Excessive Drinking in Perry County, Missouri.

Goal Statement: This prevention program aims to reduce the percentage of self-reported excessive alcohol consumption among adults aged 18 and older in Perry County, Missouri using prevention-focused programs, education, and community awareness. Significant Findings: Perry County, MO, is a rural community within Southeast Missouri. Missouri is within the top 10 % of states with the highest reported adult excessive drinking. Perry County is one of the top counties for excessive adult drinking within Missouri (County Health Rankings & Roadmaps, 2018). Excessive drinking is a community health concern due to its multitude of adverse effects on mental and physical health. Educating the community and spreading awareness can begin a journey towards changes at the societal, institutional, community, and individual levels encouraging prevention of excessive drinking. Objectives/Strategies/Interventions/Next Steps: Prevention can begin with educating everyone on the prevalence of excessive drinking and the adverse effects on the community. Encouraging easier access to mental health services to all community members and effectively advertising available substance use treatments can spread awareness and prevention. Collaborating with community-owned businesses to promote stricter policies on excessive drinking can lower the risk of drinking too much, driving impaired, and other consequences of excessive drinking. Non-alcoholic events and activities encourage social events and entertainment without alcohol. Programs, such as LifeSkills Training Program, can be funded and utilized to assist with helping individuals with the risk factors that influence the use of alcohol—for example, job skills training to ensure more fulfilling employment. Professional counselors can advocate for the community\u27s health concerns by collaborating and providing effective prevention strategies, programs, and changes

An Analysis of Functional Differences in Implicit Learning

This thesis analysed whether functional implicit learning differences existed in two areas that have produced promising, but equivocal, findings: individual differences in typical populations (e.g., Gebauer & Mackintosh, 2010) and group differences between Autism Spectrum Condition (ASC) and Typically Developing (TD) individuals (e.g., L. G. Klinger, Klinger, & Pohlig, 2007). Overall, the results from the four studies presented in this thesis emphasised a lack of functional differences in implicit learning between individuals. Study I investigated whether there were functional individual differences in implicit learning among a typical population by examining the inter-correlation between the performances of academic psychologists on three implicit learning tasks; the independence of those performances from IQ; the relationships between those performances, intuitive aspects of personality and occupational tacit knowledge; and, finally, whether the performances were related to occupational achievement. There was no evidence of inter-correlation between the implicit learning task performances, nor relationships between any of those performances, and occupational achievement, or personality. The study did replicate a finding that is important to the distinction between implicit and explicit learning: indices of explicit processing, but not performance on implicit learning tasks, were correlated with IQ (e.g., Gebauer & Mackintosh, 2007). Additionally, the study found that Academic Psychology and Business Management Tacit Knowledge Inventories measured knowledge that predicted occupational achievement in academic psychology incrementally to IQ and personality, and was general to both occupations. However, tacit knowledge appeared to be acquired primarily as a function of practice and experience, rather than individual differences in implicit learning. Overall, I asserted that a consideration of the results from Study I with the wider literature currently leads to the conclusion that there are minimal individual differences in implicit learning, which signifies that there is no general implicit learning ability that is critical to how much is learnt implicitly. In the absence of a general ability that determines how much is learnt implicitly, it was argued that there could still be general, prerequisite processes, which are always necessary for implicit learning but without those processes determining the variation in how much was learnt implicitly. Such prerequisite processes would not constitute a psychometric ability but could be SUMMARY vi conceptualised as general implicit learning processes. This conceptualisation of implicit learning would be supported by the existence of an atypical population who consistently demonstrated profound deficits on all implicit learning tasks and skills associated with an implicit acquisition. There is no convincing evidence of such a patient group, although the ASC population is a plausible candidate (e.g., L. G. Klinger, et al., 2007). Therefore, Study II compared IQ-matched ASC and TD individuals on a range of implicit learning tasks. The study, taken together with other recent reports (e.g., Barnes, et al., 2008), provided convincing evidence that implicit learning is actually intact in ASC and it was argued that deficits reported in previous studies must have resulted from differences in task procedures (e.g., L. G. Klinger, et al., 2007). In particular, the earlier studies used procedures that encouraged explicit strategies, which disadvantaged the ASC groups who had not been matched for IQ. A further analysis supported that interpretation: TD and ASC groups who were not matched for IQ exhibited differences on an explicit learning task, but not on the implicit learning tasks. In order to determine whether those previously identified implicit learning deficits in ASC resulted just from differences in IQ, or whether there was also a contribution from an ASC difficulty in explicit learning, Study III compared ASC individuals with IQ-matched TD individuals on an implicit learning task, the Serial Reaction Time (SRT) task, with a procedure that encouraged explicit strategies. The SRT procedure was combined with a contextual cueing task that provided an indirect, ongoing index of the extent to which sequence learning was explicit (Jiménez & Vázquez, in press). Study III indicated a difference in initial explicit sequence learning in ASC, which was independent of IQ. Study IV replicated the difficulty and by using a pre-task manipulation the study was also able to elaborate the nature of that difficulty: ASC individuals were able to learn sequence information explicitly, but they had a specific difficulty with learning to apply that explicit information. Thus, there was good evidence that implicit learning is intact in ASC and that instead ASC individuals have more difficulties with aspects of explicit learning. These findings refute the idea that ASC individuals successfully compensate for implicit deficits with explicit compensatory strategies. Instead, together with the ASC propensity for using explicit strategies, an ASC difficulty with explicit processing might explain some ASC deficits in a range of learnt skills, although I acknowledge that there are also plausible alternatives. More generally, these SUMMARY vii findings and ideas accord with ASC literature concerning impairments in executive functions, which require flexible and intentional processing (e.g., Russell, 1997a) and emphasise that future research is focused on how explicit, executive differences emerge and affect behaviour. In conclusion, the thesis provided no evidence for the proposal that there are functional differences between individuals in implicit learning. I propose that, taken together with the equivocal evidence discussed in my reviews of the wider literature, it is parsimonious to conclude that there is neither a general implicit learning ability, nor general, prerequisite implicit learning processes. However, in line with previous literature, the thesis did support functional distinctions between implicit and explicit learning: explicit, but not implicit, learning was related to IQ; and ASC individuals have difficulties with explicit but not implicit learning. Therefore, I assert that a descriptive distinction between explicit and implicit learning remains both useful and valid. This is true even though implicit learning seems to be defined by the absence, or minimal influence, of explicit processing rather than the general presence of an implicit learning ability or processes. Beyond the issue of functional differences, I argue that these findings and conclusions make modest, but not decisive, contributions to some of the other fierce debates in the wider implicit learning literature. Finally, I propose some recommendations, and directions, for future research

Relationship between Patient Safety Culture and Safety Outcome Measures among Nurses

Preventable errors in healthcare are a significant problem in today’s society, contributing to numerous adverse patient outcomes and even deaths on a daily basis. Identifying adverse outcomes is an imperative first step in creating a safer healthcare system, which can be followed by cause analyses and action plans to address systematic issues and improve process reliability. Despite the widespread use of voluntary reporting systems to identify adverse events, recent literature has found extreme limitations and severe underreporting with its use in healthcare facilities. A frequent theme in the literature implies that identifying reportable events and discouraging hesitation in reporting begins with a strong safety culture. However, limited evidence was found in current literature to establish a clear link between various dimensions of safety culture with event reporting and overall safety perceptions. The purpose of this MSN thesis was to investigate the relationships between the Agency for Healthcare Research and Quality’s (AHRQ) 10 safety culture dimensions and four outcome measures, as categorized in the Hospital Survey on Patient Safety Culture (HSOPSC), among direct care nurses. The primary methodology of this research involved secondary analysis of existing data in which survey results from the AHRQ’s HSOPSC were obtained from a large teaching hospital in the southeastern United Sates. Statistical correlational analyses were calculated using SPSS and Excel for a sample of 433 direct care nurses. All results were found to be statistically significant, in which a medium effect was seen in the correlations between overall dimensions of safety culture and patient safety grade (r = .476, p \u3c .001), as well as between safety culture dimensions and overall perception of safety (r = .391, p \u3c .001). A small effect was seen in the relationship between overall dimensions of safety culture and frequency of event reporting (r = .275, p \u3c .001). A negative, but minimal relationship was found between dimensions of safety culture and number of events reported (r = -.042, p \u3c .001). The results of this study are consistent with previous themes throughout the literature, in which leadership and communication were found to influence safety culture and frequency of event reporting. Due to the limitations of this MSN thesis, such as estimated frequency of event reporting on a survey item as opposed to an actual frequency, further research is needed to strengthen the relationships that were observed

Characterization of a black coating overlying rock paintings found in Little Lost River Cave, Idaho using THM-GC-MS

A black coating overlies rock paintings found within Little Lost Rive Cave, Idaho. A calibrated radiocarbon date of 1390-1040 B.C. was obtained by Steelman et al.1 However, this relies on the assumption that the black coating was formed by some human activity. For further characterization and to verify that the coating is anthropogenic, THM-GC-MS was performed on various samples collected throughout the cave, including soil samples from inside, outside, and above the cave. Humic and fulvic acids, synthetic and natural melanin, and experimentally created cooking residues were also analyzed as standard materials. By comparing the resulting chromatograms and the compounds identified by mass spectrometry, it was determined that the black coating is not a synthetic or natural melanin and bears little resemblance to the cooking residues. The coating bears most resemblance to humic acid standards, indicating an environmental origin

THE UNITED STATES IN THE GLOBAL SOYBEAN MARKET: WHERE DO WE GO FROM HERE?

This study applies the concept of a dynamic dominant-firm oligopoly model to the international soybean market. It has been suggested that the international soybean market should be viewed as an oligopoly among exporting nations. Consistent with Gaskins (1971) dynamic dominant firm model, our results indicate that the current U.S. loan deficiency-payment prices and their predecessors created an environment in which smaller (fringe) exporters could prosper and expand. The reduction of U.S. market share is thus a logical outcome of an "optimally managed decline" a la Gaskins. The study finds U.S. market share to decline at a reducing rate and predicts U.S. market share eventually to stabilize, given the expanding international market for soybeans and products. Recognition of the structure of international soybean market has policy implications for the 2002 farm program as the classic dominant firm model suggests.Crop Production/Industries, International Relations/Trade,

Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review

Background: The public health impact of health and well-being digital interventions is dependent upon sufficient real-world uptake and engagement. Uptake is currently largely dependent on popularity indicators (eg, ranking and user ratings on app stores), which may not correspond with effectiveness, and rapid disengagement is common. Therefore, there is an urgent need to identify factors that influence uptake and engagement with health and well-being apps to inform new approaches that promote the effective use of such tools. Objective: This review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults. Methods: We conducted a systematic review of quantitative, qualitative, and mixed methods studies. Studies conducted on adults were included if they focused on health and well-being smartphone apps reporting on uptake and engagement behavior. Studies identified through a systematic search in Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Scopus, Cochrane library databases, DataBase systems and Logic Programming (DBLP), and Association for Computing Machinery (ACM) Digital library were screened, with a proportion screened independently by 2 authors. Data synthesis and interpretation were undertaken using a deductive iterative process. External validity checking was undertaken by an independent researcher. A narrative synthesis of the findings was structured around the components of the capability, opportunity, motivation, behavior change model and the theoretical domains framework (TDF). Results: Of the 7640 identified studies, 41 were included in the review. Factors related to uptake (U), engagement (E), or both (B) were identified. Under capability, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E). Availability at low cost (U), positive tone, and personalization (E) were identified as physical opportunity factors, whereas recommendations for health and well-being apps (U), embedded health professional support (E), and social networking (E) possibilities were social opportunity factors. Finally, the motivation factors included positive feedback (E), available rewards (E), goal setting (E), and the perceived utility of the app (E). Conclusions: Across a wide range of populations and behaviors, 26 factors relating to capability, opportunity, and motivation appear to influence the uptake of and engagement with health and well-being smartphone apps. Our recommendations may help app developers, health app portal developers, and policy makers in the optimization of health and well-being apps

Market Forces and Price Ceilings: A Classroom Experiment

The effect of price controls on competitive equilibrium is a standard topic in many undergraduate economics courses. This classroom experiment demonstrates the effect of rent control (price ceilings) on the market for apartments. As participants in the experiment, students experience the effect of a price ceiling as buyers (renters) and sellers (landlords). The classroom-posted offer market exhibits a shortage under a binding price ceiling. Further, we explore a secondary response to rent control. When given the opportunity, landlords lower the quality of the apartments by reducing maintenance expenditures under the price ceiling, thus moving the market back to equilibrium. Since many students are themselves renters, they should relate to changes in quality due to lower maintenance by landlords. This experiment will stimulate discussion on market forces and on public policy aimed at restricting prices.

Does non-smoker identity following quitting predict long-term abstinence? Evidence from a population survey in England

Aims: ‘Categorical self-labels’ (e.g. thinking of oneself as a smoker or non-smoker) are important aspects of identity that can have a fundamental influence on behaviour. To explore the role identity aspects relating to smoking can play in smoking cessation and relapse, this study assessed the prospective associations between taking on a non-smoker identity following quitting and long-term abstinence.  Methods: A representative sample of 574 ex-smokers in England who quit smoking in the past year was followed-up at three (N=179) and six months (N=163). Post-quit identity relating to smoking (‘I still think of myself as a smoker’ or ‘I think of myself as a nonsmoker’), and demographic and smoking-related characteristics were assessed at baseline. Self-reported smoking abstinence was assessed at follow-ups.  Results: Non-smoker identity was reported by 80.3% (95%CI 76.8-83.4) of recent exsmokers. Younger age (p=0.017) and longer abstinence (p<0.001) were independently associated with a post-quit non-smoker identity. After adjusting for covariates, non-smoker identity (p=0.032) and length of abstinence at baseline (p<0.001) were associated with continued abstinence at three months follow-up, and baseline length of abstinence (p=0.003) predicted continued abstinence at six months.  Conclusions: The majority of people who quit smoking recently consider themselves as nonsmokers. Younger people and those who have been abstinent for longer are more likely to take on a non-smoker identity. Ex-smokers who make this mental transition following a quit attempt appear more likely to remain abstinent in the medium term than those who still think of themselves as smokers