Access or Exclusion? An Analysis of State Reproductive Rights and Comprehensive Sex Education

In 2009, Colorado successfully decreased their abortion rate among minors and at-risk teenagers through a privately-funded trial. This outcome was realized by offering affordable, accessible, and comprehensive reproductive healthcare options, specifically long-acting reversible contraception, to young women. Reproductive rights is an issue at the forefront of political discussion, often a determining factor for party identification. The controversy of reproductive rights--in particular, abortion--leads to a higher reliance on hear-say, instead of peer-reviewed literature, statistics, and legislation. In order to gain a well-balanced understanding of abortion politics, I compare three Midwestern states--Illinois, Indiana, and Minnesota--to determine their respective policy successes and shortcomings. I examine each state\u27 s abortion related policies including sex education and contraception access in order to determine how these factors affect the abortion rate. Determining what factors work in each state, and whether that is a pattern among the states, guides my proposed policy reforms. The purpose of this exploration is to encourage and promote the significance of women\u27s health education--specifically, reproductive rights. Considering the majority of information portrayed regarding sexual health occurs at a high school level age, there is a more structured focus on the abortion rate of minors. Access to information and birth control, coupled with mandated comprehensive sex education in schools, are key to re-shaping America\u27s current, complex state of healthcare. Change needs to be inspired, and that is the purpose of this thesis: to improve women\u27s reproductive healthcare system; lower abortion rates would simply be an added benefit

Fostering compassionate care for persons with Alzheimer\u27s disease in nursing facilities.

The aim of this dissertation study was to examine the impact of the implementation of a new Compassionate Care (CC) curriculum on the quality of care provided by Certified Nursing Assistants (CNAs) to residents with Alzheimer’s disease (AD). More specifically, this dissertation used Kirkpatrick’s model of evaluation to assess the reactions, learning, and behavior change of the CNAs exposed to the curriculum, and ultimately the impact of the curriculum on the stress levels of residents with AD. To accomplish this, we had two studies that aligned with the Kirkpatrick model of evaluation. For Study #1, the evaluation of the compassionate care curriculum (Kirkpatrick Levels One, Two, and Three), the following hypotheses guided the study: Hypothesis 1: After completion of the compassionate care curriculum by the CNA experimental group, CNAs will show a significantly higher increase in knowledge, caregiving self-efficacy, caregiving satisfaction and a significantly higher reduction in feelings of affiliate stigma than the CNAs who completed the current standard curriculum (control group). For Study #2, Evaluation of the Compassionate Care Curriculum (Kirkpatrick Level Four), the following hypotheses were used to guide the study: Hypothesis 1a: Residents with AD from the experimental nursing facility will have a different 12-week agitation change trajectory from the residents with AD from the control nursing facility. Hypothesis 1b: Residents with AD from the experimental nursing facility will have a different 12-week salivary cortisol change trajectory from the residents with AD from the control nursing facility. Hypothesis 2a: Differences in change in CNAs knowledge, confidence, satisfaction and affiliate stigma will have a differential effect on the 12-week agitation trajectories of residents with AD in the experimental and control nursing facilities. Hypothesis 2b: Differences in change in CNAs knowledge, confidence, satisfaction and stigma and differences in residents with AD agitation will have a differential effect on the 12-week salivary cortisol trajectories of residents with AD in the experimental and control nursing facilities. Methods: The study included an experimental and control nursing facility. The sample of residents with AD from the two facilities, including a convenient sample of 25 residents from the experimental group and 27 from the control group. All the CNAs who took care of the residents with AD that took part in the study were also included in the study for a total of 99 CNAs, 48 in the experimental group and 51 in the control group. At baseline, prior to the implementation of the curriculum, data were collected on the demographics of the CNAs along with their pre-test on AD knowledge, self-efficacy, caregiving satisfaction, and affiliate stigma for both the experimental and control groups. At the 12-week period, after the curriculum and care groups were implemented, data on AD knowledge, self-efficacy, caregiving satisfaction, and affiliate stigma were collected again for both groups. After equivalency between the two groups was tested, a two-way mixed method MANOVA was utilized to examine how scores changed for all of the dependent variables. For this study, the focus of the analysis was to examine whether there was a significant difference over time (within-subjects), whether there were differences between the control and experimental groups (between-subjects), and whether there was an interaction effect between time and group, indicating if the groups change differently over time. The second study examined the final element of the Kirkpatrick model, namely stress levels of residents with AD. This study was conducted by testing a hybrid multilevel growth model. Results: CNAs changes in terms of their knowledge of AD, self-efficacy, caregiving satisfaction and affiliate stigma were analyzed to understand the impact the compassionate care curriculum had on the CNAs, using levels 1, 2 and 3 of the Kirkpatrick Evaluation Model. For AD knowledge, we saw a significant increase in scores from baseline to 12 weeks for the experimental group while the control group remained the same over the 12-week period. Self-efficacy for the experimental group improved between baseline and 12-weeks but deteriorated slightly for the control group. Caregiver satisfaction showed a slight improvement at 12-weeks for both groups, yet the experimental group showed a trend of greater improvement than the control group. For the experimental group, feelings of affiliate stigma declined between baseline and 12- weeks, while the control group remained similar at the 12-week period. From the Kirkpatrick model, level 4 examined outcomes. This study focused on the stress outcomes of the residents with AD, specifically agitation and salivary cortisol levels. All models built showed that the experimental group performed better in reducing agitation and reducing salivary cortisol levels. The final models were able to show how the changes in the CNAs specifically affected these positive outcomes. CNA knowledge and self-efficacy had the most impact on changing agitation levels, and CNA knowledge and agitation levels had the most impact on salivary cortisol levels. Conclusions: The results of this study showed that integrating a compassionate care curriculum into the work that CNAs perform with persons with AD can lead to positive outcomes on CNAs knowledge, self-efficacy, caregiving satisfaction, affiliate stigma and a reduction of agitation and cortisol levels in persons with AD. This has implications for the way we conceptualize the type of care that is provided by CNAs to persons with AD in nursing facilities. Currently, CNAs are trained to only provide traditional basic nursing care focuses primarily on the basic needs of the person such as attending to activities of daily living. While traditional basic nursing care is important, it should be supplemented with compassionate care for persons with AD. Compassionate care (CC) emphasizes the bond between the caregiver (the CNA) and the care receiver (the person with AD) and their journey together. CC can also provide CNAs with skills to respond to the changes that the person with AD experiences as they decline

EXPRESS: Influence of the physical effort of reminder-setting on strategic offloading of delayed intentions

Intention offloading involves the use of external reminders such as diaries, to-do lists, and digital alerts to help us remember delayed intentions. Recent studies have provided evidence for various cognitive and metacognitive factors that guide intention offloading, but little research has investigated the physical cost of reminder-setting itself. Here we present two pre-registered experiments investigating how the cost of physical effort associated with reminder-setting influences strategic intention offloading under different levels of memory load. At all memory loads, reminder-setting was reduced when it was more effortful. The ability to set reminders allowed participants to compensate for the influence of memory load on accuracy in the low-effort condition; this effect was attenuated in the high-effort condition. In addition, there was evidence that participants with less confidence in their memory abilities were more likely to set reminders. Contrary to prediction, physical effort had the greatest effect on reminder-setting at intermediate memory loads. We speculate that the physical costs of reminder-setting might have the greatest impact when participants are uncertain about their strategy choice. These results demonstrate the importance of physical effort as one of the factors relevant to cost-benefit decision-making about cognitive offloading strategies

Partially Overlapping Neural Correlates of Metacognitive Monitoring and Metacognitive Control

Metacognition describes the process of monitoring one’s own mental states, often for the purpose of cognitive control. Previous research has investigated how metacognitive signals are generated (metacognitive monitoring), for example when people (both f/m) judge their confidence in their decisions and memories. Research has also investigated how metacognitive signals are used to influence behavior (metacognitive control), for example setting a reminder (i.e. cognitive offloading) for something you are not confident you will remember. However, the mapping between metacognitive monitoring and metacognitive control needs further study on a neural level. We used fMRI to investigate a delayed-intentions task with a reminder element, allowing human participants to use their metacognitive insight to engage metacognitive control. Using multivariate pattern analysis, we found that we could separately decode both monitoring and control, and, to a lesser extent, cross-classify between them. Therefore, brain patterns associated with monitoring and control are partially, but not fully, overlapping

Task Switching: A PDP Model

When subjects switch between a pair of stimulus–response tasks, reaction time is slower on trial N if a different task was performed on trial N-1. We present a parallel distributed processing (PDP) model that simulates this effect when subjects switch between word reading and color naming in response to Stroop stimuli. Reaction time on ‘switch trials’ can be slowed by an extended response selection process which results from (a) persisting, inappropriate states of activation and inhibition of task-controlling representations; and (b) associative learning, which allows stimuli to evoke tasks sets with which they have recently been associated (as proposed by Allport & Wylie, 2000). The model provides a good fit to a large body of empirical data, including findings which have been seen as problematic for this explanation of switch costs, and shows similar behavior when the parameters are set to random values, supporting Allport and Wylie’s proposal

Well-being increased during the first UK lockdown – but not for everyone

Sam Gilbert, Mark Fabian, and Roberto Foa draw on data from the first UK lockdown to illustrate how well-being levels improved, contrary to what may have been expected. They nevertheless explain that such improvements were not evenly distributed among the population and discuss the policy implications of their findings

Subjective well-being during the 2020-21 global coronavirus pandemic: Evidence from high frequency time series data.

We investigate how subjective well-being varied over the course of the global COVID-19 pandemic, with a special attention to periods of lockdown. We use weekly data from YouGov's Great Britain Mood Tracker Poll, and daily reports from Google Trends, that cover the entire period from six months before until eighteen months after the global spread of COVID-19. Descriptive trends and time-series models suggest that negative mood associated with the imposition of lockdowns returned to baseline within 1-3 weeks of lockdown implementation, whereas pandemic intensity, measured by the rate of fatalities from COVID-19 infection, was persistently associated with depressed affect. The results support the hypothesis that country-specific pandemic severity was the major contributor to increases in negative affect observed during the COVID-19 pandemic, and that lockdowns likely ameliorated rather than exacerbated this effect

Value-based routing of delayed intentions into brain-based versus external memory stores

Individuals have the option of remembering delayed intentions by storing them in internal memory or offloading them to an external store such as a diary or smartphone alert. How do we route intentions to the appropriate store, and what are the consequences of this? We report three experiments (two preregistered) investigating the role of value. In Experiment 1, participants preferentially offloaded high-value intentions to the external environment. This improved memory for both high- and low-value content. Experiment 2 replicated the low-value memory enhancement even when only high-value intentions were offloaded. This provides evidence for a cognitive spillover effect: When high-value content is offloaded, internal memory becomes reallocated to low-value content instead. Experiment 3 confirmed a theoretical prediction of this account: participants had superior memory for low- than high-value content when the external store was removed. These results imply that value-based offloading can lead to a cognitive spillover effect from high- to low-value content, similar to the automatic allocation of "spare" capacity that has been proposed in the domain of visual attention. Individuals prioritize high-value information for external memory; consequently, they can be left with predominantly low-value information if it fails. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Abnormal functional specialization within medial prefrontal cortex in high-functioning autism: a multi-voxel similarity analysis

Multi-voxel pattern analyses have proved successful in ‘decoding’ mental states from fMRI data, but have not been used to examine brain differences associated with atypical populations. We investigated a group of 16 (14 males) high-functioning participants with autism spectrum disorder (ASD) and 16 non-autistic control participants (12 males) performing two tasks (spatial/verbal) previously shown to activate medial rostral prefrontal cortex (mrPFC). Each task manipulated: (i) attention towards perceptual versus self-generated information and (ii) reflection on another person's mental state (‘mentalizing'versus ‘non-mentalizing’) in a 2 × 2 design. Behavioral performance and group-level fMRI results were similar between groups. However, multi-voxel similarity analyses revealed strong differences. In control participants, the spatial distribution of activity generalized significantly between task contexts (spatial/verbal) when examining the same function (attention/mentalizing) but not when comparing different functions. This pattern was disrupted in the ASD group, indicating abnormal functional specialization within mrPFC, and demonstrating the applicability of multi-voxel pattern analysis to investigations of atypical populations