• Examining health equity through satisfaction and confidence of patients in primary healthcare in the Republic of Trinidad and Tobago

      Rudzik, Alanna E. F. (BioMed Central, 2003)
      Surveys of patient satisfaction are widely used for identifying priorities and problems in healthcare reforms. The present study examined satisfaction and confidence of patients in public healthcare in Trinidad and Tobago. Data were gathered by interviewing a random sample (n = 280) of primary healthcare (PHC) patients. Level of patient satisfaction was high but not constant. Results of interviews showed that patients with a higher monthly income (p = 0.032) and patients who most recently used private medical care (p = 0.037) had lower levels of satisfaction with health services. Employment had an effect on satisfaction (p = 0.065), significant among patients who had recently accessed private medical care (p = 0.039). Patients using PHC clinics preferred private care to public care. Confidence in public care decreased with increasing complexity of the medical condition. These preliminary results support continued efforts in health-sector reforms and call for the enhancement of data on satisfaction through more comprehensive qualitative data-collection methods.
    • Determinants of Tubal Ligation in Puebla, Mexico

      Rudzik, Alanna E. F.; Leonard, Susan H.; Sievert, Lynnette L. (Taylor & Francis Online, 2011)
      Tubal ligation provides an effective and reliable method by which women can choose to limit the number of children they will bear. However, because of the irreversibility of the procedure and other potential disadvantages, it is important to understand factors associated with women's choice of this method of birth control. Between May 1999 and August 2000, data were collected from 755 women aged 40 to 60 years from a cross-section of neighborhoods of varying socio-economic make-up in Puebla, Mexico, finding a tubal ligation rate of 42.2%. Multiple logistic regression models were utilized to examine demographic, socio-economic, and reproductive history characteristics in relation to women's choice of tubal ligation. Regression analyses were repeated with participants grouped by age to determine how the timing of availability of tubal ligation related to the decision to undergo the procedure. The results of this study suggest that younger age, more education, use of some forms of birth control, and increased parity were associated with women's decisions to undergo tubal ligation. The statistically significant difference of greater tubal ligation and lower hysterectomy rates across age groups reflect increased access to tubal ligation in Mexico from the early 1970s, supporting the idea that women's choice of tubal ligation was related to access.
    • The Experience and Determinants of First-Time Breast-Feeding Duration among Low-Income Women from São Paulo, Brazil

      Rudzik, Alanna E. F. (University of Chicago Press, 2012)
      While the ability to breast-feed is virtually universal among women, the experience of breast-feeding is particular to each woman and is influenced by her social, economic, and personal circumstances. This paper explores quantitative and experience-focused ethnographic data on the experiences of low-income women from the eastern periphery of the city of São Paulo, Brazil, who were breast-feeding for the first time. The prospective, longitudinal data collection method involved repeated in-depth interviews with a group of 65 women, from the end of pregnancy through the first 12 weeks postpartum. Multivariate statistical analyses of the quantitative data revealed that older age, lower interpersonal satisfaction, and unplanned pregnancy shortened the period of exclusive breast-feeding and increased women’s likelihood of having begun supplementation by 12 weeks postpartum. Ethnographic data analysis exposed the meanings of breast-feeding and motherhood for women who had experienced unplanned pregnancy and helped to shed light on the dramatic influence of unplanned pregnancy on women’s breast-feeding practice.
    • Discrepancies in maternal reports of infant sleep vs. actigraphy by mode of feeding

      Rudzik, Alanna E. F.; Robinson-Smith, Lyn; Ball, Helen L. (Elsevier, 2018-09)
      Objectives: Many studies of infant sleep rely solely on parentally-reported data, assuming that parents accurately report their infant's sleep parameters. The objective of this paper is to examine whether night-time sleep parameters of exclusively breastfed or exclusively formula-fed infants differ, and whether correspondence between parental reports and objective measures varies by feeding type. Methods: Mother-infant dyads intending to breastfeed or formula-feed exclusively for 18 weeks were recruited. Mothers were multiparas and primiparas, aged between 18 and 45 years. Infants were full-term, normal birthweight singletons. Maternal report and actigraphic data on infant sleep were collected fortnightly, from four to 18 weeks postpartum. Data were analysed cross-sectionally using t-tests and GLM analysis to control for interaction between feed-type and sleep location. Results: Actigraphy-assessed infant sleep parameters did not vary by feed-type but parentally reported sleep parameters did. Maternal report and actigraphy data diverged at 10 weeks postpartum and discrepancies were associated with infant feeding type. Compared to actigraphy, maternal reports by formula-feeding mothers (controlling for infant sleep location) over-estimated infant's Total Sleep Time (TST) at 10 weeks and Longest Sleep Period (LSP) at 10, 12 and 18 weeks. Conclusions: These results raise questions about the outcomes of previous infant sleep studies where accuracy of parentally-reported infant sleep data is assumed. That parental reports of infant sleep vary by feeding type is particularly important for reconsidering previous studies of infant sleep development and intervention studies designed to influence sleep outcomes, especially where feed-type was heterogeneous, but was not considered as an independent variable.
    • Residential immersive life skills programs for youth with disabilities: a case study of youth developmental trajectories of personal growth and caregiver perspectives

      Rudzik, Alanna E. F.; McPherson, Amy C.; King, Gillian; Kingsnorth, Shauna (BMC / Springer Nature, 2019)
      Background: Professional support in pediatric and rehabilitation care environments has been recommended as a means to build youth competence in life skills during their transition to adulthood. Life skills are the essential psychosocial competencies and interpersonal skills needed to manage one’s life. Residential immersive life skills (RILS) programs offer youth with physical disabilities enriched learning environments to acquire these skills. This study explored trajectories of personal growth in life skills and positive psychological outcomes among youth participating in a RILS program and related caregiver perspectives. Method: Delivered by a multidisciplinary healthcare team, The Independence Program is an intensive summer program housed in a college residence that provides realistic experiences of living away from home for small groups of youth between 17 and 21 years of age who have congenital and/or acquired physical disabilities. Using a longitudinal case study and qualitative descriptive design, four youth and their parents/guardians participated in semi-structured interviews prior to, and then 1 month, and 3 to 4 months after the program. A conventional content analysis yielded chronological narratives for each youth and caregiver dyad of their experiences, perceptions and outcomes over time. These narratives were further summarized using a ‘line of development’ perspective to describe individual developmental trajectories of personal growth. Results: All four of the youth returned from the program with positive reports about the new life skills acquired and new behaviours they engaged in. These positive reports generally continued post-program, albeit with differing trajectories unique to each youth and varying levels of congruence with their caregivers’ readiness to support, accommodate and facilitate these changes. Caregivers differed in their capacity to shift in their parenting role to support consolidation of youth life skill competencies following program participation. Conclusions: RILS programs can be transformative. Varied youth trajectories identified significant personal growth through enhanced self-determination, self-efficacy and self-advocacy. Congruence in youth and caregiver perceptions of post-program changes was an important transactional factor. Professional support addressing caregiver needs may be beneficial to facilitate developmentally appropriate shifts in parenting roles. This shift is central to a model of shared management whereby adolescents take on greater responsibility for their own care and life choices.
    • Designing High Structure Courses to Promote Student Engagement

      Beck, Edward J.; Roosa, Kristen A. (Human Anatomy and Physiology Society (HAPS), 2020-08)
      While there are many strategies for increasing the inclusiveness of anatomy and physiology courses, increasing course structure is a strategy that can not only close achievement gaps for first generation and underrepresented minority students, but also increase performance for all students. High structure courses are characterized by clear learning goals, regular in-class exercises that promote student participation, and frequent out-of-class assignments that promote practice and preparation. In this article we describe ways to increase the structure of your course design and the learning environment in both face-to-face and online courses.
    • A classification scheme for identifying snowstorms affecting central New York State

      Hartnett, Justin J. (Wiley, 2020-11)
      The Great Lakes region experiences anomalously high seasonal snowfall totals relative to similar latitudes. Although lake‐effect snowstorms are common in this region, snowfall occurs from a variety of storm types. This study examines snowstorms in a subsection of the Lake Ontario basin to develop a classification scheme to categorize the different types of snowstorms affecting the region. From 1985 to 2015, there were 11 different snowstorm types to affect the study area. The classification system was used to assess the frequency of, and snowfall produced by the different storm types within the eastern Great Lakes region. From the classification, snowstorms were categorized as either non‐direct cyclonic storms (NDCS) or direct cyclonic storms (DCS). Lake‐effect snowstorms, a type of NDCS, were the most frequent storm (35.1% of all storms) and accounted for approximately 39.4% of the snowfall. Most lake‐effect storms (37.7%) produced moderate snowfall totals (10.2–25.3 cm), yet heavy snowfall storms (≥25.4 cm) contributed significantly (ρ ≤ .05) more to seasonal snowfall totals than lighter snowfall storms. Direct cyclonic clippers forming over high latitudes of northwestern Canada, were the most frequent DCS in Central New York (11.3% of all storms), with nearly three quarters of the storms originating over Alberta. These storms only contributed 9.2% of the seasonal snowfall in the study area, compared to 12.7% from direct cyclonic Nor'easters forming near the east coast of North America. Although Nor'easters occur less frequently than clippers, when they do occur, they tend to produce heavy widespread snowfall across the region. The classification system proposed can be modified to accommodate snow basins across the globe. Classifying snowstorms will help determine the seasonal snowfall contribution from different storms and aid in future climate predictions, as individual snowstorm types may respond differently to a warming global climate.
    • Monumental Mobility: The Memory Work of Massasoit (review)

      Walker, William S. (Oxford University PressOrganization of American Historians, 2020-12)
      [excerpt] Monumental Mobility is a welcome addition to a growing literature examining monuments and memorials related to the history of settler colonialism. While Confederate statues have sparked high-profile public controversies, monuments that address the history of settler colonialism have garnered less attention; nevertheless, some have provoked strong criticisms, especially from activists who seek to “decolonize” museums and public history...
    • Biologically normal sleep in the mother-infant dyad

      Rudzik, Alanna E. F.; Ball, Helen L. (Wiley, 2021)
      Objectives: We examine infant sleep from evolutionary, historico‐cultural, and statistical/epidemiological perspectives and explore the distinct conceptions of “normal” produced by each. We use data from the “Sleeping Like a Baby” study to illustrate how these perspectives influence the ideals and practices of new parents. Methods: The “Sleeping Like a Baby” study investigated maternal–infant sleep in north‐east England. Sleep data for exclusively breastfeeding (EBF) and formula‐feeding (EFF) dyads were captured every 2 weeks from 4 to 18 weeks postpartum through actigraphy and maternal report. Mothers also reported their infant sleep ideals and practices. Results explore objective and maternally‐reported infant sleep parameters, and concordance of maternal ideals and practices with public health guidance. Results: Comparison of sleep measures showed that mothers overestimate infant sleep duration compared with actigraphy; EFF mothers' reports were significantly more inaccurate than those of EBF mothers. For infants moved to a separate bedroom, maternally‐reported sleep increases were not borne out by actigraphy. Across the study period, concordance of maternal ideal sleep location with public health recommendations occurred on average for 54% of mothers, while concordance in practice fell from 75% at 4–8 weeks to 67% at 14–18 weeks. Discordance for EBF dyads occurred due to bedsharing, and for EFF dyads due to infants sleeping in a room alone. Conclusions: Beliefs about “normal” infant sleep influence parents' perceptions and practices. Clinical and scientific infant sleep discourses reinforce dominant societal norms and perpetuate these beliefs, but biological and evolutionary views on infant sleep norms are beginning to gain traction with parents and health practitioners.
    • Short‐term responses of freshwater mussels to floods in a southwestern U.S.A. river estimated using mark–recapture sampling

      Stich, Daniel S.; Sotola, V. A.; Sullivan, K. T.; Littrell, B. M.; Martin, N. H.; Bonner, T. H. (Wiley, 2021)
      Floods can directly affect riverine organisms by displacing them, and population‐level responses to floods can vary depending on flood magnitude and organism mobility. Benthic organisms can resist displacement until substrates become unstable, whereas mobile organisms are generally more resilient. Freshwater mussels are benthic organisms with low mobility, and there is limited research on their population‐level responses to floods. This study provides novel insights to population‐level responses of mussels to large floods (>500 m3/s). Population dynamics (i.e. abundance, survival, and site fidelity) and sampling efficiency (i.e. detection probability) were estimated in a robust design framework for four freshwater mussel species (Cyclonaias petrina, Cyclonaias pustulosa, Amblema plicata, and Tritogonia verrucosa) from 2017 to 2019 at two sites (upper and lower sites) within riffle habitats in the Colorado River, Texas, U.S.A. Individuals of each species were affixed with shellfish tags, with C. petrina and C. pustulosa individuals also being affixed with passive integrated transponder tags. Changes in population dynamics related to the flood event at each site were directly tested. During sampling, a major flood occurred at each of the two study sites; the floods differed in magnitude but were in the 99th percentile of historical flows at their respective gages. There were site‐ and species‐specific differences in estimated abundances, survival, and site fidelity during periods with the floods. Estimated abundances of C. petrina, C. pustulosa, and T. verrucosa were reduced 40–78% by the lesser flood magnitude (1,283 m3/s) at the upper site. Estimated abundances of C. petrina, C. pustulosa, and A. plicata were reduced 93–95% by the greater flood magnitude (4,332 m3/s) at the lower site. There was a reduction in survival of C. petrina at the upper site, while initially high survival at the lower site was reduced during the interval with the flood for all species. Finally, there was a reduction in site fidelity of C. pustulosa at the lower site. Floods reduced the abundance of all species within riffle habitats at the two sites. Large floods, therefore, affect population dynamics of mussels, but the fate of the displaced mussels is unknown, and with limited inference, reach‐scale effects are unknown. This study adds to the growing body of knowledge about responses of aquatic organisms to large floods, although quantification of recolonisation and fate of displaced mussels are needed to fully understand long‐term effects of large floods on mussel communities.
    • Toward a Bioarchaeology of Urbanization: Demography, Health, and Behavior in Cities in the Past

      Betsinger, Tracy K.; DeWitte, Sharon N. (Wiley, 2021-02)
      Urbanization is one of the most important settlement shifts in human history and has been the focus of research within bioarchaeology for decades. However, there have been limited attempts to synthesize the results of these studies in order to gain a broader perspective on whether or how urbanization affects the biology, demography, and behavior of humans, and how these potential effects are embodied in the human skeleton. This paper outlines how bioarchaeology is well-suited to examine urbanization in the past, and we provide an overview and examples of three main ways in which urbanization is studied in bioarchaeological research: comparison of (often contemporaneous) urban and rural sites, synchronic studies of the variation that exists within and between urban sites, and investigations of changes that occur within urban sites over time. Studies of urbanization, both within bioarchaeology and in other fields of study, face a number of limitations, including a lack of a consensus regarding what urban and urbanization mean, the assumed dichotomous nature of urban versus rural settlements, the supposition that urbanization is universally bad for people, and the assumption (at least in practice) of homogeneity within urban and rural populations. Bioarchaeologists can address these limitations by utilizing a wide array of data and methods, and the studies described here collectively demonstrate the complex, nuanced, and highly variable effects of urbanization.
    • Preface

      Stengler, Erik (SUNY Oneonta, 2021-05)
      This is the first of many “Cabinets of Curiosities” that students of the Cooperstown Graduate Program will imagine with objects from the collection of the Little Falls Historical Society in Little Falls, NY. As part of the course “Science Cabinet of Curiosities” the students select objects for this imaginary cabinet of curiosities, do in-depth research about them and their role in a specific aspect or period in the history of Little Falls, and then create a product that supports the Historical Society’s Museum and its programming. In 2020, the product has been this book about the industrialization in Little Falls.