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      • Ecclesia laus Corinthiensis: Negotiating ethnicity under empire

        Concannon, Cavan W Harvard University 2010 해외박사(DDOD)

        RANK : 247343

        This dissertation examines the earliest reception of the letters of Paul to the Corinthians, focusing on issues of ethnicity, civic identity, and empire. At its core, the dissertation seeks to understand how Paul's earliest audience in Corinth heard and responded to Paul's rhetoric of ethnicity. This dissertation makes three important contributions to the study of Paul, the Corinthian correspondence, and the city of Corinth. First, I lay out the local context that offered Paul's audience myths, stories, practices, and experiences with which to think when interpreting Paul's letters. This shift requires pairing literary and archaeological materials as a means of reconstructing the ways in which the rhetoric of ethnicity was deployed in Corinth. Second, placing Paul within this local context shows him to be one among many using the rhetoric of ethnicity to persuade Corinthian audiences. This focus on the multiplicity of voices in Corinth seeks to open up spaces or cracks in our interpretation of the Corinthian correspondence where we might hear the voices of the Corinthians who heard and interpreted Paul's letters. Attention to ethnicity and its importance in the Corinthian correspondence is my third contribution. Studies of Paul and ethnicity have generally focused on the letters to the Galatians and Romans, except when discussing specific confrontations that Paul may have had with Jewish missionaries (e.g., the "super apostles" of 1 Corinthians 10--13). Thus, in Pauline studies, scholars have generally only tackled the topic of ethnicity when they have seen Judaism and Jewish voices opposing Paul's as affecting particular letters. Ethnicity, however, was relevant as well to the Gentiles who heard and responded to Paul's preaching. In this dissertation I show that the rhetoric of ethnicity was central to how Paul presented himself to his Corinthian audience and how he argued over community boundaries and practices. Ultimately, this allows Paul to emerge as one of many using the rhetoric of ethnicity to persuade discerning Corinthian audiences.

      • A cost and outcomes analysis of emergency transport, inter-hospital transfer and hospital expansion in cardiac care

        Concannon, Thomas William Harvard University 2006 해외박사(DDOD)

        RANK : 247343

        Primary percutaneous coronary intervention (Aversano, Aversano et al. 2002) yields better clinical outcomes than thrombolytic therapy (TT) in ST-segment elevation myocardial infarction (STEMI). TT is still widely used because most U.S. hospitals are not equipped to perform PCI. The first of three studies in this dissertation examines the impact on patient mortality and hospital volumes of Emergency Medical Services (EMS) strategies to increase transport of patients with STEMI to PCI-capable hospitals. A second study investigates the costs and clinical benefits of expanding hospital capacity to perform PCI. A third study explores the effects of patient race, ethnicity and neighborhood on time spent in EMS care. All three studies were based on a detailed geospatial model of Dallas County, Texas. Studies one and two drew patient-level clinical trial data into a series of Monte-Carlo micro-simulations that tested EMS- and hospital-based strategies for increasing the availability of PCI. Study three was based on 2004 administrative data from ten Dallas area municipal EMS systems. Nearly all of the potential mortality benefit of PCI was realized with EMS and hospital policies that target the procedure to high-risk patients. By comparison, making PCI universally available confers little additional benefit to patients while bringing about substantially higher health care costs and potentially adverse effects on systems of care. In study three, statistically significant differences in time to treatment were detected among racial and ethnic subgroups but these differences were too small to be clinically meaningful. This study did, however, demonstrate an unexpected and potentially harmful delay in EMS care among women compared to men. Calls for the universal availability of PCI have become common in the cardiac care literature, and the case for this position is generally based on average patient outcomes as reported in clinical trials. This approach masks important heterogeneity in the outcomes of patients with STEMI. Policy development that takes this heterogeneity in account can maximize the benefits of PCI while minimizing adverse effects on costs and systems of care. PCI should be targeted to patients who can benefit most from the procedure.

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