Addressing Childhood Adversity and Social Determinants inPediatric Primary Care:Recommendations for New Hampshire

Research has clearly demonstrated the significant short- and long-term impacts of adverse childhood experiences (ACEs) and the social determinants of health (SDOH) on child health and well-being.1 Identifying and addressing ACEs and SDOH will require a coordinated and systems-based approach. Pediatric primary care* plays a critical role in this system, and there is a growing emphasis on these issues that may be impacting a family. As awareness of ACEs and SDOH grows, so too does the response effort within the State of New Hampshire. Efforts to address ACEs and the SDOH have been initiated by a variety of stakeholders, including non-profit organizations, community-based providers, and school districts. In late 2017, the Endowment for Health and SPARK NH funded the NH Pediatric Improvement Partnership (NHPIP) to develop a set of recommendations to address identifying and responding to ACEs and SDOH in NH primary care settings caring for children. Methods included conducting a review of literature and Key Informant Interviews (KII). Themes from these were identified and the findings are summarized in this report

Ethical Challenges in Data-Driven Dialogue Systems

The use of dialogue systems as a medium for human-machine interaction is an increasingly prevalent paradigm. A growing number of dialogue systems use conversation strategies that are learned from large datasets. There are well documented instances where interactions with these system have resulted in biased or even offensive conversations due to the data-driven training process. Here, we highlight potential ethical issues that arise in dialogue systems research, including: implicit biases in data-driven systems, the rise of adversarial examples, potential sources of privacy violations, safety concerns, special considerations for reinforcement learning systems, and reproducibility concerns. We also suggest areas stemming from these issues that deserve further investigation. Through this initial survey, we hope to spur research leading to robust, safe, and ethically sound dialogue systems.Comment: In Submission to the AAAI/ACM conference on Artificial Intelligence, Ethics, and Societ

Eliminating Mental and Physical Health Disparities Through Culturally and Linguistically Centered Integrated Healthcare

Since the U.S. Surgeon General’s report on mental health (1999) declared mind and body to be inseparable, integrated healthcare, bringing the body and mind back together, has been gaining significant momentum across the nation as a preferred approach to care for people with co-morbid physical health and mental health conditions. Primary care settings often are the gateway to healthcare for racial and ethnic minority populations and individuals with limited English proficiency (LEP) and, as such, it has become the portal for identifying undiagnosed or untreated behavioral health disorders. An integrated holistic philosophical approach to behavioral healthcare provides an opportunity to address mental and physical health disparities and achieve health equity through a culturally and linguistically centered integrated healthcare delivery model that by definition must be person-centered, family-centered, and community-centered

Mapping metaphors of wealth and want: a digital approach

The AHRC-funded Mapping Metaphor with the Historical Thesaurus project aims to provide data on the extent and development of metaphor across the history of English. It uses the full database of the Historical Thesaurus of English, which extensively categorises and classifies the recorded vocabulary of the English language from Old English to the present day. By using this database to map semantic categories onto one another, and thus showing lexical overlap in different conceptual fields, we aim in the project to provide results which will demonstrate the widespread, systematic and far-reaching impact of metaphor on English.<p></p> This paper outlines the digital and linguistic methodologies used by the project, and presents a case study of the semantic categories of wealth and poverty, demonstrating the metaphorical links between these categories and the rest of the language. In addition, we discuss the nature of lexical overlap as we use it in the project, and discuss both the quantitative and diachronic dimensions of the data we are manipulating and their implications for projects of this type.<p></p&gt

Analysis of an Online Support Group for Women with Breast Cancer

With over 200,000 new diagnoses in 2004, breast cancer is one of the most commonly diagnosed cancers among women in the United States. Both the stress of treatment and the threat of a potentially lethal illness present significant challenges to an individual\u27s emotional well-being and coping skills, yet paradoxically many women report benefits from dealing with this adversity. The aims of this investigation were to describe the characteristics of benefit finding as expressed by breast cancer survivors participating in an online breast cancer support group, and to assess the relationship between symptom distress, emotional well-being and benefit finding using baseline assessment measures. Qualitative content analysis and computerized text analysis were used to characterize the emotional, cognitive, and structural components present in online therapy transcripts. Correlational analysis was also used to identify both convergent and divergent characteristics of expressed benefit finding the context of an online support group and self-reported benefit finding using a structured assessment measure. With respect to the relationship between symptom distress, emotional well-being and benefit finding, self-reported benefit finding was found to have a mediating relationship between symptom distress and emotional quality of life, however expressed benefit finding did not share this relationship. This study suggests a potential difference between the benefits participants may endorse on a structured measure versus the opportunity to discuss benefits in an unstructured, somewhat social environment

Factors Correlating with Resilience in Bolivian Street Girls

Resilience is defined as the ability to respond adaptively and maintain a high quality of life even after adversity or trauma. Research conducted in Western cultures has identified multiple factors that correlate with resilience for survivors of childhood trauma, including social support, the presence of a stable adult, internal locus of control, supportive spiritual beliefs and lack of self-blame regarding the trauma (Crenshaw, 2013; Brooks & Goldstein, 2004; Goldstein, Brooks, & Devries, 2013). This study explored whether the factors that previous research has identified as predictive of resilience have a similar predictive value when applied to another culture. This research found that the presence of a stable adult, social support, supportive spiritual beliefs and a minimal amount of self-blame all correlated with resilience in the examined population of adolescent Bolivian street girls. However, no correlation was found between internal locus of control and resilience among this population. Implications of these findings and suggestions for further research are discussed