Browsing by Author "Smith, Ryan"
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Item Open Access Access and Absence: A Quasi-Experimental Study of the Effect of North Carolina School Health Centers on Student Absenteeism(2014-04-25) Smith, RyanThe first school-based health center (SBHC) was introduced in North Carolina in Greene County in 1983. Over the last thirty years, School Health Centers (SHCs), which include school-based, school-linked, mobile units and telemedicine units, have been introduced in over 80, primarily rural, public schools in 28 counties. These centers provide a wide range of health care services, with many providing comprehensive primary and mental health care services, to populations with historically limited access to health care. Some of these centers have closed in recent years due to budget cuts and competing priorities for limited funding. Given the scant amount of research on the effectiveness of SHCs in North Carolina, the difficulty in generalizing findings from other studies to this state, and the increased pressure on wraparound services to demonstrate their ability to improve student academic performance, this paper serves as a first step toward providing policy makers with a greater understanding of the effect SHCs in North Carolina have on reducing rates of student absenteeism. It is widely accepted that student absenteeism inhibits student learning and that children in poor health are more likely to miss school. Research shows that as the number of school days a student misses increases, academic achievement tends to decline. Studies on the relationship between SHCs and student absenteeism have been both limited in number and varied in their findings. Non-random assignment of SHCs in schools with high concentrations of students from low-income households, who are at increased risk for poor academic outcomes, makes assessing the effect of school health services on academic indicators difficult to accurately measure due to selection bias. To address evaluation challenges created by selection bias, as well as by a lack of reliable attendance data pre-2006 (long after many SHCs were introduced in North Carolina), I take advantage of student transitions between schools to examine the effect of entering or leaving a school with more robust health services. I follow four cohorts of students from 2006 to 2012 as they transition between schools in counties where SHCs are located. Using the timing of student entry and exit from schools combined with changes in health services available from year to year as a result of these school transitions, I estimate how enrollment in schools with primary care health services affects student absenteeism. Results from Poisson regression models indicate that SHCs are associated with moderate reductions in rates of student absenteeism. Students who transition from a school without a SHC to a school with a SHC miss, on average, 8.2 percent fewer days of school in the year of transition. By contrast, students who move to schools with less robust health services miss 13.2 percent more days of school in the year of transition. Students eligible for free and reduced price lunch and students with a history of chronic absenteeism benefit even more than the general student population from enrollment in schools with SHCs, especially if the model of care is a school-based health center. When these subgroups traditionally considered at higher risk for poor academic outcomes transition from schools without SHBCs to schools with SBHCs they miss, on average, 13.4 and 18.1 percent fewer days, respectively. These findings have important implications for public health and education policies aimed at improving the health and academic outcomes of North Carolina’s most at-risk children.Item Open Access Different Resistance Exercise Loading Paradigms Similarly Affect Skeletal Muscle Gene Expression Patterns of Myostatin-Related Targets and mTORC1 Signaling Markers.(Cells, 2023-03) McIntosh, Mason C; Sexton, Casey L; Godwin, Joshua S; Ruple, Bradley A; Michel, J Max; Plotkin, Daniel L; Ziegenfuss, Tim N; Lopez, Hector L; Smith, Ryan; Dwaraka, Varun B; Sharples, Adam P; Dalbo, Vincent J; Mobley, C Brooks; Vann, Christopher G; Roberts, Michael DAlthough transcriptome profiling has been used in several resistance training studies, the associated analytical approaches seldom provide in-depth information on individual genes linked to skeletal muscle hypertrophy. Therefore, a secondary analysis was performed herein on a muscle transcriptomic dataset we previously published involving trained college-aged men (n = 11) performing two resistance exercise bouts in a randomized and crossover fashion. The lower-load bout (30 Fail) consisted of 8 sets of lower body exercises to volitional fatigue using 30% one-repetition maximum (1 RM) loads, whereas the higher-load bout (80 Fail) consisted of the same exercises using 80% 1 RM loads. Vastus lateralis muscle biopsies were collected prior to (PRE), 3 h, and 6 h after each exercise bout, and 58 genes associated with skeletal muscle hypertrophy were manually interrogated from our prior microarray data. Select targets were further interrogated for associated protein expression and phosphorylation induced-signaling events. Although none of the 58 gene targets demonstrated significant bout x time interactions, ~57% (32 genes) showed a significant main effect of time from PRE to 3 h (15↑ and 17↓, p < 0.01), and ~26% (17 genes) showed a significant main effect of time from PRE to 6 h (8↑ and 9↓, p < 0.01). Notably, genes associated with the myostatin (9 genes) and mammalian target of rapamycin complex 1 (mTORC1) (9 genes) signaling pathways were most represented. Compared to mTORC1 signaling mRNAs, more MSTN signaling-related mRNAs (7 of 9) were altered post-exercise, regardless of the bout, and RHEB was the only mTORC1-associated mRNA that was upregulated following exercise. Phosphorylated (phospho-) p70S6K (Thr389) (p = 0.001; PRE to 3 h) and follistatin protein levels (p = 0.021; PRE to 6 h) increased post-exercise, regardless of the bout, whereas phospho-AKT (Thr389), phospho-mTOR (Ser2448), and myostatin protein levels remained unaltered. These data continue to suggest that performing resistance exercise to volitional fatigue, regardless of load selection, elicits similar transient mRNA and signaling responses in skeletal muscle. Moreover, these data provide further evidence that the transcriptional regulation of myostatin signaling is an involved mechanism in response to resistance exercise.Item Open Access You Really Need to Open This. Using Behavioral Economic Nudges to Increase Property Tax Compliance(2017-06-19) Gamble, TylerBy utilizing low-cost, behavioral economic "nudges," we achieved a significant increase in the rate of on-time property tax payments in Guilford County, North Carolina. Using a large-scale randomized control trial, we were able to demonstrate that a short, handwritten note - combined with minor alterations to a county-issued "reminder letter" - increased the likelihood that single property owners made a full or partial tax payment by 35.6%. In isolation, the small alterations to the reminder letter increased the likelihood of full or partial payment by 12.4%. All told, our interventions saved the county of Guilford around $70,000 in collection costs.