The Assertion of Identity: Storytelling and Testimony in the Works of Edwidge Danticat

Haitian-American author Edwidge Danticat evokes the Haitian tradition of storytelling in many of her novels and short story collections. A tradition formulated by vodou religion and the amalgamation of African cultures, storytelling acts to entertain, educate and enlighten the people of Haiti. Additionally, her novels are often written in the context of traumatic events in Haitian history. While Danticat\u27s works have been studied with focus on their depiction of storytelling and of trauma, little has been done on the restorative power that storytelling provides. In this thesis, I seek to examine the potential for Danticat\u27s characters and works to create narratives that build community, present testimony, and aid traumatized individuals in recovery

BUILDING READINESS AND INTENTION TOWARDS STEM FIELDS OF STUDY AMONG HIGH SCHOOL STUDENTS

This dissertation study investigated the cognitive and contextual influences contributing to the developmental process that high school students undergo in preparing for and considering the selection of an academic major in a STEM field. Guided by the theoretical framework of SCCT (Lent et al., 1994) and Wang’s (2013) conceptual model, I developed a new conceptual model for understanding the STEM readiness and intention development process. The STEM Readiness and Intention Development (SRID) Conceptual Model addresses gaps in previous research, such as the absence of parental involvement. In addition, my research design overcame measurement and analytic shortcomings, while examining the moderating effect of self-efficacy on high school students’ intention to major in a STEM field. Through the use of structural equation modeling with data from the High School Longitudinal Study of 2009, I tested the SRID Conceptual Model and examined the indirect effects of self-efficacy on high school students’ intention to major in a STEM field. The results of these analyses suggest several cognitive and contextual influences contributing to building STEM readiness and students’ intention to major in STEM during high school. This study revealed that STEM readiness is impacted directly by several factors, including SES, math ability, parental involvement, math self-efficacy, science self-efficacy, math interest, and science interest. Intention to major in STEM is directly impacted by STEM readiness, as well as high school students’ interest in math and interest in science. In addition, I found that self-efficacy in math and science had a mediating effect through math and science interest on high school students’ intention to major in STEM, emphasizing the critical impact of self-efficacy throughout the career development process. Overall, this dissertation study expands our knowledge of the process that leads high school students to become prepared for and aspire to pursue majors in STEM. Through facilitating this process among all student populations, we may improve overall enrollment and persistence through the STEM pipeline and contribute to the national goal of increasing the number of graduates in STEM fields of study

Connecting school and home: Examining parental and school involvement in readiness for college through multilevel SEM

Parental involvement is widely acknowledged as a critical factor influencing the college choice process among families. What is not clear, though, is whether this parental driven factor also takes place at the school level along with school related factors. Using a national sample of 9th grade students drawn from about 900 schools, we found that parental involvement also operates at the school context along with a high school’s academic press. Moreover, at both individual- and school-level contexts, parental involvement creates a “college-going” cultural capital in the form of attainment of milestones towards college

The diagnostic accuracy and cost-effectiveness of magnetic resonance spectroscopy and enhanced magnetic resonance imaging techniques in aiding the localisation of prostate abnormalities for biopsy : a systematic review and economic evaluation

Peer reviewedPublisher PD

APPLICATION OF FINITE ELEMENT METHOD TAKING INTO ACCOUNT PHYSICAL AND GEOMETRIC NONLINEARITY FOR THE CALCULATION OF PRESTRESSED REINFORCED CONCRETE BEAMS

Abstract. Objectives Modern building codes prescribe the calculation of building structures taking into account the nonlinearity of deformation. To achieve this goal, the task is to develop a methodology for calculating prestressed reinforced concrete beams, taking into account physical and geometric nonlinearity. Methods The methodology is based on nonlinear calculation algorithms implemented and tested in the computation complex PRINS (a program for calculating engineering constructions) for other types of construction. As a tool for solving this problem, the finite element method is used. Non-linear calculation of constructions is carried out by the PRINS computational complex using the stepwise iterative method. In this case, an equation is constructed and solved at the loading step, using modified Lagrangian coordinates. Results The basic formulas necessary for both the formation and the solution of a system of nonlinear algebraic equations by the stepwise iteration method are given, taking into account the loading, unloading and possible additional loading. A method for simulating prestressing is described by setting the temperature action on the reinforcement and stressing steel rod. Different approaches to accounting for physical and geometric nonlinearity of reinforced concrete beam rods are considered. A calculation example of a flat beam is given, in which the behaviour of the beam is analysed at various stages of its loading up to destruction. Conclusion A program is developed for the calculation of flat and spatially reinforced concrete beams taking into account the nonlinearity of deformation. The program is adapted to the computational complex PRINS and as part of this complex is available to a wide range of engineering, scientific and technical specialists

Models of nonlinear deformation of concrete in a triaxial stress state and their implementation in the PRINS computational complex

Modern construction standards and regulations prescribe to carry out calculations of concrete and reinforced concrete structures in a nonlinear formulation with account of the real properties of concrete and reinforcement. However, the most of finite-element program complexes cannot perform such calculations in a nonlinear formulation with account of plastic deformations of concrete and reinforcement. To solve this problem, a methodology has been developed and a solid finite element adapted to the PRINS computing complex has been created, which made it possible to perform calculations of reinforced concrete structures considering their actual work. The aim of the study - development and implementation of a method for calculating reinforced concrete structures under conditions of a three-dimensional stress state, considering both brittle fracture and elastic-plastic deformation of concrete. A finite-element methodology, algorithm, and program for calculation of massive reinforced concrete structures with account of plastic deformations of concrete have been presented. The methodology is based on the modified Willam and Warnke strength criterion supplemented with the flow criterion. Two models of volumetric deformation of concrete have been regarded: the elastic model at brittle failure and the ideal elastoplastic model. An eight-node finite element with linear approximating functions of displacements implementing the mentioned deformation models is created. Verification calculations of a massive concrete structure in three-axial compression testify to the accuracy and convergence of the developed finite elements. The PRINS can be effectively used by engineers of designing and scientific organizations to solve a wide class of engineering problems related to calculations of building structures

Accuracy and cost-effectiveness of dynamic contrast-enhanced CT in the characterisation of solitary pulmonary nodules — the SPUtNIk study

$\textbf{Introduction:}$ Solitary pulmonary nodules (SPNs) are common on CT. The most cost-effective investigation algorithm is still to be determined. Dynamic contrastenhanced CT (DCE-CT) is an established diagnostic test not widely available in the UK currently. $\textbf{Methods and analysis:}$ The SPUtNIk study will assess the diagnostic accuracy, clinical utility and cost-effectiveness of DCE-CT, alongside the current CT and 18-flurodeoxyglucose-positron emission tomography) ($^{18}$FDG-PET)-CT nodule characterisation strategies in the National Health Service (NHS). Image acquisition and data analysis for $^{18}$FDG-PET-CT and DCE-CT will follow a standardised protocol with central review of 10% to ensure quality assurance. Decision analytic modelling will assess the likely costs and health outcomes resulting from incorporation of DCE-CT into management strategies for patients with SPNs. $\textbf{Ethics and dissemination:}$ Approval has been granted by the South West Research Ethics Committee. Ethics reference number 12/SW/0206. The results of the trial will be presented at national and international meetings and published in an Health Technology Assessment (HTA) Monograph and in peer-reviewed journals.The trial is funded by the National Institute for Health Research HTA Programme (grant no: 09/22/117) and is being run by Southampton Clinical Trials Unit, directed by Professor Gareth Griffiths and part funded by Cancer Research UK. NRQ and RCR are part funded by the Cambridge Biomedical Research Centre and the Cancer Research Network: Eastern

Dynamic contrast-enhanced CT compared with positron emission tomography CT to characterise solitary pulmonary nodules: the SPUtNIk diagnostic accuracy study and economic modelling

BACKGROUND: Current pathways recommend positron emission tomography-computerised tomography for the characterisation of solitary pulmonary nodules. Dynamic contrast-enhanced computerised tomography may be a more cost-effective approach. OBJECTIVES: To determine the diagnostic performances of dynamic contrast-enhanced computerised tomography and positron emission tomography-computerised tomography in the NHS for solitary pulmonary nodules. Systematic reviews and a health economic evaluation contributed to the decision-analytic modelling to assess the likely costs and health outcomes resulting from incorporation of dynamic contrast-enhanced computerised tomography into management strategies. DESIGN: Multicentre comparative accuracy trial. SETTING: Secondary or tertiary outpatient settings at 16 hospitals in the UK. PARTICIPANTS: Participants with solitary pulmonary nodules of ≥ 8 mm and of ≤ 30 mm in size with no malignancy in the previous 2 years were included. INTERVENTIONS: Baseline positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography with 2 years' follow-up. MAIN OUTCOME MEASURES: Primary outcome measures were sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computerised tomography. Incremental cost-effectiveness ratios compared management strategies that used dynamic contrast-enhanced computerised tomography with management strategies that did not use dynamic contrast-enhanced computerised tomography. RESULTS: A total of 380 patients were recruited (median age 69 years). Of 312 patients with matched dynamic contrast-enhanced computer tomography and positron emission tomography-computerised tomography examinations, 191 (61%) were cancer patients. The sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography were 72.8% (95% confidence interval 66.1% to 78.6%), 81.8% (95% confidence interval 74.0% to 87.7%), 76.3% (95% confidence interval 71.3% to 80.7%) and 95.3% (95% confidence interval 91.3% to 97.5%), 29.8% (95% confidence interval 22.3% to 38.4%) and 69.9% (95% confidence interval 64.6% to 74.7%), respectively. Exploratory modelling showed that maximum standardised uptake values had the best diagnostic accuracy, with an area under the curve of 0.87, which increased to 0.90 if combined with dynamic contrast-enhanced computerised tomography peak enhancement. The economic analysis showed that, over 24 months, dynamic contrast-enhanced computerised tomography was less costly (£3305, 95% confidence interval £2952 to £3746) than positron emission tomography-computerised tomography (£4013, 95% confidence interval £3673 to £4498) or a strategy combining the two tests (£4058, 95% confidence interval £3702 to £4547). Positron emission tomography-computerised tomography led to more patients with malignant nodules being correctly managed, 0.44 on average (95% confidence interval 0.39 to 0.49), compared with 0.40 (95% confidence interval 0.35 to 0.45); using both tests further increased this (0.47, 95% confidence interval 0.42 to 0.51). LIMITATIONS: The high prevalence of malignancy in nodules observed in this trial, compared with that observed in nodules identified within screening programmes, limits the generalisation of the current results to nodules identified by screening. CONCLUSIONS: Findings from this research indicate that positron emission tomography-computerised tomography is more accurate than dynamic contrast-enhanced computerised tomography for the characterisation of solitary pulmonary nodules. A combination of maximum standardised uptake value and peak enhancement had the highest accuracy with a small increase in costs. Findings from this research also indicate that a combined positron emission tomography-dynamic contrast-enhanced computerised tomography approach with a slightly higher willingness to pay to avoid missing small cancers or to avoid a 'watch and wait' policy may be an approach to consider. FUTURE WORK: Integration of the dynamic contrast-enhanced component into the positron emission tomography-computerised tomography examination and the feasibility of dynamic contrast-enhanced computerised tomography at lung screening for the characterisation of solitary pulmonary nodules should be explored, together with a lower radiation dose protocol

Impact of solitary pulmonary nodule size on qualitative and quantitative assessment using 18F-fluorodeoxyglucose PET/CT: the SPUTNIK trial

Purpose: To compare qualitative and semi-quantitative PET/CT criteria, and the impact of nodule size on the diagnosis of solitary pulmonary nodules in a prospective multicentre trial. / Methods: Patients with an SPN on CT ≥ 8 and ≤ 30 mm were recruited to the SPUTNIK trial at 16 sites accredited by the UK PET Core Lab. Qualitative assessment used a five-point ordinal PET-grade compared to the mediastinal blood pool, and a combined PET/CT grade using the CT features. Semi-quantitative measures included SUVmax of the nodule, and as an uptake ratio to the mediastinal blood pool (SURBLOOD) or liver (SURLIVER). The endpoints were diagnosis of lung cancer via biopsy/histology or completion of 2-year follow-up. Impact of nodule size was analysed by comparison between nodule size tertiles. / Results: Three hundred fifty-five participants completed PET/CT and 2-year follow-up, with 59% (209/355) malignant nodules. The AUCs of the three techniques were SUVmax 0.87 (95% CI 0.83;0.91); SURBLOOD 0.87 (95% CI 0.83; 0.91, p = 0.30 versus SUVmax); and SURLIVER 0.87 (95% CI 0.83; 0.91, p = 0.09 vs. SUVmax). The AUCs for all techniques remained stable across size tertiles (p > 0.1 for difference), although the optimal diagnostic threshold varied by size. For nodules  16 mm, an SUVmax ≥ 3.6 or visual PET uptake greater than the mediastinum was the most accurate. / Conclusion: In this multicentre trial, SUVmax was the most accurate technique for the diagnosis of solitary pulmonary nodules. Diagnostic thresholds should be altered according to nodule size. / Trial registration: ISRCTN - ISRCTN30784948. ClinicalTrials.gov - NCT0201306