Multifaceted Causes Research Articles

Legal and Policy Interventions to Address Social Isolation

Americans suffer from an epidemic of loneliness stemming from perceived or actual social isolation (SI). Multi-faceted causes warrant novel public health legal responses to reduce significant impacts of SI on physical and mental health.

The Conceptualization problem in research and responses to sexual and gender-based violence in forced migration

ABSTRACT The conceptualization of sexual and gender-based violence (SGBV) has developed rapidly over recent decades and the understanding of SGBV in the context of forced migration continues to evolve. Based on a scoping review of scholarly work and reports by non-governmental organizations and international organizations between 1993 and 2018, this study identifies limitations to the current conceptualization of SGBV, and proposes a re-conceptualization. The paper argues that the existing literature overemphasizes the contexts of war zones and conflict and excludes post-flight settings, and focuses mainly on the victimization of women, excluding other at-risk groups. The tendency to focus on conflict zones and to underline the victim status of women constrains the usefulness of the conceptualization for informing research as well as protection and response. This review considers the multifaceted causes and consequences of gendered vulnerabilities and insecurities that are exposed in forced migration processes in order to make sense of SGBV as a gendered harm. Through a constructivist and de-essentialising theoretical lens, the study proposes to conceptualize SGBV in terms of continuities in forced migration occuring over time in interwoven territories and a variety of contexts from countries of origin to settlement.

Legal and Policy Interventions to Address Social Isolation.

Americans suffer from an epidemic of loneliness stemming from perceived or actual social isolation (SI). Multi-faceted causes warrant novel public health legal responses to reduce significant impacts of SI on physical and mental health.

Why "accidents" are not accidental: Using psychological science to understand and prevent unintentional child injuries.

Injuries are the leading cause of death for American children, killing over 11,000 children in 2017. They are also a rapidly increasing public health challenge globally: The World Health Organization ranks injury as the leading cause of death globally for children Ages 5 to 18 years, and the Global Burden of Diseases project estimates over 2 million children Ages 0 to 19 years died from injuries worldwide in 2017. Unintentional injuries, sometimes referred to as "accidents" by the lay public, are generally preventable, and psychological science has much to offer in societal efforts to develop, evaluate, implement, and disseminate effective prevention strategies. I first discuss the multifaceted causes of child injuries, which can be conceptualized using classic psychological theory, such as Bronfenbrenner's ecological theory, or classic injury prevention theory, such as the Haddon Matrix. In either case, behavioral risks stem from the child's developmentally influenced decisions and behaviors; the child's family, social, and physical contexts; and the child's broader cultural environments. Risks can also be conceptualized temporally, through behavioral analysis such as antecedents, behaviors, and consequences of the injury. I then present examples of behaviorally focused interventions that target the child, the adult supervisor, and the environment. In each case, I consider psychological risk factors present and the theory-based strategies that might interrupt or alter risk pathways to prevent injury events. I close with comments on the scope of injury as a global public health challenge and the central role psychologists can and should play to reduce the burden of child injury on the world's population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A longitudinal study of digital cushion thickness and its function as a predictor for compromised locomotion and hoof lesions in Holstein cows.

Lameness is a major animal welfare and economic issue for the dairy industry and is a challenge to overcome due to multifaceted causes. Digital cushion thickness (DCT) is a strong predictor of lameness and is phenotypically associated with incidence of claw horn disruption lesions (CHDL; sole ulcers and white line disease). We hypothesized that DCT varies between digits and across lactation within the cow. This variation could be characterized to predict the occurrence of CHDL or compromised locomotion. BCS, visual locomotion score (VLS), DCT, and presence or absence of lesions were collected at 4 time points: <40 d prepartum (DPP), 1 to 30 d in milk (DIM), 90 to 120 DIM, and ≥255 DIM for 183 commercial Holstein cows enrolled in the study. Cows underwent digital sonographic examination for the measurement of DCT evaluated at the typical sole ulcer site beneath the flexor tuberosity for the right front medial and lateral digits and right hind medial and lateral digits. Factors such as parity number and stage in lactation were obtained from farm management software (DairyComp 305; Valley Agricultural Software, Tulare, CA). Cows were grouped by parity: primiparous (parity = 1) or multiparous (parity ≥ 2). The prevalence of CHDL among time points ranged from 0% to 4.2% for primiparous cows vs. 2.5% to 25% for multiparous cows, whereas the prevalence of lameness based on VLS of 3 to 5 ranged from 1.7% to 8.3% for primiparous cows vs. 12.7% to 33% for multiparous cows. DCT varied within primiparous and multiparous cows based on stage of lactation and digit (P < 0.05) and was thicker for both parity groups prior to dry off (≥255 DIM) and thinnest prior to calving (<40 DPP) and after peak lactation (90 to 120 DIM). The DCT of the front medial digit was thickest for primiparous heifers, whereas the hind lateral digit was thickest for multiparous cows. The DCT of the hind medial digit was thinnest for both parity groups. Parity group and DCT of the hind lateral digit <40 DPP were important predictors of CHDL (P < 0.05), whereas parity group and DCT of the hind lateral digit and front lateral digit at 1 to 30 DIM were key predictors of VLS lameness (P < 0.05). These results may help identify animals with higher odds of developing these diseases by highlighting key time points and specific digits of importance for monitoring. In addition, it improves our biological understanding of the relationship between DCT and lameness.

Solving the clinical inertia conundrum

Solving the clinical inertia conundrum

Understanding the causes and consequences of work-family conflict

Purpose– An important theme for a twenty-first century employee is a desire for work and family balance which is devoid of conflict. Drawing on detailed empirical research, the purpose of this paper is to examine the multi-faceted causes and consequences of work-family conflict (WFC) in a non-Western context (Nigeria).Design/methodology/approach– The paper uses qualitative data gleaned from the semi-structured interviews of 88 employees (44 university lecturers and 44 medical doctors) in cities in the six geo-political zones of Nigeria.Findings– The findings showed that work pressure, heavy familial duties, poor infrastructural facilities, and a lack of suitable and practicable work-family balance policies are the main causes of WFC in Nigeria. Juvenile delinquencies, broken marriages/families, and an unhappy workforce are among the grave consequences of WFC among Nigerian employees.Originality/value– This paper suggests that the availability of basic infrastructural facilities, more governmental support, practicable work-family policies, inter alia, will reduce the level of WFC for Nigerian employees and will also results in positive spill-over from the work domain to the family domain and vice-versa.

Finding Our Direction: The Process of Building a Community-University Food Mapping Team

Multifaceted causes and consequences of food insecurity require collaborative work across multiple academic disciplines and with various community partners in order to build sustainable solutions. Interdisciplinary teams require thoughtful considerations of time devoted to team-building exercises, paying particular attention to understanding members’ values. Teams must find points of convergence, develop mutually agreed upon common language, and openly discuss needs and expectations. This paper describes the process of building a community-university Food Mapping Team to address food security. The FMT initiative allows for a well-coordinated exploration of data collection methods that capitalize on the diverse interdisciplinary expertise and resources of university researchers and extensive knowledge of community partners, whose work can inform, and be impacted by, these efforts. We provide a set of processes used to form our partnership and describe our decision-making process in the development of a community food security research project. We also include a self-assessment of the research planning and implementation process that our team used and describe areas of improvement for other community-university groups to consider.

Changing Student Beliefs about Poverty, Homelessness, and Community Service: Results from Interior Design Project Interventions

The purpose of this study was to examine undergraduate interior design student attitudes toward poverty, homelessness, and community service. A secondary purpose was to determine if exposure to design projects for those who have experienced hardship would change student beliefs. All freshmen ( n = 14), sophomore ( n = 22), junior ( n = 13), and senior ( n = 21) interior design undergraduate students at a public university completed a questionnaire based on several existing scales. During the semester, the sophomores worked on assignments that were designed to provide exposure to different socio–economic groups. First, students read the book Nickel and Dimed by Barabara Ehrenreich, which provided them with an overview of the problems associated with the poor. Next students completed three projects: (1) the design of a temporary homeless shelter, (2) a renovation of a childcare center office and reception area that provides services for low–income families, and (3) the design of a low–income, residential home. In all of these projects, students were required to conduct extensive information gathering so they could better understand the problems associated with poverty. At the end of the semester, the sophomores completed the questionnaire again and were asked additional questions regarding the class and projects. Student opinions towards the poor were more individualistic when compared to the middle class, yet when the middle–class comparison was removed, some of their attitudes provided a more complex understanding of poverty and homelessness. The semester–long intervention significantly shifted students’ understanding that emphasized structural and multifaceted causes of poverty.

Blood transfusion sampling and a greater role for error recovery.

Patient identification errors in pre-transfusion blood sampling ('wrong blood in tube') are a persistent area of risk. These errors can potentially result in life-threatening complications. Current measures to address root causes of incidents and near misses have not resolved this problem and there is a need to look afresh at this issue. PROJECT PURPOSE: This narrative review of the literature is part of a wider system-improvement project designed to explore and seek a better understanding of the factors that contribute to transfusion sampling error as a prerequisite to examining current and potential approaches to error reduction. A broad search of the literature was undertaken to identify themes relating to this phenomenon. KEY DISCOVERIES: Two key themes emerged from the literature. Firstly, despite multi-faceted causes of error, the consistent element is the ever-present potential for human error. Secondly, current focus on error prevention could potentially be augmented with greater attention to error recovery. Exploring ways in which clinical staff taking samples might learn how to better identify their own errors is proposed to add to current safety initiatives.

The EU's public finance crisis: causes, consequences and cure

This paper considers the causes and consequences of the crisis in the public finances of EU member states and other countries. It critically appraises the proposed ‘cures’ and whether they are likely to be successful by analysing ‘structural gaps’ in the public finances. The paper theorizes the multifaceted causes of the crisis—these being financial, political, institutional, economic and cultural. It concludes that the proposed cures will not necessarily close structural gaps and that a sustainable long-term strategy for the public finances has to be much more holistic, creating symmetry between decisions to spend and liability to finance those decisions.

Listening to the rumours: What the northern Nigeria polio vaccine boycott can tell us ten years on

In 2003 five northern Nigerian states boycotted the oral polio vaccine due to fears that it was unsafe. Though the international responses have been scrutinised in the literature, this paper argues that lessons still need to be learnt from the boycott: that the origins and continuation of the boycott were due to specific local factors. We focus mainly on Kano state, which initiated the boycotts and continued to reject immunisations for the longest period, to provide a focused analysis of the internal dynamics and complex multifaceted causes of the boycott. We argue that the delay in resolving the year-long boycott was largely due to the spread of rumours at local levels, which were intensified by the outspoken involvement of high-profile individuals whose views were misunderstood or underestimated. We use sociological concepts to analyse why these men gained influence amongst northern Nigerian communities. This study has implications on contemporary policy: refusals still challenge the Global Polio Eradication Initiative; and polio remains endemic to Nigeria (Nigeria accounted for over half of global cases in 2012). This paper sheds light on how this problem may be tackled with the ultimate aim of vaccinating more children and eradicating polio.

Risk Factor Analysis for Capsular Contracture

Although there are a few broadly agreed on contributory factors, the multifaceted causes of capsular contracture have remained unresolved for decades. This study investigates a variety of potential risk factors that contribute to capsular contracture in primary augmentation patients. The data used for this analysis include 5109 implants in 2560 primary augmentation patients implanted by 34 surgeons based on 5-year results from Sientra's clinical study. Patients were evaluated at annual visits where the capsular contracture Baker grade was recorded. Potential risk factors, including patient attributes, implant attributes, surgery characteristics, pocket irrigation, and postsurgery characteristics, were analyzed using frequency and multivariate models. A total of 265 capsular contracture events in 179 patients were reported through 5 years. The overall Kaplan-Meier rate for capsular contracture was 7.6 percent by device. The unadjusted analysis showed increased odds of capsular contracture in smooth devices, periareolar incision, subglandular placement, antibiotic and steroid pocket irrigation, recommended massage, and surgical bra (p<0.05 for all). Results from the multivariate analysis, adjusting for all variables in the model, found six factors to be independently associated with capsular contracture (i.e., implant placement, implant surface, incision site, hematoma or seroma development, device size, and surgical bra; p<0.05 for all). This analysis has provided evidence that submuscular placement and textured implants, in addition to other factors, are significant in reducing the incidence of capsular contracture.

Intersectoral Health Action in Tanzania – Determinants and Policy Implications

The tremendous human resource and economic burden of HIV/AIDS, malaria and diarrhoeal diseases is well acknowledged in many developing countries. Most of these diseases have multifaceted causes such as malnutrition, the consumption of contaminated water or poor education. Thus, cross-sectoral action is needed to lower the burden of disease in the long run. However, little has been done to investigate the causal relationship between investments in ‘health related’ sectors and the reduction of disease prevalence. This paper aims at analysing the marginal health returns to cross-sectoral government spending for the case of Tanzania. For this, the normative assumption is to maximise the amount of Disability Adjusted Life Years (DALYs) averted per dollar invested. A Simultaneous Equation Model (SEM) is developed to estimate the required elasticities. The results of the quantitative analysis show that the highest returns on DALYs are obtained by improved nutrition and access to safe water sources, followed by sanitation. Looking at the impact of indirect factors, the health effect of investments in mother education exceeds the effect of additional short- and long-term public spending on water.

Immunohistochemical and morphological features of a small bowel leiomyoma in a black crested macaque (Macaca nigra)

BackgroundSpontaneous gastrointestinal neoplasms in non-human primates are commonly seen in aged individuals. Due to genetic similarities between human and non-human primates, scientists have shown increasing interest in terms of comparative oncology studies.Case presentationThe present study is related to a case of an intestinal leiomyoma in a black crested macaque (Macaca nigra), kept on captivity by Matecaña Zoo, Pereira City, Colombia. The animal had abdominal distension, anorexia, vomiting, diarrhea and behavioral changes. Clinical examination showed an increased volume in the upper right abdominal quadrant caused by a neoplastic mass. The patient died during the surgical procedure. Necropsy revealed several small nodules in the peritoneum with adhesion to different portions of the small and large intestines, liver, stomach and diaphragm. Tissue samples were collected, routinely processed and stained by H&E. Microscopic examination revealed a mesenchymal tumor limited to tunica muscularis, resembling normal smooth muscle cells. Neoplastic cells were positive for alpha-smooth muscle actin and vimentin, and negative for cytokeratin AE1/AE3 by immunohistochemistry. Those morphological and immunohistochemical findings allowed to diagnose the intestinal leiomyoma referred above.ConclusionNeoplastic diseases in primates have multifaceted causes. Their manifestations are understudied, leading to a greater difficulty in detection and measurement of the real impact provides by this disease.

Paradoxes of Butchness: Lesbian Masculinities and Sexual Violence in Contemporary South Africa

In the past decade, violence targeting South African lesbians has increased exponentially. This article explores the multifaceted causes of this violence and its theoretical implications. Unstable parameters of masculinities and men’s exclusive claims to them are revealed in the ways that lesbian butchness threatens what it means to be a man, a question heightened in contemporary South Africa. The paradoxes of butchness and the possibilities offered by South African activists combating corrective or curative rape and murder suggest new models for reconceptualizing gender and sexuality more broadly.

Condition management and the causes of psychosis

PurposeThis Research Watch seeks to summarise two recent research papers. The first evaluates a scheme that trains people in managing their mental health or physical condition to increase their chances of gaining employment. The second examines the social causes of psychosis.Design/methodology/approachA search was carried out for research papers with a mental health and social inclusion focus published within the past 12 months.FindingsIn the first paper, half of a sample of over 2,000 people accessing a seven‐week cognitive behaviour therapy (CBT)‐based condition management programme (CMP) for people with mental or physical health conditions showed a clear improvement in psychological well‐being, and three months later 26 per cent were either in paid work or working towards it. However, there is a case for employment support being more integrated with the mental health system, and possibly also not to be time‐limited. The second paper highlights the importance of recognising the multifaceted and complex causes of psychosis and, in particular, social causes. If these social causes were to be given as much weight as biological factors, then it seems likely that social exclusion, and psychosis itself, would be reduced.Originality/valueThis paper summarises research relating to mental health and social inclusion that has emerged within the past 12 months.

Nitric oxide and endothelin after lipid apheresis – a pilot study

Objective Patients with the heterozygous form of familial hypercholesterolemia (FH) display an early onset of atherosclerosis due to disturbed vascular-endothelial function. Whether the improvements of endothelial function after lipid apheresis are mediated by increased NO-production or by an altered turnover of vasoconstrictors such as ET-1 is still unknown. This was the onset of the present study. Methods Patients with FH and advanced atherosclerosis receiving regular LDL apheresis at 1 to 3 weeks were recruited. Lipids, L-arginine (L-Arg), L-hydroxyarginine (NHA), L-citrulline as well as big endothelin (Big-ET) and endothelin (ET-1) were measured after DALI, HELP and TheraSorb apheresis. Results 17 patients with severe FH aged 55.6 years (mean) received a total of 30 treatments. TC, LDL-C, HDL-C, TG and TC / HDL-C ratio were reduced (55, 70, 9, 48, and 52%; p<0.01) with no differences between apheresis systems. L-Arg was reduced after apheresis (HELP −18.0%, DALI −26.5%; Therasorb −7.6%) and returned to baseline after 2h. Big-ET (p<0.01) and ET-1 were found to be increased directly and 2 hours after apheresis with HELP while transiently decreasing with DALI and Therasorb. Conclusion Improvement of endothelial function after apheresis seems to have multifaceted causes. The further elucidation of the interrelationship between endothelial dysfunction and restricted NO synthesis, as addressed in this study by measuring L-NHA, L-Arg, L-Cit, ET-1 and Big-ET will be necessary in the future.

Child Mobility in West Africa: Strategy, Poverty or Crime?

Over the past decade, the extensive mobility of children in West Africa has been systematically mis-specified as child trafficking. This mis-specification is a result of political framing that aims to attract funding to the activities of international agencies and NGOs. Attracting funding towards a group of relocating children that are often in critical need of support is in principle admirable. However, the simplifications resulting from framing a complex phenomenon has in this case prevented actors from taking into account the more multifaceted causes of child mobility in the region, and has thus led to mis-specified and even harmful policies. The article encourages the application ofa more solid knowledge base for future interventions in this area.

Cause and effect in childhood obesity: solutions for a national epidemic.

Childhood obesity has reached epidemic proportions in the United States. As a result, children are at increased risk for myriad preventable acute and chronic medical problems--many of which are associated with increased morbidity and mortality. In addition, childhood obesity has serious psychosocial consequences, such as low self-esteem, lower quality of life, and depression. The multifaceted causes and solutions to this pervasive health issue are discussed in the present review, as are pertinent health policy issues. Osteopathic physicians and other healthcare providers can play an important role in patient and family education, direct care, and advocacy.