The Grip of Trauma: How Trauma Disrupts the Academic Aspirations of Foster Youth

The academic challenges foster youth encounter during their P-12 education have been widely reported. Yet, despite these challenges, the majority of foster youth desire postsecondary education. What is less known is the reason why so few foster youth alumni who desire a four-year college degree, achieve this goal. For the participants in this four-year longitudinal study, maltreatment, resulting in foster care placement, and the ensuing exposure to the foster care system, resulted in trauma histories and mental health diagnoses. Anxiety, depression, and posttraumatic stress disorder (PTSD), were the most common diagnosis. The participants shared the ways in which these mental health challenges manifested throughout their college education. Of those in the study, almost half successfully graduated from college, a third dropped out, and only two remain enrolled. This study provides a unique and critical insight into the experiences of foster youth, enrolled in a four-year university, by sharing their storie

Pricing Heart Attack Treatments

In this paper, we estimate price indices for heart attack treatments, demonstrating the techniques that are currently used in official price indices and presenting some alternatives. We consider two types of price indices, a Service Price Index, which prices specific treatments provided, and a Cost of Living Index, which prices the health outcomes of patients. Both indices are complicated by price measurement issues: list prices and transactions prices are fundamentally different in the medical care field. The development of new or modified medical treatments further complicates the comparison of like' goods over time. And the Cost of Living Index is hampered by the need to determine how much of health improvement results from medical treatments in comparison to other factors. We describe methods to address each of these obstacles. We conclude that whereas traditional price indices when applied to heart attack treatments are rising at roughly 3 percent per year above general inflation, a corrected service price index is rising at perhaps 1 to 2 percent per year above general inflation, and the cost of living index is falling by 1 to 2 percent per year relative to general inflation. We discuss the implications of these results for official price index calculations.

Psychologization or the discontents of psychoanalysis

This article explores the possibility of a debate between psychoanalysis and the human sciences and, in particular, between psychoanalysis and psychology. Psychoanalysis's particular view on subjectivity values fiction (truth having the structure of fiction) as a constitutive dimension of personal and social reality. In contrast, the mainstream psy-sciences threaten to remain caught in the attempt to unmask things as they really are (eg, hard neurobiological reality), thus risking losing the subjective dimension as such. Drawing on examples of phenomena of psychologization (in Reality TV and in contemporary discourses of parent and child education), the author spells out the different, but eventually and necessarily intertwined, responses of psychoanalysis and psychology to modernity and modern subjectivity

How to Identify Scientifc Revolutions?

Conceptualizing scientific revolutions by means of explicating their causes, their underlying structure and implications has been an important part of Kuhn's philosophy of science and belongs to its legacy. In this paper we show that such “explanatory concepts” of revolutions should be distinguished from a concept based on the identification criteria of scientific revolutions. The aim of this paper is to offer such a concept, and to show that it can be fruitfully used for a further elaboration of the explanatory conceptions of revolutions. On the one hand, our concept can be used to test the preciseness and accuracy of these conceptions, by examining to what extent their criteria fit revolutions as they are defined by our concept. On the other hand, our concept can serve as the basis on which these conceptions can be further specified. We will present four different explanatory concepts of revolutions – Kuhn's, Thagard's, Chen's and Barker's, and Laudan's – and point to the ways in which each of them can be further specified in view of our concept

Chronic obstructive pulmonary disease in the awareness of Polish society. Report from the public opinion survey by the Polish Respiratory Society and TNS Polska

Introduction: It is assumed that signs of chronic obstructive pulmonary disease (COPD) can be found in 9.3% subjects of more than 40 years of age in general population in Poland. The aim of the presented survey was to assess knowledge of COPD in adult general population in Poland.Material and methods: The study was performed in June 2013 in a representative sample of 1,000 persons of at least 15 years of age in Poland, using standardized direct interview.Results: In 2013 only 3% Polish people admitted they had ever heard of COPD and knew what the acronym meant. Further 11% persons admitted having heard the term but had no further knowledge of the subject. Thus, the total of 14% persons in general population had previously heard of COPD albeit superficially. This figure is slightly higher as compared to the study performed in 2004. The second part of the study was performed in patients with COPD. Patients perceive the disease as a limiting factor in their daily lives, including negative impact on physical activity, causing loss of physical attractiveness (more often reported by women) or hurting their image of a strong and caring person (more often reported by men). The disease demands re-evaluation of the previous lifestyle, alienates patients from other people, and generates financial burden. Half of the entire studied general population either does not have any associations concerning potential causes of COPD or report various erroneous connotations (e.g. excessive alcohol consumption as a cause of the disease). Even patients with COPD have a similar view on causes of the disease. Importantly, the study revealed that awareness of the disease in smokers does not essentially differ from that in general public. Half of the res pondents admitted having no knowledge on prevention of COPD.Conclusions: There is an urgent need for widespread public education on preventive measures. Study results support the need of educating both healthy subjects and patients with COPD as to how effectively reduce the risk of developing the disease. One third of all respondents has no assumptions in this regard (i.e. explicitly declares having no knowledge at all on the subject), and more than 40% subjects have various misconceptions. Educators should therefore spread information about the disease but also correct these misconceptions.Wstęp: Przyjmuje się, że w Polsce u 9,3% badanych powyżej 40. rż. obecne są cechy przewlekłej obturacyjnej choroby płuc (POChP). Celem obecnego badania opinii publicznej była ocena wiedzy ogółu dorosłych Polaków na temat tej choroby.Materiał i metody: Badanie zrealizowano w czerwcu 2013 roku przy zastosowaniu standaryzowanego wywiadu bezpośredniego przeprowadzonego w liczącej 1000 osób reprezentatywnej próbie ludności Polski w wieku co najmniej 15 lat.Wyniki: W 2013 roku zaledwie 3% Polaków przyznało, że słyszało określenie POChP i wie, co ono oznacza. Kolejne 11% deklarowało, że gdzieś się z nim spotkało, lecz nie wie, co ono oznacza. Tak więc o POChP słyszało, choćby bardzo powierzchownie, w sumie 14% społeczeństwa, czyli nieco więcej niż w 2004 roku. Druga część badania przeprowadzona wśród chorych na POChP pokazała, że postrzegają oni swoją chorobę jako przyczynę różnych ograniczeń aktywności, zwłaszcza sprawności fizycznej, utraty atrakcyjności cielesnej (częściej wśród kobiet) i wizerunku silnego, opiekuńczego człowieka (wśród mężczyzn). Przewlekła obturacyjna choroba płuc wymaga przewartościowania dotychczasowego życia, wyobcowuje spośród innych ludzi, generuje obciążenia finansowe. Ogółem połowa Polaków nie ma żadnych skojarzeń dotyczących potencjalnych przyczyn tej choroby, bądź ma różne błędne skojarzenia (np. nadmierne spożywanie alkoholu). Osoby chorujące na POChP w podobny sposób widzą jej przyczyny. Ważny jest ujawniony w badaniu fakt, że świadomość osób palących tytoń zasadniczo nie różni się od świadomości ogółu społeczeństwa w tym zakresie. Co druga osoba przyznaje, że nie wie, czy można zapobiegać wystąpieniu POChP.Wnioski: Istnieje pilna potrzeba szerokiej edukacji profilaktycznej społeczeństwa, za którą przemawiają ustalenia dotyczące przekonań zarówno zdrowych, jak i chorych o tym, co może skutecznie zmniejszać ryzyko zachorowania na POChP. Co trzecia osoba nie ma tu żadnych przypuszczeń (wprost deklaruje, że nie wie), a ponad 40% wyraża różne błędne poglądy. Stąd ważnym wyzwaniem dla autorów komunikatów edukacyjnych jest nie tylko popularyzowanie informacji o chorobie, ale także potrzeba korygowania tych błędnych przekonań.

Extending Provenance For Deep Diagnosis Of Distributed Systems

Diagnosing and repairing problems in complex distributed systems has always been challenging. A wide variety of problems can happen in distributed systems: routers can be misconfigured, nodes can be hacked, and the control software can have bugs. This is further complicated by the complexity and scale of today’s distributed systems. Provenance is an attractive way to diagnose faults in distributed systems, because it can track the causality from a symptom to a set of root causes. Prior work on network provenance has successfully applied provenance to distributed systems. However, they cannot explain problems beyond the presence of faulty events and offer limited help with finding repairs. In this dissertation, we extend provenance to handle diagnostics problems that require deeper investigations. We propose three different extensions: negative provenance explains not just the presence but also the absence of events (such as missing packets); meta provenance can suggest repairs by tracking causality not only for data but also for code (such as bugs in control plane programs); temporal provenance tracks causality at the temporal level and aims at diagnosing timing-related faults (such as slow requests). Compared to classical network provenance, our approach tracks richer causality at runtime and applies more sophisticated reasoning and post-processing. We apply the above techniques to software-defined networking and the border gateway protocol. Evaluations with real world traffic and topology show that our systems can diagnose and repair practical problems, and that the runtime overhead as well as the query turnarounds are reasonable

Augmentative and Alternative Communication (AAC) for a patient with a nonfluent/ agrammatic variant of PPA in the mutism stage

Introduction The paper presents an example of the successful administration of the Augmentative and Alternative Communication (AAC) system. Such an approach is of particular significance in cases of patients with speech and language deterioration, which is observed in a nonfluent/agrammatic variant of primary progressive aphasia (PPA-G). Regaining the ability to communicate with others proves to be very important for the patients’ self-esteem and enables them to restore previously broken social bonds. Case history The patient A.G., aged 73, a right-handed woman, had been a teacher of Polish before suffering from speech disorders of the PPA-G type. As the disease progressed, her communication deteriorated and finally she developed mutism. The patient was given a clinical and imaging-supported diagnosis of an isolated nonfluent/ agrammatic variant of primary progressive aphasia (PPA-G). The Augmentative and Alternative Communication (AAC) system specially designed for her needs was introduced to help the patient to regain the possibility to communicate. After 20 sessions of training with the use of simple equipment she was again able to communicate non-verbally with her son and with the staff of the nursing home. At the same time, a considerable improvements in her social functioning, including daily activities, was observed. Conclusions Loss of the ability to communicate with others has a serious impact upon a patient’s quality of life, and often results in withdrawal and an inability to lead an independent life. The introduction of the Augmentative and Alternative Communication (AAC) system proves to be a great help, not only for regaining the ability to communicate, but also for the restoration of social bonds. In consequence, the previously mute patient begins to show signs of social cooperation

What makes up good consultations? A qualitative study of GPs' discourses

Background: In medical literature, several principles that define 'good consultations' have been outlined. These principles tend to be prescriptive in nature, overlooking the complexity of general practitioners (GPs)' perspectives of everyday practice. Focusing on perspectives might be particularly relevant, since they may affect decisions and actions. Therefore, the present study adopts a bottom-up approach, analyzing GPs' narratives about 'good' and 'bad' consultations. We aimed at describing the range of discourses GPs use in relating on their practice. Methods: Semi-structured interviews were conducted with 19 Belgian GPs. By means of a qualitative analysis, the authors mapped patterns in the interview narratives and described the range of different discourses. Results: Four discourses were identified: a biomedically-centered discourse, a communication-focused discourse, a problem-solving discourse and a satisfaction-oriented discourse. Each discourse was further specified in terms of predominant themes, problems the GPs prefer to deal with and inherent difficulties. Although most participants used elements from all four discourses, the majority of the GPs relied on an individual set of predominant discourses and focused on a limited number of themes. Conclusion: This study clearly indicates that there is no uniform way in which GPs perceive clinical practice. Each of the participants used a subtle mix of different criteria to define good and bad medical consultations. Some discourse elements appear to be rooted in medical literature, whereas others are of a more personal nature. By focusing on the limitations of each discourse, this study can shed new light on some of the difficulties GPs encounter in their daily practice: being confronted with specific problems might be an effect of adhering to a specific discourse. The typification of different discourses on consultations may function as a framework to help GPs reflect on how they perceive their practice, and help them manage some of the challenges met in daily practice