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ADVERSE AND POSITIVE CHILDHOOD EXPERIENCES AND GENERAL HEALTH AMONG ASIAN AMERICAN EMERGING ADULTS
Get PDFBackground: Of the limited number of studies reporting the prevalence and impact of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) in Asian Americans, most report a lower prevalence of ACEs among Asian Americans than for other racial/ethnic groups. However, most studies fail to account for the cultural and socioeconomic heterogeneity across diverse Asian ethnic subgroups.
Purpose: This dissertation examined disparities in ACE and PCE exposures in an Asian American sample of emerging adults and described the relationships among ACEs, PCEs, health, and socioeconomic background.
Design and Methods: Using a cross-sectional survey design, Asian American emerging adults (18 - 25 years) self-identified as Asian Indian, Chinese, or Hmong Americans were recruited from November 2021 to November 2022. Participants completed online surveys measuring ACEs (Philadelphia ACEs Survey), PCEs (Benevolent Childhood Experiences Scale), general health (PROMIS Adult Global Health Scale v1.2), and childhood socioeconomic position (CSEP).
Results: In this sample of 814 Asian American emerging adults, 93.4% reported exposure to at least one ACE; 58.9% reported exposure to four or more ACEs. Moreover, 64.7% of participants reported eight or more PCEs. The ACEs and PCEs prevalence differed across the ethnic subgroups with proportionally more Hmong participants reporting four or more ACEs (68.9%) than Asian Indian (52.9%) and Chinese (50.2%) participants. Significantly lower proportion of Hmong participants (56.4%) reported eight to ten PCEs compared to Asian Indian (69.2%) and Chinese (72.3%) participants. CSEP factors accounted for some variations in the ACE and PCE disparities by ethnic subgroups. ACE score was negatively associated with health, and PCE score moderated the negative impact of ACEs on health. Contrary to the hypothesis, higher PCEs did not significantly attenuate the negative association between ACEs and health.
Conclusions: ACEs and PCEs are highly prevalent in this sample of Asian American emerging adults with significant disparities across ethnic subgroups. PCEs moderated the negative association between ACEs and health. Future research should disaggregate data by Asian ethnicity to assess the intersectional impacts of socioeconomic status and race/ethnicity on ACEs and PCEs among Asian Americans. Additional research is needed to further understand the mechanism of the moderating effects of PCEs
ADVERSE AND POSITIVE CHILDHOOD EXPERIENCES AND GENERAL HEALTH AMONG ASIAN AMERICAN EMERGING ADULTS
Get PDFBackground: Of the limited number of studies reporting the prevalence and impact of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) in Asian Americans, most report a lower prevalence of ACEs among Asian Americans than for other racial/ethnic groups. However, most studies fail to account for the cultural and socioeconomic heterogeneity across diverse Asian ethnic subgroups.
Purpose: This dissertation examined disparities in ACE and PCE exposures in an Asian American sample of emerging adults and described the relationships among ACEs, PCEs, health, and socioeconomic background.
Design and Methods: Using a cross-sectional survey design, Asian American emerging adults (18 - 25 years) self-identified as Asian Indian, Chinese, or Hmong Americans were recruited from November 2021 to November 2022. Participants completed online surveys measuring ACEs (Philadelphia ACEs Survey), PCEs (Benevolent Childhood Experiences Scale), general health (PROMIS Adult Global Health Scale v1.2), and childhood socioeconomic position (CSEP).
Results: In this sample of 814 Asian American emerging adults, 93.4% reported exposure to at least one ACE; 58.9% reported exposure to four or more ACEs. Moreover, 64.7% of participants reported eight or more PCEs. The ACEs and PCEs prevalence differed across the ethnic subgroups with proportionally more Hmong participants reporting four or more ACEs (68.9%) than Asian Indian (52.9%) and Chinese (50.2%) participants. Significantly lower proportion of Hmong participants (56.4%) reported eight to ten PCEs compared to Asian Indian (69.2%) and Chinese (72.3%) participants. CSEP factors accounted for some variations in the ACE and PCE disparities by ethnic subgroups. ACE score was negatively associated with health, and PCE score moderated the negative impact of ACEs on health. Contrary to the hypothesis, higher PCEs did not significantly attenuate the negative association between ACEs and health.
Conclusions: ACEs and PCEs are highly prevalent in this sample of Asian American emerging adults with significant disparities across ethnic subgroups. PCEs moderated the negative association between ACEs and health. Future research should disaggregate data by Asian ethnicity to assess the intersectional impacts of socioeconomic status and race/ethnicity on ACEs and PCEs among Asian Americans. Additional research is needed to further understand the mechanism of the moderating effects of PCEs
Coping Strategies, Social Support, and Self-Care Among Young Women with Pelvic Inflammatory Disease
Get PDFPelvic inflammatory disease (PID), a spectrum of inflammatory disorders of the female upper genital tract, is a serious complication of sexually transmitted infections (STIs) that may lead to chronic pelvic pain, ectopic pregnancy, and tubal infertility. Although PID treatment is critical for the preservation of fertility and health-related quality of life, many young women diagnosed with PID do not fully adhere to treatment recommendations. Interventions focused on clinician practices, patient education, and behavioral modeling have generated limited improvements in outpatient PID treatment adherence among young women, thereby suggesting the influence of other determinants, such as psychosocial factors. Coping and social support are psychosocial factors that may affect PID self-management. A comprehensive literature review revealed a dearth of published research focused on coping with PID and related social support among young women. Guided by the Transactional Model of Stress and Coping, this dissertation study used a convergent mixed methods design to examine and explore the coping strategies, social support, and self-management behaviors (medication completion, clinical follow-up visit attendance, partner notification, and sexual abstinence) of 90 young women during the PID treatment period. Study participants comprised a subsample of young women enrolled in a randomized controlled trial of an outpatient intervention designed to reduce adverse outcomes after PID. Quantitative data were collected via audio computer-assisted self-interview and structured in-person interviews. Qualitative data collection consisted of semi-structured interviews with 18 participants to explore the experiences of young women diagnosed with and treated for PID. Quantitative results indicated that the social provision of opportunity for nurturance (perceived responsibility for others) was positively associated with medication completion (AOR=1.26, 95% CI: 1.00-1.59, p=0.05) and clinical visit attendance (AOR=2.43, 95% CI: 1.19-4.93, p=0.01). Qualitative findings revealed that upon learning about their diagnosis, young women were self-motivated to ameliorate PID. With support from family and friends, they incorporated PID self-management into their daily lives—which may not have been fully consistent with prescribed medical protocols. In conclusion, social support is associated with PID self-management among young women. Assessing young women’s coping and social support resources can inform a tailored plan for successful PID treatment
Mixed-effects modeling of shortleaf pine (Pinus echinata Mill.) growth data
No full textScope and Methods of Study: The objective of this study was to develop individual-tree mixed-effects models for basal area growth and the diameter-height relationship of shortleaf pine (Pinus echinata Mill.). Repeated measurements for attributes including diameter at breast height and total height from over 200 permanent plots were available from eastern Oklahoma and western Arkansas. Models with plot random-effects were fitted using the S-Plus nlme library and SAS PROC NLMIXED utilizing a calibration dataset. Models with independently and normally distributed errors were fitted first. Then possible spatially correlated and/or heterogeneous within-plot errors were modeled for basal area growth. The most promising models were tested using an independently selected dataset from the same study.Results and Conclusions: Though increasingly popular in forestry, mixed-effects modeling technique has never previously been used in shortleaf pine growth modeling. Nonlinear mixed models with plot random-effects were found to fit the data better than the models fitted with a complete random sample assumption (the ordinary least-squares method) as reported in Lynch et al. (1999) for both a basal area growth model and a model for diameter-height relationship. Because data were grouped by plots, a mixed-effects model with plot-level random-effects was a more realistic representation of the data structure than ordinary least squares. Spatial correlation among tree measurements within a plot did not appear to be important in presence of plot random-effects. However, variance modeling using a variance function with tree basal area as a covariate accounted for heterogeneity of within-plot errors better than the modeling approach in which constant variance was assumed
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Parent and Family Resonses to a Child Undergoing BMT During Transitions in Care
No full textBackground
Pediatric blood and marrow transplantation (BMT) is an intense treatment reserved for life-threatening oncologic, hematologic, and immunologic illnesses of childhood. While BMT offers hope for cure, the intensity of the treatment and recovery period, and the associated burdens have been linked to sequelae such as decreased quality of life (QOL), emotional distress, and financial burdens. Even though pediatric BMT affects all family members, very little is known about the direct effects of BMT on the parents of BMT patients, and the resultant family impact. Self-management concepts have been identified by parents as important during their child’s BMT and recovery period, but parent and family self-management has not been explored in the pediatric BMT population.
Purpose
The specific aims of this study are to 1) Examine the relationship of family context (complexity of condition and treatment, physical and social environment, and parent and family characteristics) to parent self-regulation, QOL, and general health at five time points during the first 12 months following BMT; 2) Examine the effect over time of complexity of condition and treatment, as measured by BMT complications, on parent impact, general heath, and QOL, and 3) Explore the family self-management experience of the transition from acute to chronic care following pediatric BMT.
Method
This study used an explanatory sequential mixed methods design. The quantitative portion included a secondary analysis of an existing data set, and the qualitative portion consisted of semi-structured family as group interviews. The qualitative portion of this study was guided by the human science phenomenology approach described by Van Manen. The Individual and Family Self-Management Theory guided this study.
Results
The quantitative analysis included 363 parents of pediatric BMT patients. The Parent Impact Scale of the Child Health Ratings Inventories (CHRIs) was found to have a single factor structure. In the first three months after BMT, Parent Impact was significantly worse in the presence of aGVHD ≥ grade 2, worse organ toxicity, and systemic infection. From three months to one year, Parent Impact was significantly worse with the presence of systemic infection. A year after BMT, one-third of parents reported taking at least one day off per week from work/cutting back on usual activities.
Longitudinally, parent QOL was significantly better among partnered parents, Hispanic parents, parents with fewer children, parents with lower Parent Impact, and parents of children with better organ function. Parent General Health was significantly better among parents with higher educational attainment, parents with lower Parent Impact, parents of children with non-malignant diagnoses, and parents of children with worse organ toxicity.
Thirteen families participated in the family as group interviews including 11 mothers, 5 fathers, 4 BMT patients, and 4 siblings. Major themes included Making a Plan, Taking Care of Basic Needs, and Managing Emotional Burdens. Even though the circumstances of BMT were similar among different families, families described using vastly different self-management strategies to survive the BMT period.
Conclusions
This study provided important information about the self-management of parents and families during pediatric BMT. In the quantitative analysis parents reported taking time off work/cutting back on usual activities throughout the first year after BMT. In the qualitative interviews, parents described the stress of making work arrangements, and the resulting financial strain.
The findings that family characteristics, such as the number of siblings and partner status of the parents; as well as patient characteristics, such as infection and organ toxicity are related to parent QOL and general health provide further evidence that parent and child outcomes are linked. This information is also critical for the future formation of interventions designed to support families through pediatric BMT. Furthermore, knowing these factors may help clinicians to identify families most as risk for negative sequelae. Future research is needed to study the stability of qualitative concepts over time, and develop family-centered interventions designed to help families achieve their self-management goals during pediatric BMT
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
HIV and Tuberculosis Stigma in KwaZulu-Natal, South Africa: A Mixed-Methods Analysis of Experience, Theory, and Method
No full textInfectious disease stigma such as tuberculosis (TB) stigma, and stigma associated with human immunodeficiency virus (HIV) negatively impact quality of life and impede care engagement at all levels of the care continuum. As a result, infectious disease stigma is a major impediment to HIV and TB elimination efforts. Stigma is a complex and dynamic social construct that varies across culture, geography and by local disease burden. Quantifying stigma is difficult with many scientists electing to use unvalidated or proxy variables. We have little knowledge about how hallmarks of clinical disease such as viral suppression and TB culture conversion impact stigma or illness identity. Research examining infectious disease stigma is generally done cross sectionally without consideration location in the TB/HIV continuum. While there are a variety of validated HIV stigma scales, there is only one scale validated to measure TB stigma, the Van Rie Patient and Community Perspectives Towards Tuberculosis Scales. While the scale was psychometrically validated in Thailand, the Patient Perspectives Towards Tuberculosis have not undergone qualitative exploration in South Africa. To address all these questions, we conducted a parallel mixed-methods study that examined and explored stigma, identity, fluctuations in stigma over time, and interrogated the underlying validity of the Patient Perspectives sub-scale.
The study sample (N=59) had a mean age of 36.6 years, 59.3% were male and most were unemployed (59.3%). At entry into TB treatment 51.0% were virally suppressed with a mean time of 6.4 years since HIV diagnosis. The qualitative aims (n= 30 participants selected from among the quantitative sample) used data from in-depth interviews exploring the construct of stigma. We also employed cognitive interviewing techniques to highlight discrepancies between the lived experience of stigma and traditional quantitative measures. Participants described the negligible impact that viral suppression or undetectable equals untransmittable (U=U) had on their identity or lived-experience of stigma. Over time, participants described changes in stigma from three perspectives which was an unexpected finding. Finally, we found that while it performed well psychometrically, the Patient Perspectives Towards Tuberculosis did not accurately quantify the lived experience of TB stigma and likely reflects community rather than individual stigma
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