this mission seriously. Even as they endured persecution, they became known as a community of healing, both for their own members and for those outside of it. During famine and plagues, the early church was often the only institution that systematically cared for the sick and dying. The church’s healing ministry encompassed cures accomplished in Christ’s name, the relief of suffering, caring for the sick, reconciliation and peace-making, building families out of strangers, relieving isolation, challenging injustice, and reforming society. Historian Amanda Porterfield claims that “healing has persisted over time and across cultural spaces as a defining element of Christianity and a major contributor to Christianity’s endurance, expansion, and success.” In much of the world, the contemporary church is still known as a community of health and healing. However, many American churches define their mission and purpose without reference to health. They see themselves as the stewards of a spiritual gospel, focusing on the salvation and care of people’s souls and leaving issues of physical health and healing to systems and providers outside the church. Perhaps this is part of the reason that the American church’s response to the Covid-19 pandemic differed so dramatically from the witness of the early church in the face of epidemics. I believe that churches have unique healing gifts and assets, and that the church’s call to participate in Jesus’ work of healing and reconciliation remains as pressing today as it was at Pentecost. Churches can answer that call by developing, teaching, and embodying a theology of health and healing and making it an integral part of their mission; by identifying where health is lacking in their own context and in the communities in which they’re placed; by employing multidisciplinary tools and frameworks to identify and understand the determinants of health issues; by discerning the unique resources the church community can offer in response; and by partnering with community members and organizations in the work of healing brokenness and restoring shalom. This is work that requires knowing how to work in partnership with church and community members in a way that empowers them as co-participants and co-agents in every part of the process. How can seminaries effectively prepare Christian leaders to form their churches into communities of health and healing? Because of the interdisciplinary nature of health and healing work, much of what is needed is already covered in seminary education and training, especially if there are reconciliation-centered classes offered as a part of the curriculum (as is the case in SPS). Classes which teach and discuss spiritual, emotional and relational wholeness, as well as issues of justice and racism that disrupt the health of individuals and communities, address important determinants of health. However, there are specific skills and competencies for leading churches in the areas of health and healing that are not included in a standard seminary curriculum. In addition, seminary students are rarely given a theology, framework, and vision for church-based health and healing with which to integrate relevant resources and skills from other sources and classes. There is a clear opening and need for a seminary class that will help Christian leaders recover a vision of the church as a community of health and healing and equip them to lead churches into this vision. In my final chapter, I describe a 2-3 credit class on health, healing and the church as a seminary course offering. This class will equip students with the skills to lead churches in their health and healing mission and will support and strengthen the reconciliation and theology classes already offered. My hope is that such a class would prepare Christian leaders to form their churches into communities of health and healing that can build shalom in the wake of the COVID-19 pandemic’s destruction

Post-implementation assessment of novel rodent control devices for protection of high elevation endangered species at Hawai`i Volcanoes National Park

Reports were scanned in black and white at a resolution of 600 dots per inch and were converted to text using Adobe Paper Capture Plug-in.Invasive species, including rats, threaten the existence of many of Hawai`i’s native species pushing them to the brink of extinction. Hawai`i Volcanoes National Park has a long history of successfully managing ecosystems and providing rare species habitat through systematic invasive species control. Landscape level rodent control is prohibitively expensive; however, localized control has proven cost-effective while providing significant resource benefit. A trapping program using self-resetting Goodnature® A24 technology was implemented at two remote sites in Hawai`i Volcanoes National Park in an effort to protect five endangered plant species and three endangered bird species from black rat (Rattus rattus) predation. This trapping method has been successfully implemented on other islands, but implementation requirements are site specific. Techniques and maintenance schedules were investigated specifically for subalpine dry shrubland environments and also high elevation wet forest environments. Trap performance, recommended grid spacing, and a new chocolate long-life lure formula were evaluated over the course of this investigation. Apparent rodent control trends and subsequent native species responses were captured over the course of four months by conducting biweekly trap visits and analyzing motion triggered camera footage. Clear declines in rodent activity were documented at each site during the four month intensive monitoring period. At least 38 rodents were removed from the subalpine dry shrubland test site during this period, while at the high elevation wet forest site at least 102 rodents were removed. It is suspected that the number of total kills was underestimated using available monitoring techniques. Trapping activity appeared to prevent major damage to flowers and diminish damage to fruit of endangered Campanulaceae species at the forested test site, however it is unclear what effect trapping efforts had on native bird species at the subalpine shrubland site. Management recommendations differ by site. For subalpine shrubland sites, trap spacing should not exceed 100m x 100m to control M. musculus or R. rattus; tighter spacing may be necessary. In high elevation wet forests spacing traps at 50m x 50m is recommended to effectively reduce R. rattus populations. Pre-baiting traps is not advised to minimize potential damage done by rodents gnawing on depressurized traps. Concurrent trapping for feral cats and other scavengers, or strategic trapping schedules, are recommended to mitigate potential secondary predator attraction for sensitive sites such as Hawaiian petrel nesting areas. Schedule of trap maintenance should include monthly lure checks and ‘refreshment’ squeezes, regardless of site ecosystem. Scent of the lure diminishes between refreshment visits in arid environments and may be masked by algae or mold in wet environments. Use of the Goodnature® automatic lure pump should be considered to potentially alleviate this issue. In both environments standard lure bottles were found to last through the 16 week monitoring period. Lure was found to remain attractive to rodents, after refreshment squeezes as long as 36 weeks after deployment at the forested site. Trap maintenance should be scheduled to check CO2 status no later than 12 weeks after deployment, regardless of site ecosystem, to detect exhausted CO2 or malfunctioning traps, and at monthly maintenance visits if possible. Use of a surrogate pest such as a rubber rat to test fire through the trap shroud is advised to accurately simulate a strike, and ensure functionality of digital strik

Future Orientation Among Children Affected by Parental HIV in China: An Exploratory Analysis of Complex Interactions

We utilized an exploratory analytic approach to examine predictors of children\u27s future beliefs, an internal asset associated with resilience among children affected by HIV, with emphasis on complex interactions among multisystem factors. Children (N = 1221) affected by parental HIV in China reported on psychosocial functioning, as well as internal, familial, and community resilience assets. Exploratory data analysis was conducted using a binary segmentation program. Six binary splits on predictors accounted for 22.78% of the variance in future expectation, suggesting interactions between children\u27s perceived control of their future, loneliness, caregiver trust, and social support. Four binary splits accounted for 23.15% of the variance in future orientation, suggesting multiway interactions between control of the future, loneliness, social support, and perceived stigma. Findings suggest combinations of resilience factors are associated with children\u27s positive future beliefs. Implications for screening, prevention, and intervention among Chinese children affected by parental HIV are discussed

Pittsboro, North Carolina, Chatham County : an action-oriented community diagnosis including secondary data analysis and qualitative data collection

PURPOSE OF COMMUNITY DIAGNOSIS The Chatham Coalition for Adolescent Health and five graduate students from the Department of Health Behavior and Health Education at the UNC School of Public Health collaborated to conduct this community diagnosis of Pittsboro’s adolescents. The purpose of this community diagnosis was to learn about the health and quality of life concerns of residents of Pittsboro, both adult and adolescent, and the resources and strengths that exist in the town for dealing with these concerns. The community diagnosis process used primary and secondary data to discover and analyze both the concerns and strengths of Pittsboro and its adolescents. INTRODUCTION TO OUR COMMUNITY Pittsboro is a small, semi-rural, Southern town that has been in existence for over 200 years. It is the Chatham County seat, located 35 miles west of Raleigh and 17 miles south of Chapel Hill. The town was founded in 1787 and until recently, the population increased very little. The “quaint” downtown is Mecca for antiques lovers, and features over ten antiques stores. In addition, there are several old-fashioned country stores, and a local farmers market situated in the town fairgrounds. However, while antique shopping and tourism entice many to come to Pittsboro, the cornerstone of the community is the people who live, work, and are educated there. Within the larger community of Pittsboro, we focused on adolescents. These teens, ages 11-18, either live or work in the town of Pittsboro or attend school in the Pittsboro District. While many of the adolescents do not actually live in the town of Pittsboro proper, those who work or go to school in the district are just as much influenced by the resources and activities in Pittsboro as are those who live there. This is particularly the case with after-school activities and the county health, educational, and recreational resources that are within reasonable distance of the schools and places of employment. Because we were working in Pittsboro with the Chatham County Coalition for Adolescent Health, it was not difficult to identify teens as our target population. The challenge came in determining which adolescents to include: only those who live within the city limits or residents as well as those who go to school or work in town. Through communications with our preceptor and the service providers we interviewed, it became clear that including the teens who come into Pittsboro daily, for school or work, along with teen residents was necessary since they all have access to the various county departments and other resources in the town and convene at local places such as convenience stores and restaurants. While adolescents are an integral part of Pittsboro, they are a group that tends not to have a collective voice. In addition, it became apparent from the interviews that we conducted that there are several issues facing the entire Pittsboro population that have both direct and indirect effects on the adolescent community. In particular, the growing number of businesses turning teens away, the lack of funding for a city-run recreational center, and the community’s lack of awareness about the existing Teen Center have precluded the ability of teens to convene in a single setting or come together around organized activities. According to one service provider, the consequence is that teens have lost their sense of community and are increasingly prevented from gaining it back. Hence, while we have defined Pittsboro as our community and teens as our focus within that community, the teens may not, in fact, sense that they belong to it. Our intent through this community diagnosis is to help Pittsboro recognize the strengths and needs of its teens and take ownership over the issues relevant to them in order to help the adolescents find their own voice and role within the larger community.Master of Public Healt

Performance analysis of co-firing waste materials in an advanced pressurized fluidized-bed combustor

The co-firing of waste materials with coal in utility scale power plants has emerged as an effective approach to produce energy and manage municipal wastes. Leading this approach is the atmospheric fluidized-bed combustor (AFBC). It has demonstrated its commercial acceptance in the utility market as a reliable source of power by burning a variety of waste and alternative fuels. The application of pressurized fluidized-bed combustor (PFBC) technology, although relatively new, can provide significant enhancements to the efficient production of electricity while maintaining the waste management benefits of AFBC. A study was undertaken to investigate the technical and economical feasibility of co-firing a PFBC with coal and municipal and industrial wastes. Focus was placed on the production of electricity and the efficient disposal of wastes for application in central power station and distributed locations. Issues concerning waste material preparation and feed, PFBC operation, plant emissions, and regulations are addressed. The results and conclusions developed are generally applicable to current and advanced PFBC design concepts. Wastes considered for co-firing include municipal solid waste (MSW), sewage sludge, and industrial de-inking sludge. Conceptual designs of two power plants rated at 250 MWe and 150 MWe were developed. Heat and material balances were completed for each plant along with environmental issues. With the PFBC`s operation at high temperature and pressure, efforts were centered on defining feeding systems capable of operating at these conditions. Air emissions and solid wastes were characterized to assess the environmental performance comparing them to state and Federal regulations. This paper describes the results of this investigation, presents conclusions on the key issues, and provides recommendations for further evaluation

EXPLORE Performance in Mathematics and Science: Why are Middle School Students Unprepared for Success in Mathematics and Science?

In response to the disconnect between EXPLORE and state assessment scores, and perceived needs in math and science education at the middle school level, Western Kentucky University, a state university, its three regional campus centers, four community colleges, and 30 schools in Western Kentucky developed and established an expanded partnership, entitled the Western Kentucky Math Science Partnership (MSP) addressing a documented local, state, and national challenge: improving teaching and learning in middle school to insure access of all students to rigorous high school math and science. The 2008-2010 Western Kentucky MSP grant, funded by the National Science Foundation (NSF), was an effort to understand the circumstances that impact students’ performance on the EXPLORE test and, therefore, college and career preparedness. It was an evidence-based problem-solving process to collect and analyse data directly related to declining math/science scores in participating middle school. The research question for the project was “What factors can be identified that contribute to the disparity between EXPLORE scores and the state assessment data?” Three themes were examined to study the research question: (1) leadership and planning, (2) classroom instruction, and (3) the assessment of higher-order thinking skills and problem solving

Evaluating a Method to Estimate Mediation Effects With Discrete-Time Survival Outcomes

The utility of evaluating mediation effects spans across research domains. The model facilitates investigation of underlying mechanisms of event timing and, as such, has the potential to help strengthen etiological research and inform intervention work that incorporates the evaluation of mediating variables. In order for the analyses to be maximally useful however, it is critical to employ methodology appropriate for the data under investigation. The purpose of this paper is to evaluate a regression-based approach to estimating mediation effects with discrete-time survival outcomes. We empirically evaluate the performance of the discrete-time survival mediation model in a statistical simulation study, and demonstrate that results are functionally equivalent to estimates garnered from a potential-outcomes framework. Simulation results indicate that parameter estimates of mediation in the model were statistically accurate and precise across the range of examined conditions. Type 1 error rates were also tolerable in the conditions studied. Adequate power to detect effects in the model, with binary X and continuous M variables, required effect sizes of the mediation paths to be medium or large. Possible extensions of the model are also considered

Filter system cost comparison for IGCC and PFBC power systems

A cost comparison was conducted between the filter systems for two advanced coal-based power plants. The results from this study are presented. The filter system is based on a Westinghouse advanced particulate filter concept, which is designed to operate with ceramic candle filters. The Foster Wheeler second-generation 453 MWe (net) pressurized fluidized-bed combustor (PFBC) and the KRW 458 MWe (net) integrated gasification combined cycle (IGCC) power plants are used for the comparison. The comparison presents the general differences of the two power plants and the process-related filtration conditions for PFBC and IGCC systems. The results present the conceptual designs for the PFBC and IGCC filter systems as well as a cost summary comparison. The cost summary comparison includes the total plant cost, the fixed operating and maintenance cost, the variable operating and maintenance cost, and the effect on the cost of electricity (COE) for the two filter systems