Psychological Disability and the Director's Chair: Interrogating the Relationship Between Positionality and Pedagogy

The act of writing this essay involves some professional risk, because it also involves a disclosure: I am a writing center director and tenure-track assistant professor at a regional public university in the Midwest. I also live with an anxiety disorder – the most prevalent class of psychological disorder among U.S. residents in a 2005 study (28.8%). I know I am far from alone. Roughly half of Americans will meet the DSM-IV criteria for a mental disorder at least once during their lifespans (Kessler et al. 595).1 Within academia, however, you would not recognize mental illness’s prevalence – at least, outside anecdotes shared between close friends, or the occasional Facebook post from a colleague in which he or she discloses a diagnosis in response to a mental-health awareness campaign or high-profile celebrity suicide.University Writing Cente

Beyond Binaries of Disability in Writing Center Studies from Praxis: A Writing Center Journal Vol.19 No.1

In her introduction to the anthology Writing Centers and Disability, Allison Hitt argues for the importance of honoring the nuances and complexities of disabled student writers in writing center work (viii). In our provocation, we center these nuances and complexities of disability, not only for disabled people/people with disabilities¹, but also as these complexities might shape writing center praxis. Too often disabled experiences are not relayed in their complexity but are flattened by binary understanding of disability. We worry about the ways in which an understanding of disability in writing center studies is haunted by the stories nondisabled people tell about disability, about how Disability discourse in writing center research both opens and forecloses possibilities for disabled student writers and writing center instructors.University Writing Cente

Victorians: A Journal of Culture and Literature (Spring 2011)

Victorians. A Journal of Culture and Literature is sponsored for the Victorian Group of the Modern Language Association by Western Kentucky University and is published twice yearly.Some pages are missing from this record.Greetings from the Editor / Deborah A. Logan -- Manufacturing Men: Boys as Commodities in Kipling's Kim and Captains Courageous / Justin Jones -- The New Man in the Age of the New Woman: May 1894-February 1895 / Doug Kirshen -- Playing Hide and Seek with Venus and Madonna: Collins's Early Experiment in Pre-Raphaelite Transgression / M. Melissa Elston -- Beating them to the Punch: Satirizing Sensation from the 1860s Comic Journal to Braddon's The Doctor's Wife / Joyce E. Kelley -- Transcendental Monsters / Janice Law Trecker -- Piercing the Public Sphere: Pompilia's Rupture of the Public/Private Divide in Browning's The Ring and the Book / Elizabeth Coggin Womack -- Lillian Nayder, The Other Dickens: A Life of Catherine Hogarth / Robert Lapides -- Stefano Evangelista (ed.), The Reception of Oscar Wilde in Europe / Nikolai Endres -- George Gissing, Demos: A Story of English Socialism. Ed. Debbie Harrison / Malcolm Allen -- Books Received -- Contributors -- Announcement

Medication Adherence Does Not Explain Black-White Differences in Cardiometabolic Risk Factor Control among Insured Patients with Diabetes

BACKGROUND: Among patients with diabetes, racial differences in cardiometabolic risk factor control are common. The extent to which differences in medication adherence contribute to such disparities is not known. We examined whether medication adherence, controlling for treatment intensification, could explain differences in risk factor control between black and white patients with diabetes. METHODS: We identified three cohorts of black and white patients treated with oral medications and who had poor risk factor control at baseline (2009): those with glycated hemoglobin (HbA1c) \u3e8 % (n = 37,873), low-density lipoprotein cholesterol (LDL-C) \u3e100 mg/dl (n = 27,954), and systolic blood pressure (SBP) \u3e130 mm Hg (n = 63,641). Subjects included insured adults with diabetes who were receiving care in one of nine U.S. integrated health systems comprising the SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) consortium. Baseline and follow-up risk factor control, sociodemographic, and clinical characteristics were obtained from electronic health records. Pharmacy-dispensing data were used to estimate medication adherence (i.e., medication refill adherence [MRA]) and treatment intensification (i.e., dose increase or addition of new medication class) between baseline and follow-up. County-level income and educational attainment were estimated via geocoding. Logistic regression models were used to test the association between race and follow-up risk factor control. Models were specified with and without medication adherence to evaluate its role as a mediator. RESULTS: We observed poorer medication adherence among black patients than white patients (p \u3c 0.01): 50.6 % of blacks versus 39.7 % of whites were not highly adherent (i.e., MRA\u3c80 %) to HbA1c oral medication(s); 58.4 % of blacks and 46.7 % of whites were not highly adherent to lipid medication(s); and 33.4 % of blacks and 23.7 % of whites were not highly adherent to BP medication(s). Across all cardiometabolic risk factors, blacks were significantly less likely to achieve control (p \u3c 0.01): 41.5 % of blacks and 45.8 % of whites achieved HbA1c \u3c8 %; 52.6 % of blacks and 60.8 % of whites achieved LDL-C \u3c100; and 45.7 % of blacks and 53.6 % of whites achieved SBP \u3c130. Adjusting for medication adherence/treatment intensification did not alter these patterns or model fit statistics. CONCLUSIONS: Medication adherence failed to explain observed racial differences in the achievement of HbA1c, LDL-C, and SBP control among insured patients with diabetes

Trends in diabetes incidence among 7 million insured adults, 2006-2011: the SUPREME-DM project

An observational cohort analysis was conducted within the Surveillance, Prevention, and Management of Diabetes Mellitus (SUPREME-DM) DataLink, a consortium of 11 integrated health-care delivery systems with electronic health records in 10 US states. Among nearly 7 million adults aged 20 years or older, we estimated annual diabetes incidence per 1,000 persons overall and by age, sex, race/ethnicity, and body mass index. We identified 289,050 incident cases of diabetes. Age- and sex-adjusted population incidence was stable between 2006 and 2010, ranging from 10.3 per 1,000 adults (95% confidence interval (CI): 9.8, 10.7) to 11.3 per 1,000 adults (95% CI: 11.0, 11.7). Adjusted incidence was significantly higher in 2011 (11.5, 95% CI: 10.9, 12.0) than in the 2 years with the lowest incidence. A similar pattern was observed in most prespecified subgroups, but only the differences for persons who were not white were significant. In 2006, 56% of incident cases had a glycated hemoglobin (hemoglobin A1c) test as one of the pair of events identifying diabetes. By 2011, that number was 74%. In conclusion, overall diabetes incidence in this population did not significantly increase between 2006 and 2010, but increases in hemoglobin A1c testing may have contributed to rising diabetes incidence among nonwhites in 2011