24 results
Abnormalities in serum biomarkers correlate with lower cardiac index in the Fontan population
- Bradley S. Marino, David J. Goldberg, Adam L. Dorfman, Eileen King, Heidi Kalkwarf, Babette S. Zemel, Margaret Smith, Jesse Pratt, Mark A. Fogel, Amanda J. Shillingford, Barbara J. Deal, Anitha S. John, Caren S. Goldberg, Timothy M. Hoffman, Marshall L. Jacobs, Asher Lisec, Susan Finan, Lazaros K. Kochilas, Thomas W. Pawlowski, Kathleen Campbell, Clinton Joiner, Stuart L. Goldstein, Paul Stephens, Jr, Alvin J. Chin
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- Journal:
- Cardiology in the Young / Volume 27 / Issue 1 / January 2017
- Published online by Cambridge University Press:
- 05 July 2016, pp. 59-68
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Background
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and resultsThis study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
ConclusionsHigher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. 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Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- By Rony A. Adam, Gloria Bachmann, Nichole M. Barker, Randall B. Barnes, John Bennett, Inbar Ben-Shachar, Jonathan S. Berek, Sarah L. Berga, Monica W. Best, Eric J. Bieber, Frank M. Biro, Shan Biscette, Anita K. Blanchard, Candace Brown, Ronald T. Burkman, Joseph Buscema, John E. Buster, Michael Byas-Smith, Sandra Ann Carson, Judy C. Chang, Annie N. Y. Cheung, Mindy S. Christianson, Karishma Circelli, Daniel L. Clarke-Pearson, Larry J. Copeland, Bryan D. Cowan, Navneet Dhillon, Michael P. Diamond, Conception Diaz-Arrastia, Nicole M. Donnellan, Michael L. Eisenberg, Eric Eisenhauer, Sebastian Faro, J. Stuart Ferriss, Lisa C. Flowers, Susan J. Freeman, Leda Gattoc, Claudine Marie Gayle, Timothy M. Geiger, Jennifer S. Gell, Alan N. Gordon, Victoria L. Green, Jon K. Hathaway, Enrique Hernandez, S. Paige Hertweck, Randall S. Hines, Ira R. Horowitz, Fred M. Howard, William W. Hurd, Fidan Israfilbayli, Denise J. Jamieson, Carolyn R. Jaslow, Erika B. Johnston-MacAnanny, Rohna M. Kearney, Namita Khanna, Caroline C. King, Jeremy A. King, Ira J. Kodner, Tamara Kolev, Athena P. Kourtis, S. Robert Kovac, Ertug Kovanci, William H. Kutteh, Eduardo Lara-Torre, Pallavi Latthe, Herschel W. Lawson, Ronald L. Levine, Frank W. Ling, Larry I. Lipshultz, Steven D. McCarus, Robert McLellan, Shruti Malik, Suketu M. Mansuria, Mohamed K. Mehasseb, Pamela J. Murray, Saloney Nazeer, Farr R. Nezhat, Hextan Y. S. Ngan, Gina M. Northington, Peggy A. Norton, Ruth M. O'Regan, Kristiina Parviainen, Resad P. Pasic, Tanja Pejovic, K. Ulrich Petry, Nancy A. Phillips, Ashish Pradhan, Elizabeth E. Puscheck, Suneetha Rachaneni, Devon M. Ramaeker, David B. Redwine, Robert L. Reid, Carla P. Roberts, Walter Romano, Peter G. Rose, Robert L. Rosenfield, Shon P. Rowan, Mack T. Ruffin, Janice M. Rymer, Evis Sala, Ritu Salani, Joseph S. Sanfilippo, Mahmood I. Shafi, Roger P. Smith, Meredith L. Snook, Thomas E. Snyder, Mary D. Stephenson, Thomas G. Stovall, Richard L. Sweet, Philip M. Toozs-Hobson, Togas Tulandi, Elizabeth R. Unger, Denise S. Uyar, Marion S. Verp, Rahi Victory, Tamara J. Vokes, Michelle J. Washington, Katharine O'Connell White, Paul E. Wise, Frank M. Wittmaack, Miya P. Yamamoto, Christine Yu, Howard A. Zacur
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How well do Australian shoppers understand energy terms on food labels?
- Wendy L Watson, Kathy Chapman, Lesley King, Bridget Kelly, Clare Hughes, Jimmy Chun Yu Louie, Jennifer Crawford, Timothy P Gill
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- Public Health Nutrition / Volume 16 / Issue 3 / March 2013
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- 30 March 2012, pp. 409-417
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Objective
To investigate nutrition literacy among adult grocery buyers regarding energy-related labelling terms on food packaging.
DesignQualitative interviews and quantitative surveys to determine shoppers’ understanding of energy terms (‘energy’, ‘calories’ and ‘kilojoules’) and how energy terms affect perceptions of healthiness and intentions to purchase breakfast cereals, muesli bars and frozen meals.
SettingIndividual in-depth interviews and surveys in two metropolitan supermarkets, Sydney, Australia.
SubjectsAustralian adults (interview n 40, survey n 405) aged 18–79 years.
ResultsThe relationship between energy and perceived healthiness of food varied by product type: higher energy breakfast cereals were perceived to be healthier, while lower energy frozen meals were seen as healthier choices. Likewise, intentions to purchase the higher energy product varied according to product type. The primary reason stated for purchasing higher energy products was for sustained energy. Participants from households of lower socio-economic status were significantly more likely to perceive higher energy products as healthier. From the qualitative interviews, participants expressed uncertainty about their understanding of kilojoules, while only 40 % of participants in intercept surveys correctly answered that kilojoules and calories measured the same thing.
ConclusionsAustralian consumers have a poor understanding of energy and kilojoules and tend to perceive higher energy products as healthier and providing sustained energy. This has implications regarding the usefulness of industry front-of-pack labelling initiatives and quick service restaurant menu labelling that provides information on energy content only. Comprehensive and widely communicated education campaigns will be essential to guide consumers towards healthier choices.
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. 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List of figures and tables
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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2 - The fundamentals of the incivil encounter
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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Summary
Although this will be a simple and short chapter it will break new ground. Our aim is to answer some fundamental and often asked questions about public rudeness in a systematic way. How often do people encounter it? What is it? Where does it happen? Who does it? Is it deliberate or accidental? Who experiences victimization? Using some basic statistics we will be able to draw up a portrait of the kinds of events and people that are to be found in the world of everyday incivility. We can start with the most basic issue of all. What is logically needed for an incivil encounter with a rude stranger to take place in public? The answer is simple. There are three components: first, there must be an action interpreted as incivil that occurs in a public setting; second, this is committed by a stranger, either by accident or deliberately; third, it is experienced by a self-described victim. Here we look at each of these in turn. In effect, we will describe what happened and where, who did it and to whom.
The rude event
First, how prevalent are encounters with rude strangers? The ELIAS data show that about a third of respondents reported a rude event during the past month (508 of 1,621 respondents, or 31 per cent). As one might expect, the likelihood of encountering this type of incivility is substantially higher than more invasive interpersonal events such as crime victimizations.
7 - General attitudes towards the stranger: exploring fear and trust
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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In traditional societies most people lived in bands or in villages, their geographic horizons usually defined by how far one could walk in a day. Such familiar environments were largely without strangers. Passing migrants, gypsies, tinkers, charlatans and traders were noteworthy interruptions in biographies filled with known others, mostly family and neighbours. Even in courtly society unknown outsiders were something of a novelty. One thinks of the stir caused by the arrival of a company of travelling players in Shakespeare's Hamlet. By contrast, much of lived experience in modern societies takes place in the close physical presence of strangers. Urbanization and the evolution of affordable technologies for daily travel have led to the increased social densities and circulations that see strangers thrown against each other. Of course, at home and at work the stranger is relatively absent. Yet out in public the situation is very different.
Remarkably little objective information is known about our social connectedness with, beliefs about, or quality of interactions among those anonymous people with whom we must share public space. Still, respondents to surveys seem to be confident in claiming that things have gone to the dogs and are getting worse. The Public Agenda (2002) survey of 2001 found 79 per cent of American respondents saying that ‘lack of respect and courtesy is a serious problem for our society’, and 73 per cent believing that there was more respect around in the past. These impressions are generally supported rather than critiqued in the academic literature.
4 - Emotions and sequences
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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So far we have mapped out some basic issues. We know about the identities of perpetrators and victims. We also know what the commonplace forms of incivility look like. We have found out where and when and even why many encounters with rude strangers take place. In this chapter things become a little more complex. As we explained at the outset, this book is a study of encounters between two people. Here we look at how these meetings unfold over time. We focus on two important questions: just how do people feel when they encounter the rude stranger? What, if anything, do they do to remedy the situation?
Emotions and incivility
The existing literature suggests that we already know the answer to both these questions. Writing back in the early 1970s the famous symbolic interactionist Erving Goffman (1971) established the template with his work Relations in Public. Here the life of city dwellers is described as one revolving around suspicion and mistrust. As they navigate urban spaces they scan for dangers, constantly on guard and feeling unease. The emotions of fear and anxiety are barely suppressed and the encounter with the incivil other is traumatizing. Individuals develop action strategies of retreat and avoidance. This vision has been amplified more recently in the critical sociology of Zygmunt Bauman (2003), who identifies ‘mixophobic’ sentiments in the metropolis and suggests that social life is organized such that individuals avoid encounters with difference and risk as they move between secure bubbles dotted around the city: the home in a gated community, the mall, the country club, the office.
3 - Everyday incivility and the everyday round
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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Our major finding in our previous chapter was the very ordinary quality of incivility. It took place in everyday locations like the supermarket and car park. Rude people were generally not thugs, lurkers or even troublesome teens. They were as diverse in terms of age, gender and appearance as their victims. We also showed that rudeness could be found in a variety of low-level impolite acts. These were not threatening, malicious or crime-related deeds. Finally, a substantial proportion of events involved movement. Put together these clues suggest that rudeness should be studied as a commonplace rather than exceptional act. It is somehow structured into the opportunity spaces of daily life. It is a product of our mundane trajectories through public environments where there are strangers.
Routine activity and predictable incivility
One way to think about this finding is with routine activity theory (Cohen and Felson 1979). Developed in the field of criminology, this shifts our attention away from the study of deviants and offenders towards the analysis of situations and opportunities. The argument is that we can understand certain forms of crime without having to inquire into motivations, or without looking to faulty values and failed socialization for our explanatory context. Arguing that any given crime has to take place at a certain time and at a certain place, routine activity theory asks questions such as: when do victims and offenders come together? At what time of day are guardians away from attractive property? How do people keep safe?
References
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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Preface and acknowledgements
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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This book is the product of several years of collaborative activity by the three authors in various combinations. Describing this division of labour is somewhat complex, but might be helpful to readers should they wish to direct questions to the team. The original grant proposals, focus group pilot work, survey instrument design and administration, conceptual thinking about the new area and the book proposal were the work of Timothy Phillips and Philip Smith. The former was particularly responsible for figuring out how to capture something commonplace yet elusive using survey methods. Smith is the chief author of Chapters 1, 8 and 9, although contributions from the other two team members were also made. Chapters 2, 3 and 4 were initially written by Smith and Phillips, then revised by Ryan King as the book developed. Chapters 5, 6 and 7 were equally authored by King and Smith. Some material from Phillips appears at the start of the last of these.
Along the way this book has had the benefit of support from the many institutions that sheltered its authors at one point or another in the research or writing process. In Australia we thank the University of Tasmania, the University of Queensland and the Australian National University. In the United States we express gratitude to Yale University and the University at Albany. In Europe we were hosted by Trinity College Dublin and the Kulturwissenschaftsliches Kolleg, Universität Konstanz. We thank the professional research teams who took the project to the field.
9 - Twenty questions and answers
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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We have tried to be as clear as possible in this book and to write scholarly material in a way that will appeal to a general audience. Still, books like this one can be wordy. Also the complex statistical tables can result in an overload of information, especially for general readers. Although we have included summary bullets at the end of each chapter, we would like to conclude with a more crisp and conversational outline of what we have discovered and what remains to be found out.
The following series of questions and answers replicates what we are often asked during both academic seminars and public talks. It offers a shortcut to the entire book. Scholars who require higher academic standards and a more serious tone, or those looking for extra information after reading an answer here must return to the book itself.
Why research the rude stranger?
Rudeness is a commonplace feature of everyday life. It impacts upon pretty much everyone. We should know about it. In the mass media and on the Internet we find a lot of chatter about this. Politicians often crusade for civility. Academic researchers looking at social capital, crime and everyday life have important things to say on these topics. Their ideas have substantially influenced policy and political agendas (Chapter 1).
Don't we already know a lot about rudeness?
No. We really have no idea at all.
Index
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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5 - Gender, age and class: divergent experiences?
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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Our analyses so far in this book have concerned ‘people in general’. We have focused for the most part on outlining the features of events and their aftermath as they impact upon the woman or man in the street. Once or twice we have noted that victims with certain social or demographic characteristics have divergent experiences from the average, but we have not given sustained attention to the ways that categorical identities might shape the distribution and interpretation of victimizations. In this chapter we move the analytic spotlight onto three socio-demographic background variables: gender; age; and class.
In the backlash against universalism, a major theme in postmodern and poststructural social theory has been the claim that the experience of life is radically shaped through identity. The argument goes that when thinkers talk about generic human experience they are usually talking about or projecting the worldview of the affluent white male. General statements cloaked particular experiences. Goffman himself became prey to such critique, the case being made that he drew large conclusions from his own impressions of walking down the street. His observations about the subtleties of eye contact, the averted gaze and interpersonal space in public reflected his reality. For Goffman these behaviours were all about tact and mutual respect. The case was made that for women such body management in public might be about avoiding sexual harassment; for persons of colour the issue might be to dodge racism or to appear non-threatening.
1 - Redirecting incivility research
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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The theme of growing incivility is both a commonplace and a universal of human life. Through the ages and across civilizations there has always been talk of poor public behaviour, of increasingly unruly streets and of the decline and fall of good manners. It is a current journalistic staple to document troublesome youth, identify emergent forms of disorder from ‘road rage’ to ‘cell phone rage’, and to conduct simple experiments or cheap stunts to demonstrate that common courtesies are no longer to be found in the urban jungle (Safe 2000). Books on freefalling manners have long replaced those about etiquette on bestseller lists (Truss 2005). In a related trend, each decade sees an academic leader denounce the triumph of anti-civic individualism whether in the form of the ‘lonely crowd’, ‘narcissism’, the end of ‘public man’ or ‘bowling alone’. What makes our age distinctive is not the presence of such a complaint about the demise of an interpersonally civil society, but rather the intensity and form of the anxiety. A ‘crisis’ of civility has been identified with greater virulence and enthusiasm than ever before. Working in a sometimes uneasy, sometimes convenient, alliance, the media, politicians and academics have come together over the past dozen or so years and located profound dangers which call for desperate remedies. This activity has taken an unhelpful turn. Inspired by a criminological imagination it has come to look telescopically rather than broadly, imagines and investigates incivility in restrictive and extreme ways and stigmatizes the marginalized prematurely.
Incivility
- The Rude Stranger in Everyday Life
- Philip Smith, Timothy L. Phillips, Ryan D. King
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Has anyone ever pushed in front of you in a queue? Stolen your parking space? Talked on their mobile phone during a film at the cinema? In our everyday lives we all encounter rude and inconsiderate people. This unique book provides the first ever systematic investigation of typical encounters with rudeness. Through a meticulous analysis of over 500 events, it maps out what people experience as rude, where and when this happens and what takes place in the exchange between the participants. The inquiry further charts the emotional and social consequences of rudeness and victimization, with the results challenging the widespread assumption that bad behaviour is toxic to community life. In conclusion the study draws upon its findings and surveys a range of strategies for reducing the level of incivility in everyday life, identifying some simple and innovative solutions. Incivility will appeal to criminologists, sociologists and scholars of urban studies.
6 - After the event: coping, avoiding and changing
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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When unexpected or bad things happen to people they try to make sense of them or to cope in various other ways with the shock of what has happened. This is particularly the case with traumatic events. Further, unusual, dangerous or serious episodes can change our mental outlook and behaviours. In this chapter we explore the implications of rude stranger encounters. We start with coping.
Coping and ontological security
Much of what we know about coping is informed by the literatures in social-psychology and criminology and concerns how people cope, and hopefully recover, from very serious events: rape; incest; predatory violent crime; domestic violence; bereavement; life threatening injury. We do not wish to claim that an encounter with a rude stranger is in the same domain as such tragic misfortunes. Most obviously intense physical or psychological harms are missing. Still, the case could be made that the encounter with the rude stranger requires some adjustments. Further, it is important that as outside observers we do not prejudge. What might seem trivial from our Olympian perspective could be deeply meaningful as a personal experience.
The argument that the rude stranger encounter well might require some coping is suggested circumstantially by findings from earlier in this book. We reported in Chapters 3, 4 and 5 that in a large number of cases people were surprised by what had happened to them. Further, many times our victims had strong initial emotional reactions, including anger, disgust and fear.
8 - How to confront incivility
- Philip Smith, Yale University, Connecticut, Timothy L. Phillips, University of Tasmania, Ryan D. King, State University of New York, Albany
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Before rushing into this rather lengthy chapter we should first note that a question has been begged by our title: should we confront everyday incivility? Common sense says yes. Opinion polls show that people see rudeness as a problem worthy of remedy (Public Agenda 2002). Moreover our own book has uncovered a realm of reasonably frequent events that usually produce unwanted emotions. These generally require coping, may generate fear and aversive behaviour, and can lead to less sociable attitudes. Here, then, we have a social problem. Yet a little reflection might be in order before we move forward to propose some fixes. We might start with the sociologist Emile Durkheim's (2006 [1897]) observation, one famous among sociologists, that norm violation was often a precursor to positive social change or creative renewal. He cites the example of Socrates, a man subject to vilification, yet whose thinking was more progressive and acute than that of the Athenian state which condemned him. Perhaps a society without such ‘antisocial’ behaviour would be stagnant. Certainly, it might be rather unexciting and without grit or edge. The overwhelming comment one hears from people who have been to Singapore – even more so those who have lived there – is that it is clean, safe and boring (e.g., Singapore Expats 2007). Nobody says this about Manhattan. There is a price to be paid, it would seem, for banning chewing gum or Monty Python's irreverent and provocative Life of Brian.