Filling in the Food Security Gaps: Examining The Farmers\u27 Market System in Norwalk, Connecticut

Farmers’ markets are seen as important venues for increasing access to nutritious food and mitigating chronic diseases. The 2016 Community Health Needs Assessment found chronic disease/obesity to be the primary health priority for the Greater Norwalk Region. In Norwalk, the prevalence of adult obesity reported in 2017 (22%) was significantly higher than the surrounding towns (11%). Farmers’ markets (FM) could be a potential approach to mitigating Norwalk’s chronic disease/obesity challenges through increasing access to nutritious food sources. While there are several small farmers’ markets held each summer in Norwalk, not much is known about the benefits and challenges of farmers’ market utilization in Norwalk from the perspectives of key stakeholders. The Norwalk Health Department hopes to increase farmers’ market usage as an approach to filling important food security gaps. The objectives of this study were as follows: Identify barriers and benefits of the Norwalk farmers’ market system from the perspective of consumers, farmers, and market managers in the Norwalk farmers’ market system, and increase community access to local, state, and federal resources.https://elischolar.library.yale.edu/ysph_pbchrr/1021/thumbnail.jp

Exploring Barriers to Primary Care Utilization in Transition-Age Males in Southern Connecticut

Optimus Health Care is a Joint Commission accredited and a federally qualified health center (FQHC) in Southern Connecticut, which serves thousands of male transition-age-youth per year. Attrition among males moving from pediatric to adult primary care is a nationally recognized issue. Literature suggests that there are three key barriers to young men seeking care: (1) concerns about confidentiality; (2) embarrassment and discomfort about disclosing their concerns; and (3) concerns about cost and accessibility (location, limited open hours). Studies highlight the importance of examining demographic trends and establishing consensus among transition protocols. This study seeks to assess the prevalence and magnitude of the young male attrition problem and evaluate transition services available to Optimus patients. This project will focus on the population of male transition age youth (TAY, 18-21 years old) who live within the Southern Connecticut areas (Bridgeport and Stamford) who move from pediatric to adult primary care at any one of Optimus Health Care’s locations.https://elischolar.library.yale.edu/ysph_pbchrr/1022/thumbnail.jp

Interfaith Approach to Elder Abuse: Developing a Screening Tool to Assist Faith Leaders Reporting of Elder Abuse

Background: Elder abuse is a complex public health issue that is receiving more media attention. The National Academies of Sciences defined elder abuse as either creating intentional harm or serious risk of harm towards a vulnerable elder, or the failure to satisfy the basic needs of an elder and protect them from harm (2002).Lachs and Pillemer (2004) reviewed the clinical and legal reports on elder abuse and have identified five main types: physical abuse, psychological abuse, sexual assault, material exploitation, and neglect. Previous research has demonstrated elders who have been abused to have higher rates of depression and chronic stress (Comijs et al., 1999), increased rates of post-traumatic stress disorder (Goldstein, 1996), increased helplessness, social isolation, and anxiety (Soloman, 1983; Booth, Bruno, and Marin, 1996), as well as decreased physical health outcomes (Lachs et al., 1998). Past research also demonstrates elders maintaining a strong relationship with their religious identity (Young and Dowling, 1987). Additionally, elders consider faith leaders at a high level of trust almost as important as the level of trust displayed toward their own family members (Daciuk, 2000). Main objectives: 1.) Provide basic information on elder abuse in Connecticut, 2.) Assess baseline knowledge and attitudes of elder abuse among faith leaders, 3.) Identify existing barriers that faith leaders may face when they suspect elder abuse, and 4.) Create a culturally relevant tool for faith leaders to detect elder abuse. Conclusion: The faith leader surveys and the semi-structured interview data collected on elder abuse detection and reporting and elder’s faith experiences in Southern Connecticut, respectively, is critical information to gain a deeper understanding of the complexity of elder justice. Future directions include pilot testing, reviewing, and eventually disseminating the Digital Detection Tool for Faith Leaders in Southern Connecticut to assist faith leaders in detecting and reporting elder abuse.https://elischolar.library.yale.edu/ysph_pbchrr/1046/thumbnail.jp

Challenges to hypertension and diabetes management in rural Uganda: a qualitative study with patients, village health team members, and health care professionals.

BACKGROUND: The prevalence of hypertension and diabetes are expected to increase in sub-Saharan Africa over the next decade. Some studies have documented that lifestyle factors and lack of awareness are directly influencing the control of these diseases. Yet, few studies have attempted to understand the barriers to control of these conditions in rural settings. The main objective of this study was to understand the challenges to hypertension and diabetes care in rural Uganda. METHODS: We conducted semi-structured interviews with 24 patients with hypertension and/or diabetes, 11 health care professionals (HCPs), and 12 community health workers (known as village health team members [VHTs]) in Nakaseke District, Uganda. Data were coded using NVivo software and analyzed using a thematic approach. RESULTS: The results replicated several findings from other settings, and identified some previously undocumented challenges including patients' knowledge gaps regarding the preventable aspects of HTN and DM, patients' mistrust in the Ugandan health care system rather than in individual HCPs, and skepticism from both HCPs and patients regarding a potential role for VHTs in HTN and DM management. CONCLUSIONS: In order to improve hypertension and diabetes management in this setting, we recommend taking actions to help patients to understand NCDs as preventable, for HCPs and patients to advocate together for health system reform regarding medication accessibility, and for promoting education, screening, and monitoring activities to be conducted on a community level in collaboration with village health team members

From Castus to Casticismo: Conceptions of Purity in Modern Spain

With the exception of the well-known figure of the ángel del hogar, concepts of purity in post-inquisitional Spain have rarely been used as central categories of analysis. This dissertation aims to address an important lacuna within nineteenth-century Spanish studies by tracing the complex ways in which purity, as an ideological regime, continued to operate as a less explicit but important construct in modern Spain. Rather than declining, such regimes metamorphosed into an array of discourses that positioned purity as a foundational ideological category for modern subjectivity and national identity in late imperial Spain. Specifically, I turn to the major realist novelists of the nineteenth century - Juan Valera, Leopoldo Alas, Emilia Pardo Bazán, and Benito Pérez Galdós -- to examine how realist fiction stages counter-narratives to essentialist notions of purity and impurity formulated and consequently deployed by Medicine, the Church, and the State. The dissertation traces the ways in which historical notions of pure lineage or pure blood underwrite "modern" and "post-inquisitional" notions of sexual, racial, and bodily purity, particularly in the last third of the nineteenth century, also known as the Restoration period. I advance a critical understanding of these diverse forms of purity through what I identify as the discourse of casta. Originating from the Latin castus (clean, pure), casta can be translated into English as "caste" or "chaste," a profoundly revealing ambiguity that drives my analysis. Over the course of the dissertation I chart casta's semantic permutations including: female sexual purity (castidad); heritage, blood, and lineage (casta/o); and national purity (lo castizo/casticismo). The usage of casta/o and its related terms is always a gendered, racialized, and class-specific articulation of purity. The common thread that links these diverse definitions together, I argue, is the regulation of gender. Sexual purity, (and later racial, class- and national purity) is an implicit part of what casta evokes across its semantic evolutions. The texts examined here reveal that the discourse of casta is central to the production of idealized national subjects during a time of political instability and imperial decline. While casticismo appears to be fundamental to the production of the nation, its ambivalent and polyvalent nature complicates and at times undermines the success of nationalist project

Cardiac clients and nurses perception of self management

• Self management is an integral part of the continuum of care for cardiac health clients as cardiac conditions often require lifestyle changes. Therefore, it is important to understand how patients and health care professionals view self management to improve communications and patient health. • We investigated the literature regarding self management perspectives and found that more research needs to be done. We therefore interviewed 8 clients and 8 nurses at a cardiac outpatient clinic in Surrey, British Columbia about their perspectives on self management and their own regiments/recommendations.Applied Science, Faculty ofNursing, School ofUnreviewedUndergraduat