Articles de revues sur le sujet « Community Chest of Indianapolis (Indiana) »

Purpose Religious Freedom Restoration Act (RFRA) is a controversial bill passed by the State of Indiana and signed into law in March 2015. The purpose of this paper is to look into whether there is empirical evidence that the political shock of RFRA had a negative empirical impact upon the hotel industry in Indiana’s major city, Indianapolis, and investigate how DMOs and other organizations in the tourism and hospitality industry worked in ways to counteract the threat of a great deal of loss of business caused by the national furor caused by the passing of the original bill in March 2015. Design/methodology/approach To fully examine the impact of RFRA on hospitality business in Indiana, secondary data were used in this study. The researchers used the Trend Market report created by Smith Travel Research (STR) (2016b) with a focus on the greater Indianapolis area, which include Indianapolis South East, Indianapolis Central Business District, Indianapolis Airport/Speedway, Indianapolis North Loop, and Indianapolis small towns. In the Trend Market report, hotel operation performance results are listed including occupancy percentage, average daily rate, revenue per available room, supply, demand, and revenue. Findings The findings from this investigation illustrate that there is no empirical reason to believe that the political shock of the RFRA controversy in Indiana in 2015 had a meaningful impact upon the hospitality and tourism industry in Indianapolis, despite concerns that it would make a big and negative impact upon the industry. While event planners may have a negative perception of the city of Indianapolis and the state, these perceptions do not seem to be enough to make a difference in terms of impacting upon the hospitality industry in Indianapolis. Originality/value There are lessons that could be learned from this, as many states in the USA continue to pass similar laws to RFRA, laws that are perceived as being problematic for those in the lesbian, gay, bisexual, and transgender (LGBT) community. The most noteworthy lesson is that the passing of laws that seem to threaten people of the LGBT community will bring a national response and will likely be accompanied with threats that are economic in nature. There is a great deal of evidence to show that passing any legislation that may be interpreted as infringing upon the rights of members of the LGBT community will result in substantial responses that may be negative in nature.

The Bethel Project is about the history of Indianapolis’ oldest black church, archival records, preservation technologies, virtual experiences, and collaboration and co-creation among many different departments, heritage institutions and community members. This paper provides three perspectives on this project from individuals who’ve worked closely together over the past four years. This may seem like a long while to work on one project but for those whose research is community-based it seems about right. Three unique voices will be presented with each telling their own narrative of what she thought when the project started and how her thinking has changed until now. Andrea Copeland is an associate professor in the School of Informatics and Computing whose research focuses specifically on public libraries, community collections, and engagement. Kisha Tandy is the associate curator of social history at the Indiana State Museum who researches African American history and culture. At the center of the project is Olivia McGee Lockhart: Bethel AME Church of Indianapolis’ Keeper of History, Indianapolis native, and an Indianapolis Public Schools educator for nearly four decades.

Background: Urban tree canopies help to address issues of climate change related to all dimensions of health. Certain areas of the city of Indianapolis are more prone to the negative effects that lack of tree coverage can cause. This assessment explored the short term and potential long-term impacts of the efforts to increase the tree canopy coverage in vulnerable areas of Indianapolis. This effort was a collaboration of faculty members from the Indiana University Richard M. Fairbanks School of Public Health, Indianapolis Department of Public Works, Keep Indianapolis Beautiful, and the Indianapolis Office of Sustainability. Methods: Our team used the standard seven-step Health Impact Assessment (HIA) process to make the recommendations provided. Using direct observation of the neighborhood, secondary data collection, literature review, and a key stakeholder interview, we examined key dimensions of health including environmental, physical, and personal health outcomes resulting from increased tree canopy coverage within census tract 3505 of Marion County, Indiana. Results: Increasing the percentage of tree canopy coverage in census tract 3505 – Crown Hill has significant positive health impacts with minimal negative outcomes. Such impacts may be, but are not subject to, lower temperatures, reduced cases of respiratory and cardiac infections/illnesses, promoting animal life, increasing neighborhood property values and filtering pollutants that resultfrom human production activity. Conclusions: Further implementation of the Thrive Indianapolis project has broad positive implications for the community members living in this area. While few negative implications were found, we make recommendations to mitigate these effects while attempting to supplement the current project plan with a focus on the effects to human health.

ABSTRACT This article focuses on the history of public library services to African Americans in Indianapolis, Indiana. Early efforts in establishing libraries for African Americans include a deposit station placed by the Indianapolis Public Library in 1919 at the Flanner Guild Settlement, a social services agency for African Americans. It was not until 1922 that a branch for African Americans, the Paul Laurence Dunbar Branch, was established by the Indianapolis Public Library. The Dunbar Branch’s success spurred the creation of two additional African American branches, the George Washington Carver Branch and the Crispus Attucks Branch. At a combined operational history of fifty-two years, these three branches were instrumental in fostering a love for reading and an appreciation for literature in Indianapolis’s African American community.

Seven pre-tenure librarians at the University Library at Indiana University-Purdue University Indianapolis (IUPUI) created a peer review of teaching (PROT) group. This article provides an overview of the library literature on PROT and identifies the commonalities and variations found in PROT programs. The development, implementation, and benefits of the PROT program at IUPUI are discussed as well as outcomes pertaining to benefits for the observed, the observer, and for the PROT group as a whole. The authors also found that the implementation of a PROT program can enhance the sense of community among colleagues.

Seven pre-tenure librarians at the University Library at Indiana University-Purdue University Indianapolis (IUPUI) created a peer review of teaching (PROT) group. This article provides an overview of the library literature on PROT and identifies the commonalities and variations found in PROT programs. The development, implementation, and benefits of the PROT program at IUPUI are discussed as well as outcomes pertaining to benefits for the observed, the observer, and for the PROT group as a whole. The authors also found that the implementation of a PROT program can enhance the sense of community among colleagues.

Sport tourism is one of the fastest growing market segments in the tourism industry and is receiving increased attention for its social, environmental, and economic impacts upon destinations. Prior research in tourism impacts has tended to focus exclusively on tourism as a whole and does not differentiate among the different types of tourism that may be present in a destination. The purpose of this study was to examine how residents of Indianapolis, Indiana perceived the impacts sport tourism has upon their city. A total of 347 surveys were returned in a mailed questionnaire. Exploratory factor analysis revealed a four factor structure of social benefits, environmental benefits, economic benefits, and general negative impacts. Social and economic benefits were strong predictors for support for further sport tourism development revealing a strong identification with the advantages of sport tourism in their city such as an increased cultural identity and social interaction opportunities.

Background Health Impact Assessments (HIA) are a tool used to measure the effect of policies and/or projects that may influence the health of populations. As a way to increase HIA practitioners, university courses in HIA can benefit both students and community organizations by presenting real-world opportunities for students to conduct HIA while partnering with community organizations or policy makers. Methods In order to conduct the rapid HIA to assess the Indiana Cultural Train (ICT) expansion, students in a graduate-level course conducted a five step HIA process of screening, scoping, assessment, recommendations and reporting, and monitoring and evaluating three potential trail expansion routes. Students examined local health data, conducted walkability assessments, and conducted seven key stakeholder interviews to gather data. Results The results of data analysis show that the Riley Hospital Drive/Gateway Bridge is the best potential route for expansion due to safety considerations and the impact on the adjacent Ransom Place neighborhood. Six of the seven key informants were in favor of the expansion, with the two most cited reasons being additional space for exercise and recreation and the potential economic impact and connection to local businesses in the area. Conclusions The expansion across the proposed Gateway Bridge would combat parking issues associated with expanding the trail through Ransom Place as well as be the safest way to approach the large intersections. With local residents’ concerns of gentrification and safety in mind, the ICT trail expansion could lead to increased health outcomes by offering additional space for exercise, recreation, and active transportation.

OBJECTIVES/GOALS: Conduct an environmental scan of Marion County (Indianapolis) neighborhoods using electronic medical record data, state health data, and social and economic dataDevelop strong network of community collaboratorsConduct a thorough assessment for each targeted neighborhood by listening and understanding the pressing health issues in the community and working together to design and deliver solutionsMETHODS/STUDY POPULATION: Identify measures in the 3 domains of vulnerability, health and assets for the targeted neighborhoods and conduct bivariate descriptive statistics and multivariable regression analyses to investigate association between measures of vulnerability and health outcomes.Initiate relationships with leaders and residents in targeted neighborhoodsLocate organizations working in targeted neighborhoods through online mapping software and word-of-mouth at neighborhood events, and created a spreadsheet with contact information.Conduct multidisciplinary assessment (i.e. key informant interviews, focus groups, town hall meetings) of the targeted neighborhood.Iteratively synthesize assessments to develop areas of interest and relevance to the community.Develop a road map for solutions identified by the community.RESULTS/ANTICIPATED RESULTS: The results from the environmental scan conducted will be displayed in a report and visual “map” of health outcomes and health determinants, including assets and barriers for the targeted neighborhoods. The research team will use results from the environmental scan coupled with listening activities including attendance at community events, key informant interviews and focus groups to develop relationships and strong collaborations with the targeted neighborhood stakeholders. The relationship building between the research team and community will provide increased trust and engagement that will further enhance the effectiveness of the assessments completed with the targeted neighborhood. The assessments will help to empower communities to develop sustainable solutions and drive future work that will lead to future grant applications and larger-scale implementation in other community impact hub neighborhoods. DISCUSSION/SIGNIFICANCE OF IMPACT: Through the community impact hub work, we will develop collaborative efforts with targeted neighborhoods with the greatest health inequities in the Marion County area. In partnership with these neighborhoods, we will build a foundation – a network of community collaborators and a focused plan – upon which we will improve the health outcomes of residents while learning best practices on how to do so.

Peace is a prerequisite for creating an environment in which all people have the capacity to live safe and productive lives and to engage in meaningful activities and occupations; however, creating caring communities and measuring the impacts of peace is a challenge. To address this concern, nonprofit organizations strive to promote equity and justice by engaging in both direct service and advocacy work. One local nonprofit, the Peace Learning Center, works to promote peace in the Indianapolis community through a variety of innovative educational and advocacy programs, including equity learning, restorative practices, social emotional learning, and family learning. Uniquely, occupational therapists engaging in community-based work provide a lens through which key environmental factors, such as peace, are viewed as vital in consideration of the context surrounding a person and provide a perspective of how peace can affect the tasks and performance in which people are able to engage. Through a semester-long collaborative partnership, Indiana University occupational therapy doctoral candidates and the Peace Learning Center conceptualized peace and created implementable tools for measuring the impacts of the nonprofit’s efforts on peace building in the Indianapolis community. The following outlines the evaluative process that the student group performed and provides replicable tools and recommendations for surveying peace building impacts in K-12 restorative justice programming. By implementing these peace-measuring assessments, the Peace Learning Center will be able to gather both qualitative and quantitative data about perceived safety, violence, and peace from youth and parents in the communities that the organization serves. Recognizing the need for program evaluation, occupational therapy students have provided the Peace Learning Center with vital outcome measures that can lead to program remodeling, content recreation, and improved training, resources and follow up for facilitators, all within the profession’s scope of practice in the community-based realm.

ABSTRACT IMPACT: Congregations’ support for social, emotional, mental and spiritual wellness is foundational to human health and their community knowledge and presence can improve resilience and health in socially vulnerable neighborhoods. OBJECTIVES/GOALS: The Indiana CTSI Monon Collaborative is listening and understanding the most pressing health issues in the community and are working together to design and deliver community health solutions. We worked with our community ambassador to launch a health and wellness learning community for ten congregations seeking to build a health-connector network. METHODS/STUDY POPULATION: Study team used qualitative (interviews, focus groups, listening sessions, learning management system, participatory-design research) and quantitative (surveys) data collection methods in the development and ongoing implementation of the learning community. Study Population: Based on initial assessment of health and social vulnerability data within the Marion County neighborhoods in Indianapolis, community ambassador engaged congregations in more vulnerable neighborhoods to seek participation in learning community. Ten congregations signed a covenant of participation; learning community includes 10 clergy and 8 health advocates. RESULTS/ANTICIPATED RESULTS: Since the inception of the Learning Community in May 2020, we have developed a better understanding of the assets and barriers of LC participants around health and well-being. Through ongoing virtual gatherings (facilitated by community ambassador Good to the Soul), sharing of resources through our online modules on Canvas (LMS), and synthesis of data captured throughout our time together, LC participants have developed SMART goals which will inform priority setting for congregations to assist them in identifying the resources and connections necessary to drive forward solutions together as they seek out funding opportunities to support health improvement. DISCUSSION/SIGNIFICANCE OF FINDINGS: The learning community has provided a space and structure for congregations to align around a shared goal focused on health and wellness. Through regular gatherings we were able to connect people, organizations, and systems who were all eager to learn and work across boundaries leading to greater resilience in vulnerable communities.

HIV immunization programmes will only be effective if sufficient numbers of persons accept the vaccine. Our aims were to evaluate HIV vaccine acceptability among adolescents and to examine how vaccine characteristics influence acceptability. We recruited 661 adolescents from community health clinics in Indianapolis, Indiana, USA to complete either written or computerized questionnaires, both of which assessed HIV vaccine acceptability as a function of efficacy, cost, type of vaccine, mode of delivery, and parental permission for immunization (required or not required). For both the written and computer methods, efficacy had the strongest effect on acceptability, followed by type of vaccine and cost. Low efficacy, high cost, and live-attenuated vaccines were associated with lower acceptability. These findings suggest that as efforts to develop HIV vaccines continue, it will be important, in parallel, to anticipate potential obstacles to vaccine acceptance, including the belief that a less efficacious HIV vaccine is unacceptable.

<p>This paper emerged from many months of regular participation in the parkour community in Indianapolis, Indiana. First, this study looks at the art of parkour as a bricolent engagement with architecture. Acts of bricolage, a sort of artistic making-do with objects (including one’s body) in the environment, play with(in) the dominant order to “manipulate the mechanisms of discipline and conform to them only in order to evade them” (de Certeau, 1984: xiv). Second, this study investigates architecture’s participation in the production and maintenance of what de Certeau calls, “operational logic” (p. xi). That is, how architecture acts as a communicative mode of space; one, which conveys rationalized or acceptable ways of being in space. This critical ethnography, then, takes to task the investigation of how traceurs, the practitioners of parkour, uncover emancipatory potential in city space through bricolent use of both architecture and the body.</p>

Studying behavioral disturbances of dementia across cultures allows us to identify commonalities and differences that may be useful in determining the best approach to managing these problems. However, what we tend to find in cross-cultural studies is that the best approach may not be the same approach, given the different prevalence of and levels of tolerance for various behavioral problems. These differences are apparent in the authors' studies of four populations—Jamaicans in Kingston; Cree in Northern Manitoba, Canada; Yoruba in Ibadan, Nigeria; and African Americans in the United States. The Jamaicans in this study live in a poor suburb of Kingston, the Cree live in two fairly small, isolated communities in Northern Manitoba, and the Yoruba live in Ibadan, a city of more than 1 million people. The Yoruba community the authors are studying, although concentrated in the city center, functions much like a village. The African-American population resides in Indianapolis, Indiana, a moderately sized city of approximately 1 million people.

Abstract Background The American Society of Nephrology’s (ASN) Workforce Committee created a unique program called the Kidney Mentoring and Awareness Program for Students to engage medical students in the fight against kidney diseases and interest them in careers in nephrology. Methods The program provided a framework and 2 years of funding to three medical schools to organize and carry out health screenings in underserved areas of their communities as well as a structure for student mentoring by the practicing nephrologists. Results The Workforce Committee identified three medical schools (Emory University, Atlanta, GA; Indiana University, Indianapolis, IN and University of Louisville, Louisville, KY) and engaged faculty at each school to serve as advisors. The ASN committed funding to the groups for 2 years, after which the groups became self-sufficient. Three nephrologists participated in each chapter, building on existing relationships with community groups to identify sites and carry out kidney screening events. Conclusions We report here the experience of those chapters and a blueprint for other schools interested in setting up a similarly structured program to interest students in nephrology while working with community groups to spread awareness of the major underlying causes of kidney disease.

ABSTRACT This paper discusses the context, pedagogical approach, and design outcomes of two net-zero energy residential design projects completed by graduate architecture students as part of a comprehensive design studio course and submitted to the 2018 and 2020 USDOE Race to Zero/Solar Decathlon Design Challenge competition. The competition aims to give students real-word experience designing high-performance buildings by encouraging collaboration, involving community partners, and requiring a high degree of technical design development. Working within the competition parameters, two teams at Ball State University worked with outside partners to identify vacant/abandoned homes as a significant problem for rust-belt Indiana communities, and then focused their design efforts on high-performance retrofits of two blighted homes in Muncie and Indianapolis. Each project will be described in detail and the implications of the 2018 project on the 2020 project will be addressed. This paper will demonstrate that adaptive reuse projects can be used to engage students in context-specific challenges and to meet stringent high-performance design targets and thresholds. (162)

Objectives: To measure older adults acceptability of dementia screening and assess screening test results of a racially diverse sample of older primary care patients in the United States. Design: Cross-sectional study of primary care patients aged 65 and older. Setting: Urban and suburban primary care clinics in Indianapolis, Indiana, in 2008 to 2009. Participants: Nine hundred fifty-four primary care patients without a documented diagnosis of dementia. Measurements: Community Screening Instrument for Dementia, the Mini-Mental State Examination, and the Telephone Instrument for Cognitive Screening. Results: Of the 954 study participants who consented to participate, 748 agreed to be screened for dementia and 206 refused screening. The overall response rate was 78.4%. The positive screen rate of the sample who agreed to screening was 10.2%. After adjusting for demographic differences the following characteristics were still associated with increased likelihood of screening positive for dementia: age, male sex, and lower education. Patients who believed that they had more memory problems than other people of their age were also more likely to screen positive for dementia. Conclusion: Age and perceived problems with memory are associated with screening positive for dementia in primary care.

Background: In February 2019, in the context of a nationwide community-based hepatitis A (HAV) outbreak, Eskenazi Health (EH), an acute-care hospital in Indianapolis, Indiana, identified a healthcare worker (HCW) with HAV who had potentially exposed patients via medicine administration. Objective: We began an investigation and mitigation plan to determine the source of the HAV and the risk to patients. Methods: The investigation and mitigation consisted of 6 measures. (1) We searched the electronic medical record (EMR) tracer report to determine whether any of the HCW’s patients had HAV during the incubation period (15–50 days prior to diagnosis) or were potentially exposed during the infectious period (0–14 days prior to diagnosis). 2. We searched the EMR and CHIRP (Indiana’s electronic vaccine database) for potentially exposed patients to determine HAV immunity or HAV vaccination (HAVx). (3) We contacted potentially exposed patients. (4) We communicated with public health partners. (5) We investiged other potential exposures. (6) We communicated with employees regarding free HAVx and the community HAV outbreak via e-mail newsletters (reaching almost 6,000 unique addresses) and posts on our internal website. Results: The HCW had not provided care for a patient with diagnosed HAV during the incubation period. The HCW had provided care for 14 patients during the infectious period. No potentially exposed patient had evidence of HAV immunity or HAVx in EMR or CHIRP. We initiated communication to all 14 patients or their surrogates regarding the potential exposure, symptoms of HAV, testing, and HAVx. We could confirm HAV testing for only 1 of 14 patients, and the result was negative. None of the 14 patients developed HAV. Public health partners confirmed notification of the HCW case. No further information about the HCW’s HAV source was determined. The HCW did not share community food at work. No workplace source of HAV was identified. HAVx dispensed at the pharmacy increased after communication about availability: December 2018–February 2019, 4 HAVx dispensed and March–May 2019, 82 HAVx dispensed. Conclusions: Traditionally, hospitals view infection risk in terms of HCWs acquiring infections from or spreading infections among patients. Viewed this way, the Indiana HAV community outbreak, although serious for the community, did not appear to be a threat to the hospital: HAV acquisition in hospitals has been rare, which is supported by our results. However, this episode demonstrates that the traditional view needs to be flipped: HCWs can bring community-acquired HAV into the hospital. Nudges can quickly increase HAVx uptake among HCWs.Funding: NoneDisclosures: None

ABSTRACTBackground:Neuropsychological tests, including tests of language ability, are frequently used to differentiate normal from pathological cognitive aging. However, language can be particularly difficult to assess in a standardized manner in cross-cultural studies and in patients from different educational and cultural backgrounds. This study examined the effects of age, gender, education and race on performance of two language tests: the animal fluency task (AFT) and the Indiana University Token Test (IUTT). We report population-based normative data on these tests from two combined ethnically divergent, cognitively normal, representative population samples of older adults.Methods:Participants aged ≥65 years from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) and from the Indianapolis Study of Health and Aging (ISHA) were selected based on (1) a Clinical Dementia Rating (CDR) score of 0; (2) non-missing baseline language test data; and (3) race self-reported as African-American or white. The combined sample (n = 1885) was 28.1% African-American. Multivariate ordinal logistic regression was used to model the effects of demographic characteristics on test scores.Results:On both language tests, better performance was significantly associated with higher education, younger age, and white race. On the IUTT, better performance was also associated with female gender. We found no significant interactions between age and sex, and between race and education.Conclusions:Age and education are more potent variables than are race and gender influencing performance on these language tests. Demographically stratified normative tables for these measures can be used to guide test interpretation and aid clinical diagnosis of impaired cognition.

Because of its extreme rarity, the genetic disease arthrogryposis multiplex congenita (AMC) and the needs of individuals with the diagnosis are often overlooked. AMC refers to the development of nonprogressive contractures in disparate areas of the body and is characterized by decreased flexibility in joints, muscle atrophy, and developmental delays. Colton Darst, a seven-year-old boy from Indianapolis, Indiana, was born with the disorder, and since then, he has undergone numerous surgical interventions and continues to receive orthopedic therapy to reduce his physical limitations. His parents, Michael and Amber Darst, have hopes for him to regain his limbic motion and are very open to trying out new assistive devices that would promote independent utilization and potentially help him participate in activities with minimal assistance. This reflective essay aims to elaborate on and evaluate the human-centered design project I worked on with my EPICS Assistive Technology team and the community impact fostered by it. Our service-driven and product design project places emphasis on a family hobby that Colton wishes to be able to take part in—fishing. As a result of his condition, it is difficult for him to engage in this and similar activities, preventing him from connecting with his family and peers at a more physical level. By conducting prototyping of different autonomous systems on a device, implementing hardware programming on electrical control systems, and engaging in research and experimentation of computer-aided designs, my team and I were able to engineer and tailor to Colton’s specific needs a high-functioning assistive device that compensates for his lack of muscular mobility, allowing this project to serve as a medium through which I could integrate and channel my knowledge of physiology and mechanics and take a step forward on the journey toward innovating and revolutionizing health care technology. Additionally, this essay discusses a variety of aspects related to the bridges between empathy, innovation, service-learning, and human-centered design, and, despite its limitations, the ways our service project is helping to alleviate the problem that not only Colton, but so many others are currently facing. Similarly, the essay also outlines the impact this experience has had on me, in the context of my direct contribution to improving quality of life and raising awareness of arthrogryposis multiplex congenita at the emotional, societal, and professional levels. Given the promising impact that we all can make, it is important to contribute to paving the way and helping lead Colton and those like him toward empowerment, inclusivity, and opportunity.

ImportanceWidespread distribution of rapid antigen tests is integral to the US strategy to address COVID-19; however, it is estimated that few rapid antigen test results are reported to local departments of health.ObjectiveTo characterize how often individuals in 6 communities throughout the United States used a digital assistant to log rapid antigen test results and report them to their local departments of health.Design, Setting, and ParticipantsThis prospective cohort study is based on anonymously collected data from the beneficiaries of the Say Yes! Covid Test program, which distributed more than 3 000 000 rapid antigen tests at no cost to residents of 6 communities (Louisville, Kentucky; Indianapolis, Indiana; Fulton County, Georgia; O’ahu, Hawaii; Ann Arbor and Ypsilanti, Michigan; and Chattanooga, Tennessee) between April and October 2021. A descriptive evaluation of beneficiary use of a digital assistant for logging and reporting their rapid antigen test results was performed.InterventionsWidespread community distribution of rapid antigen tests.Main Outcomes and MeasuresNumber and proportion of tests logged and reported to the local department of health through the digital assistant.ResultsA total of 313 000 test kits were distributed, including 178 785 test kits that were ordered using the digital assistant. Among all distributed kits, 14 398 households (4.6%) used the digital assistant, but beneficiaries reported three-quarters of their rapid antigen test results to their state public health departments (30 965 tests reported of 41 465 total test results [75.0%]). The reporting behavior varied by community and was significantly higher among communities that were incentivized for reporting test results vs those that were not incentivized or partially incentivized (90.5% [95% CI, 89.9%-91.2%] vs 70.5%; [95% CI, 70.0%-71.0%]). In all communities, positive tests were less frequently reported than negative tests (60.4% [95% CI, 58.1%-62.8%] vs 75.5% [95% CI, 75.1%-76.0%]).Conclusions and RelevanceThese results suggest that application-based reporting with incentives may be associated with increased reporting of rapid tests for COVID-19. However, increasing the adoption of the digital assistant may be a critical first step.

Lay persons can learn cardiopulmonary resuscitation (CPR) with the instructors' method, and by self-training with the use of manikins. LSFA includes airway control (head-tilt, jaw thrust), mouth-to-mouth ventilation, control of external bleeding by direct compression and elevation, positioning for coma (stable side position) and shock (horizontal, legs up), and extrication from a wreck (rescue pull). LSFA so far has not included chest compressions for cardiac arrest. LSFA capability by bystanders who would treat injured victims in mass disasters might be the most important component to consider for disaster response. A LSFA self-training system, including a manual which coaches skill practice on one another, and an attractive first aid kit (A. Laerdal) was found effective in a study carried out in Norway. The present controlled study was to compare two self-training systems (designed by A. Laerdal et al), one with and one without the use of manikins, with the presently prevalent instructors' method and an untrained control group. The trainees were high school students in a typical community in Indiana PA, USA. The study was carried out in 1978–1979.

Background The Healthy Indiana Plan serves as an insurance program, expansion of Medicaid, and unique initiative of Indiana, serving citizens near the poverty line. Elements of the program like the distinction between HIP Plus and HIP Basic, as well as the Gateway to Work program and their effects on the community have yet to be fully understood in their impact on healthcare decision making, stimulating personal responsibility, and ER utilization rates. Churches and faithbased organizations have consistently provided model forms of health support supplementation for reaching community, especially as demonstrated in the work of First Baptist Church North Indianapolis and Shepherd Community Church of the Nazarene. Project Methods 18 previously conducted and transcribed interviews with community leaders and community members were deductively analyzed with qualitative assessments, specifically descriptive content analysis and later framework analysis. Key themes and a framework were developed to understand and clarify responses and to produce direct recommendations. Results Participants in HIP Plus enjoy their insurance and experience minimal difficulty in receiving prescriptions and tests. However, remaining on HIP Plus is difficult for many participants, with the fallback of HIP Basic requiring copays that many are unable or unwilling to pay in light of greater financial priorities. Important factors arose, including: threshold knowledge to gain and maintain access, community necessitated assistance (advisory and financial), easy loss of HIP Plus status, gateway to work’s incompatibility with seasonal/temporal work, and no central administrative hub to check HIP status. Successful participants are adamant about their insurance, using phone calls, office visits, or consistent communication with navigators to ensure HIP Plus status. Conclusion & Future Directions This study, as well as Worlds Apart: Gaps in Life Expectancy in the Indianapolis Metro Area, have contributed to a continuing study on health inequity, community perspective, and organizational activities in Indianapolis communities.

Abstract Background Homicide is a widely acknowledged public health problem in the United States. The majority of homicides are committed with a firearm and have long-term health consequences for family members and entire communities. When left unsolved, violence may be perpetuated due to the retaliatory nature of homicides. Improving homicide clearance rates may help prevent future violence, however, we know little about the community-level social dynamics associated with unsolved homicides. Methods This study examines the individual-and-community-level social processes associated with low homicide clearance rates in Indianapolis, Indiana between 2007 and 2017. Homicide clearance is the primary outcome, defined as if a perpetrator was arrested for that homicide case between 2007 and 2017. Individual-level variables include the victim’s race/ethnicity, sex, and age. Community-level (i.e., census tracts) variables include the number of resident complaints against the police, resident complains of community disorder, income inequality, number of police interactions, and proportion of African American residents. Results In Indianapolis over a 11-year period, the homicide clearance rate decreased to a low of 38% in 2017, compared to a national clearance rate of 60%. Homicide case clearance was less likely for minority (OR 0.566; 95% CI, 0.407–0.787; p < 0.01) and male (OR 0.576; 95% CI, 0.411–0.807; p < 0.01) victims. Resident complaints of community disorder were associated with a decreased odds of case clearance (OR 0.687; 95% CI, 0.485–0.973; p < .01)., African American victim’s cases were less likely to be cleared in 2014–2017 (OR 0.640; 95% CI, 0.437–0.938; p < 0.05), compared to 2007. Conclusions Our study identified differences in neighborhood social processes associated with homicide clearance, indicating existing measures on these community factors are complex. Programs aimed at improving signs of community disorder and building community engagement may improve neighborhood clearance rates, lower violence, and improve the health of these communities.

While Indiana University School of Medicine has had multiple regional campuses delivering the pre-clerkship phase of the education for 50 years, since 2008, all four years of medical education, including clinical, have also been available at the eight regional campuses statewide. While 67 percent of admitted students designate a preference for the Indianapolis main campus, 60 percent of students are assigned to a regional campus for pre-clerkship education. Of those, 32 percent chose to be at their assigned campus. Students are often not able to identify a compelling reason to choose a regional campus. Despite data to the contrary, including our own, a majority of students continue to believe the path to success is through the main campus in Indianapolis, and as a result, transfer to the main campus for clerkships. In 2019, the school launched a Scholarly Concentrations Program as a key strategy to address this problem. The program leverages the unique expertise and resources at its diverse campuses and shines a spotlight on them to attract and retain students at regional campuses through educational enhancement and engaged community scholarship. While still in pilot phase, significant progress has been realized. With faculty statewide, 11 concentrations launched in less than one year; 17 in two years. About 220 students are enrolled in concentrations statewide; about half at regional campuses. A special program through the admissions process resulted in 9 percent of the Class of 2024, with an average GPA of 3.8 and 512 MCAT, choosing to enroll at a regional campus and its associated scholarly concentration. Immediate plans revolve around supporting concentration growth, building systems and processes to support a sustainable program, and monitoring results of the three pilot phases to inform future development and implementation. In addition, students are being recruited to regional campuses through an Early Decision Program.

Abstract Background The Indiana University Student Outreach Clinic (IUSOC) Eye Clinic is a monthly student-run eye clinic that provides free visual screening to the Near East Side community of Indianapolis, IN, USA. Screening includes assessments of visual acuity, intraocular pressure, peripheral visual fields, refraction, and non-mydriatic fundus photography. Methods This is a retrospective chart review of 875 patients seen at the IUSOC Eye Clinic from October 2013 to February 2020. Data on demographics, insurance coverage, ocular history, physical examination, suspected diagnosis, referral status, and glasses provided were collected and analyzed. Results 875 patients were seen at the IUSOC Eye Clinic from October 2013 to February 2020. 39.2% of the patients seen at the clinic reported being uninsured. 61.4% of patients were found to have visual acuity of 20/40 or worse, while 51.3% of patients were found to have a near visual acuity of 20/40 or worse. 20.3% of patients were referred to the local county hospital for further evaluation by an ophthalmologist, 14.4% of patients received free glasses prescriptions, and 27.9% of patients received free reading glasses. Common reasons for referral for further ophthalmology evaluation included glaucoma, decreased visual acuity, and diabetic retinopathy. An estimated value of services provided over the seven years of the clinic was 1271 relative value units. Conclusion The IUSOC Eye Clinic fills an important role in advancing ocular health and preventing irreversible blindness in an underserved Indianapolis community. Additionally, the clinic demonstrates an educational model for involving medical student volunteers.

Service-learning projects enable students to apply course concepts while connecting with and providing valuable services to their larger community. Such projects are particularly valuable in civic education, where students can act as the driving forces behind political engagement education and motivation efforts. “UIndyVotes!” is a student project focused on voter registration and education at the University of Indianapolis in Indiana. It aims to engage the campus and the community in upcoming elections. In its first two iterations (in 2016 and 2018), the project organized voter registration tables, door-to-door canvassing, and voter education programs. This case study assesses the efforts of the project, including its objectives, processes, programming, and partnerships, and recommends best practices for future campus voter registration drives. The improvements observed between iterations illustrate the value of organizing early, securing key partnerships, and delegating tasks via the university network and system available to students. This case study offers guidance and recommendations for how instructors can adopt and adapt these practices to create or enhance similar service-learning experiences on their own campuses.

In this paper, we discuss our efforts to build a corpus for Laiholh, also called Hakha Chin. Laiholh is spoken in Chin State in Western Myanmar, in parts of India and Bangladesh, and in several Burmese refugee communities in the US. Indiana, for example, is home to about 25,000 Burmese refugees. The ultimate goal of our team is to contribute to the development of speech translation technology that will be of benefit, both in general and in the local community in Indianapolis. Translation tools would be of great use in local emergency rooms, schools, and businesses. In pursuing our (admittedly lofty) goals, we are building a growing community of speakers, field linguists, computational linguists, and computer scientists. As a team, we have worked to share our different skill sets and mobilize the wider community around collecting data via Mozilla’s Common Voice platform. We present here a reflection on the project thus far, the kind of description we wish had existed when we were first building this collaboration and determining preliminary project goals. We hope that other communities and language activists who are thinking about developing speech technology may benefit from hearing about our motivations, concerns, experiences, and successes.

AbstractThe Ophthalmology Student Interest Group at Indiana University School of Medicine provides a free student-run eye screening clinic for an underserved community in Indianapolis. Patients with abnormal findings are referred to the ophthalmology service of the local county hospital for further evaluation. This retrospective chart review studied 180 patients referred from our free eye clinic to follow up at the ophthalmology service of a local county hospital from October 2013 to February 2020. This study investigated factors impacting follow-up of patients by analyzing demographics, medical history, insurance coverage, and final diagnoses at follow-up. Thirty-five (19.4%) of 180 patients successfully followed up at the local county hospital with an average time to follow-up of 14.4 (± 15.9) months. Mean patient age was 51 (± 13.6) with nearly equal numbers of males and females. The most common diagnoses at follow-up included refractive error (51.4%), cataract (45.7%), and glaucoma (28.6%). Patients with diabetes diagnoses or Healthy Indiana Plan insurance coverage had increased probability of follow-up. This study reveals gaps in timely follow-up to the local county hospital, demonstrating the current limitations of our free clinic in connecting patients to more definitive care and the need for an improved referral process.

Introduction Eskenazi Health in Indianapolis, Indiana, USA. services diverse communities in Central Indiana, including the Hispanic/Latinx community. It has been postulated that this population experiences toxicities at a higher rate and with a faster onset than the general population when treated with chemotherapy or biotherapy. The published clinical trials that have evaluated chemotherapy/biotherapy efficacy and toxicity have not adequately represented the Hispanic/Latinx population. This retrospective analysis aims to analyze the incidence and severity of adverse drug events in the Hispanic/Latinx population compared to the general study population. Methods A retrospective chart review included patients reported as Hispanic/Latinx in the electronic medical record who had breast cancer, colon cancer, acute myeloid leukemia, or multiple myeloma currently receiving chemotherapy/biotherapy and/or received chemotherapy/biotherapy during the study period. Seventy-three instances of patients receiving chemotherapy/biotherapy and 46 unique patients were included in the final analysis. Results Of the 73 instances, 29 (40%) had toxicity at baseline prior to chemotherapy/biotherapy received during the study period. Of those 29 baseline toxicities, 26 (90%) of them had new toxicity during the study period. Of the 73 instances, 62 (85%) experienced toxicities during the study period. Conclusion Ethnicity has a proven effect on medication efficacy and safety, but the specific impact of ethnicity on chemotherapy/biotherapy toxicity risk has not been well elucidated. This study found that a majority (85%) of Hispanic/Latinx patients treated with chemotherapy/biotherapy experienced toxicity of any grade, and the majority (90%) patients who had prior toxicity experienced another toxicity.

ObjectiveTo identify surveillance coverage gaps in emergency department (ED) and urgent care facility data due to missing discharge diagnoses.IntroductionIndiana utilizes the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) to collect and analyze data from participating hospital emergency departments. This real-time collection of health related data is used to identify disease clusters and unusual disease occurrences. By Administrative Code, the Indiana State Department of Health (ISDH) requires electronic submission of chief complaints from patient visits to EDs. Submission of discharge diagnosis is not required by Indiana Administrative Code, leaving coverage gaps. Our goal was to identify which areas in the state may see under reporting or incomplete surveillance due to the lack of the discharge diagnosis field.MethodsEmergency department data were collected from Indiana hospitals and urgent care clinics via ESSENCE. Discharge diagnosis was analyzed by submitting facility to determine percent completeness of visits. A descriptive analysis was conducted to identify the distribution of facilities that provide discharge diagnosis. A random sample of 20 days of data were extracted from visits that occurred between January 1, 2017 and September 6, 2017.ResultsA random sample of 179,039 (8%) ED entries from a total of 2,220,021 were analyzed from 121 reporting facilities. Of the sample entries, 102,483 (57.24%) were missing the discharge diagnosis field. Over 40 (36%) facilities were missing more than 90% of discharge diagnosis data. Facilities are more likely to be missing >90% or <19% of discharge diagnoses, rather than between those points.Comparing the percent of syndromic surveillance entries missing discharge diagnosis across facilities reveals large variability. For example, some facilities provide no discharge diagnoses while other facilities provide 100%. The number of facilities missing 100% of discharge diagnoses (n = 19) is 6.3 times that of the facilities that are missing 0% (n = 3).The largest coverage gap was identified in Public Health Preparedness District (PHPD)1 three (93.16%), with districts five (64.97%), seven (61.94%), and four (61.34%) making up the lowest reporting districts. See Table 2 and Figure 12 for percent missing by district and geographic distribution. PHPD three and five contain a large proportion (38%) of the sample population ED visits which results in a coverage gap in the most populated areas of the state.ConclusionsQuerying ESSENCE via chief complaint data is useful for real-time surveillance, but is more informative when discharge diagnoses are available. Indiana does not require facilities to report discharge diagnosis, but regulatory changes are being proposed that would require submission of discharge diagnosis data to ISDH. The addition of discharge diagnose is aimed to improve the completeness of disease clusters and unusual disease occurrence surveillance data.References1. Preparedness Districts [Internet]. Indianapolis (IN): Indiana State Department of Health, Public Health Preparedness; 2017 [Cited 2017 Sept 20]. Available from: https://www.in.gov/isdh/17944.htm.

ObjectiveTo characterize the appropriateness of naloxone administration, causes of death, and history of Indianapolis Emergency Medical Services (I-EMS) service utilization among the drug overdose population in Marion County, Indiana between 2011 to 2017.IntroductionDrug overdoses are now the leading cause of accidental death in the United States, with an estimated 60,000 deaths in 2016 1. Nationally, EMS overdose responses with naloxone administration have nearly doubled from 2012 to 2016 from 573.6 to 1004.4 per 100,000 EMS events 2. Resuscitation using the opioid antagonist, naloxone is recommended in cases of suspected opioid ODs, and has been increasingly used by EMS agencies, law enforcement, healthcare providers, and Good Samaritans 3. While naloxone can save lives, it is not clear how often its use is appropriate; delivering the right care to the right patient at the right time. It has been suggested that community paramedic programs teamed with recovery services may help link OD patients to recovery and rehabilitation services and establish mechanisms for follow-up care 4. Prior to implementing community EMS programs, it is important to understand the EMS utilization patterns of the OD population. I-EMS interactions may present an opportunity for behavioral intervention and linkage to services to prevent future OD and death in the opioid-using population. Accurately documenting substances involved in drug overdose deaths has been of increasing interest to Marion County and Indiana with a recent law requiring toxicology testing 5,6. This project linked individual-level data across public health information systems to assess the appropriateness of naloxone administration, the frequency of I-EMS service utilization until final death outcome among the I-EMS OD deceased cohort, and underlying causes of death among the cohort.MethodsThe study setting is Marion County, Indiana, in which the state capital, Indianapolis is located. The population size at the 2010 census was 903,393. We performed individual-level data linkage between I-EMS overdose run data from January 1, 2011 to December 17, 2017, Marion County coroner toxicology data from 2011 to 2017, and Marion County death certificate data from 2011 to 2017. Observations were linked according to first name, last name, and date of birth. The appropriateness of naloxone administration was assessed by quantifying the following: the probability of naloxone administration given opioid positive toxicology (sensitivity); and probability of opioid toxicology given naloxone administration (positive predictive value). Primary exposure of history of OD (via I-EMS) and the outcomes of all-cause mortality, non-OD, and OD mortality were assessed. The following ICD10 drug overdose coding was utilized: X40-X44, X60-X64, X85, Y10-Y14 to identify mortality type. Standardized mortality ratios (SMR) were calculated for the cohort based on Marion County census population-level estimates and Marion County death data with sex and age adjustment on exposure. Additionally, we investigated repeat OD frequencies and time to death among the cohort.ResultsOf 8,384 individuals who utilized I-EMS for drug overdose, 6,590 (78.6%) individuals were administered naloxone on least one I-EMS run, 850 (10.1%) died, and 260 (3.1%) of the deceased had a toxicology report conducted after death from 2011 to 2017. Among the 260 individuals who had a toxicology report, 92% were administered naloxone given they tested positive for opioid and 87.7% tested positive for opioids given they were administered naloxone (Table 1). Additionally, 82.8% of individuals were administered naloxone given they tested negative for opioids. Thus, up to 8% of opioid ODs patients were not provided naloxone when potentially necessary and 17% were provided naloxone when potentially unnecessary. One-hundred-fifteen (13.5%) died on the same day of their last EMS overdose run, yet only 61 (53%) of these individuals had a toxicology report, with a 90.7% administered naloxone given they tested positive for opioids and 87.5% tested positive for opioids given they were administered naloxone (Table 1). Of 850 individuals that died, 13.5% died on the same day of their last EMS run, 5.6% died next day, 12.4% died within 2 to 7 days, 9.8% within 8 to 30 days, 18.5% within 31 to 181 days, and 10.8% within 181 to 365 days, 29.4% greater than 365 days. Based on ICD10 drug overdose coding 293 (34.5%) individuals had drug overdose deaths, with 161 (18.9%) having X44 (accidental poisoning by other and unspecified drugs) and 112 (13.2%) having X42 (accidental poisoning by narcotics and psychodysleptics). Five-hundred-fifty-seven (65.5%) individuals had non-drug overdose deaths. After accidental poisoning due to drugs, heart, lung, and brain complications related to drug use appeared as common underlying causes of death. Of 850 deceased individuals, 86.4% only had one overdose EMS run, 13.7% had two or more EMS runs, and 759 (89.3%) had at least one EMS run where naloxone was administered. The SMR for drug-related utilizers of EMS was 4.04 compared to the general Marion County population, after adjustment for sex and age.ConclusionsThis work looked at deceased individuals with I-EMS overdose interactions during the period 2011 through 2017. Our results described two important features of EMS naloxone administration, providing the right care at the right time and maximizing available resources. For deceased individuals with known toxicology and same-day I-EMS interaction, the sensitivity of I-EMS naloxone administration was 90.7%. Of the deceased I-EMS overdose cohort, 70.6% died within one year of their last I-EMS overdose interaction and 13.7% had two or more ambulance runs for drug overdose. Although the most common cause of death in the I-EMS overdose cohort was related to drug poisoning, we observed over 65% died from other causes.ReferencesOpioid Overdose [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2017 [cited 2018 Oct 8]. Available from: https://www.cdc.gov/drugoverdose/data/index.htmlCash RE, Kinsman J, Crowe RP, Rivard MK, Faul M, Panchal AR. Naloxone Administration Frequency During Emergency Medical Service Events—United States, 2012–2016. Morbidity and Mortality Weekly Report. 2018 Aug 10;67(31):850.Adams J. Surgeon General's Advisory on Naloxone and Opioid Overdose [Internet]. SurgeonGeneral.gov. [cited 2018 Oct 8]. Available from: https://www.surgeongeneral.gov/priorities/opioid-overdose-prevention/naloxone-advisory.html5 things community paramedics need to know about the opioid epidemic [Internet]. 5 things community paramedics need to know about the opioid epidemic. EMS1; 2018 [cited 2018 Oct 8]. Available from: https://www.ems1.com/opioids/articles/383830048-5-things-community-paramedics-need-to-know-about-the-opioid-epidemic/Ray B, Quinet K, Dickinson T, Watson DP, Ballew A. Examining fatal opioid overdoses in Marion County, Indiana. Journal of urban health. 2017 Apr 1;94(2):301-10.Indiana General Assembly. Senate Bill 139 - Investigation of overdose deaths [Internet]. Indiana Code 2017 - Indiana General Assembly, 2018 Session. Indiana General Assembly; 2018 [cited 2018 Oct 8]. Available from: http://iga.in.gov/legislative/2018/bills/senate/139#digest-heading

ObjectiveThis poster presentation shares Indiana’s approach of alerting local health departments (LHDs) with near real-time drug overdose data and how this process has been enhanced through mapping and analysis with a geographic information system (GIS).IntroductionSince 2008, drug overdose deaths exceeded the number of motor vehicle traffic-related deaths in Indiana, and the gap continues to widen1. While federal funding opportunities are available for states, it often takes years for best practices to be developed, shared, and published. Similarly, local health departments (LHDs) may experience lengthy delays to receive finalized county health statistics.Indiana collects and stores syndromic emergency department data in the Public Health Emergency Surveillance System (PHESS) and uses the Electronic Surveillance System for the Early Notification of Community-based Epidemics version 1.21 (ESSENCE) to monitor public health events and trends. In July 2017, the Indiana Overdose Surveillance Team (IOST) developed a standard process for monitoring and alerting local health partners of increases in drug overdoses captured in ESSENCE at the county level. ISDH is enhancing these alerts by mapping the data in GIS and providing spatiotemporal data to LHDs to inform more targeted intervention and prevention efforts.MethodsThe IOST monitors drug overdoses statewide by analyzing daily queries from ESSENCE and sending email alerts to LHDs that are experiencing a statistically significant increase in suspected overdose activity at a hospital or county level. The IOST then requests that LHDs complete an overdose response feedback survey describing their actions after receiving an overdose alert.The IOST GIS analyst has enhanced overdose alerts by utilizing daily emergency department data queries from the PHESS database based on chief complaint and diagnosis text. Python™ and ArcGIS™ are used to deduplicate and geocode records, calculate the rate of cases within a hexagonal grid, and calculate the kernel density of case counts to show patterns at the neighborhood level. Comparisons to previous time periods are also calculated. Temporal and spatial scales of analysis are flexible, but 7 days and 30 days are used most often. Results are mapped in an HTML file using an open source Python package for dissemination to LHDs.ResultsBetween July 26, 2017, and Sept. 4, 2018, the IOST sent 89 suspected overdose alerts to LHDs. Alerts were sent to 45 different LHDs, of which 22 received multiple alerts (range: 1-9 repeat alerts). LHDs were requested to complete the survey on their initial alert, and a total of 31 jurisdictions completed this survey (31/45 = 69%). The majority of the LHD respondents (27/31 = 87%) wanted to continue receiving overdose alert emails.Our enhanced spatial analysis project has mapped more than 500 cases per week. Geocoding was successful for approximately 87% of the addresses received through PHESS. Neighborhoods in urban areas with higher counts have been identified, though variability from week to week is high. Areas of high overdose rates that cross county boundaries have also been detected, which would not have been possible using ESSENCE alone.ConclusionsNotifying LHDs of near real-time drug overdose trends is a catalyst for drug overdose planning and response efforts in Indiana. GIS mapping of the data provides an easy way for LHDs to view and share spatial trends with their local planning partners and identify community intervention strategies that can reduce drug overdose rates and improve outcomes for overdose survivors.References1 Overdose Prevention [Internet]. Indianapolis: Indiana State Department of Health; 2017. Indiana Special Emphasis Report: Drug Overdose Deaths 1999-2015; August 2017. [cited 2017 Sept 25]. Available from: http://www.in.gov/isdh/files/2017_SER_Drug_Deaths_Indiana.pdf

Background: Few studies have been conducted investigating the use of bisphosphonates in hypercalcemia of malignancy (HCM) in the setting of renal dysfunction. Objective: The primary objective was to compare the incidence of acute kidney injury (AKI) within 7 days of receiving pamidronate for the treatment of HCM with pre-existing renal dysfunction versus normal renal function at the time of pamidronate administration. The secondary objectives explored the effects of pamidronate doses and infusion rates on the safety and efficacy in those with pre-existing renal dysfunction for the treatment of HCM. Methods: A retrospective chart review was conducted on patients who received pamidronate for the treatment of HCM at a community teaching hospital in Indianapolis, Indiana, from January 1, 2013, to May 31, 2017. Results: A total of 141 pamidronate administrations were included (116 patients had normal baseline renal function, and 25 patients had pre-existing renal dysfunction before pamidronate administration for the treatment of HCM). Two (8%) patients developed AKI in the pre-existing renal dysfunction group, compared with 4 (3.4%) patients in those without pre-existing renal dysfunction ( P = .288). For those with pre-existing renal dysfunction, the incidence of AKI did not differ based on the dosage of pamidronate given ( P = .762) or infusion rates ( P = .373). Conclusion: Pamidronate appears to have limited impact on renal function at doses up to 90 mg in the setting of pre-existing renal dysfunction for the treatment of HCM.

Purpose Tax sales intersect with the market, housing policy and socioeconomic matters, but the topic in this context is understudied. The purpose of this paper is to investigate whether and how land banking is more effective in fostering positive property outcomes than tax lien sales and what market-based measures can be combined with land banking to reuse tax delinquent, vacant and abandoned properties. Design/methodology/approach This paper analyzes the consequences of tax lien sales and land banking in Indianapolis, Indiana, the USA. Various local data sources are used. Findings This paper finds that land banking, when compared to tax lien sales, results in less tax delinquency, less vacancy and abandonment, more increase in assessed value and fewer ownership changes after sales. Also, this paper shows the contributions of non-profit and for-profit developers as business partners to land banks. Practical implications This paper demonstrates the utility of the land banks that have become prevalent in some states in the USA over the past 20 years. The results of this paper recommend the realistic approach of combining government intervention and market forces. Social implications This paper sheds light on the US practice of tax lien sales. It goes largely unnoticed, but malpractice risks harming the vulnerable members of community. Originality/value Housing policy needs to find common ground with the market. It is a dilemma, more or less, for every country. The results of this paper suggest a harmonized public policy approach that includes land banking and the market can be effective in combatting with troubled properties.

ObjectiveTo discuss the use of electronic health records (EHRs) for estimation of overweight and obesity prevalence in children aged 2 to 19 years and to compare prevalence between the convenience sample obtained from EHRs to prevalence adjusted for potential selection bias.IntroductionAlthough recent data suggests childhood obesity prevalence has stabilized, an estimated 1 in 3 U.S. children are overweight or obese.1 Further, there is variation by racial and ethnic groups, location, age, and poverty2, resulting in a need for local data to support public health planning and evaluation efforts. Current methods for surveillance of childhood weight status rely on self-report from community-based surveys. However, surveys have long time intervals between data collection periods, are expensive, and are not often able to produce precise small-area estimates. EHRs have been increasingly proposed as an alternative or supplement to community surveys. Childhood weight and height is collected as a part of routine care, and leveraging these data from EHRs may provide rapid and locally precise estimates of childhood weight status. A concern for the use of EHRs is the potential for selection bias. EHRs represent only those seeking healthcare and may not generalize to the population. Additionally, the type of clinical visit (e.g., wellness vs. acute) may affect the prevalence estimates and the likelihood of collecting height and weight data in the EHR. Thus, in addition to EHRs being a convenience sample, there may be additional selection biases based on the type of visit and whether height and weight was measured and recorded. The current work sought to quantify the effect of visit type on childhood overweight and obesity prevalence and generate weights to adjust prevalence for potential EHR-related selection bias.MethodsTwo years (2014-2015) of EHR data were obtained from the Indiana Network for Patient Care, a community health information exchange. Data included clinical encounters of patients living in the eight-county metropolitan area of Indianapolis, Indiana. BMI was calculated using recorded height and weight from the most recent encounter. Encounters were screened for valid BMI entries by examining records in the 0-5th and 95-100th percentiles. BMI results were validated using the following procedure: censoring records with one encounter; removing encounters with implausible values (5 < BMI < 100); calculating the mean BMI across remaining encounters; calculating the percent difference from the mean BMI for each encounter; and removing encounters with BMI results greater or less than 10% from the mean BMI. Records which could not be validated were censored and treated as missing height and weight. Using the age- and sex- specific Centers for Disease Control and Prevention growth charts, patients were classified as underweight (0-5th percentiles), normal weight (5-85th percentiles), overweight (85-95th percentiles), and obese (>95th percentile).Wellness visits were identified using the following ICD-9-CM or ICD-10-CM diagnosis codes: V20.2, V70.0, V70.9; and Z00.121, Z00.129, Z00.00, Z00.01. To adjust for potential selection bias, two stabilized inverse probability weights (SIPW) were constructed. First, to account for potential selection bias induced by visit type and, second, to account for potential selection bias due to censoring (i.e., missing height and weight data). The SIPW were generated using logistic regression models to calculate the predicted probabilities for visit type and uncensored observations as a function of the covariates race, ethnicity, age, gender, and insurance. The SIPW weights were specified as depicted below, where W=1 is a wellness visit, L=observed covariates, and C=0 is uncensored for each child, i.[Insert formulas here]The final weight (SWFinal) was applied to the sample to create a pseudo-population in which there is no association between covariates, L and visit type and which has the same distribution of covariates, L, as the censored individuals not included in the pseudo-population, thus making censoring occur at random, given the observed covariates. Under the assumption of exchangeability and no unmeasured or residual confounding, the pseudo-population will no longer have selection bias due to differences in visit type and missing data.ResultsThe sample consisted of 130,626 unique individuals between the ages of 2 and 19 years, of which 92,755 (71%) had at least one recorded height and weight result. Of the 10,184 records screened for BMI results, 5,242 (51%) were validated using measurements from previous encounters. The final sample consisted of 87,804 records with a valid BMI result (67%) and 42,822 records censored due to missing data (33%). Compared to the U.S. Census, the EHR sample over-represented older girls (e.g., 31.2% vs. 41.2% 15-19 year-old girls) and under-represented younger girls (e.g., 34.3% vs. 29.5% for 5-9 year-old girls). Wellness visits were associated with censoring due to missing data; only 3% of censored encounters were wellness visits compared to 33% of uncensored encounters [P(χ21>14437 =< 0.0001)].In the unweighted sample, the overall prevalence of overweight or obesity was 36.5%. The overweight or obesity prevalence was lower among wellness visits (33.9%) than other visits (37.8%; P(χ21>124.2=< 0.0001). Similarly, wellness visits had lower prevalence estimates when stratified by sex, race, age, ethnicity, and insurance (Table 1). After weighting the sample by SWFinal, the overall prevalence of overweight or obesity was 36.2% and the difference between wellness (35.1%) and other visits (36.7%) was attenuated, though statistically significant [P(χ21>22.2 =<0.001). Likewise, the differences between wellness and other visits in the weighted pseudo-population were attenuated when stratified by covariates, compared to unweighted analyses (Table 1). While the SIPW method demonstrated some adjustment for selection bias due to visit type and censoring due to missing data, the adjustment was incomplete, likely as a result of unmeasured and imperfectly measured covariates.ConclusionsWellness visits were associated with lower childhood overweight and obesity prevalence and were more likely to have weight and height measurements recorded in the EHR than other visit types. Adjusting prevalence for EHR-related selection bias using stabilized inverse probability weights may produce more valid estimates but the lack of social determinant data in EHRs results in imperfect adjustment. Future work should integrate individual- or community-level social determinants of health data into the weighting models.References1. Skinner, AC, & Skelton, JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. JAMA Pediatr. 2014; 168(6).2. Ogden CL. et al. Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013-2016. JAMA. 2018;319(23).

ObjectiveTo assess the data sources used to monitor overdose events in Marion County and improve community overdose surveillance.IntroductionMirroring public health response to infectious disease outbreaks, many public health departments are taking an outbreak management approach to respond to drug overdose surges 1-3. The Marion County Public Health Department (MCPHD) has developed an overdose response plan (ORP) integrating drug overdose surveillance and community stakeholder response strategies. Effective drug overdose surveillance requires accurate and reliable data streams. This work assessed data sources utilized for county overdose surveillance and provided recommendations to improve overdose surveillance.MethodsData sources utilized as of September 2018 for opioid overdose surveillance in Marion County were assessed on utilization history by epidemiologists. General recommendations to improve overdose surveillance were created based on the findings. The three primary sources were emergency department data, ambulance run data, and death certificate data. Secondary sources included Indiana Poison Center (IPC) and toxicology data. General recommendations were generated based on challenges/solutions encountered and good practices observed from other health departments 4,5.ResultsThe assessment of data sources and utilization showed variation of data entry at the hospital level, limited identifiers in some cases, and varying timeliness ranges which may limit combined use of many data sources. The emergency department data source showed particular variation in data entry, limited unique identifier information), and no incident location information which impedes geographical surveillance. Periodic data checks by the ambulance service data holder appears to drastically increase data quality. Intermittent data feed drops from specific emergency departments also interfered with effective surveillance. Recommendations were generated based on lessons learned during successful partnerships with Indianapolis Emergency Medical Services, IPC, and emergency departments and challenges encountered during overdose surveillance work (Figure 1).In application of the strategy, the MCPHD is interested in linking data and looking for other ways to improve our overdose response to get a fuller picture of what is happening with overdoses, so we applied the steps in figure one to find areas of improvement. We found that limited identifiers and incomplete fields are our biggest challenge to linking datasets, so to combat these gaps we identified sources that have the necessary fields of interest and have been working with others to improve the data quality. Additionally, data sources will be evaluated on experiences with three categories: completeness in data fields, timeliness of data delivery, and consistency of data feed. Data quality measures were developed for completeness by fields present per record, timeliness by lag time from time added to time of event, and consistency by record counts per facility over time. We also recognized that meeting with partners is necessary to share how we are using the data and additional datasets that we might use in the future. Additionally we have been meeting with academic researchers so that we can expand our analyses to identify other issues related to overdoses. Finally, in order to make a difference in Marion County we are applying our findings to our outreach and interventions to hopefully prevent more overdoses and deaths.Future plans include data partnerships include police drug arrest data, fire department naloxone administration data, prescription drug monitoring data, Medicaid claims data, and health information exchange overdose data. Future research partnerships will consider a solutions based framework 6.ConclusionsThe results of our work demonstrate the value in surveillance assessment to summarize limitations of the many data sources utilized at a local level to conduct overdose surveillance. Our evaluation approach provides a path to improve and fill in surveillance gaps with new processes. Other health departments interested in optimizing overdose surveillance may seek a similar evaluation approach. Periodic data linkages have not been implemented which presents an opportunity to glean valuable insights on longitudinal patterns of drug use in the population. Future collaboration with researchers presents an opportunity to improve MCPHD ORP, Safe Syringe Access and Support Program, and Substance Use Outreach Services interventions.References[1] Moore K, Boulet M, Lew J, Papadomanolakis-Pakis N. A public health outbreak management framework applied to surges in opioid overdoses. Journal of opioid management. 2017;13(5):273-81.[2] Rudd RA. Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR. Morbidity and mortality weekly report. 2016;65.[3] Rowe C, Wheeler E, Jones TS, Yeh C, Coffin PO. Community-Based Response to Fentanyl Overdose Outbreak, San Francisco, 2015. Journal of Urban Health. 2018 May 3:1-6.[4] Chen H, Hailey D, Wang N, Yu P. A review of data quality assessment methods for public health information systems. International journal of environmental research and public health. 2014 May 14;11(5):5170-207.[5] Massachusetts. Department of Public Health. An Assessment of Opioid-Related Deaths in Massachusetts (2013-2014). Massachusetts Department of Public Health; 2016.[6] Wiehe SE, Rosenman MB, Chartash D, Lipscomb ER, Nelson TL, Magee LA, Fortenberry JD, Aalsma MC. A Solutions-Based Approach to Building Data-Sharing Partnerships. eGEMs. 2018;6(1).

Lorri Neilsen, whose feature article appears in this edition of M/C Journal, is Professor of Education at Mount Saint Vincent University in Halifax, Nova Scotia, Canada. Neilsen has been teaching and researching in literacy studies for more than four decades. She is internationally recognised as a poet and as an arts-based research methodologist specialising in lyric inquiry. In the latter half of this last decade she was appointed for a five year term to be the Poet Laureate for Nova Scotia. As an academic, she has published widely under the name of Lorri Neilsen; as a poet, she uses Lorri Neilsen Glenn. In this article I refer to her as Neilsen. This article reflects specifically on the poetics and the politics of the work of poet-scholar Lorri Neilsen. In doing so, it explores the theme of catastrophe in several senses. Firstly, it introduces the reader to the poetic articulations of the everyday catastrophes of grief and loss found in Neilsen’s recent work. Secondly, it uses Neilsen’s work on grief and loss to draw attention to a rarely recognised scholarly catastrophe: the catastrophe of the methodological divide between the humanities and the social sciences that runs the risk of creating, for the social sciences, a limiting and limited approach to research project design, knowledge production, and relationships between researchers and subjects, to which Lorri Neilsen’s ground-breaking use of lyric inquiry is a response. And thirdly, it alerts us to the need to fight to retain the arts and humanities within universities, in order to avoid a scholarly catastrophe of a different order. In undertaking this exploration, the article uses several terms with which some readers of M/C Journal might not be familiar. Research literacies is a term used to signal capacity and fluency in the understanding and use of research methodologies. Arts-based inquiry is the umbrella term used by researchers using their creative practice in the arts—in writing, theatre performance, visual arts, music, dance, movement—to lead them into new insights into the topic under investigation. This work is frequently embodied and sensuous. So, for example, the understanding of anorexia might be deepened by a dance performance or a series of paintings or a musical score devised in response to work with research participants; or, as I argue here, understandings of the everyday catastrophes of grief and loss might be deepened by the writing of poetry or expressive prose that uncovers nuance and sheds light in ways not possible using the more traditional research methodologies available to social scientists. Lyric inquiry, a sub-set of arts-based inquiry, is Neilsen’s own term for a research methodology that uses writing itself as the research tool, and whose hallmark is embodied language expressed as poem, song, or poetic prose, to “create the possibility of a resonant, ethical, engaged relationship between the knower and the known” (Handbook 94).This article, then, reflects on the research work of Lorri Neilsen. In this article I use Neilsen’s responses to grief and loss as the starting point to follow her journey from the early days of her involvement in literacy research to her present enchantment with arts-based inquiry in literacy and social science research. I outline her writing on research literacies, explore her notion of lyric inquiry as a crucial facet of arts-based research, and conclude with examples of her poetry born of creative reflection on what we might call everyday catastrophes. Ultimately I argue the need to avoid a scholarly catastrophe of a different order from those Neilsen explores, through the continued recognition of the crucial place of the arts in academic institutions.I open with excerpts from a piece in Lorri Neilsen’s collection, Threading Light, published in 2011. This piece, The Sea, written out of the grief of losing her aged mother, is one I find most moving. It begins: Days later—a week, a month, hard to tell—sun comes out of drizzle and ice and fog and snow showers, ripping open a bright day. Snow-mounded. If you were a kid, you’d look for your sled. He is sure the box of wrenches is in the cabin, and you know a drive to the country is better than another day in bed with Kleenex and a hacking cough, hiding a flayed heart, and pouring CBC into your ears around the clock. (104) The two figures in the piece, he and she, head south to their seaside cabin. They take a walk beside an ice-covered seashore.Today, you step carefully because of ice, and what you find catches your breath. For a brief moment you have escaped the grizzly claws of grief ripping at your chest. You are kneeling on the ice, touching the frosted edges of kelp and weeds, slimy umber and sienna, and putrid green growths that slurp in and out most of the year, but here, now, are stunned, immobile, impaled on the rocks by the cold. Desire is a feral animal; let it loose, it will seek beauty. You point out to each other tableaus: rimming white, translucent blues and greens, coppered plants flash-frozen, fringed by crystalline tatters. A Burtynsky, you think, but not man-made. This is life’s ebb, as Tu Fu wrote. The ocean’s winter verge. Death’s magnificent intaglio. Your fingers follow the lines of kelp: these things once lived, and moved. Take the long view, maybe they still do. You pause to sit on a cold rock and look at the sky; for a moment you are back beside her body, that last morning, your fingers on cooling flesh. Then, water, the sound of waves. Presence. You look up. He has found one periwinkle fused to a rock, then another. Several more. He places them in your hand, one by one, each dark brown ball with its own scurf of ice that gives off the smallest breath of mist as it touches the heat of your palm. Each a small jolt. This is what the sea creates while you are busy with your own tides: precise cups of glossy perfection with curves like a blues howl that open your heart, craning for light. (Threading Light 104–5)One of the things I appreciate most about Lorri Neilsen’s lyric work is her capacity to hold the miniscule simultaneously with the universal; a flash of insight under the arc of a timeless sky. “Smaller than small; larger than large,” write the Hindu prophets (Upanishads). “This is what the sea creates while you are busy with your own tides,” she writes, and in that moment of reading I am jolted into an awareness of the contours of grief that no amount of social scientific observation could provide: an awareness of the nature of self-absorption and inward focus so intense that even the most inevitable of natural rhythms—the ocean’s tides—are forgotten: forgotten, that is, until the protagonist is shaken awake again, by exquisite beauty, into a new kind of response-ability to the world. Lorri Neilsen’s feature article in this edition of M/C creates layer upon layer of insights exploring the notion that loss, an everyday catastrophe, involves a turning inside-out, a jolting into a new sense of self, or a propulsion out of an old, restrictive one; and that inevitably it propels us headlong into a state of living in the moment, of being present to what is, rather than distantly taking stock of what we have. As I ponder this experience, as a reader of her work, I re-experience that moment of stasis:physiologically we all know that experience of time suspended after shock, time inexplicably, irrationally, standing still. But what Neilsen has done so successfully as a poet-scholar, in my view, is not simply find words to express this turning inside out as poetry. Additionally, she has claimed the moment of poetic insight as a crucial form of knowledge-making that has a central and necessary place in illuminating our social worlds. This claim has far-reaching political significance for social science researchers, introducing, as it does, a re-invigorated understanding of the very concept of research:Research [she tells us] is not only the creation of products to market at the academic fair; research is the process of learning through the words, actions and revisionings of our daily life. […] Research is the attuned mind/body working purposefully to explore, to listen, to support, to transgress, to gather with care, to create, to disrupt, to offer back, to contribute, sometimes all at once […] Inquiry is praxis that cannot be boxed up and delivered: it is a story with no ending. (Knowing 264) Neilsen’s particular fascination is with lyric inquiry which she claims as political, poetic, and sustaining of the individual and the larger world: It has the capacity to develop voice and agency in both researcher and participant; it foregrounds conceptual and philosophical processes marked by metaphor, resonance and liminality; and it reunites us with the vivifying effects of imagination and beauty – those long-forgotten qualities that add grace and wisdom to public discourse. (Knowing 101)So what has led her here, to that place where lyric inquiry forms the basis of her engagement with the knowledge-making endeavour in the academy and beyond? As a feminist scholar fascinated by biography, by life writing and story, I find myself drawn as much towards the story of Neilsen’s evolution as a poet-scholar as to the work itself. How has she come to an awareness of the need to create new ways of doing research? What has she uncovered here about the ethics and the politics of doing research in the social world? As I read her work I become aware that her current desire to dance at the edge of the conventional research world has been driven as much by a series of professional catastrophes as by an underpinning desire for methodological innovation. Neilsen herself explores these issues in her 1998 collection of academic essays, called Knowing Her Place: Research Literacies and Feminist Occasions. There are several threads weaving their way through this account of a young academic researcher and scholar finding her way into a larger, wiser, more resonant space: there’s the story of the young graduate student learning the language of and experiencing the perpetual isolation of disembodied fact-finding statistically resonant research into literacy; there’s the story of the young mother juggling academic life and research and parenting, wanting to make sense to the teaching research participants she is working with, wanting to close the gap between the public and the private worlds, wanting to spend time with her partner and her two sons, especially her second son whose birth could have been a catastrophe but whose gentle ways of being in the world gifted them all with the desire to slow down, to see afresh; and, later, there’s the story of the mature woman whose impulse is to community and to solitude, to living with a generosity of spirit that takes seriously the intertwining of her poetic life and her academic and everyday worlds. Interwoven with these stories is the story of writing itself: here we find the formal disembodied writing of Western scientific research practices; here now is collectivist writing generated at kitchen tables, in community centres, in schools; here now is every mode of writing that evokes nuance and explores the senses; and here now too is the research writing that privileges response-ability, scholartistry, bodily sensation, reciprocity, engagement with the world.Neilsen’s account of this journey begins when, as a young postgraduate student doing research into literacy, she learned the language of statistical significance to measure syntactic complexity, noting, as she wrote up her MA, the distance between the language she had learned and the everyday language of the classroom teachers the research was meant to inform. The emphasis of this early research was on removing language from its context, isolating components of language for scrutiny, making findings that were replicable. In time she came to see this kind of knowledge-making as dry, limited, rule-bound, androcentric. From this disengaged, disembodied place she moved, over decades, into a space where compassion, wisdom, humility, and wonder combine to locate her as researcher who understands, alongside researcher David Smith, that “writing is a holy act, an articulation of limited understanding” (qtd. in Neilsen, Knowing 119). In an echo of Luce Irigaray’s insistence that the research and writing we do as fully alive feminist scholars will link the celestial and the terrestrial, the horizontal, and the vertical, and in a further echo of Helene Cixous’ claim that when writing from the body, “an opera inhabits me” (Cixous 53), Neilsen writes unabashedly of the metaphysical nature of her research world: Artful living, artful writing, connecting with a purpose to help each other transcend and grow through inquiry. Connection, embodiment, transformation, transcendence. All these expressions tap spiritual chords […] But if inquiry is to transcend the destructive circumstances of our lifeworlds, if its purpose is to make a difference, not a career, we cannot avoid using words such as vision, spirit, humanity, soul. Interest in metaphysical perspectives is not new in feminist circles, but is IS new in conventional research communities where the intangible, the deeply disturbing and consciousness-awakening dimensions of life are compartmentalized, reserved […] for a walk by the ocean, for the rare meditative times of our lives, if we find them at all […] But (she concludes) the awareness that we know when we live in the eternal present […] is an awareness full of tremendous power, and, ultimately, hope. (Knowing 280)In the final chapter of this 1998 text outlining her journey into research literacies, called Notes on Painting Ghosts and Writing the Poetry Report: Some Things I know But Not For Certain, Lorri Neilsen writes confidently against the grain of what she sees as the limits of androcentric research practices: Everything we know is at once out there and in here […] My place is to apprentice myself to the world, to paraphrase Merleau-Ponty, not in subservience and compliance, as the androcentric practices we have followed would keep me, but in reciprocity, curiosity and response-ability. What we must seek are the transgressive experiences and the fresh words which reveal us, in Annie Dillard’s words, ‘startlingly to ourselves as creatures set down bewildered’. (qtd. in Neilsen, Knowing 261)And in a gesture that I find heartwarming, she writes of the impact of being scooped up into a collective research-making endeavour, of belonging to a community of scholars (including poet-sociologists Laurel Richardson and Trinh T. Minh-ha) whose research agenda is to expand the ways we might know, to reflect the fullness and richness and complexity of the research endeavour itself, and, in so doing, of human experience: Time and enculturation have combined to make inquiry a terrain where I live, rather than a place I visit on occasion.Inquiry is less a stance and more an intentional gesture, a re-bodied approach to working with people, particularly women, on projects which matter to them locally and globally. Inquiry is a conspiracy, a breathing together, for which we need the conditions of being together and sharing a climate, or air, for breathing. Inquiry values difference, rather than fearing it, sees contiguity or complementarity as necessary for working together without suppressing our diversity. (Knowing 262) Hers is no airy-fairy disengaged mood-making endeavour. It is decidedly political: the inclination is to openness and growth, to take risks, to create critical spaces[…] When we make the assumptions of the norms of research problematic, we make the assumptions and the norms of life together on this planet problematic as well. We begin to dismantle the Western knowledge project, and we begin to learn a fundamental humility. Expanding our research literacies keeps us full of wonder, in spite of the shakey ground and the shadows. We can learn more when our pen is a tool of discovery, not domination.And her focus is ever on the artistry of research practices: The ontological and epistemological waters in which these [research] literacies continue to develop are social, political, ecological [...] Re-imagining inquiry is re-imagining ways to work with people and ideas which keep us, like the painter, the dancer, and the performance artist, watchfully poised, momentarily still, and yet fluidly in motion. (Knowing 263)In summary, then, the kind of writing that accompanies the research methodology that Lorri Neilsen has created cuts across the notion of knowledge as product, commodity, trump card. Knowing [for Neilsen] is an experience of immersion and expression rather than one of gathering data only to advance an argument […] A reader does not take away three key points or five examples. A reader comes away with the resonance of another’s world…our senses stimulated, our spirit and emotions affected. (Knowing 96) This kind of writing emerges from her desires to create a resonant, embodied, ethical, activist, feminist-honouring, and collaborative way to grapple with the nuance of human experience. This she calls lyric inquiry. Lyric inquiry sits on the margins, inhabits the liminal spaces, “places where we perceive patterns in new ways, find sensuous openings into new understandings, fresh concepts, wild possibilities” (Knowing 98). In her chapter on lyric inquiry in the 2008 Sage Handbook of the Arts in Qualitative Research, Neilsen argues that lyric inquiry leans on no other mode of enquiry: it stands on its own, resonant and expressive, inviting fresh ways to see, read, consider experience. Unlike the narrative enquiry that currently popularly accompanies much social science research in order to bolster an argument, or illustrate a point being made in policy formulation or discussion (Hopkins), lyric inquiry adopts its own mode, its own performative spaces. It’s a heady concept and, I would argue, a brave contribution to the repertoire of qualitative arts-based research methodologies.For me Lorri Neilsen’s stance as poet, writer, researcher, woman, is beautifully captured in her piece from Threading Light which she has titled Writing has always felt like praying. Here we glimpse the lives of four figures: the Buddha, Muhammad, Jesus Christ, and the poet herself, each responding to catastrophe of sorts: Gotama saw the face of his infant son and sleeping wife,shaved his head and beard, put on his yellow robe, andleft without saying good-bye. Duties, possessions,ties of the heart: all dustweighing down his soul. He walked and walked,seeking a life wide open, complete and pure as polished shell.In a cave away from the fray of Mecca, vendettas,and a world soured by commerce, Muhammadshook as the words of a new scripturecame to him. Surrendered himselfto its beauty, singing and weeping verse by verse, year by yearfor twenty-one years.Of course you remember the man from Galileewho carried on his back the very wood on whichhis blood was spilled. How he pushed back the rockfrom the front of the cave and – this is gospel –ascended, emptied of self and full of god, returningnow in offerings of bread and wine.I pace back and forth on a cliff above the unknowable, luredby slippery and maverick tales that call forth terror, crackthe earth, shatter my bones with light. I have no needto verify old brown marks of stigmata, translate Coptic fragments.A burlap robe on display in the cold stone air of the Church of Santa Croceis inscrutable: it tells me only that my body is a ragged garmentand will be discarded too.But here, now, I am ready as a tuned stringto witness what is ravenous, mythic. Here I am holy, misbegotten,gossip on the lips of the gods, forgotten by the time the cupsare washed and put away. So I start as I start every day,cobbling a makeshift pulpit, casting for truths as they are given me:Man, woman, child, sun, moon, breath, tears,Stone, sand, sea. (Threading Light 102–3) It is ironic that the kind of research that Neilsen advocates, research that draws specifically on the arts to create new methodologies for the uncovering of topics traditionally explored by the social sciences, is being developed at precisely that moment when university arts departments around the world are being dismantled, and their value questioned (See Cohen, NY Times; Donoghue, Chronicle of Higher Education; Kitcher, Republic). As I indicated at the beginning of the article, I use this homage to Lorri Neilsen and her work to make the broader point that we lose the arts and the humanities in our universities at our peril. It’s not just that the arts are a pleasant addition, a ruffle on the edge of the serious straight-tailored cut of the research garment: rather, as Neilsen has argued throughout her research and writing career, the arts are central to our survival as a response-able, interactive, creative, thoughtful species. To turn our back on the arts in contemporary research practices is already a dangerous erosion, a research and knowledge-making catastrophe which Neilsen’s lyric inquiry seeks to address: to lose the arts from universities altogether would be a catastrophe of a much higher order. References Cohen, Patricia. “In Tough Times, the Humanities Must Justify Their Worth”. New York Times. 24 Feb. 2009. Cixous, Helene. Coming to Writing and Other Essays. Ed. Deborah Jensen. Cambridge: Harvard University Press, 1991.Dillard, Annie. The Writing Life. New York: Harper & Row, 1993. Donoghue, Frank. “Can the Humanities Survive the 21st Century?” The Chronicle of Higher Education. 5 Sep. 2010. Hopkins, Lekkie. “Why Narrative? Reflections on the Politics and Processes of Using Narrative in Refugee Research.” Tamara Journal for Critical Organisation and Inquiry 8.2 (2009): 135-45.Irigaray, Luce. “Sexual Difference.” The Irigaray Reader. Ed. Margaret Whitford. Oxford: Blackwell, 1987. 165-77. Kitcher, Philip. “The Trouble with Scientism”. New Republic. 4 May 2012.Muller, M. (trans.). The Upanishads. Oxford: The Clarendon Press, 1879.Neilsen Glenn, Lorri. Threading Light. Explorations in Loss and Poetry. Regina, SK: Hagios Press, 2011. Neilsen, Lorri. “Lyric Inquiry.” Handbook of the Arts in Qualitative Research. Eds. J. Gary Knowles and Ardra Cole. Thousand Oaks: Sage, 2008. 88-98. Neilsen, Lorri. Knowing Her Place: Research Literacies and Feminist Occasions. San Francisco: Caddo Gap Press, and Halifax, NS: Backalong Books, 2008. Richardson, Laurel. “The Consequences of Poetic Representation: Writing the Self and Writing the Other.” Investigating Subjectivity: Windows on Lived Experience. Eds. Carolyn Ellis and Michael Flaherty. Newbury Park: Sage, 1992. 125-140. Richardson, Laurel. “Writing: A Method of Inquiry.” Handbook of Qualitative Research. Eds. Norman K. Denzin and Yvonna. S. Lincoln. Thousand Oaks: Sage, 1994. 959-978.Trinh, T. Minh-ha. Woman, Native, Other. Bloomington and Indianapolis: Indiana University Press, 1989.

In the last decade, the cell phone’s transformation from a tool for mobile telephony into a multi-modal, computational “smart” media device has engendered a new kind of emplacement, and the ubiquity of technological mediation into the everyday settings of urban life. With it, a new kind of media literacy has become necessary for participation in the networked social publics (Ito; Jenkins et al.). Increasingly, the way we experience our physical environments, make sense of immediate events, and form impressions is through the lens of the camera and through the ear of the microphone, framed by the mediating possibilities of smartphones. Adopting these practices as a kind of new media “grammar” (Burn 29)—a multi-modal language for public and interpersonal communication—offers new perspectives for thinking about the way in which mobile computing technologies allow us to explore our environments and produce new types of cultural knowledge. Living in the Social Multiverse Many of us are concerned about new cultural practices that communication technologies bring about. In her now classic TED talk “Connected but alone?” Sherry Turkle talks about the world of instant communication as having the illusion of control through which we micromanage our immersion in mobile media and split virtual-physical presence. According to Turkle, what we fear is, on the one hand, being caught unprepared in a spontaneous event and, on the other hand, missing out or not documenting or recording events—a phenomenon that Abha Dawesar calls living in the “digital now.” There is, at the same time, a growing number of ways in which mobile computing devices connect us to new dimensions of everyday life and everyday experience: geo-locative services and augmented reality, convergent media and instantaneous participation in the social web. These technological capabilities arguably shift the nature of presence and set the stage for mobile users to communicate the flow of their everyday life through digital storytelling and media production. According to a Digital Insights survey on social media trends (Bennett), more than 500 million tweets are sent per day and 5 Vines tweeted every second; 100 hours of video are uploaded to YouTube every minute; more than 20 billion photos have been shared on Instagram to date; and close to 7 million people actively produce and publish content using social blogging platforms. There are more than 1 billion smartphones in the US alone, and most social media platforms are primarily accessed using mobile devices. The question is: how do we understand the enormity of these statistics as a coherent new media phenomenon and as a predominant form of media production and cultural participation? More importantly, how do mobile technologies re-mediate the way we see, hear, and perceive our surrounding evironment as part of the cultural circuit of capturing, sharing, and communicating with and through media artefacts? Such questions have furnished communication theory even before McLuhan’s famous tagline “the medium is the message”. Much of the discourse around communication technology and the senses has been marked by distinctions between “orality” and “literacy” understood as forms of collective consciousness engendered by technological shifts. Leveraging Jonathan Sterne’s critique of this “audio-visual litany”, an exploration of convergent multi-modal technologies allows us to focus instead on practices and techniques of use, considered as both perceptual and cultural constructs that reflect and inform social life. Here in particular, a focus on sound—or aurality—can help provide a fresh new entry point into studying technology and culture. The phenomenon of everyday photography is already well conceptualised as a cultural expression and a practice connected with identity construction and interpersonal communication (Pink, Visual). Much more rarely do we study the act of capturing information using mobile media devices as a multi-sensory practice that entails perceptual techniques as well as aesthetic considerations, and as something that in turn informs our unmediated sensory experience. Daisuke and Ito argue that—in contrast to hobbyist high-quality photographers—users of camera phones redefine the materiality of urban surroundings as “picture-worthy” (or not) and elevate the “mundane into a photographic object.” Indeed, whereas traditionally recordings and photographs hold institutional legitimacy as reliable archival references, the proliferation of portable smart technologies has transformed user-generated content into the gold standard for authentically representing the everyday. Given that visual approaches to studying these phenomena are well underway, this project takes a sound studies perspective, focusing on mediated aural practices in order to explore the way people make sense of their everyday acoustic environments using mobile media. Curation, in this sense, is a metaphor for everyday media production, illuminated by the practice of listening with mobile technology. Everyday Listening with Technology: A Case Study The present conceptualisation of curation emerged out of a participant-driven qualitative case study focused on using mobile media to make sense of urban everyday life. The study comprised 10 participants using iPod Touches (a device equivalent to an iPhone, without the phone part) to produce daily “aural postcards” of their everyday soundscapes and sonic experiences, over the course of two to four weeks. This work was further informed by, and updates, sonic ethnography approaches nascent in the World Soundscape Project, and the field of soundscape studies more broadly. Participants were asked to fill out a questionnaire about their media and technology use, in order to establish their participation in new media culture and correlate that to the documentary styles used in their aural postcards. With regard to capturing sonic material, participants were given open-ended instructions as to content and location, and encouraged to use the full capabilities of the device—that is, to record audio, video, and images, and to use any applications on the device. Specifically, I drew their attention to a recording app (Recorder) and a decibel measurement app (dB), which combines a photo with a static readout of ambient sound levels. One way most participants described the experience of capturing sound in a collection of recordings for a period of time was as making a “digital scrapbook” or a “media diary.” Even though they had recorded individual (often unrelated) soundscapes, almost everyone felt that the final product came together as a stand-alone collection—a kind of gallery of personalised everyday experiences that participants, if anything, wished to further organise, annotate, and flesh out. Examples of aural postcard formats used by participants: decibel photographs of everyday environments and a comparison audio recording of rain on a car roof with and without wipers (in the middle). Working with 139 aural postcards comprising more than 250 audio files and 150 photos and videos, the first step in the analysis was to articulate approaches to media documentation in terms of format, modality, and duration as deliberate choices in conversation with dominant media forms that participants regularly consume and are familiar with. Ambient sonic recordings (audio-only) comprised a large chunk of the data, and within this category there were two approaches: the sonic highlight, a short vignette of a given soundscape with minimal or no introduction or voice-over; and the process recording, featuring the entire duration of an unfolding soundscape or event. Live commentaries, similar to the conventions set forth by radio documentaries, represented voice-over entries at the location of the sound event, sometimes stationary and often in motion as the event unfolded. Voice memos described verbal reflections, pre- or post- sound event, with no discernable ambience—that is, participants intended them to serve as reflective devices rather than as part of the event. Finally, a number of participants also used the sound level meter app, which allowed them to generate visual records of the sonic levels of a given environment or location in the form of sound level photographs. Recording as a Way of Listening In their community soundwalking practice, Förnstrom and Taylor refer to recording sound in everyday settings as taking world experience, mediating it through one’s body and one’s memories and translating it into approximate experience. The media artefacts generated by participants as part of this study constitute precisely such ‘approximations’ of everyday life accessed through aural experience and mediated by the technological capabilities of the iPod. Thinking of aural postcards along this technological axis, the act of documenting everyday soundscapes involves participants acting as media producers, ‘framing’ urban everyday life through a mobile documentary rubric. In the process of curating these documentaries, they have to make decisions about the significance and stylistic framing of each entry and the message they wish to communicate. In order to bring the scope of these curatorial decisions into dialogue with established media forms, in this work’s analysis I combine Bill Nichols’s classification of documentary modes in cinema with Karin Bijsterveld’s concept of soundscape ‘staging’ to characterise the various approaches participants took to the multi-modal curation of their everyday (sonic) experience. In her recent book on the staging of urban soundscapes in both creative and documentary/archival media, Bijsterveld describes the representation of sound as particular ‘dramatisations’ that construct different kinds of meanings about urban space and engender different kinds of listening positions. Nichols’s articulation of cinematic documentary modes helps detail ways in which the author’s intentionality is reflected in the styling, design, and presentation of filmic narratives. Michel Chion’s discussion of cinematic listening modes further contextualises the cultural construction of listening that is a central part of both design and experience of media artefacts. The conceptual lens is especially relevant to understanding mobile curation of mediated sonic experience as a kind of mobile digital storytelling. Working across all postcards, settings, and formats, the following four themes capture some of the dominant stylistic dimensions of mobile media documentation. The exploratory approach describes a methodology for representing everyday life as a flow, predominantly through ambient recordings of unfolding processes that participants referred to in the final discussion as a ‘turn it on and forget it’ approach to recording. As a stylistic method, the exploratory approach aligns most closely with Nichols’s poetic and observational documentary modes, combining a ‘window to the world’ aesthetic with minimal narration, striving to convey the ‘inner truth’ of phenomenal experience. In terms of listening modes reflected in this approach, exploratory aural postcards most strongly engage causal listening, to use Chion’s framework of cinematic listening modes. By and large, the exploratory approach describes incidental documentaries of routine events: soundscapes that are featured as a result of greater attentiveness and investment in the sonic aspects of everyday life. The entries created using this approach reflect a process of discovering (seeing and hearing) the ordinary as extra-ordinary; re-experiencing sometimes mundane and routine places and activities with a fresh perspective; and actively exploring hidden characteristics, nuances of meaning, and significance. For instance, in the following example, one participant explores a new neighborhood while on a work errand:The narrative approach to creating aural postcards stages sound as a springboard for recollecting memories and storytelling through reflecting on associations with other soundscapes, environments, and interactions. Rather than highlighting place, routine, or sound itself, this methodology constructs sound as a window into the identity and inner life of the recordist, mobilising most strongly a semantic listening mode through association and narrative around sound’s meaning in context (Chion 28). This approach combines a subjective narrative development with a participatory aesthetic that draws the listener into the unfolding story. This approach is also performative, in that it stages sound as a deeply subjective experience and approaches the narrative from a personally significant perspective. Most often this type of sound staging was curated using voice memo narratives about a particular sonic experience in conjunction with an ambient sonic highlight, or as a live commentary. Recollections typically emerged from incidental encounters, or in the midst of other observations about sound. In the following example a participant reminisces about the sound of wind, which, interestingly, she did not record: Today I have been listening to the wind. It’s really rainy and windy outside today and it was reminding me how much I like the sound of wind. And you know when I was growing up on the wide prairies, we sure had a lot of wind and sometimes I kind of miss the sound of it… (Participant 1) The aesthetic approach describes instances where the creation of aural postcards was motivated by a reduced listening position (Chion 29)—driven primarily by the qualities and features of the soundscape itself. This curatorial practice for staging mediated aural experience combines a largely subjective approach to documenting with an absence of traditional narrative development and an affective and evocative aesthetic. Where the exploratory documentary approach seeks to represent place, routine, environment, and context through sonic characteristics, the aesthetic approach features sound first and foremost, aiming to represent and comment on sound qualities and characteristics in a more ‘authentic’ manner. The media formats most often used in conjunction with this approach were the incidental ambient sonic highlight and the live commentary. In the following example we have the sound of coffee being made as an important domestic ritual where important auditory qualities are foregrounded: That’s the sound of a stovetop percolator which I’ve been using for many years and I pretty much know exactly how long it takes to make a pot of coffee by the sound that it makes. As soon as it starts gurgling I know I have about a minute before it burns. It’s like the coffee calls and I come. (Participant 6) The analytical approach characterises entries that stage mediated aural experience as a way of systematically and inductively investigating everyday phenomena. It is a conceptual and analytical experimental methodology employed to move towards confirming or disproving a ‘hypothesis’ or forming a theory about sonic relations developed in the course of the study. As such, this approach most strongly aligns with Chion’s semantic listening mode, with the addition of the interactive element of analytical inquiry. In this context, sound is treated as a variable to be measured, compared, researched, and theorised about in an explicit attempt to form conclusions about social relationships, personal significance, place, or function. This analytical methodology combines an explicit and critical focus to the process of documenting itself (whether it be measuring decibels or systematically attending to sonic qualities) with a distinctive analytical synthesis that presents as ‘formal discovery’ or even ‘truth.’ In using this approach, participants most often mobilised the format of short sonic highlights and follow-up voice memos. While these aural postcards typically contained sound level photographs (decibel measurement values), in some cases the inquiry and subsequent conclusions were made inductively through sustained observation of a series of soundscapes. The following example is by a participant who exclusively recorded and compared various domestic spaces in terms of sound levels, comparing and contrasting them using voice memos. This is a sound level photograph of his home computer system: So I decided to record sitting next to my computer today just because my computer is loud, so I wanted to see exactly how loud it really was. But I kept the door closed just to be sort of fair, see how quiet it could possibly get. I think it peaked at 75 decibels, and that’s like, I looked up a decibel scale, and apparently a lawn mower is like 90 decibels. (Participant 2) Mediated Curation as a New Media Cultural Practice? One aspect of adopting the metaphor of ‘curation’ towards everyday media production is that it shifts the critical discourse on aesthetic expression from the realm of specialised expertise to general practice (“Everyone’s a photographer”). The act of curation is filtered through the aesthetic and technological capabilities of the smartphone, a device that has become co-constitutive of our routine sensorial encounters with the world. Revisiting McLuhan-inspired discourses on communication technologies stages the iPhone not as a device that itself shifts consciousness but as an agent in a media ecology co-constructed by the forces of use and design—a “crystallization of cultural practices” (Sterne). As such, mobile technology is continuously re-crystalised as design ‘constraints’ meet both normative and transgressive user approaches to interacting with everyday life. The concept of ‘social curation’ already exists in commercial discourse for social web marketing (O’Connell; Allton). High-traffic, wide-integration web services such as Digg and Pinterest, as well as older portals such as Reddit, all work on the principles of arranging user-generated, web-aggregated, and re-purposed content around custom themes. From a business perspective, the notion of ‘social curation’ captures, unsurprisingly, only the surface level of consumer behaviour rather than the kinds of values and meaning that this process holds for people. In the more traditional sense, art curation involves aesthetic, pragmatic, epistemological, and communication choices about the subject of (re)presentation, including considerations such as manner of display, intended audience, and affective and phenomenal impact. In his 2012 book tracing the discourse and culture of curating, Paul O’Neill proposes that over the last few decades the role of the curator has shifted from one of arts administrator to important agent in the production of cultural experiences, an influential cultural figure in her own right, independent of artistic content (88). Such discursive shifts in the formulation of ‘curatorship’ can easily be transposed from a specialised to a generalised context of cultural production, in which everyone with the technological means to capture, share, and frame the material and sensory content of everyday life is a curator of sorts. Each of us is an agent with a unique aesthetic and epistemological perspective, regardless of the content we curate. The entire communicative exchange is necessarily located within a nexus of new media practices as an activity that simultaneously frames a cultural construction of sensory experience and serves as a cultural production of the self. To return to the question of listening and a sound studies perspective into mediated cultural practices, technology has not single-handedly changed the way we listen and attend to everyday experience, but it has certainly influenced the range and manner in which we make sense of the sensory ‘everyday’. Unlike acoustic listening, mobile digital technologies prompt us to frame sonic experience in a multi-modal and multi-medial fashion—through the microphone, through the camera, and through the interactive, analytical capabilities of the device itself. Each decision for sensory capture as a curatorial act is both epistemological and aesthetic; it implies value of personal significance and an intention to communicate meaning. The occurrences that are captured constitute impressions, highlights, significant moments, emotions, reflections, experiments, and creative efforts—very different knowledge artefacts from those produced through textual means. Framing phenomenal experience—in this case, listening—in this way is, I argue, a core characteristic of a more general type of new media literacy and sensibility: that of multi-modal documenting of sensory materialities, or the curation of everyday life. 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