Institutional processes to determine community engagement impact : a collective case study.

This qualitative, collective case study is designed to examine the processes by which urban, metropolitan institutions determine the impact their community engagement has within the local community. The study addresses the lack of research on community engagement at the institutional level, the processes that track and coordinate engagement, as well as the perspectives of community partners in this work. Research is more developed regarding individual engagement activities and student learning outcomes than it is to institutional accountability structures or community impact. Studies that center the institution as the unit of analysis are needed to address these limitations in research and practice. A collective case study using grounded theory was designed to address the research question. The use of grounded theory aligns with the exploratory nature of the research, allowing for data from institutional contexts to inform an area of research with limited models and theories. Three institutions were selected as cases to provide comparative data. Multiple data sources informed each case. Data were collected over eight months, including a two-month pilot phase to revise interview protocols and planned implementation. Findings across cases indicate that institutional processes vary, and determining the extent and impact of their community engagement efforts at the local level are limited. Respondents in all cases noted pockets of high engagement activity, and in some cases subsequent assessment, but these levels vary in quantity and quality. The capacity to determine impact was cited up to the individual project, program, or course level. Respondents further suggested the ability to identify, track, and report these activities, creating an institutional narrative on a particular area of impact, was limited without greater institutionalization of engagement. Community representation and voice in institutional assessment processes were limited or not included, though community input at the unit level was cited across cases. Findings suggest that as institutional capacity for engagement and its assessment builds (i.e. institutionalization), systematic solicitation of community perceptions of impact may serve as a proxy for realized community outcomes. Findings further indicate that greater attention to community engagement assessment can support institutional relevance, productivity, and mission attainment. Conclusions and recommendations for research and practice are presented in the final chapter

A study of Reading First implementation and literacy performance of students in kindergarten through fifth grade in Lancaster School District

This study examined elementary student literacy performance in Lancaster School District in kindergarten through 5th grades for 6 elementary schools implementing the Reading First program and 6 elementary schools not implementing Reading First. Subgroup data for English Language Learners, Hispanic, and African American students was closely examined and compared with the literacy performance data of white students to determine whether implementation of the Reading First program has narrowed the achievement gap. The study also explored the relationship, if any, between the level of Reading First program implementation (RFII) and literacy achievement of students as measured by the English Language Arts (ELA) California Standards Test (CST) and the Reading First Achievement Index (RFAI). The study was quantitative in approach, multiple methods in design, and was conducted in 2 phases. Phase 1 was comparative and descriptive and explored observable trends in student achievement between Reading First and non-Reading First schools. Phase 2 was correlational and examined potential relationships between implementation of the Reading First program and student achievement. The study found that Reading First schools experienced greater growth in ELA student achievement than non-Reading First schools. In addition, the study revealed that implementation of Reading First strategies is likely to impact positively ELA CST student achievement outcomes for English Language Learners, African American, and Hispanic students in 2nd through 5th grades. The study found no correlation between the level of Reading First implementation and ELA CST student achievement based on RFII and CST data collected between 2005 and 2009. However, there was a statistically significant correlation between the level of Reading First implementation and the RFAI for the district. The study concluded that overall growth in literacy achievement of students in kindergarten through 5th grade did occur in the schools in which the essential components of the Reading First program were implemented with fidelity. It is, therefore, recommended that school districts work to develop district-wide literacy programs that utilize a comprehensive curriculum, offer coaching and structured professional development opportunities for teachers and administrators, and support student-centered collaboration that monitors student learning based on data

Translational Models for Advancement of Regenerative Medicine and Tissue Engineering

At the root of each regenerative medicine or tissue engineering breakthrough is a simple goal, to improve quality of healing, thus improving a patient’s quality of life. Each tissue presents its own complexities and limitations to healing, whether it is the scarring nature of tendon healing or the mechanical complexity driving bone regeneration. Preclinical, translational models aim to reflect these complexities and limitations, allowing for effective development and refinement of tissue engineered therapeutics for human use. The following body of work explores several of these translational models, both utilizing them for tissue regenerative therapy development and evaluating the benefits and complications incurred with each model. This work begins with a discussion of the complexity of bone healing and how dysfunction in the mechanical, surgical, and systemic fracture environment can lead to delayed healing and nonunion. A comprehensive review of the advances in preventative and corrective therapeutics for bone nonunion is included next, with specific focuses on mechanical and tissue-engineered technology. Then, this work presents a tissue-engineered application of mesenchymal stem cells in acute tendon injury, highlighting experimentation in cell fate direction in vitro and intralesional mesenchymal stem cell implantation in vivo. Next, this work presents a series of experiments that evaluated and refined a commonly utilized preclinical model of delayed bone healing, the caprine segmental tibial defect stabilized using single locking plate fixation. First, the biomechanical stability of the model was evaluated in vivo using plantar-pressure analysis of gait. Then, the surgical technique was refined through a retrospective analysis of the effects of plate length and position on fixation stability in vitro and in vivo. Finally, the comorbidities of this preclinical model were explored via an analysis of the effect of long-term tibial locking plate fixation on cortical dimensions and density

Seafloor ripples created by waves from Hurricane Ivan on the west Florida shelf

Submitted in partial fulfillment of the requirements for the degree of Master of Science at the Massachusetts Institute of Technology and the Woods Hole Oceanographic Institution September 2006Recent studies have shown that the presence of sand ripples on the seabed improves sonar detection of buried mines at sub-critical angles. Sidescan sonar data of ripples on the west Florida shelf were collected as part of ONR's Ripples Departmental Research Initiative (DRI) September 26-29th and November 7-9th, 2004. Hurricane Ivan, the strongest storm of the 2004 hurricane season, passed over the experiment site a week before the first data collection. This study focuses on the ripples created by Ivan. Average relict ripple wavelengths left after the storm were found to increase with water depth (50 cm, 62 cm, and 83 cm in 20, 30, and 50 meter water depths) despite the fact that orbital diameter decreases with water depth. Ripple prediction requires information about surface gravity waves and sediment grain size. The most reliable offshore wave field available was created with Wavewatch III by Naval Postgraduate School scientists. These waves were inputted into Delft3D WAVE, incorporating the nearshore wave model SWAN to predict waves at the locations where ripples were measured. Orbital motions at the seabed and grain size were inputted into a time-dependent ripple model with varying dissipation parameters to estimate sand ripples created by Hurricane Ivan. Ripple wavelength was found to be more strongly dependent on grain size than wave dissipation.Funding from the Oceanographer of the Navy and the Rear Admiral Richard F. Pittenger, USN (Ret) Fellowship

Using SBAR to Decrease Transfers from the Long-term Care to the Emergency Room

Care of the elderly, long-term care resident in the emergency department is an issue of importance because of the overall impact on healthcare costs, potential for negative outcomes for the resident, and the loss of revenue. The purpose of this project was to decrease avoidable transfer of residents to the Emergency Department. Using the Antecedent, Target, Measurement logic model, poor quality assessment data was deemed the antecedent of the avoidable transfer. The goal of the project was the implementation of a standardized process of assessment that would have decreased avoidable transfer of the resident. The project would have involved training of the nursing staff in the use of the Situation Background Assessment and Recommendation tool for collecting and communicating pertinent data. The tool would have been completed at each acute complaint and would have indicated disposition. Data would have been collected by the Education Coordinator and organized for review and comparison with preintervention data. Social change implications would have included enhanced communication, potential for increased nurse and physician satisfaction which could have potentially increased job satisfaction, and improved recruitment and retention. Autonomy and self-pertinence empowers the nurse to be a stronger advocate. Positive outcomes increase when care is provided by those familiar with the patient norms and the setting. Financial savings can have an impact on the cost of healthcare. This project would also have allowed for and encouraged internal review of process and practices. This project was not implemented and so remains inconclusive

Exploring what leads high school students to enroll in Hispanic-Serving Institutions: A multilevel analysis

This study examined the student and high school contextual factors associated with high school students’ enrollment in Hispanic-Serving Institutions. We drew on a conceptual framework of college choice involving the concepts of multiple capitals, and individual and organizational habitus, to examine the postsecondary trajectories of high school graduates using the Educational Longitudinal Study 2002/06. Using Hierarchical Linear Modeling, we analyzed two separate models. One model predicted enrollment in an HSI within the 2-year sector and one within the 4-year sector. Distinct predictors of HSI versus non-HSI enrollment were found, particularly for the 4-year sector. This study suggests that, in both sectors, high school contexts had a significant effect of channeling students toward HSIs. Keywords: Hispanic-Serving Institutions, College choice, Hierarchical Linear Modeling, Habitus, Capita

Achieving Access Parity for Inpatient Psychiatric Care Requires Repealing the Medicaid Institutions for Mental Disease Exclusion Rule

Approximately 3.4% of Americans have a mental health condition and suicide is the 10th leading cause of death. While the rate of mental health conditions has slightly increased for adult populations, America’s youth has experienced a significant rise in depression. From 2008 to 2017, occurrence of depression in the adolescent population increased from 8.3% to 13.3%. As adolescents mature into adults; it is likely the rate of mental health conditions for the adult population will rise as well as it is the common thread that binds the “diseases of despair”: drug abuse, alcoholism and suicide. Arising out of the deinstitutionalization movement of the 1960’s, the Medicaid IMD Exclusion Rule (§1905(a)(B) of the Social Security Act) prohibits reimbursement for Medicaid recipients ages 21 to 64 years receiving inpatient care at a psychiatric hospital with 16 or more beds. Consequently, the rule limits payment for psychiatric treatment to general hospitals and smaller, non-specialized centers, which blocks patients from receiving inpatient care, and transfers the financial burden of care onto psychiatric hospitals. The IMD Rule is approaching its 55th anniversary. It requires re-evaluation. Although a state waiver process is available, use of this option has the potential to increase the incidence of racial and ethnic disparities across states. Full repeal of the IMD Exclusion Rule could help provide immediate access to inpatient care that is consistent nationwide and be a vital step toward creating financial, treatment and ethical parity for mental health services

Life Science Mini Projects: Taking the Lab Outside the Laboratory

The development of core skills in practical investigation are important for Life Science graduates, however, due to COVID-19 restrictions during this year, Level 3 Human Biology and Physiology students from the University of Glasgow were unable to conduct laboratory-based work. In previous years, students created and undertook small-scale lab-based practical projects at the end of semester 2 to attain course ILOs and graduate attributes. This pandemic year, academic and technical staff proposed that students work in small groups of 5-6 to develop an experimental hypotheses and study design, then collected data in home-based projects over the course of a scheduled experimental week. Whilst students were steered away from projects relying on immobile laboratory equipment in controlled lab environments, they were provided with examples of measurements that could be feasibly performed in isolated ‘real-world’ experiments. Technicians were then able to send wearable measurement devices (e.g. heart rate monitors, continuous glucose monitors) directly to students’ homes to be used during the experimental phase. All data was collected by students at home using laboratory techniques approved by the safety committee. This poster will present the opportunities to staff and students in undertaking ‘real-world’ mini projects and highlight learnings that could be transferred to future academic years. In addition, we will promote the often-overlooked role of laboratory technical staff in teaching provision ; as well as being key to risk assessments and facilitating home-delivery of equipment, laboratory technicians were available for troubleshooting during the data collection phase. Take home messages: 1. Some investigative projects are possible in remote delivery with appropriate planning and safety considerations 2. Remote delivery presented opportunity for creation of experiments with real-world application 3. Technical staff are key members of the teaching team and have valuable expertise to facilitate the learning experience

Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards

Aggressive behaviour is a critical issue for modern acute psychiatric services, not just because of the adverse impact it has on patients and staff, but also because it puts a financial strain on service providers. The aim of this study was to assess the relationship of patient violence to other variables: patient characteristics, features of the service and physical environment, patient routines, staff factors, the use of containment methods, and other patient behaviours. A multivariate cross sectional design was utilised. Data were collected for a six month period on 136 acute psychiatric wards in 26 NHS Trusts in England. Multilevel modelling was conducted to ascertain those factors most strongly associated with verbal aggression, aggression toward objects, and physical aggression against others. High levels of aggression were associated with a high proportion of patients formally detained under mental health legislation, high patient turnover, alcohol use by patients, ward doors being locked, and higher staffing numbers (especially qualified nurses). The findings suggest that the imposition of restrictions on patients exacerbates the problem of violence, and that alcohol management strategies may be a productive intervention. Insufficient evidence is available to draw conclusions about the nature of the link between staffing numbers and violence