Pragmatic randomised controlled trial of an allergy intervention for children aged 6 to 16 with asthma and rhinitis in general practice

Background: It is widely believed that for allergic rhinitis and asthma, avoidance of specific triggers can improve symptom control. Whilst many children with asthma or rhinitis are sensitised to airborne allergens, primary care diagnostic and management decisions are often made without a detailed history of the allergic triggers or allergy testing. Thus, treatment decisions are empirical and allergen avoidance advice is either not given or, if given, not tailored to the child’s sensitivities. Objective: To ascertain whether allergy assessment and tailored advice in General Practice enhances outcomes of children with asthma and rhinitis. Method: Pragmatic RCT of allergy intervention (structured allergy history, skin prick testing and appropriate allergy avoidance advice) versus usual care in children with asthma and/or rhino-conjunctivitis. A blinded observer assessed outcomes at 12 months. Main outcome measures were symptom scores and disease-specific health-related QoL. Secondary outcomes were health care utilisation, days unable to pursue usual activities, and self-rated improvement. Results: 335 participants were randomised to formal allergy assessment or normal care. There were no differences in participants’ demographic or clinical characteristics at baseline (all p>.05). At 12 months, participants receiving the allergy intervention had fewer rhinitis symptoms (MD -3.14, 95% CI -6.01, -0.81) and an improvement in QoL (MD -0.50, 95% CI 0.32, 0.68). There were no significant changes in asthma symptoms, health care utilisation or number of days unable to pursue usual activities. Conclusion: Amongst children with known asthma and/or rhinitis in primary care, taking a structured allergy history with skin prick testing and tailored advice on allergy avoidance resulted in reduced symptoms of rhinitis and improved QoL

Detecting Scale Recalibration in Survey Research: A Laboratory Investigation

The accurate detection of scale recalibration is an issue that should not be ignored by organizational researchers and practitioners concerned with the accurate assessment of change interventions. In an effort to more effectively operationalize one methodology that is designed to detect scale recalibration (using ideal scales), three research questions were developed and investigated in a laboratory study utilizing videotape technology. It was concluded that ideal scale methodology can be used to accurately detect the presence of scale recalibration in survey research data. The implications of these findings for both researchers and practitioners are discussed.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Factors associated with risk of evacuation failure from Hurricane Isabel in North Carolina, 2003

Important differences in evacuation exist across households. This study describes associations between social factors and evacuation from Hurricane Isabel by residents of North Carolina in 2003. Census blocks in three affected counties were stratified by flood zone and 30 census blocks were selected probability proportionate to population size from each flood zone. Within selected blocks, 7 random interview locations were chosen using a geographic information systems-based site selection tool. Risk differences and 95% confidence intervals for evacuation were calculated. High levels of neighborhood social cohesion, markers of territoriality (e.g., no trespassing signs), membership in church or civic organization, volunteerism, neighbors’ evacuation, and longer length of residence were associated with reduced hurricane evacuation. Differential levels of social capital, social cohesion, and related social factors contributed to differential rates of evacuation from Hurricane Isabel. Those who reported closer relationships with neighbors and were active volunteers in the community may be more susceptible to evacuation failure and should receive targeted messages regarding evacuation from officials

Unconditional positive self-regard, intrinsic aspirations and authenticity: pathways to psychological well-being

Unconditional positive self-regard (UPSR) is regarded by humanistic psychologists as an important determinant of well-being. However, until recently it has received little empirical attention. The current study aims to examine the association between unconditional positive self-regard and several key constructs consistent with the ideas of well-being within contemporary positive psychology. Study 1 is a confirmatory factor analysis of the UPSR scale. The statistically significant best fit for the data was a related two-factor model. Study 2 used the two-factors of the UPSR scale to explore the association with intrinsic aspirations. The study showed positive self-regard was statistically significantly positively correlated with the intrinsic aspirations total scale and with each of the separate scores for IA-importance and IA-chance. Unconditionality of regard was statistically significantly negatively correlated with IA-importance but was not statistically significantly correlated to either the IA-total or IA-chance scores. Study 3 considers the association between UPSR, intrinsic aspirations and authenticity. Unconditionality of regard was statistically significantly positively correlated with the authenticity scale score. Only IA-chance scores showed a statistically significant and positive correlation with authenticity. The remaining correlations between intrinsic aspirations and authenticity were not statistically significant. Results call for further empirical attention to UPSR within positive psychology research

Understanding Face and Shame: A Servant-Leadership and Face Management Model

Clergy can have a negative impact on churches and other individuals when they knowingly or unknowingly attempt to save face, that is, try to protect their standing or reputation. The desire to gain face and the fear of losing face and feeling ashamed will likely permeate clergy’s decision-making processes without even being noticed. This study explores the essence of face and face management and the relationship between face management and two characteristics of servant-leadership—awareness and healing—in both Chinese and American churches through the methodology of hermeneutic phenomenology. Prior to this study, to my knowledge, no hermeneutic phenomenological research of face management has been conducted in a church setting. Through a review of the literature, four areas are explored: face and shame, face management, servant-leadership, and face, shame, and face management within the church. This study obtained approval from the Institutional Review Board and informed consent from the participants. Three Chinese and three American Christian ministers were chosen to complete a question sheet and participate in two semi-structured interview sessions. A first cycle of open coding and second cycle of pattern coding were used during data analysis. Face experiences are discussed in light of eight major themes: body, triggers, becoming, face concepts, strategies, emotions, servant-leadership, and the church. Findings from the study help build a servant-leadership and face management model, which can offer an anchored approach for clergy and pastoral counselors to address face and shame and to develop therapeutic interventions

Intent to Receive Pandemic Influenza A (H1N1) Vaccine, Compliance with Social Distancing and Sources of Information in NC, 2009

BACKGROUND:Public adherence to influenza vaccination recommendations has been low, particularly among younger adults and children under 2, despite the availability of safe and effective seasonal vaccine. Intention to receive 2009 pandemic influenza A (H1N1) vaccine has been estimated to be 50% in select populations. This report measures knowledge of and intention to receive pandemic vaccine in a population-based setting, including target groups for seasonal and H1N1 influenza. METHODOLOGY AND PRINCIPAL FINDINGS:On August 28-29, 2009, we conducted a population-based survey in 2 counties in North Carolina. The survey used the 30x7 two-stage cluster sampling methodology to identify 210 target households. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated. Knowledge of pandemic influenza A (H1N1) vaccine was high, with 165 (80%) aware that a vaccine was being prepared. A total of 133 (64%) respondents intended to receive pandemic vaccine, 134 (64%) intended to receive seasonal vaccine, and 109 (53%) intended to receive both. Reporting great concern about H1N1 infection (PR 1.55; 95%CI: 1.30, 1.85), receiving seasonal influenza vaccine in 2008-09 (PR 1.47; 95%CI: 1.18, 1.82), and intending to receive seasonal influenza vaccine in 2009-10 (PR 1.27; 95%CI: 1.14, 1.42) were associated with intention to receive pandemic vaccine. Not associated were knowledge of vaccine, employment, having children under age 18, gender, race/ethnicity and age. Reasons cited for not intending to get vaccinated include not being at risk for infection, concerns about vaccine side effects and belief that illness caused by pandemic H1N1 would be mild. Forty-five percent of households with children under 18 and 65% of working adults reported ability to comply with self-isolation at home for 7-10 days if recommended by authorities. CONCLUSIONS AND SIGNIFICANCE:This is the first report of a population based rapid assessment used to assess knowledge and intent to receive pandemic vaccine in a community sample. Intention to receive pandemic and seasonal vaccines was higher than previously published reports. To reach persons not intending to receive pandemic vaccine, public health communications should focus on the perceived risk of infection and concerns about vaccine safety

Improvements to water purification and sanitation infrastructure may reduce the diarrheal burden in a marginalized and flood prone population in remote Nicaragua

<p>Abstract</p> <p>Background</p> <p>The isolated northern region of Nicaragua has one of the highest rates of diarrheal disease in Central America. Political and environmental hardships faced by inhabitants of this region are contributing factors to this health inequity. The aim of this study was to assess the relationship between water and latrine infrastructure and the prevalence of diarrhea in this region.</p> <p>Methods</p> <p>A population-based, cross-sectional survey of women of reproductive age was conducted in the Sahsa region of northern Nicaragua in July, 2009. Households were selected by two stage cluster sampling methodology. A questionnaire was administered in Spanish and Miskito with assessment of household and socioeconomic conditions, sanitation practices, and health care access. Diarrhea prevalence differences at the household level over a two week reporting period were estimated with a standardized instrument which included assessment of water treatment and latrine use and maintenance.</p> <p>Results</p> <p>There were 189 women enrolled in the current study. The use of water purification methods, such as chlorine and filters, and latrine ownership were not associated with reduced prevalence of household diarrhea in the two week reporting period. Latrine overflow, however, was associated with an increased prevalence of diarrhea during the same two week period [adjusted prevalence difference and 95% CI: 0.19 (0.03, 0.36)].</p> <p>Conclusions</p> <p>Simple, low cost interventions that improve water and latrine infrastructure may reduce the prevalence of diarrheal disease in the isolated regions of Nicaragua and Central America.</p

Interpersonal Arrogance and the Incentive Salience of Power <i>Versus</i> Affiliation Cues

The arrogance dimension of the circumplex contrasts people who seemingly value power over affiliation (high arrogance) versus those who do not (low arrogance). Following this line of thinking, and building on an incentive salience model of approach motivation, three studies (total N = 284) examined the differential processing of power versus affiliation stimuli in categorization, perception and approach–avoidance paradigms. All studies found interactions of the same type. In study 2, for example, people high in arrogance perceived power stimuli to be larger than affiliation stimuli, but this differential pattern was not evident at low arrogance levels. People high, but not low, in arrogance also approached power stimuli faster than affiliation stimuli in a motor movement task (study 3). The results contribute to a process–based understanding of how interpersonal arrogance functions while linking such differences to the manner in which power versus affiliation cues are perceived and reacted to. Copyright © 2014 European Association of Personality Psychology </jats:p

Does self-love or self-hate predict conspiracy beliefs? Narcissism, self-esteem, and the endorsement of conspiracy theories

Across three studies, we examined the role of self-evaluation in predicting conspiracy beliefs. Previous research linked the endorsement of conspiracy theories to low self-esteem. We propose that conspiracy theories should rather be appealing to individuals with exaggerated feelings of self-love, such as narcissists, due to their paranoid tendencies. In Study 1, general conspiracist beliefs were predicted by high individual narcissism but low self-esteem. Study 2 demonstrated that these effects were differentially mediated by paranoid thoughts, and independent of the effects of collective narcissism. Individual narcissism predicted generalized conspiracist beliefs, regardless of the conspiracy theories implicating in-group or out-group members, while collective narcissism predicted belief in out-group but not in-group conspiracies. Study 3 replicated the effects of individual narcissism and self-esteem on the endorsement of various specific conspiracy theories and demonstrated that the negative effect of self-esteem was largely accounted for by the general negativity toward humans associated with low self-esteem