Perinatal mortality in Pakistani, Bangladeshi and White British mothers, in Luton

Addressing modifiable factors in perinatal mortality is a key priority for commissioners and service providers, aiming to improve birth outcomes and reduce preventable deaths (Department of Health, 2016; National Maternity Review, 2016). Luton, a town with a plural population, experiences higher rates of perinatal mortality than the national average (CDOP, 2015). Figures show an ethnic variation; Pakistani and Bangladeshi mothers experience higher rates of perinatal mortality in England compared with White British mothers, and the reasons for this are unclear. Much of the existing literature approaches the problem by examining individual risk factors quantitatively or exploring South Asian women’s experiences qualitatively. There is little research considering how Pakistani, Bangladeshi and White British women’s health beliefs impact on their health behaviour through the maternity care pathway, in Luton, and how this might contribute to perinatal mortality. This study takes an intersectional approach, using a convergent mixed-methods research design, reviewing retrospective secondary data (2008-2013) from the Luton and Dunstable Hospital NHS Foundation Trust’s Circona Maternity information System, to identify risk factors for perinatal mortality in Luton. Additionally, focus groups were conducted with lay women (aged over 16, living in LU1-LU4, who had experienced a live birth, at 37 weeks of gestation in the previous 6-24 months), and face-to-face interviews were held with bereaved mothers (aged over 16, who suffered an infant bereavement in the preceding 6-24 months, living in LU1-LU4). Health care professionals working on the maternity care pathway also took part in focus groups or interviews, providing their views on the service needs of Pakistani, Bangladeshi and White British women. The results/findings showed that risk factors varied according to ethnicity. Pakistani mothers had a greatest number of risk factors i.e. birthweight, diabetes, gestational diabetes, BMI 12 weeks). Deprivation featured in 81% of all deaths in 2014. The findings with the mothers revealed mostly similarities among women, regardless of their ethnicity; the majority of women wanted more pregnancy-related information, especially in respect of stillbirth and adverse outcomes. Similarly, bereaved mothers regardless of their ethnicity also reported mostly similarities, which included experiencing intuition when things were not right with the pregnancy. A few differences according to ethnicity were also identified, which focused on cultural or religious needs, such as cultural therapies (mostly dietary restrictions) undertaken by Pakistani and Bangladeshi women. The intersectional approach allowed simultaneous and aggregated factors (i.e. heritable, socio-economic status, structural factors and health beliefs and health behaviours) to be exposed; staff believed Pakistani and Bangladeshi women were not proactive in seeking pregnancy-related information, relying on verbal information and staff assumed mothers were literate and understood health messages. The intersected findings also revealed that few women took folic acid preconception, and many women co-slept with their baby. This study contributes new knowledge to the understanding of how Pakistani, Bangladeshi and White British women’s health beliefs influence their health behaviour, and contributes to perinatal mortality in Luton

COMING OUT OF THE COFFIN AS THE POSTHUMAN: POSTHUMAN RHETORIC AND HARRIS’ SOOKIE STACKHOUSE SERIES

In this article, I argue that the vampires in Charlaine Harris’ Sookie Stackhouse novels illustrate clearly the posthuman self in its connection beyond itself to other vampires, humans, and non-humans. Learning to co-exist becomes problematic in Harris’ series, where we encounter a “new” representation of vampire. These vampires have come out of the coffin, and their revelation allows us to explore how they can be viewed in connection to the human world and how their transcendence can be seen as a move toward posthumanism, as its particular blend of body and community help demonstrate what the self expanded could be. As a species that differs from us “typical” humans and yet must co-exist with us and other non-humans, the posthuman provides a theoretical framework for how we can approach this new representation as a disembodied non-unitary subject. Through their transcendence from the world of the living to the life of the undead, these vampires let us see humanity as a distinct moment in evolution that is a continuous process, not a resolution. There are six areas where we see these common characteristics between posthumanism and Harris’ vampires. The first is the vampire being represented as an other. Like the posthuman, Harris’ vampires are juxtaposed against the human population and because vampires are marked as other this creates tension where they must co-exist with humans and yet still be examined from an anthropocentric perspective. Another way the posthuman allows us to interpret this fear of vampires is from the position of the de-centered human. Because humans prior to the “great revelation” in Harris’ fictional world, believed themselves to be what defined humanism versus their non-human others; they must shift in where they are located on the species podium due to vampires and that creates a fear. Another correlation is that of immortality; which is what vampires inherit when they become a member of the undead, but for the posthuman it is encoding and dematerialization that allows us to transcend these mortal bodies. This notion of disembodiment demonstrates the body being a rhetorical strategy to create an effect, such as manipulation. Since the body for the posthuman is seen as materiality and therefore they are not embedded to only exist within it, the vampire likewise is able to exploit the body in order to accomplish its purpose. Next for the posthuman, transcendence is the way they not only become immortal, but also how they move from identifying as individuals to identifying as part of a larger community. For the vampires in the Stackhouse series, their consciousness lies in their information and not in their material bodies, thus they are able to situate themselves within the larger network with other vampires, humans, and non-humans. And lastly the connection through the exchange of blood, which for the vampire is a literal connection, but for the posthuman is instead an ideal network which removes individuality

Translating Knowledge of Autism Spectrum Disorders to Action Through Tool Development and Exploration

Translational processes are needed to move research development, methods, and techniques into clinical application. The knowledge to action framework organizes this bench to bedside process through three phases including: research, translation, and institutionalization without being specific to one disease or condition. The overall goal of this research is to bridge gaps in the translational process from assay development to disease detection through a mixed methods approach. A literature review identifies gaps associated with intestinal permeability and autism spectrum disorders. Mining social media related to autism and GI symptoms captures self-reported or observed data, identifies patterns and themes within the data, and works to translate that knowledge into healthcare applications. Development of novel tests can then examine relationships between zonulin levels, haptoglobin genotype, and autism spectrum disorders, and propose a paradigm shift in the use of proteomics and genomic diagnostic testing from clinical diagnosis to pre-symptomatic testing. Although results from this study do not find statistically significant relationships between zonulin and autism spectrum disorders, they do suggest clinical significance and the need to conduct larger studies. The discovery presents a novel approach for measuring intestinal permeability. Qualitative and quantitative methods collaboratively point toward implementation of molecular and data mining techniques in the development and evaluation of early diagnostic tests and interventions. Equally, the two methods working together drive the field forward in design and development to strengthen the outcomes

An analysis of the privatization of public AAU institutions and their changing resource acquisition before and after the Great Recession

Thesis (Ph.D.) - Indiana University, School of Education, 2015Public institutions have historically adapted to their changing external environment in order to try to best serve their students and achieve their goals. Part of this adaption included dealing with decreasing state support. While state funding has shown increasing patterns of support to higher education after a recession, the Great Recession proved different. As a result, public institutions have become increasingly privatized with increasing proportions of their revenue coming from students and declining proportions coming from the state. The purpose of this study was to examine the changing state appropriations and tuition revenue that public AAU institutions received before and after the start of the Great Recession in order to better understand whether they received a changing amount of total revenue per student and simultaneously became more heavily funded by students. This study used IPEDS variables and all data was collected between 2003-04 and 2011-12 to create the three main variables used to answer six research questions. The three main variables included: gross-tuition revenue per FTE, net-tuition revenue per FTE, and state appropriations revenue per FTE. All data was analyzed through descriptive statistics. The results of this study showed that on average public AAU institutions received increasing amounts of total revenue per FTE between 2003-04 and 2011-12 in terms of tuition revenue and state appropriations per FTE combined. Many of these institutions also became increasingly privatized during this time as there were increases in the proportion of the total revenue that came from tuition revenue per FTE. The findings from this study also showed that while all institutions became increasingly privatized after the start of the Great Recession, an increasing number of institutions began operating with decreasing levels of total revenue per FTE. Others received an increasing amount of total revenue as a result of increases in tuition revenue per FTE. Regardless, this study showed that students have continued to bear increasing proportions of the cost of higher education. It also provided a new perspective on the amount of revenue that these institutions believed they needed in order to continue to provide quality education to their students

A Public Policy Analysis of an Allied Health Career Pathway Model at a Local Technical College

Policymakers, philanthropists, and related stakeholders assert that education is “the civil rights issue of our generation” (The White House, n.d). In turn, a career-based business model where “career and technical education encourages employability” (Wilder, 2013) has been implemented, providing readily accessible post-secondary opportunities to address perpetual societal inequality. Many stakeholders perceive the two-year institution as helping bridge the perpetual equity gap by creating access streams needed to acquire good-paying jobs. Because of the diverse socioeconomic student narrative within the Midwestern technical college, a study inquiry was conducted to ascertain the institution’s ability to reproduce the desired results advertised by public policy and determine whether this incremental process “reflects the kinds of things that society ought to be doing to help the marginalized” (Fischer, 2006, p.1) and to address current research gaps. Following Fischer’s (2006) Interpretive Policy Analysis Framework, all research activities were conducted via a sequential explanatory mixed methods design to not only verify empirical and descriptive program data, but also to obtain the participants’ perspectives, sense of agency, and overall outcomes simultaneously with higher level societal goals and values via interpretive analysis. Although each variable’s impact on student success will depend on individual situations, participants specifically discerned systems within the pathway framework inhibiting outcomes. From both the nominal and interpretive research data, maintaining the pathway model as-is potentially impeded social progress and economic stability, especially for the most vulnerable populace. This project provided the chance to appreciate pathway graduate/learner’s persistence even when multiple personal and educational barriers existed while attending school. The complex nature of how this policy affected non-traditional students afforded the opportunity to “not only assess the progress of achieving the (pathway model’s) goal, but the appropriateness of the goal itself” (Fischer, 2006, p. 6) to create or dissuade societal value within the adjacent urban community

Algebraic and combinatorial aspects of sandpile monoids on directed graphs

The sandpile group of a graph is a well-studied object that combines ideas from algebraic graph theory, group theory, dynamical systems, and statistical physics. A graph's sandpile group is part of a larger algebraic structure on the graph, known as its sandpile monoid. Most of the work on sandpiles so far has focused on the sandpile group rather than the sandpile monoid of a graph, and has also assumed the underlying graph to be undirected. A notable exception is the recent work of Babai and Toumpakari, which builds up the theory of sandpile monoids on directed graphs from scratch and provides many connections between the combinatorics of a graph and the algebraic aspects of its sandpile monoid. In this paper we primarily consider sandpile monoids on directed graphs, and we extend the existing theory in four main ways. First, we give a combinatorial classification of the maximal subgroups of a sandpile monoid on a directed graph in terms of the sandpile groups of certain easily-identifiable subgraphs. Second, we point out certain sandpile results for undirected graphs that are really results for sandpile monoids on directed graphs that contain exactly two idempotents. Third, we give a new algebraic constraint that sandpile monoids must satisfy and exhibit two infinite families of monoids that cannot be realized as sandpile monoids on any graph. Finally, we give an explicit combinatorial description of the sandpile group identity for every graph in a family of directed graphs which generalizes the family of (undirected) distance-regular graphs. This family includes many other graphs of interest, including iterated wheels, regular trees, and regular tournaments.Comment: v2: Cleaner presentation, new results in final section. Accepted for publication in J. Combin. Theory Ser. A. 21 pages, 5 figure

A not-so-grim tale: how childhood family structure influences reproductive and risk-taking outcomes in a historical U.S. Population.

Childhood family structure has been shown to play an important role in shaping a child's life course development, especially in industrialised societies. One hypothesis which could explain such findings is that parental investment is likely to be diluted in families without both natural parents. Most empirical studies have examined the influence of only one type of family disruption or composition (e.g. father absence) making it difficult to simultaneously compare the effects of different kinds of family structure on children's future outcomes. Here we use a large, rich data source (n=16,207) collected by Alfred Kinsey and colleagues in the United States from 1938 to 1963, to examine the effects of particular childhood family compositions and compare between them. The dataset further allows us to look at the effects of family structure on an array of traits relating to sexual maturity, reproduction, and risk-taking. Our results show that, for both sexes, living with a single mother or mother and stepfather during childhood was often associated with faster progression to life history events and greater propensity for risk-taking behaviours. However, living with a single father or father and stepmother was typically not significantly different to having both natural parents for these outcomes. Our results withstand adjustment for socioeconomic status, age, ethnicity, age at puberty (where applicable), and sibling configuration. While these results support the hypothesis that early family environment influences subsequent reproductive strategy, the different responses to the presence or absence of different parental figures in the household rearing environment suggests that particular family constructions exert independent influences on childhood outcomes. Our results suggest that father-absent households (i.e. single mothers or mothers and stepfathers) are most highly associated with subsequent fast life history progressions, compared with mother-absent households, and those with two natural parents