Medicine and Health Sciences Commons^™

Salutogenesis And The Prevention Of Social Death: Cross-Cultural Lessons From Genocide-Impacted Rwandans And Indigenous Youth In Canada, Jobb D. Arnold

Genocide Studies and Prevention: An International Journal

Combining trans-disciplinary theories with cross-cultural ethnographic research, this paper explores community-based approaches to genocide prevention among Canadian-Indigenous groups as well as with Rwandan student genocide survivors. A Salutogenic framework is used to examine community responses to the micro-foundations of genocide (Antonovsky 1987). These processes are explored using first-hand accounts from “New Family” networks of student genocide survivors in Rwanda and members of a Canadian urban-Indigenous “Village.” These perspectives shed light on how locally adaptive, socially networked practices can help promote emergent forms of genocide prevention (Williams 1977). This paper focuses on three areas of local practice that have helped build …

Differential Qualitative Analysis: A Pragmatic Qualitative Methodology To Support Personalised Healthcare Research In Heterogenous Samples, Freda N. Gonot-Schoupinsky, Gulcan Garip

The Qualitative Report

Differential qualitative analysis (DQA) was developed as a pragmatic qualitative health methodology for the exploration of individual differences, behaviours, and needs within heterogeneous samples. Existing qualitative methodologies tend to emphasise the identification of general principles, an approach that can lead to standardised treatment, care, and medicine. DQA emphasises the identification of individual variation, in order to inform personalised healthcare. DQA comprises an accessible three-stage approach: first individual profiles are explored and differentiated into research-relevant subgroups; then each subgroup is analysed, and findings identified; finally, the data is analysed in its entirety and overall and subgroup findings are presented. DQA was …

You Learn When You Teach: A Narrative Pedagogy For Faculty And Doctoral-Level Student Teaching Assistants, Lauren A. Acosta Ms, Rn, Phd Candidate, Penny M. Overgaard Phd, Msn, Rn, Natalie M. Pool Phd, Rn, Bsn, Susan M. Renz Phd, Dnp, Rn, Gnp-Bc, Janice D. Crist Phd, Rn, Fwan, Faan

The Qualitative Report

The purpose of this study was to understand the meaning of online co-teaching for PhD faculty and teaching assistants (TAs). Narrative pedagogy underpinned the inquiry, which was designed to advance the discourse on mentorship of PhD future faculty. A faculty member and TA authors kept concurrent weekly journals or after-the-fact written reflections. The authors analyzed data as a team using a five-phase interpretive phenomenological analysis process to interpret the meaning of co-teaching for faculty and TAs. Lines of inquiry, central concerns, exemplars, shared meanings, and paradigm cases supported the overall interpretation, “You Learn When You Teach.” Co-mentorship should be a …

Healthy Older Adults’ Motivation And Knowledge Related To Food And Meals, Kai Victor Hansen

The Qualitative Report

The population over 60 years old is growing rapidly in Norway and in many other countries, and researchers often focus on elderly people and various diseases. This article examines the healthy elderly who are active in their daily lives to understand their motivation and knowledge about food and meals. The method used was CurroCus® group interviews, or fast focus groups. Nine CurroCus® groups were conducted, lasting for 37 to 56 minutes (average = 45 minutes). Altogether, 76 persons participated, ranging in age from 60 to 87 years; participants were predominantly female (>80%). The article discusses two areas: motivation and …

Using Emphasis-Purposeful Sampling-Phenomenon Of Interest–Context (Eppic) Framework To Reflect On Two Qualitative Research Designs And Questions: A Reflective Process, Michael E. Kalu

The Qualitative Report

A satisfactory research question often signifies the beginning point for many researchers. While this can be true for quantitative studies because of pre-defined research questions, qualitative research questions undergo series of revisions through a reflective process. This reflective process provides the framework for the subjectivity associated with qualitative inquiry. The continuous iterative reflective process is an essential component for developing qualitative research questions that correspond with the various qualitative study designs. Although qualitative inquiry is term exclusively subjective, there is a need to use a framework in developing qualitative research questions. The Emphasis- Purposeful sampling- Phenomenon of interest – Context …

Research, Reflections, And Resistance: A Review Of Body Battlegrounds: Transgressions, Tensions, And Transformations, Alexandra Ch Nowakowski

The Qualitative Report

Body Battlegrounds: Transgressions, Tensions, and Transformations offers a superb learning resource for exploring the body in social, emotional, cultural, and political contexts across many different career stages and disciplines. Edited by seasoned embodiment scholars Dr. Chris Bobel and Dr. Samantha Kwan, this new collection brings together 13 research reflections and 16 personal essays on different aspects of embodied resistance. It offers an expansive view of intersecting forms of body marginalization and ways to center these experiences in seeking embodiment justice. It also makes a superb resource for orienting learners at all career stages to embodied resistance and its crucial role …

Boomers And Fraudsters: A Closer Look At The Financial Elder Abuse Cycle In America, Ryan E. Brown

Marriott Student Review

In 2011, a landmark study was published by the Metlife Mature Market Institute claiming that nearly $3 billion disappears from the wallets and bank accounts of senior citizens annually. More surprising is that a similar study reported that figure could be as high as $36 billion. Because so many seniors let incidents of fraud or financial deceit go unreported, there is a huge discrepancy in annual reporting. This contributes to the overall lack of understanding we have of elder financial abuse, or why seniors continue to lose to fraudsters and scam artists. In a brief overview of financial elder abuse …

Barriers To Hiv Testing Within A Sample Of Spanish-Speaking Latinx Gay, Bisexual, And Other Men Who Have Sex With Men: Implications For Hiv Prevention And Care, Danielle N. Horridge, Timothy S. Oh, Jorge Alonzo, Lilli Mann-Jackson, Amanda E. Tanner, Eunyoung Y. Song, Benjamin D. Smart, Cornelius N. Van Dam, Logan S. Baker, Scott D. Rhodes

Health Behavior Research

Gay, bisexual, and other men who have sex with men (GBMSM) have higher rates of HIV infection compared to the general population in the United States, and the infection rate is growing among Latinx GBMSM, compared to a decline in most other demographic subgroups. Uptake of pre-exposure prophylaxis (PrEP), a biomedical strategy designed to reduce HIV transmission, is very low among Latinx GBMSM. HIV testing is a critical first step in the HIV prevention and care continua. We analyzed data from a community-based sample of Latinx GBMSM in the southeastern United States to identify the most common HIV testing barriers …

Why We Can’T Solve The Opioid Problem, Wayne F. Coombs, Ph.D.

Journal of Appalachian Health

Appalachia’s opioid epidemic is a complex, systemic problem being addressed by limited intervention processes conceptualized through narrow disciplinary models that are not working. We need a new comprehensive, collaborative approach if we ever hope to find solutions to this problem.

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

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Adult Food Security And The Relationship With Adverse Childhood Experiences Among Residents Of Appalachian North Carolina, Manan Roy, Erin Bouldin, Maggie Bennett, Adam Hege

Journal of Appalachian Health

Introduction: The Appalachian region has worse health outcomes than the remainder of the United States. These disparities are often linked to the underlying social and environmental determinants of health. Adverse childhood experiences (ACEs) are associated with poor health outcomes across the lifespan and have a significant impact on future social determinants as an adult, including food security status.

Purpose: To explore the relationships between ACEs and food security among adults in the Appalachian counties of North Carolina and make comparisons with the rest of the state.

Methods: Researchers used North Carolina’s 2012 Behavioral Risk Factor Surveillance System data; namely, …

Roanoke's Collective Public Health Activities, Michael Lytton

Journal of Appalachian Health

Roanoke is addressing problems that confront many small and medium sized cities in the U.S., especially disparities in health and life expectancy between neighborhoods. These disparities are often legacies of decades of racial and economic segregation, resulting in low-income or disinvested communities. Typically, such neighborhoods have fewer parks, higher vacancy rates and less stable affordable housing stock, inadequate public transit systems, too few clinics, too many fast food restaurants and insufficient access to high quality schools. In Roanoke these are the northwest and southeast quadrants, both federally designated Medically Underserved Areas, and characterized by a large proportion of the city’s …

Conflict Between Religious Beliefs And Sexuality: An Autoethnography, Carlos E. Gerena

The Qualitative Report

Despite the shift in attitudes in religious institutions toward homosexuals in the United States, there are some religions that continue to view same-sex behavior as a deviant and damning sin. For many, religious beliefs and values provide meaning and impact personal identity. Using autoethnography, I will explicate my own experiences with religious institutions and the ongoing conflict between religious beliefs and sexuality. I will discuss messages received from the Pentecostal church, family, and Latino community, and how these messages influenced my human development and emotional well-being. I show that internalization of the principles taught by the Pentecostal Church triggered a …

Exploration Of The Experiences And Viewpoints Of Faculty Members On Continuing Education Webinars: A Qualitative Study, Fatemeh Jafarzadeh-Kenarsari, Kobra Abouzari-Gazafroodi, Fatemeh Zaersabet

The Qualitative Report

Continuing education is necessary to improve the professional knowledge and skills of graduates of medical sciences, which may be implemented via e-learning. This qualitative study aimed to explore the experiences and viewpoints of faculty members participating in continuing education webinars. The participants consisted of 15 faculty members selected purposefully and with maximal variation regarding their sex, age, the field of specialization, academic rank, and work experience. Data were collected through semi-structured individual face-to-face interviews. Data analysis of these transcripts using a qualitative content analysis approach revealed 3 themes and 9 sub-themes. The main themes included “Moving across the boundaries of …

Hope, Courage, And Resilience In The Lives Of Transgender Women Of Color, Nadine Ruff, Amy B. Smoyer, Jean Breny

The Qualitative Report

There is a lack of qualitative and strengths-based knowledge about the lived experience of transgender women of color in the US. To address this research gap, a Photovoice project was undertaken with five transgender women living in a small urban area. Thematic analysis of the participants’ discussion of their photographs identified three major themes: hope, courage, and resilience. Analysis suggests a framework for understanding these women’s lived experiences and the psychosocial tools that they use to negotiate their daily lives and persevere in the face of interpersonal and structural oppression.

Review Of Infected Kin: Orphan Care And Aids In Lesotho, Cassandra L. Workman

The Journal of Social Encounters

In the opening vignette, “A Story about Joala,” we readers are brought to the highlands of Lesotho to share homebrewed beer with brewers, research participants, and the authors. This experience of sharing a drink asks us to consider what it means to share in Lesotho, what the ties are that hold people together. Like the communal sharing of food, sharing joala is a defining social activity and as we learn throughout the ethnography, one that is important in the creation of kin. Indeed, this book is presented though a kinship-first perspective.

Using this framework and ground-up analytical methodology, Block and …

The Gendered Experiences Of Male Students In A Speech-Language Pathology Graduate Program: A Multi-Case Study, Jairus-Joaquin R. Matthews, Derek E. Daniels

Teaching and Learning in Communication Sciences & Disorders

Speech-language pathology is a profession with a gender disparity wherein the majority of speech-language pathologists are female. This disparity is also reflected in speech-language pathology graduate programs. The American Speech, Language, and Hearing Association has developed many initiatives over the years to address this issue, yet the gender disparity still remains. The purpose of this study was to develop some initial insights into reasons that men enter into the profession of speech-language pathology, and their experiences in graduate programs. In this qualitative case-study approach, interviews were conducted with four male graduate students. The interviews were transcribed and analyzed for major …

An Interpretative Phenomenological Analysis Investigating Uk Female Experiences Of Psychosocial Adjustment Following Bariatric Surgery, Mark J. Maxwell

The Qualitative Report

The psychosocial impact of bariatric surgery has not been studied as diligently as the physical impact, particularly within the first 6 months following surgery. The aim of the present study was to explore psychosocial adjustment in UK bariatric candidates within this time-scale. Six female participants were purposively recruited to complete a semi-structured interview, and Interpretative Phenomenological Analysis was used to analyse their experiences. Four super-ordinate themes emerged from the interview data which were: (1) "It was me but it wasn’t me": pre-surgery identity, (2) "I don’t see myself as this fat blob of a person anymore": transforming identity, (3) "No …

Getting Change-Space: A Grounded Theory Study Of Automated Ehealth Therapy, Marianne T. S. Holter, Ottar Ness, Ayna Johansen, Håvar Brendryen

The Qualitative Report

A promising tool for bettering people’s health is eHealth (or “mHealth”) programs: fully automated, web-based health interventions. However, we know surprisingly little about eHealth’s working mechanisms. One possible working mechanism is that program users benefit from a collaborative “relationship”—a “working alliance”—with the program. Although evidence support the existence of a person-to-program alliance it is unclear if and how it influences change. Therefore, we conducted a grounded theory study of how relating to an eHealth program for quitting smoking influenced the participants’ change processes. The ensuing model focuses on how participants got change-space—feeling free from social forcing and able to work …

A Legacy Of Disease, Arthur L. Frank

Journal of Appalachian Health

In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.

Using Mini-Grants To Build Multi-Sector Partnerships In Rural Tennessee, Ginny Kidwell, Kristine Bowers, Taylor M. Dula, Randolph F. Wykoff

Journal of Appalachian Health

Rural counties in Tennessee, including those located in Appalachia, face some of the greatest health challenges in the nation. Unpublished data collated by the East Tennessee State University College of Public Health (ETSU) show that Tennessee’s 52 Appalachian counties vary dramatically from its 43 non-Appalachian counties in virtually all socioeconomic, behavioral, and health outcome metrics. Since 2011, the Tennessee Institute of Public Health (TNIPH) has actively encouraged local communities to address behavior change, enhance educational achievement, and improve economic conditions as essential components for improving health and well-being in rural Tennessee.

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Disparities In Quality Of Life By Appalachian-Designation Among Women With Breast Cancer, Robin C. Vanderpool, Ann L. Coker, Heather M. Bush, Sarah E. Cprek

Journal of Appalachian Health

Introduction: Few studies have examined the association of geography and quality of life (QOL) among breast cancer patients, particularly differences between Appalachian and non-Appalachian Kentucky women, which is important given the cancer and socioeconomic disparities present in Appalachia.

Purpose: The purpose of this study was to determine whether women with breast cancer residing in Appalachian Kentucky experience poorer health outcomes in regards to depression, stress, QOL, and spiritual wellbeing, relative to those living in non-Appalachian Kentucky after adjusting for demographic, socioeconomic, and health-related factors.

Methods: Women, aged 18–79, recruited from the Kentucky Cancer Registry between 2009 and 2013 with an …

West Virginia’S Sugary Drink Tax: Examining Print Media Frames In Local News Sources, Lauri Andress, Ogaga Urhie, Christine Compton

Journal of Appalachian Health

Introduction: Framing is an important aspect of the policy process that helps the public and decision makers sort through and resolve highly charged claims about an issue. Through slight changes in the presentation of issues, a framing effect may alter public support. The way a proposed sugary drink tax is discussed in public discourse and by the media significantly influences policy acceptance. Given the public health significance of obesity and diabetes in West Virginia (WV) the study of media frames employed to represent a sugary drink tax policy is useful.

Methods: Using quantitative content analysis, this study assessed news articles—published …

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Root Causes Of Appalachia’S Deaths Of Despair, F. Douglas Scutchfield Md

Journal of Appalachian Health

The U.S. is experiencing a decline in life expectancy, particularly among rural white males in their most productive years. Appalachia is disproportionally represented in mortality rates, accounting for 30% of the U.S. population, but 50% of the excess mortality attributed to the “deaths of despair”: drug overdose, suicide, and alcoholic cirrhosis. A substantial proportion of that excess mortality is related to the current opioid crisis we are experiencing. We have data on evidence-based solutions to the treatment of addiction, but little information on prevention of addiction as well as the other deaths of despair, likely with the same etiologic agent. …

Clinic Exploration Of Care Processes To Promote Colorectal Cancer Screening In Rural Accountable Care Organization Clinics: A Qualitative Case Study, Sarbinaz Bekmuratova, Jungyoon Kim, Hongmei Wang, Lufei Young, Daniel J. Schober, Li-Wu Chen

The Qualitative Report

It is essential to have an effective care process to promote colorectal cancer (CRC) screening particularly in rural areas. Primary care health care providers may have a significant impact on improving CRC screening rates among rural residents through systematic screening processes in their clinics. In this qualitative study, we aimed to explore the whole clinic processes of recommending and referring CRC screening in the rural accountable care organization (ACO) primary care clinics. We collected qualitative data through 21 semi-structured in-depth interviews with healthcare providers in rural primary care ACO clinics in Nebraska. We audio recorded and transcribed the interviews and …

Neverland: A Critical Autoethnography Of Aging With Cystic Fibrosis, Alexandra Ch Nowakowski

The Qualitative Report

In this autoethnography, I analyze stereotypes and misconceptions about people with cystic fibrosis (CF). I examine these illness representations and their social underpinnings through critical analysis of my journey to conclusive diagnosis with CF after first being tested for the disease in early life, and the events that have followed from that turning point. Using experiential data and prior research, I explore and refute harmful misconceptions about life with CF. I challenge the notion that people with CF never grow old. I also contest the idea that people who receive conclusive diagnoses during adulthood only then transition into patient identities. …

21st Century Teenagers And Young Adults Who Are Deaf Or Hard Of Hearing: Outcomes And Possibilities, Jean S. Moog, Amanda M. Rudge 3730756

Journal of Early Hearing Detection and Intervention

The purpose of this study was to document demographics, characteristics, and long-term outcomes of teenagers and young adults who are deaf or hard of hearing (DHH) and who all attended the Moog Center for Deaf Education for preschool and/or a portion of elementary school. Data were obtained via an online survey that was designed to assess educational, personal, and professional outcomes of individuals who were currently in high school and beyond. Survey questions were about the lives of these individuals after leaving the Moog Center. Participants included 108 individuals who were DHH, ranging from 15 to 32 years of age. …

Amputee Perspectives Of Virtual Patient Education, Sandra L. Winkler, Michelle Schlesinger, Krueger Alice, Ann Ludwig

The Qualitative Report

Amputees have expressed the need for more information on the recovery path that follows amputation. Inclusion of education in the amputation rehabilitation process empowers amputees to make decisions about their options and form realistic expectations. Virtual worlds are effective as healthcare support communities because they provide both synchronous and asynchrous communication, voice enabled technology, file sharing and more, enhanced by immersion in a visually stimulating and interactive 3-D environment. The objective of this research was to discover how a virtual world could be used to address amputees’ educational needs. A focus group of three lower limb amputees ages ranging from …