Social Autonomy ≠ Social Empowerment: The Social Self-Restriction Model

This paper introduces the social self-restriction (SSR) model, which highlights a drawback associated with the increasingly accessible privilege of social autonomy. Social autonomy enables individuals to connect with preferred social partners and avoid undesirable others. The benefits of social autonomy are undeniable; however, the SSR model makes the novel assertion that people tend to exercise social autonomy in ways that ultimately constrain their potential for social empowerment—a higher-order form of personal freedom. Attaining the ideal of high social empowerment requires both high social autonomy and high social adaptability. People with high social adaptability can feel reasonably comfortable and act competently in social environments they did not choose to inhabit. Unfortunately, people with high social autonomy are unlikely to possess high social adaptability. We propose that social autonomy undermines social adaptability by tempting people to avoid social challenges and socialize selectively with similar others in familiar contexts, a habit that limits social skill development, promotes social intolerance, and distorts social perceptions. In essence, we argue that social autonomy allows people to live in their social comfort zones, at the cost of restricting their social range. Our discussion of the SSR model incorporates evidence and perspectives from a broad range of academic disciplines, and includes consideration of opportunities for future research

Two cardiac arrests, one medical team

Journal ArticleThe most painful of all medical care decisions concerns life-preserving measures which, because of limited resources, require certain individuals to be excluded in favor of others. How does one weigh the relative rights of individuals to such care? Whenever possible, decisions to withhold lifesaving therapy should be made in advance. but in the absence of a clear expression that lifesaving care should be withheld, the person in charge must assume that care was intended

A New Pathway for the Preparation of Highly Qualified Teachers: The Master of Arts in Teaching (MAT)

This article reports on the development and initial implementation of a Master of Arts in Teaching (MAT) degree, an accelerated graduate program that encourages and scaffolds individuals with existing disciplinary expertise in entering the teaching profession. First, the context for developing the program is outlined. Next, the unique structure of the 15-month program, which consists of three blocks, is described. Expectations about students are then shared, quality control features of the program are highlighted, and the lessons we learned about program development and implementation are detailed. Finally, thoughts about the future of this program and others of its type are shared based upon our experience

DATA SHARING TO DRIVE THE IMPROVEMENT OF TEACHER PREPARATION PROGRAMS

Background/Context: Teacher preparation programs (TPPs) face increasing pressure from the federal government, states, and accreditation agencies to improve the quality of their practices and graduates, yet they often do not possess enough data to make evidence-based reforms. Purpose/Objective: This manuscript has four objectives: (a) to present the strengths and shortcomings of accountability-based TPP evaluation systems; (b) to detail the individual-level data being shared with TPPs at public universities in North Carolina; (c) to describe how data sharing can lead to TPP improvement and the challenges that programs will need to overcome; and (d) to detail how three TPPs are using the data for program improvement. Setting: North Carolina public schools and schools of education at public universities in North Carolina. Importantly, this individual-level data sharing system can be instituted among TPPs in other states. Population/Participants/Subjects: Teachers initially-prepared b

Attitudes Toward Immigrants: Test of Protestant Work Ethic, Egalitarianism, Social Contact, and Ethnic Origin

Americans’ attitudes toward immigrants can be described as ambivalent. While some attitudes toward immigrants have been antagonistic, Americans have also espoused beliefs that the United States is a nation of immigrants and that cultural diversity is one of America’s foremost strengths. These ambivalent attitudes toward immigrants might be explained by egalitarianism, which is characterized by social equality and social justice, and the Protestant Work Ethic (PWE), which is characterized by self-discipline and individual achievement. Using data collected from a major metropolitan area in the Midwest (n=382), this study explored two questions: 1) are there any differences in attitudes toward immigrants of differing ethnic origins? and 2) what are the roles of egalitarianism, PWE, personal, and impersonal contact in people’s attitude toward immigrants? The results of repeated measures ANOVA indicated a significant effect of ethnic origin, with European immigrants perceived most positively and Middle Eastern immigrants least positively. The results of regression analyses also revealed that egalitarianism was associated with positive general attitudes toward immigrants and PWE with negative attitudes. Further, close contact was associated with positive attitudes toward immigrants, whereas impersonal contact did not impact general attitudes toward immigrants. Implications for intercultural education are discussed

Time-series hyperpolarized xenon-129 MRI of lobar lung ventilation of COPD in comparison to V/Q-SPECT/CT and CT

Purpose To derive lobar ventilation in patients with chronic obstructive pulmonary disease (COPD) using a rapid time-series hyperpolarized xenon-129 (HPX) magnetic resonance imaging (MRI) technique and compare this to ventilation/perfusion singlephoton emission computed tomography (V/Q-SPECT), correlating the results with high-resolution computed tomography (CT) and pulmonary function tests (PFTs).Materials and methods Twelve COPD subjects (GOLD stages I–IV) participated in this study and underwent HPX-MRI, V/QSPECT/CT, high-resolution CT, and PFTs. HPX-MRI was performed using a novel time-series spiral k-space sampling approach. Relative percentage ventilations were calculated for individual lobe for comparison to the relative SPECT lobar ventilation and perfusion. The absolute HPX-MRI percentage ventilation in each lobe was compared to the absolute CT percentage emphysema score calculated using a signal threshold method. Pearson’s correlation and linear regression tests were performed to compare each imaging modality.Results Strong correlations were found between the relative lobar percentage ventilation with HPX-MRI and percentage ventilation SPECT (r = 0.644; p Conclusion Lobar ventilation with HPX-MRI showed a strong correlation with lobar ventilation and perfusion measurements derived from SPECT/CT, and is better than the emphysema score obtained with high-resolution CT.</div

Off-label Utilization of Antihypertensive Medications in Children

Objective— To examine off-label utilization and costs of antihypertensive drugs in children using a national sample of prescription claims. Design— Cross-sectional study. Setting— 2002 Medstat MarketScan Database, a national sample of outpatient prescription claims of children ≥18 years old enrolled in private, employer-sponsored health plans. Main Outcome Measures— Off-label use of antihypertensive drugs by patient age and costs of antihypertensives calculated as mean cost per child per 30-day fill. Results— One-half of the index antihypertensive prescription claims were off-label, based on minimum age criteria. Boys were more likely (56%) than girls (46%) to be prescribed off-label antihypertensives (p<0.001). Children aged ≥12 years were more likely to be prescribed off-label antihypertensives (53%) compared with children aged ≥5 (46%) and 6–11 years (42%, p<0.001). Off-label use varied significantly by class of antihypertensive drugs (p<0.001). Overall, off-label antihypertensives were significantly more expensive than on-label antihypertensives. Conclusions— Despite availability of often less expensive on-label alternatives for the same class of antihypertensive drugs, off-label antihypertensive drugs were prescribed frequently in children. These findings underscore the potential clinical and economic implications of common off-label prescribing, for children, their parents, physicians and payers. Originally published Ambulatory Pediatrics, Vol. 7, No. 4, July 200

Comparison of an in-house real-time duplex PCR assay with commercial HOLOGIC® APTIMA assays for the detection of Neisseria gonorrhoeae and Chlamydia trachomatis in urine and extra-genital specimens

Abstract Background Extra-genital Neisseria gonorrhoeae and Chlamydia trachomatis infections are mostly asymptomatic, and important reservoir sites of infection as they often go undetected and may be more difficult to eradicate with recommended therapeutic regimens. Commercial nucleic acid amplification tests (NAATs) have not received regulatory approval for the detection of N. gonorrhoeae and C. trachomatis in extra-genital specimens. The HOLOGIC® APTIMA Combo2 assay for N. gonorrhoeae and C. trachomatis has performed well in evaluations using extra-genital specimens. Methods We assessed the performance of an in-house real-time duplex PCR assay for the detection of N. gonorrhoeae and C. trachomatis in urine and extra-genital specimens using the HOLOGIC® APTIMA assays as gold standard comparators. Urine, oropharyngeal and ano-rectal specimens were collected from each of 200 men-who-have-sex-with-men (MSM) between December 2011 and July 2012. Results For N. gonorrhoeae detection, the in-house PCR assay showed 98.5–100% correlation agreement with the APTIMA assays, depending on specimen type. Sensitivity for N. gonorrhoeae detection was 82.4% for ano-rectal specimens, 83.3% for oropharyngeal specimens, and 85.7% for urine; and specificity was 100% with all specimen types. The positive predictive value (PPV) for N. gonorrhoeae detection was 100% and the negative predictive value (NPV) varied with sample type, ranging from 98.5–99.5%. For C. trachomatis detection, correlation between the assays was 100% for all specimen types. The sensitivity, specificity, PPV and NPV of the in-house PCR assay was 100% for C. trachomatis detection, irrespective of specimen type. Conclusion The in-house duplex real-time PCR assay showed acceptable performance characteristics in comparison with the APTIMA® assays for the detection of extra-genital N. gonorrhoeae and C. trachomatis