Resilience and Coping in Mothers of Children with Sickle Cell Disease

Sickle cell disease (SCD) is a prominent chronic illness in the United States. The Centers for Disease Control and Prevention (2016) estimated that one child out of every 365 African-American births will have SCD, affecting approximately 100,000 Americans. Supporting and promoting the integrity of the family and its’ members when a child has SCD is important for each family member’s well-being. Specific family characteristics, such as resilience and coping are important to understand because they can mitigate stress and create positive family outcomes (Brown et al., 1993; Cousino & Hazen, 2013; Hildenbrand, Barakat, Alderfer, & Marsac, 2015; O’Hanlon, Camic, & Shearer, 2012; Oliver-Carpenter, Barach, Crosby, Valenzuela, & Mitchell, 2011; Windle, 2010). The relationship between resilience and coping is one of great research interest in patients and families living with chronic health conditions. Research on resilience indicates it is a dynamic process that is multidimensional, indicating variation among different populations (Luthar, Cicchetti, & Becker, 2000). The literature review revealed gaps in this research interest involving mothers caring for children with SCD. The purpose of this study was to examine the variables that may influence coping in mothers caring for a child or children with SCD and to determine if resilience contributes to coping. The resiliency model of family stress, adjustment, and adaptation (McCubbin & McCubbin, 1993) was the theoretical framework of the study. Findings are intended to assist healthcare professionals in supporting resilience interventions to produce positive outcomes. This study utilized a nonexperimental exploratory correlational design to determine variable relationships in the study population. This study was conducted online using Qualtrics. Participants were mothers, over the age of 18, caring for a child or children with SCD. The participants were a representative sample (N=108) from regional SCD support group agencies. Data were collected and analyzed from the participants’ self-reported responses to the researcher developed demographic questions and two situational variable questions, the Connor-Davidson Resilience Scale (CD-RISC), and the Coping Health Inventory for Parents (CHIP). Study findings indicate the strong positive relationship between resilience and coping. The mothers’ responses to the situational variables, stress level and how sick their child is, were also significant in predicting resilience and coping in the study population. The findings of this study allow the researcher to predict one’s coping score based on their resilience score. Interventions implemented by healthcare professionals to increase resilience in the study population can likewise increase coping and overall well-being of the entire family when caring for a child with a chronic illness such as SCD

Crowd behaviour in chemical, biological, radiological and nuclear (CBRN) emergencies: behavioural and psychological responses to incidents involving emergency decontamination

Planning for incidents involving mass decontamination has focused almost exclusively on technical aspects of decontamination, with little attempt to understand public experiences and behaviour. This thesis aimed to examine relevant theory and research, in order to understand public behaviour during incidents involving mass decontamination, and to develop theoretically-derived recommendations for emergency responders. As these incidents involve groups, it was expected that social identity processes would play an important role in public responses. A review of small-scale incidents involving decontamination is presented, along with a review of decontamination guidance documents for emergency responders. This literature shows that responder communication strategies play an important role in public experiences and behaviour, but that the importance of communication is not reflected in guidance documents. Theories of mass emergency behaviour, in particular the social identity approach, are reviewed, in order to generate hypotheses and recommendations for the management of incidents involving mass decontamination. It is hypothesised that effective responder communication will increase public compliance and cooperation, and reduce anxiety, mediated by social identity variables (e.g. perceptions of responder legitimacy, identification with emergency responders and other members of public, and collective agency). The empirical research presented in this thesis tests the hypotheses and recommendations derived from the social identity approach. The research includes: a responder interview study; three studies of volunteer feedback from field exercises; a visualisation experiment; and a mass decontamination field experiment. Findings show that effective responder communication consistently results in increased willingness to comply with decontamination, and increased public cooperation; this relationship is mediated by social identity variables. Results support the hypotheses, and show that an understanding of the social identity approach facilitates the development of effective responder communication strategies for incidents involving mass decontamination. Four theoretically-derived, and evidence-based, recommendations for emergency responders are generated as a result of this thesis

Soil water movement along a loess and alluvium interface in West Tennessee

Ongoing water quality research at the University of Tennessee Ames Plantation Agricultural Experiment Station in west Tennessee, has provided opportunity to examine the factors affecting soil water movement, for applications in determining the fate of agricultural chemicals. This research was to create a high intensity, order one soil survey map of the research plot, and to examine the effects of soil morphology on the direction of soil water movement. In order to establish general morphology of the research area, four soil cores equally spaced in a 15.24 meter linear transect were taken with a Giddings-S-M hydraulic probe using a 7.62 cm sampling tube. Morphology of each core was recorded in the field. Individual horizons of each core were sampled and taken to the laboratory for determination of; total carbon, particle size, citrate-dithionite extractable iron oxides, KCI exchangeable acidity, hydroxylamine-hydrochloride extractable manganese, exchangeable bases, cation exchange capacity, free carbonates, and pH. Moist sub-samples of each horizon were refrigerated for determination of background chloride levels. Based on field morphology notes and laboratory data, the four transect cores were classified to the family level, as fine-silty, mixed, thermic Typic Hapludalfs. The soil morphology for 32 cores surrounding a 0.05 hectare release area on the research plot were recorded. Alluvium was found underlying the surface loessial layer across the entire plot. Based on the depth to this alluvial paleosol and soil morphology, a high intensity, order one soil survey map was created. Surface and paleosurface topography and 3-dimensional surface maps were also made based on measured elevations and depths. Shallow sampling wells were set to the depth of the alluvium in each of the 32 holes where the cores were taken. A prediction as to which wells would receive water based on their topographic position on the alluvial surface, and also a prediction of the general expected direction of movement across the plot were made. A 527 m2 tracer release area was established in the center of the previously designated release area. A calcium chloride tracer solution was applied to the release area and allowed to move into and through the soil, after which wells that yielded water were sampled. A total of two background and three post-release sampling events occurred, lon-chromatography results reflecting background and post-release chloride levels were statistically inconclusive, and could not be used to prove or disprove the validity of the prediction. Instead, the presence of water samples in a well on all three sampling dates was considered to make that well a consistent receptor. While individual wells were not very successfully predicted, the general direction of soil water movement was quite accurately forecasted

Effective responder communication improves efficiency and psychological outcomes in a mass decontamination field experiment: implications for public behaviour in the event of a chemical incident

The risk of incidents involving mass decontamination in response to a chemical, biological, radiological, or nuclear release has increased in recent years, due to technological advances, and the willingness of terrorists to use unconventional weapons. Planning for such incidents has focused on the technical issues involved, rather than on psychosocial concerns. This paper presents a novel experimental study, examining the effect of three different responder communication strategies on public experiences and behaviour during a mass decontamination field experiment. Specifically, the research examined the impact of social identity processes on the relationship between effective responder communication, and relevant outcome variables (e.g. public compliance, public anxiety, and co-operative public behaviour). All participants (N = 111) were asked to visualise that they had been involved in an incident involving mass decontamination, before undergoing the decontamination process, and receiving one of three different communication strategies: 1) Health-focused explanations about decontamination, and sufficient practical information; 2) No health-focused explanations about decontamination, sufficient practical information; 3) No health-focused explanations about decontamination, insufficient practical information. Four types of data were collected: timings of the decontamination process; observational data; and quantitative and qualitative self-report data. The communication strategy which resulted in the most efficient progression of participants through the decontamination process, as well as the fewest observations of non-compliance and confusion, was that which included both health-focused explanations about decontamination and sufficient practical information. Further, this strategy resulted in increased perceptions of responder legitimacy and increased identification with responders, which in turn resulted in higher levels of expected compliance during a real incident, and increased willingness to help other members of the public. This study shows that an understanding of the social identity approach facilitates the development of effective responder communication strategies for incidents involving mass decontamination

Recognising and understanding collective resilience in crowds of survivors

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Using Speed Meetings to Connect Extension Experts with University Health Researchers

Speed meetings are an innovative approach to creating partnerships among Extension experts and university health researchers. Extension educators play a pivotal role in providing community-based education, building partnerships across the state, and disseminating local research on a community level. The Extension Health Research team at Michigan State University has organized and held four speed meetings to educate researchers and faculty on Extension\u27s history, infrastructure, and existing health programs. Participants at the speed meetings gained familiarity with Extension, and subsequent connections made with educators have strengthened research and funding opportunities in mutually beneficial ways

Preparing Extension Educators for Community-Based Research and Grant Partnerships

Two trainings to prepare Extension educators for research and grant partnerships were designed, implemented, and evaluated. These trainings further national goals to address health disparities, gain partnerships in the health care sector, and support health extension. The workshop Are You Research Ready? prepares Extension educators to participate in community-based human health research. Evaluations indicated that attendees gained a self-assessment of research readiness and felt more confident to position themselves for grants. Program evaluations also showed that educators needed additional training on how to create partnerships. A second workshop, Are You Partnership Ready?, addresses this need, increasing participants\u27 confidence and skills for engaging in research projects and building partnerships

The Effects of Age, Sex, and Class Stratification and the Use of Health Care Services among Older Adults in the United Kingdom

As the population ages, providing health services for the growing number of older people will become an increasingly difficult problem. In countries where the health services are provided by the government, these problems are involved with complicated issues of finance and ethics. This is the case of the National Health Service, the government institution providing health care for the citizens of the United Kingdom. Knowing what social factors influence health care usage can be a link to match usage and funding. Literature has shown that health care utilization can be predicted by social factors, as well as the medical model, and from this orientation social variables were drawn from the 1994 General Household Survey. Social factors were analyzed to determine relationships that exist between certain types of health care use and these factors. Age, sex, and class, the three main factors shown in literature to affect usage, were then analyzed to determine if services are allocated on the basis of these factors or the basis of need from illness and disability. Results of the study show that of the predisposing variables, age, sex, and class, are associated with most types of health care use. From the enabling variables, both source of income and visits from friends and relatives are associated with most types of health care. Of the illness determinants, disability, limiting illness, restricted activity days and eyesight difficulty were all related to health care use. When intervening control variables were introduced, the intervening control variables of difficulty with activities of daily living and difficulty with instrumental activities of daily living had an explanatory effect on the use of home help, district nursing, consultations with a general practitioner at home, consultations with a general practitioner at a surgery or health clinic, and inpatient stays. These services were offered more according to need than the factors of age, sex, and class

Maoism, religion and political socialization in China : a functional analysis.

Thesis. 1978. Ph.D.--Massachusetts Institute of Technology. Dept. of Political Science.MICROFICHE COPY AVAILABLE IN ARCHIVES AND DEWEY.Vita.Bibliography : leaves 345-357.Ph.D