Qualitative Examination of Historical Trauma and Grief Responses in the Oceti Sakowin

Past research regarding historical trauma in the Lakota, one of the three major groups of the Oceti Sakowin or Sioux, has contributed to the historical trauma theory, but gaps continue to exist. The purpose of the study was to examine the historical trauma experiences and grief responses of individuals who identify as Oceti Sakowin, specifically the Nakota and Dakota, including present experiences. Interpretive phenomenological analysis was the study\u27s methodology and the conceptual framework of this research was historical trauma theory, which refers to the persistence of trauma and transmission of trauma from generation to generation. Participant interviews were conducted using a researcher-designed interview schedule. Participants were Oceti Sakowin who identify as Nakota or Dakota and who were over the age of 18, and a total of 8 participants were interviewed. This research yielded themes about how the phenomena affected the participants, which can provide insight into how others who have had their own experiences relate to the phenomena. These themes were concerns and pain about ancestors\u27 experience, concern for personal experiences but hope for the future, and the loss of the past is the sorrow of today. Increasing the knowledge of historical trauma and historical trauma grief responses can lead to better understanding that leads to positive social change through greater empathy and sensitivity toward those who have had these experiences, which can increase respect toward the traditions and cultures of others as well as culturally informed interventions to address historical trauma and grief

Price, Access and Education at Philadelphia Farmers\u27 Markets

Inadequate intake of fruits and vegetables is linked to chronic disease and obesity. However, consumption rates of fruits and vegetables in the US and specifically in Philadelphia continue to fall short of recommendations for a healthy diet. Access and price are two barriers in the food environment that prevent sufficient fruit and vegetable consumption. Farmers’ markets offer increased access to fruit and vegetables, yet continue to be perceived as being more costly than grocery stores. This study’s primary aim was to determine if the price of fruit and vegetables are more expensive at farmers’ markets than grocery stores in Philadelphia. The secondary aim was to determine if the established Jefferson Farmers’ Market Heath Education table was a suitable environment for health education and to assist in the dissemination of the price comparison results. A cross-sectional quantitative price analysis was used over nine points in time to determine if the price of fruit and vegetables at three farmers’ markets compared to three grocery stores and price data from sixteen produce items were averaged. The Jefferson Farmers’ Market 2010 Survey and on-site assessment at the farmers’ market was used to determine the utilization of the health education table by the Jefferson community. The data showed that farmers’ markets were $0.26 per pound less expensive than grocery stores. This suggests that farmers’ markets are a viable option for the purchase of produce and more economical than grocery stores. Additional results show that the Health Education table was widely utilized by the Jefferson Community. This advocates that the Jefferson Farmers’ Market Health Education table is a suitable environment for health education and to disseminate the results of the price comparison

Family relationships of nine psychotic unmarried mothers.

Thesis (M.S.)--Boston Universit

The Mid-Pleistocene Transition induced by delayed feedback and bistability

The Mid-Pleistocene Transition, the shift from 41 kyr to 100 kyr glacial-interglacial cycles that occurred roughly 1 Myr ago, is often considered as a change in internal climate dynamics. Here we revisit the model of Quaternary climate dynamics that was proposed by Saltzman and Maasch (1988). We show that it is quantitatively similar to a scalar equation for the ice dynamics only when combining the remaining components into a single delayed feedback term. The delay is the sum of the internal times scales of ocean transport and ice sheet dynamics, which is on the order of 10 kyr. We find that, in the absence of astronomical forcing, the delayed feedback leads to bistable behaviour, where stable large-amplitude oscillations of ice volume and an equilibrium coexist over a large range of values for the delay. We then apply astronomical forcing. We perform a systematic study to show how the system response depends on the forcing amplitude. We find that over a wide range of forcing amplitudes the forcing leads to a switch from small-scale oscillations of 41 kyr to large-amplitude oscillations of roughly 100 kyr without any change of other parameters. The transition in the forced model consistently occurs near the time of the Mid-Pleistocene Transition as observed in data records. This provides evidence that the MPT could have been primarily a forcing-induced switch between attractors of the internal dynamics. Small additional random disturbances make the forcing-induced transition near 800 kyr BP even more robust. We also find that the forced system forgets its initial history during the small-scale oscillations, in particular, nearby initial conditions converge prior to transitioning. In contrast to this, in the regime of large-amplitude oscillations, the oscillation phase is very sensitive to random perturbations, which has a strong effect on the timing of the deglaciation events

Cochrane dementia group turns 21—older and (slightly) wiser

This invited editorial describes the achievements of the last 21 years of the Cochrane Dementia and Cognitive Improvement Group (DR Quinn is the coordinating editor of the group)

Are methodological quality and completeness of reporting associated with citation-based measures of publication impact? A secondary analysis of a systematic review of dementia biomarker studies

Objective: To determine whether methodological and reporting quality are associated with surrogate measures of publication impact in the field of dementia biomarker studies. Methods: We assessed dementia biomarker studies included in a previous systematic review in terms of methodological and reporting quality using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) and Standards for Reporting of Diagnostic Accuracy (STARD), respectively. We extracted additional study and journal-related data from each publication to account for factors shown to be associated with impact in previous research. We explored associations between potential determinants and measures of publication impact in univariable and stepwise multivariable linear regression analyses. Outcome measures: We aimed to collect data on four measures of publication impact: two traditional measures—average number of citations per year and 5-year impact factor of the publishing journal and two alternative measures—the Altmetric Attention Score and counts of electronic downloads. Results: The systematic review included 142 studies. Due to limited data, Altmetric Attention Scores and electronic downloads were excluded from the analysis, leaving traditional metrics as the only analysed outcome measures. We found no relationship between QUADAS and traditional metrics. Citation rates were independently associated with 5-year journal impact factor (β=0.42; p<0.001), journal subject area (β=0.39; p<0.001), number of years since publication (β=-0.29; p<0.001) and STARD (β=0.13; p<0.05). Independent determinants of 5-year journal impact factor were citation rates (β=0.45; p<0.001), statement on conflict of interest (β=0.22; p<0.01) and baseline sample size (β=0.15; p<0.05). Conclusions: Citation rates and 5-year journal impact factor appear to measure different dimensions of impact. Citation rates were weakly associated with completeness of reporting, while neither traditional metric was related to methodological rigour. Our results suggest that high publication usage and journal outlet is not a guarantee of quality and readers should critically appraise all papers regardless of presumed impact

Andersen-Tawil syndrome: report of 3 novel mutations and high risk of symptomatic cardiac involvement.

IntroductionAndersen-Tawil syndrome (ATS) is a potassium channelopathy affecting cardiac and skeletal muscle. Periodic paralysis is a presenting symptom in some patients, whereas, in others, symptomatic arrhythmias or prolongation of QT in echocardiographic recordings will lead to diagnosis of ATS. Striking intrafamilial variability of expression of KCNJ2 mutations and rarity of the syndrome may lead to misdiagnosis.MethodsWe report 15 patients from 8 Polish families with ATS, including 3 with novel KCNJ2 mutations.ResultsAll patients had dysmorphic features; periodic paralysis affected males more frequently than females (80% vs. 20%), and most attacks were normokalemic. Two patients (with T75M and T309I mutations) had aborted sudden cardiac death. An implantable cardioverter-defibrillator was utilized in 40% of cases.ConclusionsKCNJ2 mutations cause a variable phenotype, with dysmorphic features seen in all patients studied, a high penetrance of periodic paralysis in males and ventricular arrhythmia with a risk of sudden cardiac death

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the diagnosis of dementia within community dwelling populations

<b>Background</b><p></p> Various tools exist for initial assessment of possible dementia with no consensus on the optimal assessment method. Instruments that use collateral sources to assess change in cognitive function over time may have particular utility. The most commonly used informant dementia assessment is the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).<p></p> A synthesis of the available data regarding IQCODE accuracy will help inform cognitive assessment strategies for clinical practice, research and policy.<p></p> <b>Objectives</b><p></p> Our primary objective was to determine the diagnostic accuracy of the informant based questionnaire IQCODE, for detection of all cause (undifferentiated) dementia in community-dwelling adults with no previous cognitive assessment. We sought to describe the accuracy of IQCODE (the index test) against a clinical diagnosis of dementia (the reference standard).<p></p> Our secondary objective was to describe the effect of heterogeneity on the summary estimates. We were particularly interested in the traditional 26-item scale versus the 16-item short form; and language of administration. We explored the effect of varying the threshold IQCODE score used to define 'test positivity'.<p></p> <b>Search methods</b><p></p> We searched the following sources on 28 January 2013: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), BIOSIS Previews (ISI Web of Knowledge), Web of Science with Conference Proceedings (ISI Web of Knowledge), LILACS (BIREME). We also searched sources relevant or specific to diagnostic test accuracy: MEDION (Universities of Maastrict and Leuven); DARE (York University); ARIF (Birmingham University). We used sensitive search terms based on MeSH terms and other controlled vocabulary.<p></p> <b>Selection criteria</b><p></p> We selected those studies performed in community settings that used (not necessarily exclusively) the IQCODE to assess for presence of dementia and, where dementia diagnosis was confirmed, with clinical assessment. Our intention with limiting the search to a 'community' setting was to include those studies closest to population level assessment. Within our predefined community inclusion criteria, there were relevant papers that fulfilled our definition of community dwelling but represented a selected population, for example stroke survivors. We included these studies but performed sensitivity analyses to assess the effects of these less representative populations on the summary results.<p></p> <b>Data collection and analysis</b><p></p> We screened all titles generated by the electronic database searches and abstracts of all potentially relevant studies were reviewed. Full papers were assessed for eligibility and data extracted by two independent assessors. For quality assessment (risk of bias and applicability) we used the QUADAS 2 tool. We included test accuracy data on the IQCODE used at predefined diagnostic thresholds. Where data allowed, we performed meta-analyses to calculate summary values of sensitivity and specificity with corresponding 95% confidence intervals (CIs). We pre-specified analyses to describe the effect of IQCODE format (traditional or short form) and language of administration for the IQCODE.<p></p> <b>Main results</b><p></p> From 16,144 citations, 71 papers described IQCODE test accuracy. We included 10 papers (11 independent datasets) representing data from 2644 individuals (n = 379 (14%) with dementia). Using IQCODE cut-offs commonly employed in clinical practice (3.3, 3.4, 3.5, 3.6) the sensitivity and specificity of IQCODE for diagnosis of dementia across the studies were generally above 75%.<p></p> Taking an IQCODE threshold of 3.3 (or closest available) the sensitivity was 0.80 (95% CI 0.75 to 0.85); specificity was 0.84 (95% CI 0.78 to 0.90); positive likelihood ratio was 5.2 (95% CI 3.7 to 7.5) and the negative likelihood ratio was 0.23 (95% CI 0.19 to 0.29).<p></p> Comparative analysis suggested no significant difference in the test accuracy of the 16 and 26-item IQCODE tests and no significant difference in test accuracy by language of administration. There was little difference in sensitivity across our predefined diagnostic cut-points.<p></p> There was substantial heterogeneity in the included studies. Sensitivity analyses removing potentially unrepresentative populations in these studies made little difference to the pooled data estimates. The majority of included papers had potential for bias, particularly around participant selection and sampling. The quality of reporting was suboptimal particularly regarding timing of assessments and descriptors of reproducibility and inter-observer variability.<p></p> <b>Authors' conclusions</b><p></p> Published data suggest that if using the IQCODE for community dwelling older adults, the 16 item IQCODE may be preferable to the traditional scale due to lesser test burden and no obvious difference in accuracy. Although IQCODE test accuracy is in a range that many would consider 'reasonable', in the context of community or population settings the use of the IQCODE alone would result in substantial misdiagnosis and false reassurance. Across the included studies there were issues with heterogeneity, several potential biases and suboptimal reporting quality