The Role of Recovery in Attenuating the Negative Effects of Perceived Stigmatizing Attitudes for Persons with Psychiatric Disabilities

For many people who experience psychiatric disabilities (PD), community experiences are largely characterized by stigmatizing interactions, discrimination, and losses of opportunities for employment, housing, or relationships. Social withdrawal and loss of self-esteem can be secondary consequences of such negative experiences. However, research has also explored various mechanisms through which people in historically stigmatized social groups can minimize some of the negative effects of stigma. Many of these strategies are theorized to be similar to a mental health recovery orientation which emphasizes the empowerment, capabilities, and strengths of mental health consumers. The present investigation explores the possibility of recovery attenuating some of the negative consequences of perceived stigma for individuals diagnosed with PD. Specifically, the study hypothesizes that the relationship between perceived stigma and social functioning indicators (i.e., vocational engagement, social network size and contact, community integration) will be stronger in those with a lower sense of recovery than those in a high recovery group. A series of logistic and linear regressions testing perceived stigma as a predictor of the three outcomes were compared for participants with recovery scores in the highest and lowest thirds of the sample. Results partially supported hypotheses for social networks and community integration: those with a higher sense of recovery experienced a weaker relationship between stigma and these negative outcomes than their lower-recovery peers. This finding supports the theory that one\u27s sense of recovery has potential to attenuate some of the negative outcomes associated with stigmatizing attitudes. Contrary to hypotheses, however, results of analyses on vocational engagement indicated a positive relationship between stigma and vocational engagement, suggesting that those with more vocational experiences are more aware of stigmatizing attitudes. Altogether, these findings provide a basis for further theory-building and research on the relationship between recovery, stigmatizing attitudes, and community experiences

International Social Survey Programme: Role of Government I-V - ISSP 1985-1990-1996-2006-2016

Das International Social Survey Programme (ISSP) ist ein länderübergreifendes, fortlaufendes Umfrageprogramm, das jährlich Erhebungen zu Themen durchführt, die für die Sozialwissenschaften wichtig sind. Das Programm begann 1984 mit vier Gründungsmitgliedern - Australien, Deutschland, Großbritannien und den Vereinigten Staaten - und ist inzwischen auf fast 50 Mitgliedsländer aus aller Welt angewachsen. Da die Umfragen auf Replikationen ausgelegt sind, können die Daten sowohl für länder- als auch für zeitübergreifende Vergleiche genutzt werden. Jedes ISSP-Modul konzentriert sich auf ein bestimmtes Thema, das in regelmäßigen Zeitabständen wiederholt wird. Details zur Durchführung der nationalen ISSP-Umfragen entnehmen Sie bitte der Dokumentation. Die vorliegende Studie konzentriert sich auf Fragen zu politischen Einstellungen und der Rolle der Regierung

Evaluation of the US COVID-19 Scenario Modeling Hub for informing pandemic response under uncertainty

Abstract Our ability to forecast epidemics far into the future is constrained by the many complexities of disease systems. Realistic longer-term projections may, however, be possible under well-defined scenarios that specify the future state of critical epidemic drivers. Since December 2020, the U.S. COVID-19 Scenario Modeling Hub (SMH) has convened multiple modeling teams to make months ahead projections of SARS-CoV-2 burden, totaling nearly 1.8 million national and state-level projections. Here, we find SMH performance varied widely as a function of both scenario validity and model calibration. We show scenarios remained close to reality for 22 weeks on average before the arrival of unanticipated SARS-CoV-2 variants invalidated key assumptions. An ensemble of participating models that preserved variation between models (using the linear opinion pool method) was consistently more reliable than any single model in periods of valid scenario assumptions, while projection interval coverage was near target levels. SMH projections were used to guide pandemic response, illustrating the value of collaborative hubs for longer-term scenario projections

International Social Survey Programme: Role of Government I-V ADD ON - ISSP 1985-1990-1996-2006-2016

The International Social Survey Programme (ISSP) is a continuous programme of cross-national collaboration running annual surveys on topics important for the social sciences. The programme started in 1984 with four founding members - Australia, Germany, Great Britain, and the United States – and has now grown to almost 50 member countries from all over the world. As the surveys are designed for replication, they can be used for both, cross-national and cross-time comparisons. Each ISSP module focuses on a specific topic, which is repeated in regular time intervals. Please, consult the documentation for details on how the national ISSP surveys are fielded. The present study focuses on questions about political attitudes and the role of government.The release of the cumulated ISSP ´Role of Government´ modules for the years 1985, 1990, 1996, 2006 and 2016 consists of two separate datasets: ZA4747 Role of Government I-V and ZA4748 Role of Government I-V Add On. ZA4747 contains all the cumulated variables, while the supplementary data file ZA4748 contains all those variables that could not be cumulated for various reasons. A comprehensive overview on the contents, the structure and basic coding rules of both data files are provided in the Variable Reports. Role of government I-V Add On: Country-specific variables (for countries included in the cumulated dataset): education (highest degree earned), party affiliation, party voted for in last general election, size of community, country-specific occupational codes (respondent and spouse), personal income, household income, country of origin or ethnic group, religious affili-ation or denomination; Slovakia 2006: political interest; New Zealand 2016: political interest. Module-specific variables: respondent´s religious affiliation or denomination 2006, employment status 2016 (respondent and spouse), living in steady partnership 2016, spouse: working hours 2016; spouse: supervise other employees 2016; parents´ country if birth 2016; Italy: type of housing 1985; type of community (urban/ rural) 1985, 1990, 1996. Additionally coded: Unique cumulation respondent ID Number; Country/ Sample Prefix ISO 3166 Code – alphanumeric; region (country-specific).Das International Social Survey Programme (ISSP) ist ein länderübergreifendes, fortlaufendes Umfrageprogramm, das jährlich Erhebungen zu Themen durchführt, die für die Sozialwissenschaften wichtig sind. Das Programm begann 1984 mit vier Gründungsmitgliedern - Australien, Deutschland, Großbritannien und den Vereinigten Staaten - und ist inzwischen auf fast 50 Mitgliedsländer aus aller Welt angewachsen. Da die Umfragen auf Replikationen ausgelegt sind, können die Daten sowohl für länder- als auch für zeitübergreifende Vergleiche genutzt werden. Jedes ISSP-Modul konzentriert sich auf ein bestimmtes Thema, das in regelmäßigen Zeitabständen wiederholt wird. Details zur Durchführung der nationalen ISSP-Umfragen entnehmen Sie bitte der Dokumentation. Die vorliegende Studie konzentriert sich auf Fragen zu politischen Einstellungen und der Rolle der Regierung.Die Veröffentlichung der kumulierten ISSP-Module "Role of Government" für die Jahre 1985, 1990, 1996, 2006 und 2016 besteht aus zwei separaten Datensätzen: ZA4747 Role of Government I-V und ZA4748 Role of Government I-V Add On. ZA4747 enthält alle kumulierten Variablen, während der Zusatzdatensatz ZA4748 all jene Variablen enthält, die aus verschiedenen Gründen nicht kumuliert werden konnten. Ein umfassender Überblick über den Inhalt, die Struktur und die grundlegenden Kodierungsregeln beider Datenfiles wird in den Variablenreports gegeben. Rolle des Staates I-V Add On: Länderspezifische Variablen (für die im kumulierten Datensatz enthaltenen Länder): Bildung (höchster erworbener Abschluss), Parteizugehörigkeit, bei den letzten allgemeinen Wahlen gewählte Partei, Größe der Gemeinde, länderspezifische Berufscodes (Befragter und Ehepartner), persönliches Einkommen, Haushaltseinkommen, Herkunftsland oder ethnische Gruppe, Religionszugehörigkeit oder Konfession; Slowakei 2006: politisches Interesse; Neuseeland 2016: politisches Interesse. Modulspezifische Variablen: Religionszugehörigkeit oder Konfession des Befragten 2006, Beschäftigungsstatus 2016 (Befragter und Ehegatte), Leben in fester Partnerschaft 2016, Ehegatte: Arbeitszeit 2016; Ehegatte: Aufsicht über andere Mitarbeiter 2016; Geburtsland der Eltern 2016; Italien: Art der Wohnung 1985; Art der Gemeinde (Stadt/Land) 1985, 1990, 1996. Zusätzlich kodiert: Eindeutige Kumulierungs-ID-Nummer des Befragten; Land/Stichprobenpräfix ISO 3166 Code - alphanumerisch; Region (länderspezifisch)

Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000–14 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries

Background: Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0–14 years) and adults (aged 15–99 years) diagnosed with a haematological malignancy during 2000–14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0–24 years). Methods: We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0–14 years), adolescents (15–19 years), and young adults (20–24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. Findings: 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010–14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010–14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000–14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. Interpretation: This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used