Self vs. Parent: Factors Influencing Likelihood of Hiring a Healthcare Advocate

Objective: To determine how the factors that may lead an individual to hire a healthcare advocate to aid him/herself in navigating the healthcare system when dealing with chronic or complex health issues differ from the factors that are considered when deciding to hire a healthcare advocate for one’s parent.Methods: 1,740 randomly selected participants completed a brief vignette-based questionnaire that indicated their likelihood of hiring an HCA for oneself or a parent. Confirmatory factor analysis and structural equation modeling were used to test the effects of predisposing, enabling, and illness factors on the predicted likelihood.Results: Although neither model fit well statistically, both fit well descriptively. The direct path from predisposing to enabling factors and the indirect path from predisposing factors to illness level were significant in both models. Discussion: Understanding the factors that influence the decision to hire an HCA could help health providers target patients who are most likely to use HCA services, thereby reducing the burden on the healthcare system and improving quality of care

The effect of age on neural processing of pleasant soft touch stimuli

Tactile interactions with our environment stimulate afferent fibers within the skin, which deliver information about sensations of pain, texture, itch and other feelings to the brain as a comprehensive sense of self. These tactile interactions can stimulate brain regions involved in interoception and reward processing. This study examined subjective, behavioral, and neural processing as a function of age during stimulation of A-beta (Aβ) and C tactile (CT) afferents using a soft brush stroke task. 16 adolescents (ages 15–17), 22 young adults (ages 20–28), and 20 mature adults (ages 29–55) underwent a simple continuous performance task while periodically anticipating and experiencing a soft touch to the palm or forearm, during functional magnetic resonance imaging (fMRI). fMRI results showed that adolescents displayed greater bilateral posterior insula activation than young and mature adults across all conditions and stimulus types. Adolescents also demonstrated greater bilateral posterior insula activation than young and mature adults specifically in response to the soft touch condition. Adolescents also exhibited greater activation than mature adults in bilateral inferior frontal gyrus and striatum during the soft touch condition. However, mature adults showed greater striatum activation than adolescents and young adults during anticipation. In the left anterior cingulate cortex, mature adults exhibited greater activation than adolescents and young adults when anticipating the upcoming touch. These results support the hypothesis that adolescents show an exaggerated neural response to pleasant stimulation of afferents, which may have profound effects on how they approach or avoid social and risky situations. In particular, heightened interoceptive reactivity to pleasant stimuli might cause adolescents to seek experiences that are associated with pleasant stimulation

A Comparison Between Conventional and High-Priority Bus Services in Davao City, Southern Philippines

The increasing demand for transport system in Davao City has paved the way for the proposal of two transportation options, namely, the conventional bus service (CBS) and high-priority bus service (HPBS). A necessary step for transport policy making is quantitatively determining the differences between these transport options. In this study, we compare the projected performances of CBS and HPBS in terms of their expected load factor and passenger waiting time at chosen stations in Davao City. Our assessment is based on the data gathered about the existing public transport system at eight stations in the Mintal area during the morning rush hours. A single server batch service queueing model was adopted in this study to approximate the passenger waiting time at a station for each transport option. Passenger arrivals are fitted to a Poisson distribution using least square methods yielding a headway/service time of 3 min and service frequency during the observation period is 40. Our results show that though the load factor of CBS is higher than the HPBS, it fails to meet the passenger demands at some stations, which resulted in increased passenger waiting time

Effects of Age, Mental Health, and Comorbidity on the Perceived Likelihood of Hiring a Healthcare Advocate

Background and Purpose: The projected increase in chronically ill older adults may overburden the healthcare system and compromise the receipt of quality and coordinated health care services. Healthcare advocates (HCAs) may help to alleviate the burden associated with seeking and receiving appropriate health care. We examined whether having dementia or depression, along with hypertension and arthritis, or having no comorbid medical conditions, and being an older adult, affected the perceived likelihood of hiring an HCA to navigate the health care system. Method: Participants (N = 1,134), age 18 or older, read a vignette and imagined themselves as an older adult with either a mood or cognitive disorder, and comorbid medical conditions or as otherwise being physically healthy. They were then asked to complete a questionnaire assessing their perceived likelihood of hiring an HCA. Results: Participants who imagined themselves as having dementia reported a greater likelihood of hiring an HCA than participants who imagined themselves as having depression (p < .001). Conclusion: It is imperative that health care professionals attend to the growing and ongoing needs of older adults living with chronic conditions, and HCAs could play an important role in meeting those needs

Apples and Oranges: Comparing the Backgrounds and Academic Trajectories of International Baccalaureate (IB) Students to a Matched Comparison Group

This report presents findings from a retrospective study of the academic histories of International Baccalaureate (IB) students and other students in the state of Florida. The IB Diploma Program is an internationally recognized college-preparatory curriculum designed to provide students with a rigorous and comprehensive academic experience. IB has grown dramatically in recent years and is thought by many to be among the best college-preparatory programs in existence. As such, there is tremendous interest in the potential impacts of IB, but any attempts to examine those impacts must deal with selection bias that results from the voluntary participation of schools and students. Failure to do so makes it impossible to determine whether the performance of participating students was actually influenced by IB, or whether the outcomes for these students would have been just as good without IB. As a critical step in understanding the impacts of IB, the analyses presented in this report examined the selection mechanisms behind IB participation across Florida, the state with the second highest representation of IB programs in the nation. We use longitudinal student and school-level data from 1995 through 2009 from the Florida K-20 Education Data Warehouse (EDW) to characterize individual students’ educational histories from elementary school through high school and into college. To address issues of selection bias, we use propensity score methods (Rosenbaum & Rubin, 1983) to adjust for preexisting differences between IB and non-IB students

The Subjectivities of Wearable Sleep-Trackers - A Discourse Analysis

Self-reported quality and duration of sleep in Western populations is declining. The interest in wearable sleep-trackers that are promis- ing better sleep is growing. By wearing a device day and night the sleeper is continuously connected to a more-than-human net- work. The mass-adoption of sleep-tracking devices has an impact on the personal, social and cultural meaning of sleep. This study looks at the discourse forming around wearable sleep-trackers. This extended abstract presents how non-human subjectivities are accounted for in this discourse. Through a posthuman discourse analysis of textual and visual artefacts from interviews, academic research and popular media, six distinct roles for these non-human social agents were identified: ‘Teacher’, ‘Informant’, ‘Companion’, ‘Therapist’, ‘Coach’ and ‘Mediator’. This characterisation is a first step to understanding sleep-trackers as social agents, reorganising personal and contextual relationships with the sleeping self

Predicting selection for antimicrobial resistance in UK wastewater and aquatic environments: ciprofloxacin poses a significant risk

Antimicrobial resistance (AMR) is a threat to human and animal health, with the environment increasingly recognised as playing an important role in AMR evolution, dissemination, and transmission. Antibiotics can select for AMR at very low concentrations, similar to those in the environment, yet their release into the environment, e.g., from wastewater treatment plants, is not currently regulated. Understanding the selection risk antibiotics pose in wastewater and receiving waters is key to understanding if environmental regulation of antibiotics is required. We investigated the risk of selection occurring in UK wastewater and receiving waters by determining where measured environmental concentration data (n = 8187) for four antibiotics (ciprofloxacin, azithromycin, clarithromycin, and erythromycin) collected in England and Wales 2015–2018 (sites n = 67) exceeded selective concentration thresholds derived from complex microbial community evolution experiments undertaken previously. We show that selection for AMR by ciprofloxacin is likely to have occurred routinely in England and Wales wastewater during the 2015–2018 period, with some seasonal and regional trends. Wastewater treatment reduces the selection risk posed by ciprofloxacin significantly, but not completely, and predicted risk in surface waters remains high in several cases. Conversely, the potential risks posed by the macrolides (azithromycin, clarithromycin, and erythromycin) were lower than those posed by ciprofloxacin. Our data demonstrate further action is needed to prevent selection for AMR in wastewater, with environmental quality standards for some antibiotics required in the future, and that selection risk is not solely a concern in low/middle income countries

Fiction Fix 08

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