An inquiry into the concept of God as held by members of a unit for emotionally disturbed children. Concepts of God held by patients and personnel: relevancy of ideas of God in terms of choice relationships

Thesis (M.S.)--Boston Universit

Longitudinal examination of social and environmental influences on motivation for physical activity

Background: Physical activity behavior is influenced by numerous factors including motivation, social interactions, and the walkability of the environment. Aim: To examine how social contexts and environmental features affect physical activity motivational processes across time. Methods: Participants (N=104) completed 3 monthly online surveys assessing self-determination theory constructs, social partners in physical activity, neighborhood walkability, and weekly physical activity. Longitudinal path analysis examined the degree to which physical activity was predicted by individual goals, orientation, and autonomy support and whether these associations were meditated by motivation and moderated by the social and environmental contexts of physical activity. Results: The effect of controlled exercise orientations on physical activity was mediated by autonomous motivation. This association was stronger among those who perceived less crime in their neighborhoods. Discussion: To improve the ability to tailor physical activity counseling it is important to understand how each person views exercise situations and to understand his/her social and neighborhood environments

Social Comparisons, Social Support, and Self-Perceptions in Group Exercise for People With Parkinson's Disease

People with Parkinson's disease (PD) may experience declining function and limited interaction with others with PD. Group exercise provides opportunities for physical accomplishment and social support, as well as potential social challenges. We used interpretative phenomenological analysis to examine experiences of social comparison, social support, and self-perceptions of 20 people with PD in group exercise. Participants experienced (a) reticence evolving to inspiration, (b) anxiety relief through camaraderie and breaking taboos, and (c) maintaining athletic identity through participating and helping others. Practical implications include facilitating a safe space and support to alleviate anxiety and sustain participation

Additive decomposition applied to the semiconductor drift-diffusion model

A new numerical method for semiconductor device simulation is presented. The additive decomposition method has been successfully applied to Burgers' and Navier-Stokes equations governing turbulent fluid flow by decomposing the equations into large-scale and small-scale parts without averaging. The additive decomposition (AD) technique is well suited to problems with a large range of time and/or space scales, for example, thermal-electrical simulation of power semiconductor devices with large physical size. Furthermore, AD adds a level of parallelization for improved computational efficiency. The new numerical technique has been tested on the 1-D drift-diffusion model of a p-i-n diode for reverse and forward biases. Distributions of , n and p have been calculated using the AD method on a coarse large-scale grid and then in parallel small-scale grid sections. The AD results agreed well with the results obtained with a traditional one-grid approach, while potentially reducing memory requirements with the new method

Walking for our health: couple-focused interventions to promote physical activity in older adults

More than 50% of U.S. adults do not engage in sufficient physical activity to meet current recommendations, making physical activity change and maintenance a priority for health promotion throughout adulthood. Among married partners, change in physical activity of one partner often is concordant with change of activity of the other. The primary purpose of this study was to examine two couple-focused interventions that capitalize on the co-occurrence of health behavior change within couples to promote physical activity in older adults. In this study, partners (N = 31 couples) participated together in assessment and intervention activities, and were randomized together into one of two couple-focused conditions. In one condition (concurrent), standard goal-setting techniques were extended to a couple-focused design with each partner setting daily step goals and monitoring her or his own progress. In the other condition (combined), partners collaborated to set and monitor shared daily step goals. Physical activity was assessed with accelerometers pre- and post-intervention. Post-intervention, average weekly physical activity increased by 58 min (p \u3c 0.001), and average body mass index (BMI) decreased by 0.50 kg/m2 (p = 0.001), from pre-intervention measures. Similar levels of change in weekly physical activity and in BMI were detected in both intervention groups. Furthermore, participants demonstrated high adherence to the intervention protocol. Results suggest that couple-focused physical activity interventions can be effective in eliciting increases in physical activity among older adults. Further research is needed to uncover interpersonal mechanisms that maximize physical activity promotion and maintenance within couples over time

Genetic therapies for cardiomyopathy: survey of attitudes of the patient community for the CureHeart project

Cardiomyopathies are a group of inherited heart muscle disorders. Expressivity is variable and while sometimes mild, complications can result in sudden cardiac death (SCD) at any age, heart failure and stroke. In around a third of patients a monogenic cause is identifiable, and development of genetic therapies that aim to correct the underlying genetic defect is underway. Here we describe results of a survey designed to understand preliminary views of the patient community about genetic therapies in the context of disease burden. The internet survey was publicized with a bespoke information video via patient support groups in the UK and USA; 634 people responded of whom 96% had a personal and/or family history of cardiomyopathy. Findings show that concern about cardiomyopathy-related issues with a future dimension, such as disease progression, is significantly greater than concern about current issues. A total of 93.6% thought that genetic therapies should be developed for cardiomyopathy. A majority would consider participation in a genetic therapy trial in six scenarios varying by age and clinical situation significantly more in the scenario of an adult with symptomatic disease and evident progression than an asymptomatic adult with SCD risk, or a child. In all scenarios, a majority said that the chance genetic therapy would stop or slow progression, and risk of serious adverse and unintended effects, were important considerations. Qualitative analysis of free-text responses found that concern was often informed by family experience. Patient consideration of genetic therapy is likely to require individualized assessment of the benefits and risks

A Content Analysis of Catholic School Written Discipline Policies

School discipline has traditionally endorsed the use of exclusionary practices (i.e. suspension and expulsion). Such practices can have a negative short- and long-term impact on student lives, and tend to be enforced disproportionately with certain student populations. Although public school discipline policies have received increased scrutiny in recent years, Catholic school policies have received very little attention. This study presents the results of a content analysis of the written discipline policies of 33 Catholic secondary schools from two dioceses within a major metropolitan area. Results suggest that although variability exists in the types of behaviors included in formal written policies, schools in this sample rely heavily on exclusionary practices as possible consequences to many behaviors, even relatively minor ones. Further, they include positive or restorative consequences minimally, if at all. Suggestions for future research related to discipline practices in Catholic schools are made

Program Signaling in Emergency Medicine: The 2022–2023 Program Director Experience

Introduction: Program signaling (PS), which enables residency applicants to signal their preference for a specific program, was introduced in emergency medicine (EM) in the 2022–2023 residency application cycle. In this study we evaluated EM program directors’ (PD) utilization of PS in application review and ranking. This study also explores the relationship between program characteristics and number of signals received as well as the relative importance and utilization of signals related to the number of signals received. Methods: This is an institutional review board-approved, cross-sectional study of PDs at Accreditation Council for Graduate Medical Education-accredited EM residency programs. We used descriptive statistics to describe the characteristics of residency programs and practices around PS. Measures of central tendency and dispersion summarized continuous variables. We used chi-square analysis or the Fisher exact test for comparisons between groups for categorical variables. Comparisons for continuous variables were made using the t-test for independent samples or analysis of variance. Results: The response rate was 41% (n = 113/277 EM programs). Most programs participated in PS(n = 261/277 EM programs, 94.2%). Mean number of signals received was 60 (range 2–203). Signals received varied based on program characteristics including geographic location and program type, duration, environment, and longevity. Most used PS in holistic review (52.2%), but other uses varied by proportion of applications that were signaled. The importance of PS in application review (mean 2.9; 1–5scale,1= not important, 5 = extremely important) and rank list preparation (2.1) was relatively low compared to other application elements such as standardized letters of evaluation (4.97 for review, 4.90 for ranking). Conclusion: The study provides insights into PS utilization in EM’s inaugural year. We have identified patterns of signal use based on program characteristics and number of signals received that can inform signal allocation and utilization on an individual applicant and program level. A more nuanced understanding of signal use can provide valuable insight as the specialty of EM grapples with fluctuations in its applicant numbers and shifting demographics of its applicant pool

Improving Colorectal Cancer Screening Decision Making Processes

Introduction: Although shared decision making is recommended for cancer screening, it is not routinely completed in practice because of time constraints. We evaluated a process for improving decision making about colorectal cancer (CRC) screening using mailed decision aids (DA) with follow-up telephone support in primary care practices. Methods: We identified patients aged 50-75 who were not up to date with CRC screening in three primary care practices. DA were distributed via mail with telephone follow-up to eligible patients, and charts were reviewed six months later for CRC screening completion. Results: Among 1,064 eligible patients who received the mailed DA, 513 (48.2%) were reached by phone. During the six months after the intervention, 148/1064 (13.9%) patients were screened for CRC (4.8% underwent FIT, 9.1% underwent colonoscopy). Younger patients (aged 50-54) had higher rates of any screening (32.4%) compared with all other age groups (range 12.8%-19.6%), p=0.026, while Medicaid patients had the lowest rates of screening (4.0%), and insured patients had the highest rates (45.3%), p=0.003. Overall, 113/513 (22.0%) who were reached by phone went on to complete screening within 6 months, compared with 35/551 (6.4%) of patients who were not reached by phone (p Conclusion: A standard process for identifying patients unscreened for CRC and DA distribution via mail with telephone decision support modestly increased CRC screening and is consistent with the goal of providing preference-sensitive care and informed decision making. Improving care processes to include decision support outside of office visits is possible in primary care practices

Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity

<p>Abstract</p> <p>Background</p> <p>The relationship between relative metabolic disturbances and developmental disorders is an emerging research focus. This study compares the nutritional and metabolic status of children with autism with that of neurotypical children and investigates the possible association of autism severity with biomarkers.</p> <p>Method</p> <p>Participants were children ages 5-16 years in Arizona with Autistic Spectrum Disorder (n = 55) compared with non-sibling, neurotypical controls (n = 44) of similar age, gender and geographical distribution. Neither group had taken any vitamin/mineral supplements in the two months prior to sample collection. Autism severity was assessed using the Pervasive Development Disorder Behavior Inventory (PDD-BI), Autism Treatment Evaluation Checklist (ATEC), and Severity of Autism Scale (SAS). Study measurements included: vitamins, biomarkers of vitamin status, minerals, plasma amino acids, plasma glutathione, and biomarkers of oxidative stress, methylation, sulfation and energy production.</p> <p>Results</p> <p>Biomarkers of children with autism compared to those of controls using a t-test or Wilcoxon test found the following statistically significant differences (p < 0.001): Low levels of biotin, plasma glutathione, RBC SAM, plasma uridine, plasma ATP, RBC NADH, RBC NADPH, plasma sulfate (free and total), and plasma tryptophan; also high levels of oxidative stress markers and plasma glutamate. Levels of biomarkers for the neurotypical controls were in good agreement with accessed published reference ranges. In the Autism group, mean levels of vitamins, minerals, and most amino acids commonly measured in clinical care were within published reference ranges.</p> <p>A stepwise, multiple linear regression analysis demonstrated significant associations between several groups of biomarkers with all three autism severity scales, including vitamins (adjusted R²of 0.25-0.57), minerals (adj. R²of 0.22-0.38), and plasma amino acids (adj. R²of 0.22-0.39).</p> <p>Conclusion</p> <p>The autism group had many statistically significant differences in their nutritional and metabolic status, including biomarkers indicative of vitamin insufficiency, increased oxidative stress, reduced capacity for energy transport, sulfation and detoxification. Several of the biomarker groups were significantly associated with variations in the severity of autism. These nutritional and metabolic differences are generally in agreement with other published results and are likely amenable to nutritional supplementation. Research investigating treatment and its relationship to the co-morbidities and etiology of autism is warranted.</p