bluuebunny/crossref_metadata_2025 huggingface dataset:
Arauco domado de Lope de Vega: Reflexión ética acerca de la historia
Authors: Taub María Quiroz
Published: August 2012

Lope afirma en el prólogo de su tragicomedia Arauco domado que él escribe una obra histórica sobre las hazañas de don García Hurtado de Mendoza en Chile. Debido a que se trata de una obra por encargo, el lector o espectador espera una obra laudatoria del conquistador. Sin embargo, el dramaturgo, acatándose a las teorías literarias de la época, produce una tragicomedia que se vale de lenguaje ambiguo para caracterizar a los dos bandos contrincantes. La obra emplea anfibología o ambigüedad para reflexionar sobre la moralidad de la conquista y, a la vez, exponer de modo velado una condena a la empresa española. Acorde a las convenciones de la época, el drama trata de comprender la realidad mediante el uso de mimesis e identifica el proceso de imitación con la inventio. Arauco domado presenta las posiciones opuestas con respecto a la naturaleza del indio que se discutían a lo largo del siglo XVI y demuestra que simpatiza con las ideas de Bartolomé de Las Casas. Este defensor de los indios aboga por un tratamiento cristiano de la población del Nuevo Mundo y sostiene que los indios son seres similares a los españoles. La obra, siguiendo el postulado lascasiano, demuestra que existe un paralelismo entre los personajes españoles y los indígenas. Este ensayo propone que la victoria bélica de los españoles se logra a costa de la perversión de su religión.
From the Street to the Stage: Performing Faith in the Virgin's Immaculacy at the University of Salamanca
Authors: Pérez Mirzam C.
Published: August 2012

This article analyzes the University of Salamanca's adoption of a statute requiring its students to pledge their conviction in the Virgin Mary's immaculacy by studying two texts commissioned for the occasion: Lope de Vega's play La limpieza no manchada (1618) and the Relación de las fiestas que la Universidad de Salamanca celebró (1618). The University of Salamanca's festivities offer a contextualized example of institutional performance of piety and political support for Philip III's endorsement of the doctrine of the Immaculate Conception to reveal how academic theater strengthened the political ties of Spain's oldest and most important university with the Habsburg monarchy. Moreover, in La limpieza no manchada Lope includes in his staged feast of Mary's immaculacy references to a variety of races, ethnicities, and nations politically and historically tied to Spain to encourage his audience to come together as one multicultural and multiethnic nation of shared religious convictions.
The Social Reconstruction of “Home” among African Immigrants in Canada
Authors: Baffoe Michael
Published: August 2012

Many Africans migrating to new countries view this as a temporary economic move. Most hope to return to their homelands, after acquiring sufficient money and resources to live comfortably. However, for many African immigrants relocated in Canada, there is an “emotional reconstruction” of “home” as they begin to regard their adopted country as their permanent home. This deconstruction and reconstruction process involves very complex processes of emotional, cultural, economic, and social adjustment. This study of African immigrants in three Canadian cities—Montreal, Toronto and Winnipeg—demonstrates how they continue to maintain a strong attachment to their homelands, while struggling with adapting to their new country.

Beaucoup d’Africains qui émigrent dans de nouveaux pays, pensent que ce n’est qu’un geste tem-poraire de caractère économique. La plupart espèrent revenir dans leur patrie, une fois acquis l’argent et les ressources qui leur permettront de vivre confortablement. Cependant, pour nombre d’émigrés africains relocalisés au Canada, une «reconstruction émotionnelle» d’un «chez soi» s’élabore au fur et à mesure que leur terre d’adoption devient pour eux un domicile permanent. Ce processus de déconstruction et de reconstruction comprend un mécanisme très complexe d’ajustement émotionnel, culturel, économique et social. L’étude ci-dessous d’émigrés africains dans trois villes canadiennes – Montréal, Toronto et Winnipeg – montre comment ils continuent à maintenir un lien fort avec leur pays d’origine, tout en luttant pour s’adapter à leur nouveau pays.
Contesting the Meanings of Migration: German Women’s Immigration to Canada in the 1950s
Authors: Freund Alexander
Published: August 2012

Twenty-five thousand German women immigrated to Canada as domestic servants between 1947 and 1962. Pushed by West German society that was increasingly hostile to women’s employment and emancipation, the female migrants, in their search for freedom, independence, and adventure, used Canadian immigration schemes that were based on patriarchal and paternalistic understandings of gender and class. The male Canadian bureaucrats who recruited the German women viewed them as cheap and docile labour for the growing middle class and as future citizens and mothers who fit the racial and religious criteria of immigration policy. The article illuminates the clashes between the female migrants and the mostly male bureaucrats over divergent meanings of migration within larger discourses of gender, class, and ethnicity. The article documents the women’s agency in the face of state control and how the women benefited from privileges received as white, Christian, Northwest Europeans. It argues that domestic servant immigration failed as a labour market policy, but, in the short term, supported Canada’s racial demographic policy to keep Canada white and Christian. It further argues that the migrants’ perspectives and actions must be taken into consideration in order to understand government policy and its implementation.

25 000 Allemandes ont immigré au Canada comme employées de maison de 1947 à 1962. Poussées par une société ouest-allemande de plus en plus hostile à l’emploi et à l’émancipation des femmes, les immigrantes se sont servies dans leur recherche de liberté, d’indépendance et d’aventure du système d’immigration canadien basé sur une interprétation patriarcale et paternaliste du sexe et de la classe sociale. Les bureaucrates canadiens masculins qui ont recruté les Allemandes voyaient en elles du personnel docile et bon marché pour la classe moyenne en expansion et de futures citoyennes et mères qui correspondaient aux critères raciaux et religieux de leur politique d’immigration. Cet article met en lumière les heurts entre les immigrantes et les bureaucrates, pour la plupart des hommes, sur les différences de signification de la migration au sein du discours portant plus largement sur le sexe, la classe et l’ethnicité. Nous y documentons l’agence des femmes face au contrôle étatique et comment celles-ci ont bénéficié de privilèges reçus en tant qu’Européennes du Nord-Ouest, blanches et chrétiennes. Nous y démontrons que l’immigration d’employées de maison a échoué en tant que politique de marché du travail, mais qu’elle a appuyé dans le court terme les principes démographiques raciaux du Canada pour y maintenir son caractère blanc et chrétien. Nous argumentons de plus que l’on doit tenir compte des perspectives et des actions des immigrants afin de comprendre la ligne de conduite du gouvernement et sa mise en œuvre.
Pratiques identitaires et racialisation des immigrants africains francophones en Alberta
Authors: Madibbo Amal
Published: August 2012

This article discusses the identity practices of the first generation of African Francophone immigrants in Alberta. It demonstrates that they develop multiple forms of belonging to many social groups, whose principal manifestation includes a collective belonging to the ethnic community of the country of origin, to the francophone community, and to Canadian society in general. The racialisation which is manifested in three forms of discrimination—i. e., linguistic discrimination towards the Francophones of Canada, racial discrimination in Canadian society in general, and racial discrimination within the Francophone community—has a major impact on the identity practices of the immigrants. The article underlines that these multiple identities materialize in order to acquire social capital which could support the social and economic integration of the immigrants. It will allow us to understand the many aspects of their migratory trajectory and to consider the politics of linguistic and racial equity, as well as possible solutions that could reinforce the feeling of belonging and the socio-economic integration of the immigrants into the Francophone and the wider Canadian society.
The Stuff of Legend: T/Selling the Story of Reena Virk
Authors: Byers Michele
Published: August 2012

This essay looks at texts that tell stories that claim to be “true,” “based on,” or “indebted to” the murder of Reena Virk. Girls in these stories are value-laden symbols that frame and reframe the story of girlhood identity within the Canadian nation in particular ways. I argue that these framings often obliterate the particularity of girlhood identities through which the nation might be understood as mired in histories of racialized and sexualized violence, through the creation of universal girl subjects whose identities better meet the needs of the publishing industry and its desired audiences. The texts in question—the play The Shape of a Girl (2001) by Joan MacLeod, the teen novel The Beckoners (2004) by Carrie Mac, and Under the Bridge (2005), a true crime novel by Rebecca Godfrey—explicitly reference Virk but their key characters are primarily white, Anglo girls. The stories are written in such a way that the experiences of second-generation immigrant youth in Canada are displaced onto universal girl subjects, disconnecting the murder from colonial oppression, misogyny, and white supremacy.

Cet essai porte sur des rapports d’histoires qui prétendent être «vraies», «basées sur» ou «rede-vables» au meurtre de Reena Virk. Les jeunes filles de ces histoires sont des symboles à fortes connotations qui cadrent et recadrent l’histoire de l’identité féminine adolescente de façon particulière au sein de la nation canadienne. Je soutiens que les cadrages de ces identités effacent souvent leurs particularités chez les jeunes filles, alors que c’est par celles-ci que l’on peut comprendre la nation, telle que reflétée dans des histoires de violence racialisée et sexualisée, et ce, par la création d’exemplaires de l’adolescente universelle dont les identités répondent mieux aux besoins de l’industrie de la publicité et des audiences visées. Les textes en question – la pièce de théâtre The Shape of a Girl (2001) de Joan MacLeod, le roman pour adolescents The Beckoners (2004) de Carrie Mac et Under the Bridge (2005), l’histoire d’un vrai crime par Rebecca Godfrey – font explicitement référence à Virk, mais leurs personnages clés sont avant tout des Anglo-saxonnes blanches. Ces histoires sont écrites de manière à transférer les expériences de jeunes immigrant(e)s de deuxième génération à des personnages de jeune fille universelle, en déconnectant le meurtre de l’oppression coloniale, de la misogynie et de la suprématie blanche.
La conciliation travail-études : défis et réalité pour les jeunes élèves africains noirs de Brooks
Authors: Mulatris Paulin , Liboy Malanga Georges
Published: August 2012

To meet their essential needs or those of their families, young black African immigrants from 15 to 24 years of age living in Brooks, Alberta, Canada, are trying to reconcile full-time night work with full-time school attendance. In most cases employers comply with the regulations on employment of children in Alberta, but no one can state with certainty that the age limit for this kind of employment is always observed. This pilot research examines the social impact of such work and study arrangements on young Francophone immigrants.
Ethnicity and Seeking Treatment for Depression: A Canadian National Study
Authors: Gadalla Tahany M.
Published: August 2012

This research was based on data collected in the Health and Mental Health cycle of the Canadian Community Health Survey to assess the effects of ethnic background on seeking treatment for major depression episodes (MDE) and to investigate types of barriers to mental health care reported by members of different racial/ethnic groups. Findings indicated that racial/ethnic background had a significant effect on treatment-seeking rates, controlling for socio-economic, demographic and health factors. Proportion of MDE sufferers with unmet mental health care needs varied significantly across racial/ethnic groups, with the lowest rate reported among Blacks and the highest among South Asians. Results identified some access problems that were common across all racial/ethnic groups and some problems unique to members of specific groups. For example, two-thirds of depressed individuals of all racial/ethnic backgrounds with unmet needs reported personal barriers to treatment, i.e., they decided not to seek treatment. In contrast, rates of accessibility and availability barriers differed significantly across racial/ethnic groups. Results signaled an urgent need for psycho-educational programs aimed at Canadians of all racial/ethnic backgrounds, as well as the need for culturally sensitive screening and intervention policies to ensure equal access to mental health services for all Canadians.

Cette recherche s’est faite à partir de données collectées par la partie de l’Enquête sur la santé dans les collectivités canadiennes portant sur la santé mentale, afin d’évaluer les effets du contexte ethnique dans la demande de traitement pour des épisodes majeurs de dépression (EMD), et pour étudier les types d’obstacles aux soins médicaux ad hoc, tels qu’en ont rendu compte des membres de groupes raciaux et ethniques. Selon les résultats, le contexte racial et ethnique joue un rôle important sur les taux de demande de traitement, en contrôlant les facteurs socio-économiques, démographiques et touchant à la santé. La proportion de malades souffrant d’EMD qui n’ont pas reçu de soins médicaux appropriés varie de manière significative d’un groupe à l’autre, les réponses indiquant le taux le plus bas chez les Noirs et le plus élevé chez les Sud-Asiatiques. Nous avons aussi identifié des problèmes d’accès, certains communs à tous les groupes raciaux et ethniques, d’autres propres à des groupes spécifiques. Par exemple, dans tous les contextes concernés, les deux-tiers des personnes dépressives qui n’ont pas reçu de soins adéquats ont indiqué des obstacles d’ordre personnel à un traitement, à savoir qu’elles n’ont pas demandé à en suivre un. Par contraste, les taux d’accessibilité et les obstacles à la disponibilité de soins mentaux diffèrent remarquablement d’un groupe racial ou ethnique à l’autre. Les conclusions indiquent un besoin urgent de dépistage et de politiques d’interventions qui tiennent compte de la culture afin d’assurer un accès égal aux services de santé mentale pour tous les Canadiens.
Les frontières linguistiques à Québec : le rôle des interactions scolaires
Authors: Magnan Marie-Odile
Published: August 2012

The Quebec English-speaking population has always formed a demographic minority. Comprising 25% of the population at the creation of Confederation, this proportion declined to 8.2% in 2006. However, the English-speaking group in Quebec only started to perceive itself as a minority in the 1970s, at which time the new term “Québécois” encouraged them to redefine themselves in relationship to the identity affirmation of this “new” Other. Research on Quebec Anglophones was first undertaken during this period of political and social turmoil. Still, until now there have been few studies on their minority status from the perspective of ethnic boundaries established by social agents in local interactive situations. In this article we shall examine linguistic boundaries negotiated in the context of Quebec City, based on the narrative of young adults who attended English high school there. Indeed, the qualitative interviews that we conducted in 2008–2009 with thirty-three young adults suggest a clear boundary between Francophones and Anglophones—a boundary which was reinforced by the very manner in which the Francophone Other regarded their English school counterparts in Quebec. We conclude that there may be several different ways of testing linguistic boundaries in Quebec.
Accès aux services de santé parmi les immigrants au Canada
Authors: Lebrun Lydie A.
Published: August 2012

Meeting the health care needs of immigrant populations is important because of their large and growing numbers. Currently, foreign-born individuals make up about 20% of the population in Canada. If trends persist, these numbers are expected to continue increasing over time. Access to health care is especially important because underutilization of services may lead to underdiagnosis and delayed treatment of health problems, resulting in immigrants’ worsening health outcomes over time. This commentary summarizes evidence about health care access and barriers among foreign-born populations in Canada. The aim is to inform policy makers about the extent to which these groups can access health care, as well as the factors that influence access to health care among a segment of the population that is characterized by diverse demographic, language, cultural, and socioeconomic features.
The Ethnic and National Identity of South Asian Immigrant Seniors Living in Edmonton, Canada
Authors: Ng Cheuk Fan , Northcott Herbert C.
Published: August 2012

The Canadian population is aging and also becoming more ethnically diverse. This study examined differences in identities among South Asian seniors who immigrated at different life stages with different lengths of residency in Canada. We interviewed 161 immigrants of South Asian descent in Edmonton, Canada, aged 60 and older about their ethnic/national identity, transnational ties, cultural retention and practices, and participation in and concerns about life in Canada. Our findings show that women were more likely than men to see themselves as more South Asian than Canadian. Furthermore, logistic regression analysis showed that older age at immigration and low English-language proficiency were significant predictors of ethnic identity. These findings indicated the importance of language for ethnic and national (Canadian) identity and revealed that South Asian immigrant elders who came to Canada in later life tended to retain their ethnic identities, while immigrant elders who came to Canada earlier in life were more likely to have developed a bicultural identity that incorporated both ethnic and Canadian identity. Related to the notion of bicultural identity, strong transnational ties with the country of origin were associated with greater participation in Canadian society.

La population canadienne vieillit et, par ailleurs, se diversifie ethniquement. Cette étude porte sur les différences identitaires parmi les aînés immigrés d’Asie du Sud qui sont arrivés au Canada à des âges divers et qui y sont depuis plus ou moins longtemps. Cent soixante et une personnes de 60 ans et plus ont répondu à nos questions portant sur leur identité ethnique / nationale canadienne, leurs liens transnationaux, le maintien d’habitudes culturelles ainsi que leur participation et l’intérêt qu’elles portent à la vie au Canada. Il en résulte que les femmes ont davantage que les hommes tendance à se percevoir plutôt comme sud-asiatiques que comme canadiennes. En outre, l’analyse de régression logistique montre qu’un âge plus avancé lors de l’immigration et une connaissance limitée de l’anglais sont des indices significatifs d’identité ethnique. Selon nos résultats, la langue joue un rôle important à cet égard, et c’étaient surtout les aînés plus âgés lors de leur immigration d’Asie du Sud qui tendaient à maintenir cette ethnicité, alors que ceux venus plus jeunes au Canada avaient davantage propension à une identité biculturelle qui incorporait les deux aspects, l’ethnique et le canadien. À propos de la définition d’identité biculturelle, nous avons découvert que de forts liens transnationaux avec le pays d’origine étaient associés à une plus grande participation à la société canadienne.
Pills, Potions, Products: Kava's Transformations in New and Nontraditional Contexts
Authors: Baker Jonathan D.
Published: August 2012

This article focuses on kava ( Piper methysticum G. Forst, Piperaceae) in its various forms: plant, beverage, medicine, and dietary supplement. Specifically, I examine a relatively unexplored dimension of kava's use: the ways in which both the form and the use of kava are changing as it is introduced into new and different cultural contexts. Kava's popularity outside Oceania has led to changes in how and why it is used, as well as transformations in the form in which people consume it. The best known of these is the manufacture of kava-containing pills and tinctures, which are marketed for treating anxiety and depression in Western countries. But kava is also undergoing a transformation into an alcohol-like recreational analogue, and it is being incorporated into a range of food products. In this article, I first seek to document some of these transformations and to describe the contexts into which kava has been introduced. Second, I analyze these transformations and attempt to frame them within larger discourses about medicines, recreational intoxicants, and notions of authenticity and exoticism. Finally, I speculate about the future face of kava. The collapse of demand for kava for use in dietary supplements provides a second chance for kava growers and wholesale distributors to consider how they want kava to be represented and sold to the wider world. The article's conclusion outlines some of the ongoing efforts to shape this future, while highlighting some of the lessons that might be learned by considering the problems associated with the previous kava boom.
Postcolonial Anxieties and the Browning of New Zealand Rugby
Authors: Grainger Andrew D. , Falcous Mark , Newman Joshua I.
Published: August 2012

This article examines postcolonial race politics and the re-centering of embodied whiteness and mediated white bodies as constituted through "white flight" and the so-called browning of rugby in New Zealand. Previous studies have problematized the ways in which rugby union is often framed within the national imaginary as a culturally unifying space—commonly depicted as transcendent of New Zealand's postcolonial racial tensions. Here we extend these critiques by pointing to several themes that have recently emerged within popular sports media, namely, those that position male Māori and Pacific Islander bodies as a threat to the well-being of the national game and the national identities it authorizes, and those that locate the Pākehā (white) male sporting body as under duress, or made vulnerable, by the brown-bodied, interloping "Other." The article concludes with a discussion of how these popular representations of racialized rugby-playing bodies, in the age of global mobility and national multiculturalism, articulate to and within foundational (white) national myths of white-settler meritocracy, rurality, and coloniality.
The Trauma of Goodness in Patricia Grace's Fiction
Authors: Visser Irene
Published: August 2012

Postcolonial literary critics today increasingly draw on cultural trauma theory to illuminate processes concerning the traumatic aftermath of colonization. There is also, however, a growing resistance to some of cultural trauma theory's central concepts and its basic orientation, which are often deemed inadequate for the interpretation of postcolonial literatures. This article aims to contribute to this discussion as well as to contribute to a critical understanding of Patricia Grace's fiction—or more precisely, of the aftermath of colonial repression that is represented in her novels of the 1980s and 1990s as an invidious and in fact traumatic "goodness." The fictional dramatization of the trauma of "goodness" in the settings of school, orphanage, and hospital foregrounds a paradox that is central to Grace's depiction of the lives of Māori children in the second half of the twentieth century, when the colonial contradictions between education and repression, care and wounding were still making themselves felt. Grace's emphasis is on the long-lasting psychological imprint of colonial repression in primary schools, as institutes of care and instruction, where the concept of goodness is contaminated to the extent that it becomes indistinguishable from evil. In exploring this traumatic "goodness" as a colonizing concept in Grace's fiction, this article reflects on the expository potential of trauma theory and on its limitations for postcolonial critical praxis.
Sniffing Oceania's Behind
Authors: Diaz Vicente M.
Published: August 2012

Part tribute to the late Epeli Hau'ofa and part reflective historiography, this essay examines the figure of the anus in Hau'ofa's short story Kisses in the Nederends in order to open up an inquiry into an olfactory history of Oceania. My broader goal is to augment if not challenge canonical methods still heavily reliant on literacy and visuality, and realist modalities that I believe are inadequate to the task of apprehending subaltern aspects of Oceania's ongoing past.
The Effect of Solution-Focused Groups on Self-Regulated Learning
Authors: Fitch Trey , Marshall Jennifer , McCarthy Wanda
Published: August 2012

Student affairs professionals seek innovative methods to enhance academic achievement for students. A recent study highlighted the need to bridge student development work with course curricula (Kilpatrick, Stant, Downes, & Gaither, 2008). This study also linked the importance of nonacademic cognitive variables, such as locus of control, to academic success. Group work in particular has been shown to promote academic achievement (Wegge, 2000). Counselors provide academic support groups and consult to apply group work in these settings. A solution-focused goal-setting group demonstrates a dynamic example of an academic support group that is interactive, student-focused, and useful in improving academic skills related to self-regulated learning.
Exploring a Hidden Form of Minority Status: College Students' Religious Affiliation and Well-Being
Authors: Bowman Nicholas A. , Small Jenny L.
Published: August 2012

Despite the importance of religion in many college students' lives, little is known about how religious affiliation is associated with student growth and development. This study examines the relationship between college students' religious affiliations and well-being using a longitudinal sample of 14,527 students at 136 institutions. Analyses show that students who do not identify with any religious affiliation have reduced well-being compared with mainline Christian students. Moreover, engaging in religious activities and attending an institution with an inclusive religious climate are associated with greater gains in well-being. Implications for practice and future research are discussed.
Relations With Faculty as Social Capital for College Students: Evidence From Puerto Rico
Authors: Dika Sandra L.
Published: August 2012

In this study, a social capital framework was adopted to investigate the extent to which academically focused interactions with faculty and other institutional agents serve as social capital for college students, using National Survey of Student Engagement data from a large, science, technology, engineering and math-focused institution in Puerto Rico. As expected, previous achievement variables were the strongest factors in explaining college grade point average. Perceived quality of relations with faculty members was more important than frequency of interactions in explaining performance. Further research utilizing more specific measures of student-faculty interaction is necessary. Institutional interventions can help increase student-faculty interaction and cultivate broadened access to this form of social capital.
Interactions Into Opportunities: Career Management for Low-Income, First-Generation African American College Students
Authors: Parks-Yancy Rochelle
Published: August 2012

This study explores how low-income, African American college students obtain social capital resources from university contacts to set and achieve career goals. Students knew little about career options available to future college graduates beyond jobs that were related to their current jobs. Few students utilized the information, influence, and opportunity resources of their university contacts that could increase their career ambitions because they were unaware that informal interactions with these individuals could be helpful. Thus, students had more constrained career plans than they could have had. Strategies to enhance the career expectations of this student population are proposed.
Alcohol Use Problems Mediate the Relation Between Cannabis Use Frequency and College Functioning Among Students Mandated to an Alcohol Diversion Program
Authors: McChargue Dennis E. , Klanecky Alicia K. , Anderson Jennifer
Published: August 2012

The present study examined the degree to which alcohol use problems explained the relationship between cannabis use frequency and college functioning. Undergraduates (N = 546) mandated to an alcohol diversion program at a Midwestern United States university completed screening questionnaires between October 2003 and April 2006. Sobel's (1982) test of mediation showed that problematic drinking fully mediated cannabis use frequency's relationship to (a) lower grades and (b) greater legal problems. Findings underscore the notion that cannabis use's association with college functioning may depend on the severity of alcohol use problems.
"Not Half But Double": Exploring Critical Incidents in the Racial Identity of Multiracial College Students
Authors: Kellogg Angela H. , Liddell Debora L.
Published: August 2012

This qualitative study explored how critical incidents shape multiracial students' understanding of race and identity at predominantly White institutions. Participants included 14 multiracial undergraduate students from two institutions in the Midwest. Four categories of critical incidents were identified from the data: (a) confronting race and racism, (b) responding to external definitions, (c) defending legitimacy, and (d) affirming racial identity. The incidents took many forms and occurred in many contexts. The majority of incidents involved interactions with other students, underscoring the influence of peers. The study also suggests implications for higher education practice and research.
Think Before You Teach: Preparing for Dialogues About Racial Realities
Authors: Quaye Stephen John
Published: August 2012

Race is a difficult topic to discuss openly within college and university settings. Postsecondary educators who wish to facilitate dialogues about race and racism among students must take necessary steps to prepare for these discussions. Using data from a qualitative case study, this article discusses the strategies that educators employed to engage learners in these racial exchanges, including shifting from educator to facilitator, developing ground rules, considering students' comfort and developmental readiness, and structuring racially/ethnically diverse groups. Implications for practice are also provided.
Student Conduct Administration: How Students Perceive the Educational Value and Procedural Fairness of Their Disciplinary Experiences
Authors: King Rachel Heafitz
Published: August 2012

For this study, 1,884 adjudicated college students provided their impressions of the educational value and procedural fairness of their disciplinary experiences. Results indicated that a strong correlation exists between perceived fairness and educational value. Differences in students' perceptions emerged in regards to age, gender, and GPA, among other characteristics. The value students assigned to the disciplinary hearing they attended with a student affairs professional best predicted the degree to which they believed their involvement in the process would cause them to avoid future violations of university policy and change their behavior.
Disease Management of Early Childhood Caries: Results of a Pilot Quality Improvement Project
Authors: Ng Man Wai , Torresyap Gay , White Alex , Melvin Patrice , Graham Dionne , Kane Daniel , Scoville Richard , Ohiomoba Henry
Published: August 2012

Objectives . The purpose is to report findings of a quality improvement (QI) project implemented at two hospital-based dental clinics that care for children with early childhood caries (ECC). Methods . We tested a disease management (DM) approach in children younger than age 60 months with ECC. Results . After 30 months, for the 403 and 234 DM patients at Children’s Hospital Boston (CHB) and Saint Joseph Hospital (SJH) who returned for at least two visits, rates of new cavitation, pain, and referrals to the OR were 26.1, 13.4 and 10.9% for CHB and 41.0, 7.3 and 14.9% for SJH. Rates of new cavitation, pain, and referrals to the OR for historical controls were 75.2, 21.7, and 20.9% for CHB and 71.3, 31.3, and 25.0% for SJH. Conclusions . A risk-based DM approach utilizing QI strategies to address ECC can be implemented into practice and has the potential to improve care and health outcomes.
Urban Health and Primary Care at Johns Hopkins: Urban Primary Care Medical Home Resident Training Programs
Authors: Stewart Rosalyn , Feldman Leonard , Bitzel Daniel , Gibbons M. Christopher , McGuire Maura
Published: August 2012

Johns Hopkins University recently implemented two novel urban health residency training programs (UHR). The programs include increased access programs, community health worker-delivered care, substance abuse screening and treatment, community psychiatry/ mental health programs, case and disease management teams, and interprofessional training. These programs are designed to create well-trained physicians who competently provide care for the underserved inner-city patient.
The Healthy Weight Collaborative: Quality Improvement Methods Promoting Healthy Weight
Authors: McPherson Marianne E. , VanderKruik Rachel , Reims Kathy , Coulouris Natasha , Anand Shikha , Linde-Feucht Sarah , Homer Charles J.
Published: August 2012

Promoting healthy weight requires innovative approaches and a concerted response across all sectors of society. This commentary features the framework guiding the Healthy Weight Collaborative, a two-phased quality improvement (QI) learning collaborative and key activity of the Collaborate for Healthy Weight initiative. Multi-sector teams from primary care, public health, and community-based organizations use QI to identify, test, and implement program and policy changes in their communities related to promoting healthy weight. We describe the Collaborative’s overall design based on the Action Model to Achieve Healthy People 2020 Goals and our approach of applying QI methods to advance implementation of sustainable ways to promote healthy weight and healthy equity. We provide specifics on measurement and change strategies as well as examples of Plan-Do-Study-Act cycles from teams participating in Phase 1 of the Collaborative. These teams will serve as leaders for sustainable, positive change in their communities.
Lessons Learned from a Quality Improvement Intervention with Homeless Veteran Services
Authors: Chinman Matthew , Hannah Gordon , McCarthy Sharon
Published: August 2012

Homeless veterans are a vulnerable population, with high mortality and morbidity rates. Evidence-based practices for homelessness have been challenging to implement. This study engaged staff members from three VA homeless programs to improve their quality using Getting-To-Outcomes (GTO), a model and intervention of trainings and technical assistance that builds practitioner capacity to plan, implement, and self-evaluate evidence-based practices. Primarily used in community-based, non-VA settings, this study piloted GTO in VA by creating a GTO project within each homeless program and one across all three. The feasibility and acceptability of GTO in VA is examined using the results of the projects, time spent on GTO, and data from focus groups and interviews. With staff members averaging 33 minutes per week on GTO, each team made significant programmatic changes. Homeless staff stated GTO was helpful, and that high levels of communication, staff member commitment to the program, and technical assistance were critical.
Interprofessional Collaborative Model for Medication Therapy Management (MTM) Services to Improve Health Care Access and Quality for Underserved Populations
Authors: Truong Hoai-An , Groves C. Nicole , Congdon Heather Brennan , Botchway Rosemary , Dang Diem-Thanh (Tanya) , Clark Nancy Ripp , Zarfeshan Faramarz
Published: August 2012

Summary : As part of the Health Resources and Services Administration Patient Safety and Clinical Pharmacy Services Collaborative (PSPC), an interprofessional model with medication therapy management documentation and outcomes tracking tools (MTM-DOTT) is established to improve health care access and quality for underserved populations. Despite limitations, there have been positive outcomes and national recognitions.
Hemoglobinopathy Learning Collaborative: Using Quality Improvement (QI) to Achieve Equity in Health Care Quality, Coordination, and Outcomes for Sickle Cell Disease
Authors: Oyeku Suzette O. , Wang C. Jason , Scoville Richard , Vanderkruik Rachel , Clermont Emily , McPherson Marianne E. , Adams William G. , Homer Charles J.
Published: August 2012

Care and outcomes for individuals living with sickle cell disease (SCD) vary across institutions and communities. The Hemoglobinopathy Learning Collaborative (HLC) seeks to improve outcomes across the life course through improvement science. Faculty identified five key drivers of improved outcomes: a strong community network; knowledgeable, proactive individuals, families and providers; reliable identification and follow-up; seamless co-management between primary and specialty care; and appropriate treatment for acute episodes. Using a modified Delphi process, we selected improvement measures aligned with the drivers. Data are collected via a Web-based system linked to a reporting portal. Participating teams include consumers, community organizations and primary and specialty care providers. This commentary reviews the context of SCD in the U.S.; describes the framework, measures, and technology infrastructure already created for the HLC; reports on the early experience of teams; highlights the initiative’s challenges and opportunities; and reflects on its implications in the setting of health reform.
National Performance Measures within a Changing Environment: How a Federal Agency Developed and Improved the Measurement for HIV Care and Treatment
Authors: Matthews Tracy , DeLorenzo Lori , Matosky Marlene , Young Steven , Huang Anna , Feit Brian , Malitz Faye , Cheever Laura
Published: August 2012

The United States Department of Health and Human Services (HHS) must ensure that access to high quality care is provided through the Ryan White HIV/AIDS Program (RWP). The RWP is committed to improving the quality of care and services to reduce mortality and improve quality of life for people living with HIV. This commitment is evidenced by the comprehensive range of efforts taken by the HHS, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) to address the quality of care, treatment and other services across all programs funded by the RWP. To assure high quality care, HRSA/HAB engages in many quality initiatives, with the development of performance measures as a central core of its overall activities. The HRSA/HAB defined a solid foundation for the measures development process, which has been refined over time, facilitating the timely release and use of performance measures by the HIV service provider community.
Geographic Proximity of HRSA, VA, and DOD Clinics: Opportunities for Interagency Collaboration to Improve Quality
Authors: Brownell Julia , Xierali Imam , Herrera Angelica P. , Calvo Ahmed
Published: August 2012

Clinics funded by the Department of Veterans Affairs (VA), Department of Defense’s Military Health System (MHS), and Department of Health and Human Services’ Health Resources and Services Administration (HRSA) all play a role in serving the military, veterans, and their families. Publicly available location data on federal health care clinics was merged, analyzed, and geographically overlaid using GIS. Results showed that 20% of U.S. counties contain both HRSA and VA sites, and 5% contain HRSA and MHS facilities. Additionally, 80% of VA and 76% of MHS clinics are within 10 miles of a HRSA clinic. Specific clinic types of interest also overlay; for instance, 90% of HRSA homeless clinics are in the same county as a VA facility. This demonstrated geographic proximity of health care sites may indicate prime opportunities for collaboration between HRSA, VA, and MHS systems to improve quality of care for the military, veterans, and their families.
Chronic Care Model Implementation for Cancer Screening and Follow-up in Community Health Centers
Authors: Haggstrom David A. , Taplin Stephen H. , Monahan Patrick , Clauser Steven
Published: August 2012

Background . The Health Disparities Cancer Collaborative (HDCC) implemented six components of the Chronic Care Model (CCM) to increase cancer screening and follow-up among underserved populations from 2003–05. Methods . Organizational surveys were administered among 19 community health centers participating in the HDCC and 22 matched control centers. Health care providers, directors, financial officers, information systems personnel, and general staff completed surveys to measure CCM implementation (primary outcome) and cancer care process improvement (secondary outcome) at the organizational level. Results . The HDCC community health centers were more likely to report CCM implementation than control centers. The HDCC and control centers were equally likely to report cancer care process improvement, but CCM implementation was significantly associated with process improvement in adjusted models. Conclusions . Implementation of CCM, not solely HDCC participation, was associated with cancer care process improvement. Organizational and individual change is challenging among the large, healthy populations eligible for cancer screening.
Collaborative Development of a Randomized Study to Adapt a Diabetes Quality Improvement Initiative for Federally Qualified Health Centers
Authors: Gold Rachel , Muench John , Hill Christian , Turner Ann , Mital Meena , Milano Christina , Shah Amit , Nelson Christine , DeVoe Jennifer E. , Nichols Gregory A.
Published: August 2012

Summary : This case study describes how we are translating a diabetes care quality improvement initiative from an insured (HMO) setting into federally qualified health centers (FQHCs). We outline the innovative collaborative processes whereby researchers and FQHC providers adapted this initiative, which includes health information technology tools, to meet the FQHCs’ needs.
Electronic Health Records Improve the Quality of Care in Underserved Populations: A Literature Review
Authors: Weinfeld Jeffrey M. , Davidson Laurie W. , Mohan Vishnu
Published: August 2012

Organizations in underserved settings are implementing or upgrading electronic health records (EHRs) in hopes of improving quality and meeting Federal goals for meaningful use of EHRs. However, much of the research that has been conducted on health information technology does not study use in underserved settings, or does not include EHRs. We conducted a structured literature search of MEDLINE to find articles supporting the contention that EHRs improve quality in underserved settings. We found 17 articles published between 2003 and 2011. These articles were mostly in urban settings, and most study types were descriptive in nature. The articles provide evidence that EHRs can improve documentation, process measures, guideline-adherence, and (to a lesser extent) outcome measures. Providers and managers believed that EHRs would improve the quality and efficiency of care. The limited quantity and quality of evidence point to a need for ongoing research in this area.
Improved Quality of HIV Care over Time among Participants in a National Quality Improvement Initiative
Authors: Chow Wendy , Hirschhorn Lisa R. , Ng Darryl W. , Wells Christopher G. , Schneider Karen L. , Agins Bruce D.
Published: August 2012

Ensuring comprehensive quality HIV and primary care is critical for effective HIV management. This study evaluates the impact of long-term engagement in a quality management (QM) initiative on performance measures. HIVQUAL-US is a federally-funded program to build clinic QM capacity to improve care for people living with HIV/AIDS. Forty-five facilities with four or more years of HIVQUAL-US performance measurement between 2002 and 2009 were included. Composite quality scores were constructed for HIV care, primary care and overall quality. Unadjusted analyses showed significant improvements in HIV care (76.2% to 88.8%, p<.0001), primary care (65.7% to 71.4%, p<.05) and overall (70.6% to 79.6%, p<.0001). Improvement was higher among clinics performing in the lowest quartile. Adjusting for clinic factors, the probability of improvement increased with each additional year of data submission for all scores. Engagement in a QM capacity building program was associated with continuing improvement in quality of HIV and primary care.
Preventing Diabetes among Fair Haven Families: A Community-Based Approach to Quality Improvement
Authors: Chakkalakal Rosette J. , Camp Anne W. , Magenheimer Elizabeth , Savoye Mary , Lubsen Julia , Lucas Georgina , Rosenthal Marjorie S.
Published: August 2012

Summary : In this paper, we describe our efforts to integrate the Diabetes Prevention Program and the Bright Bodies program into a coordinated intensive lifestyle intervention program for families living in Fair Haven, an underserved Hispanic neighborhood in New Haven, Connecticut with high rates of obesity and prediabetes in adults and children.
Improving Care for Depression: Performance Measures, Outcomes and Insights from the Health Disparities Collaboratives
Authors: Cole Steven , Reims Kathy , Kershner Liz , McCombs Harriet G. , Little Kevin , Ford Daniel E.
Published: August 2012

This paper reports 10 measures, outcomes, and insights from HRSA Depression Health Disparities Collaboratives, representing attempts to accelerate evidence-based guidelines into practice. The authors analyze interviews with leadership of high-performing centers. Monthly data was submitted on 38,000 patients from 94 centers. Regression analyses were conducted to identify process measures predictive of better outcomes. Results indicated that these 10 measures of care were effective in guiding and quantifying improved outcomes. One measure, early and sustained response (ESR), proved particularly useful as it reflects long term outcomes. Regression analyses identified one process measure (Patient Health Questionnaire Reassessment) strongly associated with improved clinical outcomes (n=37, R 2 =44%). Interviews identified 18 process changes deemed pivotal for meaningful change. In sum, well-designed approaches utilizing proven improvement methodologies resulted in substantial enhancements in depression care. This approach and these measures, especially ESR and PHQ Reassessment, may improve depression care in other under-served settings.