Arrival in Dakar

Postcard from Jenna Johnson, during the Linfield College Semester Abroad Program in Dakar, Senega

The Press, National Security, and Civil Discourse: How a Federal Shield Law Could Reaffirm Media Credibility in an Era of “Fake News”

The Constitution expressly provides protection for the freedom of the press. Yet there is one area in which the press is not so free: the freedom to refuse disclosing confidential sources when subpoenaed by the federal government. Currently, there is no federal reporter’s privilege. The Supreme Court has held the First Amendment provides no such protection, and repeated congressional attempts to codify a reporter’s privilege in a federal shield law have failed. Arguments against a shield law include national security concerns and the struggle to precisely define “journalist.” Such concerns were evident in the most recently proposed shield law, the Free Flow of Information Act of 2017. This Comment advocates in favor of passing a federal shield law. Specifically, this Comment analyzes the Free Flow of Information Act of 2017 against the backdrop of a post-9/11 America where “fake news” runs rampant. Though far from perfect, the proposed law was a step toward balancing national security concerns with press freedom. Legislators can and should strike an effective balance between these two tensions by accurately defining terms like “national security” and “properly classified” to prevent government overreach. Finally, this Comment argues that a federal shield law is necessary to combat the recent national security concerns raised by “fake news” and thereby reaffirm media credibility

Data-Driven Change in Oregon Psychologists’ Knowledge and Attitudes about Prescriptive Authority

With over half of all states having considered legislating prescriptive authority, an immense amount of time and money has been invested. The literature is limited in terms of understanding if opinions toward prescriptive authority are grounded in knowledge and what implications that has for altering these opinions. Following a veto of a prescriptive authority bill in Oregon, 160 licensed Oregon clinical psychologists were surveyed regarding their attitudes and knowledge. In terms of knowledge, only 5.6% knew which three states/territories currently have prescriptive authority and 70.4% were unfamiliar with any of the prerequisites for postdoctoral training in psychopharmacology. Reflecting division, 42.8% were in favor, 20.1% were undecided, and 37.1% were in opposition to broadening privileges for psychologists. Further, only 15.1% expressed interest in pursuing training or 6.4% in becoming a prescriber. Data on access, training, and legislative costs were presented to participants in the education condition. These participants showed significant gains in their knowledge across all domains and their opinions shifted only in these specific areas leaving their general stance on the issue unchanged. In contrast to ardent supporters who argue that their “data should provide reassurance to psychologists spearheading legislative initiatives” because of high approval ratings (Sammons et al., 2000, p. 608), our data suggest disagreement amongst a group of professionals who are not particularly well-informed, nor interested in becoming prescribers. Future work should investigate whether expanding the data relevant to other facets of the argument contributes to further targeted change or an overall change in opinion toward prescriptive authority

Where Words Fail, Music Speaks: The Impact of Music Intervention on Speech Therapy Outcomes

Within this thesis, the benefits of music-based intervention used within speech therapy sessions is explored through the study of neurology, literature reviews, and research data. The neurological pathways of speech and music depend on common processes in the mind; this relationship could potentially reveal benefits when using certain music activities in speech therapy sessions. The neurological link between language and music has been implemented in studies in speech therapy clients with fluency disorders (stuttering), patients with Parkinson’s disease, and children with autism spectrum disorders (ASD). However, there is a shockingly small number of studies surrounding patients with speech sound disorders, one of the most common populations treated in the field of speech therapy. These studies, along with an analysis of neurological pathways involved in both music and speech processing, provided knowledge that guided independent research with a client in the Eastern Kentucky University Speech-Language-Hearing Clinic with an articulation disorder. Data was collected to assess the use of auditory bombardment through song and musical instruction during speech therapy sessions with this client. The use of these musical interventions showed an increase in both motivation and enjoyment of speech therapy; an increase in these areas of client response correlates with an increase in progress towards speech therapy goals. While there are many limitations to the study that do not allow the results to be generalized, there are many evident benefits of music intervention in speech therapy sessions that have been identified through this study

Treadmill Walking Capacity among Older Adults in Assisted Living Settings: A pilot, feasibility study

Background: Decreased physical activity levels are an increasing concern, specifically for the aging population. Older adults (>65 years) are able to achieve health benefits from participating in a regular exercise program based on studies done in younger community-dwelling older adults. However, there is less research investigating the efficacy of exercise for improving physical function among the older adult population in assisted living settings. Barriers among the research that has been done so far include generalizability, specificity and varying exercise prescription details. The present study investigated the novel idea of using a treadmill with a harness system, to engage older adults in aerobic exercise. It is unknown if it is feasible to recruit and retain older adults in assisted living settings for such a treadmill study and if older adults would be able to achieve intensities associated with health benefits. Objectives: To determine the feasibility of recruitment and retention of older adults in an assisted living facility for a pilot treadmill walking study. Secondary objectives include: to identify determinants of participation and compliance with the treadmill study and to determine if the older adult population in assisted living settings are able to achieve exercise intensities aligned with established guidelines that are associated with health benefits. Design and Setting: Pilot, multi-visit feasibility study in an Assisted Living Facility in the Kitchener-Waterloo Region with care needs ranging from Retirement Home to Palliative Care Population: Older adults (>65y) living in an assistive living facility who could follow two-step commands and were able to walk two metres independently (with or without the use of an aid). Methods: The feasibility of recruitment and retention was determined by recording: the number of older adults who consented to participate in treadmill walking for three weeks; the number of older adults (and/or their legal representatives) who declined treadmill participation and reasons as to why; and the number of participants who completed the six treadmill sessions. Healthrelated and demographic characteristics were collected to characterize the population while age, number of co-morbidities, number of medications, cognition, fear of falling and walking ability were evaluated as potential determinants of participation. A detailed attendance log was used to assess compliance with the study. To determine if participants could achieve the recommended exercise intensity associated with health benefits, exercise intensity (40 %HRR) and duration (twenty minutes) achieved after the final treadmill session were reported. Results: Thirty percent of the residents on the eligibility list were recruited and consented to participate in the treadmill study. Average compliance was 94.4%±10.8%; one treadmill participant dropped out due to declining health. There are no significant differences between treadmill participants and those who chose not to walk on the treadmill. Treadmill participants were able to achieve the recommended intensity (40%HRR) and achieved an average intensity of 50.3% ± 30.2% and a frequency of three sessions in one week. Average total duration was approximately five minutes shy (14:53min ± 6:43min) of the recommendation of twenty minutes. Conclusion: The current study provides preliminary evidence that it is feasible to recruit and retain older adults in assisted living facilities to participate in a three week treadmill walking study, however it may be difficult to recruit a large number of individuals for a larger study. Treadmill participants were able to achieve ACSM’s recommended intensity and frequency for aerobic or endurance exercise. Secondly, the older adult population living in assisted settings may be able to achieve the recommended exercise prescription targets for cardiovascular training, specifically intensity and frequency; however they may need more than three weeks of progression or multiple sessions per day to obtain the recommended duration

Force of Beauty or Object of Desire? The Priming Effects of Makeup Video Advertisements on Self-Objectification in College Women

Women are too often valued for their beauty and have shifted their focus from character to body improvement (Brumberg, 1998). Objectification theory (Frederickson & Roberts, 1997) posits that sexual objectification socializes females to evaluate themselves based on looks. Self-objectification is the attempt to control this external perception by monitoring one’s physical appearance. Women are more likely to think “How do I look?” than “What am I capable of?” The priming effects of positive and negative body-focused makeup advertisements on college-aged women’s level of self-objectification were examined in two separate studies. In study one, 87 participants viewing positive vs. negative advertisements reported more traits and abilities; this was especially true for high self-objectifiers. Participants viewing positive advertisements reported more positive emotions, suggesting the salutary role that positive messaging may play. Results were replicated in study two, with 172 participants who viewed positive vs. negative advertisements reporting significantly fewer body shape statements, more trait and abilities, as well as more physical competence statements. In addition, individuals who viewed advertisements with non-objectifying content responded with a significantly greater number of positively valenced statements and significantly fewer negative statements about themselves in comparison to women who viewed objectifying advertisements. These results suggest that marketers should eschew advertising that sexually objectifies women and promotes unattainable beauty goals. Future research should evaluate cumulative and long-term effects of advertisement and examine whether exposure that leads to lower levels of objectification also minimizes negative consequences associated with objectifying media influences (e.g., body shame, depression, eating disorder)

Oregon Psychologists on Prescriptive Authority: Divided Views and Little Knowledge

With over half of all states having considered legislating prescriptive authority, an immense amount of time and money has been invested. The literature is limited in terms of understanding if opinions toward prescriptive authority are grounded in knowledge and what implications that has for altering these opinions. Following a veto of a prescriptive authority bill in Oregon, 399 licensed Oregon clinical psychologists were surveyed regarding their attitudes and knowledge. In terms of knowledge, only 6.5% knew which three states/territories currently have prescriptive authority and 70.4% were unfamiliar with any of the prerequisites for postdoctoral training in psychopharmacology. Reflecting division, 43.4% were in favor, 25.4% were undecided, and 31.2% were in opposition to broadening privileges for psychologists. Further, only 15.2% expressed interest in pursuing training or 6.7% in becoming prescribers. Data on access, training, and legislative costs were presented to participants in the education condition. These participants showed significant gains in their knowledge across all domains and their opinions shifted only in these specific areas leaving their general stance on the issue unchanged. In contrast to ardent supporters who argue that their “data should provide reassurance to psychologists spearheading legislative initiatives” because of high approval ratings (Sammons et al., 2000, p. 608), our data suggest disagreement amongst a group of professionals who are not particularly well-informed, nor interested in becoming prescribers. Future work should investigate whether expanding the data relevant to other facets of the argument contributes to further targeted change or an overall change in opinion toward prescriptive authority

Physical Therapists\u27 Knowledge, Beliefs, and Practices Pertaining to Health Promotion and Fitness Testing

BACKGROUND AND PURPOSE: The American Physical Therapy Association(APTA) Vision 2020 established a goal which states that physical therapists (PTs) will be recognized as providers of health promotion, wellness, and risk reduction programs. It is clear that health promotion is important in physical therapy, but it is unclear if PTs are promoting health and how they are completing these tasks. The purposes of this study were to identify PTs’ knowledge, beliefs, and practices in promoting healthy behaviors(HBs) and assessing general fitness (GF) and to examine barriers and facilitators PTs face when addressing HBs and assessing GF. HBs examined were promoting physica lactivity, abstaining from tobacco, maintaining healthy weight/BMI, and managing stress.GF categories included body composition, aerobic capacity, muscular strength, muscular endurance, and flexibility. METHODS: This was a cross-sectional descriptive study utilizing an on-line survey. The survey was e-mailed to 1,118 Minnesota APTA members and consisted of four main sections: demographics, health promotion, general fitness, and knowledge questions. RESULTS: The response rate was 21% (n=234). Respondents agreed (90%) that PTs have a role in preventing chronic disease by promoting HBs.Beliefs and practices differed for the four HBs: physical activity (100% vs. 99.0%),maintaining healthy weight/BMI (96.6% vs. 81.0%), stress management (88.7% vs.74.0%), and abstaining from tobacco (87.2% vs. 74.0%). An analysis of the HB of maintaining healthy weight/BMI exposed differences between the following groups ofPTs: PTs without DPT, PTs licensed greater than 10 years, and PTs who practiced in non-outpatient setting. Respondents also agree (85%) that PTs have a role in fitness testing, although there is a large discrepancy in what respondents believe vs. what they practice. PTs identified time as the most challenging barrier to addressing HBs and assessing fitness. Patient/client interest was identified as the most beneficial facilitator to addressing HBs and education as the most benefcial facilitator to assessing fitness. More than 50% of the respondents incorrectly answered questions regarding activity recommendations for older adults and children. CONCLUSION: Results show a difference between PTs’ beliefs and practices in the promotion of four HBs. Although PTs reported numerous barriers, most believe that PTs have a role in preventing chronic disease. PTs’ knowledge demonstrated preparedness to promote HBs, however, PTs are not consistently addressing HBs with patients/clients. Further efforts need to be made to increase PT knowledge of activity recommendations

Redesigning Systems to Improve Teamwork and Quality for Hospitalized Patients (RESET): Study Protocol Evaluating the Effect of Mentored Implementation to Redesign Clinical Microsystems

Background: A number of challenges impede our ability to consistently provide high quality care to patients hospitalized with medical conditions. Teams are large, team membership continually evolves, and physicians are often spread across multiple units and floors. Moreover, patients and family members are generally poorly informed and lack opportunities to partner in decision making. Prior studies have tested interventions to redesign aspects of the care delivery system for hospitalized medical patients, but the majority have evaluated the effect of a single intervention. We believe these interventions represent complementary and mutually reinforcing components of a redesigned clinical microsystem. Our specific objective for this study is to implement a set of evidence-based complementary interventions across a range of clinical microsystems, identify factors and strategies associated with successful implementation, and evaluate the impact on quality. Methods: The RESET project uses the Advanced and Integrated MicroSystems (AIMS) interventions. The AIMS interventions consist of 1) Unit-based Physician Teams, 2) Unit Nurse-Physician Co-leadership, 3) Enhanced Interprofessional Rounds, 4) Unit-level Performance Reports, and 5) Patient Engagement Activities. Four hospital sites were chosen to receive guidance and resources as they implement the AIMS interventions. Each study site has assembled a local leadership team, consisting of a physician and nurse, and receives mentorship from a physician and nurse with experience in leading similar interventions. Primary outcomes include teamwork climate, assessed using the Safety Attitudes Questionnaire, and adverse events using the Medicare Patient Safety Monitoring System (MPSMS). RESET uses a parallel group study design and two group pretest-posttest analyses for primary outcomes. We use a multi-method approach to collect and triangulate qualitative data collected during 3 visits to study sites. We will use cross-case comparisons to consider how site-specific contextual factors interact with the variation in the intensity and fidelity of implementation to affect teamwork and patient outcomes. Discussion: The RESET study provides mentorship and resources to assist hospitals as they implement complementary and mutually reinforcing components to redesign the clinical microsystems caring for medical patients. Our findings will be of interest and directly applicable to all hospitals providing care to patients with medical conditions. Trial Registration: NCT03745677. Retrospectively registered on November 19, 2018