Autism, Social Comprehension, and Cognitive Impenetrability

Autism is a neurodevelopmental disorder featuring severe social and communicative deficits. Cognitive impenetrability is the inability of systems to be affected by an individual’s beliefs and desires. Individuals with autism have delayed performance on mindreading tasks. Mindreading is the interpretation of others which enables successful social interactions. This task performance is not correlated with everyday social function in autism. These deficits are in contrast with general intelligence and reasoning abilities within the normal range, resistant to cognitive behavioral training, and partially attributable to atypical social predispositions. This suggests individuals with autism perform social tasks differently than typicals. I argue that this mindreading deficit is cognitively impenetrable, then position this deficit within a theoretical framework, enactivism, emphasizing cognitive embodiment and inseparability of social comprehension and action. This framework helps explain the cognitive impenetrability of these social deficits by locating failure to penetrate in individuals\u27 failure to properly interact with the environment

Jenny's Cycle Components: Managing a Lean Supply Chain

Cover Photo: PHOTO COURTESY OF THOMPSON CHOPPERS/ WWW.THOMPSONCHOPPERS.COMJenny’s Cycle Components (JCC) manufactures a product used by an original equipment manufacturer (OEM) for building motorcycles. JCC relies on vendors to supply parts it uses to manufacture its product for the OEM. Problems involving management turnover, on-time delivery, and variation in the quality of purchased parts have been highlighted by its Lean supply chain. These problems (as well as increased production volumes and price concessions demanded by the OEM) have resulted in reduced profitability for a capacity-constrained JCC.The Student Case Competition is sponsored annually by IMAThe Student Case Competition is sponsored annually by IM

Assessing COVID-19 Vaccine Effectiveness in Observational Studies via Nested Trial Emulation

Observational data are often used to estimate real-world effectiveness and durability of coronavirus disease 2019 (COVID-19) vaccines. A sequence of nested trials can be emulated to draw inference from such data while minimizing selection bias, immortal time bias, and confounding. Typically, when nested trial emulation (NTE) is employed, effect estimates are pooled across trials to increase statistical efficiency. However, such pooled estimates may lack a clear interpretation when the treatment effect is heterogeneous across trials. In the context of COVID-19, vaccine effectiveness quite plausibly will vary over calendar time due to newly emerging variants of the virus. This manuscript considers a NTE inverse probability weighted estimator of vaccine effectiveness that may vary over calendar time, time since vaccination, or both. Statistical testing of the trial effect homogeneity assumption is considered. Simulation studies are presented examining the finite-sample performance of these methods under a variety of scenarios. The methods are used to estimate vaccine effectiveness against COVID-19 outcomes using observational data on over 120,000 residents of Abruzzo, Italy during 2021.Comment: 27 pages, 2 figure

Estimating HIV Medication Adherence and Persistence: Two Instruments for Clinical and Research Use

Antiretroviral therapy (ART) requires lifelong daily oral therapy. While patient characteristics associated with suboptimal ART adherence and persistence have been described in cohorts of HIV-infected persons, these factors are poor predictors of individual medication taking behaviors. We aimed to create and test instruments for the estimation of future ART adherence and persistence for clinical and research applications. Following formative work, a battery of 148 items broadly related to HIV infection and treatment was developed and administered to 181 HIV-infected patients. ART adherence and persistence were assessed using electronic monitoring for 3 months. Perceived confidence in medication taking and self-reported barriers to adherence were strongest in predicting non-adherence over time. Barriers to adherence (e.g., affordability, scheduling) were the strongest predictors of non-adherence, as well as 3- and 7-day non-persistence. A ten-item battery for prediction of these outcomes (www.med.unc.edu/ncaidstraining/adherence/for-providers) and a 30-item battery reflective of underlying psychological constructs can help identify and study individuals at risk for suboptimal ART adherence and persistence

Gender and Racial/Ethnic Disparities: Cumulative Screening of Health Risk Indicators in 20-50 Year Olds in the United States

This study explored potential gender and racial/ethnic disparities in overall health risk related to 24 health risk indicators selected across six domains: socioeconomic, health status and health care, lifestyle, nutritional, clinical, and environmental. Using the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), it evaluated cross-sectional data for 5,024 adults in the United States. Logistic regression models were developed to estimate prevalence odds ratios (PORs) adjusted for smoking, health insurance status, and age. Analyses evaluated disparities associated with 24 indicator variables of health risk, comparing females to males and four racial/ethnic groups to non-Hispanic Whites. Non-Hispanic Blacks and Mexican Americans were at greater risk for at least 50% of the 24 health risk indicators, including measures of socioeconomic status, health risk behaviors, poor/fair self-reported health status, multiple nutritional and clinical indicators, and blood lead levels. This demonstrates that cumulative health risk is unevenly distributed across racial/ethnic groups. A similarly high percentage (46%) of the risk factors was observed in females. Females as compared to males were more likely to have lower income, lower blood calcium, poor/fair self-reported health, more poor mental health days/month, higher medication usage and hospitalizations, and higher serum levels of some clinical indicators and blood cadmium. This analysis of cumulative health risk is responsive to calls for broader-based, more integrated assessment of health disparities that can help inform community assessments and public health policy