Matching Items (15)
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During the 1960s, American youth were coming of age in a post–war period marked by an unprecedented availability of both money and leisure time. These conditions afforded young people new opportunities for exploring fresh ways of thinking and living, beyond the traditional norms of their parents' generation. Tom Wolfe recognized

During the 1960s, American youth were coming of age in a post–war period marked by an unprecedented availability of both money and leisure time. These conditions afforded young people new opportunities for exploring fresh ways of thinking and living, beyond the traditional norms of their parents' generation. Tom Wolfe recognized that a revolution was taking place, in terms of manners and morals, spearheaded by this latest generation. He built a career for himself reporting on the diverse groups that were developing on the periphery of the mainstream society and the various ways they were creating social spaces, what he termed “statuspheres,” for themselves, in which to live by their own terms. Using the techniques of the New Journalism—“immersion” reporting that incorporated literary devices traditionally reserved for writers of fiction—Wolfe crafted creative non–fiction pieces that attempted not only to offer a glimpse into the lives of these fringe groups, but also to place the reader within their subjective experiences. This thesis positions Wolfe as a sort of liminal trickster figure, who is able to bridge the gap between disparate worlds, both physical and figurative. Analyzing several of Wolfe's works from the time period, it works to demonstrate the almost magical way in which Wolfe infiltrates various radical, counterculture and otherwise “fringe” groups, while borrowing freely from elements across lines of literary genre, in order to make his subjects' experiences come alive on the page. This work attempts to shed light on his special ability to occupy multiple spaces and perspectives simultaneously, to offer the reader a multidimensional look into the lives of cultural outsiders and the impact that they had and continue to have on the overarching discussion of the American Experience. Ultimately, this paper argues that by exposing these various outlying facets of American culture to the mainstream readership, Wolfe acts as a catalyst to reincorporate these fringe elements within the larger conversation of what it means to be American, thereby spurring a greater cultural awareness and an expansion of the collective American consciousness.
ContributorsKilduff, Josiah (Author) / Ortiz, Simon J. (Thesis advisor) / De La Garza, Sarah A. (Committee member) / Gutkind, Lee (Committee member) / Arizona State University (Publisher)
Created2014
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This long form creative nonfiction essay gives insider details on working in an emergency room as a medical scribe. The most pertinent topic is death and how the author copes with seeing patients die on a regular basis. Other topics are emergency room procedures, specific diagnoses and treatments, as well

This long form creative nonfiction essay gives insider details on working in an emergency room as a medical scribe. The most pertinent topic is death and how the author copes with seeing patients die on a regular basis. Other topics are emergency room procedures, specific diagnoses and treatments, as well information on the other personnel in an emergency room.
ContributorsFeller, Aaron Lee (Author) / Gutkind, Lee (Thesis director) / Robert, Jason (Committee member) / Rowe, Todd (Committee member) / Barrett, The Honors College (Contributor) / Department of Chemistry and Biochemistry (Contributor) / Department of English (Contributor)
Created2013-05
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This dissertation is both creative and scholarly, engaging in the technique of "narrative scholarship," an increasingly accepted technique within the field of ecocriticism. The project is framed by my experiences with Spanish and Latino actors as well as activists involved with the 15-M movement in and around Madrid. It takes

This dissertation is both creative and scholarly, engaging in the technique of "narrative scholarship," an increasingly accepted technique within the field of ecocriticism. The project is framed by my experiences with Spanish and Latino actors as well as activists involved with the 15-M movement in and around Madrid. It takes a "material ecocritical" approach, which is to say that it treats minds, spirits and language as necessarily "bodied" entities, and creates an absolute union between beings and the matter that constructs them as well as their habitat. I apply the lens of Jesper Hoffmeyer's Biosemiotics, which claims that life is at its most essential levels a communicative process. In other words, I will explore how "all matter is 'storied' matter," as well as how the "semiosphere," which is an important concept in biosmiotics, signaling a semiotic environment that predicts and defines all biological bodies/life, the human, the plant and the animal as beings who are made of and involved in semiotic activity, can serve as a basis for union amongst all bodies and provide a model of cooperation rooted in "storytelling." My project aims to embody what Wendy Wheeler describes as ecocriticism's, "syntheses between the sciences and the humanities" It is my strong opinion that creative writing has the power to offer the general public insight into the reasons why new research in biosemiotics is so important to the work that activists are doing to raise awareness of how humans can live responsibly on the only planet that is our home. This will help readers of creative writing and cultural studies scholars understand why they ought to embrace science, especially in literary and cultural studies, as a path to better understanding of the role of the humanities in an increasingly scientifically oriented world.
ContributorsDay, Timothy (Author) / Adamson, Joni (Thesis advisor) / Gutkind, Lee (Committee member) / Flys-Junquera, Carmen (Committee member) / Arizona State University (Publisher)
Created2016
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ABSTRACT

This study sought to inform the curriculum of crew resource management (CRM) for multi-pilot flight deck operations. The CRM curriculum requires continued reexamination to ensure safe flight in the changing demographic of flight decks in the US. The study calls attention to the CRM curriculum’s insufficient inclusion of robust training

ABSTRACT

This study sought to inform the curriculum of crew resource management (CRM) for multi-pilot flight deck operations. The CRM curriculum requires continued reexamination to ensure safe flight in the changing demographic of flight decks in the US. The study calls attention to the CRM curriculum’s insufficient inclusion of robust training components to address intercultural communication skills and conflict management strategies.

Utilizing a phenomenological approach, the study examined the communicative experiences of African American female military and airline transport pilots on the flight deck and within the aviation industry. Co-cultural theory was used as a theoretical framework to investigate these co-researcher’s (pilots) experiences. A parallel goal of the investigation was to better understand raced and gendered communication as they occur in this specific context—the flight deck of US airlines and military aircraft.

The researcher conducted in-depth semi-structured interviews and shadowed two co-researchers (pilots) for a period of days and built a relationship with them over the course of one year. Eight years of preparation working in the airline industry situated the researcher for this study. The researcher collected stories and interviews during this time immersed in industry. The data collected offers initial insights into the experiences of non-dominant group members in this unique organizational environment.

The study’s findings are reported in the form of a creative
arrative nonfiction essay. This effort was twofold: (1) the narrative served to generate a record of experiences for continued examination and future research and (2) created useful data and information sets accessible to expert and non-expert audiences alike.

The data supports rationalization as a co-cultural communication strategy, a recent expansion of the theory. Data also suggests that another strategy—strategic alliance building—may be useful in expanding the scope of co-cultural theory. The proposed assertive assimilation orientation identifies the intentional construct of alliances and warrants further investigation.
ContributorsZirulnik, Michael L. (Author) / Alberts, Janet (Thesis advisor) / Broome, Benjamin (Thesis advisor) / Gutkind, Lee (Committee member) / Orbe, Mark (Committee member) / Arizona State University (Publisher)
Created2015
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Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening

Homeless individuals encounter barriers such as lack of health insurance, increased cost of care and unavailability of resources. They have increased risk of comorbid physical disease and poor mental health. Depression is a prevalent mental health disorder in the US linked to increased risk of mortality. Literature suggests depression screening can identify high-risk individuals with using the patient health questionnaire (PHQ-9).

The objective of this project is to determine if screening identifies depression in the homeless and how it impacts healthcare access. Setting is a local organization in Phoenix offering shelter to homeless individuals. An evidence-based project was implemented over two months in 2019 using convenience sampling. Intervention included depression screening using the PHQ-9, referring to primary care and tracking appointment times. IRB approval obtained from Arizona State University, privacy discussed, and consent obtained prior to data collection. Participants were assigned a random number to protect privacy.

A chart audit tool was used to obtain sociodemographics and insurance status. Descriptive statistics used and analyzed using Intellectus. Sample size was (n = 18), age (M = 35) most were White-non-Hispanic, 44% had a high school diploma and 78% were insured. Mean score was 7.72, three were previously diagnosed and not referred. Three were referred with a turnaround appointment time of one, two and seven days respectively. No significant correlation found between age and depression severity. A significant correlation found between previous diagnosis and depression severity. Attention to PHQ-9 varied among providers and not always addressed. Future projects should focus on improving collaboration between this facility and providers, increasing screening and ensuring adequate follow up and treatment.

ContributorsParamo, Cinthia Arredondo (Author) / Thrall, Charlotte (Thesis advisor)
Created2020-05-04
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Adverse childhood experiences (ACEs) are traumatic events experienced during childhood that have negative effects starting as a child and extending into adulthood. The presence of multiple ACEs increases negative mental, physical, and behavioral health outcomes. Children of parents who have experienced ACEs are at a higher risk of experiencing ACEs

Adverse childhood experiences (ACEs) are traumatic events experienced during childhood that have negative effects starting as a child and extending into adulthood. The presence of multiple ACEs increases negative mental, physical, and behavioral health outcomes. Children of parents who have experienced ACEs are at a higher risk of experiencing ACEs themselves, creating an intergenerational cycle of trauma between parents and their children. Evidence suggests that parenting education can reduce the impact of ACEs and potentially eliminate poor health outcomes. The literature revealed that parenting education was found to increase parenting competency, which will in turn reduce the impact of ACEs on children.

The purpose of this evidence-based project is to evaluate parenting competency and parenting self-efficacy after implementing six parenting workshops. The workshop topics consist of: (a) stress management, (b) understanding trauma, (c) positive parenting, (d) positive discipline, (e) play, and (f) learning development and support. The workshops were delivered at a community residential facility for women seeking recovery from abuse, incarceration, chemical dependency and other life-controlling problems. Participants included 10 female residents.

Demographics, ACE scores, pre and post Parenting Sense of Competency Scale, and a post intervention satisfaction questionnaire and discussion were used to collect data from the participants. Mothers’ ACE scores ranged from 2-9. The parenting self-efficacy score increased in the subgroup that attended all six workshops. All of the mothers agreed that the workshops would help with parenting their children. The findings suggest that parenting education increases parenting knowledge and self-efficacy, and may reduce the impact of ACEs on children.

ContributorsGohlke, Melissa (Author) / Thrall, Charlotte (Thesis advisor)
Created2020-05-04
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Psychological stress plays a vital role in skin disease. The worsening and reoccurrence of signs and symptoms of a wide array of skin diseases have been linked by various studies to stress. Together, stress and skin disease synergistically inhibit occupational, social, and emotional functioning resulting in diminished quality of life

Psychological stress plays a vital role in skin disease. The worsening and reoccurrence of signs and symptoms of a wide array of skin diseases have been linked by various studies to stress. Together, stress and skin disease synergistically inhibit occupational, social, and emotional functioning resulting in diminished quality of life (Dixon, Witcraft, & Perry, 2019). Heightened levels of stress may contribute to an assortment of immediate and future adverse outcomes. These outcomes include triggering a skin outbreak, impairing function, behavioral avoidance, intense negative emotions such as shame and embarrassment, and emotional distress such as depression and anxiety (Dixon et al., 2019).

The purpose of this paper is to discuss the relationship of stress, anxiety, and depression to the specific chronic skin diseases of acne vulgaris, psoriasis, vitiligo, rosacea, and atopic dermatitis. It will also discuss how a psychotherapeutic intervention called mindfulness-based stress reduction (MBSR) may decrease anxiety and depression in individuals affected by chronic skin diseases. This paper will also highlight the impact of MBSR on treatment adherence to dermatological prescription medications. A pilot program conducted in a dermatology clinic evaluates the effectiveness of an online mindfulness-based stress reduction intervention to decrease patient anxiety and depression.

Results indicate clinical significance in that participants noted reduced anxiety and depression symptoms and scores, enjoyed MBSR and would continue MBSR. The potential benefits of this pilot program may include decreased patient anxiety and depression, increased patient satisfaction, increased treatment adherence, improved patient satisfaction of intervention, and improved patient outcomes.

ContributorsHuebsch, Kylee M. (Author) / Thrall, Charlotte (Thesis advisor)
Created2020-04-25
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Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events

Primary health care clinics are essential first defenders determined to confront the upsurge in health-related leading causes of death in the United States. Unfortunately, the underserved or uninsured community continues to struggle to access these vital health care services. Consequently, this vulnerable population seeks venues such as community services events to obtain these unmet primary care services. Community services events effectively disseminate health-related material and provide access to vital medical services. Currently, community services strive to bridge the gap between underserved individuals and primary care clinics by providing participants referrals for low-fee or free clinics to establish ongoing care. A lack of data exists on whether these events sufficiently impact the participants to motivate them to follow-up with a health care clinic. A critical appraisal of evidence showed that follow-up adherence rates are remarkably improved by directly referring participants to a primary clinic during a community services event. This paper explores the effect on health outcomes and health disparities when establishing connections between community services participants and ongoing healthcare services.
Created2021-04-22
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Capturing and presenting high-quality data can be challenging for free clinics due to lack of resources and technology avoidance. If free clinics are unable to present impactful data to current and potential donors, this may limit funding and restrict care provided to underserved and vulnerable populations. The following is a

Capturing and presenting high-quality data can be challenging for free clinics due to lack of resources and technology avoidance. If free clinics are unable to present impactful data to current and potential donors, this may limit funding and restrict care provided to underserved and vulnerable populations. The following is a quality improvement project which addresses utilization of information systems within a free clinic. For one month, volunteer providers completed appointment summary forms for each patient seen in the clinic. Electronic form submissions (E=110) were compared to paper form submissions (P=196), with quality of data determined by form completeness scores. Welch’s t-test was used to determine statistical significance between electronic and paper form completeness scores (E=9.7, P=8.5) (p < .001). Findings suggest that utilization of electronic data collection tools within a free clinic produce more complete and accurate data. Barriers associated with technology utilization in this under-resourced environment were substantial. Findings related to overcoming some of these barriers may be useful for future exploration of health information technology utilization in under-resourced and technology avoidant settings. Results warrant future investigation of the relationship between quality of free clinic data, information management systems, provider willingness to utilize technology and funding opportunities in free clinics.
Created2021-04-24
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Declaration of Conflicts: This project has no conflicts of interest to declare.

Context: This project was completed at a federally qualified primary healthcare clinic in Phoenix, Arizona that served patients of all age groups, but primarily cared for the Hispanic population providing primary care, preventative services, family planning, two lab

Declaration of Conflicts: This project has no conflicts of interest to declare.

Context: This project was completed at a federally qualified primary healthcare clinic in Phoenix, Arizona that served patients of all age groups, but primarily cared for the Hispanic population providing primary care, preventative services, family planning, two lab technicians, one promoter, two medical assistant supervisors, five front desk staff, one chief administrative officer, one chief financial officer, two medical directoers who were also providers at the clinic.

Problem and Analysis Assessment: During my clinical rotations, I saw the burden a missed patient appointment had not only on the patients themselves, but also on the clinic, providers, and the staff. It caused delay in treatment for patients, and it did not allow other patients that wanted to be seen to be seen. It also increased unnecessary costs and wasted provider time. Thereafter, I met with some of the leadership team and one of the medical directors to determine a solution to reduce the number of missed appointments that were occurring. An educational session was kept to discuss the findings of this problem to the providers and the staff and when surveys were handed out to the patients, providers, and staff to assess their satisfaction with the old scheduling system versus the new scheduling system, they were also provided with a cover letter discussing the project.

Intervention: In order for improvements in care to occur, a system process change including the way patients are scheduled must occur. In this case, an open-access scheduling system (OAS) was implemented. OAS allows a patient to schedule an appointment on the 'same-day' or the 'next-day' to be seen. One provider at each of the clinics, each day of the week was available for 'same-day' appointments from 1300-1600. The providers were still available for scheduled appointments using the previous scheduling method. Walk-ins were still accepted, and were scheduled based on patient provider preference; however, if an appointment was not available for their preferred provider, they were typically seen with the provider that was the 'same-day' provider for that day.

Strategy for change: Since patients were only allowed to schedule appointments one month in advance, only one month was needed to implement this process change. A recommendation for the future would be to clearly identify the patient encounter type, and label it as a same-day appointment, as this would be helpful when gathering and extracting data for this type of patient group specifically.

Measurement of Improvement: Over a three-month period, a data collection plan was used to determine the number of Mas over a three-month period before and after implementation of this change. Satisfaction scores were measured using likert scales for patients, provider, and staff, and a dichotomous scale was used to determine the likelihood of emergency room or urgent care use. A comparison was done to measure revenue during the same time frame. During the three months, a clinically significant decrease in MAs was seen (<0.52%), with an increase in revenue by 41%. Additionally, a statistically significant increase in patient, provider and staff satisfaction was also noted when compared to the old scheduling system, as >68% of all patients, providers and staff reported feeling either very satisfied or extremely satisfied with the new scheduling system. Additionally, patients also reported that they were less likely to visit an emergency room(88%) or urgent care (90%) since they were able to be seen the same-day or the next-day by a provider.

Effects of changes: An incidental finding occurred during this study - where 877 more patients were seen in the three months during the implementation of this project, compared to the three months prior; which likely resulted in a 41% increase in revenue. Additionally this project, allowed patients that wanted to be seen on the same day, to be seen, and it decreased unnecessary costs associated with emergency room or urgent care visits. Some of the limitations involved included the current political environment, appointment slots that were previously 15 minutes in length (in 2016), increased to 20 minutes in length (in 2017), a language barrier was noted for the patient surveys since English was not the first language for many of the patients who completed the survey (although documents were translated), and the surveys used were not reliable instrument given that a reliable instrument in previous studies could not be found.

Lessons learnt: In order to have accuracy of the survey results, it is best for the author of the study to hand out and provide scripture for the survey so that complete data is received from the surveyors.

Messages for others: Begin by making a small process change where only one provider allows for the open-access scheduling so that the entire office is not affected by it, and if results begin to look promising then it can be expanded. Additionally, correct labeling of patients as 'same-day' is also important so that additional data can be gathered when needed regarding the 'same-day' patients.

Patient/Family/Guardian Involvement: Patients who benefited from the new scheduling system (open-access scheduling) were asked to fill out a survey that asked them to disclose some demographic data and asked them to determine their satisfaction with the new vs old scheduling system and their likelihood of visiting an emergency room or urgent care.

Ethics Approval: Arizona State University Institutional Review Board (IRB) Received: September 2017
ContributorsPatel, Dimple (Author) / Thrall, Charlotte (Thesis advisor) / Glover, Johannah-Uriri (Thesis advisor)
Created2018-05-02