9 research outputs found

    The potential role for educational psychologists working with systems supporting young people with eating disorders

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    This two-part study investigated how educational psychologists (EPs) might support schools working with young people (YP) with eating disorders (EDs). Part one explored the current support in UK schools for secondary-aged pupils with EDs, and the areas that parents (n52) and school staff (n39) felt needed further development, using online questionnaires. Data were analysed, using descriptive statistics and thematic analysis to inform the focus for semi-structured interview questions for part two, whereby eight EPs offered their views on aspects highlighted in part one. Ways forward are discussed, including how input to schools could be implemented. In summary, staff and parents considered that the support schools offered could be greatly enhanced. Four themes emerged from the EP data, which included recommendations for EPs to improve the support around EDs in schools. This study highlights the potential role EPs could have in supporting schools, working with YP with EDs, and their families

    Self-, other-, and dual-harm during adolescence: a prospective-longitudinal study of childhood risk factors and early adult correlates

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    Background Little is known about the childhood antecedents and adult correlates of adolescent dual-harm (i.e. co-occurring self- and other-harm). We examine the longitudinal associations between (a) social and psychological risk factors in childhood and adolescent dual-harm and (b) adolescent dual-harm and social and mental health impairments in early adulthood. Methods Participants (N = 1482) are from a prospective longitudinal community-representative study. Dual-, self-, and other-harm were self-reported at ages 13, 15, and 17. Social and psychological risk factors in childhood were assessed between 7 and 11; early adult correlates at age 20. Groups with dual-harm, self-harm only, other-harm only, and no harm were compared. Results Between 13 and 17, 7.2% of adolescents reported dual-harm (self-harm only: 16.2%; other-harm only: 13.3%). Some childhood risk factors (e.g. sensation-seeking, parental divorce, victimization by peers) characterized all harm groups; others were common to the dual- and self-harm (anxiety/depressive symptoms, relational aggression) or dual- and other-harm groups only (low self-control, substance use, delinquency). Adolescents with dual-harm had reported more physical aggression and harsh parenting, and lower school bonding in childhood than any other group. In early adulthood, they reported more anxiety/depressive symptoms, psychopathy symptoms, homicidal ideations, delinquency, and victimization experiences than any other group. Conclusions Adolescent dual-harm follows psychological problems and social disconnection in childhood and signals risk of psychopathology and isolation in early adulthood. To curb the burden from dual-harm, interventions must target adolescents, families, peer networks, and school environments. Differentiating youth with dual-harm from those with single-harm is important for developing personalized treatments

    Axiomatizability of propositionally quantified modal logics on relational frames

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    Propositional modal logic over relational frames is naturally extended with propositional quantifiers by letting them range over arbitrary sets of worlds of the relevant frame. This is also known as second-order propositional modal logic. The propositionally quantified modal logic of a class of relational frames is often not axiomatizable, although there are known exceptions, most notably the case of frames validating the strong modal logic S5 . Here, we develop new general methods with which many of the open questions in this area can be answered. We illustrate the usefulness of these methods by applying them to a range of examples, which provide a detailed picture of which normal modal logics define classes of relational frames whose propositionally quantified modal logic is axiomatizable. We also apply these methods to establish new results in the multimodal case

    Relational Dynamics of Treatment Behavior Among Individuals with Tuberculosis in High-Income Countries: A Scoping Review

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    Although tuberculosis (TB) incidence has significantly declined in high-income, low-incidence (HILI) countries, challenges remain in managing TB in vulnerable populations who may struggle to stay on anti-TB treatment (ATT). Factors associated with non-adherence to ATT are well documented; however, adherence is often narrowly conceived as a fixed binary variable that places emphasis on individual agency and the act of taking medicines, rather than on the demands of being on treatment more broadly. Further, the mechanisms through which documented factors act upon the experience of being on treatment are poorly understood. Adopting a relational approach that emphasizes the embeddedness of individuals within dynamic social, structural, and health systems contexts, this scoping review aims to synthesize qualitative evidence on experiences of being on ATT and mechanisms through which socio-ecological factors influence adherence in HILI countries. Six electronic databases were searched for peer-reviewed literature published in English between January 1990 and May 2020. Additional studies were obtained by searching references of included studies. Narrative synthesis was used to analyze qualitative data extracted from included studies. Of 28 included studies, the majority (86%) reported on health systems factors, followed by personal characteristics (82%), structural influences (61%), social factors (57%), and treatment related factors (50%). Included studies highlighted three points that underpin a relational approach to ATT behavior: 1) individual motivation and capacity to take ATT is dynamic and intertwined with, rather than separate from, social, health systems, and structural factors; 2) individuals' pre-existing experiences of health-seeking influence their views on treatment and their ability to commit to long-term regular medicine-taking; and 3) social, cultural, and political contexts play an important role in mediating how specific factors work to support or hinder ATT adherence behavior in different settings. Based on our analysis, we suggest that person-centered clinical management of tuberculosis should 1) acknowledge the ways in which ATT both disrupts and is managed within the everyday lives of individuals with TB; 2) appreciate that individuals' circumstances and the support and resources they can access may change over the course of treatment; and 3) display sensitivity towards context-specific social and cultural norms affecting individual and collective experiences of being on ATT

    Cognitive impairment in eating disorder patients of short and long-term duration: a case-control study.

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    Introduction: Several studies have noted the potentially negative effect of eating disorders (ED) on cognitive performance. Objective: To compare the impact of the duration of abnormal eating behaviors on cognitive performance in a sample of people with short- and long-term eating disorders and in two control groups matched for age. Method: The neuropsychological performance of 82 women diagnosed with an eating disorder were compared with two control groups from the community of 66 healthy women. Time of duration of the disorder was less than two years in half of the clinical sample, and more than 10 years in the other half. The following instruments were used to measure neuropsychological performance: the Matrix Test, the Stroop task, the Trail-Making Test, the Tower of London Test, the Posner Spatial Task, the Rey's Complex Figure, the Wechsler Vocabulary Test, and the Hayling Completion Test. Results: It showed that persons with long-term ED presented more impaired neuropsychological profiles, but not in all areas. In contrast, the short-term ED group presented similar profiles to the control groups. Discussion: This study highlights the positive association between cognitive impairment and time of evolution of ED, above all in perceptual measures and non-verbal memory. Considering the effect of the evolution of ED cognitive performance (especially in long-term patients) may further our understanding of the development of the disorder and the factors that may favor its persistence

    Similar Neural Responses Predict Friendship

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    Human social networks are overwhelmingly homophilous: individuals tend to befriend others who are similar to them in terms of a range of physical attributes (e.g., age, gender). Do similarities among friends reflect deeper similarities in how we perceive, interpret, and respond to the world? To test whether friendship, and more generally, social network proximity, is associated with increased similarity of real-time mental responding, we used functional magnetic resonance imaging to scan subjects’ brains during free viewing of naturalistic movies. Here we show evidence for neural homophily: neural responses when viewing audiovisual movies are exceptionally similar among friends, and that similarity decreases with increasing distance in a real-world social network. These results suggest that we are exceptionally similar to our friends in how we perceive and respond to the world around us, which has implications for interpersonal influence and attraction

    CARE COORDINATION, QUALITY AND OUTCOMES: A STUDY IN OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

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    Background: Care coordination may be most effective in older adults with multiple chronic conditions because they see multiple primary care and specialist physicians, which may complicate efforts to coordinate care for their conditions. There is little evidence on how to best measure and improve care coordination in this population. Objective: The objective of this thesis is to better understand care coordination in older adults with multiple chronic conditions. The first study examines how to measure care coordination. The second study examines the relationship of care coordination with quality of care processes and patient rating of care. The third study whether one dimension, continuity of care, is associated with subsequent emergency department utilization, and hospital utilization. Study Design: This is an observational study. All analyses were conducted in a sample of 1,600 adults 65 years of age and older with multiple chronic conditions selected to participate in a patient survey. All subjects were enrolled in a Medicare Advantage Special Needs Plan living in Alabama, Georgia, Missouri, South Carolina, and Texas. Results: The first study identifies three underlying domains of care coordination: continuity of care, informational continuity between clinicians, and information flow to the patient. The second study finds that patient reported experiences of informational continuity are strongly related to the patient related to the patient’s rating of care, but not related to other measures of technical care quality. The third study finds that higher levels continuity of care is associated with lower odds of a preventable hospitalization in patients with five or fewer conditions but continuity of care is not related to better outcomes in patients with six or more conditions. Conclusion: Care coordination is a multidimensional construct. Evaluations of care coordination programs should consider using both claims-based and patient survey measures in order to comprehensively assess care coordination programs. Medicare and health plans should consider incentivize informational continuity between clinicians to improve patient rating of care
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