Topics: 1. Effect of Test Anxiety on Academic Performance among Medical Students
2. Ponzi schemes
- Your hard work has paid off (!!!), and you will use the following workshop activities completed in class to help you write your complete draft of your discussion section:
p. 17b – Think of this like your formal introduction into the Discussion section.
p. 17c – Summary of the foundation to your recommendation. (evidence-based)
p. 18a – Your actual recommendation. You will took at specific parts of the Foundation to the Recommendation and choose, at most, 3 specific parts to recommend. Define your chosen parts, and explain how it can serve a particular population/location ailed with the problem. Cite every step of the way.
YOU MUST USE THE “CHECK YOUR SIMILARITY HERE” FOLDER TO ENSURE NO PLAGAIRISM BEFORE SUBMITTING HERE FOR GRADING!Grading: MUST USE ALL ASPECTS OF APA-7
Create an APA-7-Compliant Title Page = 10 pts
p. 2 of the document must have a Level 1 Header – “Discussion” = 5 pts
Use p. 17b notes to write paragraph 1 = 15 pts
Use p. 17c notes to write paragraph 2 = 25 pts
Use p. 18a notes to write paragraph 3 = 25 pts
APA-7-Compliant References Page = 20 pts
Welcome Back!
Remember this?
Which parts have you done?
What comes NEXT?
What comes NEXT?
So, what do
you think the
Discussion
section of a
Research
Paper is for?
So, what do
you think the
Discussion
section of a
Research
Paper is for?
So, what do
you think the
Discussion
section of a
Research
Paper is for?
To definitely “discuss” something!
So, what do
you think the
Discussion
section of a
Research
Paper is for?
To definitely “discuss” something!
Varies depending on the course you are
taking and the requirements of the
professor
So, what do
you think the
Discussion
section of a
Research
Paper is for?
To definitely “discuss” something!
Varies depending on the course you are
taking and the requirements of the
professor
What is YOUR task in KG604?
So, what do
you think the
Discussion
section of a
Research
Paper is for?
To definitely “discuss” something!
Varies depending on the course you are
taking and the requirements of the
professor
What is YOUR task in KG604?
To find a problem to research and form a
recommendation based on evidence
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
Article found in Google
or database
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
Article found in Google
or database
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
Article found in Google
or database
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
Article found in Google
or database
Research
article
s (4)
found through library
databases
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
Article found in Google
or database
Research articles (4)
found through library
databases
What have you
done already?
KG 604’s TASK
Find a problem
Research
Form
Recommendation
HOW WAS IT ACHIEVED?
Article found in Google
or database
Research articles (4)
found through library
databases
Basis of KG 604’s Discussion will be your
Recommendation
But, you must
establish your
POINTS of
DISCUSSION
How?
You must
establish your
POINTS of
DISCUSSION
How?
In other classes, the Points of Discussion
might be related to a theory, framework,
or some type of concept associated with
the course, related to your research topic.
You must
establish your
POINTS of
DISCUSSION
How?
In other classes, the Points of Discussion
might be related to a theory, framework,
or some type of concept associated with
the course, related to your research topic.
The Discussion section of a paper is
typically the area where a student can
really show off their skills learned in the
course, because it includes deeper in-text
citation control and analyses.
So, what are points of
discussion that can be
applied to KG 604?
Do you
remember this
from Week 2?
Take a step back
and think as a
reader: What
makes logical
sense to include
in the Discussion
section of your
paper?
Take a step back
and think as a
reader: What
makes logical
sense to include
in the Discussion
section of your
paper?
Take a step back
and think as a
reader: What
makes logical
sense to include
in the Discussion
section of your
paper?
Take a step back
and think as a
reader: What
makes logical
sense to include
in the Discussion
section of your
paper?
Take a step back
and think as a
reader: What
makes logical
sense to include
in the Discussion
section of your
paper?
Approaching
the Discussion
in three (3)
powerful
paragraphs
Steps
Paragraph 1:
Summary of the
problem
Approaching
the Discussion
in three (3)
powerful
paragraphs
Steps
Paragraph 1:
Summary of the
problem
Achieved through…
A few options:
Approaching
the Discussion
Steps
Paragraph 1:
Summary of the
problem
Achieved through…
A few options:
Your news
article
Approaching
the Discussion
Steps
Paragraph 1:
Summary of the
problem
Achieved through…
A few options:
Your news
article
Supplemental
news articles
Approaching
the Discussion
Steps
Paragraph 1:
Summary of the
problem
Achieved through…
A few options:
Your news
article
Supplemental
news articles
Research from
your Literature
Review
Approaching
the Discussion
Steps
Paragraph 1:
Summary of the
problem
Achieved through…
A few options:
Your news article
Supplemental
news articles
Research from
your Literature
Review
However you get
there, CITE!!!
BUT, what
should
paragraph 1’s
Summary
entail?
(Points of
Summary)
Summarized through your new(s)
article(s) or research articles:
BUT, what
should
paragraph 1’s
Summary
entail?
(Points of
Summary)
Summarized through your new(s)
article(s) or research articles:
1. Restate the problem. CITE
BUT, what
should
paragraph 1’s
Summary
entail?
(Points of
Summary)
Summarized through your new(s)
article(s) or research articles:
1. Restate the problem. CITE
2. Where is it happening? (location) CITE
BUT, what
should
paragraph 1’s
Summary
entail?
(Points of
Summary)
Summarized through your new(s)
article(s) or research articles:
1. Restate the problem. CITE
2. Where is it happening? (location) CITE
3. And, what population(s) are affected by
the problem? CITE
BUT, what
should
paragraph 1’s
Summary
entail?
(Points of
Summary)
Summarized through your new(s)
article(s) or research articles:
1. Restate the problem. CITE
2. Where is it happening? (location) CITE
3. And, what population(s) are affected by
the problem? CITE
Did I mention that you must cite?
What should
paragraph 1’s
Summary
entail?
Summarized through your new(s)
article(s) or research articles:
1. Restate the problem. CITE
2. Where is it happening? (location) CITE
3. And, what population(s) are affected by
the problem? CITE
Did I mention that you must cite?
BUT, what
should
paragraph 1’s
Summary entail?
(Points of
Summary)
TASK: Open your Final ‘Mission’ Packet to p. 17b
Emoji when you’re ready!
Summarized through your new(s)
article(s) or research articles:
1. Restate the problem. CITE
2. Where is it happening? (location) CITE
3. And, what population(s) are affected by
the problem? CITE
Did I mention that you must cite?
Complete p. 17b (Final ‘Mission’
Packet) and SAVE your progress!
Break
Approaching
the Discussion
in three (3)
powerful
paragraphs
Steps
Notes for
Paragraph 1:
Summary of the
problem
Approaching
the Discussion
in three (3)
powerful
paragraphs
Steps
Notes for Paragraph
1: Summary of the
problem
PREPARE for
Paragraph 2:
Foundation of Your
Recommendation
What is a
“Foundation of
your
Recommendation”
????
What is a
“Foundation to the
Recommendation”
????
A recommendation that RESEARCH
SHOWS is effective
What kind of
research article
SHOWS/
REPORTS on
effectiveness
of an existing
‘solution’?
Basic?
Applied
?
What kind of
research article
SHOWS/
REPORTS on
effectiveness
of an existing
‘solution’?
Basic Applied
What kind of
research article
SHOWS/
REPORTS on
effectiveness
of an existing
‘solution’?
Basic
Gathers details of a
topic
Demographics
Locations
Etc.
Will make some
type of
recommendation
for the future
Applied
What kind of
research article
SHOWS/
REPORTS on
effectiveness
of an existing
‘solution’?
Basic
Gathers details of a
topic
Demographics
Locations
Etc.
Will make some
type of
recommendation
for the future
Applied
What kind of
research article
SHOWS/
REPORTS on
effectiveness
of an existing
‘solution’?
Basic
Gathers details of a
topic
Demographics
Locations
Etc.
Will make some
type of
recommendation
for the future
Applied
Gathers data on how
an implemented
solution is performing
Will look at a
specific program
or policy
Analyzes the
effectiveness of
explored policy or
program
What kind of
research article
SHOWS/
REPORTS on
effectiveness
of an existing
‘solution’?
Basic
Gathers details of a
topic
Demographics
Locations
Etc.
Will make some
type of
recommendation
for the future
Applied
Gathers data on how
an implemented
solution is performing
Will look at a
specific program
or policy
Analyzes the
effectiveness of
explored policy or
program
Did you include an applied
research article in your
Literature Review?
Did you include an applied
research article in your
Literature Review?
YES! But, you should not worry if you do not
have one!
Did you include an applied
research article in your
Literature Review?
YES! But, you should not worry if you do not have
one! Because, we will work on this today!
Approaching
the Discussion
in three (3)
powerful
paragraphs
Steps
Notes for Paragraph
1: Summary of the
problem
PREPARE for
Paragraph 2:
Foundation of your
recommendation
Your Focus:
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for Paragraph
1: Summary of the
problem
PREPARE for
Paragraph 2:
Foundation of your
recommendation
Your Focus:
What is an existing
policy, program, or
organization/company
that has shown success
in mitigation of this
problem?
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for Paragraph
1: Summary of the
problem
PREPARE for
Paragraph 2:
Foundation of your
recommendation
Your Focus:
What is an existing
policy, program, or
organization/company
that has shown success
in mitigation of this
problem?
(perhaps featured in
your applied research
article, so be sure to
LOOK!)
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for Paragraph
1: Summary of the
problem
PREPARE for
Paragraph 2:
Foundation of your
recommendation
Your Focus:
What is an existing
policy, program, or
organization/company
that has shown success
in mitigation of this
problem?
Let’s go!
“Guidance to Finding Foundation to
Recommendation” p. 18 in Final ‘Mission’
Packet
Your Task: Find an
evidence-based
recommendation
1) Look at your
applied/basic
research articles
Your Task: Find an
evidence-based
recommendation
1) Look at your
applied/basic
research articles
-or-
2) Conduct new
research
Your Task: Find an
evidence-based
recommendation
1) Look at your
applied/basic
research articles
Your Task:
Research
Look for hints in
your Literature
Review’s
recommendations
Find a policy, program, organization/company,
or law that is doing a good job trying to solve this
problem (this could be from another state or even
country where populations are comparable).
Google or Library Databases
Your Task:
Research
Look for hints in
your Literature
Review’s
recommendations
Find a policy, program, organization/company,
or law that is doing a good job trying to solve this
problem (this could be from another state or even
country where populations are comparable).
Google or Library Databases
Your Task:
Research
Look for hints in
your Literature
Review’s
recommendations
Find a policy, program, organization/company, or law
that is doing a good job trying to solve this problem (this
could be from another state or even country where
populations are comparable).
Google or Library Databases
*Source must have evidence that the
company/organization/policy has made an impact
toward mitigating the problem.*
Complete your points
of summary–
p. 17c & SAVE
Paragraph 3 next time!
To Blackboard!
Welcome Back!
Approaching
the Discussion
in 3 paragraphs
Steps
Achieved Through…
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for
Paragraph 1:
Summary of the
problem
Achieved Through…
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for
Paragraph 1:
Summary of the
problem
Achieved Through…
Activity: p. 17b
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for
Paragraph 1:
Summary of the
problem
Notes for
Paragraph 2:
Foundation of Your
Recommendation
Achieved Through…
Activity: p. 17b
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for
Paragraph 1:
Summary of the
problem
Notes for
Paragraph 2:
Foundation of Your
Recommendation
Achieved Through…
Activity: p. 17b
Activity: p. 17c
Approaching
the Discussion
in 3 paragraphs
Steps
Notes for
Paragraph 1:
Summary of the
problem
Notes for
Paragraph 2:
Foundation of Your
Recommendation
What About
Paragraph 3?
Achieved Through…
Activity: p. 17b
Activity: p. 17c
The Discussion’s
paragraph 3, for
KG 604, you
develop your
recommendation
The Discussion’s
paragraph 3, for
KG 604, you
develop your
recommendation
Use the policy, program, or
organization/company, found last class as a basis
for your recommendation (you do not need to use
the ENTIRE existing policy, program,
organization/company, or law; pick 1-3 points to
adopt and form your recommendation [CITE]).
The Discussion’s
paragraph 3, for
KG 604, you
develop your
recommendation
Use the policy, program, or organization/company
found last class as a basis for your recommendation
(you do not need to use the ENTIRE existing policy,
program, organization/company, or law; pick 1-3
points to adopt and form your recommendation
[CITE]).
Connect this recommendation to the research
problem:
The Discussion’s
paragraph 3, for
KG 604, you
develop your
recommendation
Use the policy, program, or organization/company
found last class as a basis for your recommendation
(you do not need to use the ENTIRE existing policy,
program, organization/company, or law; pick 1-3
points to adopt and form your recommendation
[CITE]).
Connect this recommendation to the research
problem:
How do you see it working toward mitigation of
the problem?
The Discussion’s
paragraph 3, for
KG 604, you
develop your
recommendation
Use the policy, program, or organization/company
law found last class as a basis for your
recommendation (you do not need to use the
ENTIRE existing policy, program,
organization/company, or law; pick 1-3 points to
adopt and form your recommendation [CITE]).
Connect this recommendation to the research
problem:
How do you see it working toward mitigation of
the problem?
For example, if Apple is doing really well
tackling a problem that Google is challenged
with, you could suggest to Google to adopt a
strategy used by Apple. Connect the dots for
the reader. Be specific. What should be done?
Your Tasks:
#1
#2
Begin to write the
draft of your
Discussion (Week 9
HW folder)
Use the policy, program, or organization/company
law found last class as a basis for your
recommendation (you do not need to use the
ENTIRE existing policy, program,
organization/company, or law; pick 1-3 points to
adopt and form your recommendation [CITE]).
Connect this recommendation to the research
problem:
How do you see it working toward mitigation of
the problem?
For example, if Apple is doing really well
tackling a problem that Google is challenged
with, you could suggest to Google to adopt a
strategy used by Apple. Connect the dots for
the reader. Be specific. What should be done?
Final ‘Mission’ Packet!
p. 18a – SAVE your
progress!
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 1
Racial Disparities in Healthcare Among Pregnant Women in the United States
Tamifer Lewis
Department of Public Health, Monroe College, King Graduate School
KG604-144: Graduate Research and Critical Analysis
Dr. Manya Bouteneff
December 4, 2022
I attest that I have used the checklist on pages 71-78 of my manual
I attest that I passed this paper through the free version of Grammarly
I attest that I incorporated ALL feedback from all previous assignments to make this paper
SHINE
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 2
Racial Disparities in Healthcare Among Pregnant Women in the United States
Introduction
African American, American Indian, and Alaska Native women are up to three times
more likely to die from adverse pregnancy related outcomes, a disparity that increases with age
(Centers for Disease Control and Prevention [CDC], 2019). Researchers found a program which
provided support to African American women through group trainings, entailing of stress
reduction techniques, life skills development, and the building of social support. This enabled
mitigation efforts to be focused and geared around the factors that influence and contributed to
adverse pregnancy outcomes among the minority women within the community, thus reducing
and preventing negative pregnancy outcomes in women of color. In the United States, maternal
mortality and adverse health outcomes persist within the minority community, yet as racial
disparities in healthcare among pregnant women is a current preventable public health concern, it
is vital to understand the determinants of health that influences negative pregnancy related
outcomes in minority women, similar to one of California’s intervention programs, the Black
Infant Health Program (Nichols & Cohen, 2019).
Literature Review
Introduction to Literature Review
Research suggests that racial disparities in healthcare among pregnant women persists in
the United States (Zhang et al., 2013). Due to this continuous occurrence, it is vital to examine
the factors that contribute to the adverse outcomes in maternal health. The literature review
contained only research articles about factors that impacted and influenced disparities in
pregnancy outcomes. Factors that were reviewed were socioeconomic status, public health
insurance, race/ethnicity, and poverty status. The literature review was conducted using EBSCO
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 3
Host and ProQuest databases from the Monroe College Library. The search terms used to
compile pertinent articles were racial disparities maternal health, adverse pregnancy outcomes,
and maternal health outcomes.
Review of Literature
Adverse Pregnancy Outcome Factors
Darling et al. (2021) conducted a study between 2001 and 2018 to examine the efficiency
of qualified interventions in preterm birth, small for gestational age, low birth weight, neonatal
death, cesarean deliveries, maternal care satisfaction, and coast effectiveness programs. A
systematic review was used to collect data from the United States, France, Spain, and the
Netherlands. The studies consisted of mostly non- Caucasian women from low-income
population ranging from 12 to 46 years of age and being between 20 to 32 weeks’ gestation.
Interventional programs were implemented into three categories: group prenatal care, augmented
prenatal care, or a combination of both group and augmented prenatal care (Darling et
al., 2021).
The researchers found that certain interventions, such as prenatal care and augmented care, or a
combination of both, may decrease adverse outcomes in small-for-gestational-age and preterm
birth, and could aid in increasing maternal care satisfaction. Interventions that worked on
enhancing coordination of care were found to result in providing more effective cost savings.
The researchers also found disparities in the quality of access to care in the vulnerable
population. There was insufficient evidence of suitable quality to confirm that the interventions
were successful at enhancing clinical outcomes in prenatal care for at risk populations (Darling et
al., 2021).
Similar observations were made in a study conducted by Nichols and Cohen (2020),
between 2006 and 2018 to examine the methods used to improve the results of maternal
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 4
mortality in California. The study was conducted using a scoping review to evaluate research on
women and maternal health in the United States. The researchers used information from the US
Maternal Fetal Medicine Network to measure the percentage of studies where pregnant women,
women, and children were the main focus. The researchers also reviewed documentation on
healthcare policies and practices from California’s public health department, healthcare
foundation, and Maternal Quality Care Collaborative. Nichols and Cohen (2020) found that
although the health of fetus and children could be adversely affected by the health of the mother,
the majority of maternal programs in the United States places emphasis on the child. The
researchers also found four areas of concern in women health experiences, both in pre and
postnatal care. The problem areas entailed inadequate investment in women’s health, inefficient
quality of care and avoidable caesarean delivers, expanding disparities in minority women and
women living in rural areas, and contradictory collection and distribution of data (Nichols &
Cohen, 2020).
Approaches to Improving Pregnancy Outcomes
In contrast to the preceding studies, Zhang et al. (2013) conducted a study between 2005
and 2007 to calculate the excessive rate of unfavorable outcomes in pregnancy within racial and
ethnic groups. The study also aimed to measure the possibility of Medicaid savings that are
linked to paid maternal care claims resulting from the inequalities that contribute to unfavorable
maternal outcomes. A cross-sectional study using Medicaid Analytic eXtract (MAX) data was
used to gather pregnancy outcome information from inpatient hospitals from 14 states (Florida,
Alabama, Arkansas, North Carolina, Georgia, Louisiana, Kentucky, Mississippi, Maryland,
Missouri, Tennessee, South Carolina, Virginia, and Texas). The study consisted of a little over 2
million patients who were insured with Medicaid and had a delivery code of maternal delivery
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 5
stay. Zhang et al. (2013) found that, with the exception of gestational diabetes, African American
women showed the worst outcomes out of all unfavorable pregnancy outcomes. These disparities
are postulated as being multi-factorial, having causes stemming from complicated experiences
with racism, poverty, and complex healthcare interactions. It was also found that women covered
under Medicaid health insurance were more likely to have consistency in care from prenatal care
through delivery compared to their counterparts. However, due to participation in Medicaid
programs being influenced by reimbursement rates, some providers may choose to stop
accepting Medicaid patients because of reimbursement delays and low payment rates, which
could contribute to negative birth outcomes (Zhang et al., 2013).
Analysis of Literature
In the United States, the persistence of maternal mortality continues to be a problem area
in public health. The contributing factors that impact pregnancy outcomes persist in burdening
the U.S., leading to poor healthcare quality, and increasing health disparities. The studies used in
this literature review each used a different form of research methodology to collect data,
including systematic and scoping reviews and cross-sectional studies. Similarly, Darling et al.
(2021), Nichols and Cohen (2020), and Zhang et al. (2013) have emphasized the correlation
between race/ethnicity and financial status playing a part in influencing quality of care, access of
care, and pregnancy outcomes in pregnant minority women. To mitigate the disparities in
maternal health Darling et al. (2021) and Zhang et al. (2013) suggested that interventions should
be inspected and geared towards determining and eradicating the racial and ethnic disparities that
affect pregnancy-related outcomes. Whereas Nichols and Cohen (2020) suggested focusing on
exploring the distinctive experiences of particular at-risk subgroups of women, such as women in
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 6
prison, who are of childbearing age, and the pregnant women who are less likely to pursue
prenatal care, such as undocumented women.
Discussion
Introduction to Discussion
There is current evidence that racial disparities in healthcare among pregnant women
continues to be a problem in the United States. In an article published by The New York Times
(Rabin, 2019), there has been a persistence and growth in racial disparity throughout the years
despite calls to take action to improve medical care access for women of color. Similarly, in a
study conducted by Nichols and Cohen (2019) mounting disparities continue amid women health
outcomes in the United States, primarily among race and ethnicity and within residents living in
urban and rural areas (Nichols & Cohen, 2019). These disparities directly affect African
American, Alaska Native and Native American Women (Rabin, 2019). When compared to other
high-income countries, the United States has substandard records in maternal health outcomes,
and while the rate of maternal mortality dropped across the world, America’s maternal health
outcomes have worsened (Rabin, 2019).
Evidence-Based Recommendation
To reduce the disparities among minority women policy changes have been made.
Federal law enacted the Preventing Maternal Death Act providing states with grants to explore,
examine and investigate pregnancy related deaths for up to one year after the birth of a child
(Rabin, 2019). Also, The American College of Obstetrics and Gynecologists created new
guidelines in treating cardiovascular disease in pregnant women (Rabin, 2019). In 2014 Alliance
for Innovation on Maternal Health (AIM) was developed by the American College of Obstetrics
and Gynecology to collaborate with partners of the states and hospitals to gather information on
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 7
safety measures being taken to improve maternal health outcomes, allowing partners to assess
and track program progress (Nichols & Cohen, 2019). In the study conducted by Nichols and
Cohen (2019), two out of the various programs that California implemented were the Black
Infant Health Program (BIH) and increasing the states income eligibility for pregnant women to
200% of the federal poverty level. With the implementation of these programs, mortality rates
decreased from 22.1% to 8.3% in the best practices toolkit, a program developed for hemorrhage
and high blood pressure during pregnancy. Altogether, California’s maternal mortality rate
decreased by above 50% between 2006 and 2018 (Nichols & Cohen, 2019). To prevent negative
pregnancy outcomes in women of color, California used federal funds to develop programs that
focused on African American mothers and the health determinants that are influenced by social
and structural factors. The Black Infant Health Program provided support to African American
women through group trainings, entailing of stress reduction, life skills development, and
building social support (Nichols & Cohen, 2019). Nearly half of the babies born in the United
States are insured under Medicaid which covers the child through the first year of life. However,
in most states, Medicaid provides coverage for the mother until 60 days postpartum, after which
the mother must meet the federal poverty level to be eligible for coverage (Nichols & Cohen,
2019). This exposes the mother to various risks that can adversely affect her health. Expanding
Medicaid access would mitigate the maternal healthcare barriers that affect low socioeconomic
minority women.
Racial disparities in maternal healthcare are a persistent problem in the United States.
African American mothers experience higher adverse pregnancy outcomes and are less likely to
obtain sufficient prenatal care when compared to Caucasian women (Zhang et al., 2013).
Similarly, racial disparities among women of color are made worse by partialities in the
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 8
healthcare that they receive (Nichols & Cohen, 2019). To mitigate racial disparities in maternal
health among minority women it is important to understand the determinants that contribute to
their health outcomes. With increased federal funding, programs can be geared towards
providing quality care to women of color. This can be established by utilizing specific methods
of care that are relatable to those being serviced in the community, providing them with medical
professionals that are culturally competent and adequately trained in servicing underserved
communities, fostering a trusting provider-patient relationship. Nichols and Cohen (2019)
suggest that funding should be used to address the social factors that influence maternal health to
reduce the psychosocial risks in women who may be more vulnerable to adverse pregnancy
outcomes. The pregnancy-related risks of a mother do not end after her child’s birth. The
expansion of Medicaid access and coverage would provide a mother with the means of receiving
adequate care during all stages of pregnancy and during the postpartum period, in which she can
still be adversely affected from her pregnancy. It is vital for the federal government to enact
policies requiring states to provide medical coverage to women for one year after the birth of
their child. Providing coverage to various specialties would ensure the mother has efficient
access to care should adverse symptoms develop. Nichols and Cohen (2019) postulated that state
programs should expand Medicaid coverage for women focusing on their healthcare needs
before, during and after pregnancy, paying close attention to women’s health and chronic disease
management, especially to those who have or had high risk pregnancies. Implementing these
programs would develop a foundation in the quality of racial maternal care across all states and
provide cohesion and uniformity in the delivery of care.
Conclusion
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 9
As seen in one of California’s intervention programs, the Black Infant Health Program
(Nichols & Cohen, 2019), a program which provided support to African American women
through group trainings, which entailed stress reduction techniques, life skills development, and
the building of social support enabled mitigation efforts to be focused and geared around the
influencing factors that contributed to adverse pregnancy outcomes among the minority women
within the community, thus reducing and preventing negative pregnancy outcomes in women of
color. African American, American Indian, and Alaska Native women are up to three times more
likely to die from adverse pregnancy related outcomes, a disparity that increases with age (CDC,
2019). In the United States, maternal mortality and adverse health outcomes persist within the
minority community and as a result racial disparities in healthcare among pregnant women is a
current preventable public health concern, therefore it is vital to understand the determinants of
health that influences negative pregnancy related outcomes in minority women.
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 10
References
Centers for Disease Control and Prevention. (2019, September 6). Racial and ethnic disparities
continue in pregnancy-related deaths. CDC.
https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-
deaths.html
Darling, E. K., Cody, K., Meara Tubman-Broeren, & Marquez, O. (2021). The effect of prenatal
care delivery models targeting populations with low rates of PNC attendance: A
systematic review. Journal of Health Care for the Poor and Underserved, 32(1), 119-
136. https://www.proquest.com/scholarly-journals/effect-prenatal-care-delivery-models-
targeting/docview/2507722229/se-2
Nichols, C. R., & Cohen, A. K. (2021). Preventing maternal mortality in the United States:
Lessons from California and policy recommendations. Journal of Public Health Policy,
42(1), 127-144. https://doi.org/10.1057/s41271-020-00264-9
Rabin, R. C. (2019, May 8). Huge racial disparities persist in pregnancy-related deaths, and are
growing. New York Times, A20(L).
https://link.gale.com/apps/doc/A584694288/ITOF?u=nysl_me_moncol&sid=bookmark-
ITOF&xid=b9422ff9
Zhang, S., Cardarelli, K., Shim, R., Ye, J., Booker, K. L., & Rust, G. (2013). Racial disparities in
economic and clinical outcomes of pregnancy among Medicaid recipients. Maternal and
Child Health Journal, 17(8), 1518+.
https://link.gale.com/apps/doc/A344827866/PPNU?u=nysl_me_moncol&sid=bookmark-
PPNU&xid=51747d52
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2 Use a Level 1 Heading for “Discussion” and reintroduce
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Resources on
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7 Submit your Draft of the Discussion Submission
1
Literature Review: Effect of Test Anxiety on Academic Performance among Medical Students
Student’s name
Professor’s name
Course title
Institution
Date
Test Anxiety among Medical Students
Introduction to Literature Review
Test anxiety affects up to 40% of the entire student population, with medical school most affected because it features one of the more intensive and involving education programs that students pursue (Maier et al., 2021). Overall, it is normal for students to feel some level of anxiety or stress in relation to examinations. There is healthy anxiety which does not have significant implications on the outcomes of tests. However, at very high levels, anxiety potentially affects the learning process and the performance of students on their tests (Maier et al., 2021). Given the common nature of test anxiety among medical students, it is integral to examine the impact that the anxiety has on students’ performance. The literature review features articles that are established the role that test anxiety plays in the test outcomes of medical students. The focus articles included factors that are relevant to the development of test anxiety, including age, gender, year of study, family, and course load. The databases that were utilized in the search for literature included PubMed, PubMed Central (PMC), Cochrane, and EMBASE. The focus of the search was India. The search terms that were utilized were test anxiety, medical students, and test and exam performance.
Review of Literature
The Relationship Between Test Anxiety and Academic Performance
Jha et al. (2019) researched the association between test anxiety and students’ academic performance. The researchers in the study were associated and assistant professors working in the Department of Community Medicine, BPS Government Medical College for Women. The study was conducted from January 2018 to December 2018. Jha et al. (2019) applied a cross-sectional study design to investigate the existing relationship between test anxiety and academic performance. Data was collected from Khanpur Kalan, Sonepat, a province in India, and the government school’s location. The students who were involved in the study featured individuals who had been enrolled in the school in the period between 2013 and 2017. Students from the first to the final year of the study were integrated into the study. Through the use of a pre-designed and pre-tested questionnaire, the researchers obtained associated with socio-demographic characteristics and end-year academic performance. Jha et al. (2019) found out that there while about a quarter of the students (26.3) did not suffer from anxiety, approximately 63% of students experienced healthy anxiety, while 10.8% had unhealthy test anxiety. The results showed that students with higher anxiety levels had a lower academic performance. The researchers also found out that students from rural areas were more likely to experience both healthy and healthy anxiety. The type of family, religion, and occupation, and level of education of parents did not yield a significant correlation between high anxiety levels and students’ performance (Jha et al. (2019).
The Correlation Between Test Anxiety and the Outcomes of the Tests
Semwal et al. (2022) also conducted their study on the correlation between test anxiety and the outcomes of the tests. Unlike the findings from the study by Jha et al. (2019), the research conducted by Semwal et al. (2022) did not find a connection between test anxiety and the performance of students. The latter conducted their study on undergraduate medical students between the 2016 and 2020 academic years through the use of a cross-sectional study design. The study was carried out at All India Institute of Medical Science, Rishikesh, Uttarakhand, India. Semwal et al. (2022) used self-administered questionnaires to gauge students’ performance in their final exams. They also used the perceived stress scale to measure stress levels, the Ten Item Personality Inventory to assess anxiety among the students, and the Pittsburgh sleeps quality index for evaluation of sleep quality. The study found no significant correlation between anxiety trait personality and students’ academic performance. In addition, there was no significant association between perceived stress, sleep quality, and academic performance. In consideration of other variables, correlates such as gender, monthly family income, religion, place of residence, education of the head of the family, and caste showed significant association with the academic performance of students Semwal et al. (2022). On the other hand, correlates that included the occupation of the head of the family, coaching for entrance, having doctors in the family, sibling pursuing medical study, handedness, and knowledge of language did not show any significant relationship with the academic performance of the students who partook in the study Semwal et al. (2022).
How Test Anxiety affect Performance of Students
Similar to studies by Jha et al. (2019) and Semwal et al. (2022), the research by Loya & Jiwane (2019) was also conducted in a government medical school in India, Government Medical College and Hospital Chandrapur, Maharashtra, India. Loya & Jiwane (2019) also investigated the relationship between test anxiety and the performance of students. Like Jha et al. (2019), Loya & Jiwane (2019) found out that exam anxiety was associated with poorer academic performance amongst the participant students. Loya & Jiwane (2019) conducted their study through an observational cross-sectional study carried out between June 2018 to June 2019. The researchers found out that the majority of students felt that anxiety affected their level of performance. While some of the students had the opinion that anxiety improved their performance, most of them expressed that it resulted in the deterioration of their performance. The anxiety came in the form of trouble sleeping, sweaty and shaky hands, palpitations, and deciding the correct answers. The researchers also determined that most students’ common means of anxiety alleviation were listening to music, watching TV, exercising, taking beverages, taking breaks, browsing the internet, doing yoga/meditation, and playing games.
Analysis of Literature
Across medical institutions in India, the issue of test anxiety is a significant problem and has implications for student’s performance for the most part. The main factors associated with anxiety and the impact that this has on the test outcomes include gender, year of study, area of residence, type of family that students come from, the level of education, and occupation of parents. All articles that have been incorporated in the literature review applied cross-sectional study designs to conduct with the minor difference between Loya & Jiwane (2019), who applied observational cross-sectional design, unlike Semwal et al. (2022), who utilized descriptive design. Each research was based on a different institution, which was an integral factor in providing a more informed perspective on medical students and how exam anxiety affects them. The studies showed that there was an apparent correlation between test anxiety and academic performance. However, Semwal et al. (2022) found that there was no significant correlation between anxiety and test outcomes. What was also common across the studies by Jha et al. (2019) and Loya & Jiwane (2019) is that anxiety does not always lead to poor performance though only a minority of students expressed that anxiety helped improve their performance levels. Jha et al. (2019) and Loya & Jiwane (2019) provided perspectives on different kinds of anxieties, which further helped in showing the association that the trait has with academic performance. Consideration of healthy and unhealthy anxieties was influential in better understanding how students react to tests, as the latter form of anxiety is more likely to be tied to poor academic performance.
While there was uniformity between Jha et al. (2019) and Loya & Jiwane (2019) in regards to high levels of anxiety being associated with worse student performance, the statistics on the rate of anxiety amongst students and the impact that the characters had on the performance of students varied across the articles. This could be the result of the use of different measurement instruments, student samples, and the difference in settings. Both Jha et al. (2019) and Loya & Jiwane (2019) utilized the Nist and Diehl test anxiety questionnaire but had varied student samples (240 students and 387 students, respectively. Semwal et al. (2022) applied a different statistical tool (IBM SPSS Statistics version 23 SPSS South Asia Pvt Limited) from that utilized by Jha et al. (2019) (Statistical software R v 3.5.1). On the other hand, Loya & Jiwane (2019) used Epi info7 software. The variation in the statistical analysis could be a factor in the differences in outcomes.
A key variation between the articles included the incorporation of some variables or correlates, which were not common across all studies. Semwal et al. (2022) factored in coaching, having a doctor in the family, and knowledge of the English language in addition to other variables such as age, area of residence, and year of study. Only Loya & Jiwane (2019) covered the role of intervening methods such as yoga/meditation, leisure, and physical activities. The study indicated the impact of the interventions and students’ personal preferences. Another difference was discernible in the study by Jha et al. (2019), as they showed that students in rural regions are more likely to experience test anxiety. Overall, the articles showed that test anxiety is a major factor among medical students, and the problem has significant implications for test outcomes. All researchers expressed the need for early interventions to minimize test anxiety’s potential impact.
References
Jha, Dr, S., S. K., Punia, A., & Babita, B. (2019). The relationship between test anxiety and academic performance among undergraduate medical students: A cross-sectional study.
SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3358112
Loya, N. S., & Jiwane, N. N. (2019). Exam Anxiety in Professional Medical Students.
International Journal of Innovative Science and Research Technology, 2456-2165. https://www.ijisrt.com/assets/upload/files/IJISRT19AUG681
Maier, A., Schaitz, C., Kröner, J., Berger, A., Keller, F., Beschoner, P., & Sosic-Vasic, Z. (2021). The association between test anxiety, self-efficacy, and mental images among university students: Results from an online survey.
Frontiers in Psychiatry, 2179. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.618108/full
Semwal, P., Kumari, R., Rawat, V. S., Aravindan, N., & Dhankar, A. (2022). Psychological and other Correlates of Academic Performance in Medical Students at a Tertiary Care Hospital: A Cross-Sectional Study.
Indian Journal of Community Medicine,
47(3), 364-368. doi.10.4103/ijcm.ijcm_1067_21
2
The Literature Review Section
Student’s name
Professor’s name
Course title
Institution
Date
The Literature Review Section
Introduction
Cryptocurrency swindling is increasingly becoming an international concern, with numerous sources indicating a rise in the occurrence and losses from cryptocurrency fraud (Trozze et al., 2022). Due to the rise in of cryptocurrency fraud there is need to research on common issues and ponzi schemes related to cryptocurrency and how the cases can be minimized. The literature review contained only research articles about ponzi schemes in relation to cryptocurrency. Factors that were reviewed by the research articles were blockchain fraud, pseudo-anonymity, fraudulent behavior, smart Ponzi contracts, Ethereum security, and top influencer on blockchain fraud. The literature review was conducted using EBSCO Host, Gale and ProQuest databases from the Monroe College Library. The search terms used to compile pertinent articles were blockchain fraud, Ponzi schemes in Ethereum, fraud in cryptocurrency, blockchain technology, and cryptocurrency and security.
Review of Literature
Ponzi Schemes on Ethereum
Galletta & Pinelli (2023) conducted a study about Ethereum blockchain between January 2015 and January 2019 in Italy. The researchers collected data on all Ethereum transactions during this period and filtered it to identify transactions that were associated with known Ponzi schemes. The study was completed with the purpose of improving the detection and prevention of Ponzi schemes and other types of financial fraud in the cryptocurrency market. The researchers hoped to learn more about the key factors that contribute to the success of Ponzi schemes in the cryptocurrency market and to develop a machine learning algorithm that could detect fraudulent activity in real-time. The researchers used a variety of data analysis and machine learning techniques to identify patterns and trends in the data, including clustering analysis, classification algorithms, and graph-based analysis. They found that there were several key features that were common to most Ponzi schemes on the Ethereum blockchain, including high rates of return, short-term contracts, and referral programs (Galletta & Pinelli, 2023). The study found that machine learning algorithms can be effective in detecting Ponzi schemes on the Ethereum blockchain, and that this approach could be used to improve the detection and prevention of financial fraud in the cryptocurrency market.
Similar observations were made by He et al. (2022) in a study in China about Ethereum blockchain. The study was completed with the purpose of developing a tool for identifying Ponzi schemes on the Ethereum blockchain. The researchers hoped to learn more about the characteristics of Ethereum-based Ponzi schemes and to develop a system that could automatically detect these schemes in real-time. The data used in the study was collected from the Ethereum blockchain between August 2017 and August 2018. The researchers collected data on all smart contracts deployed on the Ethereum blockchain during this period and filtered it to identify contracts that exhibited Ponzi scheme characteristics. The researchers used a variety of data analysis and machine learning techniques to identify patterns and trends in the data, including clustering analysis, feature selection, and classification algorithms. They found that Ethereum-based Ponzi schemes typically had a large number of participants, high rates of return, and used a multi-level referral system to attract new investors (He et al., 2022). The researchers developed a tool called CTRF (Contractor Trust Rank Factor) that uses machine learning algorithms to automatically detect Ethereum-based Ponzi schemes.
Prevention and detection of financial crime
Phan et al. (2019) researched the blockchain issue and what scams blockchain users endure when using such technology. The three authors are qualified to be in the study because they are members of Bryant University. Since several individuals and companies globally are moving to a new cashless payment method of crypto, the researchers wanted to discover the fraudulent problems involved. The authors purposed to review the issue of cryptocurrency and how enterprises are adopting this new method of making payments. Phan et al. (2019) conducted this research in the year 2018 after having to collect Twitter data from November to December. The research had no based geographical boundaries as the data in use came from various sources across the globe. The researchers used Twitter as a social media platform to gather data from tweets that mentioned the keywords of the study. The researchers wanted to contribute to the research surrounding blockchain technology and using bitcoin to make payments. The researchers were determining the kinds of scams that cryptocurrency users face when dealing with that means of payment. The research found that fraud in this new payment method was rampant in first-world nations that deeply use it.
Trozze et al. (2022) completed a study with the purpose of identifying the key risks and challenges associated with cryptocurrencies and financial crime and to explore potential solutions and best practices for addressing these challenges. The researchers hoped to learn more about the ways in which cryptocurrencies are being used for criminal activities, including money laundering, terrorist financing, and Ponzi schemes (Trozze et al., 2022). The study was conducted between 2013 and 2018. The data used in the study was drawn from various sources, like academic sources, government reports, industry publications, and case studies. The researchers analyzed this data to identify common themes and trends related to cryptocurrency and financial crime.
The study found that cryptocurrencies present significant risks and challenges to the prevention and detection of financial crime, particularly due to the anonymity and decentralization of blockchain technology. The researchers identified several areas where improvements are needed, including greater regulation and oversight, improved detection and monitoring capabilities, and enhanced collaboration between law enforcement agencies and the cryptocurrency industry.
Analysis of Literature
Cases of Ponzi Schemes in relation to Cryptocurrency continue to rise. Factors like lack of regulation, pseudonymity, new technology, hype and speculation, greed, and lack of transparency are some of the factors contributing to the rise in ponzi schemes. Both He et al. (2022) and Galletta & Pinelli (2023) used experimental methodology for the study. The other studies used in this literature review used a different form of research methodology to collect data, including observation and use of systematic review. Galletta & Pinelli (2023) used open source similar to He et al. (2022). On the other hand, Phan et al. (2019) used social media (Twitter) whereas Trozze et al. (2022) used publication databases. All the studies indicated that fraud in relation to cryptocurrency has been on the rise. While the findings from all studies pointed to the rise in crypto scams, they featured variations in their focus points. While Trozze et al. (2022) focused on classifying the frequency of different forms of crypto fraud, including Ponzi schemes and market manipulation, Galletta and Pinelli (2023) and He et al. (2022) on the other hand only focused on Ponzi schemes and smart Ponzi contracts associated with Ethereum. The study by Phan et al. (2019) was also different from the other research in that their findings featured coverage of scams and fraud in general. To reduce the cases of ponzi schemes in relation to cryptocurrency He et al. (2022), Phan et al. (2019), and Trozze et al. (2022) suggested that more research should be conducted to aid the understanding or detection, and prevention of crypto fraud whereas Galletta & Pinelli (2023) suggested a further step which was developing a model for classifying and detecting different forms of cryptocurrency fraud.
References.
Galletta, L., & Pinelli, F. (2023). Sharpening Ponzi Schemes Detection on Ethereum with Machine Learning.
arXiv preprint arXiv:2301.04872.
https://arxiv.org/pdf/2301.04872
He, X., Yang, T., & Chen, L. (2022). CTRF: Ethereum-Based Ponzi Contract Identification.
Security and Communication Networks,
2022.
https://doi.org/10.1155/2022/1554752
Phan, L., Li, S., & Mentzer, K. (2019). Blockchain technology and the current discussion on fraud.
https://digitalcommons.bryant.edu/cgi/viewcontent.cgi?article=1027&context=cisjou\
Trozze, A., Kamps, J., Akartuna, E. A., Hetzel, F. J., Kleinberg, B., Davies, T., & Johnson, S. D. (2022). Cryptocurrencies and future financial crime.
Crime Science,
11, 1-35.
https://doi.org/10.1186/s40163-021-00163-8
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