Medicine and Health Sciences Commons^™

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 …

The Need To Codify Roe V. Wade: A Case For National Abortion Legislation, Kathryn N. Peachman

Journal of Legislation

No abstract provided.

Our Criminal Justice System Should Not Be Our Mental Health System (But It Is), Donald Roth

Faculty Work Comprehensive List

"Our criminal justice system is like the silt layer at the bottom of the ocean. If a problem isn’t taken care of higher up in society, it will eventually find its way down to the criminal justice system."

Posting about the need for criminal law reform from In All Things - an online journal for critical reflection on faith, culture, art, and every ordinary-yet-graced square inch of God’s creation.

https://inallthings.org/our-criminal-justice-system-should-not-be-our-mental-health-system-but-it-is/

Healthcare Access And Poverty Among Central Appalachian Residents, Kacey M. Lefevers

Kentucky Journal of Undergraduate Scholarship

Healthcare access is an important shaping force in the lives of Appalachian people. Appalachians often face both inadequate availability of medical facilities and poverty, which limits access to health insurance and therefore healthcare. This results in reduced life expectancy and health disparity. In this study, the author examines relationships between adequate healthcare and access to healthcare among Appalachian residents. Using a convenience sample of Appalachian residents, the author finds that income, education, and being an Appalachian resident have unique impacts on healthcare access or perceptions of healthcare in general.

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

Psychosocial Well-Being And Efforts To Quit Smoking In Pregnant Women Of South-Central Appalachia, Brittney Stubbs, Valerie Hoots, Andrea D. Clements, Beth Bailey

ETSU Faculty Works

Introduction: Psychosocial well-being variables from the Tennessee Intervention for Pregnant Smokers (TIPS) study, a longitudinal smoking cessation study in South-Central Appalachia, were investigated as potential predictors of smoking status.

Methods: A sample of 1031 pregnant women participated in an expanded 5A's (Ask, Advise, Assess, Assist, Arrange) program, from 2008 to 2011. Measures of stress, self-esteem, depressive symptoms, and disordered eating collected by interview during the first trimester, or during the third trimester in a combined interview if participants began prenatal care late, were hypothesized to differ among three groups of participants: pregnant women who never smoked, pregnant women who smoked …

“You Do It Without Their Knowledge”: Is Nonconsensual Comdom Removal The New Public Health Emergency?, Marwa Awad Mohamed

Electronic Theses, Projects, and Dissertations

Background: Sexual consent is often defined as the voluntary agreement to participate in a sexual act, though the differing definitions across and within countries make legal consensus difficult. In recent years, due to popularization through social media, nonconsensual condom removal, termed stealthing, is becoming common, especially among young adults. Yet, little to no empirical evidence exists on this sexual behavior.

Methods: In this exploratory sequential mixed methods approach, we aimed to address the current perception of stealthing among young adults. College students were recruited from general education courses at a medium-sized four- year public university. Focus groups were conducted to …

Youth-Sized Lab Coats: When Children Become Doctors Through Adolescent Healthcare Brokering, Lindsey Russell

Social Sciences

Child language brokering refers to the practice of children acting as linguistic and cultural mediators in general settings like school, stores, banks and other personal uses. The primary focus of this paper is “adolescent healthcare brokering,” a term coined in 2016 by researchers Jennifer R. Banas, James W. Ball, Lisa C. Wallis and Sarah Gershon, to refer to the use of children as interpreters for family and community members, specifically in the healthcare setting; these cross-lingual communications may occur during regular physician appointments, trips to the emergency department or at specialized visits in fields such as obstetrics or oncology.

This …

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 …

Illness And The American Workplace: Issues And Implications For Employers And Employees, Victoria R. Dolan

Student Theses and Dissertations

This project aims to identify American employee experiences and existing workplace policies and cultures surrounding illness, disability, and sick leave. This approach was taken in order to closely examine what looks to be working well for companies and workers, and what could benefit from a more human centric approach in regards to workplace policy and employee support programs. The study of employee experiences in particular represents a gap in the current scholarly literature regarding illness and illness policy in the American workplace, and more accurately represents the experiences for both employees and employers. Furthermore, it assists with distinguishing the types …

The Impact Of Cleft Lip/Palate And Clp Surgical Intervention On The Social Integration Of Adolescents In India, Mustafa Zahid

Master's Theses

Cleft Lip/Palate, a congenital orofacial anomaly, carries an incidence rate of approximately 1 in every 1000 births. In addition to the stigma associated with the condition, the varying levels of cleft severity might result in lower life outcomes which could include lower cognitive ability, physical and psychological well-being, social and behavioral outcomes of adolescents. This paper focuses on the social integration element of life outcomes, which is composed of the social inclusion and prosocial behavior of the adolescent. Despite the affordability of restorative surgeries, patients in rural areas of Low and Middle-Income Countries (LMICs) such as India face accessibility and …

“Do I Need Exercise?” A Qualitative Study On Factors Affecting Leisure-Time Physical Activity In India, Shalini Garg, V Raman Kutty

The Qualitative Report

Physical activity can reduce the risk of premature mortality from various chronic diseases. Previous research in Kerala, India indicates several barriers which can impact physical activity levels. Perceptions about the importance of health-promoting physical activity were examined among adults in Kerala and various facilitators, motivators and barriers to physical activity were identified using focus group discussions and interviews with key informants. At present, the attitude of people and health professionals is that physical activity has to be taken up when diagnosed with a disease (obesity, diabetes) and advised by a health professional. Men were more likely to start exercising after …

Watering Black Roots: Exploring Black Ecological Identity Development Within Nature-Based Expressive Arts Therapy, Stormy Saint-Val

Expressive Therapies Capstone Theses

Nature-based expressive arts therapy promotes the holistic healing and recovery of individuals by interweaving the practices of ecopsychology, ecotherapy, and expressive arts therapy. These interventions have been proven to mediate ranges of symptomologies, such as anxiety disorders and PTSD. Research conducted by the U.S. National Park Services indicates that African- Americans are less likely to have a positive relationship to nature than all other racial groups. The amplification of this report without introspection of its context perpetuates racialized generalizations. This can limit a black individual’s ability to embrace their ecological identity and be receptive of nature-based expressive arts therapy interventions. …

The Stories Behind The Struggle: A Closer Look At First Experiences With Opioid Misuse, Khary Rigg, Shannon M. Monnat, Kate Mclean, Ashton Verdery, Glenn Sterner

Population Health Research Brief Series

Opioid use disorders and overdoses from prescription opioids, heroin, and fentanyl have become a national public health crisis. Improving our knowledge about how people first come to misuse opioids can help to inform prevention and treatment interventions. This research brief dives into the stories behind opioid use initiation and provides intervention strategies.

Women’S Experiences With Epilepsy Treatment In Southern India: A Focused Ethnography, Jane R. Von Gaudecker 3172782758, Ann Gill Taylor, Janice M. Buelow, Sailas Benjamin, Claire B. Draucker

The Qualitative Report

Women with epilepsy in rural southern India often do not receive anti-epilepsy drugs (AEDs) or take these drugs regularly, but little is known about how they experience the epilepsy treatment they do receive. The purpose of this study was to provide an in-depth description of the treatment experiences of women in this region who had been diagnosed with epilepsy but who do not consistently take AEDs. Focused ethnography was conducted using participant observation and in-depth interviews with six women with epilepsy, eight of their family members, and two traditional healers. The women’s treatment experiences are best described as living at …

Implementation Of An Advance Care Planning Protocol To Increase Advance Directive Completion Rates, Christine Engle

Evidence-Based Practice Project Reports

Advanced directives (AD) allow an individual to retain autonomy in end-of-life decisions and can prevent unnecessary costs and treatments associated with aggressive life-prolonging measures. As of 2017, only an estimated 36.7% of the United States adult population had a form of advance directive documented (Yadav et al., 2017). The purpose of this evidence-based project was to determine if implementation of an advanced care planning (ACP) protocol would increase ACP discussions, AD completion, and result in a modification in stage of change or behavior. The Transtheoretical Model (TTM) and Stetler Model of evidence-based practice were used as the framework to guide …

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 …

Measurement Of Bystander Actions In Violence Intervention Evaluation: Opportunities And Challenges, Heather M. Bush, Samuel C. Bell, Ann L. Coker

Biostatistics Faculty Publications

Purpose of Review

This review discusses design and methodological challenges specific to measuring bystander actions in the evaluation of bystander-based violence prevention programming. “Bystanders” are defined as people who are present immediately before, during and/or after a violent event, but are not a perpetrator nor the intended victim. Bystander-based violence prevention programs seek to prevent or mitigate violent events by empowering bystanders to intervene on acts of violence and social norms that promulgate violence.

Recent Findings

Effective bystander-based violence prevention programs demonstrate increased bystander intentions, actions, and attitudes [Bringing in the Bystander: Banyard et al. J Community Psychol. 2007;35:463-481; iSCREAM: …

An Introduction To Transformative Inquiry: Understanding Compelling And Significant Relationships For Personal And Societal Transformation, Mark L. Mccaslin, Kelly A. Kilrea

The Qualitative Report

Transformative inquiry is a theoretical model designed to facilitate the inquiry of important and meaningful relationships that transform and potentiate us. Creswell (2007) described the essential elements of a research agenda: the axiological, ontological, epistemological, methodological, and rhetorical. Each carries with it assumptions that hold implications for practice and research. Transformative inquiry addresses all of these elements through considerations given to deep ecology, transdisciplinarity, integral meta-theory, heuristic research, and eudaimonistic philosophy, respectively. Transformative inquiry is an approach to understanding and fostering the full range of deep and meaningful relationships from the personal to the political, and beyond. It is a …

Health Literacy Challenges And Opportunities: Bringing Children’S Mercy And Kansas City Together, Jennifer A. Lyon, Angie Knackstedt, Barbra Rudder, Mamta Reddy Md, Courtney R. Butler

Posters

BACKGROUND: A multidisciplinary group at Children's Mercy Kansas City applied for and received the NNLM MCR's Immersive Workshop Grant in December, 2017, and used the funding to organize and host a two-day immersive, interprofessional workshop in April, 2018, that 1) brought together health literacy-invested groups and individuals within the Kansas City community to learn about health literacy including cultural, language, numeracy and digital inclusion factors; and 2) provided specialized training to targeted CM participants to improve the provision of bedside health information to patients and caregivers. Objectives included: increasing community-wide collaboration, sharing resources, encouraging participants to become change agents, and …

God, I Hope This Part Of My Life Is Over: A Focused Ethnography Of A Correctional Youth Facility’S Therapeutic Climate, Eric Meyer

Theses & Dissertations

Although all prisons have the same goal of isolating offenders from society, the precise strategies used vary from one jurisdiction to the next. Some prisons use means of punishment to gain inmate compliance. Other prisons concentrate their limited resources on rehabilitation. Contained within the following pages are details of a focused ethnography that was completed in a state correctional youth facility that housed males between the ages of 15 and 21 years, all of whom were convicted of violent crimes. This study had the objective of exploring the climate of therapy in this correctional youth facility where rehabilitative programs were …

Rationale, Design, And Baseline Characteristics Of Walkit Arizona: A Factorial Randomized Trial Testing Adaptive Goals And Financial Reinforcement To Increase Walking Across Higher And Lower Walkable Neighborhoods, Marc A. Adams, Jane Hurley, Christine Phillips, Michael Todd, Siddhartha Angadi, Vincent Berardi, Melbourne F. Hovell, Steven Hooker

Psychology Faculty Articles and Research

Little change over the decades has been seen in adults meeting moderate-to-vigorous physical activity (MVPA) guidelines. Numerous individual-level interventions to increase MVPA have been designed, mostly static interventions without consideration for neighborhood context. Recent technologies make adaptive interventions for MVPA feasible. Unlike static interventions, adaptive intervention components (e.g., goal setting) adjust frequently to an individual's performance. Such technologies also allow for more precise delivery of “smaller, sooner incentives” that may result in greater MVPA than “larger, later incentives”. Combined, these factors could enhance MVPA adoption. Additionally, a central tenet of ecological models is that MVPA is sensitive to neighborhood environment …

Determination Of Intersex Humans In Human Remains, Audria Payne

CURCE Annual Undergraduate Conference

Currently, there isn’t much research on whether forensic anthropologists include the identification of intersex humans in human remains. Forensic anthropologists tend to have varied training that is related to identifying skeletal remains, but there isn’t much research about how to identify intersex humans after death or whether they have come across intersex in skeletal remains at all, besides those they have classified as ambiguous. In this paper, I will be researching various skeletal remains to see if the current identification methods of identifying sex are accurate in identifying intersex. I will also research ambiguous and undetermined remains to see if …

“Flowing Along The Wall”: Anarcha-Feminist Bioethics And Resistance In Octavia E. Butler’S Dawn 2019., Theresa Mendez

Master's Theses

Science fiction (sf) texts conversant with the temporal play between past, present, and future push readers to imagine the extremes of human and environmental existence, interaction, and potential. Simultaneously, despite the sf genre’s tendency to traffic in extremes, these texts provoke readers to consider the ways in which these imagined worlds are grounded in history as well as in the contemporary social moment. As Donna Haraway has argued, “the boundary between science fiction and social reality is an optical illusion” (306). This illusory boundary must continue to be traversed in order to consider how sf literatures, particularly those which imagine …

“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 …

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 …

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.