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New Blogger Emily Zou: Bound By a Promise

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My eyes peered at my mom’s hand, rarely blinking. My ever-bouncing leg had stilled. My mind caught every subtle movement, attempting to decipher the pattern. I watched, entranced, as my mom’s fingers nimbly wove together the pieces of red thread into the bracelet I would wear every day for the rest of my life.

My senior photo, red string bracelet on my left wrist.

Chinese red string bracelets are a symbol of luck, prosperity, health, protection, and courage. In ancient China, the emperor would give his first, therefore most important, wife a red string bracelet. Similarly, red string bracelets are gifted to newlywed couples to commemorate their true love and wish them well in a new stage of their lives. Close relatives also gift a red string bracelet to women and girls on their 本命年 (Year of Birth), in order to protect them from the negative energy they will face that year.

A bracelet serves as a physical representation of a promise. Most obviously, a friendship bracelet shows a promise to love and trust your matching bracelet wearer. But any string on your wrist represents a promise. A W.W.J.D. band serves as a promise of faith and to live like Christ. A 4Ocean beaded bracelet is a promise to care for the Earth’s aquatic life. Even an Apple Watch is a promise to live healthily.

I was given my red string bracelet by my mom in 2016 (the Year of the Monkey). When I wear it, I remember my family’s unconditional love for me and the history of my Chinese heritage. The bracelet serves as a mutual agreement between my family and me: to protect and look after one another.

My name is Emily Zou and I’m a freshman from a suburb outside of Portland, Oregon. The bracelet my mom made 6 years ago sat on my wrist the entire flight from PDX to RDU. Similarly, my parents’ promise is what has landed me here. Throughout the past 18 years of my life, my parents have taken care of me: they cooked me dinner at 9 pm after school board meetings, drove me 4 hours to debate tournaments at 4 a.m., cut endless bowls of fruit for late night study sessions, and of course, are paying my college tuition.

My mom and I at Blue Devils Day, when I committed to Duke. Notice the left wrist 😉

A promise is a unique moral obligation. The obligation isn’t inherent; there’s no biological or evolutionary reason to keep a promise. It’s also not for fear of consequence; simply breaking a promise does not inflict physical or emotional damage on you, but rather the consequence is the act itself. And yet, promises are expected to be kept universally, regardless of scope, culture, or time period. This is because just like a red string bracelet, a promise is made with intentionality. Just like each knot must be precisely made, so must each part of a promise.

Now, it’s my turn to uphold my end of the promise. I’m extremely lucky to attend a university like Duke, and I plan to use every opportunity possible to someday give my parents even half of what they’ve given me throughout my childhood. And not just to my parents, but to the rest of the world, as well. I believe that each one of us wears a metaphorical bracelet symbolizing our promises to society. To protect one another and leave this world better than how we found it.

My bracelet sits perfectly positioned against the pulsing heartbeat in my wrist’s veins, pumping its promise into my veins to accompany the red blood cells to every part of my body. It remains visible as I ride the C1 to my Economics lecture, code an APT, or throw a ceramic piece on the wheel. As long as a bracelet is worn, its wearer swears to keep their promise. However, much like a bracelet worn every day, it’s often easy to forget the various commitments in daily life. Friendship bracelets fray, W.W.J.D. bands become stained, and Apple Watches become simply a way to check text messages.

Our society’s foundation is based on promises: promises to value community, act with integrity, abide by the law, show up to work or school, put our shopping carts away, etc. Some of the most important promises are made by leaders and institutions. If we anthropomorphize the American government, we can imagine the slew of red string bracelets it hands out to its citizens, each representing a different promise. These promises are explicitly laid out in the preamble to the Constitution: to “establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity.” More specifically, each amendment lays out a specific promise from the government to the people about certain rights and privileges. However, it seems that in its daily wear and tear, the US Government has forgotten about its promise to its people as we experience daily violations of these promises.

My mom and I at graduation; again, you can see my red string bracelet on my left wrist.

This is what I want to discuss at Duke, and more specifically, on the Duke Research Blog. Promises transcend so many different academic and research fields: the promises parents make to their children, promises schools make to their students, promises countries make to their citizens.

When we tie the knot around our wrist for the very first time, the bracelet’s strings taut and secure, it’s simple to uphold its promise for the days following. Hyper aware of its presence, each time we move our arm, we recognize it: I made an effort to improve my Mandarin during the first days of the Year of the Monkey; the recently converted attend church every Sunday; Apple Watch users take their 10,000 steps. However, as our minds become used to the bracelet, or overwhelmed by the fresh new ones, its promises become obsolete. This phenomenon can only be reversed when we ground ourselves in the intentions of our bracelets: to protect one another, the marginalized, and our planet.

At Duke, I’m weaving my bracelets from scratch, which includes the Duke Research Blog. But a lot of my future bracelets are still up in the air. I’m still collecting my strings, and I’m learning that that is okay. And moving forward, not all of my posts will wax so philosophical, actually, probably none of them will. I just figured if I get one opportunity to make a first impression, I might as well share my life philosophy.

Post by Emily Zou, Class of 2027

Meet Some of the Teams at the Bass Connections Showcase

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If you weren’t outside enjoying the sun on Wednesday, April 19, you were probably milling around Penn Pavilion, a can of LaCroix in hand, taking in the buzz and excited chatter of students presenting at the 2023 Fortin Foundation Bass Connections Showcase.

Open floor presentations at the 2023 Bass Connections Showcase

This annual celebration of Bass Connections research projects featured more than 40 interdisciplinary teams made up of Duke faculty, graduate students, undergraduate students, and even partners from other research institutions.

Research teams presented posters and lightning talks on their findings. You might have heard from students aiming to increase representation of women in philosophy; or perhaps you chatted with teams researching physiotherapy in Uganda or building earthquake warning systems in Nepal. Below, meet three such teams representing a wide variety of academic disciplines at Duke.

Building sustainable university-community partnerships

As Bass Connections team member Joey Rauch described, “this is a poster about all of these other posters.” Rauch, who was presenting on behalf of his team, Equitable University-Community Research Partnerships, is a senior double-majoring in Public Policy and Dance. His interest in non-profit work led him to get involved in the team’s research, which aims to offer a framework for ethical and effective university-community research collaboration – exactly what teams do in Bass Connections. The group looked at complicated factors that can make equitable relationships difficult, such as university incentive structures, power dynamics along racial, socioeconomic, and ethnic lines, and rigid research processes.

Senior Joey Rauch with his team’s 2nd-place poster!

Along the lines of rigid research, when asked about what his favorite part of Bass Connections has been, Rauch remarked that “research is oddly formal, so having a guiding hand through it” was helpful. Bass Connections offers an instructive, inclusive way for people to get involved in research, whether for the first or fourth time. He also said that working with so many people from a variety of departments of Duke gave him “such a wealth of experience” as he looks to his future beyond Duke.

For more information about the team, including a full list of all team members, click here.

Ensuring post-radiation wellness for women

From left to right: seniors Danica Schwartz, Shernice Martin, Kayle Park, and Michelle Huang

Seniors Michelle Huang, Shernice Martin, Kayle Park, and Danica Schwartz (all pictured) were gathered around the poster for their team, Promoting Sexual Function and Pelvic Health in Women’s Healthcare.

The project has been around for three years and this year’s study, which looked at improving female sexual wellness after pelvic radiation procedures, was in fact a sister study to a study done two years prior on reducing anxiety surrounding pelvic exams.

As Huang described, graduate students and faculty conducted in-depth interviews with patients to better understand their lived experiences. This will help the team develop interventions to help women after life events that affect their pelvic and sexual health, such as childbirth or cancer treatment. These interventions are grounded in the biopsychosocial model of pain, which highlights the links between emotional distress, cognition, and pain processing.

For more information about the team, including a full list of all team members, click here.

From dolphins to humans

Sophomores Noelle Fuchs and Jack Nowacek were manning an interactive research display for their team, Learning from Whales: Oxygen, Ecosystems and Human Health. At the center of their research question is the condition of hypoxia, which occurs when tissues are deprived of an adequate oxygen supply.

Sophomores Noelle Fuchs and Jack Nowacek

Hypoxia is implicated in a host of human diseases, such as heart attack, stroke, COVID-19, and cancer. But it is also one of the default settings for deep-diving whales, who have developed a tolerance for hypoxia as they dive into the ocean for hours while foraging.

The project, which has been around for four years, has two sub-teams. Fuchs, an Environmental Science and Policy major, was on the side of the team genetically mapping deep-diving pilot whales, beaked whales, and offshore bottlenose dolphins off the coast of Cape Hatteras  to identify causal genetic variants for hypoxia tolerance within specific genes. Nowacek, a Biology and Statistics double-major, was on the other side of the research, analyzing tissue biopsies of these three cetaceans to conduct experiences on hypoxia pathways.  

The team has compiled a closer, more interactive look into their research on their website.

And when asked about her experience being on this team and doing this research, Fuchs remarked that Bass Connections has been a  “great way to dip my toe into research and figure out what I do and don’t want to do,” moving forward at Duke and beyond.

For more information about the team, including a full list of all team members, click here.

Post by Meghna Datta, Class of 2023

Recovery, Resilience, and Coexistence: Nature-based Solutions on the Coast

When it comes to balancing the needs of humans and the needs of nature, “Historically it was ‘develop or conserve’ or ‘develop or restore,’” says Carter Smith, Ph.D., a Lecturing Fellow in the Division of Marine Science & Conservation who researches coastal restoration.

However, according to Brian Silliman, Ph.D., Rachel Carson Distinguished Professor of Marine Conservation Biology, “We are having a new paradigm shift where it’s not just… ‘nature over here’ and ‘humans over here.’”

Instead, conservation initiatives are increasingly focusing on coexistence with nature and ecological resilience, according to this panel discussion of marine science experts during Duke Research and Innovation Week 2023.

Nature-based solutions — protecting and restoring natural shoreline habitats — have a proven role in protecting and restoring coastal ecosystems. According to the International Union for Conservation of Nature (IUCN), “Nature-based solutions… address societal challenges effectively and adaptively, simultaneously benefiting people and nature.”

The panel, moderated by Andrew J. Read, Ph.D., Stephen A. Toth Distinguished Professor of Marine Biology and Professor of Marine Conservation Biology, also included Brian Silliman, Carter Smith, and Stephanie Valdez, a Ph.D. Student in Marine Science & Conservation.

Living shorelines can help protect coastal ecosystems from storms while also offering benefits for climate and conservation. Photos by Carter Smith.

According to Smith, nature-based solutions can “leverage nature and the power of healthy ecosystems to protect people” while also preserving biodiversity and mitigating climate change. She spoke about living shorelines as an effective and ecologically responsible way to protect coastal ecosystems.

“The traditional paradigm in coastal protection is that you build some kind of hard, fixed structure” like a seawall, Smith said, but conventional seawalls can have negative effects on biodiversity, habitats, nutrient cycling, and the environment at large. “In this case, coastal protection and biodiversity really are at odds.”

After multiple hurricanes, living shorelines had significantly less visible damage or erosion than sites with conventional hardscape protection, like seawalls.

Nicholas Lecturing Fellow Carter Smith

That’s where living shorelines come in. Living shorelines incorporate plants and natural materials like sand and rock to stabilize coastal areas and protect them from storms while also creating more natural habitats and minimizing environmental destruction. But “if these structures are actually going to replace conventional infrastructure,” Smith says, it’s important to show that they’re effective.

Smith and colleagues have studied how living shorelines fared during multiple hurricanes and have found that living shorelines had significantly less “visible damage or erosion” compared to sites with conventional storm protection infrastructure.

After Hurricane Matthew in 2016, for instance, both natural marshes and conventional infrastructure (like seawalls) lost elevation due to the storm. Living shorelines, on the other hand, experienced almost no change in elevation.

Smith is also investigating how living shorelines may support “community and psychosocial resilience” along with their benefits to biodiversity and climate. She envisions future community fishing days or birdwatching trips to bring people together, encourage environmental education, and foster a sense of place.

PhD student Stephanie Valdez then spoke about the importance of coastal ecosystems.

Blue carbon ecosystems,” which include sea grasses, marshes, and mangroves, provide services like stabilizing sediments, reducing the destructive force of powerful waves, and storing carbon, she said. These ecosystems can bury carbon much faster than terrestrial ecosystems, which has important implications when it comes to climate change.

In the atmosphere, carbon dioxide and other greenhouse gasses contribute to global warming, but plants pull carbon dioxide out of the air during photosynthesis and convert it to carbohydrates, releasing oxygen as a byproduct. Therefore, ecosystems rich in fast-growing plants can serve as carbon sinks, reducing the amount of atmospheric carbon, Valdez explained.

Unfortunately, blue carbon ecosystems have suffered significant loss from human activities and development. We’ve replaced these wild areas with farms and buildings, polluted them with toxins and waste, and decimated habitats that so many other creatures rely on. But given the chance, these places can sometimes grow back. Valdez discussed a 2013 study which found that seagrass restoration led to a significantly higher carbon burial rate within just a few years.

Sea grasses, marshes, and mangroves provide services like stabilizing sediments, reducing the destructive force of powerful waves, and storing carbon.

PhD Student Stephanie Valde

Valdez also talked about the importance of recognizing and encouraging natural ecological partnerships within and between species. Humans have taken advantage of such partnerships before, she says. Consider the “Three Sisters:” beans, corn, and squash, which Native Americans planted close proximity so the three crops would benefit each other. Large squash leaves could provide shade to young seedlings, beans added nitrogen to the soil, and cornstalks served as a natural beanpole.

Recognizing that mutualistic relationships exist in natural ecosystems can help us preserve habitats like salt marshes. Valdez points to studies showing that the presence of oysters and clams can positively impact seagrasses and marshes. In restoration, it’s important “that we’re not focusing on one species alone but looking at the ecosystem as a whole”—from top predators to “foundation species.”

“There is hope for successful restoration of these vital ecosystems and their potential to aid in climate change mitigation,” Valdez said.

Finally, Prof. Brian Silliman discussed the role of predators in wider ecosystem restoration projects. Prioritizing the protection, restoration, and sometimes reintroduction of top predators isn’t always popular, but Silliman says predators play important roles in ecosystems around the world.

“One of the best examples we have of top predators facilitating ecosystems and climate change mitigation are tiger sharks in Australia,” he says. When the sharks are around, sea turtles eat fewer aquatic plants. “Not because [the sharks] eat a lot of sea turtles but because they scare them toward the shoreline,” reducing herbivory.

However, Silliman said it’s unclear sometimes whether the existence of a predator is actually responsible for a given benefit. Other times, though, experiments provide evidence that predators really are making a difference. Silliman referenced a study showing that sea otters can help protect plants, like seagrasses, in their habitats.

Restoring or reintroducing top predators in their natural habitats can help stabilize ecosystems impacted by climate change and other stressors.

And crucially, “Predators increase stress resistance.” When physical stressors reach a certain point in a given ecosystem, wildlife can rapidly decline. But wildlife that’s used to coexisting with a top predator may have a higher stress threshold. In our ever-changing world, the ability to adapt is as important as ever.

“I think there is great optimism and opportunity here,” Silliman says. The other speakers agree. “Right now,” Valdez says, “as far as restoration and protection goes, we are at the very beginnings. We’re just at the forefront of figuring out how to restore feasibly and at a level of success that makes it worth our time.”

Restoring or reintroducing top predators in their natural habitats can help stabilize ecosystems impacted by climate change and other stressors.

Brian Silliman

Smith emphasized the important role that nature-based solutions can play. Even in areas where we aren’t achieving the “full benefit of conserving or restoring a habitat,” we can still get “some benefit in areas where if we don’t use nature-based solutions,” conservation and restoration might not take place at all.

According to Valdez, “Previously we would see restoration or… conservation really at odds with academia itself as well as the community as a whole.” But we’re reaching a point where “People know what restoration is. People know what these habitats are. And I feel like twenty or thirty years ago that was not the case.” She sees “a lot of hope in what we are doing, a lot of hope in what is coming.”

“There’s so much that we can learn from nature… and these processes and functions that have evolved over millions and millions of years,” Smith adds. “The more we can learn to coexist and to integrate our society with thriving ecosystems, the better it will be for everyone.”

Post by Sophie Cox, Class of 2025

Truman Scholar Maya Durvasula, T’18, on her Research Journey Through Duke and Beyond

Maya Durvasula, T’18, and a current Ph.D. student at Stanford University, grew up in Albuquerque, New Mexico. “And it’s hard to grow up there without a very keen sense of what it looks like when policy doesn’t work for people,” she remarks.

Maya Durvasula, T’18

After graduating high school with an interest in politics, she decided to take a gap year and bounced around organizations in New Mexico, working for the state legislature, political campaigns, and even a think tank. In hindsight, she says, “Having a block of time where you have time is super helpful.” One thing she learned was that she didn’t really want to do politics. “People were making policy, but debates were heavy on feelings and politics and light on facts.”

A high school mentor suggested that maybe she would get along better with economists than politicians, so once she got to Duke, she took that to heart.

As a first-year, she says, she knew she wanted to be exposed to a lot of things, and she knew she wanted to do research, but she wasn’t really sure what “research” meant for a first-year. In the beginning, she cold-emailed a lot of people and received multiple rejections.

After rejection, though, eventually something clicks, and for Durvasula, what clicked were three main research projects she undertook in her time at Duke.

The instinct is always to start with where you want to end up and then work backward, but you don’t know where you’re going to end up”

Maya Durvasula, T’18

Her first experience in a research group was a joint venture between an academic team in China and at UNC-Chapel Hill. Their group studied behavioral interventions to increase the uptake of health technologies, with a particular focus on sexual health. Usually, as a country industrializes, the rates of sexually transmitted infections will drop, but in China, rates of HIV and syphilis continued to rise as the economy grew. Durvasula and the team looked at different interventions that might make testing for HIV more attractive to patients, such as alternative testing locations, different advertisement design, and compensation.

She also did a project with Duke professor Bob Korstad in the history department and the Samuel DuBois Cook Center on Social Equity, looking at the history of housing in Durham. Finally, she worked with her primary advisor, Duke economics professor Duncan Thomas, in his joint lab with UNC’s Elizabeth Frankenberg, on projects related to household decision-making in Indonesia.

Duke Economics Thesis Symposium in 2018

A notable part of her undergraduate time at Duke was winning the Truman Scholarship. What was most valuable to her about the Truman was the people she met. “Most people I’ve met are defined by picking something they care about and doing a lot with it,” she says. And it’s inspiring to be surrounded by people who love what they do and immerse themselves so wholly in it.

Duke Economics Graduation, 2018

Durvasula graduated Duke with numerous experiences and accolades under her belt. But from there, how did she find her way to doing a Ph.D. at the intersection of law, technology, and economics? As she describes it, the interplay between economics and law is inextricable. Both economic incentive and legal institutions affect the rate and direction of innovation, which affects how quickly technology is developed, and ultimately what products ends up in our hands. A question at the heart of her research is wondering how to make sure the value of this technology is distributed equally across society.

So five to ten years from now, where will we see Durvasula? She sees herself remaining in academia, although at some point she wants to work in public service. “I love learning new things, and I want to take advantage of being in a space where people are always willing to teach you things.”

And in that vein, her advice to a curious Duke student is to explore everything. “The instinct is always to start with where you want to end up and then work backward, but you don’t know where you’re going to end up,” she said.

Pursue the questions that you find exciting, and let that point you in the right direction – clearly, Durvasula is proof that this process will take you places.

Post by Meghna Datta, Class of 2023

Working with Humans and Animals to Save What’s Left

“Krithi  Karanth is…” begins a long sentence if not pruned, so I will settle on the following: Dr. Karanth is the Chief Conservation Scientist and Director at the Centre for Wildlife Studies in India, an adjunct professor in the Nicholas School at Duke, and a Vogue Woman of the Year

On Oct. 13, she visited her alma mater to catch us up on her work.

Karanth grew up in close contact with an abundance of wildlife as the daughter of tiger biologist Dr. Ullas K. Karanth in India. Her first experience in the jungle was at the ripe age of one, and she credits this “sheer joy of watching nonhumans uninterrupted” as the basis for her deep concern and care for wildlife.  

Krithi Karanth, Ph.D. (2008)

She received her Ph.D from the Nicholas School after scouring historic hunting journals and interviewing Indian wildlife scientists to build a database that documents the havoc wreaked on wildlife populations in India, beginning in the mid-nineteenth century. The results are gut-wrenching, among them: an estimated 96% plunge in the lion population, 67% drop in tigers, and a 62% decline in wolves.

After thirteen years studying and researching in the U.S., Karanth returned home to India, where she felt her impact could be greater.  

Today, large British hunting parties are no longer the main cause of species decline in India. Instead, man and beast find themselves stepping on each other’s toes and tails more and more as towns expand and animals like elephants and leopards lose their habitats.

At the Centre for Wildlife Studies, Karanth’s work focuses on mitigating the most prevalent problems in human-wildlife interaction: crop and property damage, livestock predation, and human injury and death.

Her tactics for doing so are expansive. At CWS, she leads several initiatives targeting different sides of the problem.

WildSeve deploys timely assistance to people, most often farmers, dealing with destructive wildlife encounters. Farmers can call a toll free number, and a member of the team will ride out to their farm to help document the incident and file a claim for government compensation, allowing farmers to complete what would otherwise be an arduous and expensive legal process. In “peak season,” between October and November when many farmers are growing a cover crop known to attract elephants, WildSeve deploys as many as thirty conflict responders per day.

Dr. Karanth presenting at the Nicholas School

The goal of these interactions is not simply response, but mitigation. WildSeve helps farmers understand what factors increase the likelihood of human-wildlife conflict (HWC) and how to avoid these encounters in the future. 

Another project in the works, WildCarbon, will assist farmers in transitioning their land from agriculture to carbon-sequestering agro-forests in places where the benefits can outweigh the costs.

Karanth says that trust is key to ensuring that the advice from the team is well-received. It is often difficult to convince a farmer to change their practices. Farming technique is both a careful science and the basis of a farmer’s livelihood. The project is in its seventh year, and Karanth says it has taken time for farmers to see that their assistance works. One factor that helps build this trust is that many members of the WildSeve team are locals in the communities.  

Another program, WildShaale, is designed to foster understanding and appreciation for local wildlife in schoolchildren. Karanth pointed out that many school-age children easily recognize a kangaroo despite their lack of proximity to or interaction with the Australian marsupial, but could not identify the Indian wolf native to their backyard.

For children living in communities that come in close contact with wildlife, their perception of the animals is often one of fear. Karanth said the curiosity and empathy that WildShaale nurtures is critical to creating communities that have a net positive relationship with their animal neighbors. By fostering this empathy, violence becomes a last resort when dealing with wildlife conflicts.

After Karanth’s talk, I grabbed a chai latte from Beyu Cafe and sat down in Penn Pavilion for New York Times columnist Bret Stephens’ chat on cross-partisan conversation. At the time, I didn’t see much connection between the two events, but in retrospect, it is there. Both talks touched on that attempt at harmony, respect, and civil discourse I so often find myself craving: for Karanth, it’s between animals and people; for Stephens, people and people.

As I got ready to write this article, I turned on my GE digital clock radio to keep me company. I debated switching to a podcast, but then the host mentioned elephants and — given their relevance to task — I leaned in a little closer. 

The radio still works!

WUNC was playing this week’s segment of the TED Radio Hour, which centered on finding resolutions in situations of conflict. The woman being interviewed was discussing her own solution to elephant-human conflict in Kenya: beehives.

I will leave it to the reader to find out how, but the remainder of the segment drove home my key takeaway from hearing Karanth speak: Seeking out simple, yet innovative answers to human-wildlife conflict, a life or death issue, can teach us a lot about the importance of finding solutions to interpersonal conflict.  

Post by Addie Geitner, Class of 2025

Cancer Stigma, Contraceptives, Covid-19: 2022 Global Health Research Showcase

Last Monday, Oct. 17, Duke University students who had conducted global health research had the opportunity to present their work. From North Carolina to Sub-Saharan Africa, the 2022 Global Health Research Showcase featured works that tackle some of the world’s most pressing health issues. Over 40 undergraduate, Masters, and PhD student projects examined a broad range of issues, determinants, and phenomena in countries from almost every continent. Here’s a few project highlights, in case you missed it:

Maeve Salm, pursuing her Master of Science in Global Health, went to Tanzania to study contraceptive use. Tanzania’s youth are highly impacted by teen pregnancy, and Salm wanted to understand desires for contraceptive use among adolescents affected by HIV. She learned that, much like in the U.S., stigma influences access to sexual healthcare for adolescents. This qualitative study aimed to support young people in achieving their desired health outcomes and reducing HIV transmission by examining barriers and facilitators to family planning. Findings indicate that youth agency in reproductive health is of utmost importance.

Maeve Salm presenting her poster at the 2022 Global Health Research Symposium.

Wondering about the Covid-19 response in other countries? Master of Science in Global Health Candidate Stephanie Stan explored the barriers and enablers to the pandemic response in Peru. Per capita, Peru experienced the highest mortality rate form the disease compared to any other country. Due to several challenging factors, they were slow to receive COVID-19 vaccines. However, they implemented highly successful vaccination campaigns once vaccines were obtained. What can be learned from Peru’s pandemic response? Prolonged and proactive collaborations between sectors (healthcare, academics, and government) enable swift public health responses in a crisis. It’s important to have elected officials who are empowered to make decisions promoting science.

“Definitely meeting all the incredible people that I interviewed and learning about their work and involvement in Peru’s pandemic response. Learning about what happens moving forward from their point of view.”

Stephanie Stan, when asked about her global health research experience

Winning the first-place Graduate Student Research Award, Judith Mwobobia’s project examined the stigma of cancer in sub-Saharan Africa. Stigma is a huge barrier to receiving treatment, which is a problem considering that 70% of global cancer deaths originate from Africa. Perceptions of financial stress, misconceptions about cancer, and fear of death were common attitudes driving cancer stigma. Proposed interventions included education and policy recommendations for low-resourced communities. Mwobobia is pursuing her Master of Science in Global Health. Clearly a supportive group, her classmates erupted in cheers when the award was announced.

By Victoria Wilson, Class of 2023

It’s Their Future and Gen Z Has Already Seen a Lot

Young people have the power to generate change, whether they know it or not.

At least that was the sentiment expressed by the Director of Polling at the Harvard Institute of Politics, John Della Volpe at a seminar earlier this month. A leading authority on the intersection of young Americans and political influence, Della Volpe discussed the key role Generation Z will play in the 2022 and 2024 elections.

But does Generation Z really have what it takes to change the course of American politics?

“We spend a lot of time talking about Gen Z, and not enough time talking to you,” Della Volpe began as he addressed a crowd of young Duke students. “This is one of the rare occasions where I’m going to be doing most of the talking rather than most of the listening.”

Stanford Researcher Roberta Katz describes Generation Z — those born between 1997 and 2012 — as a highly collaborative cohort with a pragmatic attitude about generational issues like political engagement.

Exit Polls from NBC reveal that Gen Z was responsible for more than 9% of total votes in the 2020 presidential election, with that number only expected to grow. In Georgia and Arizona, young voters turned out to be critical for President Joe Biden’s victory, Della Volpe said.

Exit Polls From NBC show 2020 total votes for Biden compared to Trump, with Generation Z voting for Biden two-to-one.

He urges Gen Z to “remind elected officials that you did change things and that you will continue changing things.” Della Volpe predicts that Gen Z’s choices will also be crucial in the 2022 midterms.

Occupy Wall Street, the election of Trump, the Parkland Shooting, Greta Thunberg, and the killing of George Floyd were five events that Della Volpe believed were crucial in shaping this trajectory, as well as Gen Z’s political view as a whole.

“We have to look collectively at what you as a cohort saw and how that’s affecting you. In fact, I think that’s a far better way to think about our politics than what state you are in.”

The way parents think about bills and taxes, the way that weighs on your shoulders, that’s the way we think about living and dying.

Gen Z woman in conversation with John Della Volpe

“No generation in 70 years has dealt with more chaos, more trauma, more struggle before your brain is even fully developed,” Della Volpe asserted. He maintains that Generation Z is dealing with extremely complex issues much earlier than other generations.

Research from the American Psychological Association bears this out, indicating that Gen Zers are currently the most stressed demographic of people in the United States. They are also significantly more likely to rate their mental health as poor in comparison to other generations.

“I’m very cognizant of not putting any more pressure on you,” said Della Volpe. “You are already doing such a good job of managing yourselves and managing your situation.”

John Della Volpe’s book, published earlier this year.

Generation Z is managing so well, in fact, that Della Volpe argues they are essential to the success of US politics moving forward. In his book ‘Fight: How Generation Z is Channeling Their Fear and Passion to Save America,’ Della Volpe argues that the challenges unique to Gen Z prepare them to take control of their future in this nation.

Thanks to Della Volpe the answer is overwhelmingly clear: Gen Z does have what it takes to turn this nation around. So get out there and vote!

Still need to register to vote? Click here.

Need to check your registration status? Click here.

Post By Skylar Hughes, Class of 2025

Nursing’s Trial by Fire: COVID-19 and the Path Forward

The list of professions that have been pushed to the brink during the pandemic is ever-expanding. However, the sea change that swept over nursing in the past three years rivals that of almost any occupation, said panelists in a Sept. 28 event hosted by Duke University School of Nursing.

Already one of the most overworked professions, the pandemic only seemed to magnify nursing’s enduring problems, according to panelist and journalist Lauren Hilgers. A few months into the pandemic, nurses around the country began quitting in droves due to both burnout and undervaluation by their employers. As the front lines dwindled, hospitals working at full capacity needed to meet patient demand by any means necessary.

Enter travel nursing agencies, independent staffing organizations that matched nurses from across the country with hospitals dealing with acute labor shortages. Already increasing in popularity in the lead-up to the pandemic, demand for travel nurses in recent times has exploded. As this fundamental change in the make-up of the nursing labor pool occurred, people started to take notice.

In February of 2022, an article was published in the New York Times titled “Nurses Have Finally Learned What They’re Worth”. In the piece, Hilgers chronicles the major trends in the nursing workforce over the past three years. Hilgers describes the unique proposition facing the nurses who chose not to quit: remain as a staff nurse on their current salaries or sign up with a traveling agency and uproot their lives, albeit for higher pay. And the pay bump was substantial. Certain travel nurse jobs paid up to $10,000 a week, many times what staff nurses were earning. These nurses would often stay at a hospital anywhere from a couple of weeks to months, providing much-needed relief to healthcare systems. However, as the practice spread, questions soon began to emerge about the disparities in pay between staff and travel nurses, the sustainability of travel nurse programs, and, moreover, how the American healthcare system enabled travel nursing to rise to such prominence in the first place?

These questions served as the foundation of the Dean’s Lecture Series event, “The Value & Importance of the Nursing Health Care Workforce for U.S. Health and Wellbeing”. Moderated by Dean Vincent Guilano-Ramos PhD, the event featured Hilgers alongside a panel of distinguished speakers including Solomon Barraza, CCRN, cardiac ICU nurse at Northwest Texas Hospital, Benjamin Smallheer, PhD, Associate Professor at the School of Nursing, and Carolina Tennyson, DNP, Assistant Professor at the School of Nursing.

From left to right: Solomon Barraza, Lauren Hilgers, Vincent Guilano-Ramos, Benjamin Smallheer, Carolina Tennyson. Photo by Andrew Buchanan.

“Nursing is the largest segment of the healthcare workforce…yet what we contribute to the health and wellbeing of our country is invisible,” mentioned Dean Ramos at the discussion’s outset.

Smalheer agreed, adding that nurses today are contributing to patient care in ways that were vastly outside of their scope of practice just twenty years ago. A unique combination of technical proficiency, aptitude during crisis response, and ability to provide feelings of care and comfort, Hilgers describes nursing as one of, if not the only, profession in healthcare that considers the “entirety of a patient.”

A frequently cited statistic during the panel presentation referenced results from a Gallup poll indicating that nursing was rated as the most trusted profession for the 20th year in a row. While nurses were always aware of their influence and worth, getting healthcare systems to agree proved to be a much larger effort, one that only grew in importance as COVID-19 progressed.

“The pandemic has hardened us,” explains Smallheer. No longer were nurses willing to tolerate slights against their treatment as a profession. And they had tolerated plenty. Barraza, one of the protagonists of Hilgers’ piece, described the relentless search for purpose amidst constant burnout, especially during the pandemic’s heaviest waves. From finding efficient triage methods during a surge of cases to celebrating patient discharges, Barraza actively sought out ways to be “consistent when there was no consistency.” A charge nurse located in a region with severe labor shortages, Barraza had seen the influx of travel nurses firsthand every week. What ultimately kept him from traveling across the country in the pursuit of a more lucrative job, however, was the relationships he had forged within the hospital. Nurses, students, patients-they had all left an indelible mark on Barraza and enabled him to push through the long and grueling hours. Tennyson reinforced Barraza’s story by claiming that “you can be burnt out and still find value in a profession.” This seemingly contradictory duality may have proved sufficient to retain nurses during the pandemic, but as for long-term solutions, the panelists agree that significant change must occur at a systemic level.

Hilgers (pictured right) spent months speaking to nurses around the country, including Barraza (pictured left). Photo by Andrew Buchanan.

One of the central tensions of Hilgers’ article is that between the hospital and the worker. The explosion of travel nursing during the pandemic was but a manifestation of decades of undervaluation by hospitals of nurses. In order to undo this narrative and enact concrete change, Tennyson argues that nurses must be represented in more interdisciplinary professional spaces, from healthcare administration to policy to business. Hilgers restates this idea more broadly, saying that nurses “need to have a seat at the table” in reshaping the healthcare system post-COVID-19.

Much of this work begins at the level of the educational institution. Smallheer and Tennyson spoke at length about how nurses can better be prepared to navigate the ever-changing healthcare workforce. They both highlighted a few of the Duke School of Nursing’s novel instructional methods, including early exposure to complicated patient cases, extensive practice with end-of-life scenarios, and recognition of overstimulation points in the field. Also important for nurses-in-training and existing nurses, according to all panelists, was collective action. Through supporting state and national nursing associations, writing to local politicians, and speaking to healthcare administrators, they argued that nurses will be better equipped to voice their demands.

Christine Siegler Pearson Building at Duke University School of Nursing

As the panel reached its closing stages, one of the main talking points centered around changing the narrative of nursing as solely a burnout profession. Hilgers in particular remains critical of the portrayal of nurses, and more broadly those involved in care work, in popular media. She strongly advocates for authentic storytelling that including the voices of actual nurses, nurses such as Barraza. Ramos describes Barraza as someone who “represent[s] the best in nursing,” and the panelists maintained a strong desire to see such stories of resilience and passion spotlighted more frequently.

There is no simple formula to reform the nursing profession in the United States. However, through a combination of effective storytelling, more current educational standards, greater interdisciplinary involvement, and collective action, the panelists of the Dean’s Lecture Series firmly believe that lasting change is possible. 

Post by Vibhav Nandagiri, Class of 2025

Banned Books Then and Now

With the never-ending news of schools banning books, one has to ask about the history and effectiveness of banned books. Fortunately, the Duke Forever Learning Institute hosted a seminar on the history of banned books in late September and provided examples that showed the ineffectiveness of banned books throughout time.

There was one particular story, however, that caught my eye, and that was the retelling of the history behind a banned book written by a man named Gottschalk. Clare Woods, an associate professor of Classical Studies at Duke, delineated the narrative of Gottschalk’s life from birth to prisoner.

A map containing the monasteries Gottschalk visited. (provided by Dr. Clare Woods)

Gottschalk was born to an aristocratic family around 803 AD and started his academic career when he moved into Fulder, a monastery, to become a monk. However, in 829 AD, Gottschalk left Fulder for reasons based either on the loss of his older brother or the enlightenment he received from the monastery he attended while studying abroad.

Upon leaving Fulder, Gottschalk studied at the monasteries of Corby and then moved to northern Italy after he received his orientation as a priest. Gottschalk was unusual because monks tended not to move around that much, and monks also tended not to speak about their studies on heretical doctrine. Unfortunately for Gottschalk, he ignored the criticisms from other monks and instead grew confident in his studies to the point where he wrote a book about them.

While receiving hate for his ideas from multiple people, one man from Gottschalk’s past was truly adamant about having Gottschalk punished. This man was named Rabbanis, and he was accused by Gottschalk of coercing Gottschalk’s earlier career as a monk. From that, and with Gottschalk leaving the Fulder, Rabbanis developed a personal vendetta against Gottschalk.

This is an excerpt from Gottschalk’s confession, which was provided by Dr. Clare Woods.

Gottschalk, the confident man he was, decided to defend himself at a Synod in Mainz, but it proved unsuccessful because he was condemned by the Synod and banned from the Kingdom of Louis. From there on, things did not improve for Gottschalk because, in the following year, he was brought to a second Synod that was attended by King Charles, who was the brother of King Louis the German. By the end of this Synod, Gottschalk was stripped of his priesthood, sentenced to silence, and imprisoned.

However, even with the punishments Gottschalk personally received and his books being burned, his books were still preserved and influential on others.

This influence seen with Gottschalk’s books after being banned was not an anomaly because that was seen with all banned books throughout history.

Another example was given by Lauren Ginsberg, an associate professor of classical studies, who presented Permussius Cordis, an author who lived under the Roman emperor Tiberius in the 1st century AD.

His story ended in tragedy since his books were included in a mass book burning and he was sentenced to death. However, his book still was able to influence the Roman population due to his daughter Marsha’s vigilance in keeping her father’s book alive.

While I only provided two examples, this pattern of books withstanding their ban is throughout time, and it is being repeated in the present. Across this country, book banning is back in style. In 2018, there were only 347 books that schools formally challenged, but in 2021 it became 1,500.

An example of books that have been banned in multiple schools (Freedman)

While this does put light on our current education system in this country, this is simply a gesture. It does make us think about what children will be learning in schools, but because the books are banned in schools does not mean the information within those books will not reach their target demographic. As seen in history, knowledge always finds a way of spreading, but of course, that is dependent on those who want to expand that knowledge.

At the end of this article, I hope you are reassured that seeing a banned book does not mean it is forever silenced. Instead, I hope that by reading this, you understand that you have all the power to ensure that the words within a book can withstand anything, including time.

Post by Jakaiyah Franklin, Class of 2025

Citation: Freedman, Samuel G. “A Display of Banned or Censored Books at a Bookstore Last October. Over a Recent 9 Month Period More than 1,500 Books Have Been Banned in Schools, Most Featuring Nonwhite Protagonists, Dealing with Racism, or Addressing the LGBTQ Experience.” Los Angeles Times, Los Angeles Times, 27 June 2022, https://www.latimes.com/opinion/story/2022-06-27/book-bans-critical-race-theory-wisconsin. Accessed 10 Oct. 2022.

Applying the Ways of the Sea to Outer Space: A Conversation Hosted by Duke’s Space Diplomacy Lab

Whether it was Marco Polo traversing the Silk Road (which was more like Silk Routes), Columbus sailing the ocean blue, or even Moana restoring the heart to Te Fiti; oceans have been integral to our way of life as humans for thousands and thousands of years.

The Silk Road, mapped
The (fictional) story of Moana draws from (true) Polynesian history and seafaring lore

But humans have always been bad at sharing – most wars are fought over territory, land especially. And as time has passed, the things we share as humans has evolved – from oceans and land to the Internet and outer space. So how do you keep things diplomatic? Last Friday, Duke’s Space Diplomacy Lab, co-chaired by Dr. Benjamin Schmitt of Harvard University and Duke’s own Dr. Giovanni Zanalda, hosted a webinar on what space diplomacy can learn from ocean diplomacy. Featuring Dr. Clare Fieseler of the Smithsonian Institution and Dr. Alex Kahl of the National Marine Fisheries Service, the conversation covered everything from zoning to equity to even the lessons we can learn from Indigenous communities.

Sharing data and sharing fish

There are multiple challenges to sharing the world’s waterways. Fieseler did not start out her career studying ocean diplomacy. Initially stationed in the Persian Gulf, building a marine mammal monitoring network, she noticed that the fraught state of politic affairs in the region made it hard to share data on the animals that were washing up on the shore.

Dr. Fieseler presenting

Meanwhile, Kahl, who works in Hawaii as the National Resources Manager at the National Marine Fisheries Service, runs into problems not in sharing data but primarily in sharing fish. “How do you focus on the shared exploitation of a natural resource?” he asked.

Two key themes arose in linking the sharing of the ocean to the sharing of outer space.

First, Fieseler pointed out that engaging scientists can help in transcending politics, something that ocean diplomacy does well. She pointed to efforts to establish a Marine Peace Park between North Korea and South Korea, and that if two of the worlds most polarized countries could come to an agreement in the name of science and human betterment, then “surely other countries can too.”

Second, Kahl remarked, unlike in the ocean, the primary resource in space is, well, space. You need fish to eat to survive – do you need space to survive?   

Centering equity

On the topic of whether we really need space in space to survive, Kahl pointed to the significance that many celestial bodies have in cultures here on Earth, such as in Hawaii and the Pacific Islands. Does interfering with these celestial bodies cross a red line for cultures on Earth? It’s worth noting that as Kahl said, with space exploration, “very few people are profiting,” so balancing the interests of people on Earth as well as in space is important.

Dr. Kahl presenting

Fieseler spoke to the need to build equity in space through some sort of formal agreement, similar to the Law of the Sea. But, she says, that might be skipping a few steps. Right now, “many developing countries can’t even afford to go to space.” How can you build equity in a region where not everyone even has a seat at the table? Kahl pointed out that this marginalization impedes discussions on how to share space – something that should be consensus-driven.

Zoning

As Fiesler remarked, zoning of the ocean has been key to a relatively peaceful sharing of this resource for the variety of uses that people have for the sea. A good example of this is the Antarctic Treaty, which zoned different places in Antarctica for scientific use.

Kahl spoke to being a beneficiary of the Antarctic Treaty – “it reduces bureaucratic burdens, and the collective benefits are also increased.” However, he made the point that the slicing and dicing of space, as with anything, could lead to initial tensions.

Science should have a seat at the table

A central theme that ran throughout the conversation was that, as Kahl put it, scientists “rely on each other to level-set the truth” – even in spaces where they might be in the minority, such as in a room of politicians engaging in diplomatic talks.

Fieseler pointed to how in environmental justice work, her Indigenous colleagues were good at taking the initiative – and finding the urgency – to demand a seat at the table. “As scientists, we sit around, thinking that one day the phone will ring and someone will invite me to be a part of the conversation – but that’s not how it works.” Diplomacy will always be a necessity as we aim to navigate sharing the vast resources at our disposal, but many scientists hope that we won’t forget to center the pursuit of the truth as we make decisions.

Post by Meghna Datta, Class of 2023

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