bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Photovoice to Explore Quality of Life Factors of Adults With Crouzon Syndrome
Authors: Wheeler Kelly J. , Early Jody O.
Published: December 2017

In the United States, one in 60,000 adults live with Crouzon Syndrome (CS) and facial malformations. Phenomenological studies about their lived experiences and quality of life are lacking. The purpose of this participatory action research study was to gain a richer understanding of the perceived biopsychosocial and socioecological factors that impact quality of life for adults living with CS using Photovoice. Another aim was to develop a conceptual framework of quality of life for those experiencing CS to enhance tailored health education and services. A purposeful sample of nine adults with CS were recruited from U.S. national surgery centers and support groups. Participants used photography to represent their experiences and participated in individual interviews and focus groups. Data were analyzed with the participants using thematic analysis, and 44 themes emerged which informed the development of a quality of life conceptual framework and action plan described in this article.
Building a Public Health Law and Policy Curriculum to Promote Skills and Community Engagement
Authors: Campbell Amy T.
Published: December 2017

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes with a more intensive service-learning strategy through the development of a Policy Lab.
Seminar in Public Health Law and Policy in an Interprofessional Setting: Preparing Practitioners for Collaborative Practice at the Macro Level
Authors: McCabe Heather A.
Published: December 2017

The author created a new course, called “Seminar in Public Health Law and Policy in an Interprofessional Setting” to address the need for interprofessional education (IPE) to equip graduate and professional students for collaborative practice at the systemic and policy (i.e., macro”) levels in the health care and public health fields. Despite important work being done at the clinical practice level, limited existing IPE models examine larger systemic issues. The course is designed specifically to enable students in social work, law, and public health to recognize the reciprocal relationships between policy and interprofessional collaborative practice, including the need for understanding of the impact of team-practice work at the system and policy levels.
Innovation in Higher Education: Lessons Learned from Creating a Faculty Fellowship Program
Authors: Kaufman Nancy J. , Scott Charity
Published: December 2017

This concluding essay offers reflections on core components of the faculty fellowship program, its outcomes and results, and program design and administration. Amid the current calls for reform in legal and other professional education, the lessons we learned and perspectives we gained during this fellowship program may be relevant to any faculty members and university administrations that are seeking to create more effective and engaged professional and graduate school programs, whatever may be their subject-matter discipline.
Cardiac Surgical Repair Should Be Offered to Infants with Trisomy 18, Interrupted Aortic Arch and Ventricular Septal Defect
Authors: Kavarana Minoo N.
Published: December 2017

The management of children born with trisomy 18 is controversial, and both providers and parents often have differing opinions. Many parents choose to terminate the pregnancy while others go forward, making decisions based on their beliefs, understanding, and physician recommendations. Physicians are similarly divided regarding treatment of these children, as some feel that aggressive treatments are futile while others defer to the parents' wishes.

Interrupted aortic arch with ventricular septal defect in children with trisomy 18 presents an ethical dilemma that highlights the kinds of controversies in medical decision making facing physicians on a daily basis. Repair of interrupted aortic arch with ventricular septal defect poses a high risk to newborns with or without trisomy 18. Therefore, the option for surgery should be treated as with any routine informed consent process. Parents should be counseled about the risks, benefits, alternatives, and the likelihood of success both short and long term and be should offered a choice between surgery and palliative care.
Raising Genomic Citizens: Adolescents and the Return of Secondary Genomic Findings
Authors: Sabatello Maya , Appelbaum Paul S.
Published: December 2017

Whole genome and exome sequencing (WGS/WES) techniques raise hope for a new scale of diagnosis, prevention, and prediction of genetic conditions, and improved care for children. For these hopes to materialize, extensive genomic research with children will be needed. However, the use of WGS/WES in pediatric research settings raises considerable challenges for families, researchers, and policy development. In particular, the possibility that these techniques will generate genetic findings unrelated to the primary goal of sequencing has stirred intense debate about whether, which, how, and when these secondary or incidental findings (SFs) should be returned to parents and minors. The debate is even more pronounced when the subjects are adolescents, for whom decisions about return of SFs may have particular implications. In this paper, we consider the rise of “genomic citizenship” and the main challenges that arise for these stakeholders: adolescents' involvement in decisions relating to return of genomic SFs, the types of SFs that should be offered, privacy protections, and communication between researchers and adolescents about SFs. We argue that adolescents' involvement in genomic SF-related decisions acknowledges their status as valuable stakeholders without detracting from broader familial interests, and promotes more informed genomic citizens.
Individual Responsibility for Promoting Global Health: The Case for a New Kind of Socially Conscious Consumption
Authors: Hassoun Nicole
Published: December 2017

The problems of global health are truly terrible. Millions suffer and die from diseases like tuberculosis, HIV/AIDS, and malaria. One way of addressing these problems is via a Global Health Impact labeling campaign (http://global-health-impact.org/). If even a small percentage of consumers promote global health by purchasing Global Health Impact products, the incentive to use this label will be substantial. One might wonder, however, whether consumers are morally obligation to purchase any these goods or whether doing so is even morally permissible. This paper suggests that if the proposal is implemented, purchasing Global Health Impact labelled goods is at least morally permissible, if not morally required. Its argument should, moreover, be of much more general interest to those considering different kinds of ethical consumption.
Biobank Regulation in South Korea
Authors: Lee Won Bok
Published: December 2017

Like many other countries, South Korea has recognized the importance of biobanks as a tool for medical research and has engaged in two very important tasks to foster biobanking infrastructure: funding biobanks and setting up rules to protect the integrity of biobanks that share potentially sensitive personal information.
Early Experience with the ACA: Coverage Gains, Pooling of Risk, and Medicaid Expansion
Authors: Blumberg Linda J. , Holahan John
Published: December 2017

We provide an overview of the characteristics of those who have gained insurance coverage due to the ACA as well as the characteristics of the remaining uninsured. We also describe the implications for the broader sharing of health care risks required under the law, and how they vary by individuals' health status. Finally, we assess the implications of state decisions to expand or not expand Medicaid eligibility under the law, how those decisions affect state finances, health care providers, residents, and how the effects may vary for those states using waivers to expand eligibility using strategies designed to be more broadly politically acceptable.
Who Do You Trust?
Authors: Mehlman Maxwell J.
Published: December 2017

The ability of patients to trust physicians to act in their best interests is a critical aspect of a welfare-maximizing relationship. This commentary discusses physician trustworthiness within the framework of the Affordable Care Act and considers steps to reinforce trustworthy behavior.
Show Us the Data: The Critical Role Health Information Plays in Health System Transformation
Authors: Thorpe Jane Hyatt , Gray Elizabeth A. , Cartwright-Smith Lara
Published: December 2017

Truly transforming the healthcare delivery and payment system turns on the ability to engage in the interoperable electronic exchange of patient health information across and beyond the care continuum. Achieving transformation requires a legal framework that supports information sharing with appropriate privacy and security protections and a trusted governance structure.
Regulating Information or Allowing Deception? Pharmaceutical Sales Visits in Canada, France, and the United States
Authors: Habibi Roojin , Guénette Line , Lexchin Joel , Reynolds Ellen , Wiktorowicz Mary , Mintzes Barbara
Published: December 2017

Diverse legal and regulatory measures are used internationally to control the information provided during pharmaceutical sales visits. Little is known about the comparative effectiveness of these measures however. We analyzed the perceptions of regulators, pharmaceutical industry officials, health professionals, and consumer respondents concerning these approaches in Canada, France, and the United States using an empirical realist interests-based approach. Interviews focused on the aims and effectiveness of regulation, barriers and enablers to regulation and suggestions for improvement. An alignment was found in North America regulator and industry respondents' satisfaction with the status quo and their view that further intervention is unfeasible and unnecessary. Health professionals generally expressed a lack of confidence in the impact of regulations on sales visit information while consumer advocates voiced their disappointment in both regulators and health professionals for their failure to counteract the influence of pharmaceutical marketing. Regulator and industry respondents in France differed from their North American counterparts in their willingness to increase and diversify the scope of regulatory interventions. As the first international comparison of regulatory experiences in this sector, the findings highlight the universal need for more focused and inclusive discussions among groups about how to tailor regulations to achieve public health goals.
Are Military and Medical Ethics Necessarily Incompatible? A Canadian Case Study
Authors: Rochon Christiane , Williams-Jones Bryn
Published: December 2017

Military physicians are often perceived to be in a position of ‘dual loyalty’ because they have responsibilities towards their patients but also towards their employer, the military institution. Further, they have to ascribe to and are bound by two distinct codes of ethics (i.e., medical and military), each with its own set of values and duties, that could at first glance be considered to be very different or even incompatible. How, then, can military physicians reconcile these two codes of ethics and their distinct professional/institutional values, and assume their responsibilities towards both their patients and the military institution? To clarify this situation, and to show how such a reconciliation might be possible, we compared the history and content of two national professional codes of ethics: the Defence Ethics of the Canadian Armed Forces and the Code of Ethics of the Canadian Medical Association. Interestingly, even if the medical code is more focused on duties and responsibility while the military code is more focused on core values and is supported by a comprehensive ethical training program, they also have many elements in common. Further, both are based on the same core values of loyalty and integrity, and they are broad in scope but are relatively flexible in application. While there are still important sources of tension between and limits within these two codes of ethics, there are fewer differences than may appear at first glance because the core values and principles of military and medical ethics are not so different.
Public Participation in Drafting of the 21st Century Cures Act
Authors: Hwang Thomas J. , Sachs Rachel E. , Kesselheim Aaron S.
Published: December 2017

The 21st Century Cures Act is a major act of legislation that contains numerous changes to drug and device regulation. The House of Representatives passed the Act after considerable interest group lobbying, but the bill and the key changes made during its drafting remain controversial. Using publicly disclosed records of written comments on the bill, we reviewed the key areas of lobbying activity and the compromises made in the final text. We focused on legislative provisions relating to management of the National Institutes of Health, incentives for medical product development, and approval standards for new drugs and devices. By the end of the first comment period, the Committee received 118 comments. Most respondents were patient organizations, professional societies, and pharmaceutical and device companies. Overall, the majority of public comments were positive, although public health and consumer organizations were underrepresented in the number of submitted comments. As the legislative process continued, the draft bill underwent several changes relating to NIH funding, market exclusivity provisions, and scrutiny of regulatory evidentiary standards. Understanding the key statutory provisions and how they have evolved could help patients, researchers, and advocates make more informed comments on the bill and future health care legislation.
Skin and Bone: Beauty as Critical Praxis
Authors: Spry Tami
Published: December 2017

That so many hegemonic constructs have been devised to exoticize and belittle beauty should be evidence enough that something about beauty is devastating to power, something just below the skin. And in revealing patriarchy’s sleight of hand, we may begin to see that beauty is skin, deep as skin, moving into muscle, bone, marrow. This essay seeks to explore beauty as a critical praxis; not a gender-only matrix, beauty’s critical strength is in the conscious sociocultural construction of bodies, their colors, shapes, sizes, and abilities. Beauty as a critical praxis is a personally, politically, willfully wanton utopian performative. That so many hegemonic constructs have been devised to exoticize and belittle beauty should be evidence enough that something about beauty is devastating to power, something just below the skin. And in revealing patriarchy’s sleight of hand, we may begin to see that beauty is skin, deep as skin, moving into muscle, bone, marrow. This essay seeks to explore beauty as a critical praxis; not a gender-only matrix, beauty’s critical strength is in the conscious sociocultural construction of bodies, their colors, shapes, sizes, and abilities. Beauty as a critical praxis is a personally, politically, willfully wanton utopian performative.
Mascots, Metaphor, Methodology: Counter Poetics
Authors: Lail Andrew J. , Lahman Maria K. E.
Published: December 2017

Through a series of counter poems, the authors, one of whom is a sport mascot performer, consider the experiences, cultural (mis)representations, and significance of sports mascots in United States.
Reflection of plane waves from the boundary of an initially stressed incompressible half-space
Authors: Shams M
Published: December 2017

In this paper, nonlinear theory of elasticity is used to study the effect of initial stress on plane waves in an incompressible material. For this problem, the initial stress is not associated with a finite elastic deformation and the material is assumed to be isotropic in the absence of the initial stress. The theory of superposition of infinitesimal deformations on finite deformation is applied to a problem of plane incremental motions in an initially stressed incompressible homogeneous elastic half-space. The general formulation of the problem is presented first and then specialized using a prototype strain energy function. Homogeneous plane waves are considered and the analysis is carried out for incompressible materials in both the deformed and the undeformed reference configurations. In addition to this, problems for the reflection of small amplitude homogeneous waves from the plane boundary of an initially stressed half-space are also considered and graphical results are included, which show the effect of initial stress on reflection. It is noted that the reflection coefficients in this case behave in a similar fashion when the initial stress is a pre-stress.
Variable-Centered, Person-Centered, and Person-Specific Approaches
Authors: Howard Matt C. , Hoffman Michael E.
Published: December 2017

The variable-centered approach is favored in management and applied psychology, but the person-centered approach is quickly growing in popularity. A partial cause for this rise is the finer-grained detail that it allows. Many researchers may be unaware, however, that another approach may provide even finer-grained detail: the person-specific approach. In the current article, we (a) detail the purpose of each approach, (b) describe how to determine when each approach is most appropriate, and (c) delineate when the approaches diverge to give differing results. Through achieving these goals, we suggest that no single approach is the “best.” Instead, the choice of approach should be guided by the research question. To further emphasize this point, we provide illustrative examples using real data to answer three distinct research questions. The results show that each research question can be fully addressed only by the appropriate approach. To conclude, we directly suggest certain research areas that may benefit from the application of person-centered and person-specific approaches. Together, we believe that discussing variable-centered, person-centered, and person-specific approaches together may provide a more thorough understanding of each.
Breast Cancer Survivors, Common Markers of Inflammation, and Exercise: A Narrative Review
Authors: Mills Robert Coleman
Published: December 2017

Exercise may help positively improve inflammatory marker levels, therefore promoting better outcomes in breast cancer survivors. This narrative review is intended to provide an overview between inflammation and breast cancer, in addition to the effects exercise may have on common inflammatory markers that have been examined in both healthy populations and breast cancer survivors throughout the literature. The inconsistencies and gaps in the literature addressed may be important for future research to further understand the relationship between exercise and inflammation, as well as the underlying biological mechanisms that are responsible for these changes. For the purpose of organization, this review is structured into the following sections: (1) Breast Cancer Facts, Treatment-Related Side Effects, and General Exercise Benefits; (2) Effects of Exercise on Markers of Inflammation in Cancer-Free Populations; (3) Cancer and Markers of Inflammation; (4) Effects of Exercise on Markers of Inflammation in Breast Cancer Survivors; and (5) Conclusions.
Clinical and Echocardiographic Predictors of Arrhythmias Detected With 24-Hour Holter Electrocardiography Among Hypertensive Heart Failure Patients in Nigeria
Authors: Mene-Afejuku Tuoyo Omasan , Balogun Michael Olabode , Akintomide Anthony Olubunmi , Adebayo Rasaaq Ayodele , Ajayi Olufemi Eyitayo , Amadi Valentine N , Oketona Omolola Abiodun , Ikwu Amanze Nkemjika , Mene-Afejuku Bamidele , Bamikole Olaniyi James
Published: December 2017

Background:

Hypertensive heart failure (HHF) is the commonest form of heart failure in Nigeria. There is paucity of data in Nigeria on 24-hour Holter electrocardiography (24-HHECG) and important predictors of arrhythmias among HHF patients.

Objectives:

To determine the 24-HHECG characteristics among HHF patients. To determine the clinical and echocardiographic predictors of arrhythmias detected using 24-HHECG among HHF patients.

Methods:

A total of 100 HHF patients as well as 50 age-matched and sex-matched apparently healthy controls were prospectively recruited over a period of 1 year. They all had baseline laboratory tests, echocardiography, and 24-HHECG.

Results:

Hypertensive heart failure patients had significantly higher counts of premature ventricular contractions (PVCs) than the controls ( P ≤ .001). Ventricular tachycardia (VT) was recorded in 29% of HHF patients as compared with controls who had no VT on 24-HHECG. The standard deviation of all normal to normal sinus RR intervals over 24 hours (SDNN) was abnormally reduced among HHF patients when compared with controls ( P = .046). There was positive correlation between atrial fibrillation (AF) and the following parameters: PVCs ( r = .229, P = .015), New York Heart Association (NYHA) ( r = .196, P = .033), and VT ( r = .223, P = .018). Following multiple linear regression, left ventricular ejection fraction (LVEF) ( P ≤ .001) and serum urea ( P = .037) were predictors of PVCs among HHF patients. Serum creatinine ( P ≤ .001), elevated systolic blood pressure (SBP) ( P = .005), and PVCs ( P ≤ .001) were important predictors of VT among HHF patients.

Conclusions:

Renal dysfunction and reduced LVEF were important predictors of ventricular arrhythmias. High counts of PVCs and elevated SBP were predictive of the occurrence of VT among HHF patients. The NYHA class and ventricular arrhythmias have a significant positive correlation with AF. The SDNN is reduced in HHF patients.
Takotsubo Cardiomyopathy Precipitated by Tapering of Anxiolytic Medication: A Case Report
Authors: Lafferty Christopher J , Lafferty Kristen M , Bhat Tariq , Olson Peter C , Atoot Adam , Daneshvar Farshid , McCord Donald A
Published: December 2017

Takotsubo cardiomyopathy is a transient apical ballooning of the left ventricle typically with electrocardiographic changes and enzyme release without evidence of obstructive coronary artery disease. It typically occurs in postmenopausal women and may have a predilection for patients with anxiety disorders. The following is a case in which we believe takotsubo cardiomyopathy was induced by the tapering of antianxiety medications. We feel that health care professionals should be aware of this possibility in such a patient population especially when they have demonstrated cardiovascular symptomatology.
Peritoneal Dialysis and Retroperitoneal Laparoscopic Radical Nephrectomy: A Favorable Experience With a Patient Complicated by Renal Cell Carcinoma
Authors: Imai Reika , Akimoto Tetsu , Kimura Takaaki , Kohara Marina , Shimizu Toshihiro , Oka Kentaro , Shuto Miwa , Asakura Maki , Nagayama Izumi , Takeda Shin-ichi , Yagisawa Takashi , Muto Shigeaki , Nagata Daisuke
Published: December 2017

Peritoneal dialysis (PD) is an accepted modality for managing end-stage kidney disease. We herein report a 75-year-old female patient on chronic PD who was complicated by renal cell carcinoma. She was successfully treated with retroperitoneal laparoscopic radical nephrectomy followed by a prompt resumption of the procedure. Various surgeries disturbing the abdominal wall integrity often disrupt the regular PD schedule, and using minimally invasive approaches is therefore an attractive therapeutic option. Our experience emphasizes the feasibility and safety of a retroperitoneal approach–based laparoscopic technique based on several empirical examples. However, systemic studies on this topic are obviously lacking, so we strongly recommend the accumulation of more cases similar to our own. Several surgical concerns that need to be dealt with among PD patients are also discussed.
Evaluation of FreeStyle Libre Flash Glucose Monitoring System on Glycemic Control, Health-Related Quality of Life, and Fear of Hypoglycemia in Patients with Type 1 Diabetes
Authors: Al Hayek Ayman A , Robert Asirvatham A , Al Dawish Mohamed A
Published: December 2017

Background/objectives:

In the current era of modern technology and the development of smart devices such as the flash glucose monitoring (FGM) systems, patients can easily monitor their glucose levels more frequently without any inconvenience. In this study, we evaluate the effect of FreeStyle Libre FGM system on glycemic control, hypoglycemia, health-related quality of life (QoL), and the fear of hypoglycemia (FOH) among children and young people with type 1 diabetes (T1D).

Design and methods:

A prospective study was conducted at the Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between January 2017 and May 2017 on 47 (aged 13-19 years) registered patients with T1D who used conventional finger-pricking method for self-testing the glucose. At baseline visit, the FGM sensors were placed on each participant by a trained diabetes educator. The data collected from the sensors were computed to generate the respective ambulatory glucose profiles so as to determine the total number of scans conducted during the study period. At the baseline and at 3 months of the experiment, a trained interviewer administered the questionnaire Hypoglycemia Fear Survey-Child Version (HFS-C) and PedsQL 3.0 (QoL questionnaire) to each patient. The age, sex, weight, height, adjusted body mass index, duration of diabetes, treatment modality, and glycosylated hemoglobin A1c (HbA1c) levels of each patient were recorded.

Results:

As compared with the baseline, a significant improvement was noted in the behavior of FOH ( P = .0001), worry ( P = .0001), QoL ( P = .002), HbA1c level ( P = .008), and hypoglycemia ( P = .023) at 3 months. Significant improvement was noted in the behavior ( P = .0001), worry ( P = .0001), QoL ( P = .003), HbA1c level ( P = .014), and hypoglycemia ( P = .001) among the multiple-dose insulin injection–treated patients as compared with baseline. Significant improvement was noted in the behavior ( P = .0001), worry ( P = .0001), and hypoglycemia ( P = .001) among the insulin pump–treated patients as compared with baseline. A positive correlation was recorded in the behavior ( r = .47; P < .001), QoL ( r = .70; P < .001), and the mean number of FGM scans. A negative correlation was recorded in the worry ( r = −.43; P = .002), HbA1c level ( r = −.58; P < .001), hypoglycemia ( r = −.65; P < .001), and the mean number of FGM scans.

Conclusions:

The frequent use of FGM scanning reduced the frequency of hypoglycemia, HbA1c level, and worry and increased the behavior and QoL. As compared with self-testing by the conventional finger-pricking method, the use of FGM increased the frequency of self-testing and thus diabetes control.
A multicenter randomized controlled trial of two group education programs for fatigue in multiple sclerosis: Short- and medium-term benefits
Authors: Hugos Cinda L , Chen Zunqiu , Chen Yiyi , Turner Aaron P , Haselkorn Jodie , Chiara Toni , McCoy Sean , Bever Christopher T , Cameron Michelle H , Bourdette Dennis ,   On Behalf of the VA MS Fatigue Study Group
Published: December 2017

Background

Fatigue occurs in 75%–95% of people with multiple sclerosis (MS) and is frequently reported as the most disabling symptom. A multicomponent group program of six weekly 2-hour sessions, Fatigue: Take Control (FTC), was developed from an international MS fatigue management guideline.

Objective

To determine whether FTC is associated with greater improvements in fatigue than MS: Take Control (MSTC), a similarly structured general MS education program.

Methods

This four-site, parallel, single-blind, randomized controlled trial compared FTC and MSTC in 204 ambulatory participants with MS. The primary outcome, the Modified Fatigue Impact Scale (MFIS), and secondary outcomes of self-efficacy, physical activity, sleep, and medications were assessed at baseline, program completion, and 3 and 6 months later.

Results

Mean MFIS scores improved in both groups between baseline and program completion (FTC −4.4, p < 0.001; MSTC −3.8, p < 0.001), between baseline and 3 months after program completion (FTC −3.2, p = 0.01; MSTC −3.3, p = 0.01), and between baseline and 6 months after program completion (FTC −5.2, p < 0.001; MSTC −4.8, p < 0.001). These improvements were not statistically different between groups ( p = 0.64, 0.92, and 0.82, respectively).

Conclusion

Participation in FTC modestly improved self-reported fatigue for up to 6 months. This improvement did not differ significantly from that occurring with the control program.
Social media for health promotion: What messages are women receiving about cardiovascular disease risk by the Canadian Heart and Stroke Foundation?
Authors: Gonsalves Christine A , McGannon Kerry R , Schinke Robert J
Published: December 2017

The aim of this study was to explore the meanings of women’s cardiovascular disease constructed within the Canadian Heart and Stroke Foundation Facebook page. Posts from Heart and Stroke Foundation and public user comments surrounding the launch of the Heart and Stroke Foundation re-branding were of interest. Ethnographic content analysis was employed to analyse text ( n = 40), images ( n = 32), videos ( n = 6), user comments and replies ( n = 42) from November 2016 to March 2017. Constructions (re)presented on Facebook of ‘typical’ women at risk and risk reduction were problematic as women most at risk were excluded through the use of consumerist, medicalized identities which also excluded promotion of healthy behaviour changes.
‘A UK Sociolinguistic Perspective: Gene, Jeffrey and Evangelical ‘Broad Inclusion’ Intersubjectivity’
Authors: Heather Noel
Published: December 2017

Critical sociolinguistics (conceived as Critical Discourse Analysis: CDA), which has a focus on inclusive and exclusive language within social practice, can be used to shed light on underlying aspects of recent debates about the appointment of homosexual bishops in the UK and USA. One strand of the CDA approach is to examine the social cognitions implicit in the behaviours of communities. In the case of the religious communities involved here, a basic feature of their differences lies in their use of contrasting socio-theological, mentally-encoded schemata: the Evangelical, group-focused, strong commitment frame (SCF) contrasts sharply with the more liberally-inclined, more ‘individual-respecting’, social normalcy frame (SNF). One of the consequences of this is that Evangelicals appear to enjoy a particularly strong sense of ‘mental bonding of outlook’, intersubjectivity, in which a high focus on group objectives and social outlooks is closely allied to their traditional beliefs. And although Evangelical, ‘group- thought’ intersubjectivity may aid mental resistance to change on some social issues (eg homosexual bishops), it may however also help maintain ‘broad inclusion’ in terms of social marginalisation of normally more common, but perhaps less ‘culturally visible’ kinds (eg the single and elderly).
‘Trees don't Talk: A Methodological Account of a Forest Sociologist in Mexico’
Authors: Mitchell Ross E.
Published: December 2017

This paper examines personal experience as both a sociologist and forester collecting data in the southern state of Oaxaca, Mexico. It builds on writings where researchers have taken an introspective or auto/biographical approach to problematizing their own involvement. My findings illustrate that demographic and social features such as gender, nationality, and language can both hinder and privilege social science research. Moreover, this paper disputes the contention that expertise in a given specialty automatically makes for good field research. Depending upon the type of research and the questions being addressed, previous professional experience may actually hinder the building of rapport in certain cases. Genuine efforts to engage in local discourse can ultimately serve to improve fieldwork, and contribute to mutual understanding.
‘Cyber-Mothers: Online Synchronous Interviewing using Conferencing Software’
Authors: O'Connor Henrietta , Madge Clare
Published: December 2017

The potential of the Internet as a valuable methodological tool for social science research is increasingly being recognised. This paper contributes to the debate surrounding virtual synchronous interviews and the value of online research. Specifically it introduces the use of a software conferencing technique - Hotline Connect - and discusses the implications of using the technique for Internet- based research. In particular issues of interview design, developing rapport, the role of insiders and outsiders in the research process, language use and the virtual interface are considered. The paper draws on the experience of a recent research project entitled ‘Cyberparents’ and concludes that the use of conferencing software holds great potential for synchronous online interviewing. However, this must be combined with sensitive, ethical handling of both the research process and the data to overcome both the weaknesses of this particular method and those inherent in any interviewing situation.
Researching Hard-to Reach Populations: Privileged Access Interviewers and Drug Using Parents
Authors: Taylor Nicola Jane , Kearney Jackie
Published: December 2017

Accessing drug using populations is notoriously fraught with difficulties for researchers (Gurdin & Patterson, 1987; Griffiths, Gosspo & Strang, 1993; Renzetti & Lee, 1993; Spreen & Zwaagstra, 1994; Goode, 2000; Elliott et al., 2002). These difficulties are the result of a number of reasons. The main one being that drug use is often illicit and/or illegal which often leads to the stigmatization of drug users within the media and elsewhere and this may ultimately lead to their lives being ‘concealed by a veil of ignorance’ (Elliott et al., 2002: 172). When one adds to this the fact that the population in question may have even more reason to remain hidden, for example, that they are drug using parents who may wish to conceal their identity as either parent or as drug user, accessing them may be even more complicated for researchers, service providers and policy makers alike.
Network Dynamics in the Transition to Democracy: Mapping Global Networks of Contemporary Indonesian Civil Society
Authors: Nugroho Yanuar , Tampubolon Gindo
Published: December 2017

This paper seeks to make transparent the mutually reinforcing relationships between global civil society, democracy and network society, which are often implicit in extant theories. The concept of a ‘global civil society’ cannot be separated from the promotion of democracy. Global civil society itself is one of the most explicit instances of the emergence of network society in the modern age and democracy lies at the very heart of what constitutes a network society. However, very little has been said about how these apparent mutually reinforcing relationships arise. Focusing on the case of Indonesia during the fraught regime change from authoritarianism to democracy, we investigate the role of transnational and national civil society organisation during the periods of pre-reform, reform and post-reform. Using multi-methods, including social network analysis and interviews with civil society activists and networkers, we discover a less encouraging picture of these relationships and conclude that the forging of this virtuous circle has some obvious gaps. We attempt to account for these apparent gaps in this mutually reinforcing relationship in terms of different modes of political participation. We suggest that some forms of ‘chequebook activism’ characterised the global civil society role during an abrupt and bloody regime change.
Posttraumatic world assumptions among treatment-seeking refugees
Authors: ter Heide F. Jackie June , Sleijpen Marieke , van der Aa Niels
Published: December 2017

The clinical relevance of negative changes in cognitions about oneself, others, and the world is reflected in the diagnostic criteria for posttraumatic stress disorder (PTSD) in the DSM-5 and complex posttraumatic stress disorder in the ICD-11. Although such changes in cognition have been posited to be especially relevant for traumatised refugees, few studies have examined this in refugee populations. The present study used a cross-sectional design to compare negative cognitions among 213 adult treatment-seeking refugees with those in previously published samples from the general population, veterans with combat-related PTSD, and whiplash victims. Measures included the World Assumptions Scale (WAS) and the Events and DSM-IV PTSD subscales of the Harvard Trauma Questionnaire (HTQ). Path models examined the relation of the WAS subscales to five demographic and trauma-related variables. Results showed that world assumptions were especially negative with regard to Benevolence of World, Benevolence of People, and Luck subscales, on which refugees scored lower than all reference samples. Differences between the refugee sample and the reference samples were smallest with regard to self-worth and self-controllability. World assumptions were associated with gender and PTSD symptom severity but not with age, length of residence in the Netherlands, and number of traumatic event types. The DSM-5 criterion of negative changes in belief about oneself, others, and the world appears more applicable to refugees than the more narrowly formulated ICD-11 criterion of diminished and defeated sense of self. Prevention and treatment efforts with refugees may need to be especially aimed at preventing a further decline of trust as well as restoration of trust in others and the world.
Posttraumatic stress disorder and comorbid depression among refugees: Assessment of a sample from a German refugee reception center
Authors: Belz Maria , Belz Michael , Özkan Ibrahim , Graef-Calliess Iris T.
Published: December 2017

In 2015, a large number of refugees arrived in Germany, mostly driven to emigrate by devastating circumstances in their countries of origin. Arriving refugees are distributed to reception centers within the German federal states, frequently facing marginal conditions in terms of overcrowding or waiting time of several months until their application for asylum is processed. Most of these refugees underwent numerous traumatizing experiences—both in their country of origin and while fleeing from their country of origin. Furthermore, they faced and will likely continue to face various access barriers to mental health care. In this study, we assessed a sample of 85 refugees from a reception center in Germany selected due to their observed psychological strain. Results showed that the majority suffered from posttraumatic stress disorder, mostly with symptoms of intrusion, hyperarousal, avoidance, and dissociation. Most refugees also suffered from comorbid depression. We discuss implications of these findings for reception services and the need for more preventive psychiatric care.
The emotional distress of asylum seekers in Israel and the characteristics of those seeking psychiatric versus medical help
Authors: Kiat Naama , Youngmann Rafael , Lurie Ido
Published: December 2017

Israel has become a destination for asylum seekers. Asylum seekers often experience emotional distress, but have limited access to health services and rarely use psychiatric services. This study sought to understand and characterize the use of psychiatric versus medical services by asylum seekers in Israel. We compared the emotional distress, stressful life events and previous treatment consultations of 21 psychiatric service users (PSU) and 55 medical service users (MSU) at the Open Clinic of Physicians for Human Rights in Tel-Aviv. Participants completed a socio-demographic questionnaire, the General Health Questionnaire (GHQ-12), the Stressful Life Events Scale and the Health Care Utilization Questionnaire. PSU and MSU did not have significantly different levels of emotional distress. PSU reported significantly more stressful life events during the past year than MSU ( M = 5.81, SD 3.47 vs. M = 3.8, SD 2.35, p < 0.01). In comparison to MSU, PSU utilized more medical ( M = 4.33, SD 2.28) and non-medical ( M = 2.38, SD 1.92) services ( p < 0.001) than MSU. Asylum seekers who consulted multiple treatment agencies in the last year were 1.55 times more likely to seek psychiatric treatment than those who had consulted only a few treatment agencies. Emotional distress in asylum seekers appears to be under-diagnosed in the Open Clinic and under-treated by mental health professionals. To better detect this distress, a thorough screening is recommended at assessment. Collaboration with mental health professionals and community and religious leaders consulted in the past is important and can contribute to good health care outcomes in this population.
Treatment of sleep disturbances in refugees suffering from post-traumatic stress disorder
Authors: Sandahl Hinuga , Vindbjerg Erik , Carlsson Jessica
Published: December 2017

Sleep disturbances are often referred to as the hallmark of Post-Traumatic Stress Disorder (PTSD). Although PTSD is prevalent in refugees, studies on sleep disturbances in trauma-affected refugees are scarce. This article presents the results of two studies: a systematic review of the literature on treatment of sleep disturbances in adult trauma-affected refugees and a study of the role of sleep disturbances in the PTSD symptom structure. Study 1, the literature review, identified five studies on treatment of sleep disturbances: four studies were on pharmacological treatment and one study on music therapy. The identified studies had small sample sizes and few carried out statistical analysis. It was not possible from the available literature to recommend any specific treatment of sleep disturbances. In Study 2, a clinical sample of 752 refugees, fulfilling criteria for PTSD and enrolled in treatment at the Competence Centre for Transcultural Psychiatry, Denmark, completed the Harvard Trauma Questionnaire (HTQ) before and after treatment. To determine item discrimination, the data was tested with a Rasch model. 99.1% reported trouble sleeping and 98.7% reported recurrent nightmares. The Rasch analysis displayed fit residuals of 0.05 for trouble sleeping and –1.16 for nightmares, indicating sufficient discrimination. Trouble sleeping and nightmares proved important parts of the HTQ response structure. This study indicates that sleep disturbances are a prominent part of the PTSD symptom structure in refugees but that research on treatment of sleep disturbances is limited. Further research on sleep disturbances in trauma-affected refugees is therefore needed.
“If I speak English, what am I? I am full man, me”: Emotional impact and barriers for refugees and asylum seekers learning English
Authors: Salvo Tania , de C Williams Amanda C
Published: December 2017

Lack of proficiency in the language of the host country predicts distress among refugees, but many refugees and asylum seekers in the United Kingdom have less than functional English. This study examined how learning English affected refugees’ and asylum seekers’ lives, particularly their emotional wellbeing, to explore what factors, particularly psychological ones, facilitated or impeded their learning English. We recruited 16 refugees and asylum seekers from an inner-city National Health Service trauma service and from a charity providing one-to-one English classes. All participants were interviewed in English. Interview data were analysed using thematic analysis from a critical realist perspective. Interviewees provided consistent accounts of their efforts to learn English, integrated into often unsettled and difficult lives. The analysis generated six themes in two domains. The impact of learning English was mainly positive, associated with autonomy, sense of achievement, and aspirations. Barriers to learning English consisted of other problems affecting refugees’ capacity to learn, limited opportunities to speak English, and a sense of shame associated with perceived lack of English language competence. Findings highlight the need to provide adequate psychological support for refugees and asylum seekers learning English, recognising its importance in promoting both their integration in the UK and their individual psychological well-being.
Mental health of immigrants and refugees seeking legal services on the US-Mexico border
Authors: Paat Yok-Fong , Green Rachel
Published: December 2017

The debates on the mental health benefits associated with immigration are mixed. On the one hand, immigrants are provided with more opportunities not available in their home countries. On the other hand, they are far away from home and may have been exposed to traumatic experiences on their journeys to the receiving country. Even after settling down in the receiving country, most continue to face legal battles associated with their immigration status, as shown in this study. This study examined the risk and protective factors associated with the mental health conditions in a sample of 39 immigrants and refugees seeking legal services on the US-Mexico border. Participants were recruited from a southwestern community agency serving the region’s immigrant population over the past three decades. Negative mental health states including stress, sadness, and anxiety were frequently reported by the participants. Six themes were identified as significantly related to the participants’ adjustment in the US: (1) political turmoil and safety issues; (2) economic hardship and extreme poverty; (3) trauma before and after resettlement; (4) immigration status; (5) family relational strain; and (6) identity struggle and acculturation. Overall, results demonstrate the complexity of issues pertaining to cross-country migration, cultural sensitivities, and mental health.
Long-term effects of a Swedish lifestyle intervention programme on lifestyle habits and quality of life in people with increased cardiovascular risk
Authors: Lidin Matthias , Ekblom-Bak Elin , Rydell Karlsson Monica , Hellénius Mai-Lis
Published: December 2017

Aims: The aim of this study was to evaluate the effects of a structured intervention programme on lifestyle habits and quality of life after six months and one year in participants with increased cardiovascular risk. Methods: Participants aged ≥18 years with increased cardiovascular risk were referred from primary health care and hospitals. The programme was launched at an outpatient clinic in a department of cardiology at a university hospital. It consisted of individual visits to a nurse for a health check-up and lifestyle counselling at baseline, after six months and at one year. In addition, five group sessions – focusing on nicotine, alcohol, physical activity, eating habits, stress, sleep and behavioural change – were offered to the participants and their relatives or friends. Lifestyle habits and quality of life were assessed with questionnaires at baseline, after six months and at one year. Results: One hundred participants (64 women, 36 men, age 58±11 years) were included in the programme. Compared with the baseline, significant and favourable changes in reported lifestyle habits were noted. Exercise levels were higher after one year and sedentary time decreased from 7.4 to 6.3 h/day. Dietary habits improved and the number of participants with a high consumption of alcohol decreased. Quality of life improved after one year. Conclusions: Participating in a structured lifestyle programme resulted in improved lifestyle habits and quality of life over one year in people with increased cardiovascular risk. Components such as an inter-professional teamwork, a focus on lifestyle rather than the disease, and combining individual visits and group sessions, might be central to the positive outcome of the programme.