North Country Community College
  • Saranac Lake, United States
Recent publications
We hypothesized that transgender and nonbinary (TNB) individuals who reported a longer period of time from realizing they were TNB to beginning their transition will have a longer history of nonsuicidal self-injury (NSSI) and that participants who report higher levels of body investment, fewer years from realization of TNB identity to transition, and more years since NSSI will report lower levels of current anxiety, stress, and depression. We conducted a secondary data analysis of a dataset collected online, which included 217 participants. We conducted multiple regressions to explore the hypotheses. Results revealed that TNB people who had a longer time between realizing their gender identity and beginning a transition had a longer history of NSSI. Exploratory analyses were also conducted to help understand the relationship between NSSI, transition, and body investment on mental health outcomes. Providers are cautioned that the presence of NSSI should not necessarily be a contraindication to transition.
This article describes an initiative to train public sector clinicians in competency-based clinical supervision. It was delivered as an 18-session course taught online to clinicians employed in departments of behavioral health in nine Southern California counties. The curriculum was co-constructed by a team of clinical supervision scholars and leaders who then served as instructors. Each two-hour meeting addressed a specific topic for which a training video had been prepared, usually featuring a member of the training team who had expertise in that topic. The second part of each meeting focused on a class member’s supervision case presentation. Those presentations revealed 35 themes; the four most frequently occurring were: developing supervisees’ clinical competencies, addressing countertransference and parallel process, balancing clinical and administrative supervisory roles, and addressing record keeping/paperwork. Participants’ pre-to-post supervisory self-efficacy changes demonstrated a moderate effect size (Cohen’s d = .46) for the training, with the greatest pre- to post-training changes being in the use of technology, multicultural competencies (awareness of oppression, bias, and stereotyping in clinical work and in clinical supervision), and contracting. They reported that the strengths of the course included an inclusive learning environment and opportunities to reflect on and apply new knowledge and skills, though they also reported struggling with the assignments and the course platform software. Lessons learned reflected the use of technology in this online program, the importance of obtaining buy-in from agency decision makers and being prepared to address challenges related to the use of direct observation in supervision, gatekeeping, and enacting the simultaneous roles of administrative and clinical supervisor.
Purpose Fecal occult blood testing (FOBT) is a pragmatic screening option for many community health centers (CHCs), but FOBT screening programs will not reduce mortality if patients with positive results do not undergo diagnostic colonoscopy (DC). This study was conducted to investigate DC completion among CHC patients. Methods This retrospective cohort study used data from three CHCs in the Midwest and Southwest. The primary study outcome was DC completion within 6 months of positive FOBT among adults age 50–75. Patient data was collected using automated electronic queries. Manual chart reviews were conducted if queries produced no evidence of DC. Poisson regression models described adjusted relative risks (RRs) of DC completion. Results The study included 308 patients; 63.3 % were female, 48.7 % were Spanish speakers and 35.7 % were uninsured. Based on combined query and chart review findings, 51.5 % completed DC. Spanish speakers were more likely than English speakers to complete DC [RR 1.19; 95 % confidence interval (CI) 1.04–1.36; P = 0.009], and DC completion was lower among patients with 0 visits than those with 1–2 visits (RR 2.81; 95% CI 1.83–4.33; P < 0.001) or ≥3 visits (RR 3.06; 95% CI 1.57–5.95; P = 0.001). Conclusions DC completion was low overall, which raises concerns about whether FOBT can reduce CRC mortality in practice. Further research is needed to understand whether CHC navigator programs can achieve very high DC rates. If organizations use FOBT as their primary CRC screening approach and a substantial number of patients receive positive results, both screening rates and DC rates should be measured.
In this chapter, the author draws on this volume's chapters to identify prominent issues and challenges facing student affairs professionals. Suggestions for practice are provided that support the work of professionals to create quality educational environments.
The role of the mid-level manager as an organizer, communicator, and problem-solver in student affairs has been examined within the literature, but current discussion generally excludes the perspective of managers at community colleges. This chapter focuses on the importance of managerial identity and roles, particularly as it is enacted within a community college context. A framework is proposed as a tool for understanding the characteristics of the described managerial selves and how they are perceived by themselves and others.
This session will describe the development and implementation of Hermosa Vida (A Beautiful Life), a childhood obesity community prevention project led by a community health center (CHC) to address a significant problem in a low income, racially and ethnically diverse community. Unique features of this project include leadership from a CHC but taking a public health approach to the problem, and the use of a community-based approach incorporating a rapid assessment methodology called RARE (Rapid Assessment Research and Evaluation) that has been popularized in international HIV work. The CHC leaders recruited an interdisciplinary steering committee including representatives from the neighborhood association, the county health department, the city parks department, the local hospital, and anthropologists from the local university. The committee used results from the RARE assessment to organize a multi-faceted intervention plan primarily focused on the neighborhood grade school with local leadership provided by a community health worker and community organizer hired for the project, along with involvement from all the stakeholders represented on the steering committee and the principal and nurse from the school. In the presentation, we will discuss the development of the pilot project and steering committee, findings from the RARE evaluation and how they, together with evidence based practices, influenced the demonstration project proposal, the inclusion of a community health worker and organizer, and the variety of activities initiated in the first year of the implementation phase.
The vitellarium is a highly proliferative organ, producing cells which are incorporated along with a fertilized ovum into the schistosome egg. Vitellarial growth fails to occur in virgin female schistosomes in single sex (female-only) infections, and involution of this tissue, which is accompanied by physical shrinkage of the entire worm, occurs when mature females sexually regress upon removal from their male partners. We have found that upon removal from their hosts into tissue culture, female parasites regress whether they are mated or not, but that cessation of egg production and a decline in expression of the vitelline gene p14 is delayed by mating. We used BrdU labeling to investigate whether there was a loss of proliferation in the vittelarium that might account for regression and found that the proliferation rate declined equally in paired and singled females once placed into culture. However, TUNEL staining and Caspase 3 activity measurements indicate that the loss of vitrellarial cellularity associated with regression is associated with profound apoptotic vitelline cell death, which is not apparent in the vitellaria of paired females immediately ex vivo, and which develops in vitro regardless of whether males are present or not. Furthermore, primordial vitellaria in virgin females have a high frequency of apoptotic cells but are characterized by a proliferation rate that is indistinguishable from that in fully developed vitellaria in mature paired females. Taken together, our data suggest that the vitelline proliferation rate is independent of pairing status. In contrast, the survival of vitelline cells, and therefore the development of the vitellarium, is highly male-dependent. Both processes are negatively affected by removal from the host regardless of whether male worms are present or not, and are unsustainable using standard tissue culture approaches.
Purpose: A substantial number of women screened for breast cancer have an inconclusive or abnormal finding on mammogram, yet do not return in a timely manner for diagnostics and treatment. Lack of effective transitions from screening to resolution increases vulnerability to delayed treatment and poorer outcomes. Consequences associated with delay include later entry into the health system with advanced disease, more extensive and expensive care, and burden on financial resources. Delays of more than 90 days in women with symptomatic breast cancer are associated with increased recurrence and death. The purpose of this research is to describe contextual characteristics at the health delivery level and individual characteristics of women with incomplete or abnormal mammography, and their association with use of follow- up health services. Particularly, this research examines the differences between women who are early and late responders. Background: In the United States, breast cancer is a significant problem, affecting approximately one in eight women. Invasive breast cancer is second only to lung cancer as a cause of cancer- related death in women. Early detection and treatment improves patient outcomes so timely follow- up is crucial. This research used the Model of Use of Health Services (Andersen, et al, 2007) as a framework for explaining predisposing, enabling and need factors at the individual and health system level. The model also differentiates access representing health disparity or health equity. Methods: The participants were a convenience sample of 380 uninsured women who participated in mobile breast cancer screening. A subset of women with inconclusive or abnormal mammogram findings was the focus of analysis. This research utilized a descriptive correlational design with primary data collection through participant survey at mobile mammogram screening events in urban and rural Arizona. Participants requiring further health care were followed by chart review. Results: Data indicated the time to the first follow- up appointment ranged from 1- 110 days with 77.4% of participants seen within 60 days, 6.5% within 60-90 days, and 16.1% without a visit after 90 days. Significant relationships between contextual and individual characteristics and delay were found. Results suggest organizational health system characteristics of urban location and not providing a clinical breast exam with mammography contribute to delay. Individual predisposing characteristics of previous abnormal mammogram and beliefs associated with value of health care were associated with late responders. Individual enabling financial characteristics of out of pocket costs and perceptions of financial assistance were associated with early responders. Individual needs such as depression were associated with early responders and lack of preventive patterns was associated with late responders. Satisfaction with the last health visit and mammograms in general was associated with early responders. Implications: Nurses are well positioned to facilitate transitions and reduce barriers to health care access. Identification of indicators that facilitate follow- up after health screening assists development of interventions to improve practice and patient outcomes. Health disparity related to screening without adequate options for access to health care and resolution is ethically untenable. Promotion of health equity has important implications for health policy.
From 2005 through 2007, Seattle health care providers identified cases of primary multiclass drug-resistant (MDR) HIV-1 with common patterns of resistance to antiretrovirals (ARVs). Through surveillance activities and genetic analysis, the local Health Department and the University of Washington identified phylogenetically linked cases among ARV treatment-naive and -experienced individuals. HIV-1 pol nucleotide consensus sequences submitted to the University of Washington Clinical Virology Laboratory were assessed for phylogenetically related MDR HIV. Demographic and clinical data collected included HIV diagnosis date, ARV history, and laboratory results. Seven ARV-naive men had phylogenetically linked MDR strains with resistance to most ARVs; these were linked to 2 ARV-experienced men. All 9 men reported methamphetamine use and multiple anonymous male partners. Primary transmissions were diagnosed for more than a 2-year period, 2005-2007. Three, including the 2 ARV-experienced men, were prescribed ARVs. This cluster of 9 men with phylogenetically related highly drug-resistant MDR HIV strains and common risk factors but without reported direct epidemiologic links may have important implications to public health. This cluster demonstrates the importance of primary resistance testing and of collaboration between the public and private medical community in identifying MDR outbreaks. Public health interventions and surveillance are needed to reduce transmission of MDR HIV-1.
This study focuses on the role of formal continuing education in helping persons prepare for retirement. The subjects were 206 classified, university employees between the ages of 50 and 65. The Retirement Preparation Indexes were used to measure behavior, information, and attitude toward retirement. Using the analysis of variance (a = .05), participants in formal continuing education (N = 46) scored significantly higher on the indexes community activity behavior, health care issues, psychological adjustment information, preretirement zest attitude, total behavior, total information, and the complete retirement preparation index. Preretirees involved in lifelong learning were found to be more concerned about their own development regardless of age and more aware of the options available to them upon retirement.
Values and beliefs regarding communityfood security were investigated among participants in2–3 day participatory planning events related to thelocal food system in six rural counties from oneregion of upstate New York. The results of Qmethodology reveal three distinct viewpoints: a) theSocial Justice viewpoint, which is primarily concernedwith hunger and the potential harm caused by welfarereform; b) the Pragmatist viewpoint, which values thecontributions agriculture makes to local communitiesand is not concerned about environmental or socialexternalities of the dominant food system; and c) theVisionary viewpoint, which also values agriculture inthe community but is very concerned aboutenvironmental and social externalities. After theplanning events, the Pragmatist viewpoint experiencedan 88% increase in members and the other twoviewpoints became less salient. Various categories ofprofessionals (e.g., nutrition, social welfare,agriculture, environmental) tend to express theviewpoints associated with their professions and/orthe client groups they serve. Despite thesedifferences among participants, the planning events inall six counties resulted in a wide range of goals andobjectives centered on a theme of re-localizing avariety of food system activities. These results arediscussed in relation to the desirability ofdeveloping an explicit philosophy of food andagriculture and the ideal processes required to doso.
During the past several decades, red spruce (Picea rubens) in the northeastern US has undergone a large decline in both number and vigor. The purpose of this study was to determine quantitative relationships between visible and histological characteristics of both stems and needles of first-year shoots of red spruce trees from four high elevation mountain sites in the Adirondack Mountains, New York, before, during, and after an overwintering period, 1994–1995. Most shoot elongation was completed and phellem formation began by September 1994. In samples of November/December 1994, needles of current-year stems exhibited between 3 and 50% dead mesophyll cells, there was a nearly full complement of needles and 1.2–2.0 phellem layers were present within current-year stems. Anatomical injuries to mesophyll cells of autumn (November/December) 1994 needle samples were identical to ozone injuries to conifers from published reports. None of the stem and needle samples in the forest (in situ) and none of the preserved stem and needle samples from 1994 showed any visible symptoms of injury. However, preserved samples of needles and stems from March and May 1995 exhibited extensive visible injuries. For March and May samples, most visible injuries on needles were located near shoot terminals and most visible injuries to stems occurred near needle bases. For March needle samples between 38 and 94% of all mesophyll cells were dead. By May 1995, only about 66% of all needles were present on shoots. The mean numbers of phellem layers were 3.6 and 4.0, for March and May 1995 samples, respectively. In March and May samples, percentages of discolored needles were negatively correlated with numbers of phellem layers. Stem segments exhibited between two and six localized areas of internal tissue injury per twig. The two to six areas of injury in stem segments may have resulted because only 1.2–2.0 (mean=1.6) phellem layers were present in November/December samples. These extensive injuries occurred in needles and stems during a winter in which temperatures were not unusual for the region. These results suggest that visible injuries to foliage of red spruce so predominant during and after winter may occur prior to overwintering and that the overall damages may be attributed to cellular injuries that are not visible in needles and/or stems.
Community food security (CFS) is an incipient movement based on the re-localization of many food system activities in response to values concerning the social, health, economic, and environmental consequences of the globalizing food system. This study examines the salience of these values based on the action agendas and accomplishments emerging from community planning events in six rural counties of New York, and the nature and type of participation and local support. The study finds a high level of agreement between CFS values as articulated by national leaders in this incipient movement and the action agendas. Further evidence of the salience of these themes is seen in the levels and types of activities and accomplishments taking place 8--12 months after the planning events. However, these follow-through activities appear to have been impeded by a variety of government regulations, uneven levels of support from community organizations and agencies, and a policy environment of fiscal austerity, narrow outcome-oriented accountability, and allocation of agency staff toward special-purpose grants and contracts. Many of these constraints are likely to exist in other communities and are beyond the scope of what community volunteers and practitioners can be expected to address on their own.
New York's North Country Community College's model of general education specifies the particular competencies that should be achieved in the college's liberal arts courses. In 1991, a study was undertaken to assess the general education competencies attained by students enrolled in Introductory Psychology. Using a pre-test/post-test design, 111 students were assessed in terms of gains in objective and subjective knowledge of psychology, critical thinking, and writing skills. A 36-item objective test of psychology knowledge, and an essay test of subjective knowledge, critical thinking, and writing ability were administered during the first and last weeks of the course. Three independent reviewers were trained to assess general education competencies as they appeared in student writing samples. Scores were given in each testing category, as well as for each answer's correctness, detail, and style. Significant increases were found for all four competencies examined. The methodology used to study general education from a course-embedded approach was successful and appears to be one which can be used with other courses across the curriculum in assessing general education competencies. A course outline is included. (Author/DJD)
Apical dieback is the predominant injury symptomatology associated with growth declines of high elevation Picea rubens Sarg. trees in North America. Histological observation of uninjured tissues and of initial injury to tissues were made to understand the mechanism of injury to this species. Observations were made of hundreds of grab samples of apparently uninjured tissues and of uninjured twigs from trees growing on mountains of the Adirondack Mt., NY; Mount Mansfield, VT; Mt. Mitchell, NC; and Clingman's Dome, TN, from March 1985 to April 1986. The timing of developmental events varied markedly among buds of individual trees and among trees. Tissue necrosis occurred in twigs during their first overwintering period. Injured twigs with necrotic tissues had only one or two continuous or discontinuous phellem layers. In samples that exhibited initial injury, necrotic tissues consisted mostly of cortical cells and phloem subjacent to this meager periderm. Frequently, necrotic tissues developed initially near the bases of needles and at branch nodes (transition zone tissues with older twigs). In contrast, twigs of healthy appearance had two or more continuous phellem layers external to the phellogen.
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42 members
Peter C Sayles
  • Math/Science Department
Gabrielle F Schneider
  • Department of Nursing
Marlene Ringer
  • Department of Nursing
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Saranac Lake, United States