Heritage and nation narration in contested societies

The targeted destruction of heritage sites in recent conflicts in Syria, Iraq and Mali has tragically illustrated how the treatment of heritage, as the tangible manifestation of the identity of the ‘other’, can be a symptom of the nadir to which group relations can descend. In a world in which the nation-state remains the primary means of identification, the following overarching research question was investigated: How do nation-states narrate their pasts in the built form? Drawing upon the conceptualisation of heritage as a present-orientated and political construct that is utilised to represent the values of the “dominant political, social, religious or ethnic groups” (Graham, Ashworth & Tunbridge 2000: p.183), this paper discusses the role that heritage interventions can play in both emphasising gulfs and building bridges in divided post-conflict societies (Fojut 2009).

Complexity of risk: Mixed methods approach to understanding youth risk and insecurity in post-conflict settings

In settings of intergroup conflict, identifying contextually-relevant risk factors for youth development in an important task. In Vukovar, Croatia, a city devastated during the war in former Yugoslavia, ethno-political tensions remain. The current study utilized a mixed method approach to identify two salient community-level risk factors (ethnic tension and general antisocial behavior) and related emotional insecurity responses (ethnic and non-ethnic insecurity) among youth in Vukovar. In Study 1, focus group discussions (N=66) with mother, fathers, and adolescents 11 to 15-years-old were analyzed using the Constant Comparative Method, revealing two types of risk and insecurity responses. In Study 2, youth (N=227, 58% male, M=15.88 SD=1.12 years old) responded to quantitative scales developed from the focus groups; discriminate validity was demonstrated and path analyses established predictive validity between each type of risk and insecurity. First, community ethnic tension (i.e., threats related to war/ethnic identity) significantly predicted ethnic insecurity for all youth (β=.41, p<.001). Second, experience with community antisocial behavior (i.e., general crime found in any context) predicted non-ethnic community insecurity for girls (β=.32, p<.05), but not for boys. These findings are the first to show multiple forms of emotional insecurity at the community level; implications for future research are discussed.

Ethnicity and the prostate cancer experience: a qualitative metasynthesis

Objectives: To summarise black and minority ethnic (BME) patients' and partners
experiences of prostate cancer (PCa) by examining the findings of existing qualitative studies
Methods:
We undertook a systematic metasynthesis of qualitative studies using a modified version of
Noblit and Hare's 'meta-ethnography' approach, with a 2000-2015 search of seven databases.
Results: Thirteen studies of men from US and UK BME groups were included. We explored
constructs with BME-specific features. Healthcare provider relationships, formation of a
spiritual alliance with God (which enhanced the participants’ feeling of empowerment and
ability to cope with the cancer) and living on for others (generally to increase cancer
awareness), often connected to spiritual regrowth, were the three constructs most commonly
reported. A magnified effect from erectile dysfunction was also common. Initially this
affected men’s disclosure to others about their cancer and their sexual problems, but
eventually men responded by shifting their conceptualisations of masculinity to sustain self
and social identities. There was also evidence of inequality resulting from financial
constraints and adversity that necessitated resilience in coping.
Conclusions: The prostate cancer experience of BME men and their partners is affected by a
complex intersection of ethnicity with other factors. Healthcare services should acknowledge
this. If providers recognise the men’s felt masculinities, social identities and spiritual beliefs
and their shifting nature, services could be improved, with community as well as individual
benefits. More studies are needed in diverse ethnic groups

Changes in children’s body mass index between 2006/07 and 2013/14 National Child Measurement Programme

This report is the sixth in a series of annual reports which use National Child Measurement Programme (NCMP) data to examine changes in children’s body mass index (BMI) that have taken place since 2006/07. It explores trends in obesity, overweight, excess weight and underweight prevalence, as well as changes in mean BMI over time. Trends within different socioeconomic and ethnic groups are also examined to determine whether existing health inequalities are widening or becoming smaller.

LUNG CANCER IN NEPAL: THE ROLE OF TRADITIONAL TOBACCO PRODUCTS AND COMBUSTION RELATED HOUSEHOLD AIR POLLUTION

The burden of chronic diseases such as cancer is increasing in low and middle income countries around the globe. Nepal, one of the world’s poorest countries, is no exception to this trend, with lung cancer as the leading causes of cancer deaths. Despite this, limited data is available on the environmental and behavioral risk factors that contribute to the lung cancer etiology in Nepal. The objectives of this dissertation are to: 1) investigate the ethnic differences in consumption of local tobacco products and their role in lung cancer risk in Nepal; 2) evaluate urinary metabolite of 1,3-butadiene as a biomarker of exposure to combustion related household air pollution (CRHAP); 3) investigate the association between CRHAP exposure and lung cancer risk using urinary metabolite of 1,3-butadiene as a biomarker of exposure; 4) investigate the association between CRHAP exposure and lung cancer risk using questionnaire based measure of exposure. Lung cancer cases (n=606) and frequency matched controls (N=606) were recruited from B.P. Koirala Memorial Cancer Hospital. We obtained biological samples and information on lifestyles including cooking habits and type of fuels used. We used liquid chromatograph tandem mass spectrometer (LC-MS/MS) to quantify urinary metabolites of 1,3-butadiene in urine samples. We employed a combination of logistic and linear regression models to detect any exposure-disease associations while controlling for known confounding variables. Overall, we found that ethnic groups in Nepal use different tobacco products that have different differing cancer potency -we observed the highest odds ratios for the traditional tobacco products. The biomarker analysis showed strong evidence that monohydroxybutyl mercapturic acid is associated with biomass fuel use among participants. However, we did not find significant association between urinary MHMBA and lung cancer risk. When we used questionnaire based measure of exposure to household air pollution, we observed significant, dose-response associations between CRHAP exposure and lung cancer risk, particularly among never-smokers. Our results show that important role of local tobacco products in lung cancer risk in Nepal. Furthermore, we demonstrate that CRHAP exposure is a risk factor for lung cancer risk, independent of tobacco smoking.

Participation Space Studies: a socio-technical exploration of activist and community groups’ use of online and offline spaces to support their work

Participation Space Studies explore eParticipation in the day-to-day activities of local, citizen-led groups, working to improve their communities. The focus is the relationship between activities and contexts. The concept of a participation space is introduced in order to reify online and offline contexts where people participate in democracy. Participation spaces include websites, blogs, email, social media presences, paper media, and physical spaces. They are understood as sociotechnical systems: assemblages of heterogeneous elements, with relevant histories and trajectories of development and use. This approach enables the parallel study of diverse spaces, on and offline. Participation spaces are investigated within three case studies, centred on interviews and participant observation. Each case concerns a community or activist group, in Scotland. The participation spaces are then modelled using a Socio-Technical Interaction Network (STIN) framework (Kling, McKim and King, 2003). The participation space concept effectively supports the parallel investigation of the diverse social and technical contexts of grassroots democracy and the relationship between the case-study groups and the technologies they use to support their work. Participants’ democratic participation is supported by online technologies, especially email, and they create online communities and networks around their goals. The studies illustrate the mutual shaping relationship between technology and democracy. Participants’ choice of technologies can be understood in spatial terms: boundaries, inhabitants, access, ownership, and cost. Participation spaces and infrastructures are used together and shared with other groups. Non-public online spaces, such as Facebook groups, are vital contexts for eParticipation; further, the majority of participants’ work is non-public, on and offline. It is informational, potentially invisible, work that supports public outputs. The groups involve people and influence events through emotional and symbolic impact, as well as rational argument. Images are powerful vehicles for this and digital images become an increasingly evident and important feature of participation spaces throughout the consecutively conducted case studies. Collaboration of diverse people via social media indicates that these spaces could be understood as boundary objects (Star and Griesemer, 1989). The Participation Space Studies draw from and contribute to eParticipation, social informatics, mediation, social shaping studies, and ethnographic studies of Internet use.

Fatalism, Attributions of Failure and Academic Performance in Mapuche and Non-Mapuche Chilean Students

This study investigated the role of fatalism as a cultural value orientation and causal attributions for past failure in the academic performance of high school students in the Araucania Region of Chile. Three thousand three hundred and fourty eight Mapuche and Non-Mapuche students participated in the study. Consistent with the Culture and Behavior model that guided the research, the test of causal models based on the analysis of structural equations show that academic performance is in part a function of variations in the level of fatalism, directly as well as indirectly through its influence in the attribution processes and failure-related emotions. In general, the model representing the proposed structure of relations among fatalism, attributions, and emotions as determinants of academic performance fit the data for both Mapuche and non-Mapuche students. However, results show that some of the relations in the model are different for students from these two ethnic groups. Finally, according to the results from the analysis of causal models, family SES appear to be the most important determinant of fatalism.

Lifestyle factors, adiposity and cardiometabolic risk factors in South Asian women living in Scotland

South Asians migrating to the Western world have a 3 to 5-fold higher risk of developing type 2 diabetes and double the risk of cardiovascular disease (CVD) than the background population of White European descent, without exhibiting a proportional higher prevalence of conventional cardiometabolic risk factors. Notably, women of South Asian descent are more likely to be diagnosed with type 2 diabetes as they grow older compared with South Asian men and, in addition, they have lost the cardio-protective effects of being females. Despite South Asian women in Western countries being a high risk group for developing future type 2 diabetes and CVD, they have been largely overlooked. The aims of this thesis were to compare lifestyle factors, body composition and cardiometabolic risk factors in healthy South Asian and European women who reside in Scotland, to examine whether ethnicity modifies the associations between modifiable environmental factors and cardiometabolic risks and to assess whether vascular reactivity is altered by ethnicity or other conventional and novel CVD risks. I conducted a cross-sectional study and recruited 92 women of South Asian and 87 women of White European descent without diagnosed diabetes or CVD. Women on hormone replacement therapy or hormonal contraceptives were excluded too. Age and body mass index (BMI) did not differ between the two ethnic groups. Physical activity was assessed and with self-reported questionnaires and objectively with the use of accelerometers. Cardiorespiratory fitness was quantified with the predicted maximal oxygen uptake (VO2 max) during a submaximal test (Chester step test). Body composition was assessed with skinfolds measured at seven body sites, five body circumferences, measurement of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) with the use of magnetic resonance imaging (MRI) and liver fat with the use MR spectroscopy. Dietary density was assessed with food frequency questionnaires. Vascular response was assessed by measuring the response to acetylcholine and sodium nitroprusside with the use of Laser Doppler Imaging with Iontophoresis (LDI-ION) and the response to shear stress with the use of Peripheral Arterial Tonometry (EndoPAT). The South Asian women exhibited a metabolic profile consistent with the insulin resistant phenotype, characterised by greater levels of fasting insulin, lower levels of high density lipoprotein (HDL) and higher levels of triglycerides (TG) compared with their European counterparts. In addition, the South Asians had greater levels of glycated haemoglobin (HbA1c) for any given level of fasting glucose. The South Asian women engaged less time weekly with moderate to vigorous physical activity (MVPA) and had lower levels of cardiorespiratory fitness for any given level of physical activity than the women of White descent. In addition, they accumulated more fat centrally for any given BMI. Notably, the South Asians had equivalent SAT with the European women but greater VAT and hepatic fat for any given BMI. Dietary density did not differ among the groups. Increasing central adiposity had the largest effect on insulin resistance in both ethic groups compared with physical inactivity or decreased cardiorespiratory fitness. Interestingly, ethnicity modified the association between central adiposity and insulin resistance index with a similar increase in central adiposity having a substantially larger effect on insulin resistance index in the South Asian women than in the Europeans. I subsequently examined whether ethnic specific thresholds are required for lifestyle modifications and demonstrated that South Asian women need to engage with MVPA for around 195 min.week-1 in order to equate their cardiometabolic risk with that of the Europeans exercising 150 min.week-1. In addition, lower thresholds of abdominal adiposity and BMI should apply for the South Asians compared with the conventional thresholds. Although the South Asians displayed an adverse metabolic profile, vascular reactivity measured with both methods did not differ among the two groups. An additional finding was that menopausal women with hot flushing of both ethnic groups showed a paradoxical vascular profile with enhanced skin perfusion (measured with LDI-ION) but decreased reactive hyperaemia index (measured with EndoPAT) compared with asymptomatic menopausal women. The latter association was independent of conventional CVD risk factors. To conclude, South Asian women without overt disease who live in Scotland display an adverse metabolic profile with steeper associations between lifestyle risk factors and adverse cardiometabolic outcomes compared with their White counterparts. Further work in exploring ethnic specific thresholds in lifestyle interventions or in disease diagnosis is warranted.

Pre-colonial institutions and long-run development in Latin America

The present doctoral thesis studies the association between pre-colonial institutions and long-run development in Latin America. The thesis is organised as follows: Chapter 1 places the motivation of the thesis by underlying relevant contributions in the literature on long-run development. I then set out the main objective of the thesis, followed by a brief outline of it. In Chapter 2, I study the effects of pre-colonial institutions on present-day socioeconomic outcomes for Latin America. The main thesis of this chapter is that more advanced pre-colonial institutions relate to better socioeconomic outcomes today - principally, but not only, through their effects on the Amerindian population. I test such hypothesis with a dataset of 324 sub-national administrative units covering all mainland Latin American countries. The extensive range of controls covers factors such as climate, location, natural resources, colonial activities and pre-colonial characteristics - plus country fixed effects. Results strongly support the main thesis. In Chapter 3, I further analyse the association between pre-colonial institutions and present-day economic development in Latin America by using the historical ethnic homelands as my main unit of analysis. The main hypothesis is that ethnic homelands inhabited by more advanced ethnic groups -as measured by their levels of institutional complexity- relate to better economic development today. To track these long-run effects, I construct a new dataset by digitising historiographical maps allowing me to pinpoint the geospatial location of ethnic homelands as of the XVI century. As a result, 375 ethnic homelands are created. I then capture the levels of economic development at the ethnic homeland level by making use of alternative economic measures --satellite light density data. After controlling for country-specific characteristics and applying a large battery of geographical, locational, and historical factors, I found that the effects of pre-colonial institutions relate to a higher light density --as a proxy for economic activity- in ethnic homelands where more advanced ethnic groups lived. In Chapter 4, I explore a mechanism linking the persistence of pre-colonial institutions in Latin America over the long-run: Colonial and post-colonial strategies along with the ethnic political capacity worked in tandem allowing larger Amerindian groups to "support" the new political systems in ways that would benefit their respective ethnic groups as well as the population at large. This mechanism may have allowed the effects of pre-colonial institutions to influence socioeconomic development outcomes up to today. To shed lights on this mechanism, I combine the index of pre-colonial institutions prepared for the second chapter of the present thesis with individual-level survey data on people's attitudes. By controlling for key observable and unobservable country-specific characteristics, the main empirical results show that areas with a history of more advanced pre-colonial institutions increase the probability of individuals supporting present-day political institutions. Finally, in Chapter 5, I summarise the main findings of the thesis, and emphasise the key weaknesses of the study as well as potential avenues for future research.

An Investigation of Child and Adolescent Dental Sealant Predictors, NHANES 2011-2012

Objective: To examine sociodemographic and dental factors for associations with dental sealant placement in children and adolescents aged 6-18 years old. Methods: Secondary data analysis of 2011-2012 NHANES data was conducted. Multiple logistic regression models were used to assess relationships between predictor variables and sealant presence. Results: More than a third (37.1%) of children and adolescents have at least one sealant present; 67.9% of children compared with 40.4% of adolescents. Racial/ethnic differences exist, with Non-Hispanic black youth having the lowest odds of having sealants. Sealant placement odds vary by presence of dental home; the magnitude of the odds varies by age group. Those with untreated decay have lower odds of having sealants than those who do not have untreated decay (child OR: 2.6, 95% CI: 1.83-3.72; adolescent OR: 3.9, 95% CI: 2.59-6.07). Conclusion: Disparities exist in odds of sealant prevalence across racial/ethnic groups, income levels, and dental disease and visit characteristics. Further research is necessary to understand the reasons for these differences and to inform future interventions.

Essays on cultural and institutional dynamics in economic development using spatial analysis

This thesis seeks to research patterns of economic growth and development from a number of perspectives often resonated in the growth literature. By addressing themes about history, geography, institutions and culture the thesis is able to bring to bear a wide range of inter-related literatures and methodologies within a single content. Additionally, by targeting different administrative levels in its research design and approach, this thesis is also able to provide a comprehensive treatment of the economic growth dilemma from both cross-national and sub-national perspectives. The three chapters herein discuss economic development from two broad dimensions. The first of these chapters takes on the economic growth inquiry by attempting to incorporate cultural geography within a cross-country formal spatial econometric growth framework. By introducing the global cultural dynamics of languages and ethnic groups as spatial network mechanisms, this chapter is able to distinguish economic growth effects accruing from own-country productive efforts from those accruing from interconnections within a global productive network chain. From this, discussions and deductions about the implications for both developed and developing countries are made as regards potentials for gains and losses from such types and levels of productive integration. The second and third chapters take a different spin to the economic development inquiry. They both focus on economic activity in Africa, tackling the relevant issues from a geo-intersected dimension involving historic regional tribal homelands and modern national and subnational administrative territories. The second chapter specifically focuses on attempting to adopt historical channels to investigate the connection between national institutional quality and economic development in demarcated tribal homelands at the fringes of national African borders. The third chapter on the other hand focuses on looking closer at the effects of demarcations on economic activity. It particularly probes how different kinds of demarcation warranted by two different but very relevant classes of politico-economic players have affected economic activity quite distinguishably within the resulting subnational regions in Africa.

Estimation of whole body muscle, adipose/fat mass, validation in health and during weight loss. Development of prediction equations using MRI as reference method

Background: Body composition is affected by diseases, and affects responses to medical treatments, dosage of medicines, etc., while an abnormal body composition contributes to the causation of many chronic diseases. While we have reliable biochemical tests for certain nutritional parameters of body composition, such as iron or iodine status, and we have harnessed nuclear physics to estimate the body’s content of trace elements, the very basic quantification of body fat content and muscle mass remains highly problematic. Both body fat and muscle mass are vitally important, as they have opposing influences on chronic disease, but they have seldom been estimated as part of population health surveillance. Instead, most national surveys have merely reported BMI and waist, or sometimes the waist/hip ratio; these indices are convenient but do not have any specific biological meaning. Anthropometry offers a practical and inexpensive method for muscle and fat estimation in clinical and epidemiological settings; however, its use is imperfect due to many limitations, such as a shortage of reference data, misuse of terminology, unclear assumptions, and the absence of properly validated anthropometric equations. To date, anthropometric methods are not sensitive enough to detect muscle and fat loss. Aims: The aim of this thesis is to estimate Adipose/fat and muscle mass in health disease and during weight loss through; 1. evaluating and critiquing the literature, to identify the best-published prediction equations for adipose/fat and muscle mass estimation; 2. to derive and validate adipose tissue and muscle mass prediction equations; and 3.to evaluate the prediction equations along with anthropometric indices and the best equations retrieved from the literature in health, metabolic illness and during weight loss. Methods: a Systematic review using Cochrane Review method was used for reviewing muscle mass estimation papers that used MRI as the reference method. Fat mass estimation papers were critically reviewed. Mixed ethnic, age and body mass data that underwent whole body magnetic resonance imaging to quantify adipose tissue and muscle mass (dependent variable) and anthropometry (independent variable) were used in the derivation/validation analysis. Multiple regression and Bland-Altman plot were applied to evaluate the prediction equations. To determine how well the equations identify metabolic illness, English and Scottish health surveys were studied. Statistical analysis using multiple regression and binary logistic regression were applied to assess model fit and associations. Also, populations were divided into quintiles and relative risk was analysed. Finally, the prediction equations were evaluated by applying them to a pilot study of 10 subjects who underwent whole-body MRI, anthropometric measurements and muscle strength before and after weight loss to determine how well the equations identify adipose/fat mass and muscle mass change. Results: The estimation of fat mass has serious problems. Despite advances in technology and science, prediction equations for the estimation of fat mass depend on limited historical reference data and remain dependent upon assumptions that have not yet been properly validated for different population groups. Muscle mass does not have the same conceptual problems; however, its measurement is still problematic and reference data are scarce. The derivation and validation analysis in this thesis was satisfactory, compared to prediction equations in the literature they were similar or even better. Applying the prediction equations in metabolic illness and during weight loss presented an understanding on how well the equations identify metabolic illness showing significant associations with diabetes, hypertension, HbA1c and blood pressure. And moderate to high correlations with MRI-measured adipose tissue and muscle mass before and after weight loss. Conclusion: Adipose tissue mass and to an extent muscle mass can now be estimated for many purposes as population or groups means. However, these equations must not be used for assessing fatness and categorising individuals. Further exploration in different populations and health surveys would be valuable.

Maternal Age and Infant Mortality for White, Black, and Mexican Mothers in the United States

Funding for Open Access provided by the UMD Libraries Open Access Publishing Fund.

Validating the multimedia activity recall for children and adolescents in a large New Zealand sample

The aim of the study was to validate the self-report Multimedia Activity Recall for Children and Adolescents (MARCA) against accelerometry for the assessment of physical activity in New Zealand children. Participants (n = 716, 10-18 years) recalled 3-4 days of activity using the MARCA and underwent a partially overlapping 7-day accelerometry protocol during a national survey. Spearman correlation coefficients (ρ) assessed the association between accelerometer-derived counts per minute and MARCA-derived physical activity level and time in locomotion. Both data sources estimated time spent in light and moderate-vigorous physical activity. Association and agreement between methods for light physical activity and moderate-vigorous physical activity was assessed using correlations and Bland-Altman plots respectively, and paired t-tests conducted. Accelerometer-derived activity counts were moderately correlated with both MARCA-derived physical activity level and locomotion (ρ = 0.38, P < 0.0001). The correlation between methods was -0.14 for light physical activity and 0.28 for moderate-vigorous physical activity (P < 0.0001). The MARCA overestimated moderate-vigorous physical activity compared with accelerometry (120 min, P < 0.0001), which increased as moderate-vigorous physical activity time increased. Some sex and ethnicity (Māori [indigenous] versus non-Māori) differences were observed. Overall, the MARCA indicated moderate validity for assessment of physical activity level, locomotion and moderate-vigorous physical activity and poor validity for assessment of light physical activity. This was comparable to other self-report tools. The MARCA has utility for future large-scale research.

Not Getting By: Poverty Management and Homelessness in Miami

Urban inequality has emerged as one of the dominant themes of modern life and globalization. More than three million people experienced homelessness in the United States last year; in Miami-Dade, more than 15,000 individuals were homeless. Surviving extreme poverty, and exiting or avoiding homelessness, involves negotiating a complex mix of public and private assistance. However, a range of factors influence what types of help are available and how they can be accessed. Frequently, larger social structures determine which resource are available, leaving many choices entirely out of the individual’s control. For single men, who are ineligible for many benefits, homelessness can be difficult to avoid and even harder to exit. My study seeks to better understand how adult, minority men living in extreme poverty in Miami-Dade negotiate their daily survival. Specific research questions address: Do black and Hispanic men who are homeless or at risk of homelessness have different personal characteristics and different experiences in avoiding or exiting homelessness? How does Miami’s response to extreme poverty/homelessness, including availability of public benefits and public and private service organizations, either maximize or constrain the choices available to this population? And, what is the actual experience of single, adult men who are homeless or at risk of homelessness, in negotiating their daily survival? A mixed methods approach combines quantitative survey data from 7,605 homeless men, with qualitative data from 54 semi-structured interviews incorporating the visual ethnography techniques of Photo Elicitation Interviewing. Results show the differences experienced by black and Hispanic men who are poor and homeless in Miami. Findings also highlight how the community’s official and unofficial responses to homelessness intersect with the actual experiences of the persons targeted by the policies and programs, challenging preconceived notions regarding the lives of persons living in extreme poverty. It adds to the existing body of literature by focusing on the urban Miami context, emphasizing disparities amongst racial and ethnic groups. Findings are intended to provide an empirically grounded thesis that humanizes the subjects and illuminates their personal experiences, helping to inform public policy around the needs of extremely poor populations.