Appalachia can be both exquisitely breathtaking and socially tragic, it’s a place to which many Americans trace their ancestry, and yet also it often seems forgotten. In the 1960s, the region was a major target area of the US government’s War on Poverty. Once highly noted for its tremendous post-industrial era contributions to the world’s timber and coal industries, subsequent changing economic demands and industry closures in the region have left many still living in a state of unforgiving poverty. The prevalence of counties living at or below the poverty rate, as estimated by the Appalachian Regional Commission (2015), has dropped from 295 counties in the 1960s to 90 in a 2009-2013 report. Despite this drop the region still greatly suffers due to high concentrated poverty, inadequate health care access, and unemployment. Poverty still demands attention, and scholars must understand its persistence. Many note the consistent lack of access to resources, both economic and social, as primary factors (Saegert, Thompson and Warren 2001; Blakeney 2006). Therefore, I draw on social capital and its underlying relational, social engagements as my main theoretical frame. I explore some of the sociological dynamics underlying Appalachia’s persistent poverty. Through an artifact-based ethnography in a rural eastern Kentucky community, this thesis argues that the current understandings of social capital – as a mechanism to gain social or economic resources – is greatly influenced by the presence of stigma and this is most notably manifested through the readings of cultural artifacts. This thesis’ empirical data draws on ethnographic fieldwork that also included participant observation and 45 semi-structured interviews. I tried to understand the operation of social capital through the lenses of three key artifacts that seemed to me to capture elements of poverty dynamics in the region: home, ‘welfare check’, and glucose meter. These artifacts were chosen because they allowed me to understand how mobility, access, acquisition, utilization, boundaries, and the role in which stigma affects all of these areas is presented. The fieldwork and interview data was understood and supplemented by examining official statistics, government documents, and literature focusing on the emergence and maintenance of the artifacts. The thesis articulates the complicated notions surrounding social capital and how it is manifested through the usage and reading of these objects. Furthermore, this project illustrates how actors within and outside of the community affect the reading of the objects that results in the construct of physical and social boundaries. The findings for this thesis indicates the way in which individuals in communities and external agents understand resources and interact with potential resources for impoverished individuals in providing them access is negated by their reading of objects surrounding them and is affected by the stigma attached to such objects. Chapter 4 on the home examines the concept of rootedness and social mobility; how the strong kinship ties are both a response to and protection from the effects of poverty and stigma in the region. Chapter 5 on the ‘welfare check’ illustrates further the effect that strong bonding ties can have on impeding the development of bridging ties – most notably how fear or people’s reactions, are a response founded in stigma, potentially leads to the heavy reliance on an object which arguably perpetuates poverty. Lastly, Chapter 6 uses the glucose meter to examine the effect that stigma can have internally and externally to a community, thus resulting in inadequate access to health care. The thesis’ key theoretical contribution lies in an attempt to develop an understanding of some of the paradoxical ways in which social capital operates in an impoverished community, and more especially in a theorization of the role that stigma plays in our understanding of social capital. In order to explore this further, the thesis relies heavily upon the utilization of Robert Putnam’s understanding of social capital and loosely on Pierre Bourdieu’s understanding of inequality and its influence on social capital. Erving Goffman’s notion of stigma is used to contextualize the conceptual employment of social capital and its relationship with the artifacts. Current social capital literature uses the presence of, or lack of, bonding and bridging capital in order to illustrate the amount of social capital a community has. However, I illustrate that this is heavily influenced by the presence of stigma.

Point-of-care testing (POCT) is defined as medical testing at or near the site of patient care and has become a critical component of the diagnostic industry. POCT has many advantages over tests in centralized laboratories including small reagent volumes, small size, rapid turnaround time, cost-effectiveness, low power consumption and functional integration of multiple devices. Paper-based POCT sensors are a new alternative technology for fabricating simple, low-cost, portable and disposable analytical devices for clinical diagnosis. The focus of this dissertation was to develop simple, rapid and low cost paper-based POCT sensors with high sensitivity and portability for disease biomarker detection. Lateral flow strips (LFS) were used as the basic platform as it provides several key advantages such as simplicity, fast response time, on site and cost-effectiveness, and it can be used to detect specific substances including small molecules, large proteins and even whole pathogens, in a sample by immunological reactions. Earlier designs of paper strips lacked the quantitative information of the analyte concentration and could only provide single analyte detection at a time. In this study, a series of modifications were made to upgrade the platform to compensate for these limitations. First, we developed a gold nanoparticle based LFS for qualitative colorimetrical detection of bladder cancer related biomarkers in standard solutions and in urine samples. Second, by incorporating an image processing program “ImageJ”, a semi-quantitative LFS platform was established. The capability of the strip was evaluated by testing a small DNA oxidative damage biomarker in urine and cell culture models. Third, we combined the electrochemical method and colorimetrical method for quantitative biomarker detection. Finally, we integrated a commercialized blood glucose meter to quantitatively detection of two non-glucose biomarkers by converting their signals to that of glucose. The upgraded sensor could provide a noninvasive, rapid, visual, quantitative and convenient detection platform for various disease biomarkers. In addition, this platform does not require expensive equipments or trained personnel, deeming it suitable for use as a simple, economical and portable field kit for on-site biomarker monitoring in a variety of clinical settings.

<p>Since the late 1970s, biomedical researchers have heavily invested in the development of portable insulin pumps that allow people with Type 1 Diabetes (T1D) to carry several days-worth of insulin to be injected on an as-needed basis. That means fewer needles and syringes, making regular insulin injections less time consuming and troublesome. As insulin pump use has become more widespread over the past twenty years among people with T1D, the social and cultural effects of using these medical devices on their everyday experiences have become both increasingly apparent for individuals yet consistently absent from social and cultural studies of the disease.</p><p><br></p><p>In this dissertation, I explore the technological, medical, and cultural networks of insulin pump treatment to identify the role(s) these biomedicalized treatment acts play in the structuring of people, their bodies, and the cultural values constructed around various medical technologies. As I will show, insulin pump treatment alters people’s bodies and identities as devices become integrated as co-productive actors within patient-users’ biological and social systems. By analyzing personal interviews and digital media produced by people with T1D alongside archival materials, this study identifies compulsory patterns in the practices, structures, and narratives related to insulin pump use to center chapters around the productive (and sometimes stifling) relationship between people, bodies, technologies, and American culture.</p><p><br></p><p>By analyzing the layered and intersecting sites of insulin pump treatment together, this project reveals how medical technologies, health identities, bodies, and cultures are co-constructed and co-defined in ways that bind them together—mutually constitutive, medically compelled, cultural and social. New bodies and new systems, I argue, come with new (in)visibilities, and while this new technologically-produced legibility of the body provides unprecedented management of the symptoms and side-effects of the disease, it also brings with it unforeseen social consequences that require changes to people’s everyday lives and practices. </p>