45 results
65 Verbal and Visual-Spatial Abilities Differ by Ethnicity in a Referred Pediatric Sample
- Gary P. Rempe, Patricia Lyke, Jennifer G. Walter, John H. King
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 741-742
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Objective:
To compare performances of matched groups derived from caregiver-reported ethnicity on measures of verbal comprehension and visual-spatial abilities, and to identify factors potentially related to differences.
Participants and Methods:Participants included 159 English speaking children from 615 years of age who were referred for neuropsychological evaluation at a clinic in the southwestern region of the United States. Participants were matched across four groups based on caregiver-reported ethnicity, including American Indian (n = 41), Hispanic (n= 41), White (n = 41), and Other (i.e., Black, Asian; n = 36) categories. Propensity score matching was used to derive samples, with participants matched on age, caregiver-reported sex assigned at birth, and the full-scale intelligence quotient on the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V).
Results:Using a dependent variable derived from subtracting the WISC-V Verbal Comprehension Index from the Visual-Spatial Index, significant differences across groups were found via a factorial analysis of variance model (p = .02, eta squared = .06). Achieved power was .82. Post-hoc analysis indicated significantly greater differences between verbal comprehension and visual-spatial abilities amongst participants of American Indian (mean difference = -6.61 standard score points) and Hispanic (mean difference = -6.66 standard score points) ethnicity relative to participants of White ethnicity (mean difference = 2.17 standard score points; p < .01). Differences did not relate to participant age or assigned sex.
Conclusions:Greater differences between visual and verbal intellectual abilities were found amongst Hispanic and American Indian participants relative to White participants. Hispanic and American children tended to perform higher on visual spatial rather than verbal tasks, while the pattern was reversed for White children. Findings are congruent with previous research conducted using older versions of the WISC and continue to highlight potential issues related to the external validity of this measure in certain populations. This study contributes to the existing literature by replicating previous findings with the most recent iteration of the WISC in a referred sample. Current results continue to suggest that the WISC-V Verbal Comprehension Index may function more as a measure of English language ability rather than verbal intellectual ability. Given these findings, it is important that weaknesses in verbal comprehension amongst children of Hispanic or American Indian ethnicity be interpreted in this context when identified in clinical and research settings. Discrepancies between ethnic groups may relate broadly to cultural and systemic factors (e.g., differing patient/examiner characteristics, inequalities in access to education/intervention and healthcare, bilingualism/exposure to the English language).
7 - Literacy Development and Language of Instruction in Sub-Saharan Africa
- from Part I - Regional Variations
- Edited by Ludo Verhoeven, Radboud Universiteit Nijmegen, Sonali Nag, University of Oxford, Charles Perfetti, University of Pittsburgh, Kenneth Pugh, Yale University, Connecticut
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- Global Variation in Literacy Development
- Published online:
- 23 November 2023
- Print publication:
- 07 December 2023, pp 133-154
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Summary
The Sustainable Development Goals (SDGs) adopted in 2015 represent an important opportunity to improve learning globally. In this light, this chapter draws on a unique set of early literacy assessment results and demographic information from six African countries (Ghana, Kenya, Liberia, Malawi, Tanzania, and Zambia) to better understand the role that language plays in influencing early reading outcomes. While these data have been published in individual country reports, the information has not been analyzed and released prominently in the narrative surrounding learning outcomes in the region, although data like those presented in this chapter have begun to reverse this tendency. Following this introduction, a brief history is provided of postcolonial trends in literacy acquisition and language policyin sub-Saharan Africa from about 1960 to the present day, documenting the current language of instruction policies for twenty countries. Key questions are also outlined to drive the interest in gaining a better understanding of the variation in literacy acquisition in a selection of target countries for which we have data; then the chapter documents the data and methods usedas well as the results. Finally, the chapter discusses the implications of this work a for future policy and planning to achieve the promises made under the SDGs.
Clinical factors and diagnoses associated with inappropriate urine-culture ordering in primary care
- Marissa Valentine-King, Barbara Trautner, Roger Zoorob, Michael Hansen, Jennifer Matas, Robert Atmar, Larissa Grigoryan
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue S2 / June 2023
- Published online by Cambridge University Press:
- 29 September 2023, p. s1
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Background: Inappropriate urine-culture ordering is associated with increased antibiotic prescribing in myriad care environments, including acute and long-term care. In primary care, where urinary tract infections (UTIs) are commonly encountered, the appropriateness of urine-culture ordering has not been well described. We examined the appropriateness of urine-culture ordering and factors associated with inappropriate urine-culture ordering in primary care. Methods: We conducted a secondary analysis of data from a previous prospective study that included patients aged ≥18 years presenting with provider-suspected UTI with an accompanying urine culture at 2 safety-net, primary-care clinics in Houston, Texas, between November 2018 and March 2020. Patients with complicated or uncomplicated UTI were included, but those with a urinary catheter and pregnant females were excluded. Urine cultures were considered appropriate if the patient had an evidence-based symptom of UTI (ie, dysuria, frequency, urgency, hematuria, fever, chills, costovertebral angle tenderness, suprapubic, pelvic, or flank pain, or nephrolithiasis) as a diagnostic code or listed in providers’ free-text documentation. Diagnostic codes for symptoms that were not evidence based were grouped into categories based on body system, visit type (eg, routine visit), or sign or symptom clusters. We evaluated the relationships among demographic and clinical factors, the clinic visited, and non–evidence-based diagnostic codes with inappropriately ordered cultures. Results: We examined 870 cultures from 807 patients. Overall, 61.5% of patients were Hispanic (61.5%) and 23% were African American or Black. Also, 70.6% were women; the mean age was 49.2 years (SD, 14.6); and the mean Elixhauser score was 1.9 (SD, 5.4). Among the 870 cultures, 210 (24%) were ordered inappropriately. Dysuria (n = 289), frequency (n = 129), and UTI or cystitis (n = 117) were the most common, evidence-based codes among appropriate cultures. In the adjusted model, the nonteaching clinic (aOR, 6.33) and diagnostic codes comprising the following categories were associated with inappropriate culturing: acute lower back pain (aOR, 5.42), cardiac-related visits (aOR, 2.41), urinary incontinence (aOR, 4.46), routine health visits (aOR, 3.66), urine characteristics (aOR, 14.32), voiding difficulties (aOR, 3.88), and well-woman visits with a gynecological exam or family planning aspect (aOR, 12.27) (all P < .05). Conclusions: This research highlights potential gaps or miscues in provider behavior related to urine culture ordering, and unveiled problematic culturing related to urine characteristics and to routine visits, especially of a gynecological nature. This information can be incorporated into diagnostic stewardship interventions to address misconceptions, and to further explore the reasoning or processes wherein urine cultures are ordered for routine visits.
Financial support: NIAID UM1AI104681
Disclosure: None
Antibiotic prescribing for acute gastroenteritis during ambulatory care visits—United States, 2006–2015
- Jennifer P. Collins, Laura M. King, Sarah A. Collier, John Person, Megan E. Gerdes, Stacy M. Crim, Monina Bartoces, Katherine E. Fleming-Dutra, Cindy R. Friedman, Louise K. Francois Watkins
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 43 / Issue 12 / December 2022
- Published online by Cambridge University Press:
- 26 August 2022, pp. 1880-1889
- Print publication:
- December 2022
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Objective:
To describe national antibiotic prescribing for acute gastroenteritis (AGE).
Setting:Ambulatory care.
Methods:We included visits with diagnoses for bacterial and viral gastrointestinal infections from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS; 2006–2015) and the IBM Watson 2014 MarketScan Commercial Claims and Encounters Database. For NAMCS/NHAMCS, we calculated annual percentage estimates and 99% confidence intervals (CIs) of visits with antibiotics prescribed; sample sizes were too small to calculate estimates by pathogen. For MarketScan, we used Poisson regression to calculate the percentage of visits with antibiotics prescribed and 95% CIs, including by pathogen.
Results:We included 10,210 NAMCS/NHAMCS AGE visits; an estimated 13.3% (99% CI, 11.2%–15.4%) resulted in antibiotic prescriptions, most frequently fluoroquinolones (28.7%; 99% CI, 21.1%–36.3%), nitroimidazoles (20.2%; 99% CI, 14.0%–26.4%), and penicillins (18.9%; 99% CI, 11.6%–26.2%). In NAMCS/NHAMCS, antibiotic prescribing was least frequent in emergency departments (10.8%; 99% CI, 9.5%–12.1%). Among 1,868,465 MarketScan AGE visits, antibiotics were prescribed for 13.8% (95% CI, 13.7%−13.8%), most commonly for Yersinia (46.7%; 95% CI, 21.4%–71.9%), Campylobacter (44.8%; 95% CI, 41.5%–48.1%), Shigella (39.7%; 95% CI, 35.9%–43.6%), typhoid or paratyphoid fever (32.7%; (95% CI, 27.2%–38.3%), and nontyphoidal Salmonella (31.7%; 95% CI, 29.5%–33.9%). Antibiotics were prescribed for 12.3% (95% CI, 11.7%–13.0%) of visits for viral gastroenteritis.
Conclusions:Overall, ∼13% of AGE visits resulted in antibiotic prescriptions. Antibiotics were unnecessarily prescribed for viral gastroenteritis and some bacterial infections for which antibiotics are not recommended. Antibiotic stewardship assessments and interventions for AGE are needed in ambulatory settings.
Truth and Reparation for the U.S. Imprisonment and Policing Regime: A Transitional Justice Perspective
- Jennifer M. Page, Desmond King
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- Journal:
- Du Bois Review: Social Science Research on Race / Volume 19 / Issue 2 / Fall 2022
- Published online by Cambridge University Press:
- 16 November 2021, pp. 209-231
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In the literature on transitional justice, there is disagreement about whether countries like the United States can be characterized as transitional societies. Though it is widely recognized that transitional justice mechanisms such as truth commissions and reparations can be used by Global North nations to address racial injustice, some consider societies to be transitional only when they are undergoing a formal democratic regime change. We conceptualize the political situation of low-income Black communities under the U.S. imprisonment and policing regime in terms of three criteria for identifying transitional contexts: normalized collective and political wrongdoing, pervasive structural inequality, and the failure of the rule of law. That these criteria are met, however, does not necessarily mean that a transition is taking place. Drawing on the American political development and abolition democracy literatures, we discuss what it would mean for the United States to transition out of its present imprisonment and policing regime. A transitional justice perspective shows the importance of not only pushing for truth and reparation, but for an actual transition.
Analytical solution for the cumulative wake of wind turbines in wind farms
- Majid Bastankhah, Bridget L. Welch, Luis A. Martínez-Tossas, Jennifer King, Paul Fleming
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- Journal:
- Journal of Fluid Mechanics / Volume 911 / 25 March 2021
- Published online by Cambridge University Press:
- 02 February 2021, A53
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This paper solves an approximate form of conservation of mass and momentum for a turbine in a wind farm array. The solution is a fairly simple explicit relationship that predicts the streamwise velocity distribution within a wind farm with an arbitrary layout. As this model is obtained by solving flow-governing equations directly for a turbine that is subject to upwind turbine wakes, no ad hoc superposition technique is needed to predict wind farm flows. A suite of large-eddy simulations (LES) of wind farm arrays is used to examine self-similarity as well as validity of the so-called conservation of momentum deficit for turbine wakes in wind farms. The simulations are performed with and without the presence of some specific turbines in the wind farm. This allows us to systematically study some of the assumptions made to develop the analytical model. A modified version of the conservation of momentum deficit is also proposed to provide slightly better results at short downwind distances, as well as in the far wake of turbines deep inside a wind farm. Model predictions are validated against the LES data for turbines in both full-wake and partial-wake conditions. While our results highlight the limitation in capturing the flow speed-up between adjacent turbine columns, the model is overall able to acceptably predict flow distributions for a moderately sized wind farm. Finally, the paper employs the new model to provide insights on the accuracy of common wake superposition methods.
Moving Beyond Contact Precautions: Implementation of a Staphylococcus aureus Screening and Decolonization Program
- Sarah Hochman, Anna Stachel, Michael Phillips, Stephanie Sterling, Jennifer Lighter, Maria Aguero-Rosenfeld, Tamara King-Morrieson
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s321-s322
- Print publication:
- October 2020
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Background:Staphylococcus aureus–colonized hospitalized patients are at risk for invasive infection and can transmit S. aureus to other patients in the absence of symptoms. Infection isolation precautions do not reduce the risk of infection in colonized patients and are untenable in health systems with high rates of S. aureus colonization. Objective: We implemented an inpatient S. aureus screening and targeted decolonization program across hospital campuses to reduce transmission and invasive infection. We screen and decolonize for methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) because MSSA makes up more than half of all S. aureus isolated from clinical cultures in our health system. Methods: All medicine, pediatrics, and transplant patients receive S. aureus nares culture at admission and upon change in level of care for medicine, and at admission and weekly for pediatrics and transplant patients. All S. aureus–colonized patients receive decolonization with nasal mupirocin ointment and chlorhexidine baths. Two implementation frameworks guide our processes for S. aureus screening and decolonization: the Consolidated Framework for Implementation Research, to evaluate factors affecting implementation at different levels of the health system, and the Dynamic Sustainability Framework, to account for iterative changes as the hospital setting and patient population change over time. Implementation interventions focus on education of patients and bedside nurses who perform S. aureus screening and decolonization; utilization of the electronic health record to identify patients for screening and/or decolonization and avoid human error; and introduction of a clinical nurse specialist to oversee the program and to provide iterative feedback. Results: At baseline, 21% of patients had S. aureus colonization, 20% of which was MRSA, and the MRSA bloodstream infection rate was 0.06 per 1,000 patient days. After program implementation, there was no change in S. aureus colonization and the MRSA bloodstream infection rate fell to 0.04 per 1,000 patient days. Screening compliance improved from 39% (N = 1,805) of eligible patients in the 6-month period before the introduction of the clinical nurse specialist to 52% (N = 2,024) after the introduction of the clinical nurse specialist. In the same periods, decolonization increased from 18.6% to 41% of eligible patients. Conclusions: We used 2 implementation frameworks to design our S. aureus screening and decolonization program and to make iterative changes to the program as it evolved to include new patient populations and different hospital settings. This resulted in a large-scale, sustainable, health system program for S. aureus control that avoids reliance on infection isolation precautions.
Funding: None
Disclosures: None
Perinatal anxiety and depressive symptoms and perception of child behavior and temperament in early motherhood
- Michelle L. Miller, Breanna M. Williams, Jennifer E. McCabe, J. Austin Williamson, Suzanne King, David P. Laplante, Kimberly J. Hart, Michael W. O’Hara
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- Journal:
- Journal of Developmental Origins of Health and Disease / Volume 12 / Issue 3 / June 2021
- Published online by Cambridge University Press:
- 10 September 2020, pp. 513-522
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The perinatal period is a vulnerable time for the development of psychopathology, particularly mood and anxiety disorders. In the study of maternal anxiety, important questions remain regarding the association between maternal anxiety symptoms and subsequent child outcomes. This study examined the association between depressive and anxiety symptoms, namely social anxiety, panic, and agoraphobia disorder symptoms during the perinatal period and maternal perception of child behavior, specifically different facets of development and temperament. Participants (N = 104) were recruited during pregnancy from a community sample. Participants completed clinician-administered and self-report measures of depressive and anxiety symptoms during the third trimester of pregnancy and at 16 months postpartum; child behavior and temperament outcomes were assessed at 16 months postpartum. Child development areas included gross and fine motor skills, language and problem-solving abilities, and personal/social skills. Child temperament domains included surgency, negative affectivity, and effortful control. Hierarchical multiple regression analyses demonstrated that elevated prenatal social anxiety symptoms significantly predicted more negative maternal report of child behavior across most measured domains. Elevated prenatal social anxiety and panic symptoms predicted more negative maternal report of child effortful control. Depressive and agoraphobia symptoms were not significant predictors of child outcomes. Elevated anxiety symptoms appear to have a distinct association with maternal report of child development and temperament. Considering the relative influence of anxiety symptoms, particularly social anxiety, on maternal report of child behavior and temperament can help to identify potential difficulties early on in mother–child interactions as well as inform interventions for women and their families.
One-carbon metabolites, B vitamins and associations with systemic inflammation and angiogenesis biomarkers among colorectal cancer patients: results from the ColoCare Study
- Rama Kiblawi, Andreana N. Holowatyj, Biljana Gigic, Stefanie Brezina, Anne J. M. R. Geijsen, Jennifer Ose, Tengda Lin, Sheetal Hardikar, Caroline Himbert, Christy A. Warby, Jürgen Böhm, Martijn J. L. Bours, Fränzel J. B. van Duijnhoven, Tanja Gumpenberger, Dieuwertje E. Kok, Janna L. Koole, Eline H. van Roekel, Petra Schrotz-King, Arve Ulvik, Andrea Gsur, Nina Habermann, Matty P. Weijenberg, Per Magne Ueland, Martin Schneider, Alexis Ulrich, Cornelia M. Ulrich, Mary Playdon
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- Journal:
- British Journal of Nutrition / Volume 123 / Issue 10 / 28 May 2020
- Published online by Cambridge University Press:
- 05 February 2020, pp. 1187-1200
- Print publication:
- 28 May 2020
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B vitamins involved in one-carbon metabolism have been implicated in the development of inflammation- and angiogenesis-related chronic diseases, such as colorectal cancer (CRC). Yet, the role of one-carbon metabolism in inflammation and angiogenesis among CRC patients remains unclear. The objective of this study was to investigate associations of components of one-carbon metabolism with inflammation and angiogenesis biomarkers among newly diagnosed CRC patients (n 238) in the prospective ColoCare Study, Heidelberg. We cross-sectionally analysed associations between twelve B vitamins and one-carbon metabolites and ten inflammation and angiogenesis biomarkers from pre-surgery serum samples using multivariable linear regression models. We further explored associations among novel biomarkers in these pathways with Spearman partial correlation analyses. We hypothesised that pyridoxal-5’-phosphate (PLP) is inversely associated with inflammatory biomarkers. We observed that PLP was inversely associated with C-reactive protein (CRP) (r –0·33, Plinear < 0·0001), serum amyloid A (SAA) (r –0·23, Plinear = 0·003), IL-6 (r –0·39, Plinear < 0·0001), IL-8 (r –0·20, Plinear = 0·02) and TNFα (r –0·12, Plinear = 0·045). Similar findings were observed for 5-methyl-tetrahydrofolate and CRP (r –0·14), SAA (r –0·14) and TNFα (r –0·15) among CRC patients. Folate catabolite acetyl-para-aminobenzoylglutamic acid (pABG) was positively correlated with IL-6 (r 0·27, Plinear < 0·0001), and pABG was positively correlated with IL-8 (r 0·21, Plinear < 0·0001), indicating higher folate utilisation during inflammation. Our data support the hypothesis of inverse associations between PLP and inflammatory biomarkers among CRC patients. A better understanding of the role and inter-relation of PLP and other one-carbon metabolites with inflammatory processes among colorectal carcinogenesis and prognosis could identify targets for future dietary guidance for CRC patients.
Association of influenza outbreaks with advanced pediatric medical support
- Jennifer Guyther, Richard Lichenstein, Yonghong Gao, James A. Zhou, Adebola Ajao, Priti K. Bajaj, Veronica A. Combs, James C. King, Jr.
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- Journal:
- Epidemiology & Infection / Volume 146 / Issue 11 / August 2018
- Published online by Cambridge University Press:
- 30 May 2018, pp. 1366-1371
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Retrospective data evaluated increases in advanced medical support for children with medically attended acute respiratory illness (MAARI) during influenza outbreak periods (IOP). Advanced support included hospitalisation, intensive care unit admission, or mechanical ventilation, for children aged 0–17 years hospitalised in Maryland's 50 acute-care hospitals over 12 influenza seasons. Weekly numbers of positive influenza tests in the Maryland area defined IOP for each season as the fewest consecutive weeks, including the peak week containing at least 85% of positive tests with a 2-week buffer on either side of the IOP. Peak IOP (PIOP) was defined as four consecutive weeks containing the peak week with the most number of positive influenza tests. Off-PIOP was defined as the ‘shoulder’ weeks during each IOP. Non-influenza season (NIS) was the remaining weeks of that study season. Rate ratios of mean daily MAARI-related admissions resulting in advanced medical support outcomes during PIOP or Off-PIOP were compared with the NIS and were significantly elevated for all 12 study seasons combined. The results suggest that influenza outbreaks are associated with increased advanced medical support utilisation by children with MAARI. We feel that this data may help preparedness for severe influenza epidemics or pandemic.
Can we extend local sea-ice measurements to satellite scale? An example from the N-ICE2015 expedition
- Anja Rösel, Jennifer King, Anthony P. Doulgeris, Penelope M. Wagner, A. Malin Johansson, Sebastian Gerland
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- Journal:
- Annals of Glaciology / Volume 59 / Issue 76pt2 / July 2018
- Published online by Cambridge University Press:
- 17 December 2017, pp. 163-172
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Knowledge of Arctic sea-ice conditions is of great interest for Arctic residents, as well as for commercial usage, and to study the effects of climate change. Information gained from analysis of satellite data contributes to this understanding. In the course of using in situ data in combination with remotely sensed data, the question of how representative local scale measurements are of a wider region may arise. We compare in situ total sea-ice thickness measurements from the Norwegian young sea ICE expedition in the area north of Svalbard with airborne-derived total sea-ice thickness from electromagnetic soundings. A segmented and classified synthetic aperture radar (SAR) quad-pol ALOS-2 Palsar-2 satellite scene was grouped into three simplified ice classes. The area fractions of the three classes are: 11.2% ‘thin’, 74.4% ‘level’, and 14.4% ‘deformed’. The area fractions of the simplified classes from ground- and helicopter-based measurements are comparable with those achieved from the SAR data. Thus, this study shows that there is potential for a stepwise upscaling from in situ, to airborne, to satellite data, which allow us to assess whether in situ data collected are representative of a wider region as observed by satellites.
Peer effects on self-regulation in adolescence depend on the nature and quality of the peer interaction
- Kevin M. King, Katie A. McLaughlin, Jennifer Silk, Kathryn C. Monahan
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- Journal:
- Development and Psychopathology / Volume 30 / Issue 4 / October 2018
- Published online by Cambridge University Press:
- 21 November 2017, pp. 1389-1401
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Adolescence is a critical period for the development of self-regulation, and peer interactions are thought to strongly influence regulation ability. Simple exposure to peers has been found to alter decisions about risky behaviors and increase sensitivity to rewards. The link between peer exposure and self-regulation is likely to vary as a function of the type and quality of peer interaction (e.g., rejection or acceptance). Little is known about how the nature of interactions with peers influences different dimensions of self-regulation. We examined how randomization to acceptance or rejection by online “virtual” peers influenced multiple dimensions of self-regulation in a multisite community sample of 273 adolescents aged 16–17 years. Compared to a neutral condition, exposure to peers produced increases in cold cognitive control, but decreased hot cognitive control. Relative to peer acceptance, peer rejection reduced distress tolerance and increased sensitivity to losses. These findings suggest that different dimensions of adolescent self-regulation are influenced by the nature of the peer context: basic cognitive functions are altered by mere exposure to peers, whereas more complex decision making and emotion regulation processes are influenced primarily by the quality of that exposure.
How the Chinese Government Fabricates Social Media Posts for Strategic Distraction, Not Engaged Argument
- GARY KING, JENNIFER PAN, MARGARET E. ROBERTS
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- Journal:
- American Political Science Review / Volume 111 / Issue 3 / August 2017
- Published online by Cambridge University Press:
- 27 July 2017, pp. 484-501
- Print publication:
- August 2017
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The Chinese government has long been suspected of hiring as many as 2 million people to surreptitiously insert huge numbers of pseudonymous and other deceptive writings into the stream of real social media posts, as if they were the genuine opinions of ordinary people. Many academics, and most journalists and activists, claim that these so-called 50c party posts vociferously argue for the government’s side in political and policy debates. As we show, this is also true of most posts openly accused on social media of being 50c. Yet almost no systematic empirical evidence exists for this claim or, more importantly, for the Chinese regime’s strategic objective in pursuing this activity. In the first large-scale empirical analysis of this operation, we show how to identify the secretive authors of these posts, the posts written by them, and their content. We estimate that the government fabricates and posts about 448 million social media comments a year. In contrast to prior claims, we show that the Chinese regime’s strategy is to avoid arguing with skeptics of the party and the government, and to not even discuss controversial issues. We show that the goal of this massive secretive operation is instead to distract the public and change the subject, as most of these posts involve cheerleading for China, the revolutionary history of the Communist Party, or other symbols of the regime. We discuss how these results fit with what is known about the Chinese censorship program and suggest how they may change our broader theoretical understanding of “common knowledge” and information control in authoritarian regimes.
Influence of synoptic atmospheric conditions on movement of individual sea-ice floes in Fram Strait, late summer 2010
- Jennifer A. King, Grant R. Bigg, Richard Hall
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- Journal:
- Annals of Glaciology / Volume 56 / Issue 69 / 2015
- Published online by Cambridge University Press:
- 26 July 2017, pp. 445-450
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In this paper we investigate the effect on sea-ice movement of changes in the synoptic atmospheric conditions in late boreal summer 2010. Our study area is the western Fram Strait, a crucial passage for the transport of ice out of the Arctic basin. Ice dynamics here affect the movement of ice in the East Greenland Current, the transpolar drift and ice extent in the Arctic Ocean. In contrast to other times of the year, when the Fram Strait wind field is characterized by strong, persistent northerlies, we show that the weaker, more variable winds typical during late summer for the Fram Strait can slow movement of ice floes out of the area, thus slowing the export of ice from the Arctic Ocean at the end of summer, a time crucial for ice export. The Arctic Ocean could lose even more of the ice that survives the summer if this was not the case. This would leave the Arctic Ocean in an even more vulnerable position with regard to the amount of multi-year ice remaining the following summer.
Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non–Veterans Affairs Nursing Homes
- Lona Mody, M. Todd Greene, Sanjay Saint, Jennifer Meddings, Barbara W. Trautner, Heidi L. Wald, Christopher Crnich, Jane Banaszak-Holl, Sara E. McNamara, Beth J. King, Robert Hogikyan, Barbara S. Edson, Sarah L. Krein
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 38 / Issue 3 / March 2017
- Published online by Cambridge University Press:
- 05 December 2016, pp. 287-293
- Print publication:
- March 2017
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OBJECTIVE
The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non–VA nursing homes.
SETTINGVA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative.
METHODSNursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire.
RESULTSA total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; P<.001) and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs 66%; P<.001), sharing CAUTI data with leadership (94% vs 70%; P=.014) and with nursing personnel (85% vs 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004).
CONCLUSIONSAmong nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems.
Infect Control Hosp Epidemiol 2017;38:287–293
Circulating n-3 fatty acids and trans-fatty acids, PLA2G2A gene variation and sudden cardiac arrest
- Rozenn N. Lemaitre, Traci M. Bartz, Irena B. King, Jennifer A. Brody, Barbara McKnight, Nona Sotoodehnia, Thomas D. Rea, Catherine O. Johnson, Dariush Mozaffarian, Stephanie Hesselson, Pui-Yan Kwok, David S. Siscovick
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- Journal:
- Journal of Nutritional Science / Volume 5 / 2016
- Published online by Cambridge University Press:
- 01 March 2016, e12
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Whether genetic factors influence the associations of fatty acids with the risk of sudden cardiac arrest (SCA) is largely unknown. To investigate possible gene–fatty acid interactions on SCA risk, we used a case-only approach and measured fatty acids in erythrocyte samples from 1869 SCA cases in a population-based repository with genetic data. We selected 191 SNP in ENCODE-identified regulatory regions of fifty-five candidate genes in fatty acid metabolic pathways. Using linear regression and additive genetic models, we investigated the association of the selected SNP with erythrocyte levels of fatty acids, including DHA, EPA and trans-fatty acids among the SCA cases. The assumption of no association in non-cases was supported by analysis of publicly available datasets containing over 8000 samples. None of the SNP–fatty acid associations tested among the cases reached statistical significance after correction for multiple comparisons. One SNP, rs4654990 near PLA2G2A, with an allele frequency of 0·33, was nominally associated with lower levels of DHA and EPA and higher levels of trans-fatty acids. The strongest association was with DHA levels (exponentiated coefficient for one unit (1 % of total fatty acids), 0·90, 95 % CI 0·85, 0·97; P = 0·003), indicating that for subjects with a coded allele, the OR of SCA associated with one unit higher DHA is about 90 % what it is for subjects with one fewer coded allele. These findings suggest that the associations of circulating n-3 and trans-fatty acids with SCA risk may be more pronounced in carriers of the rs4654990 G allele.
How far is too far? Theorising non-conviction-based asset forfeiture
- Jennifer Hendry, Colin King
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- Journal:
- International Journal of Law in Context / Volume 11 / Issue 4 / December 2015
- Published online by Cambridge University Press:
- 02 November 2015, pp. 398-411
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Non-conviction-based (NCB) asset forfeiture is a relatively recent addition to law enforcement's armoury in the fight against organised crime in the UK. It allows for criminal assets to be forfeited to the State even in the absence of criminal conviction, the stated objective being to undermine the profit incentive of criminal activity. Until now, NCB asset forfeiture has principally been critiqued from a criminological point of view, specifically concerning the Packer models and the civil/criminal dichotomy – aside from this, however, it remains rather underdeveloped theoretically. This paper addresses this lack of legal theoretical engagement with NCB asset forfeiture by providing an initial contribution from a systems-theoretical perspective. This contribution makes use of systems theory's unique insights to critique the perceived ‘failure of law’ that gave rise to the NCB approach, and challenges the legitimacy of that approach in terms of procedural rights.
Contributors
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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. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. 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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- Book:
- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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Contributors
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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
- Edited by Eric J. Bieber, Joseph S. Sanfilippo, University of Pittsburgh, Ira R. Horowitz, Emory University, Atlanta, Mahmood I. Shafi
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- Book:
- Clinical Gynecology
- Published online:
- 05 April 2015
- Print publication:
- 23 April 2015, pp viii-xiv
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Consumer health organisations for chronic conditions: why do some people access them and others don’t?
- Adem Sav, Sara S. McMillan, Fiona Kelly, Jennifer A. Whitty, Elizabeth Kendall, Michelle A. King, Amanda J. Wheeler
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- Journal:
- Primary Health Care Research & Development / Volume 15 / Issue 4 / October 2014
- Published online by Cambridge University Press:
- 05 February 2014, pp. 418-429
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Background
Consumer health organisations (CHOs), which operate outside the mainstream healthcare system with a specific focus on supporting people to self-manage their health conditions, have become widespread. Yet, there has been little systematic research into CHOs, including their perceived benefits and barriers, which encourage or deter their access by people with a variety of chronic health conditions.
AimThis study explored the benefits of CHOs in self-management and also the barriers that inhibit their access, from the perspective of people with chronic conditions and their unpaid carers.
MethodsIn-depth, semi-structured interviews were completed with 97 participants across four regions of Australia. The sample included a high representation of people from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander people as well as non-indigenous Australians.
FindingsThree inter-related themes were identified that represented the benefits of involvement and participation in CHOs: knowledge and information, connection and support and experiential learning. However, limited access pathways emerged as a barrier that inhibited a person’s entry into CHOs. Furthermore, the person’s beliefs and experiences about their own health condition(s) also inhibited their continued participation in CHO programmes.
ConclusionAlthough our findings confirm that CHOs are a valuable resource in alleviating the ‘work of being a patient’ for some people, there seems to be some barriers that prevent their full access and utilisation. Structured integration systems to increase the reliable delivery and accessibility of CHOs are needed to ensure that people who would benefit from accessing them can do so.