Shadow Standards and the Logic of Costs: Care, Stewardship, and Data in U.S. Community Health

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are activated to bring them into compliance. Through the lens of political economic, science and technology studies, and critical medical anthropologies, I identified how reimbursement models and government funding requirements redesigned under the 2010 Affordable Care Act obligate health care providers to reframe the care they provide. Providers cultivate what I term the “logic of costs,” a budgetary lens for making care decisions that frames management of costs as essential to care. Data creation and reporting practices require providers to adopt a logic of costs, as such data informs whether their clinics will be deemed effective and the clinics’ funding reauthorized. I trace the incongruities between actual care practices and the metrics that clinics end up recording and submitting to represent their work and their patients. I argue that this work is made possible through the creation of “shadow standards,” unofficial, undocumented, and yet routinized healthcare practices that make the creation and reporting of health data possible, even when providers do not have the resources to comply

Stuck Between a Fiduciary Rock and a Prudential Hard Place: The Eighth Circuit’s Approach to Erisa’s Duty of Prudence

On July 27, 2020, in Allen v. Wells Fargo & Co., the U.S. Court of Appeals for the Eighth Circuit held that plaintiffs who bring an imprudence claim under the Employment Retirement Income Security Act against a fiduciary of an employee stock ownership plan (ESOP) alleging that the fiduciary failed to act on negative inside information do not meet their pleading burden. In doing so, the Eighth Circuit agreed with three other federal circuit courts that an imprudence claim predicated on an ESOP fiduciary’s failure to disclose negative information is insufficient to survive a motion to dismiss. Only the Second Circuit has held that plaintiffs can survive a motion to dismiss when offering early disclosure as a possible alternative action the fiduciary could have taken. This Comment argues that the Eighth Circuit’s holding is correct because it best protects ESOP plan managers and takes account of ESOP’s unique structure

Wind-tunnel investigation of the powered low-speed longitudinal aerodynamics of the Vectored-Engine-Over (VEO) wing fighter configuration

A wind-tunnel investigation incorporating both static and wind-on testing was conducted in the Langley 4- by 7-Meter Tunnel to determine the effects of vectored thrust along with spanwise blowing on the low-speed aerodynamics of an advanced fighter configuration. Data were obtained over a large range of thrust coefficients corresponding to takeoff and landing thrust settings for many nozzle configurations. The complete set of static thrust data and the complete set of longitudinal aerodynamic data obtained in the investigation are presented. These data are intended for reference purposes and, therefore, are presented without analysis or comment. The analysis of the thrust-induced effects found in the investigation are not discussed

Assisted Reading with Digital Audiobooks for Students with Reading Disabilities

The goal of this study was to compare the efficacy of assisted reading with digital audiobooks with the traditional practice of sustained silent reading (SSR) in terms of reading fluency and reading attitude with upper elementary students with reading disabilities. Treatment group participants selected authentic children’s literature and engaged in assisted reading with digital audiobooks four to five times per week over an eight-week implementation period. Results showed that while all students demonstrated growth in reading fluency as calculated by words read correctly per minute, the growth of the treatment group far outweighed that of the control group. There was no significant difference in reading attitude scores. Consequently, this study shows that teachers can promote greater growth in reading fluency when assisted reading with digital audiobooks is implemented in the place of SSR

Autonomous rendezvous and docking: A commercial approach to on-orbit technology validation

The Space Automation and Robotics Center (SpARC), a NASA-sponsored Center for the Commercial Development of Space (CCDS), in conjunction with its corporate affiliates, is planning an on-orbit validation of autonomous rendezvous and docking (ARD) technology. The emphasis in this program is to utilize existing technology and commercially available components whenever possible. The primary subsystems that will be validated by this demonstration include GPS receivers for navigation, a video-based sensor for proximity operations, a fluid connector mechanism to demonstrate fluid resupply capability, and a compliant, single-point docking mechanism. The focus for this initial experiment will be expendable launch vehicle (ELV) based and will make use of two residual Commercial Experiment Transporter (COMET) service modules. The first COMET spacecraft will be launched in late 1992 and will serve as the target vehicle. The ARD demonstration will take place in late 1994, after the second COMET spacecraft has been launched. The service module from the second COMET will serve as the chase vehicle

Blockchain in the Role of Emancipatory Technology

Historically, women miners have been at a disadvantage in the mining industries due to factors outside of their control. This has caused them problems related to less income and worse working conditions as compared to their male counterparts. This research demonstrates how blockchain can be used as an emancipatory technology that can help improve the economic and ultimately social impact of these marginalized workers. Specifically, the paper demonstrates how mediating economic opportunity through an emancipatory technology such as blockchain can reduce negative influences of gender bias, ASM involvement, poor market conditions, and ethical consumption and ultimately provide greater benefits for women miners