Public Affairs, Public Policy and Public Administration Commons^™

More Than A Century After Problem Emerged, Manhole Explosions Still Injuring Dozens In New York City, Gaspard Le Dem, Gabriel Sandoval

Capstones

Since the early days of electrification, New York City has been rattled by manhole explosions –– underground blasts that injure residents, damage buildings, force evacuations, cause power outages and traffic disruptions.

Consolidated Edison, the city's largest electric provider, has for decades blamed manhole issues on bad weather and road salt that erodes underground wires. But some experts and former utility workers say lack of maintenance is at the root of the problem.

Meanwhile, city and state officials have failed to rein in the problem through weak laws and loose oversight. As a result, unsuspecting drivers and pedestrians continue to be …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Blueprint For Shared Safety Strategic Plan, Reann Ramos

Capstone Projects and Master's Theses

The Blueprint for Shared Safety strategic plan will be adopted by Santa Cruz County Community Corrections Partnership as a framework of principles and practices that community leaders can use to lead shared safety strategies. By shifting the focus from the traditional criminal justice system to investments that can truly make our communities safer, the Blueprint aims to re-envision public safety together. The Community Corrections Partnership Community Education and Engagement Workgroup (CCP CEEW) has conducted data analysis to identify the key assets and gaps in Santa Cruz County. After identifying the key assets and gaps there were recommendation review sessions that …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

What Happened To This Child? Identifying Factors That Influence The Identification And Categorization Of Child Maltreatment In The United States, Erika Tullberg

Dissertations and Theses

Background: Research has shown that adverse childhood experiences are strongly linked with health outcomes over the life course, and that child maltreatment – generally defined as physical abuse, sexual abuse, emotional maltreatment and neglect – can have an immediate, negative impact on child health and development and a longer-term impact on adolescent and adult health, including the leading causes of morbidity and mortality in the U.S. With such significant consequences, the accurate identification of child maltreatment is critical.

Child welfare caseworkers are charged with protecting the safety and fostering the well-being of children who have been identified as maltreated or …

Development And Application Of A Teen-Informed Tool For Measuring The Power Of Food-Related Advertisements In Canadian Environments, Drew Bowman

Electronic Thesis and Dissertation Repository

Food environments are influential in shaping dietary behaviours of adolescents. Exposure to food and beverage marketing is known to impact food knowledge, behaviours, and health outcomes, yet food environment research largely overlooks advertisements. Given that marketers tend to advertise less healthy foods to teens and teens predominantly purchase low-nutrient foods, it is crucial to study the information environment in the context of secondary school environments. This thesis uses a sequential mixed-methods approach, including environmental audits and teen consultations, to develop and apply a teen-informed tool to measure the power of advertisements surrounding secondary schools. Results indicate that exposure to and …

Health Policy And Social Change: Women’S Advocacy Groups And Narrative Mobilization, Jill Moffatt

Electronic Thesis and Dissertation Repository

The goal of this study is to systematically investigate the mobilization of co-created (storyteller and story-gatherer) narratives for policy and social change. A case study format investigated the mobilization of narratives by a women’s health organization in London, Ontario. Semi-structured interviews resulted in transcripts from key actors. These transcripts were thematically coded and analyzed. All interview participants emphasized that from their perspective the organization did influence health policy or social change through their narrative use. Specific policy change examples were provided by participants, and social change was subjectively recognized as realized through the creation of awareness and affirmed through audience …

The Association Of Rural Hospital Closures With In-Hospital And 30-Day Post Hospital Discharge Mortality From Emergency Care Sensitive Conditions, Melinda A. Merrell

Theses and Dissertations

Purpose

Over 100 rural hospitals have closed in the U.S. since 2010. Continuous pressures on the rural health care delivery system suggest that the trajectory of closures will continue in at least the short-term. While the causes of rural hospital closures have been described in the literature, the effects on the health outcomes of populations that experience these closures are still poorly understood. The purpose of this study was to determine associations between rural hospital closures and in-hospital and 30-day post hospital discharge mortality rates for affected residents experiencing time-sensitive emergencies in two U.S. states.

Methods

Rural hospital closures were …

Food Insecurity Among South Asian Immigrant Communities In The Inland Empire Of Southern California, Farhan Danish

Electronic Theses, Projects, and Dissertations

Background: Food insecurity amongst South Asian Americans is a major public health issue. The South Asian American (SAA) community is the third largest Asian community in the United States. Despite this fact, very few specific studies have been conducted to investigate the food needs and barriers that exist within the SAA community so as to successfully help them improve dietary habits.

Methods: This study utilized a mixed methods convergent parallel design, where both qualitative and quantitative methods were conducted and analyzed separately and compared and contrasted at the end.

Results: The results of this study demonstrate that ethnic grocery stores …

Promoting Resilience In Economically Disadvantaged Adolescents Through School-Based Expressive Arts Groups, Bailey Knox

Expressive Therapies Capstone Theses

Since 2013, the majority of students served by the public school system in the United States have been considered “low-income” by the federal government. The stressors associated with low socioeconomic status significantly increase risk for social, emotional and behavioral challenges at all age levels, but can be particularly damaging to adolescents coping with heightened stress levels related to the intense multi-dimensional changes that define this developmental period. As the correlation between economic disadvantage and negative socio-emotional and academic outcomes is increasingly evidenced, schools have begun to recognize their responsibility for providing preventative mental health care to high-risk students. Over the …

Blacklegged Tick (Ixodes Scapularis) Distribution In Maine, Usa, As Related To Climate Change, White-Tailed Deer, And The Landscape, Susan P. Elias

Electronic Theses and Dissertations

Lyme disease is caused by the bacterial spirochete Borrelia burgdorferi, which is transmitted through the bite of an infected blacklegged (deer) tick (Ixodes scapularis). Geographic invasion of I. scapularis in North America has been attributed to causes including 20th century reforestation and suburbanization, burgeoning populations of the white-tailed deer (Odocoileus virginianus) which is the primary reproductive host of I. scapularis, tick-associated non-native plant invasions, and climate change. Maine, USA, is a high Lyme disease incidence state, with a history of increasing I. scapularis abundance and northward range expansion. This thesis addresses the question: “To …

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

Changing The Current Perception Of Affordable Housing In Worcester, Simone Mcguinness, William Roberts, Vaske Gjino, Tong Zhou, Mengxin Ma, Sarawadee Sonpuak

School of Professional Studies

One of Worcester Interfaith’s goals is to eradicate the stigma of affordable housing in Worcester. Currently, the perception of affordable housing is of an image of unkept and old residences filled with destitute citizens who cannot afford basic needs to live in a city, let alone housing. This image is perpetuated by media, stigma, and a lack of education of the true reality of affordable housing and who its recipients are. Affordable housing-qualified citizens represent a range of educations, professions, age, race, and income levels. Affordable housing units, too, represent a variety of homes, many of which are extremely well-kept …

For One Child, Zion Bereket, Xin Huang, Yitong Lin, Ruobing Pei, Rachel White, Ziyuan Li

School of Professional Studies

The entirety of this project was completed on the foundation of the three focus areas, which were identified by our client as areas of high need. The client wanted to prioritize these three areas as they believed that these three areas were the most integral to the successful achievement of their mission, as well as to the overall health and longevity of the organization.

Hiv/Aids In The Latino Community Of San Francisco: Past And Present, Jessica Da Silva

School of Professional Studies

There are approximately 122,000 people of Latino origin in San Francisco, which account for 15% of the total population (Census, 2010). Historically, Latinos have and still face several barriers to access healthcare and improvements in health (Aguirre-Molina, Molina & Zambrana, 2001). When the world was exposed to the spread of a new and unknown virus, the broader population suffered from the epidemic. The Latino community in San Francisco was and still is one of the hardest hit by the virus.

Worcester Chamber Of Commerce: Recruiting Minority Business Owners, Ryan Dimaria, Alexander Hull, Xikun Lu, Haopeng Wang, Jiacheng Hou, Danning Zhao

School of Professional Studies

Our capstone project was to help the Worcester Regional Chamber of Commerce identify how to re-frame their marketing so it would be appealing to immigrant and minority owned businesses. Based on interviews and external research, our group was able to create a tangible and resourceful data set that provided justified recommendations and ideas on how the Chamber could make adjustments to their marketing plan to attract more businesses of this particular demographic in the city of Worcester. By implementing these recommendations, we believe the Chamber has the opportunity to create a more diverse group of Chamber members, add value to …

“Greening” Worcester: Municipal Best Practices For Sustainability, Erin Mckeon, Charline Kirongozi, Jared Duval, Antannia Greene, Qianshu Sun, Zewei Yao

School of Professional Studies

In response to the urgent threat posed by climate change, more and more cities, including Worcester, are attempting to become more environmentally responsible and sustainable. Worcester is attempting to develop ways to become more sustainable; both to strengthen their communities and to protect the planet. The Green Worcester Working Group (GWWG) tasked the Clark Capstone Team with researching best practices for municipal sustainability. The GWWG has set the following priorities: climate change mitigation, resilience, open spaces, sustainable resource management, education and awareness. Taking these into account, the Clark Capstone Team researched the sustainability practices of cities in New England, across …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Service Now: Cmdb Research, Monika Patel, Smita Patil, Katerina Tzanavara, Manish Chauhan, Yuhao Wang, Houmin Xie, Lei Shi

School of Professional Studies

The MAPFRE Capstone team has been tasked with reviewing and recommending roadmap on the existing CMDB configuration. Paper discusses the team’s overall research on ServiceNow CMDB, Client’s deliverables and introduction to the latest technological innovations. Based on given objectives and team’s analysis we have recommended key solutions for the client to better understand the IT environment areas of business service impact, asset management, compliance, and configuration management. In addition, our research has covered all the majority of the technical and functional areas to provide greater visibility and insight into existing CMDB and IT environment.

Crumbling Foundations: The Case For Prioritizing Self-Care Among Educational Leaders, Joshua Brent Ray

Graduate Theses and Dissertations

There is a potentially dangerous disassociation between human behavior, decision-making, and ethics and the notion that these fundamental aspects of what it means to be human originate simply as the functions of an organ. A deeper knowledge of the operation and limitations of the brain suggests biological input could possess the ability to unknowingly alter human behavior and effectiveness. This study utilizes a research-based understanding of the implications of human health and self-care habits on neurological, psychological, and behavioral function to examine the current practices of educational administrators across Arkansas while exploring systemic and job-based factors within the profession that …

G.I. Jane Fem Etran Goes Corporate: An Exploration Of Post-9/11 Female Combat Veterans Transitioning To A Civilian Career, Tumona Austin

Dissertations

Purpose: The purpose of this multiple-case study was to explore the experiences of post- 9/11 female combat veterans transitioning from military service to civilian careers, using the Schlossberg transition model factors of situation, self, social support, and strategies.

Methodology: This multiple-case study identified and interviewed post-9/11 female combat veterans transitioning from active-duty to civilian career. Respondents were purposively chosen based on specific criteria and expert panel recommendations.

Findings: Examination of case-study interview data and artifacts from the 3 post-9/11 female combat veterans indicated nine major findings:

1. The factor of situation clearly outweighed the other Schlossberg factors in impact.

2. …

Beyond The Sentimental Cliche: How Local Communities Impact Residents And Shape Public Opinion, Kate Brunk

Theses and Dissertations

The Trump administration has recently established a rule that will prohibit abortion services providers from receiving Title X funds for the non-abortion family planning services they provide. Little public opinion research has focused on family planning and reproductive health topics outside of abortion. I find statistically significant experimental evidence that increasing perceptions of local need for a local reproductive health clinic caused subjects to be more supportive of federal reproductive health funding for local clinics. I did not find statistically significant correlational evidence that objective measures of poor reproductive health at the county level influence public opinion on federal reproductive …

Regulatory Disclosure Policies And Potential Induced Changes In Behavior: An Outcome Evaluation Of Santa Clara County’S Enhanced Food Safety Program Elements, Christian Cruz

Master's Projects

Despite countless advances in food microbiology and public health regulations, foodborne illness continues to be a major strain on public health outcomes and a costly economic burden. In the United States, many agencies are responsible for ensuring the quality of food, both domestically produced and imported. States and localities are delegated the responsibility of identifying and ensuring sound practices in the latter stages of the food production process, namely the retail distribution of food products to consumers.

Regulatory policies across the nation have only recently incorporated the evidenced-based principles of hazard risk management (Law, 2003). Still, food-related acute gastrointestinal illnesses …

Interrupted Progress: Water And Sanitation In Haiti, Emily Bauer

Thinking Matters Symposium Archive

Haiti has faced damaging environmental and social impacts, which have interrupted progress towards clean drinking water and adequate sanitation facilities for its over 10 million people. Natural disasters, disease outbreak, political corruption and economic instability have contributed to poor health and social outcomes for the small, island nation. This study used the most recent data from the World Health Organization and United Nations Children’s Fund Joint Monitoring Programme (WHO/UNICEF JMP) to assess national trends in water source and sanitation facility improvements from 1990-2015. WHO/UNICEF JMP defines water improvements as piped or non-piped protected water, and sanitation improvements as networked, flushed …

What Gun Safety And Access Policies Did Participants Think Would Be Effective In Preventing Accidental Gun Deaths?, Bridget O’Keefe, Stephen White

Thinking Matters Symposium Archive

Firearm-related incidents are often highly publicized tragedies that fuel unproductive political debates on gun policies at the local, state, and national levels. Current best practices in safe gun storage suggest that caregivers can protect their children from injury or death from an accidental gun discharge by keeping guns unloaded, locked up, and stored separately from their ammunition (Crifasi, Doucette, McGinty, Webster, & Barry, 2018). Child access prevention mechanisms including trigger locks, lock boxes, gun safes, and safe storage legislation are encouraged by the American Academy of Pediatrics (Dowd & Sege, 2012). This study gathers quantitative responses from 1,021 participants using …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Evaluating Ways To Reduce Errors In Medication Reconciliations Performed By Nurses In A Rural Hospital Setting, Kalen T. Freeman

MPA/MPP/MPFM Capstone Projects

Medication reconciliation, also known as “med recs”, are an important part of a patient’s care during their hospitalization. A med rec is when hospital personnel generate a list of the medications the patient takes at home. Med recs are vital in the hospital admission process because home medications need to be restarted at appropriate times to fully care for the patient. Also, mistakes in a home medication list can lead to serious consequences in the patient’s health. This study focuses on med recs being performed at Marcum and Wallace Hospital in Irvine, Kentucky. More specifically, the study explores the different …

Community Health Worker's Perceptions Of Integration Into The Behavioral Health Care System, Juliette Swanston Jenkins

Walden Dissertations and Doctoral Studies

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence …

Effects Of Psychiatric Hospital Closures On Local Jail Administrators, Correctional Staff, And Inmates, Mark Christian Lasko

Walden Dissertations and Doctoral Studies

A series of psychiatric hospital closures has led to a movement of care for individuals with mental illness from state-run facilities to managed care centers. Many of the individuals who no longer reside in psychiatric hospitals have become ensnared in the criminal justice system. Correctional facilities have an increased burden to care for the needs of the mentally ill, but lack the training and facilities to do so adequately. In this study, the lived experiences of correctional staff who have experienced the process of a hospital closure were examined. Psychiatric rehabilitation and gatekeeper theories served as the theoretical framework for …