Doctor of Philosophy

dissertationFollowing liver transplantation, patients require lifelong immunosuppressive care and monitoring to prevent organ rejection, drug toxicity, and death. Traditionally, transplant centers use paper-based processes that are not scalable and can lead to inefficiencies and deficiencies in information management. Clinical decision support (CDS) tools may help to overcome information management challenges, and a system-agnostic approach may help to disseminate these tools nationwide. We sought to inform the development of new transplant information systems by analyzing existing information systems. To meet this overall objective, we administered a survey and found that all liver transplant programs used manual, paper-based processes and nearly all used electronic health record (EHR) systems. Programs also had immunosuppression guidelines with similar logic patterns. Then we analyzed long-term use of a computerized notification system at one transplant center and found that a system designed specifically for the posttransplant workflow can meet long-term information management needs. Next, we assessed the clinical outcomes associated with computerized notifications for laboratory monitoring of immunosuppressive care and found that a system designed specifically for the posttransplant workflow was associated with improved clinical outcomes. Following this, we described workflow processes at two transplant centers and found that a transplant-specific notification system was associated with changes in workflow process iv measures and the satisfaction of performing laboratory monitoring tasks compared to a general EHR notification system. Finally, we administered a questionnaire to coordinators using a transplant-specific notification system and identified the usage of specific data elements in computerized notifications for posttransplant laboratory monitoring. Our findings show that near universal use of EHRs provides an infrastructure for implementing CDS tools, and logic patterns for posttransplant laboratory monitoring can be generalized to other U.S. transplant centers. Transplant-specific computerized notifications may be part of a system of processes that improve the scalability, quality, and satisfaction of patient management by postliver transplant coordinators. However, these systems must be flexible enough to accommodate new immunosuppressants and changing or additional parameters used in computerized logic as clinical practice or needs of the patient population evolve. Proactive notifications sent directly to patients regarding upcoming due dates via patient portals may also improve patient outcomes

Comparing Stigmatizing Attitudes toward Posttraumatic Stress Disorder and Traumatic Brain Injury

The present study used an experimental design to compare stigmatizing attitudes toward a hypothetical target individual described, depending on condition, as having Posttraumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), or no diagnostic label. Attributions for the diagnostic label varied across conditions as either biological or psychological in cause. Participants were queried about their attitudes toward the individual described in the vignette, and specific attitudes involving personal responsibility, pity, anger, fear, helping, and beliefs about coercion-segregation were examined. Based on modified labeling theory and attribution theory, we predicted that the highest levels of stigmatizing attitudes would be reported by participants assigned to the PTSD label/psychological attribution cause condition. We also investigated reported level of contact with persons with mental illness, personal experience with mental disorder, trauma exposure, and experience with the military as potential covariates with relations between conditions and attitudes. Contrary to hypotheses, overall stigmatizing attitudes were most pronounced in the no label/no attribution condition. Examination of the specific attitudes mentioned above (e.g., personal responsibility) resulted in mixed findings, some in line with extant theory and some in contrast. Findings are discussed in terms of foundational theory, implications, and directions for future research

Assessing the impact of sporting mega-events on the social and physical capital of communities in host cities: the Gold Coast 2018 Commonwealth Games experience

Over the past decade there has been increasing research on how sporting mega-events such as the Olympic and Commonwealth Games are developing strategies, norms and rules to govern how they impact the host nation, city and communities, and in particular their impacts on economic, social, physical, human and cultural capital. This paper addresses a gap within these interconnected fields by examining how the strategies, norms and rules used to govern a mega-event may impact the social and physical capitals of communities in the host city during and following a mega-event. These associations are revealed through a novel methodology that combines the Institutional Grammar Tool developed by Crawford and Ostrom and the Community Capitals Framework devised by Flora and Flora, to analyse policy documentation, complemented by 11 in-depth interviews on the refurbishment of the Broadbeach Lawn Bowls Club as a venue for the 2018 Commonwealth Games in the City of Gold Coast, Australia

Observing quantum chaos with noisy measurements and highly mixed states

A fundamental requirement for the emergence of classical behavior from an underlying quantum description is that certain observed quantum systems make a transition to chaotic dynamics as their action is increased relative to $\hbar$. While experiments have demonstrated some aspects of this transition, the emergence of quantum trajectories with a positive Lyapunov exponent has never been observed directly. Here, we remove a major obstacle to achieving this goal by showing that, for the Duffing oscillator, the transition to a positive Lyapunov exponent can be resolved clearly from observed trajectories even with measurement efficiencies as low as 20%. We also find that the positive Lyapunov exponent is robust to highly mixed, low purity states and to variations in the parameters of the system.Comment: 3 figures, 5 pages, updated after comment

Vigilantism, Current Racial Threat, and Death Sentences

Capital punishment is the most severe punishment, yet little is known about the social conditions that lead to death sentences. Racial threat explanations imply that this sanction will be imposed more often in jurisdictions with larger minority populations, but some scholars suggest that a tradition of vigilante violence leads to increased death sentences. This study tests the combined explanatory power of both accounts by assessing statistical interactions between past lynchings and the recent percentage of African Americans after political conditions and other plausible effects are held constant. Findings from count models based on different samples, data, and estimators suggest that racial threat and lynchings combine to produce increased death sentences, but the presence of liberal political values explains the absence of death sentences. These findings both confirm and refine the political version of conflict theory because they suggest that the effects of current racial threat and past vigilantism largely directed against newly freed slaves jointly contribute to current lethal but legal reactions to racial threat

Efficiency measurements of a single stage turbine in a short duration facility

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Aeronautics and Astronautics, 1998.Includes bibliographical references (p. 155-156).by Jason J. Jacobs.M.S

Who Survives on Death Row? An Individual and Contextual Analysis

What are the relationships between death row offender attributes, social arrangements, and executions? Partly because public officials control executions, theorists view this sanction as intrinsically political. Although the literature has focused on offender attributes that lead to death sentences, the post-sentencing stage is at least as important. States differ sharply in their willingness to execute and less than 10 percent of those given a death sentence are executed. To correct the resulting problems with censored data, this study uses a discrete-time event history analysis to detect the individual and state-level contextual factors that shape execution probabilities. The findings show that minority death row inmates convicted of killing whites face higher execution probabilities than other capital offenders. Theoretically relevant contextual factors with explanatory power include minority presence in nonlinear form, political ideology, and votes for Republican presidential candidates. Inasmuch as there is little or no systematic research on the individual and contextual factors that influence execution probabilities, these findings fill important gaps in the literature

Using Whole Mount in situ Hybridization to Link Molecular and Organismal Biology

Whole mount in situ hybridization (WISH) is a common technique in molecular biology laboratories used to study gene expression through the localization of specific mRNA transcripts within whole mount specimen. This technique (adapted from Albertson and Yelick, 2005) was used in an upper level undergraduate Comparative Vertebrate Biology laboratory classroom at Syracuse University. The first two thirds of the Comparative Vertebrate Biology lab course gave students the opportunity to study the embryology and gross anatomy of several organisms representing various chordate taxa primarily via traditional dissections and the use of models. The final portion of the course involved an innovative approach to teaching anatomy through observation of vertebrate development employing molecular techniques in which WISH was performed on zebrafish embryos. A heterozygous fibroblast growth factor 8 a (fgf8a) mutant line, ace, was used. Due to Mendelian inheritance, ace intercrosses produced wild type, heterozygous, and homozygous ace/fgf8a mutants in a 1:2:1 ratio. RNA probes with known expression patterns in the midline and in developing anatomical structures such as the heart, somites, tailbud, myotome, and brain were used. WISH was performed using zebrafish at the 13 somite and prim-6 stages, with students performing the staining reaction in class. The study of zebrafish embryos at different stages of development gave students the ability to observe how these anatomical structures changed over ontogeny. In addition, some ace/fgf8a mutants displayed improper heart looping, and defects in somite and brain development. The students in this lab observed the normal development of various organ systems using both external anatomy as well as gene expression patterns. They also identified and described embryos displaying improper anatomical development and gene expression (i.e., putative mutants)