Open Access Journals at IU Indianapolis
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Older Adults and their Experience with Interfacility Transfer
No full textBackground/Objective:Interfacility transfers are an integral part of integrated systems of care in modern healthcare. Many transferred patients are older adults, a particularly vulnerable patient population. Unfortunately, interfacility transfers can result in discomfort during the transport, increased distance from family and home, a significant bill for the ambulance ride, and risk of an accident occurring during transport.
Methods:To better understand the experiences of older adults before, during, and after interfacility transfer, cognitive interviews were performed with patients and their caregivers at the bedside of the receiving hospital. A standard set of questions was used to assess multiple aspects of the interfacility transfer process including the consent process at the sending hospital, experience with the transfer, and perceived benefits/harms resulting from the transfer.
Results:21 patients and 14 caregivers were interviewed in this study and five themes were present throughout these conversations. These themes included, a perceived lack of participation in the decision to be transferred, failed expectations at the receiving hospital, and greater trust in trauma centers like Methodist Hospital.
Conclusion:Our interviews demonstrate a greater need for thorough consent for transfer at sending hospitals discussing the realistic outcomes and risks that can be expected from interfacility transfer. With these conversations patients and their caregivers can be empowered to make informed decisions about their care and will likely be more satisfied with the care that they receive and know what to expect during their treatment
Familial Adenomatous Polyposis within the Pediatric Hereditary Polyposis Registry
Get PDFBackground/Objective:
Familial Adenomatous Polyposis (FAP) is a condition characterized by values exceeding hundreds of colorectal adenomatous polyps. FAP has a prevalence of 1 in 8,300 people, demonstrating an autosomal dominant inheritance pattern. This condition follows a pathogenic variation of the Adenomatous Polyposis Coli (APC) gene, located on chromosome 5q21-22. These mutations are heavily correlated with the incidence of colorectal carcinoma, requiring prophylactic colectomy. The management and treatment of FAP requires routine surveillance to reduce gastrointestinal polyp burden. The objective for this study is to characterize the current patient population at Riley with polyposis syndromes and assess clinical surveillance in patients diagnosed with FAP.
Methods:
Historical data from 2020-2022 GI clinical visits were reviewed using the diagnostic codes Family history of colonic polyps, Benign neoplasm of colon unspecified, and Other phakomatoses not elsewhere classified. These criteria identified 93 patients of which 64 patients were diagnosed with a hereditary polyposis syndrome for inclusion within the registry. Of the 64 patients, 42 had a diagnosis of FAP. Clinical data reviewed included the patient’s age of diagnosis, completion of genetic testing and follow-up, surgical treatment, routine endoscopic surveillance, and modes of imaging.
Results:
Results indicated a median age of diagnosis of 10 years, lower than previously reported national averages of 13.5-17 years. Evaluation of routine follow-up indicated a rate of endoscopy at 0.822 scopes per year and demonstrated that abdominal CT scans as well as abdominal X-rays were the most common supplemental modes of imaging.
Conclusion/ Future Directions:
The data from this registry will help direct care of patients with FAP, ensuring they receive treatment in accordance with national guidelines for routine surveillance and prophylactic colectomy. Moving forward, the intention is to expand the registry\u27s date range to incorporate more patients and elaborate further on endoscopic findings for the specific subtypes of FAP
A Position Paper on Paid Music Therapy Internships: An Analysis of Strengths, Weaknesses, Opportunities, and Threats to Initiate Dialogue: Paid music therapy internships SWOT
No full textThe music therapy internship represents the culmination of students’ clinical training. Currently, most music therapy internships are unpaid while other healthcare professions offer paid internship options or do not require an internship. The purpose of this position paper was to conduct a SWOT (strengths, weaknesses, opportunities, and threats) analysis and initiate dialogue regarding paid music therapy internships in the United States. Designed to initiate dialogue and conversation, this article is not a research paper. I conducted an initial SWOT analysis on paid music therapy internships. I then shared the analysis with music therapy students, internship directors, clinicians, business owners, and faculty and integrated their feedback. Although the SWOT analysis indicated that the current internship model can result in strong clinicians, there are weaknesses regarding workforce diversity, accessibility, and finances. There may be numerous opportunities for the profession to strengthen itself through paid internships. The profession’s mission and values regarding increased access to music therapy for service users, greater workforce diversity, and quality of care amid escalating tuition and cost of living expenses are consequential factors that may influence paid music therapy internships. Although paid internships may be beyond the control of clinical training directors and thus may not be feasible in all contexts, the large number of unpaid internships may hinder the music therapy profession from thriving and advancing toward its mission. The profession may have an opportunity to use its own agency by valuing itself through paid music therapy internships. Questions and considerations are provided to conclude the paper
Ray Bradbury’s 21st Century Guide for Space Travel
Get PDFThis article deals with the importance of space as Ray Bradbury saw it. Inspired as a child by Buck Rogers, Bradbury was told as a youngster that there would never be a space age. Fast forward to age twenty-nine, and he wrote The Martian Chronicles, a seminal work on what humankind may find and become, beyond the Earth. Established as a science fiction writer, Bradbury found himself writing non-fiction essays in celebration of the real-life Space Age, and meeting the Apollo astronauts who had been influenced by his fictions and his essays.
Late in life, Bradbury was honored by participants in the space program, but became distraught at how little attention was paid to space travel thereafter.
Bradbury’s position on space travel—that it is an imperative if humankind is to survive into the far future, and must become possible for all—is in contrast to today’s “Billionaire space race”, which prioritizes the egos of the big spenders
Space, Race, and Earthling Trash: Race, Refugees, and the Martian New Deal
Get PDFThis essay explores how Ray Bradbury’s stories reflect the intersections of race, space, and social injustice in post-apocalyptic settings. The stories “Way in the Middle of the Air” and “The Other Foot” deal overtly with race and prejudice, showing how African Americans are first driven to Mars and then, having fled there, must confront white refugees from Earth, offering a nuanced exploration of race, revenge, and reconciliation. “The Garbage Collector,” while less overtly about race, also reveals systemic racial hierarchies.
Bradbury’s works, while progressive for their time, remain complicated by the author’s own later-life comments on race, yet they remain vital texts relating to Afrofuturism and post-racial narratives in science fiction
Implementing Rest as Resistance: Balancing care for students, community, and self
Get PDFThis article seeks to examine the tensions between the culture of higher education, the needs community and the ways that antiblackness and intersectionality impact students, faculty, staff and communities of color utilizing Hersey’s (2022) Rest is Resistance as a framework for analysis. Hersey offers up rest as an act of collective care, linking directly to the current and historical experience of Black Americans. She acknowledges that American capitalism was birthed on plantations, through the forced and violent labor of enslaved Black people. In opposition to white supremacist work culture, Hersey proposes that liberation “resides in our deprogramming and tapping into the power of rest and in our ability to be flexible and subversive” (Hersey, 2022, p.16). In alignment with community engaged values of decolonizing the institution and our minds, staff and faculty have the opportunity to be a model of a well worker, a person unwilling to donate their body to capitalism. Higher education professionals sit at one point of the triangle balanced between students\u27 needs and community needs. Hersey offers one guide to unlearn grind culture and critically examine what sacrifices are asked of staff, faculty, students, and partners, as well as the consequences of those sacrifices
Student Support and Retention: College Specific Integration of Social Work Case Management in a Higher Education Setting
Get PDFTraditional student support services offered by universities are broad and varied; however, many of these fall under either student or academic affairs and are located centrally on campus. Offering a decentralized, college-specific model of student support and retention that partners with both academic and student affairs allows for a holistic, integrated approach to student resources that is easily accessed within a student’s own academic area. UA Little Rock has implemented this innovative model by housing a licensed social worker in each main campus college. These social workers provide case management services ranging from triage of at-risk students to coordination of on-campus and community resources. Each social worker is also able to provide a limited number of small micro-grants as emergency funds. Primary goals of this initiative include increased student use of the case management services, increased faculty referrals, improved student retention, evaluation of interventions, and student satisfaction. Pilot evaluation data indicates that a diverse population of students across multiple disciplines are utilizing these services and that retention rates for students receiving case management services differs based on their presenting issue(s). To support ongoing evaluation of services, there is a need to more clearly standardize data collection without disruption to practice
Evolving Dynamics of Higher Education Institutions and Their Cities (1980-2020)
Get PDFThis research examines the significance of higher education institutions (HEIs) as anchors in their host cities and their community engagement strategies from 1980 to 2020. By examining four case studies of urban-based universities that are members of the Coalition of Urban and Metropolitan Universities (CUMU) across diverse geographical and socio-economic contexts, this study analyzes the impact of anchor strategies on local communities, economic growth, and urban revitalization. Two public institutions—Rutgers University-Newark (RU-N) and the University of Pretoria (Mamelodi Campus, South Africa)—and two private institutions—Syracuse University (S.U.) and the University of Pennsylvania (UPenn)—comprise the four selected institutions.
Comparative analysis of the case studies reveals that effective anchor strategies frequently involve multidimensional approaches that address their respective cities\u27 social, economic, and public safety challenges. In addition, I identify the key factors contributing to the efficacy of anchor strategies, such as strong leadership, stakeholder collaboration, and maximizing the role of foundations and long-term vision.
The findings of my study highlight the significance of universities as significant agents of urban change in guiding policymakers, urban planners, and higher education administrators who seek to harness the potential of universities in shaping sustainable and inclusive community
engagement. My findings highlight the interplay between universities and their environments rooted in their host cities