Present Future, Present Past: Mass Casualty Incident Preparedness in the Research Triangle Region of North Carolina

In this thesis, I draw on exploratory research conducted in the fall of 2018 to explore questions concerning the logics of mass casualty incident (MCI) preparedness operating in medical institutions and local governments within the Research Triangle region of North Carolina. Interviews with emergency management administrators, emergency medicine physicians, and first responders revealed that the unique forms of coordinated preparation and response that MCIs require, refashions personal and institutional relationships into capacity building resources that work across time and space. Drawing on social science literature on preparedness and infrastructure, this analysis will show that whether it be through time, space or both, the network of relationships developed through the work of MCI preparedness serves diverse roles and functions: as pathways and grounds for the movement of people, objects, and knowledge. These relationships and the resources they move collectively constitute an infrastructure of MCI preparedness.Master of Art

Narrative Theory Applied to the Autobiographies of Three Life-Course Offenders

The written autobiographical accounts of three life-course offenders, which were published following extended life-course offending, were analyzed using a theory-led thematic analysis. The protagonists were each responsible for a broad range of acquisitive and violent crimes, although different offense types are often studied as separate entities. The utility of narrative theory was explored as a life-course theory by contrasting its framework with these disparate areas of inquiry, along the developmental trajectory of the protagonist's account. Findings showed that onset began with trait-driven and versatile offending, which progressed toward specialization, incorporating modus operandi and rational choice making. Specialization was underpinned by themes of violence and control. The concluding themes dealt with the process of desistance, which was facilitated by a series of cognitive shifts, allowing these offenders to retain a core element of the "self." Results further showed that narrative-identity played an influential role in the development of specialization and eventual desistance, but less so with onset. Narrative theory has the potential to aid understanding of the criminal life-course trajectory, which in turn can assist in both detection and rehabilitation processes. © 2016, © The Author(s) 2016

The First Hybrid International Educational Comprehensive Cleft Care Workshop.

OBJECTIVE Describe the first hybrid global simulation-based comprehensive cleft care workshop, evaluate impact on participants, and compare experiences based on in-person versus virtual attendance. DESIGN Cross-sectional survey-based evaluation. SETTING International comprehensive cleft care workshop. PARTICIPANTS Total of 489 participants. INTERVENTIONS Three-day simulation-based hybrid comprehensive cleft care workshop. MAIN OUTCOME MEASURES Participant demographic data, perceived barriers and interventions needed for global comprehensive cleft care delivery, participant workshop satisfaction, and perceived short-term impact on practice stratified by in-person versus virtual attendance. RESULTS The workshop included 489 participants from 5 continents. The response rate was 39.9%. Participants perceived financial factors (30.3%) the most significant barrier and improvement in training (39.8%) as the most important intervention to overcome barriers facing cleft care delivery in low to middle-income countries. All participants reported a high level of satisfaction with the workshop and a strong positive perceived short-term impact on their practice. Importantly, while this was true for both in-person and virtual attendees, in-person attendees reported a significantly higher satisfaction with the workshop (28.63 ± 3.08 vs 27.63 ± 3.93; P = .04) and perceived impact on their clinical practice (22.37 ± 3.42 vs 21.02 ± 3.45 P = .01). CONCLUSION Hybrid simulation-based educational comprehensive cleft care workshops are overall well received by participants and have a positive perceived impact on their clinical practices. In-person attendance is associated with significantly higher satisfaction and perceived impact on practice. Considering that financial and health constraints may limit live meeting attendance, future efforts will focus on making in-person and virtual attendance more comparable