Rhetoric in film: Three explorations of influence in documentaries and digital stories

This thesis is made up of three distinct articles, two written with the intention of publication while the third consists of a digital story and subsequent reflection on the process of creation. The first article serves to answer the question “Do documentary films inspire activism?” by analyzing data gained after surveying 266 members of the James Madison University community. The results suggest that viewers are moved to emotion when witnessing struggle but that they are moved to action when said action directly impacts their own life. The second article is a rhetorical analysis of the 2013 documentary film Blackfish. Both the director, Gabriela Cowperthwaite, and the film as a whole are considered an author and the construction of empathy is explored as the primary rhetorical device. The societal impact of the film is explored as well how the empathetic approach to storytelling contributed to the resulting changes in attitudes and actions towards SeaWorld. The third piece consists of a link to a digital story focused on the experience of the class of 2018 at the University of Virginia. The reflection that follows provides details of the filming process and outlines the rhetorical choices employed and the limitations of the medium

ECONOMIC INSECURITY AND MORTALITY IN THE UNITED STATES

Background The field of social epidemiology has grappled with the measurement of macrosocial, upstream factors and the assessment of their impact on health. Economic insecurity is one such determinant of health that has been understudied in the public health literature. Objectives The goal of this dissertation was to develop and validate a novel determinant of health, economic insecurity, and assess its association with mortality, tobacco smoking, and heavy and binge drinking. Methods In aim 1, county-level indicators of economic insecurity were drawn from the US Census and Federal Reserve Bank for seven states in the north-Atlantic and Midwest regions of the US in the year 2000 based on our theoretical framework. We used confirmatory factor analysis to assess our measurement model and evaluate model fit. We validated this model using county-level indicators of socioeconomic status, social disruption, and mortality outcomes. In aim 2, we expanded this measurement model to all counties in all states in the US for the years 2000 and 2010. We then estimated the association between the change in economic insecurity between 2000 and 2010 and the rate of change in mortality due to suicide, drug and alcohol poisoning, and chronic liver disease and in midlife mortality (ages 45-54) from 2001-05 to 2011-15, using linear regression models. Finally, in Aim 3 we test the association between change in economic insecurity and trends in three health behaviors from 2002 to 2012: cigarette smoking, binge drinking, and heavy drinking using ecological longitudinal models. Results The five indicators of percent unemployed, percent not in labor force, percent employed in the service sector, percent of income spent on rent, and percent with subprime credit rating (credit score below 660) produced a measurement model of county economic insecurity with adequate fit. Counties with elevated economic insecurity in either or both 2000 and 2010 had larger increases in suicide, poisoning, and chronic liver disease mortality than counties with low insecurity in both time periods, and larger increases in all-cause, midlife mortality. Counties with high economic insecurity in both 2000 and 2010 also had slower declines in smoking among both men and women. Higher economic insecurity, however, appears to be associated with lower levels of drinking. Conclusions Measuring and validating upstream determinants of health is challenging. Future work should 1) explore other health outcomes sensitive to economic insecurity and 2) explore policy interventions that may reduce economic insecurity in counties or ameliorate its effects

Presentation: NNLM Course Development for Building Nursing and Allied Health Research Skills

In 2019, the Network of the National Library of Medicine embarked on a process to update a course that aimed to 1) teach participants how to evaluate quality health websites for nurses; 2) enable participants to describe and evaluate quality nursing resources available on the internet; and 3) demonstrate searches for nursing literature in PubMed. The curriculum development team further refined these objectives. The new course would enable participants to connect National Library of Medicine resources to the needs of nursing and allied health professionals. After taking the course, participants would be able to list the ways librarians can support the information needs of their nursing and allied health audiences. The NNLM curriculum development team met from November 2019 through December 2020 to develop a course that would be launched in early 2021. In the kick-off meeting, the team agreed to investigate needs and best practices for librarians teaching nursing and allied health professionals. Members of the team divided up course development tasks. They reconvened bimonthly to share relevant information resources, sharpen the learning objectives, and share ideas for course activities such as readings, quizzes, and written assignments. The result is a three-week asynchronous course that is designed for library staff who support, or who want to support, nursing and allied health professionals. In Week One, participants learn about the information needs of nursing and allied health professionals. Week Two introduces participants to relevant information resources. Week Three asks participants to apply learning through creating and sharing a professional development plan. We gathered evaluation data after the pilot launch in December 2020 and the three sessions taught in early 2021. We will address participant needs for better navigation and more time to complete the professional development plan. We hope to offer the course again in Summer 2021

Examining the Attitudes and Knowledge of Pregnant Teens on the Topic of SIDS

Background: Norfolk has the second highest teen pregnancy rate and third highest infant mortality rate in Southeastern Virginia. SIDS is the third leading cause of infant death in Virginia. Providing a group education intervention modeled after centering pregnancy gives teen mothers the opportunity to learn and receive support in a safe space in hopes of making a positive impact on their attitudes and knowledge regarding SIDS. Hypothesis: Do the attitudes and knowledge of pregnant teens and recent teen mothers change positively after a group education intervention on sudden infant death syndrome (SIDS). Method: Quasi-experimental non-randomized group trial. This includes pregnant females ages fifteen to nineteen in Norfolk, Virginia at a city general hospital. The data will be collected from a pretest before and posttest after a group education intervention on SIDS. Data Collection: Hypothesis testing will be conducted using a t-test to determine group differences in attitudes and knowledge after the intervention. Participants will also be completing a PRAMS demographics survey. Goal: To see if the SIDS education intervention has an impact on the knowledge of teen mothers in efforts to reduce the current SIDS rate contributing to Norfolk\u27s high infant mortality rate

The impact of adsorption–desorption reactions on the chemistry of Himalayan rivers and the quantification of silicate weathering rates

A.K. was supported by a NERC DTP studentship (NE/S007164/1). This work was funded by the NERC grant NE/T007214/1.Common environmental adsorbents (clay minerals, metal-oxides, metal-oxyhydroxides and organic matter) can significantly impact the chemistry of aqueous fluids via adsorption–desorption reactions. The dissolved chemistry of rivers have routinely been used to quantify silicate mineral dissolution rates, which is a key process for removing carbon dioxide (CO2) from the atmosphere over geological timescales. The sensitivity of silicate weathering rates to climate is disproportionately weighted towards regions with high erosion rates. This study quantifies the impact of adsorption-desorption reactions on the chemistry of three large Himalayan rivers over a period of two years, utilising both the adsorbed and dissolved phases. The concentration of riverine adsorbed cations are found to vary principally as a function of the concentration and cation exchange capacity (CEC) of the suspended sediment. Over the study period, the adsorbed phase is responsible for transporting ∼70% of the mobile (adsorbed and dissolved) barium and ∼10% of the mobile calcium and strontium. The relative partitioning of cations between the adsorbed and dissolved phases follows a systematic order in both the monsoon and the dry-season (preferentially adsorbed: Ba > Sr & Ca > Mg & K > Na). Excess mobile sodium (Na*=Na-Cl) to silicon (Si) riverine ratios are found to vary systematically during an annual hydrological cycle due to the mixing of low temperature and geothermal waters. The desorption of sodium from uplifted marine sediments is one key process that may increase the Na*/Si ratios. Accounting for the desorption of sodium reduces silicate weathering rate estimates by up to 83% in the catchments. This study highlights that surficial weathering processes alone are unable to explain the chemistry of the rivers studied due to the influence of hydrothermal reactions, which may play an important role in limiting the efficiency of silicate weathering and hence modulating atmospheric CO2 concentrations over geological time.Peer reviewe

Psychological support for individuals historically infected with HIV and/or hepatitis C as a result of NHS-supplied blood transfusions and blood products, and for affected families

BACKGROUND: Between 1970 and 1991, between 30,000 and 33,000 people in the UK were infected with HIV and/or hepatitis C as a result of treatment with NHS blood and blood products; 2,900 deaths during 1970-2019 are estimated to be attributable to these infections, and people are still dying. The statutory Infected Blood Inquiry, launched in July 2018, has been investigating the circumstances that led to individuals becoming infected and the impacts this has had on them and their families. Among the many issues raised, the Inquiry emphasised the psychosocial impacts and the lack of access to dedicated psychological support for those infected and affected. The England Infected Blood Support Scheme (EIBSS) provides access to a discretionary payment of up to £900 for privately arranged psychological support per year (with the option of ‘further treatment’ funding), which can be accessed upon application. However, uptake of the payment among EIBSS beneficiaries and their family members has been very low, and the reasons for this are unclear. There is lack of robust evidence on the needs for psychological support among those infected and affected by infected blood and blood products. The need for this evidence has become more urgent with the Inquiry concluding in autumn 2023. This study was commissioned to help fill this evidence gap and to inform and consider options for improving the existing offer of psychological support services for infected and affected people. APPROACH We conducted in-depth interviews with 52 infected and affected people and 14 mental health practitioners and experts to understand these needs and explore possible service improvements. Interview participants came from a fairly broad age range and across regions in England, although there were a larger number of women and people identifying as White British than would reflect the UK population. Interviews were conducted between January and May 2023. PRINCIPAL FINDINGS: The infected blood scandal had, and continues to have, a profound impact on the mental health and wellbeing of infected and affected people. Study participants shared multiple accounts of grief and loss, anger, fear and anxiety, guilt, and facing stigma, isolation and discrimination because of infection. About half of the people who participated in the study explicitly said they had experienced trauma, and most described incidents that have caused them significant distress. Additionally, many participants described further long-term ill health linked to the side-effects of their infection(s) and their treatments, which many described as having life-changing impacts on their wellbeing. Affected people also reported very significant impacts of their loved one’s infection on their own wellbeing, including profound emotional and financial consequences of bereavement. Only some of those interviewed for this study had been able to access and use psychological support services for their mental health over the years, and only just over half of the study participants were aware of EIBSS payments for psychological support. Some participants only learnt about the availability of the EIBSS discretionary payment during the research interview. Identified barriers that prevented people from accessing counselling and psychological support included social and personal issues, such as feeling unable to open up, stigma 2 of NHS-supplied blood transfusions and blood products, and for affected families – Final report through encounters with the wider health system; study participants reported instances of discrimination in healthcare settings, which made it even more difficult for people to seek professional help. Only a very small number of people found the EIBSS payment scheme for psychological support easy to work through. Most described this route as requiring substantial effort, and being physically and mentally unwell further exacerbated these experiences. Study participants described feeling burdened by the application process and reported that finding a competent and suitable practitioner was often difficult. There is a substantial need for psychological support in the infected and affected communities, and this need is likely to increase once the Inquiry concludes. Practitioners working with infected and affected people cited instances where the Inquiry had already impeded the progress of clients working towards improving their mental health outcomes. Conclusions Existing psychological support services in England – whether accessed through the NHS or privately – do not currently meet the needs of infected and affected communities. Access to psychological support that is effective and experienced as tailored to an individual’s needs is not common and finding the right match between client and therapist is often down to chance. Accordingly, a future improved psychological support service should: • involve infected and affected people with a range of experiences in the development and design of the psychological support service; • address the substantial distrust in and legacy of EIBSS and the wider health system to provide an effective service; • be offered as standard to all individuals known to be infected or affected, and not just upon application; • be proactive, reaching out to and encouraging individuals to take up support; • be accessible through various routes with self-referral important to empower people and reduce access barriers; • be inclusive and broadened to a wider group of affected people than is currently the case; • be flexible and agile, allowing infected and affected people to access the service when they need it and re-enter it without additional administrative burdens for them; • be compassionate, respectful of its clients and non-judgemental. • be set in a specialist setting, include assessment, and offer individual therapy as well as peer support; • offer a range of therapeutic modalities and delivery modes (in-person, online, telephone); • work with adequately qualified, accredited and registered practitioners who have experience of working with trauma-affected populations, understand long-term health conditions that impact mental health and vice versa, and, importantly, have sensitivity to, and knowledge about the infected blood scandal, and related conditions including but not limited to HIV and hepatitis C. The service should be of high quality, with appropriate mechanisms for oversight and accountability. It should be embedded in a wider support system that is proactive, so that those who face the highest barriers or who are most vulnerable are still able to engage and benefit from this support service. This includes the creation of a single contact point or person (a navigator) who assists individuals to navigate the health and social care system more effectively. A service that ‘does the work’ by proactively reaching out to infected and affected people was seen as an important way in which the government could begin to address the harm it caused

System to control indoor air quality in energy efficient buildings

This work looks at monitoring air quality in indoor environments through the integration of several sensing technologies into a single robust, reliable and cheap detection platform, which shares air pre-conditioning and electronics. Target gases and detection limits have been set according to recommendations of different agencies in Europe and the US. The system has reached detection limits stated by the OSHA (Occupational Safety and Health Administration) for benzene. The pre-conditioning fluidic platform has also been designed, simulated, fabricated and tested with sensors so the gas flow has been optimized. Field tests in real buildings are being carried out to contrast current measurement procedures and results with the obtained using the device under development. The main aim of the system is to control HVAC (Heat Ventilation and Air Conditioning) in energy-efficient way while keeping a high air quality standard inside the building

Changing the Culture of Opioid-Related Messaging in Florida: A Formative Research Approach

Though expanding in negative impact for decades, the opioid epidemic, including heroin use, has reached public health emergency status in the United States. Heroin is not used only by the most intense drug users, but becoming more common place (Hirschfeld Davis, 2017). It is essential to better understand how young adults perceive heroin prevention, intervention, and treatment so the most effective campaign messages can be constructed to assist them. This paper presents data from four focus groups (N=24) in Orlando, Florida to better gauge young adult knowledge regarding heroin and obtain specific recommendations to successfully inform future messaging. Results suggest social media platforms are preferred channels for information dissemination, and both sources and formats of information vary based on message intention (i.e., prevention, intervention, treatment). Individuals with heroin-related experiences (e.g., family members) and physicians are preferred sources, and participants indicated statistical information, immersive testimonial stories, and brief videos are their preferred formats. Overall, results indicate social media platforms may represent a fruitful pathway for heroin-related messaging to young adults