I\u27m Not Loud Enough to be Heard: Rock \u27n\u27 Roll Camp for Girls and Feminist Quests for Equity, Community, and Cultural Production

Because of what I perceive to be important contributions to female youth empowerment and the construction of culture and community, I chose to conduct a qualitative case study that explores the methods utilized in the performance of Rock ‘n’ Roll Camp for Girls, as well as the experiences of camp administrators, participants, and volunteers, in order to identify feminist constructs, aims, and outcomes of Rock ‘n’ Roll Camp for Girls. My interests lie in the feminist and activist approaches in the construction and production of Rock ‘n’ Roll Camp for Girls, as well as in the quest for equity, community building, and the production of culture that arises through participation. This thesis discusses the themes of feminism, feminist activism, networking, community building, cultural production, and the waging of equity as they are found in the production and performance of Rock ‘n’ Roll Camp for Girls

A Randomized Field Study of a Leadership WalkRoundsTM-Based Intervention

Background: Leadership WalkRoundsTM have been widely adopted as a technique for improving patient safety and safety climate. WalkRoundsTM involve senior managers directly observing frontline work and soliciting employees’ ideas about improvement opportunities. However, the hypothesized link between WalkRoundsTM-based programs and performance has not been rigorously examined in a set of randomly selected hospitals. Objective: To fill this research gap, we conducted a randomized field study of a WalkRoundsTM-based program. Research Design: Fifty-six work areas from 19 randomly selected hospitals agreed to implement an 18-month long WalkRoundsTM-based program to improve safety. We compared their results to 138 work areas in 48 randomly selected control hospitals. Participants: We conducted the program in four types of clinical work areas: operating rooms/post-anesthesia care units; emergency departments, intensive care units, and medical/surgical units. We collected survey data from nurses in those work areas. Measures: To measure the program’s impact, we collected pre and post survey data on perceptions of improvement in performance (PIP)—a proxy for quality and an important organizational climate antecedent for positive, discretionary behaviors of frontline staff. We compare change in PIP in the treatment work areas to the same type of work areas in control hospitals. Results: On average, compared to control work areas, our WalkRoundsTM-based program was associated with a statistically significant decrease in PIP of .17 on a 5-point scale (4.5%). Conclusions: Our study calls into question the general effectiveness of WalkRoundsTM on employees' perceptions, which had been assumed in prior literature

Key Drivers of Successful Implementation of an Employee Suggestion-Driven Improvement Program

Service organizations frequently implement improvement programs to increase quality. These programs often rely on employees’ suggestions about improvement opportunities. Organizations face a trade-off with such suggestion-driven improvement programs. On one hand, the improvement literature recommends that managers focus organizational resources on surfacing a large number of problems, prioritizing these, and selecting a small set of high priority ones for solution efforts. The theory is that soliciting a large number of ideas from employees will surface a set of higher priority problems than would have been identified with a less extensive search. Scarce organizational resources can be allocated to resolving the set of problems that provide the greatest improvement in performance. We call this an “analysis-oriented” approach. On the other hand, managers can allocate improvement resources to addressing problems raised by frontline staff, regardless of priority ranking. This “action-oriented” approach enables more resources to be spent on resolving problems because prioritization receives less attention. To our knowledge, this tradeoff between analysis and action in process improvement programs has not been empirically examined. To fill this gap, we randomly selected 20 hospitals to implement an 18-month long employee suggestion-driven improvement program; 58 work areas participated. Our study finds that an action-oriented approach was associated with higher perceived improvement in performance, while an analysis-oriented approach was not. Our study suggests that the analysis-oriented approach negatively impacted employees’ perceptions of improvement because it solicited, but not act on, employees' ideas. We discuss the conditions under which this might be the case

Long-term yogurt consumption and risk of incident hypertension in adults

The Nurses' Health Study and Health Professionals Follow-up Study cohorts are supported by grants UM1 CA186107, UM1 CA176726, and UM1 CA167552 from the National Institutes of Health. The current analyses were supported by small grants from the National Dairy Council, the General Mills Bell Institute for Health and Nutrition, and the Boston Nutrition and Obesity Research Center. The Boston Nutrition Obesity Research Center is administratively based at Boston Medical Center and is funded by the National Institutes of Health (NIH/NIDDK) grant P30DK046200. (UM1 CA186107 - National Institutes of Health; UM1 CA176726 - National Institutes of Health; UM1 CA167552 - National Institutes of Health; small grants from the National Dairy Council; General Mills Bell Institute for Health and Nutrition; Boston Nutrition and Obesity Research Center; P30DK046200 - National Institutes of Health (NIH/NIDDK))Accepted manuscrip

Psychiatric profiles of mothers who take Ecstasy/MDMA during pregnancy: Reduced depression 1 year after giving birth and quitting Ecstasy

Background: The recreational drug MDMA (3,4-methylenedioxymethamphetamine) or ‘Ecstasy’ is associated with heightened psychiatric distress and feelings of depression. The Drugs and Infancy Study (DAISY) monitored the psychiatric symptom profiles of mothers who used Ecstasy/MDMA while pregnant, and followed them over the first year post-partum. Methods: We compared 28 young women whom took MDMA during their pregnancy with a polydrug control group of 68 women who took other psychoactive drugs while pregnant. The Brief Symptom Inventory (BSI) was completed for several periods: The first trimester of pregnancy; and 1, 4 and 12 months after childbirth. Recreational drug use was monitored at each time point. Results: During the first trimester of pregnancy, MDMA-using mothers reported higher depression scores than the polydrug controls. At 1 year after childbirth, their BSI depression scores were significantly lower, now closer to the control group values. At the same time point, their self-reported use of MDMA became nearly zero, in contrast to their continued use of Cannabis/marijuana, nicotine and alcohol. We found significant symptom reductions in those with BSI obsessive-compulsive and interpersonal sensitivity, following Ecstasy/MDMA cessation. Conclusions: The findings from this unique prospective study of young recreational drug-using mothers are consistent with previous reports of improved psychiatric health after quitting MDMA

Effects of Maternal Employment and Prematurity on Child Outcomes in Single Parent Families

Background Effects of maternal employment for preschool children vary based on specific characteristics of the mother’s employment, the family’s economic status, and the mother’s attitudes about employment. However, there is limited research on a growing group of children at developmental risk—those born prematurely and living in a single-parent family. Objective To examine the effects of maternal employment and prematurity on child cognition and behavior in single-parent families. Methods Sixty preterm and 61 full-term preschool children were recruited through NICU admission records and birth records. Data were collected with the Kaufmann Assessment Battery for Children, Peabody Picture Vocabulary Test, Child Behavior Checklist, Parenting Stress Index, and the Life History Calendar. Results Greater hours employed was related to higher achievement and mental processing scores only. Less discrepancy between actual and desired employment was related to higher achievement, mental processing, and language scores and lower behavior scores. Prematurity was not related to child cognitive and behavioral performance. Only the relationship between discrepancy and language remained after statistical control. Conclusions The concerns about negative effects of maternal employment on young children may be overstated, especially in low-income, single-mother families. These findings are especially important in the context of welfare reform

Limited English Proficient Patients and Time Spent in Therapeutic Range in a Warfarin Anticoagulation Clinic

Background: While anticoagulation clinics have been shown to deliver tailored, high‐quality care to patients receiving warfarin therapy, communication barriers with limited English proficient (LEP) patients may lead to disparities in anticoagulation outcomes. Methods and Results: We analyzed data on 3770 patients receiving care from the Massachusetts General Hospital Anticoagulation Management Service (AMS) from 2009 to 2010. This included data on international normalized ratio (INR) tests and patient characteristics, including language and whether AMS used a surrogate for primary communication. We calculated percent time in therapeutic range (TTR for INR between 2.0 and 3.0) and time in danger range (TDR for INR 3.5) using the standard Rosendaal interpolation method. There were 241 LEP patients; LEP patients, compared with non‐LEP patients, had a higher number of comorbidities (3.2 versus 2.9 comorbidities, P=0.004), were more frequently uninsured (17.0% versus 4.3%, P<0.001), and less educated (47.7% versus 6.0% ≤high school education, P<0.001). LEP patients compared with non‐LEP patients spent less TTR (71.6% versus 74.0%, P=0.007) and more TDR (12.9% versus 11.3%, P=0.018). In adjusted analyses, LEP patients had lower TTR as compared with non‐LEP patients (OR 1.5, 95% CI [1.1, 2.2]). LEP patients who used a communication surrogate spent less TTR and more TDR. Conclusion: Even within a large anticoagulation clinic with a high average TTR, a small but significant decrease in TTR was observed for LEP patients compared with English speakers. Future studies are warranted to explore how the use of professional interpreters impact TTR for LEP patients

The implications of alternative allocation criteria in adaptive design for panel surveys

Adaptive survey designs can be used to allocate sample elements to alternative data collection protocols in order to achieve a desired balance between some quality measure and survey costs. We compare four alternative methods for allocating sample elements to one of two data collection protocols. The methods differ in terms of the quality measure that they aim to optimise: response rate, R-indicator, coefficient of variation of the participation propensities, or effective sample size. Costs are also compared for a range of sample sizes. The data collection protocols considered are CAPI single-mode and web-CAPI sequential mixed-mode. We use data from a large experiment with random allocation to one of these two protocols. For each allocation method we predict outcomes in terms of several quality measures and costs. Although allocating the whole sample to single-mode CAPI produces a higher response rate than allocating the whole sample to the mixed-mode protocol, we find that two of the targeted allocations achieve a better response rate than single-mode CAPI at a lower cost. We also find that all four of the targeted designs out-perform both single-protocol designs in terms of representativity and effective sample size. For all but the smallest sample sizes, the adaptive designs bring cost savings relative to CAPI-only, though these are fairly modest in magnitude

Prospective Patterns and Correlates of Quality of Life among Women in Substance Abuse Treatment

Background Quality of life (QOL) is increasingly recognized as central to the broad construct of recovery in sub- stance abuse services. QOL measures can supplement more objective symptom measures, identify specific service needs and document changes in functioning that are associated with substance use patterns. To date however, QOL remains an under investigated area in the addictions field, especially in the United States. Methods This study examines patterns and predictors of QOL at 1 and 6 months post treatment intake among 240 women enrolled in substance abuse treatment in Cleveland, Ohio. The World Health Organization Quality of Life (WHOQOL-BREF) measure was used to assess physical, psychological, social and environmental domains. Hierarchical multiple regressions were conducted to identify correlates of QOL at 6 months post treatment intake. Results All QOL domains across the follow up time points improved significantly. However, QOL scores across domains remained below those of healthy population norms. Trauma symptoms significantly predicted Phys- ical and Psychological QOL. Among treatment process variables, alcohol use was the sole significant factor associ- ated with QOL and only for Environmental QOL. Recovery support and friends support for abstinence were consist- ently associated with QOL across all four domains. Implications This study suggests the usefulness of the WHOQOL measure as an indicator of functioning in sub- stance abusing populations. Findings underline the importance of helping women deal with trauma symptoms and develop support for recovery. Further research is needed on the longitudinal relationship between QOL and sub- stance use patterns