Quality Improvement for Well Child Care

Presented to the Faculty of University of Alaska Anchorage in Partial Fulfillment of Requirements for the Degree of MASTER OF SCIENCEThe American Academy of Pediatrics (AAP) Bright Futures (BF) guidelines for well child care were designed to provide quality pediatric care. Adherence to AAP-BF guidelines improves: screenings, identification of developmental delay, immunization rates, and early identification of children with special healthcare needs. The current guideline set is comprehensive and includes thirty one well child exams, thirty three universal screening exams and one hundred seventeen selective screening exams. Many providers have difficulty meeting all guideline requirements and are at risk of committing Medicaid fraud if a well exam is coded and requirements are not met. The goal of this quality improvement project was to design open source and adaptable templates for each pediatric age group to improve provider adherence to the BF guidelines. A Plan-Do-Study-Act (PDSA) quality improvement model was used to implement the project. Templates were created for ages twelve months to eighteen years and disseminated to a pilot clinic in Anchorage, Alaska. The providers were given pre-implementation and postimplementation surveys to determine the efficacy and usefulness of the templates. Templates were determined to be useful and efficient means in providing Bright Futures focused well child care. The templates are in the process of being disseminated on a large scale to assist other providers in meeting BF guideline requirements.Title Page / Table of Contents / List of Tables / List of Appendices / Abstract / Introduction / Background / Clinical Significance / Current Clinical Practice / Research Question / Literature Review / Framework: Evidence Based Practice Model/ Ethical Considerations and Institutional Review Board / Methods / Implementation Barriers / Findings / Discussion / Disseminatio

Comparing two work-engagement scales: Relationships with job satisfaction, organizational commitment, and workaholism

Although research on work engagement has made great progress over the past 10 years, how best to measure work engagement is still an open question. The aim of the present study was to compare two multidimensional scales measuring work engagement: the popular and widely used Utrecht Work Engagement Scale (UWES; Schaufeli & Bakker, 2003) capturing vigor, dedication and absorption and the newly developed ISA Engagement Scale (ISAES; Soane, Truss, Alfes, Shantz, Rees, & Gatenby, 2012) capturing intellectual, affective, and social engagement. When examining the intercorrelations of the scales’ total and subscale scores and their relationships with job satisfaction, organizational commitment, and workaholism in a sample of 130 employees, results showed that—even though UWES and ISAES total and subscale scores showed considerable overlap—they captured unique variance in the outcome variables, indicating that the two scales tap different aspects of engagement. Based on the present and previous findings (Soane et al., 2012), we recommend to use both scales when measuring work engagement to capture all aspects of the construct and gain a better understanding of how different aspects of work engagement contribute to outcomes that are of key interest to organizational and occupational psychology

Chalcogenide Nanocrystal Assembly: Controlling Heterogeneity And Modulating Heterointerfaces

This dissertation work is focused on developing methods to facilitate charge transport in heterostructured materials that comprise a nanoscale component. Multicomponent semiconductor materials were prepared by (1) spin coating of discrete nanomaterials onto porous silicon (pSi) or (2) self-assembly. Spin-coating of colloidal quantum dot (QD) PbS solutions was employed to create prototype PbS QD based radiation detection devices using porous silicon (pSi) as an n-type support and charge transport material. These devices were initially tested as a photodetector to ascertain the possibility of their use in high energy radiation detection. Short chain thiolate ligands (4-fluorothiophenolate) and anion passivation at the particle interface were evaluated to augment interparticle transport. However, the samples showed minimum interaction with the light source possibly due to poor infiltration into the pSi. The second project was also driven by the potential synergistic properties that can be achieved in multicomponent metal chalcogenide nanostructures, potentially useful in optoelectronic devices. Working with well-established methods for single component metal chalcogenide (MQ) particle gels this dissertation research sought to develop practical methods for co-gelation of different component particles with complimentary functionalities. By monitoring the kinetics of aggregation using time resolved dynamic light scattering and NMR spectroscopy the kinetics of aggregation of the two most common crystal structures for CdQ nanocrystals was studied and it was determined that the hexagonal (wurtzite) crystal structure aggregated faster than the cubic (zinc blende) crystal structure. For gel coupling of nanoparticles with differing Q (Q=S, Se and Te), once we accounted for the crystal structure effects, it was dtermined that the relative redox characteristics of Q govern the reaction rate. The oxidative sol-gel assembly routes were also employed to fabricate metal chalcogenide NC gels with different NC components with control over the degree of mixing. In order to control the degree of mixing, the factors that underscore sol-gel oxidative assembly were elucidated and the aggregation and gelation kinetics of metal chalcogenide QDs were monitored through time-resolved dynamic light scattering (TR-DLS), and nuclear magnetic resonance spectroscopy (NMR). Through these kinetic studies of the surface speciation of metal chalcogenides, control over heterogeneity in dual component CdSe-ZnS system, was achieved through adjustment of the capping ligand, the native crystal structure and the chalcogenide, thereby changing the relative rates of assembly for each component independently

Armed Flapper Moonshiners and Crusading Women: Public Personas of Minnesota Women in the Early 20th Century

This paper examines how women’s gender roles were reinforced in the Twin Cities of Minnesota during the late nineteenth and early twentieth centuries, through looking at the Women’s Christian Temperance Union and women who were attached to illegal activities during the Prohibition era. Examining these women allows for a glimpse into how some women may have chosen to not follow society’s expectations, but were still fulfilling those expectations in smaller actions. The gender role that was expected of was that they were to remain in the home and not touch the outside world without their husbands help. This is argued after viewing documents like newspapers and club journals that describe what the women were doing publicly in various fashions. This paper reveals that there were women who did not fit the typical mold left for them by society, but that these women were still fulfilling gendered expectations through their public actions

WE WANT IT THAT WAY: POST-TRADITIONAL TRANSFER STUDENT ADVISING EXPECTATIONS AS THEY TRANSITION TO THE FOUR-YEAR UNIVERSITY

Post-traditional students (typically defined as individuals who are at least 25 years of age, have experienced a gap in their educational journey, care for dependents, and who generally work full time [American Council on Education, 2022]), represented 35% of the post-secondary undergraduate population enrolled full time at four-year universities in the United States during the Fall 2019 term (NCES, 2020). The purpose of this phenomenological study was to understand the lived experiences of post-traditional transfer students and how their community college advising experience may have shaped/informed their advising expectations at their current university. Data was collected from six participants who shared their experiences of advising at their Community College and their advising expectations as they transitioned into the four-year institution through in-depth interviews. Through an Interpretive Phenomenological Analysis (IPA), there were three key findings: 1) Trusted Advisor, 2) High Expectations, 3) First Impressions and Experiences. This study informs higher education leaders and practitioners how best to support this student population

Show-Me the Money: Outdated Solicitation Laws Expose Municipalities to Liability

On any given night, roughly half a million people in the United States are homeless. In Missouri alone, approximately 6,500 people are homeless on any given day. Homeless populations create health, safety, and financial complications for municipalities. A strategy used by many municipalities to control these complications is the passage of ordinances restricting the actions of homeless populations. Commonly, these laws restrict solicitation, colloquially known as panhandling. Some laws ban panhandling altogether. While panhandling ordinances may have been a feasible solution in the past, a recent United States Supreme Court decision, Reed v. Town of Gilbert, has rendered many of these laws unconstitutional by limiting the circumstances under which municipalities may restrict speech. Though the Supreme Court handed down Reed over seven years ago, local governments have been slow to update their laws to comply with the new standar

A general education course designed to cultivate college student well-being

Mental health issues appear to be on the rise across our world, especially within the college student population. Considerable data suggests that today’s students have lower rates of well-being and healthy psychological functioning and higher rates of distress, fragility, and clinically significant mental health problems than seen in previous generations. These findings have led some scholars to define this trend as a college mental health crisis. The purpose of this study was to respond to this crisis via the development and administration of a well-being general education course conceptually grounded in Henriques’ Unified Framework of psychology and psychotherapy (see, Henriques, 2011; 2017; 2019). This study is a partial replication of Kimberly Kleinman’s positive psychology course, which was similarly grounded in Henriques’ Unified Framework and found encouraging results. However, that course was labor intensive and could not have been reasonably applied as part of a general education curriculum. As such, this project developed a course on well-being and adjustment based on positive psychology principles organized by Henriques’ Unified Framework in a manner consistent with a standard general education level curriculum. Two broad research questions were explored. First, would this intervention course be meaningful at a pedagogical level? Second, would this intervention positively impact well-being? To investigate these questions, an intervention and control group of undergraduate students were developed. Students in both groups completed seven pre-posttest well-being measures across the same semester. Data from the intervention participants suggested that the course was attractive, well-received, positively impacted well-being, and was just as pedagogically effective as Kleinman’s course even though it had less resources. In addition, significant improvements were observed in 12 of 16 quantitative measures of well-being, with the H10WB demonstrating a clinically significant improvement in well-being. When these differences were compared to participants in a control course, significant interaction effects were found for the H10WB and PANAS-positive emotion scales. A pattern of significant interaction effects was not found at the macro level. Therefore, a definitive claim cannot be made about the presence of group differences. When examined as a whole, the data offered a tentative conclusion that this intervention might have been clinically beneficial to well-being. As such, these findings advance the argument that well-being education is a potentially feasible and practical strategy to help address the college mental h