2,352 research outputs found

    Effects of municipal smoke-free ordinances on secondhand smoke exposure in the Republic of Korea

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    ObjectiveTo reduce premature deaths due to secondhand smoke (SHS) exposure among non-smokers, the Republic of Korea (ROK) adopted changes to the National Health Promotion Act, which allowed local governments to enact municipal ordinances to strengthen their authority to designate smoke-free areas and levy penalty fines. In this study, we examined national trends in SHS exposure after the introduction of these municipal ordinances at the city level in 2010.MethodsWe used interrupted time series analysis to assess whether the trends of SHS exposure in the workplace and at home, and the primary cigarette smoking rate changed following the policy adjustment in the national legislation in ROK. Population-standardized data for selected variables were retrieved from a nationally representative survey dataset and used to study the policy action’s effectiveness.ResultsFollowing the change in the legislation, SHS exposure in the workplace reversed course from an increasing (18% per year) trend prior to the introduction of these smoke-free ordinances to a decreasing (−10% per year) trend after adoption and enforcement of these laws (β2 = 0.18, p-value = 0.07; β3 = −0.10, p-value = 0.02). SHS exposure at home (β2 = 0.10, p-value = 0.09; β3 = −0.03, p-value = 0.14) and the primary cigarette smoking rate (β2 = 0.03, p-value = 0.10; β3 = 0.008, p-value = 0.15) showed no significant changes in the sampled period. Although analyses stratified by sex showed that the allowance of municipal ordinances resulted in reduced SHS exposure in the workplace for both males and females, they did not affect the primary cigarette smoking rate as much, especially among females.ConclusionStrengthening the role of local governments by giving them the authority to enact and enforce penalties on SHS exposure violation helped ROK to reduce SHS exposure in the workplace. However, smoking behaviors and related activities seemed to shift to less restrictive areas such as on the streets and in apartment hallways, negating some of the effects due to these ordinances. Future studies should investigate how smoke-free policies beyond public places can further reduce the SHS exposure in ROK

    Introduction to Psychology

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    Introduction to Psychology is a modified version of Psychology 2e - OpenStax

    Late effects of treatment in survivors of childhood acute lymphoblastic leukaemia

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    Long-term survival and probable cure have become norms in acute lymphoblastic leukaemia of childhood. The adverse effects of treatment for leukaemia are diverse and complex. In many cases, treatment effects come to light 1 ong after the end of therapy. These so-ca 11 ed 1 ate effects (which are yet obscure and incompletely understood) have become increasingly important as the number of children surviving leukaemia increases. This thesis describes a comprehensive study of leukaemia survivors attending the Oncology Clinic of the Red Cross War Memorial Children's Hospital. The study sample consisted of all leukaemia survivors in long-term remission, disease free and off treatment up to January 1st, 1984. The study is introduced by a chapter which describes acute lymphoblastic leukaemia and pays particular attention to the effects of the primary disease on organs which may subsequently exhibit late effects of treatment. Treatment of acute lymphoblastic leukaemia is described in some detail and the reasons for current treatment strategies are outlined. Individual modalities of treatment are then discussed with reference to their mechanisms of action and potential for damage to non-neoplastic tissue. The study then examines all systems likely to have been damaged during therapy, in order to achieve a comprehensive impression of the late effects of leukaemia treatment. In each chapter, pertinent literature was reviewed up to January 1987. Growth is a major task of childhood. Many chronic diseases are potential causes of growth failure. A longitudinal retrospective study showed that statured growth in leukaemia survivors was stunted during treatment. Catch-up growth did not occur at the end of treatment, although normal growth velocity was resumed. Adult height was expected to be reduced as a result. In addition to temporary stunting of statured growth, leukaemia survivors showed a progressive increase in weight-for-height during treatment. This trend continued after treatment had ended. These changes in weight and height were peculiar to leukaemia survivors. Control groups of children with solid tumours in long term remission showed less stunting during treatment and had catch-up growth after treatment, except when they had undergone spinal i rradi ati on. Normal endocrine function is a prerequisite for normal growth and development. Although growth hormone responses to insulin-induced hypoglycaemia were frequently and significantly abnormal in survivors of childhood leukaemia, these children grew normally once treatment had stopped. Impaired growth hormone secretion appeared to be a marker of hypothalamic damage caused by leukaemia therapy. Testicular and ovarian function was normal in the absence of irradiation of these organs. Thyroid function was normal in leukaemia survivors although a minority showed evidence of hypothalamic damage in their response to thyrotropin releasing hormone. Normal prolactin levels in children showing other hormonal evidence of hypothalamic damage were thought to indicate the selectivity of damage caused by leukaemia treatment. Adrenal control and function were normal in leukaemia survivors. In the absence of a growth disorder, only thyroid status may need long-term assessment in leukaemia survivors. Intellectual development is a further major task of childhood. A sibling-controlled study of intellectual function indicated an intelligence deficit in children surviving leukaemia and its treatment. This deficit was thought to be the consequence of therapy, since children surviving solid tumours showed no such deficit in comparison with their sibling controls. Survivors of childhood leukaemia also had an increased incidence of visual perceptual difficulty and more school prob 1 ems than survivors of solid tumours, particularly in early primary grades. Intellectual outcome and school performance in leukaemia survivors may be improved by early visual perceptual training. Children surviving acute lymphoblastic leukaemia had significantly more minor motor abnormalities than children surviving solid tumours. Minor motor abnormalities were frequently and significantly associated with abnormalities of the brain visualized by computerized tomography. Neurophysiologic measurement (EEG, VER, BAER) did not contribute to the assessment of neurological outcome and correlated poorly with clinical and CT scan findings. A functional assessment of neurological outcome in leukaemia survivors should include a clinical examination for minor motor dysfunction. Some children manifested other organ-specific damage due to chemotherapy or radiotherapy. These isolated cases are discussed in the form of case reports and literature reviews. Patients have received treatment with cytotoxic drugs in addition to standard leukaemia therapy need to be followed for treatment-specific late effects. The psychological outcome of leukaemia survivors was assessed by means of parent interviews and teacher questionnaires. In terms of a low frequency of behaviour problems reported by these observers, psychosocial adaptation in leukaemia survivors vas surprisingly good. Children surviving solid tumours and healthy school children from the same community (the latter from a literature report) had similar frequencies of behavioural problems. In both leukemic children ana solid tumour control patients, certain patterns of family behaviour ~ere predictive of a poor psychological outcome. It appears that an early family assessment may identify families 'at risk'. If needs to be shewn whether such families would benefit from professional psychological support. In the final chapter a 'functional deficit score' is offered as a measure of overall outcome in terms of late effects of therapy. Patients were rated in five categories (growth, intellectual outcome, neurological status, miscellaneous organ damage and psychosocial adaptation) according to the severity of persistent late effects. Children surviving acute lymphoblastic leukaemia were shown to have been more seriously damaged by their treatment than children surviving solid tumours. The difference in overall damage was the consequence of central nervous system injury. Available evidence indicates that this central nervous system injury is caused by radiotherapy (with or ·thought a synergistic effect with i intrathecal 1 methotrexate) given as central nervous system 'prophylaxis'. With few exceptions, leukaemia survivors in this study had received L400 rads of deep x-ray therapy as cranial irradiation. This dosage has since been reduced world-wide. Current cranial irradiation 'prophylaxis' consists of 1800 rad of megavoltage radiotherapy. Fa 11 ow-up studies of survivor cohorts given such radiotherapy should include the measures embodied in the 'functional deficit score' described above

    The Influence of Neuroendocrine and Genetic Markers of Stress on Cognitive Processing and Intrusive Symptoms

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    This body of research investigated the influence of neuroendocrine and genetic elements of arousal on cognitive processes in the development of intrusive memories and flash-forward intrusions as related to Post-Traumatic Stress Disorder. Specifically, this thesis investigated various mechanisms that may underlie intrusive symptoms as postulated by prevalent theories of PTSD. Study 1 examined the distinctive relationship between peritraumatic dissociation and subsequent re-experiencing symptoms. Network analyses revealed strong positive edges between peritraumatic dissociation and subsequent amnesia, as well as the re-experiencing symptoms of physical reactivity to reminders, flashbacks, intrusions, and dreams, and to a lesser extent emotional numbness and hypervigilance. The finding that peritraumatic dissociation is related to subsequent re-experiencing symptoms is consistent with cognitive models that emphasize the role of dissociative experiences during a traumatic event in the etiology of PTSD re-experiencing symptoms. Study 2 aimed to determine whether peri-traumatic stress, as measured via salivary cortisol and salivary alpha-amylase, as well as pre-existing genetic polymorphisms on the FKBP5 gene increased dissociation and data-driven processing, and subsequently impacted intrusive memories related to a trauma film. The findings revealed that greater noradrenergic arousal predicted less intrusive memory distress in individuals who scored higher on data-driven processing and trait dissociation, and in FKBP5 low-risk carriers. For individuals who reported less data-driven processing and trait dissociation, and in FKBP5 high-risk carriers, as noradrenergic arousal increased, intrusive memory distress increased. This study also showed no association between data-driven processing with memory fragmentation, and fragmentation with intrusive memories. Whilst these findings support some aspect of cognitive models of PTSD as they indicate a role for data-driven processing and dissociation in intrusive symptoms, they highlight a threshold at which these variables stop moderating the relationship between arousal and intrusive memories and suggest that memory fragmentation is not related to intrusive memories. Study 3 examined the role of cognitive control in flash-forward intrusions in the context of an enduring stressor, the COVID-19 pandemic. In line with expectations, results showed that as cognitive control worsened, FKBP5 high-risk carriers reported more flash-forward distress, and low-risk carriers reported less distress. These findings are considered in the context of hippocampal changes and are consistent with emerging theories of PTSD. Lastly, study 4 sought to investigate the role of two neurological processes, pattern separation and pattern completion in intrusive memories in individuals with PTSD compared to trauma exposed controls. Consistent with existing literature, the data indicate that individuals with PTSD reported more data-driven processing, more intrusive symptoms, and demonstrated better behavioural pattern completion than trauma-exposed controls. These findings are in line with current cognitive models of PTSD, as they again indicate a role for data-driven processing in PTSD. However, study 4 found no support for the postulate that deficient pattern separation is a feature of PTSD and found an opposite effect for the role of pattern completion. Whilst these findings are inconsistent with theory, they are in line with existing experimental studies. Overall, the findings from this thesis provide insight into cognitive and biological models of PTSD and shed light on the mechanisms underlying the nature and development of intrusive symptoms

    Exploring cognitive mechanisms involved in self-face recognition

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    Due to the own face being a significant stimulus that is critical to one’s identity, the own face is suggested to be processed in a quantitatively different (i.e., faster and better recognition) and qualitatively different (i.e., processed in a more featural manner) manner compared to other faces. This thesis further explored the cognitive mechanisms (perceptual and attentional systems) involved in the processing of the own face. Chapter 2 explored the role of holistic and featural processing involved in the processing of self-face (and other faces) with eye-tracking measures in a passive-viewing paradigm and a face identification task. In the passive-viewing paradigm, the own face was sampled in a more featural manner compared to other faces whereas when asked to identify faces, all faces were sampled in a more holistic manner. Chapter 3 further explored the role of holistic and featural processing in the identification of the own face using the three standard measures of holistic face processing: The face inversion task, the composite face task, and the part-whole task. Compared to other faces, individuals showed a smaller “holistic interference” by a task irrelevant bottom half for the own face in the composite face task and a stronger feature advantage for the own face, but inversion impaired the identification of all faces. These findings suggest that self-face is processed in a more featural manner, but the findings do not deny the role of holistic processing. The final experimental chapter, Chapter 4, explored the modulation effects of cultural differences in one’s self-concept (i.e., independent vs. interdependent self-concept) and a negative self-concept (i.e., depressive traits) on the attentional prioritization for the own face with a visual search paradigm. Findings showed that the attentional prioritization for the own face over an unfamiliar face is not modulated by cultural differences of one’s self-concept nor one’s level of depressive traits, and individuals showed no difference in the attentional prioritization for both the own face and friend’s face, demonstrating no processing advantage for the own face over a personally familiar face. These findings suggests that the attentional prioritization for the own face is better explained by a familiar face advantage. Altogether, the findings of this thesis suggest that the own face is processed qualitatively different compared to both personally familiar and unfamiliar face, with the own face being processed in a more featural manner. However, in terms of quantitative differences, the self-face is processed differently compared to an unfamiliar face, but not to a familiar face. Although the specific face processing strategies for the own face may be due to the distinct visual experience that one has with their face, the attentional prioritization of the own face is however, better explained by a familiar face advantage rather than a self-specificity effect
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