The COVID-19 pandemic sparked rapid shifts to engineering education, causing changes to course formats and student experiences. The culture of undergraduate engineering programs undoubtably affected this transition online and affected how students interpreted their experiences. To date, research on engineering culture has explored the values, beliefs, and underlying ideologies of the culture. However, what we know about engineering culture was captured predominantly during periods of stability. Because COVID-19 provides an opportunity to either challenge or uphold aspects of engineering culture, it was imperative to capture the experiences of students undergoing an engineering education during this time. In order to understand what facets of engineering culture were salient in students' interpretations of their classroom experiences during the COVID-19 pandemic, I conducted a multiple case study exploring mechanical engineering students' constructions of their experiences taking second and third year courses during the pandemic. I compared two mechanical engineering programs – one in the United States and one in South Africa – by conducting semi-structured interviews with 10 to 11 mechanical engineering undergraduate students at each site as well as 1 to 2 key informants. My analysis identified the following cultural features that emerged as salient from students' perspectives during the pandemic at both sites: intrinsic hardness, differential access to resources, and application and design. Additionally, my analysis identified the following cultural features that emerged as salient at only one site: seeking help, job market, and scientific way of thinking. The key difference between sites appeared with respect to differential access to resources. This study captures and reports critical data about students' constructions of their experiences during the COVID-19 pandemic. By investigating engineering culture during a time of stress, this research identifies the most salient features of engineering culture that remained constant through the pandemic as well as the features that changed due to the pandemic. Further, the global comparative aspect of this work highlights which features of engineering culture are universal and which are influenced by national context. Overall, this research aims to inform future educational responses to disasters as well as future change efforts in engineering. / Doctor of Philosophy / The COVID-19 pandemic sparked rapid shifts to engineering education, sending students home and shifting classes online. The beliefs and values that engineering instructors and students have about how engineering should be taught and learned impacted this shift online in ways that could either help or hinder student learning. The pandemic provides an opportunity to understand which beliefs and values in engineering were stickiest and the most important to how students described their experiences. In order to understand how students described their experiences taking classes online during the pandemic, I interviewed 10 to 11 mechanical engineering students at two universities – one university in the United States and one in South Africa. I asked students to share stories about taking classes during the pandemic. I then analyzed their responses and looked for commonalities across their stories. I found that students talked about six common features of their experiences. First, students felt like their classes were hard, and they felt their classes should have been hard because that was part of what it means to study engineering. Second, students noticed that having a laptop and Wi-Fi became very important when all teaching and learning was happening online, and not having that access made learning more challenging. Third, students missed their in-person laboratory classes, which they also saw as central to engineering. Fourth, students at the university in South Africa talked about challenges with getting help with their classes because virtual learning made accessing instructor and peer help more difficult. Fifth, students at the university in the United States had concerns about finding jobs because the pandemic was impacting the economy and their ability to obtain internships. Sixth, students at the university in the United States were frustrated that the response to the pandemic wasn't more rooted in science. This study captures and reports students' stories about their experiences during the pandemic. By looking at how students talked about their experiences during the pandemic, this research identifies the stickiest features of engineering culture that remained constant through the pandemic as well as the features that changed due to the pandemic. Further, by comparing two countries, this work highlights which beliefs and values in engineering are widespread and which are not. Overall, this research aims to inform future educational responses to disasters as well as future change efforts in engineering.

This dissertation consists of three essays in Health Economics relating to the recent challenges in the U.S. The first essay studies the impact of retirement on subsequent health and investigates the mediation effect of social network in the relationship between retirement and health. Findings reveal that retirement adversely impacts physical and mental health outcomes and a considerable portion of these effects are explained by social network changes post-retirement. In particular, shrinkage in the size of social network post-retirement deteriorates physical health and increases depression in retirees. In the second essay, we assess the differential effect of social distancing on the daily growth rate of COVID-19 infections in the US counties by considering the spatial pattern of COVID-19 spread. We also conduct a comparative analysis of the effect on urban versus rural counties, as well as low versus high socially vulnerable counties. Our analysis illustrates that a high level of social distancing compliance is needed in urban counties and in socially vulnerable areas to achieve the largest impact at curve flattening, whereas moderate-compliance is enough in reaching the peak marginal impact in rural regions and counties with low social vulnerability. In the third essay, by combining multiple data sources, we investigate how racial disparities in access to healthcare contribute to the disparity in COVID-19 infections and mortality in black versus white sub-groups. The multilevel analysis demonstrates that a higher probability of having health insurance significantly reduces disparity in COVID-19 mortality in black sub-group while it has no impact on the disparity in whites. / Doctor of Philosophy / This dissertation uses various quantitative methods to investigate policy-relevant questions regarding the recent challenges in the U.S. economy. In the first chapter, we explore how the physical and mental health of individuals changes by retirement. The results show that retirement decreases physical health while increases depression and anxiety. We also analyze how social network changes after retirement might cause changes in the health of retirees. We find that retirees may experience worse physical and mental health than non-retirees due to losing some of their relationships after retirement. In particular, the loss of contacts increases depression and deteriorates general health. In the second chapter, we investigate how compliance with social distancing within a typical county and its neighbor counties can reduce the spread of COVID-19. We examine this question for urban versus rural counties in the US and socially vulnerable versus socially not vulnerable counties. We find a high compliance level of social distancing is needed in urban counties and in socially vulnerable areas to reach the highest impact at slowing down the COVID-19 virus spread. In the third chapter, we examine whether healthcare access inequalities (e.g., having health insurance) increase the risk of COVID-19 infections and mortality for black communities. Our results show that having health insurance decreases COVID-19 mortality in communities of color but not whites.

This dissertation is comprised of two manuscripts that explore various contestations and representations of knowledge about the highly pathogenic avian influenza H5N1virus. In the first manuscript, I explore three narratives that have been produced to describe the 20-year journey of the virus. The journey begins in 1996 when the virus was a singular localized animal virus but then over the next 20 years multiplied its ontological status through a (de)stabilized global network of science and politics that promoted both fears of contagion and politics of otherness. Written by and for powerful actors and institutions in the global North, the narratives focused on technical solutions and outbreak fears. In doing so, the narratives produced policies and practices of biopower that obscured alternative considerations for equity, social justice, and wellbeing for the marginalized groups most directly affected by the H5N1 virus. The second manuscript explores a unique aspect of the H5N1 virus's journey as an emerging infectious disease -- its representation as a potential weapon for bioterrorists. The US government's recent attempt to secure what constitutes H5N1 knowledge produced a global debate between scientists and policy makers over how to balance the nation-state's desire for security with the life science's tradition of openly shared research. Known as the dual-use dilemma, this debate set up binaries of impossible reconciliation between the two groups. This dissertation argues that the dual-use dilemma obscures larger questions of justice. I propose a new concept of justice, knowledge justice, as an alternate more globally inclusive framework for exploring ways out of the dilemma. The concept is premised on the assertion that if knowledge is framed to obscure justice issues, then the justice questions of owning that knowledge can be used as a way out of the dual-use dilemma. Thus, knowledge becomes a question of justice that should be as important to policy makers as more traditional justice considerations of inequities in distribution, recognition, representation, and fairness. / Ph. D.

The COVID-19 Pandemic exacerbated a multitude of systems in the United States in 2020 up to current day. The structure of non-profit organizations across the country weakened as demands escalated for free food resources with specific pressure placed on food banks and food recovery organizations. There were citizens who had not previously relied on free food services who found themselves in drive through pickups, waiting for pre-packaged food boxes or the occasional you-pick operation to feed their families and themselves. The increase in demand for free food services was reacted to by those leading and directing the free food distribution sites through a time of crisis. This qualitative study serves to analyze food recovery organization (FRO) leadership strategies and principles that guided their decision making and problem-solving skills in response to food shortages and supply chain issues. The merge of the eight pillars of transformational and servant leadership theory provided propositional pillars that were tested in practice through interviews with FRO leaders in Appalachia. The discovery of how these leadership strategies were enacted during a time of crisis will guide the development of a training curriculum for nonprofit leaders in the future. / Master of Science in Life Sciences / The COVID-19 Pandemic exacerbated a multitude of systems in the United States in 2020 up to current day. The structure of non-profit organizations across the country weakened as demands escalated for free food resources with specific pressure placed on food banks and food recovery organizations. There were citizens who had not previously relied on free food services who found themselves in drive through pickups, waiting for pre-packaged food boxes or the occasional you-pick operation to feed their families and themselves. The increase in demand for free food services was reacted to by those leading and directing the free food distribution sites through a time of crisis. This qualitative study serves to analyze food recovery organization (FRO) leadership strategies and principles that guided their decision making and problem-solving skills in response to food shortages and supply chain issues. The merge of the eight pillars of transformational and servant leadership theory provided propositional pillars that were tested in practice through interviews with FRO leaders in Appalachia. The discovery of how these leadership strategies were enacted during a time of crisis will guide the development of a training curriculum for nonprofit leaders in the future.

SARS-CoV-2 is caused by a pathogenic and highly transmissible beta coronavirus leading to severe infections in immuno-compromised individuals. This study first evaluates the primers used in the Reverse Transcription Polymerase Chain Reaction (RT-PCR) to detect SARS-CoV-2 by understanding how mutations might affect the primer efficiency with the SARS-CoV-2 sequences. Mutations on the Spike protein of SARS-CoV-2 are the most important as the spike protein mediates the viral entry into host cells. This study tracks the course of mutations on the spike protein by focusing on the haplogroups of the sequences across the world. A comprehensive database linking three important, currently available databases is curated as part of this study to fill the gaps caused by sequencing errors. Further, this study exploits the data generated by the Illumina and Oxford Nanopore next generation sequencing methods to study the evolution of mutations in a single Septuagenarian patient over an infection period of 102 days using the gene analysis software Geneious Prime. / Master of Science / A novel corona virus named Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) has taken down the entire world by causing Covid-19 pandemic. Initially detected in Wuhan, China, the virus has now made its way to more than 200 countries with a heavy death toll. Understanding the virus through mutation tracking and improving diagnostics and vaccine design have now become the top priority of researchers. Most of these researchers depend on quality viral sequence datasets to identify and track mutations. One aim of this study is to provide a comprehensive dataset linking the GISAID (Global Initiative on Sharing All Influenza Data), NCBI (National Center for Biological Information) and the SRA (Sequence Read Archive) sequences. The dataset can be used for genome analysis and mutation tracking which can provide important insights for vaccine design and in improving diagnostic assays. In addition, this study provides an analysis of viral mutations in in the genomic regions targeted by commonly used primers in the RT-PCR tests for SARS-CoV-2 that may affect the efficiency of detection. This study also uses the haplogroup information of people across the world to track the D614G mutation on the S gene of SARS-CoV-2 as it may be associated with increased transmissibility. To track the course of mutations in SARS-CoV-2, it is important to analyze the sequencing data provided by the Illumina and Oxford Nanopore next generation sequencing methods. We present a case study to investigate the course of SARS-CoV-2 mutations in a single septuagenarian patient over a period of 102days using the Sequence Read Archive (SRA) data generated by two Next Generation Sequencing methods and compare the advantages that one has over the other.

Yes / Planetary health sees neoliberal capitalism as a key mediator of socioecological crises, a position that is echoed in much COVID-19 commentary. In this Personal View, I set out an economic theory that emphasises some of the ways in which neoliberal capitalism's conceptualisation of value has mediated responses to COVID-19. Using the intersection of ecological, feminist, and Marxist economics, I develop an analysis of neoliberal capitalism as a specific historical form of the economy. I identify the accumulation of exchange value as a central tendency of neoliberal capitalism and argue that this tendency creates barriers to the production of other forms of value. I then analyse the implications of this tendency in the context of responses to COVID-19. I argue that resources and labour flow to the production of exchange value, at the expense of production of other value forms. Consequently, the global capitalist economy has unprecedented productive capacity but uses little of this capacity to create the conditions that improve and maintain people's health. To be more resilient to coming crises, academics, policy makers, and activists should do theoretical work that enables global economies to recognise multiple forms of value and political work that embeds these theories in societal institutions.

In recent years, rare catastrophic disasters have triggered pharmaceutical supply chain disruptions, resulting in product shortages and other problems that have negatively impacted healthcare delivery. Since the health sector is part of many nations’ critical infrastructure, ensuring minimal disruption in the supporting supply chains is an essential aspect of national security. While traditional risk management approaches have proven adequate for handling independent routine operational risks, these methods are inadequate for infrequent disruptive risks that propagate further risks, producing a domino effect in complex systems. Since today’s pharmaceutical supply chains have many characteristics of complex systems, elucidating the disruptive risks and required resilience capabilities, through knowledge gained from actual disasters, can be valuable in developing mitigation strategies. This research aims to investigate two catastrophic disasters that disrupted pharmaceutical supply chains in recent years. The first case explores the impact of a localized Category IV hurricane that hit Puerto Rico and disrupted the supply chain for saline, an essential product used in the treatment of many illnesses. The risk events that propagated from the disaster are identified and modeled using a Bayesian network to determine where resilience should be strengthened. In accordance with ISO 31000 risk management guidelines, Bayesian networks have been identified as appropriate tools for modeling complex system risks. The second case employs a qualitative research study on the vaccine supply chain supporting mass immunization during the COVID-19 pandemic. A content analysis is conducted to extract the insights of over 100 professionals on disruptors and resilience capability requirements of the COVID-19 vaccine supply chain. The results indicate that a large and diverse set of risk factors and resilience capabilities are pertinent to pharmaceutical supply chains during localized severe weather and global pandemic disasters. Furthermore, to mitigate the impacts of severe weather risk in the case of Puerto Rico, the predominant type of resilience required is absorptive capacity, while in the case of the mass immunization vaccine supply chain, adaptive capacity is key. These findings should be useful to national leaders, pharmaceutical supply chain and healthcare sourcing managers, disaster preparedness officers, and others charged with pharmaceutical supply chain resilience.

Students and educators around the world faced many challenges when returning to the physical school building and environment after the disruption to our educational systems throughout the height of the COVID-19 pandemic. Educational leaders across the U.S. have expressed concerns over the substantially higher levels of anxiety and chronic absenteeism among adolescents. This study examined middle school adolescents' abilities to use coping skills for managing anxiety in the school environment post-pandemic. Qualitative data were collected from eight middle school counselors through one-on-one semi-structured interviews. Findings indicated an increase in the number of students presenting with symptoms of anxiety and the severity of symptoms. Middle school counselors noted an increase in school refusal and self-harm and indicated that the majority of their direct service time is spent with individual students. In order to better support students with managing anxiety, middle school counselors expressed the need for explicit coping skills instruction and additional mental health staffing in the school buildings. / Doctor of Education / Students and educators around the world faced many challenges when returning to the physical school building and environment after the disruption to our educational systems throughout the height of the COVID-19 pandemic. Educational leaders across the U.S. have expressed concerns over the substantially higher levels of anxiety and student absenteeism among adolescents. In this study, a total of eight middle school counselors who served as counselors prior to the pandemic and in the 2023-2024 school year participated in one-on-one interviews. Counselors were asked to describe their observations of adolescent coping strategies for managing anxiety in the school environment and share any differences in how they were working to support adolescents presenting with symptoms of anxiety. Middle school counselors reported an increase in the number of students presenting with symptoms of anxiety and the severity of symptoms. They also noted an increase in school refusal and self-harm and indicated that the majority of their time is spent with individual students. In order to better support students managing anxiety, middle school counselors expressed the need for explicit coping skills instruction and additional mental health staffing in the school buildings.

Yes / We interviewed people with dementia and carers from the IDEAL cohort to find out how the COVID-19 lockdown and continuing restrictions affected those living with dementia. Some people with dementia coped well, while others coped with difficulty or were only just coping. The additional stress of COVID-19 exacerbated pre-existing coping difficulties. For many, social isolation increased anxiety. Some felt that lack of activity or lack of social contact caused a decline in their abilities to manage everyday tasks. Confusion about COVID-19 rules or difficulty remembering what to do led to anxiety when leaving the house. People felt that members of the public might not understand their particular needs. While some carers felt they were coping well, others experienced stress when having to leave the home because the person with dementia might not be safe if left alone. Some experienced increased strain in the caring relationship compounded by an uncertainty about future availability of respite. Some were concerned about the complex health needs of the person with dementia alongside COVID-19 risk and lack of personalised information. Both people with dementia and carers talked about the importance of access to safe outdoor space. People were anxious about how others would react or behave towards them regarding keeping a distance if they went out. Being connected to friends, family and wider community or support groups was important to help combat the effects of isolation. People from BAME communities worried about their increased vulnerability to the virus. A lack of trust in Government guidance and in health care services added to their anxiety. However, some benefitted from strong community and faith group involvement. What might be helpful for people with dementia? • Reablement to help regain or maintain skills • Personalised health advice regarding managing COVID-19 risk and the opportunity to ask questions. • Identification of people with dementia who live alone and an assessment of their needs. What might be helpful for carers? • Needs assessment in regard to respite. • Novel forms of respite care that incorporate social distancing. What might be helpful for both carers and people with dementia? • Access to COVID-safe outdoor spaces. • Continuation and expansion of ‘just checking’ services. • Support to get online and use the internet. • Communication and information through non-digital means. • Community COVID-19 ‘dementia awareness’ initiatives. What might be helpful for people from Black and minority ethnic groups? • Addressing concerns about their increased risk of COVID-19. • Directing information and support through existing community and faith groups. / This report presents independent research funded by the National Institute for Health Research Policy Research Unit in Older People and Frailty.

Yes / The continuing COVID-19 pandemic and social restrictions have impacted on the cognitive decline and mental health of people with dementia. Social isolation and loss of activities due to social restrictions may also have implications as to sense of identity for people with dementia. As part of the INCLUDE (Identifying and Mitigating the Individual and Dyadic Impact of COVID-19 and Life Under Physical Distancing on People with Dementia and Carers) component of the IDEAL (Improving the Experience of Dementia and Enhancing Active Life) cohort study, the overall aim of this subtle realist qualitative study was to explore the perspectives of people with dementia on living through the COVID-19 pandemic within the context of the ‘post-vaccine’ period and the national lockdowns in England and Wales; and to determine perceived challenges to and facilitators of ‘living well’ during the COVID-19 pandemic and beyond as restrictions were eased. In addition, the study findings are considered in relation to understandings of identity in dementia which the broader accounts of living through the pandemic have highlighted. Seven people with mild-to-moderate dementia were interviewed and themes were derived using framework analysis. Themes suggest interviewees' stoic acceptance of the pandemic and social restrictions but also fear of decline related to the temporality of their condition as well as loss of self-confidence to re-engage with the world. Interviewees managed threats to social identity by striving to maintain social and emotional connections, where the importance of a shared, social identity, particularly for people with young-onset dementia, was also apparent. Unlike in previous studies during the pandemic, the relevance of occupation for identity was observed, where maintaining previous or new activities or occupations was important to facilitate identity as well as to keep a sense of purpose. Therefore, as well as supporting people with dementia as the pandemic eases, future research into occupation and identity in dementia is of potential value. / ‘Identifying and Mitigating the Individual and Dyadic Impact of COVID-19 and Life Under Physical Distancing on People with Dementia and Carers (INCLUDE)’ was funded by the Economic and Social Research Council (ESRC; grant number ES/V004964/1).