Painting Our Portraits

My Honors Capstone Project, Painting Our Portraits, is concerned with the history and process of portrait painting. I was interested in the difference in artistic approach between a portrait of the artist and a portrait of someone else. I created a series of paintings and drawings that dealt with this issue and explored the important relationship between the subject and the artist. In some instances the desires of the subject differed from the desires of the artist. In my case, this created interesting dilemmas. I had to answer for myself how important the sitter’s expectations were if they differed from my own and how I could still create a compelling work of art

Perceived Effects of Bush Burning on Agriculture and Wildlife Resources in Ghana

Peace Corps was started in the 1960s by President John F. Kennedy. Ghana was one of the first established host countries that received Peace Corps Volunteers. There are five different sectors that volunteers can work in education, health, agriculture, environment, or community and economic development. Peace Corps service begins with ten weeks of pre-service training before volunteers swear in and are placed in communities throughout the country. Training covers topics such as global Peace Corps policy, health and security concerns, local language, and technical skills. I was placed in a small, rural community in the Northern Region of Ghana. My projects focused on food security, such as growing orange flesh sweet potatoes and building a community garden. Peace Corps service came with many challenges, but the relationships I built with my community and my cohort were invaluable. As part of my service and my graduate studies, I interviewed farmers in northern Ghana about their perceptions of the effect of bush burning on agriculture and wildlife in the area. Fires are a key aspect of savanna ecology, but current anthropogenic uses of bush burning are causing soil degradation and a decrease in food security in northern Ghana. We interviewed 87 farmers on their bush burning behavior to determine if demographic factors influenced the reasoning behind farmers bush burning practices. Interviews took place in ten communities across the Northern Region using Barrier Analysis Surveys. Results were both quantitative and qualitative. Data analysis was conducted using logistic regression modeling. The number of participants categorized as burners or non-burners were modeled using demographic information and participants’ perceptions of the effects of bush burning. Models were selected based on △AICc and weight. We were able to determine some of the motivations people had to practice or not practice bush burning. Motivations to avoid bush burning included the perceived severity of its effects on agriculture and wildlife, the perceived lack of effectiveness, perceived negative consequences, and access to tools and materials. Motivations to use bush burning included perceived effectiveness and perceived positive consequences. We were also able to determine participants’ perceptions of the effects of bush burning on their farms and for wildlife. Participants noted a variety of negative consequences such as impacts to crop yield, income, soil fertility, and erosion as well as some positive consequences such as benefits to seed germination and ease of use to clear land for farming. Participants also provided some strategies to discourage the use of bush burning. Providing better access to conservation agriculture education and punishing those caught bush burning could discourage people from and therefore potentially increase their household’s income and food security

Spatial Models to Account for Variation in Observer Effort in Bird Atlases

To assess the importance of variation in observer effort between and within bird atlas projects and demonstrate the use of relatively simple conditional autoregressive (CAR) models for analyzing grid-based atlas data with varying effort. Pennsylvania and West Virginia, United States of America. We used varying proportions of randomly selected training data to assess whether variations in observer effort can be accounted for using CAR models and whether such models would still be useful for atlases with incomplete data. We then evaluated whether the application of these models influenced our assessment of distribution change between two atlas projects separated by twenty years (Pennsylvania), and tested our modeling methodology on a state bird atlas with incomplete coverage (West Virginia). Conditional Autoregressive models which included observer effort and landscape covariates were able to make robust predictions of species distributions in cases of sparse data coverage. Further, we found that CAR models without landscape covariates performed favorably. These models also account for variation in observer effort between atlas projects and can have a profound effect on the overall assessment of distribution change. Accounting for variation in observer effort in atlas projects is critically important. CAR models provide a useful modeling framework for accounting for variation in observer effort in bird atlas data because they are relatively simple to apply, and quick to run

Systematic review and meta-analysis of pre-hospital diagnostic accuracy studies

Introduction: Paramedics are involved in examining, treating and diagnosing patients. The accuracy of these diagnoses is evaluated using diagnostic accuracy studies. We undertook a systematic review of published literature to provide an overview of how accurately paramedics diagnose patients compared with hospital doctors. A bivariate meta-analysis was incorporated to examine the range of diagnostic sensitivity and specificity. Methods :We searched MEDLINE, CINAHL, Embase, AMED and the Cochrane Database from 1946 to 7 May 2016 for studies where patients had been given a diagnosis by paramedics and hospital doctors. Keywords focused on study type (‘diagnostic accuracy’), outcomes (sensitivity, specificity, likelihood ratio?, predictive value?) and setting (paramedic*, pre-hospital, ambulance, ‘emergency service?’, ‘emergency medical service?’, ‘emergency technician?’ Results: 2941 references were screened by title and/or abstract. Eleven studies encompassing 384 985 patients were included after full-text review. The types of diagnoses in one of the studies encompassed all possible diagnoses and in the other studies focused on sepsis, stroke and myocardial infarction. Sensitivity estimates ranged from 32% to 100% and specificity estimates from 14% to 100%. Eight of the studies were deemed to have a low risk of bias and were incorporated into a meta-analysis which showed a pooled sensitivity of 0.74 (0.62 to 0.82) and a pooled specificity of 0.94 (0.87 to 0.97. Discussion: Current published research suggests that diagnoses made by paramedics have high sensitivity and even higher specificity. However, the paucity and varying quality of studies indicates that further prehospital diagnostic accuracy studies are warranted especially in the field of non-life-threatening conditions

Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area.

Trans women face numerous structural barriers to health due to discrimination. Housing instability is an important structural determinant of poor health outcomes among trans women. The purpose of this study was to determine if experiences of intersectional anti-trans and racial discrimination are associated with poor housing outcomes among trans women in the San Francisco Bay Area. A secondary analysis of baseline data from the Trans *National study (n = 629) at the San Francisco Department of Public Health (2016-2018) was conducted. Multivariable logistic regression was used to analyze the association between discrimination as an ordered categorical variable (zero, one to two, or three or more experiences) and housing status adjusting for age, years lived in the Bay Area, and gender identity. We found that the odds of housing instability increased by 1.25 for every categorical unit increase (1-2, or 3+) in reported experiences of intersectional (both anti-trans and racial) discrimination for trans women (95% CI = 1.01-1.54, p-value < 0.05). Intersectional anti-trans and racial discrimination is associated with increased housing instability among trans women, giving some insight that policies and programs are needed to identify and address racism and anti-trans stigma towards trans women. Efforts to address intersectional discrimination may positively impact housing stability, with potential for ancillary effects on increasing the health and wellness of trans women who face multiple disparities

Only Time Will Tell: A Content Analysis of Juvenile and Young Adult Literature on Characters with Disabilities and Whether Character Portrayals Have Improved Over Time

This research examines fourteen examples of juvenile and young adult fiction novels that include characters with disabilities. The study aims to analyze seven works of literature written between the years 1980--1990, and seven works of literature written between the years 2000--2010 in order to determine if the portrayals of characters with disabilities have seen improvement. Improvement in this sense would mean that the characters with disabilities were portrayed in a positive light, with a realistic depiction, and including a great sense of character development throughout the novel in which they are featured. Through this study, it is evident that there is a marked improvement in the portrayals of characters with disabilities, yet further representation in the amount of novels that are available for young audiences is still a work in progress

Review: Delivering mental health support within schools and colleges – a thematic synthesis of barriers and facilitators to implementation of indicated psychological interventions for adolescents

Background: Increasing the role of schools and colleges in the provision of mental health services for young people has the potential to improve early intervention and access to treatment. We aimed to understand what factors influence the successful implementation of indicated psychological interventions within schools and colleges to help guide increased provision of mental health support within education settings. Methods: Systematic search for studies that have reported barriers or facilitators to the implementation of indicated interventions for adolescent emotional disorders delivered within schools and further education/sixth form colleges (CRD42018102830). Databases searched were EMBASE, MEDLINE, PsycINFO, CINAHL, British Nursing Index, ASSIA, ERIC and British Education Index. A thematic synthesis of factors reported to impact implementation was conducted. Results: Two thousand five hundred and sixty-nine records and 177 full texts were screened. Fifty studies were identified for inclusion, all of which were of school-based interventions. Eleven analytic themes were developed encompassing intervention characteristics, organisational capacity, training and technical assistance, provider characteristics and community-level factors. Findings indicate the need to select appropriate interventions, consider logistical challenges of the school context and provide training and supervision to enable staff to deliver interventions with fidelity. However, structural and environmental support is required for these facilitators to have the greatest impact on successful implementation. Conclusions: Implementing indicated school-based mental health interventions is challenging. Those involved in planning school-based mental health initiatives must be alert to the impact of factors on multiple interacting levels. There is a lack of research on implementing mental health support within further education and sixth form colleges

Participation in developing youth mental health services: ‘Cinderella Service’ to service re-design

Whilst there are pockets of excellence in the provision of Child and Adolescent Mental Health Services (CAMHS), many services fail to meet young people’s needs. Considering this, the current research aimed to ascertain perceptions of CAMHS provision in a rural county of the UK to inform re-design of youth mental health services. Design Methodology and Approach: The study comprised of two phases: phase one involved analysis of questionnaire data of youth views of CAMHS. Phase two involved analysis of the ‘Have Your Say’ event data which explored perceptions of CAMHS and future service re-design. Data were thematically analysed. Findings: Knowledge of the existence and purpose of CAMHS was variable. Participants wanted accessible information about services, rights, confidentiality and for this to be provided in multiple medias. Young people wanted staff that are easy to talk to, genuine, understanding and who value their insights. Participants wanted to be offered choice about appointments, location and timing. An ideal mental health service was described as a ‘one-stop-shop’ of co-locality and multi-agency collaboration. Young people clearly expressed a desire to influence the design and delivery of the radical re-design and to be embedded in its development. Practical Implications: The results highlighted multiple problems with CAMHS provision and provided a clear justification for the re-design of services. Originality/value: This was a novel approach demonstrating the importance, utility and power of effective participatory practices for informing the re-design of services

STRATEGIES FOR ADDRESSING VACCINE HESITANCY – A SYSTEMATIC REVIEW

The purpose of the systematic review of strategies for addressing vaccine hesitancy is to identify strategies that have been implemented and evaluated across diverse global contexts in an effort to respond to, and manage, issues of vaccine hesitancy. This is to fulfil the requirements of the SAGE working group (WG) dealing with vaccine hesitancy in respect to: a) identifying existing and new activities and strategies relating to vaccines or from other areas that could successfully address vaccine hesitancy; b) identifying strategies that do not work well, and; c) prioritising activities and strategies based on an assessment of their potential impact. These requirements were translated into the following specific objectives: 1. Identify published strategies related to vaccine hesitancy and hesitancy of other health technologies (reproductive health technologies (RHT) were chosen as the additional focus) and provide a descriptive analysis of the findings; 2. Map all evaluated strategies to the SAGE WG “Model of determinants of Vaccine Hesitancy” (Appendix 1) and identify key characteristics; 3. Evaluate relevant evaluated strategies relating to vaccine hesitancy using GRADE (Grades of Recommendation, Assessment, Development and Evaluation); relevance was informed by the PICO questions defined a priori by the WG, and; 4. Synthesise findings in a manner which aids the design of future interventions and further research