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Frontiers in Psychology 2024While much research has examined the correlates of climate change beliefs from an alarmist perspective, less work has systematically measured climate change skepticism....
While much research has examined the correlates of climate change beliefs from an alarmist perspective, less work has systematically measured climate change skepticism. This study aims to create a comprehensive tool capturing climate skeptics' beliefs and test its association with individual difference variables. 502 European adults completed a 22-item questionnaire on climate change (CC) skepticism as well as measures of ambiguity tolerance, belief in a just world (BJW), dark-side personality traits, and self-esteem. Principal components analysis revealed a four dimension structure of CC. Political ideology was the most consistent and significant predictor across the climate change skepticism factors. Dark-side traits, also played a role. Future research should further validate this measure and explore how climate change information could be tailored to different audiences. Understanding the nuances and causes of climate skepticism can enable more effective communication to promote sustainability.
PubMed: 38721315
DOI: 10.3389/fpsyg.2024.1328307 -
ISA Transactions Jun 2024This paper studies the control problem for a continuous-time networked system with non-linearity in the state equation as well as in the input, as saturation. The system...
This paper studies the control problem for a continuous-time networked system with non-linearity in the state equation as well as in the input, as saturation. The system is considered under denial-of-service (DoS), attacks which cause the blockage of input and/or output components in the overall closed-loop model. An event-triggering scheme that is resilient in nature, along with an observer-based control, has been considered under DoS attacks. The resultant scheme ensures efficient network resources and excludes Zeno behavior naturally due to the presence of a minimum positive interevent delay. Then, an event-based switched non-linear model is presented to address both the event-triggering scheme and the presence of DoS blocking attacks. A piece-wise Lyapunov-Krasovskii functional method on the described non-linear model, resulting in the switched system, is considered for achieving an exponentially stable response by driving the required feasibility conditions. In the presence of a non-linear system with saturation in the actuator, the presented design establishes quantitative relationships among the exponential decay rate, active/sleeping intervals of attacks, parameters of the event-triggering condition, and sampling period of the system. After that, linear matrix inequalities are presented for designing an event-triggered controller with an observer, while the design also includes the region of convergence for dealing with the input non-linearity. Finally, comparative results for an offshore structure model with non-linearity in states as well as in actuator, are demonstrated to verify the results of the control scheme that is developed. It has been verified that our design is less conservative than the previous designs, and can handle the non-linearities in the dynamics of plant and actuator saturation more efficiently, while DoS attacks are also present. By applying our proposed method, the overshoot and undershoot are less than ±2.5 percent, while system states converge to the origin within 55 s.
PubMed: 38719682
DOI: 10.1016/j.isatra.2024.04.021 -
Health Affairs (Project Hope) May 2024Private equity (PE) acquisitions in health care delivery nearly tripled from 2010 to 2020. Despite concerns around clinical and economic implications, policy responses...
Private equity (PE) acquisitions in health care delivery nearly tripled from 2010 to 2020. Despite concerns around clinical and economic implications, policy responses have remained limited. We discuss the US policy landscape around PE ownership, using policies in the European Union for comparison. We present four domains in which policy can be strengthened. First, to improve oversight of acquisitions, policy makers should lower reporting thresholds, review sequential acquisitions that together affect market power, automate reviews with potential denials based on market concentration effects, consider new regulatory mechanisms such as attorney general veto, and increase funding for this work. Second, policy makers should increase the longer-run transparency of PE ownership, including the health care prices garnered by acquired entities. Third, policy makers should protect patients and providers by establishing minimum staffing ratios, spending floors for direct patient care, and limits on layoffs and the sale of real estate after acquisition (forms of "asset stripping"). Finally, policy makers should mitigate risky financial behavior by limiting the amount or proportion of debt used to finance PE acquisitions in health care.
Topics: Humans; Ownership; United States; Health Policy; Delivery of Health Care; Private Sector; European Union; Health Equity
PubMed: 38709967
DOI: 10.1377/hlthaff.2023.00942 -
PLOS Global Public Health 2024In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often...
"I've accepted it because at the end of the day there is nothing, I can do about it": A qualitative study exploring the experiences of women living with the HIV, intimate partner violence and mental health syndemic in Mpumalanga, South Africa.
In South Africa, Mental Health (MH), HIV, and Intimate Partner Violence (IPV) form a syndemic, that disproportionately affects women. These challenges are often co-occurring and create complex adversities for women. Recognising these intersections and the broader socio-cultural dynamics at play is crucial to understanding the layered experiences of these women and developing effective interventions. This research explores the experiences of the women living with at least two of the epidemics (HIV, IPV and or MH) and how they cope. A qualitative study design was used and 20 women (22-60 years) were recruited from Mpumalanga, South Africa. To be eligible for the study the women had to have experienced at least two of the epidemics. Data were collected through home-based interviews, arts-based activities, and analysed thematically using MAXQDA (2022) software. MH challenges were prevalent among all the participants and were linked to both IPV and HIV, resulting in symptoms such as anxiety, depression, and suicidal thoughts. In relation to the HIV-MH link, MH challenges in this combination included feelings of denial, sadness and anxiety related to participant's HIV diagnosis. A bidirectional relationship also existed in the IPV-MH group where pre-existing MH challenges among women increased their vulnerability of having violent partners, whilst IPV also increased MH challenges. In the IPV-MH-HIV group early childhood violence exposure was linked with MH challenges and later victimization and vulnerability to HIV. Participants primarily used religion, acceptance, occasional alcohol, and family support as coping strategies. Particularly in IPV situations, alcohol use/misuse was the most prevalent coping strategies. The study highlights the syndemic relationship between HIV, IPV and MH challenges among South African women living in a peri-urban community, with a central emphasis on MH challenges. Interventions should holistically address these challenges, with particular focus on MH challenges, cultural sensitivity, and promotion of healthy coping strategies.
PubMed: 38709813
DOI: 10.1371/journal.pgph.0002588 -
Pediatric Transplantation Jun 2024Adolescent and young adult (AYA) solid organ transplant (SOT) recipients experience increased rates of rejection and graft loss surrounding the time of health care...
BACKGROUND
Adolescent and young adult (AYA) solid organ transplant (SOT) recipients experience increased rates of rejection and graft loss surrounding the time of health care transition, in part due to poor medication adherence. This study aims to examine the impact of a once-daily formulation of tacrolimus, LCP-tacrolimus (LCPT), on medication adherence for AYA SOT patients.
METHODS
A retrospective descriptive analysis was performed for all patients who underwent SOT and were prescribed LCPT after the age of 12 at our single-center pediatric hospital. Medication adherence was assessed via provider documentation and the medication level variability index (MLVI).
RESULTS
Twenty-nine patients were prescribed LCPT as part of their immunosuppression regimen. Twenty patients were converted to LCPT from immediate-acting (IR) tacrolimus; six patients were initiated immediately following transplant, and three patients were unable to receive LCPT due to insurance denial. There was a numeric improvement in medication adherence for converted patients when measured by provider assessment (45.0% vs. 68.4%, p = .140) and MLVI (40.0% vs. 71.4%, p = .276), though these did not reach statistical significance. There were no differences in episodes of rejection or adverse effects. LCPT prescription was not associated with decreased medication burden, and two patients transitioned back to IR tacrolimus due to increased cost.
CONCLUSIONS
LCPT use did not significantly improve patient adherence; however, it resulted in numerically higher perceived and measured adherence rates. LCPT appears to be safe and effective in the management of SOT recipients; however, it may not affect pill burden and may result in a higher financial burden. Use may be considered for a select group of AYA SOT recipients.
Topics: Humans; Tacrolimus; Adolescent; Retrospective Studies; Male; Female; Immunosuppressive Agents; Medication Adherence; Young Adult; Organ Transplantation; Graft Rejection; Transplant Recipients; Drug Administration Schedule; Child; Adult
PubMed: 38702932
DOI: 10.1111/petr.14777 -
Indian Journal of Psychological Medicine May 2024Alcohol Dependence Syndrome is a chronic illness that is relapsing in nature. Past research has shown that coping strategies that are specific to alcohol dependence are...
BACKGROUND
Alcohol Dependence Syndrome is a chronic illness that is relapsing in nature. Past research has shown that coping strategies that are specific to alcohol dependence are useful in preventing long-term relapse. This follow-up study is, therefore, an attempt to understand the coping styles and strategies that are associated with relapse among individuals dependent on alcohol.
METHODS
We aimed to cross-sectionally assess the severity of alcohol dependence and coping styles of Alcohol dependent individuals. One hundred and twenty-seven consecutive patients who satisfied the International Classification of Diseases Tenth Edition (ICD 10) criteria for alcohol dependence and who were above the age of 18 years were included. This study was conducted in the de-addiction outpatient services of a Tertiary care center in South India between April 2019 and June 2020. Our Institutional Ethical Committee granted the approval for this study. We used a self-designed proforma for collecting the socio-demographic details. The Severity of Alcohol Dependence Questionnaire (SADQ) and Coping Orientation to Problems Experienced Inventory (Brief - COPE) were administered. Patients were followed up for six months. Motivation Enhancement Therapy was given to all our participants during their monthly follow-up visit. Descriptive analysis was performed using mean and standard deviation. We used the student -test and chi-squared test to understand the differences in the coping strategies between relapsed and non-relapsed persons. Spearman's correlation was used to assess the correlation between the severity of alcohol dependence and coping strategies. A value of <.05 was taken as significant.
RESULTS
Non-relapsed individuals had significantly higher scores on active coping ( .008), emotional support ( .044), informational support ( .017), planning ( .001), acceptance ( .030), and humor ( .001). Relapsed individuals had statistically significant scores on denial ( .005), substance use ( .024), and self-blame ( .012). We found a positive correlation between the severity of alcohol dependence and maladaptive coping strategies ( .01).
CONCLUSIONS
Relapsed individuals were found to have significantly higher maladaptive coping strategies. Non-relapsed individuals exhibited greater adaptive coping styles. Maladaptive coping strategies positively correlated with the severity of alcohol dependence.
PubMed: 38699765
DOI: 10.1177/02537176231222968 -
Frontiers in Psychiatry 2024The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the...
The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors' perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations.
PubMed: 38699451
DOI: 10.3389/fpsyt.2024.1316108 -
Frontiers in Sociology 2024Australia has been widely condemned for its harsh and comprehensive external border controls that seek to control the inward mobility of would-be asylum seekers through...
Australia has been widely condemned for its harsh and comprehensive external border controls that seek to control the inward mobility of would-be asylum seekers through visa denial, interdiction and offshore detention. Less widely discussed is the fact that internal controls have been repeatedly ramped up over the past two decades. This includes the administrative removal of lawfully-present non-citizens following visa cancellation on character grounds under s501 of the Migration Act 1958 (Cth). Automatic visa cancellation was introduced in 2014 for non-citizens sentenced to a prison term of 12 months or more, or for certain offences, bypassing individualised decision-making and raising the spectre of a visa cancellation pipeline feeding a highly automated deportation machinery. In an age of increasingly automated forms of governance, a key question that arises is the role that has been played by automated systems in achieving what has been a seismic shift in practice, and the normative implications of any developments towards automation within the visa cancellation and removal systems. This paper outlines the shift towards automation in other systems of governance in Australia-most notably the notorious Robodebt scheme-before examining automation in Australia's visa cancellation system. Documentary analysis of recent parliamentary inquiries, independent reports and government policy is used to piece together the development of inter-agency data exchange practices and automation over three specific periods-historical practice pre-2014, post-2014 to the present, and proposed future developments. We conclude that Australia's s501 visa cancellation system is neither automated nor automatic. Rather, the 2014 law reform gave rise to a 'surveillance fantasy' with immense consequences for non-citizens, particularly those who face long days in immigration detention at the conclusion of their prison sentence. We show that while concerns about increasing automation are well-founded, systems based on less sophisticated forms of information handling and reliant on human decision-making nevertheless continue to raise age-old questions concerning efficiency, accuracy and fairness.
PubMed: 38698934
DOI: 10.3389/fsoc.2024.1336160 -
American Journal of Perinatology May 2024Point-of-care ultrasound (POCUS) has increasingly been used by neonatal providers in neonatal intensive care units in the United States. However, there is a lack of...
Point-of-care ultrasound (POCUS) has increasingly been used by neonatal providers in neonatal intensive care units in the United States. However, there is a lack of literature addressing the complexities of POCUS coding and billing practices in the United States. This article describes the coding terminology and billing process especially those relevant to neonatal POCUS. We elucidate considerations for neonatal POCUS billing framework and workflow integration. Directions on image storage and supporting documentation to facilitate efficient reimbursement, compliance with billing regulations, and appeal to insurance claim denial are discussed. KEY POINTS: · Code neonatal POCUS procedure precisely allows accurate reimbursement and reduced errors in billing.. · Document details to support medical necessity and reimbursement claims effectively.. · Adhere to regulations to avoid audits, denials, and ensure proper reimbursement..
PubMed: 38698594
DOI: 10.1055/s-0044-1786721 -
Ethnicity & Health May 2024Perceived discrimination (PD; e.g. racism, agism, sexism, etc.) negatively impacts quality of life (QOL) among cancer patients. Prior research has established that for... (Review)
Review
Perceived discrimination and quality of life for African American and Caucasian American cancer patients: a coping mediation analysis of subtle and overt microaggressions.
OBJECTIVE
Perceived discrimination (PD; e.g. racism, agism, sexism, etc.) negatively impacts quality of life (QOL) among cancer patients. Prior research has established that for African American Cancer Patients (AACPs) only disengagement/denial coping mediated the PD-QOL relationship. In contrast, for Caucasian American Cancer Patients (CACPs), both agentic and disengagement/denial coping were mediators of the PD-QOL relationship. However, according to social constraint theory there may be a difference between subtle and overt PD in terms of the utility of certain coping mechanisms in relation to QOL, especially for AACPs.
METHOD
217 AACPs and 121 CACPs completed measures of PD, coping (agentic, disengagement/denial, adaptive disengagement) and QOL. PD items were classified as subtle or overt microaggressions. PD was mainly attributed to race/ethnicity by AACPs and to income, age, and physical appearance for CACPs.
RESULTS
: In both subtle and overt microaggression models with CACPs, agentic coping and disengagement/denial coping were significant mediators of PD-QOL. Like CACPs, for AACPs, agentic and disengagement/denial coping were significant in the context of subtle microaggressions. In contrast, for overt microaggression only disengagement/denial coping was a significant mediator of the PD-QOL relationship for AACPs. Adaptive disengagement was related to QOL only for AACPs.
CONCLUSIONS
: Whereas more research is needed, it appears that overt microaggressions for AACPs, that consist mainly of racial and ethnic maltreatment, constitute a class of social contexts that may raise above the threshold for serious threat and harm, and, as a result, disengagement/constraint may reduce negative consequences. This additional burden for AACPs contributes to disparities in QOL. Future research is needed on the utility of adaptive disengagement for AACPs in relation to PD.
PubMed: 38698588
DOI: 10.1080/13557858.2024.2347569