Browsing by Subject "Demography"
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Item Open Access A Heterotopic Xenograft Model of Human Airways for Investigating Fibrosis in Asthma.(American journal of respiratory cell and molecular biology, 2017-03) Hackett, Tillie-Louise; Ferrante, Sarah C; Hoptay, Claire E; Engelhardt, John F; Ingram, Jennifer L; Zhang, Yulong; Alcala, Sarah E; Shaheen, Furquan; Matz, Ethan; Pillai, Dinesh K; Freishtat, Robert JLimited in vivo models exist to investigate the lung airway epithelial role in repair, regeneration, and pathology of chronic lung diseases. Herein, we introduce a novel animal model in asthma-a xenograft system integrating a differentiating human asthmatic airway epithelium with an actively remodeling rodent mesenchyme in an immunocompromised murine host. Human asthmatic and nonasthmatic airway epithelial cells were seeded into decellularized rat tracheas. Tracheas were ligated to a sterile cassette and implanted subcutaneously in the flanks of nude mice. Grafts were harvested at 2, 4, or 6 weeks for tissue histology, fibrillar collagen, and transforming growth factor-β activation analysis. We compared immunostaining in these xenografts to human lungs. Grafted epithelial cells generated a differentiated epithelium containing basal, ciliated, and mucus-expressing cells. By 4 weeks postengraftment, asthmatic epithelia showed decreased numbers of ciliated cells and decreased E-cadherin expression compared with nonasthmatic grafts, similar to human lungs. Grafts seeded with asthmatic epithelial cells had three times more fibrillar collagen and induction of transforming growth factor-β isoforms at 6 weeks postengraftment compared with nonasthmatic grafts. Asthmatic epithelium alone is sufficient to drive aberrant mesenchymal remodeling with fibrillar collagen deposition in asthmatic xenografts. Moreover, this xenograft system represents an advance over current asthma models in that it permits direct assessment of the epithelial-mesenchymal trophic unit.Item Open Access A longitudinal study of convergence between Black and White COVID-19 mortality: A county fixed effects approach.(Lancet regional health. Americas, 2021-09) Lawton, Ralph; Zheng, Kevin; Zheng, Daniel; Huang, ErichBackground
Non-Hispanic Black populations have suffered much greater per capita COVID-19 mortality than White populations. Previous work has shown that rates of Black and White mortality have converged over time. Understanding of COVID-19 disparities over time is complicated by geographic changes in prevalence, and some prior research has claimed that regional shifts in COVID-19 prevalence may explain the convergence.Methods
Using county-level COVID-19 mortality data stratified by race, we investigate the trajectory of Black and White per capita mortality from June 2020-January 2021. We use a county fixed-effects model to estimate changes within counties, then extend our models to leverage county-level variation in prevalence to study the effects of prevalence versus time trajectories in mortality disparities.Findings
Over this period, cumulative mortality rose by 61% and 90% for Black and White populations respectively, decreasing the mortality ratio by 0.4 (25.8%). These trends persisted when a county-level fixed-effects model was applied. Results revealed that county-level changes in prevalence nearly fully explain changes in mortality disparities over time.Interpretation
Results suggest mechanisms underpinning convergence in Black/White mortality are not driven by fixed county-level characteristics or changes in the regional dispersion of COVID-19, but instead by changes within counties. Further, declines in the Black/White mortality ratio over time appear primarily linked to county-level changes in COVID-19 prevalence rather than other county-level factors that may vary with time. Research into COVID-19 disparities should focus on mechanisms that operate within-counties and are consistent with a prevalence-disparity relationship.Funding
This work was supported by the National Center for Advancing Translational Sciences [E.H.: UL1TR002553].Item Open Access A Multicenter Evaluation of Clinical and Radiographic Outcomes Following High-grade Spondylolisthesis Reduction and Fusion.(Clinical spine surgery, 2017-05) Gandhoke, Gurpreet S; Kasliwal, Manish K; Smith, Justin S; Nieto, JoAnne; Ibrahimi, David; Park, Paul; Lamarca, Frank; Shaffrey, Christopher; Okonkwo, David O; Kanter, Adam SObjective
A retrospective review of the clinical and radiographic outcomes from a multicenter study of surgical treatment for high-grade spondylolisthesis (HGS) in adults. The objective was to assess the safety of surgical reduction, its ability to correct regional deformity, and its clinical effectiveness.Methods
Retrospective, multicenter review of adults (age above 18 y) with lumbosacral HGS (Meyerding grade 3-5) treated surgically with open decompression, attempted reduction, posterior instrumentation, and interbody fusion. Preoperative and postoperative assessment of the Meyerding grade, slip angle, and sacral inclination were performed based on standing radiographs. Preoperative visual analog scale scores were compared with those at the mean follow-up period. Prolo and Oswestry Disability Index scores at most recent follow-up were assessed.Results
A total of 25 patients, aged 19-72 years, met inclusion criteria. Seventeen interbody cages were placed, including 15 transforaminal lumbar interbody fusions, 1 posterior lumbar interbody fusion, and 1 anterior lumbar interbody fusion. Five patients required sacral dome osteotomies. The average follow-up was 21.3 months.At most recent follow-up there was a statistically significant improvement in both the Meyerding grade and the slip angle (P<0.05). There was 1 intraoperative complication resulting in a neurological deficit (4%) and 1 intraoperative vertebral body fracture (4%). No additional surgery was required for any of these patients. There were no cases of nonunion or device failure except for 1 patient who suffered an unrelated traumatic injury 1 year after surgery. The mean Oswestry Disability Index and Prolo scores at mean follow-up of 21.3 months were 20% (minimum disability) and 8.2 (grade 1), respectively.Conclusions
The present study suggests that reduction, when accomplished in conjunction with wide neural element decompression and instrumented arthrodesis, is safe, effective, and durable with low rates of neurological injury, favorable clinical results, and high-fusion rates.Item Open Access A multicenter phase I/II study of obatoclax mesylate administered as a 3- or 24-hour infusion in older patients with previously untreated acute myeloid leukemia.(PloS one, 2014-01) Schimmer, Aaron D; Raza, Azra; Carter, Thomas H; Claxton, David; Erba, Harry; DeAngelo, Daniel J; Tallman, Martin S; Goard, Carolyn; Borthakur, GautamAn open-label phase I/II study of single-agent obatoclax determined a maximum tolerated dose (MTD) and schedule, safety, and efficacy in older patients (≥ 70 yr) with untreated acute myeloid leukemia (AML).Phase I evaluated the safety of obatoclax infused for 3 hours on 3 consecutive days (3 h × 3 d) in 2-week cycles. Initial obatoclax dose was 30 mg/day (3 h × 3 d; n = 3). Obatoclax was increased to 45 mg/day (3 h × 3 d) if ≤ 1 patient had a dose-limiting toxicity (DLT) and decreased to 20 mg/day (3 h × 3 d) if DLT occurred in ≥ 2 patients. In the phase II study, 12 patients were randomized to receive obatoclax at the dose identified during phase I (3 h × 3 d) or 60 mg/day administered by continuous infusion over 24 hours for 3 days (24 h × 3 d) to determine the morphologic complete response rate.In phase I, two of three patients receiving obatoclax 30 mg/day (3 h × 3 d) experienced grade 3 neurologic DLTs (confusion, ataxia, and somnolence). Obatoclax was decreased to 20 mg/day (3 h × 3 d). In phase II, no clinically relevant safety differences were observed between the 20 mg/day (3 h × 3 d; n = 7) and 60 mg/day (24 h × 3 d; n = 5) arms. Neurologic and psychiatric adverse events were most common and were generally transient and reversible. Complete response was not achieved in any patient.Obatoclax 20 mg/day was the MTD (3 h × 3 d) in older patients with AML. In the schedules tested, single-agent obatoclax was not associated with an objective response. Evaluation in additional subgroups or in combination with other chemotherapy modalities may be considered for future study.ClinicalTrials.gov NCT00684918.Item Open Access Association between perceived life chaos and medication adherence in a postmyocardial infarction population.(Circulation. Cardiovascular quality and outcomes, 2013-11) Zullig, Leah L; Shaw, Ryan J; Crowley, Matthew J; Lindquist, Jennifer; Grambow, Steven C; Peterson, Eric; Shah, Bimal R; Bosworth, Hayden BBackground
The benefits of medication adherence to control cardiovascular disease (CVD) are well defined, yet multiple studies have identified poor adherence. The influence of life chaos on medication adherence is unknown. Because this is a novel application of an instrument, our preliminary objective was to understand patient factors associated with chaos. The main objective was to evaluate the extent to which an instrument designed to measure life chaos is associated with CVD-medication nonadherence.Methods and results
Using baseline data from an ongoing randomized trial to improve postmyocardial infarction (MI) management, multivariable logistic regression identified the association between life chaos and CVD-medication nonadherence. Patients had hypertension and a myocardial infarction in the past 3 years (n=406). Nearly 43% reported CVD-medication nonadherence in the past month. In simple linear regression, the following were associated with higher life chaos: medication nonadherence (β=1.86; 95% confidence interval [CI], 0.96-2.76), female sex (β=1.22; 95% CI [0.22-2.24]), minority race (β=1.72; 95% CI [0.78-2.66]), having less than high school education (β=2.05; 95% CI [0.71-3.39]), low health literacy (β=2.06; 95% CI [0.86-3.26]), and inadequate financial status (β=1.93; 95% CI [0.87-3.00]). Being married (β=-2.09, 95% CI [-3.03 to -1.15]) was associated with lower life chaos. As chaos quartile increased, patients exhibited more nonadherence. In logistic regression, adjusting for sex, race, marital status, employment, education, health literacy, and financial status, a 1-unit life chaos increase was associated with a 7% increase (odds ratio, 1.07; 95% CI [1.02-1.12]) in odds of reporting medication nonadherence.Conclusions
Our results suggest that life chaos may be an important determinant of medication adherence. Life chaos screenings could identify those at risk for nonadherence.Clinical trial registration
URL: http://www.clinicaltrials.gov. Unique identifier: NCT000901277.Item Open Access Awareness of Cervical Cancer Causes and Predeterminants of Likelihood to Screen Among Women in Haiti.(Journal of lower genital tract disease, 2017-01) Boggan, J; McCarthy, SH; Walmer, KA; Gichane, MW; Calo, WA; Beauvais, HA; Brewer, NTCervical cancer is the leading cause of cancer deaths among women in Haiti. Given this high disease burden, we sought to better understand women's knowledge of its causes and the sociodemographic and health correlates of cervical cancer screening.Participants were 410 adult women presenting at clinics in Léogâne and Port-au-Prince, Haiti. We used bivariate and multivariate logic regression to identify correlates of Pap smear receipt.Only 29% of respondents had heard of human papillomavirus (HPV), whereas 98% were aware of cervical cancer. Of those aware of cervical cancer, 12% believed that sexually transmitted infections (STIs) cause it, and only 4% identified HPV infection as the cause. Women with a previous sexually transmitted infection were more likely to have had Pap smear (34% vs 71%, odds ratio = 3.45; 95% CI = 1.57-7.59). Screening was also more likely among women who were older than the age of 39 years, better educated, and employed (all p < .05). Almost all women (97%) were willing to undergo cervical cancer screening.This sample of Haitian women had limited awareness of HPV and cervical cancer causes; but when provided with health information, they saw the benefits of cancer screening. Future initiatives should provide health education messages, with efforts targeting young and at-risk women.Item Open Access Balancing the good and the bad: Assessing the positive and negative effects of alien species on native plant demography(2022) Loomis, AlexanderAlien species are considered one of the primary threats to native plant populations and their control is often prominent among proposed management actions. While negative alien effects are well documented, there are also many ways that alien species can have positive effects on native plant populations that may actually contribute to their persistence. Moreover, the effect of alien species on native plants can change in magnitude and direction over varying abiotic conditions. The success of native plant populations is determined by a mix of ecological and genetic factors. Alien (and native) species and abiotic conditions could also drive selection of plant traits. In order to understand the drivers of native plant population success in the face of changing climate and increasing prevalence of alien species, it is vital to understand the relationship between genotype, phenotype, and fitness of native plants. In chapter one, I quantified the effects of neighboring alien and native plants on all demographic rates in a population of the Hawaiian endemic plant Schiedea globosa, performing biannual censuses for 4 years to encompass relatively harsh and as well as benign seasons and years. The effects of alien neighbors were mixed but most often positive across many demographic rates in both harsh and more benign abiotic conditions, suggesting that alien neighbors benefit S. globosa plants through multiple mechanisms, such as nurse plant effects and associational resistance. The effects of heterospecific native neighbors were less often positive, indicating fundamentally different effects of native and alien neighbors on the demography of the focal native. These mixed effects highlight the need to consider potential benefits of alien species in the management of threatened native plants and that those benefits may be altered by changing abiotic conditions. In chapter two, I constructed population models for multiple Schiedea species across populations and years, using demographic rate regressions driven by the effects of alien and native neighbors, integrating the mixed effects of alien and native species on demographic rates of populations to project the net effect on population growth of native populations. The effects of alien and heterospecific native plant neighbors were mixed but most often positive across many demographic rates in both harsh and more benign abiotic conditions, suggesting that alien and native neighbors benefit native plants through multiple mechanisms, such as nurse plant effects and associational resistance. The effect of alien and heterospecific native neighbors on population growth was generally positive-- the mixed, but largely positive, net effects of alien and native neighbors on population growth highlight the need to consider potential benefits of alien, as well as native, species in the management of at-risk native plant populations, and that those benefits may be altered by changing abiotic conditions, as indicated by differing effects across (and within) years and populations. In chapter 3, I used paternal half-sibship pairs to measure the heritability of morphological traits under field conditions of the critically endangered Schiedea adamantis, which were found to be heritable in prior studies in greenhouse conditions, in reintroduced populations. I also performed a selection analysis, regressing fitness components against traits of outplants that I hypothesized might influence response to climate and alien and native neighbors to study the relationship between genotype, phenotype, and fitness of plants in restoration outplantings and assessing potential for evolutionary rescue. I found no significant heritability of any of the morphological traits. I did find evidence of selection, as leaf shape, area, and whole plant morphology had significant effects on fitness components (growth, survival, and reproduction), and significant interaction effects showing traits influenced fitness components differently at different levels of shade. Together, these results suggest that while variation in traits benefit individual plants in differing field conditions, these outplantings may not have the ability to respond to selection through evolution.
Item Open Access COMADRE: a global data base of animal demography.(J Anim Ecol, 2016-03) Salguero-Gómez, Roberto; Jones, Owen R; Archer, C Ruth; Bein, Christoph; de Buhr, Hendrik; Farack, Claudia; Gottschalk, Fränce; Hartmann, Alexander; Henning, Anne; Hoppe, Gabriel; Römer, Gesa; Ruoff, Tara; Sommer, Veronika; Wille, Julia; Voigt, Jakob; Zeh, Stefan; Vieregg, Dirk; Buckley, Yvonne M; Che-Castaldo, Judy; Hodgson, David; Scheuerlein, Alexander; Caswell, Hal; Vaupel, James WUNLABELLED: The open-data scientific philosophy is being widely adopted and proving to promote considerable progress in ecology and evolution. Open-data global data bases now exist on animal migration, species distribution, conservation status, etc. However, a gap exists for data on population dynamics spanning the rich diversity of the animal kingdom world-wide. This information is fundamental to our understanding of the conditions that have shaped variation in animal life histories and their relationships with the environment, as well as the determinants of invasion and extinction. Matrix population models (MPMs) are among the most widely used demographic tools by animal ecologists. MPMs project population dynamics based on the reproduction, survival and development of individuals in a population over their life cycle. The outputs from MPMs have direct biological interpretations, facilitating comparisons among animal species as different as Caenorhabditis elegans, Loxodonta africana and Homo sapiens. Thousands of animal demographic records exist in the form of MPMs, but they are dispersed throughout the literature, rendering comparative analyses difficult. Here, we introduce the COMADRE Animal Matrix Database, an open-data online repository, which in its version 1.0.0 contains data on 345 species world-wide, from 402 studies with a total of 1625 population projection matrices. COMADRE also contains ancillary information (e.g. ecoregion, taxonomy, biogeography, etc.) that facilitates interpretation of the numerous demographic metrics that can be derived from its MPMs. We provide R code to some of these examples. SYNTHESIS: We introduce the COMADRE Animal Matrix Database, a resource for animal demography. Its open-data nature, together with its ancillary information, will facilitate comparative analysis, as will the growing availability of databases focusing on other aspects of the rich animal diversity, and tools to query and combine them. Through future frequent updates of COMADRE, and its integration with other online resources, we encourage animal ecologists to tackle global ecological and evolutionary questions with unprecedented sample size.Item Open Access Concurrent use of methamphetamine, MDMA, LSD, ketamine, GHB, and flunitrazepam among American youths.(Drug and alcohol dependence, 2006-09) Wu, Li-Tzy; Schlenger, William E; Galvin, Deborah MThe magnitude and the characteristics of the use of methamphetamine, MDMA (Ecstasy), LSD (d-lysergic acid diethylamide), ketamine, GHB (gamma-hydroxybutyrate), and flunitrazepam (Rohypnol) were examined in a probability sample of the U.S. civilian population that included multiethnic urban, suburban, and rural youths aged 16-23 (N=19,084).Data were drawn from the National Survey on Drug Use and Health (NSDUH). Logistic regression analyses were conducted to identify the characteristics associated with the use of each of these drugs and of multiple drugs.Approximately 20% of youths aged 16-23 reported having ever used one or more of these drugs. Less than 1% of club drug users used club drugs only, and 82% of them had ever used three or more drug classes. Females were more likely than males to report using multiple club drugs. Recent users of methamphetamine were most likely to be females and adolescents aged 16 or 17. Recent users of MDMA tended to be young adults aged 18-21 and residents of metropolitan areas. Most recent users of LSD were adolescents aged 16-19 and those in low-income families. Ketamine users were primarily employed youths. Staying in school and getting married were associated with decreased odds of club drug use. Club drug use was highly associated with the presence of criminal behaviors and recent alcohol abuse or dependence.Adolescents are more likely than young adults to use multiple drugs. The clustering of multidrug use and alcohol use disorder is a cause of concern.Item Open Access Design of the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study (NC ProCESS).(Journal of comparative effectiveness research, 2015-01) Chen, Ronald C; Carpenter, William R; Kim, Mimi; Hendrix, Laura H; Agans, Robert P; Meyer, Anne-Marie; Hoffmeyer, Anna; Reeve, Bryce B; Nielsen, Matthew E; Usinger, Deborah S; Strigo, Tara S; Jackman, Anne M; Anderson, Mary; Godley, Paul AThe North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study (NC ProCESS) was designed in collaboration with stakeholders to compare the effectiveness of different treatment options for localized prostate cancer. Using the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry, 1,419 patients (57% of eligible) with newly-diagnosed localized prostate cancer were enrolled from January 2011 to June 2013, on average 5 weeks after diagnosis. All participants were enrolled prior to treatment and this population-based cohort is sociodemographically diverse. Prospective follow-up continues to collect data on treatments received, disease control, survival and patient-reported outcomes. This study highlights several important considerations regarding stakeholder involvement, study design and generalizability regarding comparative effectiveness research in prostate cancer.Item Open Access Detection and Characterization of Human Pegivirus 2, Vietnam.(Emerging infectious diseases, 2018-11) Anh, Nguyen To; Hong, Nguyen Thi Thu; Nhu, Le Nguyen Truc; Thanh, Tran Tan; Anscombe, Catherine; Chau, Le Ngoc; Thanh, Tran Thi Thanh; Lau, Chuen-Yen; Limmathurotsakul, Direk; Chau, Nguyen Van Vinh; Rogier van Doorn, H; Deng, Xutao; Rahman, Motiur; Delwart, Eric; Le, Thuy; Thwaites, Guy; Van Tan, Le; Southeast Asia Infectious Disease Clinical Research NetworkWe report human pegivirus 2 (HPgV-2) infection in Vietnam. We detected HPgV-2 in some patients with hepatitis C virus/HIV co-infection but not in patients with HIV or hepatitis A, B, or C virus infection, nor in healthy controls. HPgV-2 strains in Vietnam are phylogenetically related to global strains.Item Open Access Determinants of Insecticide Treated Nets (ITNs) Ownership and Use in Ghana(2011) Adeyeri, OluwakemiMalaria is hyper-endemic in Ghana, and remains one of the leading causes of morbidity and mortality, especially in pregnant women and children under the age of five. The use of insecticide-treated nets is an effective intervention for malaria control; however, despite known evidence of its efficacy, there is still a low rate of implementation and usage. Considering the significant public health impact to be gained from proper use of ITNs, it is worthwhile to study factors that determine ownership of ITNs in Ghana. Cross-sectional data from the Demographic and Health Surveys (DHS) for Ghana in 2008 was analyzed to determine which variables were predictors of ITN ownership. Additional semi-structured interviews were also conducted to explore these variables. Approximately 33% of Ghanaian households own at least one ITN. The strongest positive predictors of ITN ownership were number of children <5 years (52%) and residence in a rural area (47%). Marital status and birth in the last five years were also positive predictors, 48% and 56% respectively Electricity in the household was found to be a negative predictor (28%), while wealth was not a significant predictor. Consequently, there is the need for increased targeted government interventions towards groups that are less likely to own bed nets - urban areas, low level of education. It is also paramount that already existing interventions that target risk groups - young children and pregnant women are continued to ensure continued reduction in the global burden of malaria.
Item Open Access Determinants of Teenage Childbearing in the United States(2015) Tan, Poh LinThis dissertation consists of two original empirical studies on the determinants of teenage childbearing in the United States. The first study examines the impact of educational attainment on teenage childbearing, using school entry laws as an instrument for education and a highly detailed North Carolina administrative dataset that links birth certificate data to school administrative records. I show that being born after the school entry cutoff date affects educational success in offsetting ways, with a negative impact on years of education but positive impact on test scores. Using an IV regression strategy to distinguish the impacts of years of education and test scores, I show that both educational measures have negative impacts on teenage childbearing.
The second study examines potential causes of the decline in the U.S. teenage birth rate between 1991 and 2010. Using age-period-cohort models with Vital Statistics birth data and Census population counts, I show that the decline was driven by period changes in the early 1990s but by cohort changes between the mid-1990s and mid-2000s. I also use a difference-in-differences model to investigate the extent to which social policies in the 1970s-1980s can explain these cohort changes. The evidence suggests that while legalization of abortion for adult women and unilateral divorce laws had a significant impact on teenage birth rates in the 1990s-2000s, abortion legalization is unlikely to be a major explanation for the observed decline.
Item Open Access Environmental Impacts on the Population Dynamics of a Tropical Seabird in the Context of Climate Change: Improving Inference through Hierarchical Modeling(2008-04-25) Colchero, FernandoUnder the increasing threat of climate change, it is imperative to understand the impact that environmental phenomena have on the demography and behavior of natural populations. In the last few decades an ever increasing body of research has documented dramatic changes in mortality rates and breeding phenology for a large number of species. A number of these have been attributed to the current trends in climate change, which have been particularly conspicuous in bird populations. However, datasets associated to these natural populations as well as to the environmental variables that affect their biology tend to be partial and incomplete. Thus, ecological research faces the urgent need to tackle these questions while at the same time develop inferential models that can handle the complex structure of these datasets and their associated uncertainty. Therefore, my dissertation research has focused on two main objectives: 1) to understand the relationship that demographic rates and breeding phenology of a colony of seabirds has with the environment in the context of climate change; and 2) to use and develop models that can encompass the complex structure of these natural systems, while also extending the process not only to inference but to building predictions. I divided this work in three research projects; for the first one I developed a hierarchical Bayesian model for age-specific survival for long lived species with capture-recapture data that allows the use of incomplete data (i.e. left-truncated and right-censored), and builds predictions of years of birth and death for all individuals while also drawing inference on the survivorship function. I compared this method to more traditional ones and address their limitations and advantages. My second research chapter makes use of this method to determine the age-specific survivorship of the Dry Tortugas sooty tern population, and explores the effect of changes in sea surface temperature on their cohort mortality rates. Finally, my third research chapter addresses the dramatic shift in breeding season experienced by the Dry Tortugas sooty tern colony, the most unprecedented shift reported for any bird species. I explore the role of climatic and weather variables as triggering mechanisms.
Item Open Access Essays on Fertility and Fertility Preferences in India(2014) Rajan, SowmyaIn this dissertation, I examine at the aggregate and individual levels, why contemporary fertility preferences diverge from actual fertility. I use three waves of cross-sectional survey data from the National Family Health Surveys from India (also known as the Indian Demographic and Health Surveys), fielded in 1992-3, 1998-9 and 2005-6 to investigate the disjuncture between preferences and behavior. The first empirical chapter outlines and operationalizes a new framework to decompose the incongruence between stated preferences and actual fertility into a set of parameters, such as unwanted births, gender preference and postponement of births to later ages, each of which varies in its level and intensity between societies and over time. By delineating the societal constraints that women do not incorporate in their childbearing intentions, this model provides a useful framework to explain variability in fertility in contemporary intermediate- and low-fertility populations. Equally important, the framework provides avenues to enquire into the fundamental structural and cultural correlates producing differences between family size preferences and actual fertility.
Subsequent empirical chapters explore various aspects of fertility preferences in detail. The second chapter probes a key socioeconomic correlate of individual-level fertility preferences, namely educational differences in preferences. In brief, I find that educational differences in family size preferences have considerably converged over time using two-way fixed effects models. However, there is still considerable heterogeneity in the implementation of preferences (as manifested by the use of contraception). Accordingly, in the third chapter, I analyze the multilevel sources of variation in the use of contraception by young women, given that they express a preference to space or stop childbearing. Using multilevel models, I find that community norms play a strong role in the use of contraception by young women to meet their fertility preferences to space or stop childbearing. I argue that community norms are an influential determinant of young women's ability to regulate their own fertility - serving to enhance or constrain their use of contraception to either space or stop childbearing.
Overall, findings from this dissertation highlight the macro-level factors that explain variation in contemporary fertility, of which fertility preferences emerge as a critical parameter. This dissertation also illuminates the growing convergence of fertility preferences across socioeconomic categories, while focusing attention on local community forces that influence fertility behavior even in the face of women's stated preferences.
Item Open Access Essays on Migration, Social Networks and Employment(2022) Le Barbenchon, ClaireImmigrants rely on social networks upon arrival to their country of destination to access resources, find a job, and begin the process of incorporation. However, the contours of how and under what circumstances networks support a job search or facilitate assimilation remain unexplored. In this dissertation, I look at the intersection of migration, social networks and employment to shed light on both the limitations and benefits of social networks for immigrant incorporation. In Chapter 1, I study whether return migrants use social networks to find a job when they return to their home country. In doing so, I contribute to the academic debate on whether immigrants lose or maintain their connections to friends and family when they leave. Using Colombia as a case study, I draw on data from two years of Colombian nationally representative household surveys conducted in 2016 and 2017. I use a Difference-in-Differences strategy and exploit a mass deportation event of Colombian migrants from Venezuela in 2015 which prompted a wave of return-migrants. This yields three main findings: (1) Return migrants are more likely to use networks in their search than never migrants; (2) social networks are a last resort in return migrants’ job search, and (3) jobs found through networks for return migrants may be lower quality than jobs found through other means. This paper contributes to the literature on return migrant integration, and speaks to an important question in the literature: Will friends and family still be there for you after you’ve left? In Chapter 2, co-authored with Giovanna Merli and Ted Mouw, we study how immigrants’ personal networks are related to their migration experience and key indicators of assimilation. We draw on novel data that includes network data for over 500 immigrants and use model-based clustering to understand the assimilation of a particular case of first-generation immigrants: Chinese immigrants in a sparsely dispersed in a mixed suburban/urban area (Raleigh-Durham). We identify four Chinese immigrant typologies, Chinese Friendship Networks, Socially Embedded, Undecided Newcomers, and Economically Integrated, which are distinguished simultaneously by their social networks and their demographic characteristics. In turn, we find different clusters show different patterns in assimilation indicators. These findings contribute to a growing literature that calls for more granular study of immigrant groups so we can better understand heterogeneity in their outcomes. In Chapter 3, I study the limits of social networks for the immigrant job search. The idea that migrants draw on their networks to obtain employment upon arrival at their destination is central to the immigrant integration literature. However, despite the wealth of evidence on migrants’ use of networks, little is known about when and why migrants are willing to help newcomers find work. To study this, I deploy an online vignette experiment among Latin American immigrants to the United States. I find that immigrants are more likely to provide job search support to other immigrants from their home country but are less likely to lend support to newcomers that pose a reputational risk. I also find that tie strength is important – respondents in our sample are more likely to help a close friend than a stranger, which can help immigrants overcome the difficulties associated with a competitive labor market.
Item Open Access Essays on Population, Environment and Development(2018) Burrows, Michael AndrewEcological factors and the policy environment are central constraints on population well-being. This dissertation emphasizes the role of shocks to help understand the nature of such constraints, and explores the relationship between population, environment, and development in greater detail than is typically possible.
Chapter 1 opens by contributing to a growing body of evidence around the impacts of old-age pensions on the well-being of pension recipients and their families. I draw from the unique disbursement structure of a popular, widely utilized benefits program in rural Brazil, and data from two nationally representative surveys conducted in 2013 by the Brazilian Institute of Geography and Statistics. I first employ regression discontinuity design to measure the direct effect of the program’s age threshold on pension take-up. Second, I compare differences in reports of health and well-being among age-eligible and age-ineligible adults in rural areas to the same differences among populations that generally do not qualify for the benefit (i.e., urban populations). This difference-in-differences shows robust evidence of a beneficial pension effect, though along somewhat different dimensions by gender. I then show evidence of two credible mechanisms for improved health and well-being: first, improved food security within households that have eligible pension recipients; second, the cohabitation of younger family members, potentially providing support to aging family members. Taken together, this chapter demonstrates that the rural benefits program in Brazil leads to tangible health benefits for its recipients, through channels that are likely to complement rather than crowd out other public services.
Chapter 2 moves on to explore how a massive natural disaster affected smoking behavior, a common coping mechanism. External stressors are commonly hypothesized to play a role in the adoption of certain health behaviors, but understanding the role of exposure is frequently hampered by research designs and data that are inadequate for tracing causality. I use this study to evaluate the relationship between unanticipated exposure to a natural disaster and smoking behaviors using longitudinal data collected from families in Aceh, Indonesia before and after the 2004 Indian Ocean tsunami. Exposure to the tsunami is measured as a community indicator of physical proximity to damage, and as individual indicators of personal experiences at the time of the tsunami. My analysis indicates that the effect of exposure on smoking uptake varies considerably by age, and that most forms of exposure increase smoking volume. These effects appear to be temporary, but even in the context of Indonesia’s extraordinarily high smoking rates an impact is perceptible even ten years after the tsunami.
Chapter 3 delves further into the effects of the tsunami, exploring the distribution of resources after the broad destruction of infrastructure and subsequent, fast-paced reconstruction. I evaluate multiple aspects of water access for roughly 6,000 families through 2014. Logit regression analysis show increasing disparities in access to basic amounts of water, and multinomial logit regression analysis indicates that shifts are driven by a massive increase in the market for privately distributed bottled water. This study disentangles key distributional processes to show how reconstruction influenced a central social determinant of health among an already vulnerable population.
The chapters to follow aim to relate the well-being of individuals to the influences that arise from interconnected policy choices and ecological factors. The first chapter emphasizes a policy shock, the second an ecological shock, and the second seeks to identify a combined effect of the two. This original research is intended to help illuminate the role that institutions might play in improving population well-being.
Item Open Access Experimental manipulation of seed shadows of an Afrotropical tree determines drivers of recruitment.(Ecology, 2012-03) Poulsen, John R; Clark, Connie J; Bolker, Benjamin MThe loss of animals in tropical forests may alter seed dispersal patterns and reduce seedling recruitment of tree species, but direct experimental evidence is scarce. We manipulated dispersal patterns of Manilkara mabokeensis, a monkey-dispersed tree, to assess the extent to which spatial distributions of seeds drive seedling recruitment. Based on the natural seed shadow, we created seed distributions with seeds deposited under the canopy ("no dispersal"), with declining density from the tree ("natural dispersal"), and at uniform densities ("good dispersal"). These distributions mimicked dispersal patterns that could occur with the extirpation of monkeys, low levels of hunting, and high rates of seed dispersal. We monitored seedling emergence and survival for 18 months and recorded the number of leaves and damage to leaves. "Good dispersal" increased seedling survival by 26%, and "no dispersal" decreased survival by 78%, relative to "natural dispersal." Using a mixed-effects survival model, we decoupled the distance and density components of the seed shadow: seedling survival depended on the seed density, but not on the distance from the tree. Although community seedling diversity tended to decrease with longer dispersal distances, we found no conclusive evidence that patterns of seed dispersal influence the diversity of the seedling community. Local seed dispersal does affect seedling recruitment and survival, with better dispersal resulting in higher seedling recruitment; hence the loss of dispersal services that comes with the reduction or extirpation of seed dispersers will decrease regeneration of some tree species.Item Open Access Family Structure and Child Malnutrition in China: Three Essays(2013) He, WeiOver the past three decades, the phenomenon of children's health in China has been marked by a co-existence of overweight and underweight. As the primary institution for a child, family is an opportune place for child malnutrition intervention. By advancing a framework that addresses the contextual factors which shape the heterogeneity of socioeconomic gradients of child overweight/obesity, this dissertation has sought to understand the channels through which access to family resources influences child overweight/obesity in China. Based on these developed understandings, I identified the mechanisms by which having any younger siblings and three generation living together or proximately affect child malnutrition in China. Using data drawn from China Health and Nutrition Survey, this dissertation uncovered remarkable differences in multiple levels of contextual factors that shape a child's risk of overweight/obesity and underweight in China as compared to Western society. China's stage of economic development together with the drastically increasing income inequality has created an ever-increasing socioeconomic gap in child overweight/obesity, especially after 1997. This finding confirmed the position of the Ecological System framework that access to obesogenic environment is much more important than willpower based on knowledge in shaping one's obesity-related risk behavior. Although the fertility level has been lowered by One Child Policy, resource dilution effect still affects girls' nutrition status, especially for those exposed to poverty and food insecurity. Children in the care of grandparents are healthier, probably due to the generally low degree of access to obesogenic foods and a closer intergenerational relationship that facilitates effective communication and promotes healthy lifestyle formation.
Item Open Access Family Ties, Economic Resources, and the Well-Being of Older Adults Across Communities in China(2013) Sereny, Melanie DawnMany older adults in the developing world rely on their adult children for financial, instrumental, and emotional support. The People's Republic of China (PRC), which will experience rapid population aging in the current century, is no exception. Many scholars and policy-makers are concerned that rapid economic, social, and demographic change in China is leading to a decline in traditional support for aging parents. This study examines the impact of family ties and economic resources on the receipt of support and the health of older adults across communities in China at different levels of economic development.
I analyze data from the 2002 and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) as well as the 2000 and 2005 1% Chinese Census. Initiated in 1998, the CLHLS interviewed older adults residing in a random sample of counties and cities in 22 provinces and municipalities of China. Additionally, in 2002 a subset of adult children of CLHLS respondents were also interviewed in a separate survey. Furthermore, the 2008-2009 wave collected additional data from middle-aged and older adults residing in specially designated "longevity areas" in China. In addition to the standard questionnaire and health exam, samples of blood and urine were also collected by medical personnel.
The first empirical chapter of this dissertation examines the association between filial piety/altruism and financial transfers to aging parents from adult children using factor analysis, binary logistic regression, and linear regression. The second paper looks at the socioeconomic-status health gradient using biomarker data among older adults residing in longevity areas using binary logistic regression analysis. The third paper examines both individual-level and community-level determinants of non-normative intergenerational coresidence - living with an adult daughter instead of an adult son-- through multilevel binary logistic models analyzing both survey and census data.
I find that (1) adult children's attitudes towards filial piety and family values are associated with both presence and amount of financial transfers to older parents, net of controls for adult child's socioeconomic status, parental need, parents' earlier life transfers to children, and whether elderly parents' provide instrumental support to adult children. (2) Similar to previous research in middle-income countries, many biomarkers were not associated with socioeconomic status but those that were demonstrated a reversed gradient - higher socioeconomic status was associated with worse health. (3) Greater numbers of daughters, higher levels of individual socioeconomic status, and residing in a more developed community was associated with greater likelihood of coresidence with adult daughters versus adult sons.
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