Positive Endorsement Research Articles

Psychological Distress Among Youth Probationers: Using Social Determinants of Health to Assess Suicidal Thoughts and Behaviors.

For youth probationers, it is important to understand how mental health and substance use predict their suicidal thoughts and behaviors (STB) to identify interventions to reduce their psychological distress. In this study, risk and protective factor indicators based on the Youth Assessment and Screening Instrument (YASI) Full Assessment were used to explore STB of youth probationers. The study's overarching aim was to examine the associations of psychological distress and other risk and protective factors with youth probationers' STB based on a Social Determinants of Health framework. This cross-sectional secondary analysis reviewed YASI records from a sample of 11,607 probationers of age 12-18 years within a large urban setting. The study used logistic regression models to assess risk and protective factors for STB odds (5.79%, n = 672 positive endorsement). African Americans were less likely to report STB, and girls were much more likely than boys to report STB across risk factors. Mental health disorders and substance use increased STB risk. The findings underscore the need for screening and treatment of psychological distress for youth probationers. This study discussed these findings, strengths and limitations, and directions for future research.

Criteria Definitions and Network Relations: The Importance of Criterion Thresholds

Across various structured diagnostic instruments, the criteria used to diagnose alcohol use disorder (AUD) are not assessed consistently. For example, different instruments often pose questions that reflect different thresholds of the underlying symptoms. We consider the criteria for craving and the inability to cut down or stop drinking to demonstrate the influence of using different thresholds for a positive symptom endorsement with respect to the estimated edges of a symptom network. Results indicate that the utilization of these differing thresholds leads to significant differences in edge weights. Generally, higher thresholds relate more strongly to lower prevalence rate criteria, and the reverse for lower thresholds. These findings have implications for reproducibility of effects in symptom networks and their generalization across studies.

Suicide Screening in Primary Care: Use of an Electronic Screener to Assess Suicidality and Improve Provider Follow-Up for Adolescents

PurposeThe purpose of this study was to assess the feasibility of using an existing computer decision support system to screen adolescent patients for suicidality and provide follow-up guidance to clinicians in a primary care setting. Predictors of patient endorsement of suicidality and provider documentation of follow-up were examined. MethodsA prospective cohort study was conducted to examine the implementation of a CDSS that screened adolescent patients for suicidality and provided follow-up recommendations to providers. The intervention was implemented for patients aged 12–20 years in two primary care clinics in Indianapolis, Indiana. ResultsThe sample included 2,134 adolescent patients (51% female; 60% black; mean age = 14.6 years [standard deviation = 2.1]). Just over 6% of patients screened positive for suicidality. A positive endorsement of suicidality was more common among patients who were female, depressed, and seen by an adolescent−medicine board-certified provider as opposed to general pediatric provider. Providers documented follow-up action for 83% of patients who screened positive for suicidality. Documentation of follow-up action was correlated with clinic site and Hispanic race. The majority of patients who endorsed suicidality (71%) were deemed not actively suicidal after assessment by their provider. ConclusionsIncorporating adolescent suicide screening and provider follow-up guidance into an existing computer decision support system in primary care is feasible and well utilized by providers. Female gender and depressive symptoms are consistently associated with suicidality among adolescents, although not all suicidal adolescents are depressed. Universal use of a multi-item suicide screener that assesses recency might more effectively identify suicidal adolescents.

Situating Martin Heidegger's claim to a “productive dialogue” with Marxism

This critical review aims to more fully situate the claim Martin Heidegger makes in “Letter on Humanism” that a “productive dialogue” between his work and that of Karl Marx is possible. The prompt for this is Paul Laurence Hemming's recently published Heidegger and Marx: A Productive Dialogue over the Language of Humanism which omits to fully account for the historical situation which motivated Heidegger's seemingly positive endorsement of Marxism. This piece will show that there were significant external factors which influenced Heidegger's claim and that, when seen within his broader corpus, these particular comments in “Letter on Humanism” are evidently disingenuous, given that his general opinion of Marxism can only be described as vitriolic. Any attempt to explore how such a “productive dialogue” could be construed must fully contextualise Heidegger's claim for it. This piece will aim to do that, and more broadly explore Heidegger's general opinion of Marxism.

A simple screening test to recognize fibromyalgia in primary care patients with chronic pain.

Primary care providers are increasingly expected to recognize and treat fibromyalgia (FM) without significant interaction with rheumatologists. The purpose of this study was to evaluate the potential usefulness of 3 simple measures (tenderness to digital pressure, BP cuff-evoked pain, and a single patient question) as a screening test for possible FM in a patient with chronic pain. A total of 352 patients (mean age 50±16.3years, 70% female) scheduled for routine examination in 2 primary care practices were studied. They were comprised of 52 patients (14.8%) who carried a chart diagnosis of FM, 108 (30.7%) with chronic pain but not FM, and 192 who had neither pain nor FM (54.5%). Subjects were assessed for tenderness to digital pressure at 10 locations, BP cuff-evoked pain, and a single question, "I have a persistent deep aching over most of my body" (0-10). FM patients endorsed the single deep ache question substantially more than those with chronic pain but without FM (7.4±2.9 vs 3.2±3.4; P<.0001) and exhibited greater bilateral digital evoked tenderness (6.1±3.1 vs 2.4±2.4, P<0.0001), and BP-evoked pressure pain (132.6mmHg ±45.5 vs 169.2mmHg ±48.0, P<0.0001). However, on multivariate logistic regressions, the BP cuff-evoked pain became non-significant. On further analyses, a useful screening test was provided by: (1) pain on pinching the Achilles tendon at 4kg/pressure over 4seconds, and (2) and positive endorsement of the question "I have a persistent deep aching over most of my body". These results suggest that 2 tests, taking less than 1minute, can indicate a probable diagnosis of FM in a chronic pain patient. In the case of a positive screen, a follow-up examination is required for confirmation or refutation.

Efficacy of Treating Sexual Trauma in a Substance Abuse Residential Program for Women

This is a program evaluation of treating sexual trauma in a residential substance abuse treatment program for women. Residents who were seeking treatment for their substance abuse disorder (SUD), also had a history of both childhood and adult sexual trauma. Given the literature supporting concurrent trauma-SUD treatment, the Warrior Renew (WR) protocol (Katz, Warrior Renew: Healing from military sexual trauma, Springer, New York, 2014) was added to the curriculum of Alcoholics Anonymous 12-step groups, relapse prevention, and substance abuse education classes. The WR manual consists of coping skills to address sleep and anxiety, and cognitive/experiential restructuring to address anger/resentments due to injustice, betrayal, and self-blame. It also addresses interpersonal factors such as relationship patterns and healthy interpersonal skills. This evaluation was conducted as part of routine clinical care in a naturalistic setting. Nineteen residents graduated the program and opted to complete pre-and post-treatment assessments. Findings revealed significant decreases in symptoms of anxiety, depression, posttraumatic negative thinking, and PTSD, and significant increases in positive factors of optimism and self-esteem-- all with large effect sizes. In addition, 95% of the sample had a reliable change at the 95% confidence interval. Resident’s feedback to staff reflected strong positive endorsement of the WR program. Results suggest WR is a promising effective treatment for women who have had sexual trauma in a substance abuse residential treatment program.

'Hidden identities': perceptions of sexual identity in Beijing.

This article draws upon responses given by volunteers who work in the Beijing LGBT Centre regarding perceptions of sexual identity, and how Chinese culture affects hidden or open sexual identities of Chinese lesbian and gay people in this region. The insights gained from those working carefully to create social change offers an important and original contribution to the field of gay and lesbian studies in China. The findings indicate the volunteers at the Beijing LGBT Centre are frustrated by the lack of acceptance of non-heterosexual relationships among Chinese culture and society, and by the disregard of lesbian gay and bisexual (LGB) people by the Chinese government. The findings also illustrate stigmatization of homosexuality in China is enacted in structural terms (such as in the lack of policy, legislation and positive endorsement by governmental and socio-political organizations), public expression (such as negative attitudes, beliefs or reactions towards LGB people) and internalized repression (through fear of stigmatization, and subsequent abuse due to negative societal attitudes and discrimination). Influenced by the Chinese tradition of conforming to group values, the findings from this study show that volunteers at the Beijing LGBT Centre believe LGB people in China are generally hesitant to disclose their sexual identities, and reject the idea that there had been a collective shift in Chinese culture regarding increased acceptance of LGB people. It also finds volunteers at the LGBT Centre in Beijing blame Chinese culture for its lack of acceptance of non-heterosexual relationships, and state stigmatization of homosexuality in China is due to deep-rooted cultural homophobia.

Who is the Athlete Endorser? A Cross-Cultural Exploration of Advertising Practitioners’ Views

ABSTRACTThis study, via the use of focus groups, explores the common meanings that advertising practitioners in 10 countries associate with athlete endorsers. The study's macro perspective brings a unique understanding of practitioners’ universal thinking and practices in relation to athlete endorsement. It reveals that practitioners across the world correlate athlete endorsers with a wide range of positive and useful psychological, social, physical, skillfulness, and sport meanings. In particular, authenticity, objective performance, and the athletes’ belonging to the realm of sport—considered by practitioners as a carrier of positive meanings and as a “meeting place” between audiences and endorsers—were identified as greatly contributing to athletes’ positive endorsement value. The article places the various universal dimensions of athletes raised by practitioners in a holistic conceptual profile, in order to help visualize and organize thoughts when selecting athlete endorsers for marketing campaigns.

Feasibility and Safety of a Virtual Reality Dodgeball Intervention for Chronic Low Back Pain: A Randomized Clinical Trial.

This study of a virtual reality dodgeball intervention provides evidence of feasibility, safety, and utility to encourage lumbar spine flexion among individuals with CLBP and high fear of movement.

Predicting adherence to antiretroviral therapy among pregnant women in Guyana: Utility of the Health Belief Model

Barriers to antiretroviral therapy (ART) adherence among pregnant women are varied and complex. This study explored the constructs of a theoretical model, the Health Belief Model (HBM) to understand and predict ART adherence among pregnant women in Guyana. A cross-sectional study surveyed 108 pregnant women attending 11 primary care clinics. ART adherence ranging from the past weekend to three months was assessed through self-reports, and health beliefs with the Adherence Determinants Questionnaire (ADQ). Constructs with sufficient variation in responses were tested for association with the level of adherence using Spearman's rank correlation coefficient and test. Sixty-seven per cent (72) of the women reported being always adherent. Although there was positive endorsement of ART treatment and adherence, the HBM did not help in understanding or predicting ART adherence in this population. Only one item from the perceived susceptibility construct was significantly associated (p = 0.009) with adherence. Interventions are warranted to address ART adherence in this population, as 19% of the women were recently non-adherent. Although the ADQ did not contribute to a deeper understanding or provide insight into pathways that can be targeted for intervention, theoretical models can play a key role in identifying these pathways.

False Recognition in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease-Disinhibition or Amnesia?

Episodic memory recall processes in Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) can be similarly impaired, whereas recognition performance is more variable. A potential reason for this variability could be false-positive errors made on recognition trials and whether these errors are due to amnesia per se or a general over-endorsement of recognition items regardless of memory. The current study addressed this issue by analysing recognition performance on the Rey Auditory Verbal Learning Test (RAVLT) in 39 bvFTD, 77 AD and 61 control participants from two centers (India, Australia), as well as disinhibition assessed using the Hayling test. Whereas both AD and bvFTD patients were comparably impaired on delayed recall, bvFTD patients showed intact recognition performance in terms of the number of correct hits. However, both patient groups endorsed significantly more false-positives than controls, and bvFTD and AD patients scored equally poorly on a sensitivity index (correct hits—false-positives). Furthermore, measures of disinhibition were significantly associated with false positives in both groups, with a stronger relationship with false-positives in bvFTD. Voxel-based morphometry analyses revealed similar neural correlates of false positive endorsement across bvFTD and AD, with both patient groups showing involvement of prefrontal and Papez circuitry regions, such as medial temporal and thalamic regions, and a DTI analysis detected an emerging but non-significant trend between false positives and decreased fornix integrity in bvFTD only. These findings suggest that false-positive errors on recognition tests relate to similar mechanisms in bvFTD and AD, reflecting deficits in episodic memory processes and disinhibition. These findings highlight that current memory tests are not sufficient to accurately distinguish between bvFTD and AD patients.

Political participation in Australia: contingency in the behaviour and attitudes of citizens

ABSTRACTThis article explores the idea that a citizen's relationship with their polity is contingent on and liable to change under certain conditions. The assessment of the prospects for political reform requires an understanding of the contingent nature of political engagement. Drawing from a survey of a representative sample of Australians three insights emerge. First, although many Australian citizens are not directly engaged in political actions beyond voting most do present a ‘standby’ role that suggests potential to engage. Second, willingness to shift patterns of engagement may depend on general orientations towards the polity and we find extensive evidence of negative understanding of the political system as well as more positive endorsement of representative political practices. Our third finding is that citizens might be prepared to change their relationship with the polity depending on the kind of politics that is offered; hence providing a creative space for political reform.

A clinical procedures curriculum for undergraduate medical students: the eight-year history of a third-year immersive experience

BackgroundProcedural skills training is a critical component of medical education, but is often lacking in standard clinical curricula. We describe a unique immersive procedural skills curriculum for medical students, designed and taught primarily by emergency medicine faculty at The Ohio State University College of Medicine.ObjectivesThe primary educational objective of this program was to formally introduce medical students to clinical procedures thought to be important for success in residency. The immersion strategy (teaching numerous procedures over a 7-day period) was intended to complement the student's education on third-year core clinical clerkships.Program designThe course introduced 27 skills over 7 days. Teaching and learning methods included lecture, prereading, videos, task trainers, peer teaching, and procedures practice on cadavers. In year 4 of the program, a peer-team teaching model was adopted. We analyzed program evaluation data over time.ImpactStudents valued the selection of procedures covered by the course and felt that it helped prepare them for residency (97%). The highest rated activities were the cadaver lab and the advanced cardiac life support (97 and 93% positive endorsement, respectively). Lectures were less well received (73% positive endorsement), but improved over time. The transition to peer-team teaching resulted in improved student ratings of course activities (p<0.001).ConclusionA dedicated procedural skills curriculum successfully supplemented the training medical students received in the clinical setting. Students appreciated hands-on activities and practice. The peer-teaching model improved course evaluations by students, which implies that this was an effective teaching method for adult learners. This course was recently expanded and restructured to place the learning closer to the clinical settings in which skills are applied.

Development and Validation of a Four-Item Migraine Screening Algorithm Among a Nonclinical Sample: The Migraine-4.

The present study sought to develop and validate a screening algorithm from the ICHD-3 beta diagnostic criteria for migraine utilizing a nonclinical sample. The goal was to determine the most sensitive and specific symptoms for differentiating migraine from other headache disorders and to validate the derived symptom algorithm as a screening measure. Despite its prevalence and impact, migraine remains under-recognized and under-treated. The U.S. Headache Consortium recommended development and dissemination of validated screening measures as a means to improve diagnosis. Participants were 1829 young adults (71.5% female; 74.4% white; mean age = 19.09 years [SD = 2.05]) who reported headache via computerized diagnostic interview. From this group, 158 were found to have ICHD episodic or chronic migraine and were randomly split into experimental and holdout validation samples. Within the experimental sample, receiver operating characteristic (ROC) curve data were obtained for each candidate symptom (item); backward stepwise logistic regression analysis was performed among the items with the most predictive likelihood ratios to determine the optimal model for differentiating migraine from non-migrainous headache. The retained four-symptom algorithm was then validated among the holdout sample, in which various cutoff points were compared to gold standard diagnosis via ROC curve estimations to determine the optimal operating point (OOP) of the algorithm as a screening measure. Attack duration of 4-72 hours (100% [95% CI = 95-100%]), severity ≥ 5 (91% [82-97%]), photophobia (90% [80-96%]), and phonophobia (90% [80-96%]) showed the highest sensitivity, while vomiting (98% [96-99%]), duration of 4-72 hours (92% [90-94%]), nausea (89% [86-91%]), and headache-related disability (88% [85-91%]) showed the highest specificity. The optimal retained model (Migraine-4) included: duration of 4-72 hours, nausea, photophobia, and phonophobia. Among the holdout validation sample, the OOP was positive endorsement of three out of four symptoms, which had a sensitivity of 94% (95% CI = 87-98%), a specificity of 92% (90-94%), and an area under the curve of 93% (90-96%; +LR = 12.37, -LR = 0.06, PPV = 67%, NPV = 99%). The optimal model shares some similarities with previous models but performed better than prior screeners at differentiating migraine from other headache presentations. The Migraine-4 has utility in identifying migraine among nonclinical and young adult samples. Further research with this measure is warranted to determine its utility with treatment-seeking patients and validity in direct comparison to established screening instruments.

Clinical Practice Guideline for the Treatment of Intrinsic Circadian Rhythm Sleep-Wake Disorders: Advanced Sleep-Wake Phase Disorder (ASWPD), Delayed Sleep-Wake Phase Disorder (DSWPD), Non-24-Hour Sleep-Wake Rhythm Disorder (N24SWD), and Irregular Sleep-Wake Rhythm Disorder (ISWRD). An Update for 2015

A systematic literature review and meta-analyses (where appropriate) were performed and the GRADE approach was used to update the previous American Academy of Sleep Medicine Practice Parameters on the treatment of intrinsic circadian rhythm sleep-wake disorders. Available data allowed for positive endorsement (at a second-tier degree of confidence) of strategically timed melatonin (for the treatment of DSWPD, blind adults with N24SWD, and children/ adolescents with ISWRD and comorbid neurological disorders), and light therapy with or without accompanying behavioral interventions (adults with ASWPD, children/adolescents with DSWPD, and elderly with dementia). Recommendations against the use of melatonin and discrete sleep-promoting medications are provided for demented elderly patients, at a second- and first-tier degree of confidence, respectively. No recommendations were provided for remaining treatments/ populations, due to either insufficient or absent data. Areas where further research is needed are discussed.

A brief Addiction Recovery Questionnaire derived from the views of service users and concerned others

Aims: (i) To quantify support across five stakeholder groups for 20 recovery indicators previously generated from focus groups of service users and concerned others and (ii) To create a brief recovery questionnaire. Methods: Indicators were rated by stakeholders for their overall importance and the three most important ranked. The factor structure was determined by principal component analysis. Findings: The initial 20 recovery indicators covered the spectrum of substance misuse, social and psychological domains. Positive endorsement of each indicator by stakeholder group ranged from 53% to 74% of the maximum support possible with stronger support from service users and concerned others than from practitioners and commissioners. The greatest number of individuals in each stakeholder group, from 86% of combined problem drinkers and drug takers to 36% of specialist practitioners, rated abstinence as the single most important aspect of recovery and well-being was rated second most important. The indicators were refined to create a 12-item Addiction Recovery Questionnaire – the items have good independent evidence of importance to outcome to support their inclusion. Originality: The questionnaire is derived solely from the views of service users and concerned others – it is a brief tool with high face validity and suitable for routine use.

The heterogeneity of non-motor symptoms of Parkinson's disease.

In addition to motor symptoms, patients with Parkinson's disease (PD) may experience non-motor symptoms (NMS), more often with more advanced disease stage. However, the clinical feature of the NMS and potential risk factors that affect NMS in idiopathic PD patients remain unclear. 493 PD patients diagnosed with PD via the UK. Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria and 93 healthy control subjects (CN) were recruited in the current study. Questionnaires were used to assess the NMS, motor symptoms, cognitive function, and disease severity in both groups. Levodopa daily dose was calculated in PD patients. Multivariate linear regression analysis was used to identify the risk factors that potentially affect NMS in PD patients. The results showed that, the NMS occurrence and positive endorsement rate of PD patients were significantly higher compared to CN subjects. Multiple stepwise regression analysis found the motor symptom was the only factor that affected NMS in PD patients within five years of the disease course, whereas motor symptoms, cognitive function, disease severity and Levodopa daily dose significantly affected NMS if the disease course was more than five years. These findings demonstrated that NMS are affected by several risk factors at different stages of PD. The distribution of difference NMS is associated with the severity of motor symptoms and the dosage of anti-PD medications in Chinese PD patients.

Racial discrimination is associated with distressing subthreshold positive psychotic symptoms among US urban ethnic minority young adults

Racial discrimination is related to depression, anxiety, and severe psychological distress, and evidence drawn from studies emanating from the United Kingdom and The Netherlands suggest racial discrimination is also related to clinical psychosis and subthreshold psychotic symptoms in racial and ethnic minority (REM) populations. The present study sought to determine the association between racial discrimination experiences and attenuated positive psychotic symptoms (APPS) in a United States (US) urban, predominantly immigrant and REM young adult population. A cohort of 650 young adults was administered a self-report inventory for psychosis risk [i.e., Prodromal Questionnaire (PQ)], and the Experiences of Discrimination Questionnaire. The PQ allowed the dimensional assessment of APPS, as well as the categorical assessment of a potentially "high risk" group (i.e., 8 or more APPS endorsed as distressing), the latter of which was based on previous validation studies using the structured interview for prodromal syndromes. The relations between self-reported racial discrimination and APPS, and racial discrimination and "high" distressing positive PQ endorsement were determined, while accounting for anxiety and depression symptoms. Racial discrimination was significantly associated with APPS and with significantly higher odds of endorsing eight or more distressing APPS, even after adjusting for anxiety and depression symptoms. The present study provides preliminary evidence that racial discrimination among US ethnic minorities may be associated with APPS, as well as potentially higher risk for psychosis.

Midwifery-led care embedded within primary care: consumer satisfaction with a model in New Zealand

Providing quality maternity care for high-needs, socially deprived women from ethnic minority groups is challenging. Consumer satisfaction with maternity services is an important aspect of service evaluation for this group. This pilot study aimed to investigate the feasibility of using focus groups and interviews to gauge consumer satisfaction of maternity care by high-needs women, and to explore their perceptions of the Newtown Union Health Service (NUHS) model of a midwifery-led service embedded in primary care in Wellington, New Zealand (NZ). Following a previous audit of consumer satisfaction surveys collected over a six-year period, a qualitative pilot study using a thematic analytic approach was conducted at the NUHS in late 2011. The study assessed use of focus groups and interviews, interpreted where necessary, and considered the experiences reported by women about the model of care. Interviews and focus groups were successfully conducted with 11 women: two NZ European (individual interviews), six Cambodian (five in a focus group, one interview), and three Samoan (focus group). Using a thematic analytic approach, key themes identified from the focus group and interviews were: issues with survey form-filling; importance of accessibility and information; and relationships and communication with the midwifery team. Interviews and focus groups were well received, and indicated positive endorsement of the model of care. They also revealed some hitherto unknown concerns. Good quality feedback about satisfaction with a range of maternal and child health services helps service providers to provide the best possible start in life for children in high-needs families.

Transition in, Transition out: a sustainable model to engage first year students in learning. A Practice Report

Peer mentoring, presented as an inclusive teaching approach, embedded in the curriculum, has been successfully implemented to support first year student learning. Developing sustainable and scalable models for large first year cohorts, however, provides a challenge. The Transition in, Transition out model is a sustainable peer mentoring model supporting the transition of both first and final year students. The model has been implemented in two Australian psychology programs, one face-to-face and one delivered online. The focus in this Practice Report will be on the outcome data for on-campus first year student at one university. Participants were 231 first year students (166 females and 65 males). Results suggest positive changes in academic performance and learning approaches as well as positive endorsement of the model.