Sacred Canopies or Religious Markets? The Effect of County-Level Religious Diversity on Later Changes in Religious Involvement

Secularization theories, such as Berger's Sacred Canopy argument , hold that religious diversity leads to a decline in religious participation. Religious market models (e.g., Finke and Stark) argue the opposite. Voas, Olson, and Crockett found that nearly all of the vast research exploring this important question prior to 2002 was flawed due to a previously unrecognized noncausal statistical relationship between measures of religious diversity and measures of religious participation. Since 2002, this methodological issue has largely stymied research on this important topic. We first describe how, following Voas et al.’s recommendations, longitudinal models can overcome these problems. We then apply these methods to data measuring the religious composition of all U.S. counties found in the Religious Congregations and Membership Studies from 1980, 1990, 2000, and 2010. Using multilevel longitudinal regression models, we find that greater county‐level religious diversity is followed by later declines in county‐level religious participation rates. The negative effect size of religious diversity is large and robust to changes in the control variables and different methods of measuring religious diversity

Family circumstance, sedentary behaviour and physical activity in adolescents living in England: Project STIL

<p>Abstract</p> <p>Background</p> <p>Identification of non-modifiable correlates of physical activity and sedentary behaviour in youth contributes to the development of effective targeted intervention strategies. The purpose of this research was to examine the relationships between family circumstances (e.g. socio-economic status, single vs. dual parent household, presence/absence of siblings) and leisure-time physical activity and sedentary behaviours in adolescents.</p> <p>Methods</p> <p>A total of 1171 adolescents (40% male; mean age 14.8 years) completed ecological momentary assessment diaries every 15 minutes for 3 weekdays outside of school hours and 1 weekend day. Analysed behaviours were sports/exercise, active travel, TV viewing, computer use, sedentary socialising (hanging-out, using the telephone, sitting and talking) and total sedentary behaviour. Linear regression was employed to estimate levels of association between individual family circumstance variables and each behaviour.</p> <p>Results</p> <p>Compared to girls from higher socioeconomic status (SES) groups, girls from low SES groups reported higher weekend TV viewing and higher weekday total sedentary behaviour. For boys, single parent status was associated with greater total sedentary behaviour compared to those from dual parent households. Boys and girls from low socio-economic neighbourhoods reported lower participation in sports/exercise compared to those living in higher socio-economic neighbourhoods.</p> <p>Conclusion</p> <p>Associations were not consistent across behaviours or between genders. Overall, findings indicate that boys from single parent households and girls from low socio-economic families may be at increased risk of high sedentary behaviour. Those living in low socioeconomic neighbourhoods may be at increased risk of reduced participation in sports and exercise.</p

YouTube as a source of information for patients considering surgery for ulcerative colitis

© 2017 Elsevier Inc. Background With the range of health information online, assessing the resources that patients access may improve the content of preoperative information. Our aim was to assess the content of the most viewed videos on YouTube related to surgery for ulcerative colitis (UC). Methods YouTube was searched for videos containing information on surgery for UC. The 50 most viewed videos were identified and user interaction analyzed. Upload source was classified as patient, individual health care professional (HCP), or hospital/professional association. Video content was categorized using an inductive thematic analysis on a purposive sample list of videos. The overarching theme of each video was classified once data saturation was achieved. Results Thirty videos were uploaded by patients, 15 by hospitals and 5 by HCPs. Seventeen videos (34%) discussed life after surgery. Sixteen of these were uploaded by patients who had previously undergone surgery for UC. No videos of this theme were uploaded by HCPs. Ten videos (20%) described a number of different operations. Other themes identified were alternative health therapies (12%), colonoscopy (12%), life with UC (8%), miscellaneous (8%), and education for HCPs (6%). Patient uploaded videos had significantly more comments (P = 0.0079), with 28% of comments on patient videos being users requesting further information. Conclusions Understanding the sequelae of surgery is most important to preoperative patients. There are a lack of professional videos addressing this topic on YouTube. HCPs must participate in the production of videos and adapt preoperative consultations to address common preoperative concerns

Inner-shelf circulation and sediment dynamics on a series of shoreface-connected ridges offshore of Fire Island, NY

Locations along the inner-continental shelf offshore of Fire Island, NY, are characterized by a series of shoreface-connected ridges (SFCRs). These sand ridges have approximate dimensions of 10 km in length, 3 km spacing, and up to similar to 8 m ridge to trough relief and are oriented obliquely at approximately 30 degrees clockwise from the coastline. Stability analysis from previous studies explains how sand ridges such as these could be formed and maintained by storm-driven flows directed alongshore with a key maintenance mechanism of offshore deflected flows over ridge crests and onshore in the troughs. We examine these processes both with a limited set of idealized numerical simulations and analysis of observational data. Model results confirm that alongshore flows over the SFCRs exhibit offshore veering of currents over the ridge crests and onshore-directed flows in the troughs, and demonstrate the opposite circulation pattern for a reverse wind. To further investigate these maintenance processes, oceanographic instruments were deployed at seven sites on the SFCRs offshore of Fire Island to measure water levels, ocean currents, waves, suspended sediment concentrations, and bottom stresses from January to April 2012. Data analysis reveals that during storms with winds from the northeast, the processes of offshore deflection of currents over ridge crests and onshore in the troughs were observed, and during storm events with winds from the southwest, a reverse flow pattern over the ridges occurred. Computations of suspended sediment fluxes identify periods that are consistent with SFCR maintenance mechanisms. Alongshore winds from the northeast drove fluxes offshore on the ridge crest and onshore in the trough that would tend to promote ridge maintenance. However, alongshore winds from the southwest drove opposite circulations. The wind fields are related to different storm types that occur in the region (low-pressure systems, cold fronts, and warm fronts). From the limited data set, we identify that low-pressure systems drive sediment fluxes that tend to promote stability and maintain the SFCRs while cold front type storms appear to drive circulations that are in the opposite sense and may not be a supporting mechanism for ridge maintenance

Effects of a Tailored Follow-Up Intervention on Health Behaviors, Beliefs, and Attitudes

Background: The high rates of relapse that tend to occur after short-term behavioral interventions indicate the need for maintenance programs that promote long-term adherence to new behavior patterns. Computer-tailored health messages that are mailed to participants or given in brief telephone calls offer an innovative and time-efficient alternative to ongoing face-to-face contact with healthcare providers. Methods: Following a 1-year behavior change program, 22 North Carolina health departments were randomly assigned to a follow-up intervention or control condition. Data were collected from 1999 to 2001 by telephone-administered surveys at preintervention and postintervention for 511 low-income, midlife adult women enrolled in the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) program at local North Carolina health departments. During the year after the behavior change program, intervention participants were mailed six sets of computer-tailored health messages and received two computer-tailored telephone counseling sessions. Main outcomes of dietary and physical activity behaviors, beliefs, and attitudes were measured. Results: Intervention participants were more likely to move forward into more advanced stages of physical activity change (p = 0.02); control participants were more likely to increase their level of dietary social support at follow-up (p = 0.05). Both groups maintained low levels of reported saturated fat and cholesterol intake at follow-up. No changes were seen in physical activity in either group. Conclusions: Mailed computer-tailored health messages and telephone counseling calls favorably modified forward physical activity stage movement but did not appreciably affect any other psychosocial or behavioral outcomes

Dutch healthcare reform: did it result in performance improvement of health plans? A comparison of consumer experiences over time

<p>Abstract</p> <p>Background</p> <p>Many countries have introduced elements of managed competition in their healthcare system with the aim to accomplish more efficient and demand-driven health care. Simultaneously, generating and reporting of comparative healthcare information has become an important quality-improvement instrument. We examined whether the introduction of managed competition in the Dutch healthcare system along with public reporting of quality information was associated with performance improvement in health plans.</p> <p>Methods</p> <p>Experiences of consumers with their health plan were measured in four consecutive years (2005-2008) using the CQI^®health plan instrument 'Experiences with Healthcare and Health Insurer'. Data were available of 13,819 respondents (response = 45%) of 30 health plans in 2005, of 8,266 respondents (response = 39%) of 32 health plans in 2006, of 8,088 respondents (response = 34%) of 32 health plans in 2007, and of 7,183 respondents (response = 31%) of 32 health plans in 2008. We performed multilevel regression analyses with three levels: respondent, health plan and year of measurement. Per year and per quality aspect, we estimated health plan means while adjusting for consumers' age, education and self-reported health status. We tested for linear and quadratic time effects using chi-squares.</p> <p>Results</p> <p>The overall performance of health plans increased significantly from 2005 to 2008 on four quality aspects. For three other aspects, we found that the overall performance first declined and then increased from 2006 to 2008, but the performance in 2008 was not better than in 2005. The overall performance of health plans did not improve more often for quality aspects that were identified as important areas of improvement in the first year of measurement. On six out of seven aspects, the performance of health plans that scored below average in 2005 increased more than the performance of health plans that scored average and/or above average in that year.</p> <p>Conclusion</p> <p>We found mixed results concerning the effects of managed competition on the performance of health plans. To determine whether managed competition in the healthcare system leads to quality improvement in health plans, it is important to examine whether and for what reasons health plans initiate improvement efforts.</p

An ethical framework for cardiac report cards: a qualitative study

BACKGROUND: The recent proliferation of health care report cards, especially in cardiac care, has occurred in the absence of an ethical framework to guide in their development and implementation. An ethical framework is a consistent and comprehensive theoretical foundation in ethics, and is formed by integrating ethical theories, relevant literature, and other critical information (such as the views of stakeholders). An ethical framework in the context of cardiac care provides guidance for developing cardiac report cards (CRCs) that are relevant and legitimate to all stakeholders. The purpose of this study is to develop an ethical framework for CRCs. METHODS: Delphi technique – 13 panelists: 2 administrators, 2 cardiac nurses, 5 cardiac patients, 2 cardiologists, 1 member of the media, and 1 outcomes researcher. Panelists' views regarding the ethics of CRCs were analyzed and organized into themes. RESULTS: We have organized panelists' views into ten principles that emerged from the data: 1) improving quality of care, 2) informed understanding, 3) public accountability, 4) transparency, 5) equity, 6) access to information 7) quality of information, 8) multi-stakeholder collaboration, 9) legitimacy, and 10) evaluation and continuous quality improvement. CONCLUSION: We have developed a framework to guide the development and dissemination of CRCs. This ethical framework can provide necessary guidance for those generating CRCs and may help them avoid a number of difficult issues associated with existing ones

One-stage laparoscopic-assisted resection of gastrojejunocolic fistula after gastrojejunostomy for duodenal ulcer: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastrojejunocolic fistula is a rare condition after gastrojejunostomy. It was thought to be a late complication related to stomal ulcers as a result of inadequate gastrectomy or incomplete vagotomy. We report a case of gastrojejunocolic fistula after gastrojejunostomy for peptic ulcer treated with one-stage laparoscopic resection.</p> <p>Case presentation</p> <p>A 41-year-old Japanese man complained of diarrhea for 10 months, as well as severe weight loss and weakness. After admission, we immediately started intravenous hyperalimentation. On performing colonoscopy and barium swallow, gastrojejunocolic fistula was observed close to the gastrojejunostomy site leading to the transverse colon. After our patient's nutritional status had improved, one-stage surgical intervention was performed laparoscopically. After the operation, our patient recovered uneventfully and his body weight increased by 5 kg within three months.</p> <p>Conclusions</p> <p>Modern management of gastrojejunocolic fistula is a one-stage resection because of the possibility of early recovery from malnutrition using parenteral nutritional methods. Today, laparoscopic one-stage en bloc resection may be feasible for patients with gastrojejunocolic fistula due to the development of laparoscopic instruments and procedures. We describe the first case of gastrojejunocolic fistula treated laparoscopically by one-stage resection and review the literature.</p

Metal accumulation in the tissues and shells of the Rapanine Whelk Indothais gradata along an acidified estuarine gradient

Human ImpactsPoster presentation: P-74Acidification of estuaries results from microbial CO2 generation, acid sulphate groundwater discharge, and anthropogenic activities, in the context of weak buffering potential of hyposaline waters. The resulting acidification introduces an additional yet poorly studied factor influencing the ecology and distributions of biological populations and species. Furthermore, it has a complex influence on estuarine chemistry, including altering the speciation of metals and potentially their availability to the biotic component. With the aim of providing baseline information for metal accumulation in the shells and tissues of organisms inhabiting acidified turbid tropical Asian estuaries, we studied the rapanine whelk Indothais gradata from the mineral-acidified Sungai ...postprin