Technoscientific Knowledge Practices of Adolescent Mental Health Care Work

This study examines the technoscientific knowledge-practices of adolescent psychotherapy. Employing an interpretive, feminist version of grounded theory, 40 interviews with psychotherapists were analyzed. Building on Science and Technology Studies and the Sociology of Health and Illness, the following research questions are asked: How are adolescent mental illnesses defined and approached within and across social worlds? How do practitioners negotiate social processes of diagnosis? In what ways does the Diagnostic and Statistical Manual (DSM) as a technology, shape the diagnostic and treatment work of mental health practitioners? In what ways does Managed Care (MC) shape adolescent mental health care? Social worlds define psychotherapy as an art and science, resist biomedicine and embrace eclectic theoretical orientations to treatment. Psychotherapists utilize Evidence Based Practices (EBPs) in their treatment plans but critique how EBPs privilege scientific evidence over patient subjectivity, social contexts and the therapeutic relationship. Psychotherapists challenge the cultural authority of the DSM and downplay its significance for clinical work. While the DSM is a socially-scripted technology, its significance is interpretively flexible. Psychotherapists employ work-arounds to the problems posed by biomedical and bureaucratic standardization, and participate in processes of cribbing. Cribbing signifies the collective knowledge building and translation work necessary to learn the codes that facilitate therapeutic service authorizations and minimize denials. The DSM technology and MC privilege a therapeutic focus on surface level symptoms and behaviors whereas psychotherapists focus on communication, relational and emotional issues. The assemblage of the DSM and MC creates diagnostic dissonance for psychotherapists--a conflict between their own theoretical orientations and the biomedical model. Biomedicalization processes are uneven and actively resisted. MC governs the clinical practices of psychotherapists. For-profit MC companies have shifted care from intense psychodynamic therapy towards short-term surface level medications and behavioral programs. MC policies limit services, over-manage treatment and harm the therapeutic relationship. MC stratifies providers and patients by encouraging seasoned professionals to leave public forms of insurance. The least experienced practitioners care for those with the most intense mental illness while those with experience opt-out and treat the worried-well

Implementing the Integrated Dual Disorder Treatment Model in Occupational Therapy

The purpose of this project was to develop a resource manual for occupational therapists to guide treatment planning for persons with a co-occurring mental illness and substance use disorder, according to the stages and components of the Integrated Dual Disorder Treatment (IDDT) Model. A comprehensive literature review of the issues facing persons with co-occurring disorders, the IDDT model, and the role of occupational therapy for persons with co-occurring disorders was conducted. The literature supported the effectiveness of the IDDT model, and indicated justification for occupational therapy’s implementation of the IDDT model. A resource manual was developed to support occupational therapists’ the development of effective treatment planning for persons with co-occurring disorders through the implementation of the IDDT Model. The Person-Environment-Occupation Model was selected as the guiding occupational therapy model to utilize in conjunction with the IDDT Model. The IDDT Model is widely recognized as an evidence-based approach to service delivery to persons with co-occurring mental illness and substance use disorder. Occupational therapists, as members of the interdisciplinary IDDT team, have the unique ability to improve persons’ participation in meaningful occupations, as well as developing a sense of wellness and improved quality of life

The Social Construction of Sex

This is a class activity on the construction of sex. I ask the class for all the terms and expressions they have for having sex. We collect them and put them on the board in the order they offer them. Throughout this process, students are not allowed to ask clarifying questions, so the items offered tell us what they understand sex to be. After collecting the terms, the class is broken into groups to analyze the data for themes and patterns. When we come back together, I ask the students about how the data would be different if, for example, male bodies are missing. We discuss the specific sex act (or acts) their language refers to. In other words, what constitutes sex. Lastly we compare the terms they offer to scientific terms to assess whether the assumptions they make are also contained within more proper terms

Adolescents and Antidepressants: Analyzing a Social Scientific Controversy

This thesis analyzes the scientific controversy over giving antidepressant medications to adolescents as it unfolded in a U.S. Federal Food and Drug Administration (FDA) hearing. Using the FDA hearing held on February 2, 2004, convened in response to a "crisis" evolving around the safety of antidepressant use among adolescents, this paper analyzes the unfolding response. This study utilizes social world's analysis, a qualitative methods approach designed to uncover the multiple stakes and claims of the problem as understood by each person at the hearing. I identified four distinct social worlds: 1) Adolescents, family and friends, 2) Independent professionals, 3) FDA, and 4) FDA-summoned professionals. Findings revealed that 103 actors came together around the crisis and each defined the problem of the controversy through one or more of the following four distinct frames; (1) side effects, (2) data, (3) practices and policies and/or (4) a lack of access to informed choice

Activating Race: Race Priming in an Undergraduate Population

Can a race priming intervention improve evaluations of college scholarship applicants? Building on the work of Sanchez and Bonam (2009), the present study was designed to examine how evaluations of warmth, competence, and scholarship worthiness, change as a result of race priming and stereotype activation. The hypothesis was that race priming and stereotype activation would cause participants to consider how they may apply stereotypes in their judgments of candidates, resulting in a positive shift in their evaluations on dimensions of warmth, competence, and scholarship worthiness following a race priming intervention. Participants across three studies included 228 undergraduate students, and 24 graduate students from a university in the Northwest. Students were asked to evaluate prospective student applications for a substantial diversity scholarship to the university rating candidates on dimensions of warmth, competence, and scholarship worthiness. Participants were randomly assigned to read the scholarship application of a Biracial, White, Black, or undisclosed race candidate. Study 1 suggests that with race introduction (via priming and disclosure) participants rate candidates differently depending upon race, particularly with regard to diversity scholarship worthiness. Biracial candidates had the most positive change in ratings after priming intervention, which is contrary to previous research (Sanchez, & Bonam, 2009). Study 2 found that race impacted ratings of warmth, competence, and scholarship worthiness regardless of whether evaluation took place before or after the intervention. Study 3 compared graduate students to the undergraduate population in Study 2. This study revealed that before the intervention, Biracial individuals were rated the highest on warmth, and competence, with White candidates being least scholarship worthy. However, after the intervention was presented, there was a drop in ratings for Black and Biracial candidates, resulting in Biracial candidates being considered least warm, and competent of all the race disclosure groups. Comparison between studies indicate a difference in how graduate students responded to the intervention and their post intervention candidate ratings, relative to undergraduates. Results of these studies are discussed considering essentialism (Young, Sanchez, & Wilton, 2013), cohort effects, job and college applications, and stereotype content model (Cuddy, Fiske, & Glick, 2007)

Quantifying engineered nanomaterial toxicity: comparison of common cytotoxicity and gene expression measurements

BACKGROUND: When evaluating the toxicity of engineered nanomaterials (ENMS) it is important to use multiple bioassays based on different mechanisms of action. In this regard we evaluated the use of gene expression and common cytotoxicity measurements using as test materials, two selected nanoparticles with known differences in toxicity, 5 nm mercaptoundecanoic acid (MUA)-capped InP and CdSe quantum dots (QDs). We tested the effects of these QDs at concentrations ranging from 0.5 to 160 µg/mL on cultured normal human bronchial epithelial (NHBE) cells using four common cytotoxicity assays: the dichlorofluorescein assay for reactive oxygen species (ROS), the lactate dehydrogenase assay for membrane viability (LDH), the mitochondrial dehydrogenase assay for mitochondrial function, and the Comet assay for DNA strand breaks. RESULTS: The cytotoxicity assays showed similar trends when exposed to nanoparticles for 24 h at 80 µg/mL with a threefold increase in ROS with exposure to CdSe QDs compared to an insignificant change in ROS levels after exposure to InP QDs, a twofold increase in the LDH necrosis assay in NHBE cells with exposure to CdSe QDs compared to a 50% decrease for InP QDs, a 60% decrease in the mitochondrial function assay upon exposure to CdSe QDs compared to a minimal increase in the case of InP and significant DNA strand breaks after exposure to CdSe QDs compared to no significant DNA strand breaks with InP. High-throughput quantitative real-time polymerase chain reaction (qRT-PCR) data for cells exposed for 6 h at a concentration of 80 µg/mL were consistent with the cytotoxicity assays showing major differences in DNA damage, DNA repair and mitochondrial function gene regulatory responses to the CdSe and InP QDs. The BRCA2, CYP1A1, CYP1B1, CDK1, SFN and VEGFA genes were observed to be upregulated specifically from increased CdSe exposure and suggests their possible utility as biomarkers for toxicity. CONCLUSIONS: This study can serve as a model for comparing traditional cytotoxicity assays and gene expression measurements and to determine candidate biomarkers for assessing the biocompatibility of ENMs.1R01GM84702-01 - National Institute of General Medical Science

Integrating Telehealth and Community Health Workers to Enhance Quality Care Access: A Narrative Review

Community Health Workers (CHWs) often share cultural, geographic, or other lived experiences with patients and provide health education and support. Use of CHWs and telehealth approaches are promising strategies for addressing the needs of patients with metabolic syndrome (MetS). This narrative review analyzed how these approaches were integrated into programs expanding care access for patients with MetS. Searching PubMed, PSYCInfo, Embase, Web of Science, and Google Scholar resulted in 1,630+ abstracts screened and 12 articles meeting inclusion criteria. These studies examined implementation of tele-mentoring approaches (n=4), patient group classes via videoconferencing (n=2), or individual telehealth consultations facilitated by CHWs (n=7), with some programs including multiple intervention types. This review included adults ranging from 37-79 years old. Most studies focused on late mid-life (ages 50-64). Because health behaviors in midlife have important implications for MetS and related health concerns in later life, it is important to consider midlife interventions. Using the RE-AIM framework, we evaluated studies on five dimensions: reach, effectiveness, adoption, implementation, and maintenance. Reach and implementation indicators suggest reducing barriers to engagement (e.g., home visits) allows for higher participation and program completion rates. Measures of MetS-related behavioral outcomes were heterogeneous across study designs, making overall effectiveness difficult to determine. Adjusting time spent with patients according to health literacy and clinical needs is a strategy CHW programs use to provide equitable, cost-effective care. Programmatic considerations for implementing programs that include both CHWs and telehealth are discussed, with special consideration for what works in late middle age and in older adulthood

Academic Entitlement in the Context of Learning Styles

This study explores the linkages between students’ sense of entitlement and their approaches to learning, based on survey research at a large public university in Canada.  Through literature review and pilot testing, a questionnaire instrument was developed that measures four constructs:  academic entitlement, deep learning, surface learning and strategic learning.  Survey responses (n=1=2116) suggest that students approach learning in mixed ways, and that approaches to learning intersect with students’ sense of entitlement in complex ways.  Overall, students’ scores on the sense of entitlement scale were found to be moderate, challenging some of the assertions about today’s students that have been made in the popular press.&nbsp

Electron-Ion Equilibrium and Shock Precursors in the Northeast Limb of the Cygnus Loop

We present an observational study using high-resolution echelle spectroscopy of collisionless shocks in the Cygnus Loop supernova remnant. Measured Hα line profiles constrain pre-shock heating processes, shock speeds, and electron-ion equilibration (Te /Ti ). The shocks produce faint Hα emission line profiles, which are characterized by narrow and broad components. The narrow component is representative of the pre-shock conditions, while the broad component is produced after charge transfer between neutrals entering the shock and protons in the post-shock gas, thus reflecting the properties of the post-shock gas. We observe a diffuse Hα region extending about 25 ahead of the shock with line width ~29 km s–1, while the Hα profile of the shock itself consists of broader than expected narrow (36 km s–1) and broad (250 km s–1) components. The observed diffuse emission arises in a photoionization precursor heated to about 18,000 K by He I and He II emission from the shock, with additional narrow component broadening originating from a thin cosmic-ray precursor. Broad to narrow component intensity ratios of ~1.0 imply full electron-ion temperature equilibration Te Ti in the post-shock region. Broad component line widths indicate shock velocities of about 400 km s–1. Combining the shock velocities with proper motions suggests that the distance to the Cygnus Loop is ~890 pc, significantly greater than the generally accepted upper limit of 637 pc

A Collaborative Clearinghouse for Data Management Training and Education Resources

Objective: The main objectives of this breakout session are for the Data Management Training (DMT) Clearinghouse team to: 1) introduce the Clearinghouse and its current design and implementation, 2) solicit submissions to its learning resource inventory, and 3) collect feedback upon its web interface and future development. Features of the Clearinghouse that will be demonstrated include how to search and browse its inventory as well as submit a learning resource to the Clearinghouse using the LRMI (Learning Resource Metadata Initiative) metadata format. The team will also share the roadmap for the Clearinghouse’s upcoming features. In order to provide feedback regarding the Clearinghouse’s usability, the team will invite the session attendees to test the Clearinghouse’s services and will encourage comments to guide its future development. Setting/Participants/Resources: Since the DMT Clearinghouse is entirely accessible via the web, in order to demonstrate the Clearinghouse successfully, a reliable (and preferably free of charge) internet connection, and an overhead projecting capability will need to be available to the presenter. It would also be very useful for the attendees of the session to have access to the same internet connection, so that if they desire, the attendees can follow along with the steps of the demonstration, and contribute to the Clearinghouse inventory. The main presenter will plan to bring her own laptop with built-in standard HDMI and USB ports. As a result, it will be helpful if a HDMI or USB cable could also be provided for the presenter to connect her laptop to the projecting equipment. Method: Many research organizations, government agencies, and academic institutions have been developing excellent learning resources in order to support and meet the needs for data management training. However, these learning resources are often hosted on various websites and spread across various scientific domains. Consequently, these resources can be difficult to locate, especially by those who are not already familiar with the creators/authors. This is a barrier to the use and reuse of these resources, and can have significant impact on the promotion and propagation of best practices for data management. To address this need within the Earth sciences, the U.S. Geological Survey’s (USGS) Community for Data Integration (CDI), the Federation of Earth Science Information Partners (ESIP), and the Data Observation Network for Earth (DataONE) have collaborated to create a web-based Clearinghouse1 for collecting data management learning resources that are focused on the Earth sciences. The initial seed funding for the effort was provided by a grant received from the USGS CDI earlier in 2016, and ESIP’s Drupal site provided the hosting infrastructure for the Clearinghouse. Members from the USGS, DataONE, ESIP’s Data Stewardship Committee and its Data Management Training Working Group, Knowledge Motifs LLC, as well as Blue Dot Lab met regularly between April and October, 2016 in order to discuss, create, and implement the content structure and infrastructure components necessary to build the current revision of the Clearinghouse. 1. http://dmtclearinghouse.esipfed.org Results: As a registry of information about the educational resources on topics related to research data management (initially focused on Earth sciences), the Clearinghouse serves as a centralized location for searching or browsing an inventory of these learning resources. Currently, the Clearinghouse offers search and browse functionality that is open to all, and submission of information about educational resources by login with a free ESIP account. To assist with discoverability, the learning resources are described using Learning Resource Metadata Initiative (LRMI) schema. Additionally, the resources may be associated with the steps of data and research life cycles, such as the USGS CDI’s Science Support Framework2 and DataONE’s Data Life Cycle3. Leveraging the team’s collective experience in creating, presenting and distributing data management learning resources, the Clearinghouse included the learning resources from USGS, ESIP, and DataONE as its initial inventory, but is expanding to resources from NASA and others. Crowdsourcing is currently the main mechanism for sustaining the Clearinghouse. Going forward, in addition to the built-in workflow to allow anyone from the public to submit descriptive information about the data management learning resources that s/he wishes to share, future capabilities will be added to enable contributions to review, edit, and rank the submissions, as desired. 2. https://my.usgs.gov/confluence/display/cdi/CDI+Science+Support+Framework3. https://www.dataone.org/data-life-cycle Discussion/Conclusion: The DMT Clearinghouse team was successful in completing the initial development phase as scheduled for the first six months of its funding, including some informal usability testing of the interface. The team aims to continue to develop and enhance the Clearinghouse’s capabilities, including the evaluation of its usability, through collaboration with additional communities, and if feasible, adding the capability for bulk-loading of learning resources. Being able to present the Clearinghouse at the eScience Symposium would not only allow those who are involved with or would like to learn about data management to leverage the Clearinghouse’s resources, but also connect those who would like to contribute to the project with the Clearinghouse team. Ultimately, the Clearinghouse is designed so that the resources from its inventory could be used in a variety of data management training and education environments. By exposing the Clearinghouse to diverse users and communities, the Clearinghouse team can better assess how the Clearinghouse can be updated and what technological enhancements to pursue in the future in order to improve our support of research data management training needs