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Feel the Burn(Out) and (Mom)Guilt of Doctorate Programs Amongst Latina Mothers: A Testiomonio Reflection
Full text linkResearch Focus. This research aims to explore the experiences of Latina mothers residing in San Antonio, Texas, using testimonios as a form of data collection; asynchronous interviews were completed to obtain the participants\u27 experiences as they journeyed through their respective doctoral programs. Through this qualitative study, the research provided an in-depth analysis to understand the relationship between motherhood, academia, and culture in relation to advanced degrees. In this study, LatCrit served as the leading theoretical framework, allowing the researcher to understand the obstacles the participants underwent not only as doctoral students but also as the other critical roles in their lives. This research exposes a gap in the literature that needs to explore Latina mothers\u27 experiences in higher education. San Antonio women are least likely to earn a bachelor\u27s degree or higher as compared to its neighboring cities; not only is there a difference in degree attainment amongst cities but also within racial and ethnic groups in San Antonio. A 2019 report generated by Saenz and Casura (2019) showed that 16.4% of Latina women 25 years and older hold a bachelor\u27s degree or higher, while 43.1% of white women, 26.5 Black women, and 47% of Black women possess a bachelors degree or higher. Thus making this population the least advanced degreed population in the United States, which is why the need for this study is essential.
Research Methods. A qualitative study was administered using Latina Critical Race Theory (LatCrit). LatCrit is an extension of Critical Race Theory (CRT) which acknowledges the issues that focus specifically on the events that unfold for the Latino community due to issues based on immigration status, language, culture, ethnicity, and phenotype (Solórzano & Delgado Bernal, 2001). Eight participants were selected to participate in this study and answer a series of questions based on their experiences in their respective doctoral programs, family, and personal life. Due to COVID-19, interviews were administered one-on-one using the online technology known as Flipgrid to create an environment where the participants feel comfortable speaking up and discussing their experiences, along with staying safe in conjunction with CDC protocols. Interview recordings and transcripts were downloaded from FlipGrid and placed in designated folders. Videos and transcripts were reviewed to ensure accuracy between the transcripts and the story told by the testimonialistas. A simple approach was used to develop themes across the eight testimonios explored in this inquiry. The specific methods involved a two-stage analysis using a within-case analysis followed by a cross-case analysis.
Research Results/Findings.
A careful review of the data from all eight cases revealed several themes and subthemes. The 8 testimonialistas voluntarily applied to doctoral studies for their advancement and personal fulfillment, with all but one participant being a mother before applying to get their Ph.D. All the participants voluntarily applied to doctoral programs for personal gain, with all but one being mothers before applying to get their program. Though they knew it would be a rugged mountain to climb, they took that chance to create change in their world and influence change in the culture and families. All the testimonialistas have presented unique barriers in their journey. They have chosen to preserve and follow through with their education creating time to dedicate to their studies. All the testimonialistas are very driven women, mothers, and partners. Their academic goal is to earn the title of doctor to better their lives, their children, and the Latino/a community in which they were raised. Whether they began their respective programs with children or gave birth during their programs, all the testimonialistas share their concern for missing moments with their children and bear the burden of loss of time.
Conclusions from Research.
The final analysis of this study revealed that each of the testimonialistas has the will to persevere through their educational endeavors despite the constant task-switching they encounter. The testimonialistas grapple with internal adversity yet continues to push through to complete their PhDs. They are resilient in that all the testimonialistas understand that sacrifices must be made on their journey but will do all it takes to ensure that sacrifice does not affect their children. These doctoral student mothers continue to put their children\u27s needs first, primarily through the pandemic, by continuing to homeschool their children until the pandemic slowed or the vaccinations became available for children of all ages. Motherhood is no easy task, let alone motherhood in academia; however, these strong-willed Latina women will continue their journey to inspire their children and other women in their culture
Multimodal Imaging Reveals Bilateral Idiopathic Multiple Retinal Pigment Epithelial Detachments: A Case Report
Full text linkBackground: Retinal pigment epithelial detachment (RPED) is a nonspecific finding that is common in several ocular diseases; however, cases of bilateral idiopathic multiple RPEDs are rare. Less than 50 cases have been reported to date. Bilateral multiple RPEDs are usually idiopathic and benign in nature but can infrequently be associated with various ocular and systemic diseases, including central serous chorioretinopathy (CSC). The potential role of genetic factors in this condition remains elusive. We present a case where multimodal imaging assisted in revealing the diagnosis as well as discuss the potential implications of some of the genetic findings for this patient.
Case report: A 30-year-old male presented with a chief complaint of mild, bilateral central blur of one-year duration. Health history was positive for type 2 diabetes mellitus.
Conclusion: Multimodal ophthalmic imaging is useful in ruling out various differential diagnoses in posterior segment care, as well as monitoring for progressive changes such as sensory retinal detachment and choroidal neovascularization. Bilateral idiopathic multiple RPED is a rare condition that may represent an atypical form of CSC. There is currently no preferred treatment, besides observation, as visual prognosis is typically good
Testimonios of Latinas in the Federal Government Senior Executive Service: Honoring Women Who Excel in Public Service
Full text linkThe Senior Executive Service (SES) is the highest tier of executive management and leadership in the federal government. The Latino/a population has significantly increased in the past three decades with no corresponding increase in the federal workforce and the number of Latinos/as serving in the SES remains low. As Latinos/as in the SES are largely underrepresented, their ability to influence federal policies is significantly undermined. The purpose of this study is to explore the testimonios (testimonies) of Latinas in the SES to better understand their experiences while navigating entry into the SES and maintaining their respective positions.
This study used a qualitative research approach and a narrative inquiry research design to explore the central question of this study and to encourage the participants to share their life experiences in detail. This study expands the literature by applying Critical Race Theory (CRT) and Latina/o Critical Race Theory (LatCrit) methodologies outside of educational or academic settings to learn about the role race and institutional racism play in Latinas’ SES career development. Even though CRT studies examine the discriminative role of federal laws and regulations as the central axis of institutionalized racism, there are no CRT studies in the literature that explore the impact of these federal laws and regulations in the same institutions that create them. LatCrit is a theory that elucidates Latinas/Latinos’ multidimensional identities and can address the intersectionality of racism with other forms of discrimination. In addition, these theoretical frameworks examine the intersection of race and laws in the federal government to question the adequacy of conventional approaches to racial justice. Semi-structured interviews composed of open-ended questions were used to explore the participants’ experiences. The primary research question was: How do Latinas navigate their journey in pursuing a career in the SES? Five Latinas who held an SES position participated in this study.
The participants shared experiences illustrating instances of discrimination relating to race, gender, and age as they pursued the SES, with most participants stating that sexism is more prevalent than racism. In addition, two participants mentioned youth, a form of reverse ageism, as a discrimination factor. The participants expressed faith in the federal government’s ability to help reduce workplace discrimination. Nonetheless, the participants also stated that existing programs and initiatives have done little to improve the Latino/a representation in the SES, and that this issue is not likely to improve unless the federal government actively engages in practices to improve it. In all, the participants stated that little has been done to tackle inequalities in the workplace, at least not imposing changes that have a long-term impact. As a result, the participants expressed that Latinos/as will continue to be one of the largest underrepresented minority groups in the federal workforce, and with specific relevancy to this study, in the SES
Impact of Indicators on Hispanic Student Postsecondary Stem Success
Full text linkResearch Focus. My study seeks to explore the extent that select secondary and postsecondary indicators predict STEM student enrollment and persistence particularly for Hispanic students. Identifying postsecondary STEM success and college readiness indicators with special focus on malleable indicators that can assist educators, administrators, and policymakers in designing and implementing educational interventions targeted at improving representation of Hispanic students that receive postsecondary STEM degrees. Currently there are few studies that use data from nationally representative samples of students to research the relationship between predictiveness of indicators and postsecondary STEM success, in particular, studies that explore which indicators differentially predict postsecondary STEM outcomes for Hispanic students and Hispanic subgroups. The goals of my research are to determine which indicators are most predictive of future postsecondary success of Hispanic students, and whether these indicators are consistent with previous research on predictors of postsecondary success (Hinojosa, et al., 2016; McClarty & Gartner, 2015). By better understanding the indicators most influential in predicting the future success of Hispanic students, interventions and program decisions can be more effectively tailored to the needs of these students to support increasing representation of Hispanic students enrolling in and persisting in a STEM major or degree.
Research Methods. A two-stage analysis plan was implemented for this study. The first stage of analysis involved generating descriptive statistics. The second stage of analysis involved a series of binomial logistic regression models to explore differences between Hispanic students and White students, and within Hispanic group differences moderated by socioeconomic status (SES) and English language learner (ELL) status. The sample for this study was taken from the High School Longitudinal Study of 2009 (HSLS:09) that followed a cohort of students beginning their ninth-grade year of high school. Data were collected on the students in Fall 2009, three years later in spring 2012 of their 11th grade, and as part of second follow-up three years after graduation in 2016.
Research Results/Findings. Findings indicate variables from the conceptual framework categories of achievement, behavior, motivation, and social engagement are associated with predicting the likelihood of declaring an NSF supported STEM field of study or degree. The variables of credits earned in science, time spent on math homework/studying and science homework/studying, and participation in math activities were significant for Hispanic students compared to White students, for high SES Hispanic students and for non-ELL Hispanic students, although there was a negative association to the outcome variable for time spent on math homework/studying. Variables from the conceptual framework categories of family circumstances and school characteristics were removed from analysis because of low numbers of responses. However, results from the logistic regression models created explain between 8.9% and 33.6% of the variance in declaring an NSF supported STEM field of study or degree for Hispanic students.
Conclusions From Research. The number of jobs in STEM or Science and Engineering (S&E) is expected to increase significantly, and minorities are projected to account for over half of the U.S. population by 2060, with Hispanics being one of the groups to have some of the largest gains. Hispanics, however, along with other minority groups, are underrepresented in STEM or S&E careers and completion of related postsecondary degrees. Further, there is little research using nationally representative data sets that examine “the predictive power of indicators of postsecondary STEM success for Hispanic students” or within Hispanic population differences, including such factors as SES and ELL status (Hinojosa et al., 2016, p.14). Findings from this study can provide educational stakeholders with additional insights aimed at more targeted and earlier interventions and program supports to increase equitable representation of Hispanic students completing postsecondary STEM degrees
Pituitary Adenoma Hidden by Comorbid Cataract
Full text linkBackground: A pituitary adenoma is an abnormal growth in the pituitary gland. Pituitary adenomas are the most common cause of sellar masses accounting for approximately 10% of all intracranial neoplasms. Early visual symptom of pituitary adenoma can be hidden by comorbid cataract in elderly patients. Case Report: A 74 y.o. male presented to the eye clinic with blurry vision at all distances and has trouble with glare from lights. His best corrected visual acuity (BCVA) was 20/20-1 OD, 20/25-2 OS, but subjectively of poor quality. Slit lamp exam confirmed mild nuclear sclerotic cataract OU and normal fundus exam. Patient underwent uncomplicated cataract extraction with intraocular implant, OS first then OD. Post-op course was unremarkable until one month later when patient stated that his vision OS was blurry to the left. BCVA was 20/25 OD, 20/25-2 OS. Post-op exam was still normal including FCF. Humphrey visual field (HVF) however showed a bitemporal hemianopia. Patient was referred for a brain imaging. Brain MRI confirmed a 24 x 22 x 28 mm T2 isointense enhancing mass of the sella with suprasellar extension consistent with a pituitary macroadenoma. Patient underwent endonasal transphenoidal craniectomy for debulking of the tumor subsequently by an ENT specialist. Conclusion: Clinicians need to be sure the cataract matches the visual complaint. When in doubt further ancillary testing such as comprehensive HVF is crucial to detect visual pathway disorder and brain tumors. Co-management with corresponding specialist is essential to preserve vision and save life
Utilizing a Validated Screening Tool and Treatment Protocol for Managing Agitation and Violence in a Psychiatric Emergency Services Unit
Full text linkBackground and Significance. Agitation is a significant concern in psychiatric units. If not detected early, agitated individuals are at high risk for becoming aggressive and violent, potentially causing harm to themselves, hospital staff, and property. The Psychiatric Emergency Services unit receives agitated and violent patients with psychiatric illnesses and substance use disorders. Purpose/Goal/Objectives. This quality improvement project aimed to implement a treatment protocol using the Broset Violence Checklist (BVC) to promote the early identification and management of potential for patient violence and aggression. Methods/Key Activities. Staff education for the nurses and providers on assessing patients at risk for aggression and violence and implementing the algorithm of the BVC with a treatment protocol was conducted on-the day and night shifts for ten weeks. Results/Project Outcomes. One hundred fifty-two adult psychiatric patients aged 18-54 years were screened for potential violence using the BVC with 97% (n = 147) upon admission, 91% (n = 138) every 4 hours in the first 24 hours, and 86% (n = 130) every shift until discharge. The treatment protocol was utilized in 104 (68%) patients, where 23 (15%) required intramuscular medications, and two (1.3%) required physical restraints. Implications for Practice. With early recognition of the risk for violence, timely interventions can be applied without waiting for the patient to be severely agitated or violent
A Quality Improvement Project to Improve the Management of Group A Streptococcalpharyngitis Among Children
Full text linkGroup A Streptococcal (GAS) pharyngitis is one of the most common pediatric illnesses and accounts for more than ten million yearly medical visits. GAS is commonly misdiagnosed due to overlapping symptoms. The health care provider needs to distinguish which criteria warrant testing for GAS and the recommendations for management and treatment.
The purpose and objectives of this quality improvement project were to improve adherence to the 2021 Canadian guidelines for the management and treatment of GAS pharyngitis in a small community urgent care clinic. Anticipated outcomes for this project included a decrease in unnecessary testing for GAS pharyngitis, a decrease in the overuse of antibiotics, and an increase in the recommended pharmacological treatment for GAS.
There was a reduction in unnecessary testing, an increase in the use of the recommended treatment of choice, and a decrease in the overuse of antibiotics observed during the project. A knowledge deficit was noted within the staff regarding the procedure for obtaining a throat swab; this alone contributed to inaccurate results, which led to repeated visits to the clinic. The overlapping of viral symptoms and those indicative of GAS was the primary reason for unnecessary testing. The use of appropriate antibiotics to treat GAS significantly improved during the project. After the project, the providers and staff had an increased knowledge of the 2021 Canadian guidelines for managing and treating GAS among children. There was a 100% improvement in the clinic’s adherence to the recommended guidelines
Implementation of the Mood Disorder Questionnaire in a Psychiatric Inpatient Facility
Full text linkBackground. Bipolar disorder is a combination of multiple mood disorders associated with high suicide rates. The mood disorder questionnaire is a reliable, cost-effective, and time-effective screening tool to aid in diagnosing bipolar disorder (Carvalho et al., 2015; Miller & Black, 2020). Purpose. To implement the mood disorder questionnaire during admission to improve the accuracy of diagnosing bipolar disorder among providers in patients without a history of bipolar disorder. Goal. To increase the utilization of the mood disorder questionnaire thereby increasing bipolar disorder diagnosis accuracy. Objectives. 100% of the team will attend an in-service on the project; 60% of patients without a history of bipolar disorder will be screened with the mood disorder questionnaire; 100% of patients screening positive will be evaluated for bipolar disorder by providers; 100% of patients diagnosed with bipolar disorder will be prescribed appropriate pharmacotherapies. Methods. Education regarding the mood disorder questionnaire, pre and post-education surveys, administration of the mood disorder questionnaire, weekly audits of screening and assessment documentation, and documentation of prescribed pharmacotherapies. Outcomes. 100% of staff were educated on the mood disorder questionnaire; screenings increased from 0% to 55%; 100% of the patients with a positive screening were assessed for bipolar disorder; 100% of patients diagnosed with bipolar disorder were prescribed appropriate pharmacotherapies. Implications for Practice. Utilization of a validated and evidence-based mood disorder questionnaire screening tool increases the quality and standardization of initial assessments for bipolar disorder among all providers. The mood disorder questionnaire aides to optimizes patients’ quality of care and outcomes
Acute Syphilitic Posterior Placoid Chorioretinitis; a Case Report and Review
Full text linkBackground: Acute syphilitic posterior placoid chorioretinopathy (ASPPC) is a rare but defining characteristic of ocular syphilis. Clinical findings are subtle, geographic, yellowish, macular lesions, affecting the outer-retina and inner choroid, and often associated with subretinal fluid in the early phase. This case report will review the clinical signs of ASPPC to aid the practitioner in identification and recognition of its clinical importance as it relates to early diagnosis, treatment and prognosis.
Case Report: A 79-year-old African American male presented to clinic with a chief complaint of blur in the right eye for the past two days. Spectral Domain Optical Coherence Tomography (SD-OCT) of the macula revealed a shallow retinal pigment epithelial detachment with subretinal fluid centrally with some loss of the retinal pigment epithelium (RPE) and photoreceptors nasally, in the right eye. There was rapid progression over a week to full loss of RPE and photoreceptors with reduction of vision to hand motion in the right eye suggesting an infectious eitiology. Serologic testing was ordered and an RPR and FTA-ABS were both reactive. A diagnosis of acute syphilitic posterior placoid chorioretinopathy was made. Infectious disease treated the patient with IV penicillin G. There was complete resolution of ocular findings.
Conclusion: Syphilis should be considered for any ocular inflammatory condition. ASPPC is highly suggestive of syphilis. All patients with ocular syphilis should be evaluated for neurosyphilis. Treatment is IV penicillin G for 10-14 day and considered successful when there is a four-fold reduction in titers. Full visual recovery typically occurs within 12 weeks of treatment if a diagnosis and treatment are initiated early in the course of ocular disease
Ocular Manifestations of Septo-optic Dysplasia
Full text linkBackground: Septo-optic dysplasia (SOD) is a congenital deformity of the brain which can result in neurologic, systemic, and physical malformation.Due to the proximity of these deformities to the optic chiasm and optic nerves, ocular manifestations are common.
Case Report: A 28-year-old male with a long-standing history of reduced vision presented for a routine eye examination. Upon examination he was found to have an afferent pupillary defect, bilateral optic nerve pallor with corresponding nerve fiber layer thinning by optical coherence tomography. Humphrey visual field testing revealed a bi-temporal visual field defect. Neurological imaging was obtained with a subsequent diagnosis of Septo-optic dysplasia (SOD).
Conclusion: Our patient had bilateral optic nerve hypoplasia and an absent septum pellucidum without endocrine abnormalities. This case reiterates the importance of accurate diagnosis of amblyopia only in the absence of ocular and neurological disease. This review also highlights the importance of imaging in instances of unexplained optic atrophy