Department of Curriculum Studies and Education Management / MEDCS

PHDRDV / Institute for Rural Development

No description available.

This thesis examines the personality, social, and physical needs of children attending the second grade at Horace Mann School in Amarillo, Texas.

There is widespread agreement among researchers, policy experts, and community advocates that the United States’ mass incarceration system is a policy failure. Despite bipartisan consensus and sporadic reform attempts, the policies and systems ravaging low-income families and communities of color remain largely intact. Formerly incarcerated people have been driving the social movement to dismantle mass incarceration since the movement’s inception, yet their advocacy efforts and creation of alternative programmatic and policy approaches have only recently been acknowledged and documented and have yet to be implemented widely. Through this study, I aimed to fill these gaps in knowledge about the advocacy work of women impacted by the justice system by documenting the ethos, practices, and strategies of Theater for Social Change (TSC), a performance arts-based advocacy group composed of formerly incarcerated women in service of justice system transformation. Using action research methodology, I employed dialogic and iterative processes, in partnership with TSC, to develop interview and focus group protocols and analyze data. I also undertook a thematic analysis of post-performance audience discussions, as well as the scenes and monologues created by the ensemble over the years. This research project found that the ensemble way of working—defined by Radosavljević (2013) as “collective, creative, and collaborative”—enabled TSC to develop and model the type of caring and self-organized community and capacity development, per Nixon et al. (2008), that they envision for currently and formerly incarcerated women and their families and communities to create conditions for a just and equitable society. The ensemble way of working nurtured a sisterhood and enabled the exploration of individual and shared experiences of the trauma of incarceration, as well as overcoming systemic inequalities through higher education and career success in a safe and supportive space. Performing scenes and monologues developed from personal stories allows TSC to control its advocacy messages, challenge stereotypes, and create new narratives about the worth of formerly incarcerated people. Theater and post-performance discussions also enable ensemble members to model and employ their multilevel expertise: personal experience navigating the justice system; professional expertise in reentry, mental health and human services; and advocacy leadership.

Heart disease, including principally coronary heart disease (CHD) remains the top cause of mortality in the United States among adults ages 35 and older. Disparities in CHD mortality between socially advantaged and disadvantaged groups, such as whites and blacks have persisted for decades. These social gaps persist despite advances in treatments, preventive measures, and decreases in population prevalence of smoking that have done much to reduce the burden of CHD overall. While these differences in disease burden have been well documented, there is a poor understanding of what interventions might narrow these differences. An equity-efficiency tradeoffs (EET) framework is a useful lens through which to consider this problem. Tradeoffs between equity of intervention efforts and efficiency of the returns on such efforts arise when public health interventions are deployed across groups of unequal socioeconomic position. While such interventions may achieve overall and intra-group improvement, this improvement may come at the expense of stable or widening inter-group differences. Aiming to add to this literature, we took three approaches. First, we critically assessed the literature in order to identify and summarize prior work on EETs across cardiovascular outcomes. We aimed to identify the questions that empirical studies should answer for a given policy, from an EET perspective. Second, recognizing both that tobacco taxation is an effective policy intervention on CHD, and that we have little evidence from United States based studies that it influences racial gaps in CHD we used as an example this policy intervention to examine the treatment efficiency inherent in raising tobacco taxes from an equity lens. We conducted an empirical study to estimate the treatment effectiveness of US tobacco taxation on smoking and CHD mortality. Third, we simulated the equity and treatment efficiency effects of pharmaceutical (Statins), taxation (tobacco) and early education interventions on CHD mortality, and racial gaps in CHD mortality. Our scoping review of EETs in cardiovascular disease (Chapter 2) yielded a very small number of studies (n=6), that explicitly engaged equity and efficiency, and provided information on their trade-offs in the context of CVDs. Despite a paucity of evidence, we identified 2 important lessons: (1) movement toward equity in the context of interventions on those with a high burden of CHD risk factors may be achieved by targeting deprived populations. Second, pairing these “high risk” with structural interventions can provide substantial movement toward not only efficiency, but also equity. Our nationally representative observational, state-level study of the effects of tobacco taxation on smoking prevalence and CHD mortality by race and gender (Chapter 3) showed that between 2005 and 2016, tobacco taxes were associated with reductions in both outcomes. The strongest reductions in smoking prevalence were observed among black non-Hispanic women, while an increase was observed among black non-Hispanic men. Our simulation study (Chapter 4) showed that the equity and efficiency effects of population health interventions in the context of reducing racial disparities in CHD may vary by gender. Among men, compared to no intervention, an education intervention was associated with the greatest reduction in racial disparities in CHD mortality, while among women, a $3 tobacco tax intervention was associated with the greatest reduction in racial disparities in CHD mortality. Additionally, among men, tobacco taxes were an equity lose intervention, while for women, in contrast, tobacco taxes were nearly always a win-win intervention. Conversely, compared to tobacco taxes, statins are in some cases a win-win intervention for men, and in all cases a lose-lose intervention for women. Our findings support the utility of an EET lens in the reduction of racial disparities in health, and point to the need for more scholarship and broader integration of this lens into public health practice. Consideration of the interplay between equity and efficiency in population health interventions offers a deeper understanding of intervention effects than the consideration of either dimension alone. In some cases, we need not trade equity for efficiency in the reduction of racial inequities in health.

Poverty has continued to be an enormous challenge for Africa. Immoral political decisions and tactics have led to the continued suffering of the landless poor in the city of Harare. With no consideration for the dignity of people, the government of Zimbabwe through Operation Murambatsvina (Operation Reject Filth) demolished shelters belonging to the poor in the city a decade and half ago. To this day, most of the victims of this destruction still lack adequate accommodation. The majority urban poor have been excluded from the community and inhabit shanty towns around Harare. Deprived of justice, the poor are alienated from their right to land, nourishment and dignified life. This complete disregard for life and African community values ought to be challenged. Ubuntu moral theory presents necessary guiding principles for human progress that achieves genuine harmony and equality among all people. In light of the experiences of deadly but preventable poverty in Harare, the will-to-live for all requires confirmation. Every human being is endowed with irrevocable intrinsic worth. The elimination of poverty requires practical philosophical resolutions that are driven by sincere respect for human life. / Philosophy, Practical and Systematic Theology / M.A. (Philosophy)

Construction companies in Sweden have for recent years seen an increase in the numbers of warranty complaints associated with the market of resident buildings and the cost for this has been measured to over 1.2 billion SEK per year. Working with poor quality cost as a way of creating insight about defects within the company’s processes is a method developed and used by the manufacturing industry for decades, but have not yet reached the construction industry. This study has been performed in collaboration with a Swedish construction company, where the author has been stationed at the aftersales division for residential buildings. Owing to circumstances, this published report has been made anonymous regarding the company who will further on be named the Company. The Company is aware that warranty claims produce great costs and has requested a way of putting cost and cause to specific claims in order of receiving a more specific cost view and to make the reuse of knowledge more efficient. The purpose of the thesis is to: Investigate the conditions for adopting a cost and cause measurement for specific warranty claims within the Company’s aftersales division for residential buildings. The task has been performed as a case study where the author has analysed the opportunities and obstacles for introducing the ideas of poor quality costs at the aftersales division. The empiric is based on interviews with operating staff and management with the intention of highlighting the organizational conditions. A test model was produced and incorporated with the daily work at the aftersales division for a month’s time. The result shows that the conditions are positive for dividing costs and making early cause predictions. The author presents two alternative solutions for this work: mapping and measuring system. The conclusion is that incorporation is dependent on engaged leadership, communication and involvement of co-workers, where the reuse of knowledge is the connecting issue. / Byggbolagen  i  Sverige  har  under  senare  år  sett  en  ökning  av  antalet  garanti-  och felanmälningar kopplade till bostadsproduktionen och kostnaden för detta har av Boverket uppmätts till drygt 1.2 Mdr kr årligen. Att arbeta med kvalitetsbristkostnader för att skapa insikt om fel och brister i sin verksamhet är en metod som under decennier använts inom tillverkningsindustrin men ännu inte fått fäste i byggbranschen. Denna studie har genomförts i samarbete med ett svenskt entreprenadföretaget, där författaren har varit placerad på eftermarknadsavdelningen för bostadsproduktion. På förekommen anledning är denna publicerade version av rapporten anonymiserad gällande företagsnamnet, och företaget kommer fortsättningsvis i rapporten benämnas Företaget. Företaget är medvetet om att garantiåtgärder skapar stora kostnader och har efterfrågat ett sätt att kostnads- och orsaksbestämma dessa på ärendenivå för  att skapa en  tydligare kostnadsbild och för  att effektivisera sin erfarenhetsåterföring. Examensarbetet har som syfte att: Undersöka förutsättningarna för att införa kostnads- orsaksbestämning av garanti- och felanmälningar på ärendenivå inom eftermarknaden för bostäder. Arbetet har utförts som en fallstudie där författaren har analyserat möjligheter och hinder för att arbeta med kvalitetsbristkostnader inom ramen för eftermarknadsarbete. Det empiriska materialet  bygger  på  intervjuer  med  operativ  personal  samt  berörda  personer  i  ledande befattningar för att på så sätt belysa de organisatoriska förutsättningarna. En testmodell för registrering av kostnad och orsak arbetades fram och införlivades i det dagliga arbetet på eftermarknadsavdelningen under en månads tid. Resultatet från studien visar att förutsättningarna finns att fördela kostnader och göra initiala orsaksbedömningar av  ärenden. Författaren presenterar två  alternativa lösningar på  detta arbete; kartläggning och införande av mätsystem. Slutsatsen är att införandet är beroende av engagerat   ledarskap,   kommunikation   och   aktivt   involverande   av   medarbetarna,   där erfarenhetsåterföringen är den gemensamma nämnaren.

Preterm birth is a key indicator of maternal and child health, affecting 1 in 10 deliveries in the United States (US) and contributing to long-term morbidity and healthcare costs. The COVID-19 pandemic and policies to mitigate the spread of infection may have indirectly impacted preterm birth, but the results of early epidemiological studies were mixed and declines were largely concentrated in high-income countries and populations. Moreover, while most studies focused on stress-related pathways associated with lockdown policies, healthcare disruptions may have also played a role. The goal of this dissertation was to investigate changes in preterm birth and healthcare disruptions related to the COVID-19 lockdown in a low-income population in the US. In the first aim, I conducted a systematic review of the literature on the pandemic and preterm birth, with a focus on studies that examine heterogeneity by income. In the second aim, New York State (NYS) Medicaid claims were used to examine changes in preterm birth rates during the state’s lockdown policy (NYS on PAUSE) using difference-in-difference methods. In the third aim, changes in preterm were further stratified into those that were spontaneous or medically induced, which may reflect a healthcare pathway. Weekly rates of healthcare utilization, antenatal surveillance, and maternal complications were also assessed using interrupted time series models to characterize healthcare disruptions over the course of the lockdown and across the state. Results from the systematic review documented the rapid growth in research on this topic since the beginning of pandemic. Among the 67 articles included, most reported some decline in preterm birth rates; however, there was large variation by country, methods of exposure assessment, and onset of delivery. Only seven studies focused on differences by individual income (or income proxies) and those that did were inconsistent. Results from Aim 2 suggested that NYS on PAUSE was associated with nearly a percentage point decline in preterm birth rates in the Medicaid-insured population, without a concomitant increase in stillbirth. Aim 3 demonstrated that the change in preterm was largely driven by declines in medically induced preterm. Interrupted time series models showed substantial, but time-limited, declines in pregnancy-related healthcare utilization at the beginning of NYS on PAUSE. Overall, the findings in this dissertation suggest there were modest declines in preterm birth during the COVID-19 lockdown among low-income women in NYS, particularly in medically induced preterm. Healthcare disruptions were common for Medicaid-insured women and may partially explain the reduction in preterm birth in this population. Future research is needed to determine whether this change was positive for some and negative for others, and what that might mean for efforts to improve pregnancy outcomes in the future.

Poor mental health among children and teenagers in Sweden has been recognized and been described as increasing (Folkhälsomyndigheten, 2018). Folkhälsomyndigheten (2018) suggests that there has been a twofold increase of psychosomatic symptoms within the age group of 13-to 15-year-olds in Sweden. This study enlightens the importance of the health promotions within the school system where all the professions within the school should work together to improve the mental health of the students. The purpose with this study is to produce a qualitative study where our intention is to increase the knowledge regarding lesson structures as a success factor from the perspective of the student where the sense coherence-component’s comprehensibility, management and meaningfulness describe the psychological health of the students. Our study has a qualitative approach as we wish to understand how students perceive distinct lesson structures as opposed to vague lesson structures. The collection of data used for this study consists of semi-structured interviews conducted with six informants from two separate junior high schools, that have been analyzed using both a deductive as well as an inductive hypothesis. The inductive coding gave us the subcategories: stress, security, interests, and boredom. The sense coherence-theory has helped us analyze our collection of data, the results of which indicate that of previous research; lesson structure, clarified pedagogy, and participation are the success factors when it comes to the students' sense of coherence. The study also indicates that the informant’s psychological health is affected negatively by vague lessons. The study recognizes the important work being done regarding a Special education methodology and technology approach and the preventively and health promotion within our schools which only benefit from a salutarily perspective. Keywords: clarification pedagogy, lesson structure, poor mental health and sense of coherence.