Digital Commons Network^™

Personal Strengths Reported By People With Chronic Illness: A Qualitative Study, Kurt C. Stange

Faculty Scholarship

Background: Self-management of chronic illness can be highly demanding and people need to mobilize their personal strengths to live well with their condition. More knowledge is needed about how people with chronic illness perceive and use their personal strengths as a basis for better integrating empowering person-centred approaches into health care. Objective: To explore what people with chronic illness describe as their strengths relevant to their health and well-being. Setting and Participants: Thirty-nine participants (11 men) from 4 outpatient self-management programmes were recruited to individual or group interviews. Participants included patients with chronic respiratory disease (n = 7), chronic pain …

Training Scholars In Dissemination And Implementation Research For Cancer Prevention And Control: A Mentored Approach, Kurt C. Stange

Faculty Scholarship

Background: As the field of D&I (dissemination and implementation) science grows to meet the need for more effective and timely applications of research findings in routine practice, the demand for formalized training programs has increased concurrently. The Mentored Training for Dissemination and Implementation Research in Cancer (MT-DIRC) Program aims to build capacity in the cancer control D&I research workforce, especially among early career researchers. This paper outlines the various components of the program and reports results of systematic evaluations to ascertain its effectiveness. Methods: Essential features of the program include selection of early career fellows or more experienced investigators with …

The Rise Of Self Sidelining, Leslie Culver

Faculty Scholarship

This Article coins the term "self sidelining" as an experience emanating from two theories: impostor phenomenon and gender sidelining. The impostor phenomenon is a well-established psychological construct that describes the inability of some high-achieving women and men to internalize success. Gender sidelining, recently popularized in legal scholarship, describes the undermining of women's achievements, as compared to men, that are unactionable as legal discrimination. In view of these theories, this Article contends that when internal fraudulent feelings (imposter phenomenon) are perceived to be externally validated by male gender preference (gender sidelining), women consciously or subconsciously discipline themselves to forgo their professional …

Ministries Of Catholic Sisters In The Diocese Of Cleveland: Assessing Capacity And Opportunity In A Period Of Transition, Robert L. Fischer, Rong Bai

Faculty Scholarship

Catholic sisters have long played a vital role in addressing the needs of the poor, neglected, and vulnerable members of society. In northeast Ohio, sisters have been instrumental in the arenas of education, healthcare, social service, and advocacy. This research builds on research conducted in 2009 on the characteristics of the ministries of Catholic sisters. Using a survey approach, responses were collected from 358 Catholic Sisters in 12 religious orders, approximately 60 percent of the sisters living in the Diocese of Cleveland. The study explores sisters' current ministries (work and service), the plans for their ministries to continue, and their …

Removing Obstacles To A Peaceful Death, Kathy L. Cerminara, Barbara A. Noah

Faculty Scholarship

We all will die, but the American health care system often impedes a peaceful death. Instead of a quiet death at home surrounded by loved ones, many of us suffer through overutilization of sometimes-toxic therapeutic interventions long past the time when those interventions do more good than harm. This article proposes revisions to health professional training and payment policy to eliminate as much as possible physical and existential suffering while progressing through the terminal phase of illness. The solution lies in seamless progression from treatment with integrated palliative care to hospice before death, but provider attitudes and payor practices must …

A Voice Of Their Own: Youth-Centered Representation At Ebclc, Kate Weisburd

Faculty Scholarship

No abstract provided.

The Relationship Between Black And Gay Community Involvement And Hiv-Related Risk Behaviors Among Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of young Black men who have sex with men (YBMSM) on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16 to 29. Cross-sectional measures for this study include Black and …

Pathways To Delinquency And Substance Use Among African American Youth: Does Future Orientation Mediate The Effects Of Peer Norms And Parental Monitoring?, Dexter R. Voisin

Faculty Scholarship

The following study assessed whether future orientation mediated the effects of peer norms and parental monitoring on delinquency and substance use among 549 African American adolescents. Structural equation modeling computed direct and indirect (meditational) relationships between parental monitoring and peer norms through future orientation. Parental monitoring significantly correlated with lower delinquency through future orientation (B = −.05, standard deviation =.01, p <.01). Future orientation mediated more than quarter (27.70%) of the total effect of parental monitoring on delinquency. Overall findings underscore the importance of strengthening resilience factors for African American youth, especially those who live in low-income communities.

Project Ngage: Results Of A Randomized Controlled Trial Of A Dyadic Network Support Intervention To Retain Young Black Men Who Have Sex With Men In Hiv Care, Dexter R. Voisin

Faculty Scholarship

HIV-positive young black MSM (YBMSM) experience poor outcomes along the HIV care continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16–29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n = 45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also …

A Longitudinal Analysis Of Antiretroviral Adherence Among Young Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

Purpose: Young black men who have sex with men (YBMSM) experience poorer antiretroviral therapy (ART) medication adherence relative to their white counterparts. However, few studies have longitudinally examined factors that may correlate with various classifications of ART adherence among this population, which was the primary aim of this study. Methods: Project nGage was a randomized controlled trial conducted across five Chicago clinics from 2012 to 2015. Survey and medical records data were collected at baseline and 3- and 12-month periods to assess whether psychological distress, HIV stigma, substance use, family acceptance, social support, and self-efficacy predicted ART medication adherence among …

Merging Ahead, Increase Speed: A Pilot Of Funder-Driven Nonprofit Restructuring, Robert L. Fischer, Claudia J. Coulton

Faculty Scholarship

Nonprofit agencies face increasing competition for scarce funding resources. Many agencies are considering ways to restructure themselves, often via mergers and acquisitions, as a way to become more effective and competitive. This case study examines a pilot initiative in Cleveland, Ohio, in which philanthropic funders invited and supported nonprofits in the pursuit of significant restructuring efforts. Health and human service nonprofits were recruited into a three-phase facilitated pilot that assisted the agency executive directors and boards in determining what type of restructuring was feasible and desirable. Overall, 75 nonprofits participated in some part of the pilot, 17 of which formally …

Antitrust As Disruptive Innovation In Health Care: Can Limiting State Action Immunity Help Save A Trillion Dollars?, William M. Sage, David A. Hyman

Faculty Scholarship

On February 25, 2015, the United States Supreme Court ruled in North Carolina State Board of Dental Examiners v. FTC that state licensing boards controlled by market participants are subject to federal antitrust law unless they are “actively supervised” by the state itself. The ruling may sound narrow and technical, but the significance of the case can be inferred from the number and prominence of the amici curiae who lined up to support the North Carolina State Board of Dental Examiners (“North Carolina Board”)—first when the Federal Trade Commission’s (“FTC”) internal enforcement action was appealed to the United States Court …

Re-Envisioning Professional Education, Kimberly Austin, Elizabeth Chu, James S. Liebman

Faculty Scholarship

In the dynamic, hyper-connected, and unpredictable 21st century, workplace and career paradigms are rapidly changing. The professions are no exception. Technology has routinized and increased access to the expertise that traditionally set professionals apart from other workers, leading some to forecast professions’ demise. Even if, as we suspect, new forms of complexity and needs for expertise continue to outrun technology, professionals’ lives and careers will diverge dramatically from past norms. In the world we anticipate, the number of theories, diagnoses, and strategies among which each professional — alone or in teams — must make informed and workable judgments will increase …

Testing Three Pathways To Substance Use And Delinquency Among Low-Income African American Adolescents, Dexter R. Voisin

Faculty Scholarship

Objective Mounting literature suggests that parental monitoring, risky peer norms, and future orientation correlate with illicit drug use and delinquency. However, few studies have investigated these constructs simultaneously in a single statistical model with low income African American youth. This study examined parental monitoring, peer norms and future orientation as primary pathways to drug use and delinquent behaviors in a large sample of African American urban adolescents. Methods A path model tested direct paths from peer norms, parental monitoring, and future orientation to drug use and delinquency outcomes after adjusting for potential confounders such as age, socioeconomic, and sexual orientation …

Should Domestic Violence Be Decriminalized?, Leigh S. Goodmark

Faculty Scholarship

No abstract provided.

Sexual Violence As An Occupational Hazard And Condition Of Confinement In The Closed Institutional Systems Of The Military And Detention, Hannah Brenner, Kathleen Darcy, Sheryl Kubiak

Faculty Scholarship

Women in the military are more likely to be raped by other service members than to be killed in combat. Female prisoners internalize rape by corrections officers as an inherent part of their sentence. Immigrants held in detention fearing deportation or other legal action endure rape to avoid compromising their cases. This Article draws parallels among closed institutional systems of prisons, immigration detention, and the military. The closed nature of these systems creates an environment where sexual victimization occurs in isolation, often without knowledge of or intervention by those on the outside, and the internal processes for addressing this victimization …

Unbefriended And Unrepresented: Better Medical Decision Making For Incapacitated Patients Without Healthcare Surrogates, Thaddeus Pope

Faculty Scholarship

How should we make medical decisions for incapacitated patients who have no available legally-authorized surrogate decision maker? Because these patients lack decision making capacity, they cannot authorize treatment themselves. Because they lack a surrogate, nobody else can authorize treatment either. Clinicians and researchers have referred to these individuals as “adult orphans” or as “unbefriended,” “isolated,” or “unrepresented” patients. Clinicians and researchers have also described them as “unimaginably helpless,” “highly vulnerable,” and as the “most vulnerable,” because “no one cares deeply if they live or die.”

The persistent challenges involved in obtaining consent for medical treatment on behalf of these individuals …

Assessing Law Students As Reflective Practitioners, Jodi Balsam, Susan L. Brooks, Margaret Reuter

Faculty Scholarship

No abstract provided.

The Strange Life Of Stanley V. Illinois: A Case Study In Parent Representation And Law Reform, Joshua Gupta-Kagan

Faculty Scholarship

This Article helps describe the growth of parent representation through an analysis of Stanley v. Illinois — the foundational Supreme Court case that established parental fitness as the constitutional lynchpin of any child protection case. The Article begins with Stanley’s trial court litigation, which illustrates the importance of vigorous parental representation and an effort by the court to prevent Stanley from obtaining an attorney. It proceeds to analyze how family courts applied it (or not) in the years following the Supreme Court’s decision and what factors have led to a recent resurgence of Stanley’s fitness focus.

Despite Stanley …

The Hidden Though Flourishing Justification Of Intellectual Property Laws: Distributive Justice, National Versus International Approaches, Shlomit Yanisky-Ravid

Faculty Scholarship

No abstract provided.

The Organization Of Prosecutorial Discretion, William H. Simon

Faculty Scholarship

Contemporary understanding of prosecutorial discretion is influenced by anachronistic conceptions of judgment and organization. These conceptions have lost ground dramatically in professions like medicine, teaching, and social work. Yet, they remain prominent to a unique degree in law. They are embedded both in the general professional culture and in legal doctrine. Innovative prosecutorial practices have emerged in recent decades, but their progress has been inhibited by attachment to these older conceptions.

The older conceptions understand professional judgment as a substantially tacit and ineffable decision by a single professional grounded in a relatively static and comprehensive discipline. The associated model of …

Social Interaction In Mixed-Income Developments: Relational Expectations And Emerging Reality, Mark L. Joseph

Faculty Scholarship

In many cities, public housing has come to exemplify concentrated urban poverty and the social problems associated with it. One major policy response to addressing these problems is the demolition and redevelopment of public housing complexes as mixed-income communities. Several theoretical propositions that lie behind this policy are based on assumptions about the ways in which living among higher-income residents can lead to relationships and interactions that may benefit poor people. Based on in-depth qualitative research in two mixed-income developments in Chicago, this paper explores the dynamics of social interaction in an effort to better understand the processes and factors …

Involvement In The Juvenile Justice System For African American Adolescents: Examining Associations With Behavioral Health Problems, Dexter R. Voisin

Faculty Scholarship

While researchers have found that African American youth experience higher levels of juvenile justice involvement at every system level (arrest, sentencing, and incarceration) relative to their other ethnic counterparts, few studies have explored how juvenile justice involvement and number of contacts might be correlated with this broad range of problems. A convenience sample of 638 African American adolescents living in predominantly low-income, urban communities participated in a survey related to juvenile justice involvement. Major findings using logistic regression models indicated that adolescents who reported juvenile justice system involvement versus no involvement were 2.3 times as likely to report mental health …

The Relationship Between Life Stressors And Drug And Sexual Behaviors Among A Population-Based Sample Of Young Black Men Who Have Sex With Men In Chicago, Dexter R. Voisin

Faculty Scholarship

Younger Black men who have sex with men (YBMSM) have the highest rates of HIV incidence in the U.S. and are also exposed to high life stressors (e.g., unemployment, incarceration, and exposure to communality). This study assessed whether life stressors were related to drug use and sexual risk behaviors among a representative sample of YBMSM. The South Side of Chicago and selected adjacent suburbs represents the most populous contiguous Black community in the U.S. Over 10% of the estimated YBMSM population in this geographic region were sampled. Major findings indicated that higher life stress was significantly associated with greater odds …

Penal Welfare And The New Human Trafficking Intervention Courts, Kate Mogulescu, Aya Gruber, Amy J. Cohen

Faculty Scholarship

No abstract provided.

Hope Vi Data Compilation And Analysis, Taryn Gress, Seungjong Cho, Mark L. Joseph

Faculty Scholarship

As HUD advances its mission to create strong, sustainable, inclusive communities and quality, affordable homes for all, the promotion of mixed-income communities has become a core strategy. Across the U.S., local governments and private developers are increasingly turning to mixed-income development as an approach to deconcentrate poverty and revitalize urban neighborhoods.1 With the Choice Neighborhoods Initiative, launched in 2010, the federal government has extended its commitment to supporting the mixed-income approach to public housing transformation that was first implemented through the HOPE VI initiative in the mid1990s. With the dramatic decrease in public sector funding for public housing, housing authorities …

Marijuana Use Among Young Black Men Who Have Sex With Men And The Hiv Care Continuum: Findings From The Uconnect Cohort, Dexter R. Voisin

Faculty Scholarship

Background: Young Black men who have sex with men (YBMSM) are at highest risk for HIV seroconversion in the United States. Successful movement through the HIV care continuum is an important intervention for limiting onwards HIV transmission. Objective: Little data exists on how substances most commonly used by YBMSM, such as marijuana, are related to the HIV continuum, which represents the primary aim of this study. Methods: A cohort of YBMSM (n = 618) was generated through respondent-driven sampling. Frequency of marijuana use and marijuana use as a sex-drug were assessed across the HIV care continuum using weighted logistic regression …

Temporal Effects Of Distressed Housing On Early Childhood Risk Factors And Kindergarten Readiness, Claudia J. Coulton, Francisca García Cobián Richter, Robert L. Fischer, Youngmin Cho

Faculty Scholarship

Poor housing quality and housing crises have been linked to adverse outcomes for children. However, few studies have focused on the early childhood period or been able to pinpoint how the timing and duration of housing problems contributes to early educational success. This longitudinal study draws on linked administrative records from housing, education, social service and health agencies to examine the influence of exposure to housing neighborhood conditions since birth on school readiness of all children entering kindergarten over a four-year period in a big city school system. Using marginal structural models that properly account for dynamic housing and neighborhood …

Mixed-Income Developments, Mark L. Joseph, Miyoung Yoon

Faculty Scholarship

A mixed-income development can be defined as a complex with housing and other amenities such as parks, schools and community centers that has the mixing of income groups as a fundamental part of its financial and operating plan. Mixed-income development is a housing policy that has been implemented in the U.S. and around the world to deconcentrate poverty, particularly in public housing developments. Mixed-income development engages private real estate developers to produce public housing and thus exemplifies the shift in the 1990s to a neoliberal approach to urban development and other social services. Mixed-income development has proven to be an …

Multiple Dimensions Of Stigma And Health Related Factors Among Young Black Men Who Have Sex With Men, Dexter R. Voisin

Faculty Scholarship

This study is among the first to examine the association between multiple domains of HIV-related stigma and health-related correlates including viral load and medication adherence among young Black men who have sex with men (N = 92). Individual logistic regressions were done to examine the hypothesized relationships between HIV-related stigma and various health and psychosocial outcomes. In addition to examining total stigma, we also examined four domains of HIV stigma. Findings revealed the various domains of stigma had differential effects on health-related outcomes. Individuals who reported higher levels of total stigma and personalized stigma were less likely to be virally …