Meredith Conroy CD Summer 2014

Supports faculty to redesign or develop a course in ways that implement high-impact, evidence-based, and/or innovative teaching strategies to improve student learning

Mental Health And The Role Of The States

Researchers from the State Health Care Spending Project -- a collaboration between The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation -- sought to better understand the country's mental health challenges and, in particular, the states' role in addressing them. The project found that:In 2013, approximately 44 million adults -- 18.5 percent of the population 18 and older -- were classified as having a mental illness. Of these, 10 million had a serious mental illness. The rate of serious mental illness varied from state to state.In 2009, the most recent year for which national mental health data are available, $147 billion was spent on mental health treatment in the United States. A majority of the spending, 60 percent, came from public sources such as Medicaid, state and local governments, Medicare, and federal grants. Private sources, including health insurance and individual out-of-pocket spending, made up the difference.Funding from states and localities totaled$22 billion (15 percent) in 2009. This total does not include state and local Medicaid expenditures. Counting those contributions brings total state and local spending up to $35.5 billion (24 percent).This report is intended to help federal, state, and local policymakers working to address the country's mental health challenges to better understand their prevalence, treatment, and funding trends

Phantom Limb Pain: It’s Not ‘All in my Mind, it’s in my Neurons!\u27

Phantom limb pain (PLP) is a burning, stabbing, shooting, aching, and/or throbbing pain that an amputee feels in his or her amputated limb. According to recent statistics, PLP affects 50-80% of amputees—over one million amputees in the United States alone. With this condition being so widespread and detrimental to patients’ day to day life it is important to understand its mechanisms. However, there is a great deal of debate as to whether PLP is neurological or psychological

The Rise of Women, #MeToo and Why It Matters

In light of current political events here in the United States and around the world, such as the #MeToo movement, discussions about toxic masculinity, the tumultuous appointment of Justice Kavanaugh to the U.S. Supreme Court, and a worldwide surge of participation of women in politics, it is obvious that we are living in an important historical period where ideas about gender and power are being debated, reinforced, and challenged. While some political leaders blatantly dismiss gender discrimination and gender-based violence, the global community has recently acknowledged the significance of this issue by awarding the 2018 Nobel Peace Prize to two individuals whose work directly challenges gender oppression. Nadia Murad, a Yazidi rights activist who fights for dignity of trafficked women and children, and Denis Mukwege, a doctor who helps victims of sexual violence in the Democratic Republic of Congo, both have highlighted the rights of individuals whose voices previously have been silenced. Worldwide, people are speaking out about discriminatory and violent practices. Historians will look back at this moment as one where traditional power structures were meaningfully challenged and marginalized voices spoke out about their experiences

The Two Hillary Clintons: how supporters and detractors describe the Democratic nominee

If it was not for Donald Trump’s presence in the 2016 race, Hillary Clinton would be the least favored presidential candidate there has ever been. At the same time, however, she is rated by fact checkers as being far more honest than Trump or any other primary candidate. Using a survey of Californians, Kim L. Nalder, Meredith Conroy, and Danielle Joesten Martin explore how voters feel about Clinton. They find that Trump’s framing of Clinton as “crooked” has stuck, with most of his supporters describing her as a “liar” and “untrustworthy”. Clinton’s own supporters on the other hand, were more likely to describe her as “experienced”, “smart” and “strong”. On gender lines, women tend to describe Clinton more positively compared to men, and also note her gender

Impact of Extended Recess: A Grounded Theory Study

Existing literature has established the benefits of recess and physical activity for children. In response, more schools in the United States (U.S.) are implementing, or even requiring, extended recess time for students. With these policy changes, it is important to understand the impact upon students, faculty, and staff. The following study used the shared experience of three elementary schools in the southern U.S. who recently implemented extended recess. Semi-structured focus groups with administrators, teachers, paraprofessionals, and students from three elementary schools were included in this pilot study. A Grounded theory approach was utilized, and findings confirmed the known benefits of recess but also enhanced understanding of the process, which included the challenges involved as well as the importance of stakeholder feedback. Recommendations are included for the professional school counselor which are applicable in both, the U.S. and internationally

Acute kidney injury in Ugandan children with severe malaria is associated with long-term behavioral problems

Background Acute kidney injury (AKI) is a risk factor for neurocognitive impairment in severe malaria (SM), but the impact of AKI on long-term behavioral outcomes following SM is unknown. Methods We conducted a prospective study on behavioral outcomes of Ugandan children 1.5 to 12 years of age with two forms of severe malaria, cerebral malaria (CM, n = 226) or severe malarial anemia (SMA, n = 214), and healthy community children (CC, n = 173). AKI was defined as a 50% increase in creatinine from estimated baseline. Behavior and executive function were assessed at baseline and 6, 12, and 24 months later using the Child Behavior Checklist and Behavior Rating Inventory of Executive Function, respectively. Age-adjusted z-scores were computed for each domain based on CC scores. The association between AKI and behavioral outcomes was evaluated across all time points using linear mixed effect models, adjusting for sociodemographic variables and disease severity. Results AKI was present in 33.2% of children with CM or SMA at baseline. Children ≥6 years of age with CM or SMA who had AKI on admission had worse scores in socio-emotional function in externalizing behaviors (Beta (95% CI), 0.52 (0.20, 0.85), p = 0.001), global executive function (0.48 (0.15, 0.82), p = 0.005) and behavioral regulation (0.66 (0.32, 1.01), p = 0.0002) than children without AKI. There were no behavioral differences associated with AKI in children <6 years of age. Conclusions AKI is associated with long-term behavioral problems in children ≥6 years of age with CM or SMA, irrespective of age at study enrollment

Comparative Safety and Effectiveness of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy for Weight Loss and Type 2 Diabetes Across Race and Ethnicity in the PCORnet Bariatric Study Cohort

IMPORTANCE: Bariatric surgery is the most effective treatment for severe obesity; yet it is unclear whether the long-term safety and comparative effectiveness of these operations differ across racial and ethnic groups. OBJECTIVE: To compare outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) across racial and ethnic groups in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, observational, comparative effectiveness cohort study that comprised 25 health care systems in the PCORnet Bariatric Study. Patients were adults and adolescents aged 12 to 79 years who underwent a primary (first nonrevisional) RYGB or SG operation between January 1, 2005, and September 30, 2015, at participating health systems. Patient race and ethnicity included Black, Hispanic, White, other, and unrecorded. Data were analyzed from July 1, 2021, to January 17, 2022. EXPOSURE: RYGB or SG. OUTCOMES: Percentage total weight loss (%TWL); type 2 diabetes remission, relapse, and change in hemoglobin A1c (HbA1c) level; and postsurgical safety and utilization outcomes (operations, interventions, revisions/conversions, endoscopy, hospitalizations, mortality, 30-day major adverse events) at 1, 3, and 5 years after surgery. RESULTS: A total of 36 871 patients (mean [SE] age, 45.0 [11.7] years; 29 746 female patients [81%]) were included in the weight analysis. Patients identified with the following race and ethnic categories: 6891 Black (19%), 8756 Hispanic (24%), 19 645 White (53%), 826 other (2%), and 783 unrecorded (2%). Weight loss and mean reductions in HbA1c level were larger for RYGB than SG in all years for Black, Hispanic, and White patients (difference in 5-year weight loss: Black, -7.6%; 95% CI, -8.0 to -7.1; P \u3c .001; Hispanic, -6.2%; 95% CI, -6.6 to -5.9; P \u3c .001; White, -5.9%; 95% CI, -6.3 to -5.7; P \u3c .001; difference in change in year 5 HbA1c level: Black, -0.29; 95% CI, -0.51 to -0.08; P = .009; Hispanic, -0.45; 95% CI, -0.61 to -0.29; P \u3c .001; and White, -0.25; 95% CI, -0.40 to -0.11; P = .001.) The magnitude of these differences was small among racial and ethnic groups (1%-3% of %TWL). Black and Hispanic patients had higher risk of hospitalization when they had RYGB compared with SG (hazard ratio [HR], 1.45; 95% CI, 1.17-1.79; P = .001 and 1.48; 95% CI, 1.22-1.79; P \u3c .001, respectively). Hispanic patients had greater risk of all-cause mortality (HR, 2.41; 95% CI, 1.24-4.70; P = .01) and higher odds of a 30-day major adverse event (odds ratio, 1.92; 95% CI, 1.38-2.68; P \u3c .001) for RYGB compared with SG. There was no interaction between race and ethnicity and operation type for diabetes remission and relapse. CONCLUSIONS AND RELEVANCE: Variability of the comparative effectiveness of operations for %TWL and HbA1c level across race and ethnicity was clinically small; however, differences in safety and utilization outcomes were clinically and statistically significant for Black and Hispanic patients who had RYGB compared with SG. These findings can inform shared decision-making regarding bariatric operation choice for different racial and ethnic groups of patients

The neuroscience of body memory: From the self through the space to the others.

Abstract Our experience of the body is not direct; rather, it is mediated by perceptual information, influenced by internal information, and recalibrated through stored implicit and explicit body representation (body memory). This paper presents an overview of the current investigations related to body memory by bringing together recent studies from neuropsychology, neuroscience, and evolutionary and cognitive psychology. To do so, in the paper, I explore the origin of representations of human body to elucidate their developmental process and, in particular, their relationship with more explicit concepts of self. First, it is suggested that our bodily experience is constructed from early development through the continuous integration of sensory and cultural data from six different representations of the body, i.e., the Sentient Body (Minimal Selfhood), the Spatial Body (Self Location), the Active Body (Agency), the Personal Body (Whole Body Ownership – Me); the Objectified Body (Objectified Self – Mine), and the Social Body (Body Satisfaction – Ideal Me). Then, it is suggested that these six representations can be combined in a coherent supramodal representation, i.e. the "body matrix", through a predictive, multisensory processing activated by central, top–down, attentional processes. From an evolutionary perspective, the main goal of the body matrix is to allow the self to protect and extend its boundaries at both the homeostatic and psychological levels. From one perspective, the self extends its boundaries (peripersonal space) through the enactment and recognition of motor schemas. From another perspective, the body matrix, by defining the boundaries of the body, also defines where the self is present, i.e., in the body that is processed by the body matrix as the most likely to be its one, and in the space surrounding it. In the paper I also introduce and discuss the concept of "embodied medicine": the use of advanced technology for altering the body matrix with the goal of improving our health and well-being