Faculty of Arts and Sciences

Lectures are common educational activities used in health profession education; however, they are often criticised for low learner engagement, satisfaction and learning experiences. Cognitive Load Theory (CLT) and Cognitive Theory of Multimedia Learning (CTML) can address these deficiencies. Currently, no tools exist to evaluate the extent of use of CLT and CTML as theoretical frameworks in lecture design. This research developed and validated a rubric to quantify the integration of CLT and CTML in lecture design. Two research questions guided the study: (1) What is the validity evidence according to the Messick framework for the use of a novel rubric as an assessment tool for Cognitive Load Theory and Cognitive Theory of Multimedia Learning Principles in respiratory lectures at the University of Sydney, Australia? (2) To what extent do anatomy and pathophysiology medical school lectures from the respiratory module incorporate principles of Cognitive Load Theory and Cognitive Theory of Multimedia Learning in their design and delivery? The project was conducted in two phases. Phase 1 focused on rubric development through expert input and iterative refinement. Fifteen assessors scored a lecture on histology of upper airways, yielding an intraclass coefficient (ICC) score of 0.59 (moderate inter-rater reliability (IRR)). Semi-constructed interviews gathered qualitative data, refining the rubric into a 12-item version. A second lecture on microbiology of pneumonia, scored by thirteen assessors achieved an ICC of 0.78 (good IRR), confirming no further revisions were needed. Phase 2 tested the rubric on three additional lectures covering anatomy of the upper and lower respiratory airways and pathophysiology of tuberculosis. This phase assessed the extent that CLT and CTML principles were integrated into lecture design and the consistency of IRR, yielding ICC scores of 0.99, 0.99 and 0.99 (excellent IRR). Principles 1-6, 10 and 11 associated with presentation skills, such as use of voice, visuals, gestures, and content organisation were highly used (92%-100%). Principles 7-9 and 12, associated with cognitive engagement and visual integration, were less frequently observed (0%- 62%). These results validate the rubric for assessing CLT and CTML integration in lecture design, helping medical educators optimise teaching strategies and improve educational experiences.

Lectures are common educational activities used in health profession education; however, they are often criticised for low learner engagement, satisfaction and learning experiences. Cognitive Load Theory (CLT) and Cognitive Theory of Multimedia Learning (CTML) can address these deficiencies. Currently, no tools exist to evaluate the extent of use of CLT and CTML as theoretical frameworks in lecture design. This research developed and validated a rubric to quantify the integration of CLT and CTML in lecture design. Two research questions guided the study: (1) What is the validity evidence according to the Messick framework for the use of a novel rubric as an assessment tool for Cognitive Load Theory and Cognitive Theory of Multimedia Learning Principles in respiratory lectures at the University of Sydney, Australia? (2) To what extent do anatomy and pathophysiology medical school lectures from the respiratory module incorporate principles of Cognitive Load Theory and Cognitive Theory of Multimedia Learning in their design and delivery? The project was conducted in two phases. Phase 1 focused on rubric development through expert input and iterative refinement. Fifteen assessors scored a lecture on histology of upper airways, yielding an intraclass coefficient (ICC) score of 0.59 (moderate inter-rater reliability (IRR)). Semi-constructed interviews gathered qualitative data, refining the rubric into a 12-item version. A second lecture on microbiology of pneumonia, scored by thirteen assessors achieved an ICC of 0.78 (good IRR), confirming no further revisions were needed. Phase 2 tested the rubric on three additional lectures covering anatomy of the upper and lower respiratory airways and pathophysiology of tuberculosis. This phase assessed the extent that CLT and CTML principles were integrated into lecture design and the consistency of IRR, yielding ICC scores of 0.99, 0.99 and 0.99 (excellent IRR). Principles 1-6, 10 and 11 associated with presentation skills, such as use of voice, visuals, gestures, and content organisation were highly used (92%-100%). Principles 7-9 and 12, associated with cognitive engagement and visual integration, were less frequently observed (0%- 62%). These results validate the rubric for assessing CLT and CTML integration in lecture design, helping medical educators optimise teaching strategies and improve educational experiences.

This dissertation is a study of the idea of individual rights in medieval European law and theology, ca. 1100–1360. It examines the terms dominium and ius in Roman juristic usage, and explains how and why the idea of ius (which means both “law” and “right”) changed in late-medieval law and theology. Two separate ideas of individual rights appeared in the later middle ages, one in academic law, and the other in canonistic and theological writing. The former remained beholden to the systematic jurisprudence of the Roman jurists, insofar as it preserved the distinction between rights in property and rights arising from obligations. The latter often ignored this distinction. As a result, the later middle ages transmitted to early modern European thought two incompatible ways of thinking about rights. The dissertation suggests that their incompatibility had long-lasting consequences for rights theories in European and Anglo-American law.

Health policy and racism are extremely intertwined in American politics. Racism is not only a social ill, but also contributes to poor health outcomes for minorities. Major events like the COVID-19 pandemic, the Black Lives Matter movements after the death of George Floyd, and the January 6th Capitol Riots further highlight the tension between health policy and equitable policies. This interdisciplinary dissertation aims to explore this relationship further within this context. It will use statistical methods, legal analysis, and survey methods to engage with these questions.

This dissertation is a labor history of the early-twentieth-century kisaeng, a class of women entertainers in Korea whose labor comprised a fluid combination of musical performance and sexual commerce. While the figure of the kisaeng had existed under different names and in varying roles over centuries, the combination of the abolition of the caste system and the encroachment of Japanese colonial rule at the turn of the twentieth century caused the kisaeng to be released from their previous matrilineal caste status and a system of state patronage into a competitive, police-regulated entertainment labor market. The colonial state’s subsequent bifurcation of the kisaeng into licensed sex workers and licensed musical entertainers through state-mandated licensing and increasingly corporatized management systems sets the stage for this dissertation’s account of the kisaeng’s labor actions, radical anti-imperialist activities, and struggles against criminalization from within Korea’s entertainment districts. The history of the kisaeng presented here relies on an archival study of colonial-period periodicals, police reports, colonial bank records, and sparse but extant autobiographical writings and testimonials by kisaeng of the early-twentieth century. The reading of these materials is inflected through a careful study of influential politico-ideological discourses and activities in East Asia’s interwar period and of the politico-economic context of colonial-capitalist development in Korea. By positioning the early-twentieth-century kisaeng as composite entertainment laborers who were intimately attuned to the workings of colonial capital, I furnish a reading of imperial capitalism’s impact on precarious and marginalized labor and particularly on women’s state-regulated entertainment work, and of the failure of the political Left in colonial Korea to recognize the sovereignty and political consciousness of entertainment workers. While the kisaeng have generally been historicized as subaltern subjects in an account of Japanese colonialism’s violence against Korean women in general, I aim to reframe the kisaeng as laboring people with complicated and contradictory relations to their work, to capital, and to the state, whose lives hold meanings more broadly than as symbols of colonialism’s emasculation of the nation and whose relevance extends to sexual commerce in modern-day South Korea. The study of how the kisaeng navigated and expressed their sometimes revolutionary and often contradictory desires against the forces of state regulation, capitalist exploitation, and public censure, resists seamless interpolations into accounts of abject victimhood in existing nationalist discussions of women’s sex-and-entertainment labor. In counterpoint to the rich body of existing musicological studies of the kisaeng, and to the field of music studies at large, this history of the kisaeng enacts a turn from the study of “artists” to the study of “laboring people,” departing from the question of how a focus on artists and artistic production can lend itself to abstraction from histories of capitalist systems. From the way that the artistic labor of kisaeng was forcibly separated from and protected over the sexual labor of kisaeng in discursive and judicial means during the colonial period, to the way that the kisaeng is recuperated today through a focus on their artistic legacy over their composite entertainment labor, it is possible to see how the sexual labor was seen as an abhorrent form of commodification, while the artistic labor was seen as an abstract labor of love which resists or floats above classification as “transaction” or relations of exchange. In this sense, this labor history of the kisaeng also serves as a site to explore how the delimitation of an artist always produces, at the same time that it erases, foils separated by classed, racial, and moral hierarchies of work.

This dissertation consists of three essays about the broad structural and technological changes to the US economy over the past fifty years, and their macroeconomic implications.

Chapter 1 looks at the relationship between the rise of IT and the rise in industrial concentration. Over the past four decades, most sectors of the US economy have become significantly more concentrated: a small number of large firms now have a much larger market share. Using administrative microdata on firms in every sector of the US economy, including new administrative data on firm-level IT investments, I show that the IT Revolution \disproportionately benefited the largest firms - an instance of what we might call scale-biased technological change (ScBTC). I document that the largest firms have invested more intensively in IT than smaller firms have, particularly in the most advanced and proprietary kinds of IT. I also document that larger firms are generally more capital intensive than smaller firms, and operate at higher returns to scale, but that large firms invest an even greater share of their capital expenditures on IT than small firms do. I discuss how production function estimates and a model of firm heterogeneity and fixed costs might be used to show how the decline in the price of IT ultimately led to the rise of US industrial concentration, and how this can be distinguished from competing causal theories about a fall in competition or a rise in competition. Simple calibration exercises can quantitatively generate large increases in concentration from declines in the price of IT.

Chapter 2, joint work with Jan De Loecker and Jan Eeckhout, looks at the relationship between rising industrial concentration, and rising aggregate markups. We document the evolution of markups based on firm-level data for the US economy since 1955. Initially, markups are stable, even slightly decreasing. In 1980, average markups start to rise from 21% above marginal cost to 61% now. The increase is driven mainly by the upper tail of the markup distribution: the upper percentiles have increased sharply, while the median is unchanged. In addition to fattening upper tail of the unweighted markup distribution, there is reallocation of market share from low to high markup firms. This rise occurs mostly within industry for {\it all} industries. We also find an increase in profits. While there is some increase in overhead costs, the markup increase is in excess of overhead. We then discuss the macroeconomic implications of an increase in average market power, which can account for a number of secular trends in the last four decades, most notably the declining labor and capital shares as well as the decrease in labor market dynamism.

Chapter 3 presents a broad research agenda going forward for understanding the macroeconomics of structural transformation, and specifically outlines some speculative theories about our basic theories about economic growth, and the business cycle.

This dissertation explores ways to account for heterogeneity in health decision analysis, including: the integration of individual-level risk factors into a chronic disease simulation model, evaluation of personalized blood pressure treatment decisions, and inclusion of varying community risks and preferences in a decision analysis of COVID-19 mitigation measures in schools.

Microsimulation models are often used to conduct health decision analyses for chronic disease screening and prevention strategies. These simulations track how individual-level risk factors change over time and predict disease incidence based on those risk factors, which allows decision-makers to model how different risk factor screening strategies (e.g., start atrial fibrillation screening at age 65) could impact incidence and health outcomes. In Chapter 1, we evaluate how accurately methods to parameterize these simulation models replicate observed data. In a case study using an ischemic stroke simulation model, we introduce the use of joint longitudinal and time-to-event models to parameterize the simulations and compare it to existing approaches that use standard regression and survival analysis techniques. We find that simulations parameterized with the joint model approach more accurately predict ischemic stroke incidence than existing parameterization approaches. These results indicate that joint longitudinal and time-to-event models can be used to create more precise simulation models and potentially improve chronic disease screening and prevention decision analyses.

Intensive blood pressure treatment significantly reduces the risk of cardiovascular disease events, like heart attack and stroke, but can have significant drawbacks compared to standard options (e.g., side-effects, increased medical costs). Personalized decisions that target intensive treatment towards those most likely to benefit could help mitigate these trade-offs, and previous work has estimated the heterogeneous treatment effects (HTEs) of intensive treatment across different types of patients to guide treatment decisions. In Chapter 2, using data from the SPRINT trial, we estimated the HTEs of intensive treatment using a range of methods and evaluated whether making personalized treatment decisions based on these estimates would improve overall outcomes relative to a non-personalized decision. We found that using HTEs to guide treatment decisions did not improve outcomes if the objective was to only treat individuals who have at least a minimum level of benefit from treatment (e.g., 5% decrease in cardiovascular disease risk). However, when there was a constraint on the number of individuals who could receive intensive treatment and the objective was to allocate those treatments to those most likely to benefit (i.e., no minimum benefit level), using HTEs to assign treatment improved outcomes when individuals were stratified over a few subgroups. These results demonstrate that using HTEs to personalize treatment decisions would likely only improve outcomes in specific contexts and, more broadly, that it is important to account for the decision objective when evaluating HTE estimates.

Mitigation measures like masks and ventilation have the potential to reduce COVID-19 incidence in elementary schools, but policies like mask mandates are generally temporary measures and come with drawbacks (e.g., potential impact on learning). When making decisions around mitigation policies, school districts must balance the health benefits of reduced COVID-19 incidence against these drawbacks. In Chapter 3, to help guide these decisions, we used an agent-based simulation model to estimate how COVID-19 incidence in elementary school communities is associated with in-school mitigation measures. We conducted the analysis across varying levels of local incidence in the surrounding area and vaccination within the school community. We found that school community incidence decreased with mitigation and vaccination and increased with local incidence. The local incidence thresholds for when school communities should change mitigation measures depended on their objective (e.g., keeping additional cases from ending mask mandates below 10 vs. 20 cases per month). These findings suggest that appropriate increases and decreases for in-school mitigation depend on policy makers’ goals, and that responsive plans, where mitigation is deployed based on local COVID-19 incidence and vaccine uptake, can help meet these goals.

Chemical synthesis has transformed the ability of scientists and engineers to interact with the molecular world. Yet despite almost two centuries of considerable effort, small-molecule synthesis remains a challenging task. Hundreds of new reactions are discovered every year, but few possess the requisite selectivity and generality needed to be useful for routine synthesis, and elucidation of their mechanism and underlying catalytic principles is rarely conducted. In this work, we describe a variety of efforts at the interface of organic, computational, and analytical chemistry which seek to address the linked problems of discovering selective organocatalysts and understanding the mechanism by which they operate. In Chapter 1, we report the development of a new analytical method that combines chiral stationary phase supercritical fluid chromatography with mass spectrometry-based detection to enable enantiodetermination of pooled crude reaction mixtures, greatly increasing analytical throughput. This advance allows us to perform multi-substrate screening to discover catalysts possessing good substrate scope, which we demonstrate in the optimization of a Brønsted acid catalyst for the enantioselective Pictet–Spengler reaction. In Chapter 2, we disclose the results of a mechanistic study aimed at understanding a hydrogen chloride/hydrogen-bond donor co-catalyzed Prins cyclization of alkenyl aldehydes which exhibited dramatic rate acceleration compared to the background reaction. Our studies reveal that the catalyst reacts with hydrogen chloride to form a new chiral acid in situ with a higher pKa than hydrogen chloride, which nevertheless reacts faster owing to favorable catalyst-controlled positioning of the chloride anion to electrostatically stabilize the major transition state. In Chapter 3, we report a computational study of our group’s regio- and stereoselective glycosylation of minimally protected glycosyl acceptors. The computational model described— the first of hydrogen-bond-donor-catalyzed glycosylation of glycosyl phosphate donors—contains features of the transition state previously hypothesized on the basis of experimental results, and lends support to the proposed “4H” binding mechanism. In Chapter 4, we describe the development of an enantioselective protio-semipinacol reaction of unactivated vinylic cyclopropanols. Motivated by the question of how high enantioselectivity can be achieved in a low-barrier 1,2-rearrangement, we conduct an experimental and computational mechanistic investigation and come to the surprising conclusion that protonation to form a formally achiral carbocation in fact exerts stereocontrol over the subsequent rearrangement step: the rearrangement is so rapid that the carbocation is locked in a given chiral conformation, rendering the rearrangement effectively stereospecific. Finally, in chapter 5 we detail a spectroscopic and computational study of solutions of hydrogen chloride in diethyl ether, aimed at assigning the solution structure of hydrogen chloride. In situ IR spectroscopy, combined with density-functional theory and molecular dynamics, provides evidence for the existence of oxonium ions formed from complete proton transfer to diethyl ether. This observation explains the often-inhibitory effect of diethyl ether on hydrogen chloride-catalyzed reactions and has intriguing implications for catalyst design.

This dissertation investigates how energy extraction since the 1970s enabled the birth of market-based policies for environmental protection. Through an investigation of surface mined land reclamation programs in Canada and the United States, I draw a connection between coal and oil extraction and larger shifts in environmental-economic thought. Scholars in critical geography have increasingly critiqued the capitalist motivations behind market-based environmental protection measures, however they have not addressed in detail the processes through which these measures emerged. My work contends that post-extractive land reclamation programs created a new political understanding of nature fundamental to the implementation of market-based environmental policy practiced today. This dissertation uses mined land reclamation programs in North America as a historical practice through which to explore long term changes in the capitalist construction of nature over the latter half of the twentieth-century. As the only form of regulation for surface mining today, land reclamation is the act of restoring and rehabilitating environments destroyed by mining to a state equal to or better than their pre-mined state of productivity. These programs transformed the political conception of nature from an assemblage of natural resources to one consisting of “natural capital,” in which qualities like aesthetics, ecosystems, and biodiversity imbue the environment with value. This process rendered landscapes amenable to new forms of market-based policies and regulatory instruments. My research necessarily emphasizes interdisciplinary connections, requiring investigations of economic theory, ecological techniques, and landscape design. I analyze the methods employed by reclamation professionals as political instruments used to enact legislative changes, develop new land uses, and undermine unionized labor practices. While this work is important to histories of environmental policy, my investigation also reveals how spatial and material histories are essential to understanding the politics of the environment.

In the 20th century, Chinese leaders in the Republic of China (ROC) and the People’s Republic of China (PRC) considered systemic corruption to be a serious threat to their respective state-building projects. To address this problem, both the ROC and PRC leaders conducted anti-corruption campaigns that not only led to disciplinary measures, but also criminal charges against accused officials. At the same time, the campaigns spurred the development of new regulations to combat corruption, the establishment of new oversight institutions, and the empowerment of the judiciary. Because of the state’s increased involvement in the modern nation’s economic development, some of these campaigns were implemented as an integral part of the government’s economic policies. Indeed, the regulation of commerce sometimes necessitated the state’s oversight of officials suspected in the “mismanagement” of government-owned corporations. As a result of these anti-corruption campaigns, the judicial system and the supervisory agencies did succeed, to some extent, to provide a form of “check and balances” over the conduct of Chinese officials in the 20th Century. This dissertation, however, does not make the claim that the Guomindang and the Chinese Communist Party embraced Montesquieu’s vision of state governance. In the 20th Century, the prerogatives of party-state precluded any attempts to foster judicial independence in China. Nonetheless, even in a system of rule that is predicated on the supremacy of party leadership, the courts and other supervisory bodies could still exert a degree of influence in the government. It is arguable that, with the help of the campaigns, they could still serve important functions in overseeing official behavior in modern China.