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Trends in Asthma Control, Treatment, Health Care Utilization, and Expenditures Among Children in the United States by Place of Residence: 2003-2014
No full textBackground: Examining national trends in asthma treatment and control is essential to inform treatment and public health initiatives. Objective: Explore national trends in asthma control and treatment over time among children and those residing in poor-urban areas. Methods: This was an analysis of trends from 2003 to 2014 among children (aged 1-17 years) in the Medical Expenditure Panel Survey. Indicators of poor control included use of more than 3 canisters of short-acting β-agonists (SABAs) in 3 months, asthma attack, emergency department/inpatient hospitalization, and systemic corticosteroids. Treatment included inhaled corticosteroids, controller medications, SABAs, and greater than or equal to 0.7 ratio of controller-to-total prescriptions. Other measures included the number of asthma medications, outpatient visits, asthma-specific drug, and total expenditures per-patient-per-year. Results: There were 8.4 million children with asthma in the United States in 2014; 11.1% lived in poor-urban areas. There was a statistically significant decrease in the percentage of children using inhaled corticosteroids, controller medications, daily preventive medications, systemic corticosteroids, SABAs, more than 3 canisters of SABAs (in 3 months), overall asthma prescriptions, and outpatient visits. There was a significant increase in the percentage of children reporting having an asthma attack. Trends for children residing in poor-urban areas were compared with all others; however, limited data and variability in annual estimates prevent clear conclusions. Conclusions: Results suggest lack of improvement in treatment and control since 2003 among children with asthma in the United States. There is significant room for improvement in asthma control and disease management among children
Instrument-assisted soft-tissue mobilization for the management of chronic plantar heel pain a pilot study
No full textBackground: The purpose of this study was to determine feasibility of further investigation of treatment with instrument-assisted soft-tissue mobilization (IASTM), using the Graston technique, compared with conservative care for treatment of chronic plantar heel pain (CPHP). Methods: Eleven participants with plantar heel pain lasting 6 weeks to 1 year were randomly assigned to one of two groups, with each group receiving up to eight physical therapy visits. Both groups received the same stretching, exercise, and home program, but the experimental group also received IASTM using the Graston technique. Outcome measures of pain and function were recorded at baseline, after final treatment, and 90 days later. Feasibility of a larger study was determined considering recruitment and retention rates, compliance, successful application of the protocol and estimates of the treatment effect. Results: Both groups demonstrated improvements in current pain (pain at time of survey), pain with the first step in the morning, and function after final treatment and at 90-day follow up. Medium-to-large effect sizes between groups were noted, and sample size estimates demonstrated a need for at least 42 participants to realize a group difference. A larger-scale study was determined to be feasible with modifications including a larger sample size and higher recruitment rate. Conclusions: This pilot study demonstrates that inclusion of IASTM using the Graston technique for CPHP lasting longer than 6 weeks is a feasible intervention warranting further study. Clinically important changes in the IASTM group and moderate-to-large between-group effect sizes suggest that further research is warranted to determine whether these trends are meaningful
Assessing Energy and Communication Needs for the Sustainable and Educational Development of the Inhabitants of the Galapagos Islands
No full textThis paper provides an assessment of the energy and communication needs and the viability of implementing community-based networks and renewable energy and energy-saving initiatives in the Galapagos Islands. An assessment of community assets particularly in three schools in San Cristobal Island was performed. The assessment resulted in creating a baseline of the available assets of each of the schools as well as their location with aims to implement a community Intranet capable of hosting valuable content that can be used towards improved teaching methods. In addition, solar energy and active learning application workshops were carried out to raise interest in students to participate and engage in renewable energy technologies and connectivity initiatives. Furthermore, interviews with community members, including local authorities, utility companies, and school teachers were received with positive support and helped to identify their needs and potential sustainable solutions. All of these findings are reported in this paper
Exploring the Effect of Gender Roles on Female Drug Users in Appalachia
Get PDFDrug abuse is an ever-growing problem in the United States and in other parts of the world. The Appalachian region is one of the areas hit hardest by this epidemic. Since 2000, the number of overdose deaths in Appalachia has steadily risen while state and city governments analyze the potential causes for such a widespread issue. Many economic and medical explanations have been suggested, but it is also imperative to examine the cultural belief systems that might play a role in the persistent drug use. This study looks at the influence traditional Appalachian gender roles have on female drug users. Limited research has been done on drug abuse for women in conjunction with gendered societal pressures. The data presented here indicates that many gender expectations are prevalent parts of the female experience in Appalachia. The regional belief systems seem to pressure women in their personal relationships, in the workplace, and in their roles as mothers. Additionally, female drugs users in Appalachia proved to be particularly affected by these gender expectations, and data indicates that many gendered pressures contribute to initial and prolonged drug use
Ignatian Intent: Using Ignatian Pedagogy for Sustainability in the Sociology Classroom
No full textIn the sociology classroom, students expressed thoughts of denial of the importance of a number of social issues, including climate change. During this time, I was involved in two initiatives which were collaborative efforts to weave Ignatian Pedagogy with sustainability education. First, at Canisius College, we developed a Sustainability Initiative to embrace a comprehensive approach to environmental sustainability in academics, community and campus culture. Second, I was invited to become involved with the AJCU Ecology Educators group working on the Ignatian Pedagogy for Sustainability. Through the application of the Ignatian Pedagogy for Sustainability tool kit, I took the opportunity to address the climate crisis and supporting our student’s ability to engage with the, at times overwhelming, nature of our environmental crisis. This took place through adjusting my pedagogy to connect to themes Ignatian Pedagogy for Sustainability, through different classroom opportunities
Bicycling Seminar and Ignatian Pedagogy for Sustainability
No full textIn a bicycling First Year Seminar at Xavier University students experience and respond to the Ignatian Pedagogy for Sustainability (IPS) in their final assignments. The IPS is derived from the Ignatian Pedagogy Paradigm of context, experience, reflection, action and evaluation and is being applied to interdisciplinary sustainability teaching in a number of Jesuit institutions currently
A Phenomenological Exploration: The Black Bile of Depression
Get PDFThe phenomenon of depression manifests itself in many different forms, haunting us with its simultaneously inescapable, diffuse and pervasive presence. The rich thickness of depression is often severely drained and confined within the overall field of psychology, in which this phenomenon is regularly expressed as an all-encompassing, diagnostic label, to limitedly describe an almost endless number of symptomatic permutations. We shall attempt to distill something of depression’s essence in returning to its ancient, etymological, spiritual and metaphysical roots, in order to begin transcending the traditional clinical notion of depression as simply a disease to be cured and suppressed. The relatively rare and unique theoretical lens and tools offered by phenomenology (as supplemented and informed by personal interviews with people who have personally struggled with depression), allows us to grow into a healthier relationship with this phenomenon - one that can more honorably and constructively serve us in our ongoing development to this largely murky, misunderstood and often misleading force. Perhaps only by exploring and staring into that infamous abyss, may we seek to populate it with stars
Phantom Limb Pain: Implications for Treatment When the Mechanisms Are Unknown
Get PDFDuring the Civil War, American physician Silas Weir Mitchell was the first to coin the “phantom” to the sensations individuals experienced in their nonintact limb following limb amputation. Even though physicians have been aware of phantom sensations, and similarly phantom limb pain, for over a century, the mechanism for the pain is not well understood. Because the mechanisms are not well understood, my thesis provides a bioethical framework for clinicians in order to treat phantom limb pain. The thesis begins with an introduction to the history of phantom limb pain and the current theories available to explain the phenomenon. It then looks at the treatments available for phantom limb pain and focuses specifically on mirror therapy. Mirror therapy is a noninvasive, physical therapy practice available for phantom limb pain. Through the framework provided, my thesis argues that mirror therapy should be the first treatment presented to patients experiencing phantom limb pain. It concludes with my own theory of why phantom limb could exist, and further directions of where research and treatment should be focused on phantom limb pain
Madness or Mysticism: An Analysis of the Interpretation of Hearing Voices as Auditory Hallucination or Religious Experience
Get PDFThe author explores the possibility of “hearing voices” from both a medical model, adhering closely to the psychological and neurological roots of auditory hallucination, and from a spiritual/religious model, accounting for those voices that cannot be explained or interpreted by science
Photographing Bioluminescence, Ethics, and Lessons from a Misguided Ethnographer
Get PDFThe author explores the role of the photograph in science, as well as the implicit and explicit biases associated with each use. Analysis of the various forms of manipulation present in Edward Curtis’ photographs serve to illustrate what ramifications implicit and explicit bias can have on both scientific photography and the way in which science is disseminated through photographs. This historical example highlights existing ambiguity within the scientific community regarding the use of the photograph and the pitfalls such ambiguity may generate