2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153772/1/acr24131.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153772/2/acr24131_am.pd

Reward elicits cognitive control over emotional distraction:Evidence from pupillometry

Attention is biased toward emotional stimuli, even when they are irrelevant to current goals. Motivation, elicited by performance-contingent reward, reduces behavioural emotional distraction. In emotionally-neutral contexts, reward is thought to encourage use of a proactive cognitive control strategy, altering anticipatory attentional settings to more effectively suppress distractors. The current preregistered study investigates whether a similar proactive shift occurs even when distractors are highly arousing emotional images. We monitored pupil area, an online measure of both cognitive and emotional processing, to examine how reward influences the timecourse of control. Participants (n = 110) identified a target letter flanking an irrelevant central image. Images were meaningless scrambles on 75% of trials; on the remaining 25%, they were intact positive (erotic), negative (mutilation), or neutral images. Half the participants received financial rewards for fast and accurate performance, while the other half received no performance-contingent reward. Emotional distraction was greater than neutral distraction, and both were attenuated by reward. Consistent with behavioural findings, pupil dilation was greater following emotional than neutral distractors, and dilation to intact distractors (regardless of valence) was decreased by reward. Although reward did not enhance tonic pupil dilation (an index of sustained proactive control), exploratory analyses showed that reward altered the timecourse of control – eliciting a sharp, rapid, increase in dilation immediately preceding stimulus-onset (reflecting dynamic use of anticipatory control), that extended until well after stimulus-offset. These findings suggest that reward alters the timecourse of control by encouraging proactive preparation to rapidly disengage from emotional distractors

Ambiguous loss of home: The experience of familial (im)permanence among young adults with foster care backgrounds

Achieving a stable family context for foster children--permanence--is the philosophy within which nearly all child welfare policy and practice is embedded. Although debates endure over defining permanence and the ideal pathways through which it should be achieved, this discourse rarely includes foster youth perspectives. This article presents findings from an interpretive study of 29 young adults who transitioned from foster care into adulthood without legal permanence. Findings extend ambiguous loss theory to conceptualize participants' experiences as an ambiguous loss of home, highlighting three patterns in the strategies used to manage familial impermanence: (1) creating a self-defined permanence, (2) rejecting adoption--navigating multifamilial memberships and allegiances, and (3) building permanence after foster care. Recommendations for policy, practice, and future research are offered, including a shift toward a multisystemic framework of permanence attending to both legal and relational definitions of family among youth in foster care.Adoption Ambiguous loss Family identity Foster care Permanence Transition to adulthood

Ambiguous loss of home: Syrian refugees and the process of losing and remaking home

This constructivist-interpretive study examines social-relational dimensions of change and loss following experiences of political terror, war and forced migration from the perspective of Syrian refugee men and women who were presently living in Jordan (n=31). A process model derived from the analysis theorizes four dimensions of ambiguous loss (safety and security, social connections and identities, connection to place, and dreams and imagined future) and to capture the cyclical process of losing and remaking a sense of home in displacement. Our findings underscore a more complex set of processes that remain outside the array of supports and services provided by many current practices and policies with displaced populations generally, and Syrian refugees specifically. Thus, the findings highlight the need for ecological, integrative policies, interventions and services that support refugees’ attempts to remake the multifaceted and stable phenomenon that is home as they transition into new communities