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• 651. [Article] Association of Traditional Chinese Medicine Therapy and the Risk of Dementia in Patients with Hypertension: A Nationwide Population-based Cohort Study

  Background: Patients with hypertension (HTN) reportedly have a higher risk of developing dementia. However, it remains unclear if use of Traditional Chinese Medicine (TCM), the most common form of complementary ...

  Citation × Citation Citation Abstract Copy Title: Association of Traditional Chinese Medicine Therapy and the Risk of Dementia in Patients with Hypertension: A Nationwide Population-based Cohort Study Author: Chen, Kuen-Hau, Yeh, Ming-Hsien, Livneh, Hanoch, Chen, Bor-Chyuan, Lin, I-Hsin, Lu, Ming-Chi, Tsai, Tzung-Yi, Yeh, Chia-Chou Year: 2017 Background: Patients with hypertension (HTN) reportedly have a higher risk of developing dementia. However, it remains unclear if use of Traditional Chinese Medicine (TCM), the most common form of complementary and alternative medicine, can help lower the risk of dementia for these patients. So the aim of the study was to investigate the effects of TCM on dementia risk among patients with hypertension. Methods: This longitudinal cohort study used the Taiwanese National Health Insurance Research Database (NHIRD) to identify 143,382 newly diagnosed hypertension patients aged 20–90 years who received treatment between 1998 and 2007. Among them, 52,365 (36.52%) had received TCM after the onset of hypertension (TCM users), and the remaining 91,017 patients (63.48%) were designated as a control group (non-TCM users). All enrollees were followed until the end of 2012 to record the incidence of dementia. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of dementia in patients who received TCM. Results: During the 15-year follow-up, 3933 TCM users and 10,316 non-TCM users developed dementia, representing an incidence rate of 8.41 and 11.55%, respectively, per 1000 person-years. TCM users had a significantly reduced risk of dementia compared to non-TCM users (adjusted HR = 0.76; 95% confidence interval [CI] = 0.74–0.81). The predominant effect was observed among those treated with TCM longer than 180 days (adjusted HR = 0.65; 95% CI = 0.62–0.69). Among the commonly used TCM products, Tian-Ma-Gou-Teng-Yin, Dan-Shen (Radix Salviae Miltiorrhizae), Chuan-Niu-Xi (Radix Cyathulae), Ge-Gen (Radix Puerariae), Jia-Wei-Xiao-Yao-San, and Jue-Ming-Zi (Semen Cassiae) were significantly associated with a lower risk of dementia. Conclusions: Results from this population-based study support the effects of TCM on reducing dementia risk, which may provide a reference for dementia prevention strategies. Title: Association of Traditional Chinese Medicine Therapy and the Risk of Dementia in Patients with Hypertension: A Nationwide Population-based Cohort Study Author: Chen, Kuen-Hau, Yeh, Ming-Hsien, Livneh, Hanoch, Chen, Bor-Chyuan, Lin, I-Hsin, Lu, Ming-Chi, Tsai, Tzung-Yi, Yeh, Chia-Chou Year: 2017 Background: Patients with hypertension (HTN) reportedly have a higher risk of developing dementia. However, it remains unclear if use of Traditional Chinese Medicine (TCM), the most common form of complementary and alternative medicine, can help lower the risk of dementia for these patients. So the aim of the study was to investigate the effects of TCM on dementia risk among patients with hypertension. Methods: This longitudinal cohort study used the Taiwanese National Health Insurance Research Database (NHIRD) to identify 143,382 newly diagnosed hypertension patients aged 20–90 years who received treatment between 1998 and 2007. Among them, 52,365 (36.52%) had received TCM after the onset of hypertension (TCM users), and the remaining 91,017 patients (63.48%) were designated as a control group (non-TCM users). All enrollees were followed until the end of 2012 to record the incidence of dementia. A Cox proportional hazards regression model was used to compute the hazard ratio (HR) of dementia in patients who received TCM. Results: During the 15-year follow-up, 3933 TCM users and 10,316 non-TCM users developed dementia, representing an incidence rate of 8.41 and 11.55%, respectively, per 1000 person-years. TCM users had a significantly reduced risk of dementia compared to non-TCM users (adjusted HR = 0.76; 95% confidence interval [CI] = 0.74–0.81). The predominant effect was observed among those treated with TCM longer than 180 days (adjusted HR = 0.65; 95% CI = 0.62–0.69). Among the commonly used TCM products, Tian-Ma-Gou-Teng-Yin, Dan-Shen (Radix Salviae Miltiorrhizae), Chuan-Niu-Xi (Radix Cyathulae), Ge-Gen (Radix Puerariae), Jia-Wei-Xiao-Yao-San, and Jue-Ming-Zi (Semen Cassiae) were significantly associated with a lower risk of dementia. Conclusions: Results from this population-based study support the effects of TCM on reducing dementia risk, which may provide a reference for dementia prevention strategies. Close

• 652. [Article] County-Level Cumulative Environmental Quality Associated With Cancer Incidence

  BACKGROUND: Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure ...

  Citation × Citation Citation Abstract Copy Title: County-Level Cumulative Environmental Quality Associated With Cancer Incidence Author: Jagai, Jyotsna S., Messer, Lynne C., Rappazzo, Kristen M., Gray, Christine L., Grabich, Shannon C., Lobdell, Danelle T. Year: 2017 BACKGROUND: Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. METHODS: The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. RESULTS: Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. CONCLUSION: We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures. Title: County-Level Cumulative Environmental Quality Associated With Cancer Incidence Author: Jagai, Jyotsna S., Messer, Lynne C., Rappazzo, Kristen M., Gray, Christine L., Grabich, Shannon C., Lobdell, Danelle T. Year: 2017 BACKGROUND: Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains. METHODS: The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with domain-specific indices and analyses were stratified by rural/urban status. RESULTS: Comparing the highest quintile/poorest environmental quality with the lowest quintile/best environmental quality for overall EQI, all-site county-level cancer incidence rate was positively associated with poor environmental quality overall (IRD, 38.55; 95% CI, 29.57-47.53) and for male (IRD, 32.60; 95% CI, 16.28-48.91) and female (IRD, 30.34; 95% CI, 20.47-40.21) subjects, indicating a potential increase in cancer incidence with decreasing environmental quality. Rural/urban stratified models demonstrated positive associations comparing the highest with the lowest quintiles for all strata, except the thinly populated/rural stratum and in the metropolitan/urbanized stratum. Prostate and breast cancer demonstrated the strongest positive associations with poor environmental quality. CONCLUSION: We observed strong positive associations between the EQI and all-site cancer incidence rates, and associations differed by rural/urban status and environmental domain. Research focusing on single environmental exposures in cancer development may not address the broader environmental context in which cancers develop, and future research should address cumulative environmental exposures. Close

• 653. [Article] Objective Measurement of Gait Abnormalities in Huntington Disease using a Shoe-Worn Inertial Sensor (P5.291)

  OBJECTIVE: To evaluate the feasibility and utility of a shoe-worn inertial sensor to measure gait abnormalities in Huntington disease (HD) in the home setting. BACKGROUND: Clinical rating scales provide ...

  Citation × Citation Citation Abstract Copy Title: Objective Measurement of Gait Abnormalities in Huntington Disease using a Shoe-Worn Inertial Sensor (P5.291) Author: Hogarth, Penelope, Lenahan, Arthur, Portillo, Alicia, Ramachandran, Ravi, Stenson, Katie, Legedza, Anna, Botfield, Martyn, Horak, Fay, McNames, James, El-Gohary, Mahmoud Ahmed Year: 2015 OBJECTIVE: To evaluate the feasibility and utility of a shoe-worn inertial sensor to measure gait abnormalities in Huntington disease (HD) in the home setting. BACKGROUND: Clinical rating scales provide only point assessments of disease-related impairments in HD, lack sensitivity, and require that a clinician experienced in the scale’s use evaluate the patient. A tool that would allow longitudinal, objective, quantitative measurement of impairments may offer advantages over standard clinical rating scales. DESIGN/METHODS: This was a pilot, single-blind, controlled observational study. Five ambulatory HD subjects and 5 age/gender-matched healthy controls wore inertial sensors manufactured by APDM, Inc. attached to each shoe during waking hours for 7 days. Gait parameters calculated from the sensors included stride length([percnt]height); stride velocity([percnt]height/sec); step duration(sec); double support time([percnt]); pitch at toe off (degrees) and heel strike (degrees); cadence(steps/min); and variability in each of these measures. Following blinded descriptive data analysis by APDM, independent samples t-tests were used to compare means for selected gait metrics between HD and control subjects, and Pearson correlation coefficients were used to interrogate the relationships between gait metrics, chorea score, and Total Functional Capacity (TFC, a measure of disease severity). RESULTS: Subjects were able to successfully apply, wear and charge the sensors. Blinded gait analysis correctly identified the HD and control subjects for 4/5 pairs. Significant differences were found between HD/control groups in mean(SD) stride length [53.96(9.25), 67.68(7.25), p=0.03]; mean(SD) variability per week (as measured by coefficient of variation) in stride length [28.57(5.54), 20.27(3.78), p=0.02] and pitch at toe off [25.57(4.00), 17.56(4.07), p=0.01]. Lower TFC scores correlated with greater variability in stride length[R=-0.82]; pitch at toe off[R=-0.80]; and increased double support time[R=-0.75]. Higher chorea scores correlated with shorter stride length[R=-0.76]. CONCLUSIONS: Inertial sensors may offer a feasible mechanism to objectively measure clinically-relevant gait abnormalities in HD. Title: Objective Measurement of Gait Abnormalities in Huntington Disease using a Shoe-Worn Inertial Sensor (P5.291) Author: Hogarth, Penelope, Lenahan, Arthur, Portillo, Alicia, Ramachandran, Ravi, Stenson, Katie, Legedza, Anna, Botfield, Martyn, Horak, Fay, McNames, James, El-Gohary, Mahmoud Ahmed Year: 2015 OBJECTIVE: To evaluate the feasibility and utility of a shoe-worn inertial sensor to measure gait abnormalities in Huntington disease (HD) in the home setting. BACKGROUND: Clinical rating scales provide only point assessments of disease-related impairments in HD, lack sensitivity, and require that a clinician experienced in the scale’s use evaluate the patient. A tool that would allow longitudinal, objective, quantitative measurement of impairments may offer advantages over standard clinical rating scales. DESIGN/METHODS: This was a pilot, single-blind, controlled observational study. Five ambulatory HD subjects and 5 age/gender-matched healthy controls wore inertial sensors manufactured by APDM, Inc. attached to each shoe during waking hours for 7 days. Gait parameters calculated from the sensors included stride length([percnt]height); stride velocity([percnt]height/sec); step duration(sec); double support time([percnt]); pitch at toe off (degrees) and heel strike (degrees); cadence(steps/min); and variability in each of these measures. Following blinded descriptive data analysis by APDM, independent samples t-tests were used to compare means for selected gait metrics between HD and control subjects, and Pearson correlation coefficients were used to interrogate the relationships between gait metrics, chorea score, and Total Functional Capacity (TFC, a measure of disease severity). RESULTS: Subjects were able to successfully apply, wear and charge the sensors. Blinded gait analysis correctly identified the HD and control subjects for 4/5 pairs. Significant differences were found between HD/control groups in mean(SD) stride length [53.96(9.25), 67.68(7.25), p=0.03]; mean(SD) variability per week (as measured by coefficient of variation) in stride length [28.57(5.54), 20.27(3.78), p=0.02] and pitch at toe off [25.57(4.00), 17.56(4.07), p=0.01]. Lower TFC scores correlated with greater variability in stride length[R=-0.82]; pitch at toe off[R=-0.80]; and increased double support time[R=-0.75]. Higher chorea scores correlated with shorter stride length[R=-0.76]. CONCLUSIONS: Inertial sensors may offer a feasible mechanism to objectively measure clinically-relevant gait abnormalities in HD. Close

• 654. [Article] Early Childhood Educators' Perception of Oregon's Professional Development System: A Hermeneutic Phenomenological Study

  Since 2011, the state of Oregon has embarked on a comprehensive educational policy change to create a unified birth to twenty educational system. As part of the birth to age five early childhood and family ...

  Citation × Citation Citation Abstract Copy Title: Early Childhood Educators' Perception of Oregon's Professional Development System: A Hermeneutic Phenomenological Study Author: Anderson, Ingrid Mari Year: 2014 Since 2011, the state of Oregon has embarked on a comprehensive educational policy change to create a unified birth to twenty educational system. As part of the birth to age five early childhood and family investment strategy, mandated participation in Oregon professional development system is required for all early childhood educators working in Office of Child Care licensed programs. To date, research on early childhood educators' experience in professional development systems has focused primarily on experiences with regulatory systems. This hermeneutic phenomenological study explored how four early childhood educators made meaning of their experiences of professional engagement in Oregon's state professional development system. As a researcher-participant, I conducted a two-part interview with these early childhood educators. First, we revisited the experience of the professional development journey in collage, followed by narrative semi-structured interviews. The researcher employed Dahlberg's (2006) concept of "bridling the experience" (p. 16) as a way to develop an understanding of early childhood educators' professional practice and the intersection between practice and professional engagement in Oregon's professional development system for childhood care and education. The collage and narrative dialogues illuminated the essence of each individual's experience. Experiences such as the intersection of personal professional self, acts of professional engagement, and the emotional nature of participants' work all emerged from the collage and interview process. Three essential themes emerged from the data interpretation and discussion, namely, (a)Personal and Professional Self: Intertwining Personal Experience and Professional Identity, (b)Curves Ahead: Maneuvering Rivers, Roads, and Paths, and (c)The Journey and the System are Asynchronous: "You Guys Figure that Out, Good Luck." Through the emergence of essential themes, participants demonstrated that their experiences while unique also shared common characteristics of what it means to be an early childhood educator in Oregon living with policy in the classroom. It is now the turn of policy makers and program managers of Oregon's professional development system to recognize the strength and wisdom of the voices in the early childhood classroom. Title: Early Childhood Educators' Perception of Oregon's Professional Development System: A Hermeneutic Phenomenological Study Author: Anderson, Ingrid Mari Year: 2014 Since 2011, the state of Oregon has embarked on a comprehensive educational policy change to create a unified birth to twenty educational system. As part of the birth to age five early childhood and family investment strategy, mandated participation in Oregon professional development system is required for all early childhood educators working in Office of Child Care licensed programs. To date, research on early childhood educators' experience in professional development systems has focused primarily on experiences with regulatory systems. This hermeneutic phenomenological study explored how four early childhood educators made meaning of their experiences of professional engagement in Oregon's state professional development system. As a researcher-participant, I conducted a two-part interview with these early childhood educators. First, we revisited the experience of the professional development journey in collage, followed by narrative semi-structured interviews. The researcher employed Dahlberg's (2006) concept of "bridling the experience" (p. 16) as a way to develop an understanding of early childhood educators' professional practice and the intersection between practice and professional engagement in Oregon's professional development system for childhood care and education. The collage and narrative dialogues illuminated the essence of each individual's experience. Experiences such as the intersection of personal professional self, acts of professional engagement, and the emotional nature of participants' work all emerged from the collage and interview process. Three essential themes emerged from the data interpretation and discussion, namely, (a)Personal and Professional Self: Intertwining Personal Experience and Professional Identity, (b)Curves Ahead: Maneuvering Rivers, Roads, and Paths, and (c)The Journey and the System are Asynchronous: "You Guys Figure that Out, Good Luck." Through the emergence of essential themes, participants demonstrated that their experiences while unique also shared common characteristics of what it means to be an early childhood educator in Oregon living with policy in the classroom. It is now the turn of policy makers and program managers of Oregon's professional development system to recognize the strength and wisdom of the voices in the early childhood classroom. Close

• 655. [Article] Adjustment to College among Lower Division Students with Disabilities: An Exploratory Study

  This study utilized a quality of life framework of psychosocial adaptation to explore relationships among college stress, functional limitations, coping strategies, and perceived social support in adjustment ...

  Citation × Citation Citation Abstract Copy Title: Adjustment to College among Lower Division Students with Disabilities: An Exploratory Study Author: McNulty, Kristy Lee Ann Year: 2014 This study utilized a quality of life framework of psychosocial adaptation to explore relationships among college stress, functional limitations, coping strategies, and perceived social support in adjustment to college among first-year and second-year undergraduate students with disabilities, based on specific hypothesized relations. College adjustment outcomes included: life satisfaction, academic performance, and psychosocial-emotional adjustment to college. A nonprobability sample of 103 first-year and second-year undergraduate college students with disabilities participated in the study. Respondents were registered with an office of support services for students with disabilities at a public, four-year university, located in the Pacific Northwest of the United States. Respondents were recruited by responding to an e-mail requesting participation in an online, web-based survey. Eight self-report measures included: (a) Participant Survey (developed by the researcher to collect socio-demographic information, (b) College Stress Inventory (CSI; Solberg, Hale, Villarreal, & Kavanagh, 1993), (c) Disability Functional Limitations Scale (DFLS) (developed by the researcher), (d) Brief COPE; Carver, 1997, (e) Social Support Appraisals-Revised (SSA-R) scale; Vaux et al., 1986), (f) Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985), (g) Grade Point Average-Scale (GPA-S; adapted by the researcher from a self-reported grading scale), and (h) Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1999). Data were analyzed using descriptive and correlational procedures. Bivariate analysis suggested that all predictor variables (i.e., college stress, functional limitations, engagement coping, and perceived social support) were significantly associated with student adjustment to college. Hierarchical multiple regression suggested mostly direct (i.e., main) effects for engagement coping and perceived social support. No interacting role for either engagement-type coping or perceived social support was suggested, except for the following: Engagement-type coping moderated the relationship between disability-related functional limitations (as measured by increased restrictions in the ability to perform daily routines, activities, and life roles) and adaptation to college, as measured by life satisfaction. Analyses of socio-demographic variables revealed significant associations between chronological age, gender, hours employed, and adjustment to college. Lastly, hierarchical multiple regression analysis revealed disengagement coping accounting for as much as 53% of the variance in adjustment scores. This result suggested disengagement coping adding significant predictive utility for adaptation-associated college adjustment. In light of these findings, counseling professionals may wish to consider the beneficial role of engagement coping in promoting optimal adjustment to college for lower-division undergraduate students with disabilities. Title: Adjustment to College among Lower Division Students with Disabilities: An Exploratory Study Author: McNulty, Kristy Lee Ann Year: 2014 This study utilized a quality of life framework of psychosocial adaptation to explore relationships among college stress, functional limitations, coping strategies, and perceived social support in adjustment to college among first-year and second-year undergraduate students with disabilities, based on specific hypothesized relations. College adjustment outcomes included: life satisfaction, academic performance, and psychosocial-emotional adjustment to college. A nonprobability sample of 103 first-year and second-year undergraduate college students with disabilities participated in the study. Respondents were registered with an office of support services for students with disabilities at a public, four-year university, located in the Pacific Northwest of the United States. Respondents were recruited by responding to an e-mail requesting participation in an online, web-based survey. Eight self-report measures included: (a) Participant Survey (developed by the researcher to collect socio-demographic information, (b) College Stress Inventory (CSI; Solberg, Hale, Villarreal, & Kavanagh, 1993), (c) Disability Functional Limitations Scale (DFLS) (developed by the researcher), (d) Brief COPE; Carver, 1997, (e) Social Support Appraisals-Revised (SSA-R) scale; Vaux et al., 1986), (f) Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985), (g) Grade Point Average-Scale (GPA-S; adapted by the researcher from a self-reported grading scale), and (h) Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1999). Data were analyzed using descriptive and correlational procedures. Bivariate analysis suggested that all predictor variables (i.e., college stress, functional limitations, engagement coping, and perceived social support) were significantly associated with student adjustment to college. Hierarchical multiple regression suggested mostly direct (i.e., main) effects for engagement coping and perceived social support. No interacting role for either engagement-type coping or perceived social support was suggested, except for the following: Engagement-type coping moderated the relationship between disability-related functional limitations (as measured by increased restrictions in the ability to perform daily routines, activities, and life roles) and adaptation to college, as measured by life satisfaction. Analyses of socio-demographic variables revealed significant associations between chronological age, gender, hours employed, and adjustment to college. Lastly, hierarchical multiple regression analysis revealed disengagement coping accounting for as much as 53% of the variance in adjustment scores. This result suggested disengagement coping adding significant predictive utility for adaptation-associated college adjustment. In light of these findings, counseling professionals may wish to consider the beneficial role of engagement coping in promoting optimal adjustment to college for lower-division undergraduate students with disabilities. Close

• 656. [Article] The force of manhood: The consequences of masculinity threat on police officer use of force

  Positive community-police relations, which are based on mutual trust, are key to equitable and just policing. Use of force that is perceived as unfair and biased can quickly undermine relations between ...

  Citation × Citation Citation Abstract Copy Title: The force of manhood: The consequences of masculinity threat on police officer use of force Author: Alston, Aurelia Terese Year: 2017 Positive community-police relations, which are based on mutual trust, are key to equitable and just policing. Use of force that is perceived as unfair and biased can quickly undermine relations between the police and the public. In an attempt to understand what psychological factors contribute to police use of force decisions and potentially racially biased use of force application, this study proposed masculinity threat as an important psychological factor that influences police behavior. Masculinity threat occurs when a man's status as a man is threatened, and threats to masculinity are often associated with increased aggression and dominance as a way of restoring the threatened status. Policing is a male-dominated field, and because most victims of officer use of force are men, the current research examines how threats to male police officers' masculinity, including verbal and physical manifestations of threat, contribute to officer force against civilians. Past research has explored how high levels of trait masculinity threat (as measured by the Male Gender Role Stress scale; Goff, Martin, & Gamson-Smiedt, 2012) in police officers is associated with higher levels of force against racial minority suspects, however, no such research has examined state level masculinity threat (e.g., in the moment threats) as they occur in real world police-suspect interactions. Focusing on understanding the associations between use of force and state level masculinity threat, it was predicted that officers who have their masculinity explicitly and publicly threatened by male suspects will use more force against suspects compared to interactions where no such masculinity threat has occurred. It was also predicted that minority suspects who threaten officers' masculinity will receive more force than White suspects. To test these hypotheses, reporting officers' (RO) narratives of use of force interactions (excluding lethal force) from a large police department on the West Coast were coded and analyzed. Contrary to the hypotheses, results suggest that masculinity threat within an officer-suspect interaction may relate to lower levels of average officer force and higher number of sequences (e.g., back and forth exchanges) between suspect and officer. While results are in the opposite direction of the hypotheses, they provide new information regarding the association between personal threats to officer manhood and their subsequent actions. Specifically, results suggest that masculinity threat has a more complicated relationship with force than previously predicted and future research would do well to investigate a potential interaction effect of trait level and state level masculinity on police use of force decisions. Several other areas of further research are outlined, such as the need to examine other suspect-level and officer-level variables such as age and tenure. Overall, the results of this study suggest the need for continued clarifying research. Title: The force of manhood: The consequences of masculinity threat on police officer use of force Author: Alston, Aurelia Terese Year: 2017 Positive community-police relations, which are based on mutual trust, are key to equitable and just policing. Use of force that is perceived as unfair and biased can quickly undermine relations between the police and the public. In an attempt to understand what psychological factors contribute to police use of force decisions and potentially racially biased use of force application, this study proposed masculinity threat as an important psychological factor that influences police behavior. Masculinity threat occurs when a man's status as a man is threatened, and threats to masculinity are often associated with increased aggression and dominance as a way of restoring the threatened status. Policing is a male-dominated field, and because most victims of officer use of force are men, the current research examines how threats to male police officers' masculinity, including verbal and physical manifestations of threat, contribute to officer force against civilians. Past research has explored how high levels of trait masculinity threat (as measured by the Male Gender Role Stress scale; Goff, Martin, & Gamson-Smiedt, 2012) in police officers is associated with higher levels of force against racial minority suspects, however, no such research has examined state level masculinity threat (e.g., in the moment threats) as they occur in real world police-suspect interactions. Focusing on understanding the associations between use of force and state level masculinity threat, it was predicted that officers who have their masculinity explicitly and publicly threatened by male suspects will use more force against suspects compared to interactions where no such masculinity threat has occurred. It was also predicted that minority suspects who threaten officers' masculinity will receive more force than White suspects. To test these hypotheses, reporting officers' (RO) narratives of use of force interactions (excluding lethal force) from a large police department on the West Coast were coded and analyzed. Contrary to the hypotheses, results suggest that masculinity threat within an officer-suspect interaction may relate to lower levels of average officer force and higher number of sequences (e.g., back and forth exchanges) between suspect and officer. While results are in the opposite direction of the hypotheses, they provide new information regarding the association between personal threats to officer manhood and their subsequent actions. Specifically, results suggest that masculinity threat has a more complicated relationship with force than previously predicted and future research would do well to investigate a potential interaction effect of trait level and state level masculinity on police use of force decisions. Several other areas of further research are outlined, such as the need to examine other suspect-level and officer-level variables such as age and tenure. Overall, the results of this study suggest the need for continued clarifying research. Close

• 657. [Article] Understanding Biliteracy: Exploring the Lived Experiences of Bilingual Reading Specialists

  Over the past 20 years, the United States has seen a rapid increase in school age students entering PK-12 schools for whom English is not their primary home language. These students are known as English ...

  Citation × Citation Citation Abstract Copy Title: Understanding Biliteracy: Exploring the Lived Experiences of Bilingual Reading Specialists Author: Cevallos, Tatiana Margarita Year: 2014 Over the past 20 years, the United States has seen a rapid increase in school age students entering PK-12 schools for whom English is not their primary home language. These students are known as English learners (ELs). In Oregon, 77% of ELs speak Spanish and constitute the largest minority group, 21% of the total K-12 student enrollment in 2011-2012. With such potential for bilingualism in schools, bilingual teachers should be prepared to teach biliteracy effectively, especially in the early school years when students learn to read. There is an increasing demand for bilingual teachers in Oregon each year to teach in bilingual programs, particularly at the primary grade levels. However, for the most part, the emphasis of instruction and teacher preparation is on developing student English skills rather than supporting bilingualism (Flores, Sheets, & Clark, 2011; Macedo, Dendrinos, & Gounari, 2003; Wink, 2005). There is a need in Oregon to effectively prepare bilingual teachers who can help Spanish-speaking students develop biliteracy skills in the early grades. The purpose of this qualitative phenomenological study was to explore in depth the lived experiences among Oregon bilingual reading specialists in relation to biliteracy. The research question was "How do bilingual reading specialists understand the phenomena of teaching biliteracy to bilingual students?" Three themes emerged from the interviews conducted: collaboration, language and caring. The insights gained from the lived experiences of bilingual reading specialists can allow teacher educators, school district personnel, and state policy makers to better understand the phenomenon of developing biliteracy and change the way we prepare bilingual teachers in Oregon regarding biliteracy pedagogy. Recommendations are offered for stakeholders, such as the need to include courses in biliteracy as part of the initial teaching license, deliver courses in Spanish, and provide practicum experiences that prepare bilingual teachers and reading specialists to collaborate with colleagues and families. Also, it is important that some of the strategies identified at the state level as part of the English Learner Strategic Plan specifically focus on biliteracy and dual language programs. Title: Understanding Biliteracy: Exploring the Lived Experiences of Bilingual Reading Specialists Author: Cevallos, Tatiana Margarita Year: 2014 Over the past 20 years, the United States has seen a rapid increase in school age students entering PK-12 schools for whom English is not their primary home language. These students are known as English learners (ELs). In Oregon, 77% of ELs speak Spanish and constitute the largest minority group, 21% of the total K-12 student enrollment in 2011-2012. With such potential for bilingualism in schools, bilingual teachers should be prepared to teach biliteracy effectively, especially in the early school years when students learn to read. There is an increasing demand for bilingual teachers in Oregon each year to teach in bilingual programs, particularly at the primary grade levels. However, for the most part, the emphasis of instruction and teacher preparation is on developing student English skills rather than supporting bilingualism (Flores, Sheets, & Clark, 2011; Macedo, Dendrinos, & Gounari, 2003; Wink, 2005). There is a need in Oregon to effectively prepare bilingual teachers who can help Spanish-speaking students develop biliteracy skills in the early grades. The purpose of this qualitative phenomenological study was to explore in depth the lived experiences among Oregon bilingual reading specialists in relation to biliteracy. The research question was "How do bilingual reading specialists understand the phenomena of teaching biliteracy to bilingual students?" Three themes emerged from the interviews conducted: collaboration, language and caring. The insights gained from the lived experiences of bilingual reading specialists can allow teacher educators, school district personnel, and state policy makers to better understand the phenomenon of developing biliteracy and change the way we prepare bilingual teachers in Oregon regarding biliteracy pedagogy. Recommendations are offered for stakeholders, such as the need to include courses in biliteracy as part of the initial teaching license, deliver courses in Spanish, and provide practicum experiences that prepare bilingual teachers and reading specialists to collaborate with colleagues and families. Also, it is important that some of the strategies identified at the state level as part of the English Learner Strategic Plan specifically focus on biliteracy and dual language programs. Close

• 658. [Article] Household Water Insecurity, Missed Schooling, and the Mediating role of Caregiver Depression in Rural Uganda

  Background: School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for ...

  Citation × Citation Citation Abstract Copy Title: Household Water Insecurity, Missed Schooling, and the Mediating role of Caregiver Depression in Rural Uganda Author: Cooper-Vince, Christine E., Kakuhikire, Bernard, Vořechovská, Dagmar, McDonough, Amy Q., Perkins, Jessica M., Venkataramani, Atheendar S., Mushavi, Rumbidzai, Baguma, C., Ashaba, Scholastic, Bangsberg, David, Tsai, Alexander C. Year: 2017 Background: School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children’s water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations. Method: We conducted a population-based, cross-sectional study of female household heads (N = 257) and their children ages 5–17 (N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression. Results: Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls. Conclusions: Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth. Title: Household Water Insecurity, Missed Schooling, and the Mediating role of Caregiver Depression in Rural Uganda Author: Cooper-Vince, Christine E., Kakuhikire, Bernard, Vořechovská, Dagmar, McDonough, Amy Q., Perkins, Jessica M., Venkataramani, Atheendar S., Mushavi, Rumbidzai, Baguma, C., Ashaba, Scholastic, Bangsberg, David, Tsai, Alexander C. Year: 2017 Background: School attendance rates in sub-Saharan Africa are among the lowest worldwide, placing children at heightened risk for poor educational and economic outcomes. One understudied risk factor for missed schooling is household water insecurity, which is linked to depression among women and may increase children’s water-fetching burden at the expense of educational activities, particularly among children of depressed caregivers. In this study conducted in rural Uganda, we assessed the association between household water insecurity and child school participation and the mediating pathways behind these associations. Method: We conducted a population-based, cross-sectional study of female household heads (N = 257) and their children ages 5–17 (N = 551) in the rural regions surrounding the town of Mbarara, in southwestern Uganda. We used multivariable linear regressions to estimate the association between water insecurity and missed schooling. We then assessed the extent to which the association was mediated by caregiver depression. Results: Among children, water insecurity had a statistically significant association with the number of missed school days (a standard deviation increase in water insecurity resulted in 0.30 more missed school days in the last week). The estimated association was partially mediated by caregiver depression. When stratified by sex, this mediating pathway remained significant for boys, but not among girls. Conclusions: Water insecurity is a risk factor for missed schooling among children in rural Uganda. Caregiver depression partially mediated this relationship. Also addressing caregiver mental health in water insecure families may more fully address the needs of sub-Saharan African families and promote educational participation among youth. Close

• 659. [Article] Study Design of a Cluster-Randomized Controlled Trial to Evaluate a Large-scale Distribution of Cook Stoves and Water Filters in Western Province, Rwanda

  Background: In Rwanda, pneumonia and diarrhea are the first and second leading causes of death, respectively, among children under five. Household air pollution (HAP) resultant from cooking indoors with ...

  Citation × Citation Citation Abstract Copy Title: Study Design of a Cluster-Randomized Controlled Trial to Evaluate a Large-scale Distribution of Cook Stoves and Water Filters in Western Province, Rwanda Author: Nagel, Corey L., Kirby, Miles, Zambrano, Laura D., Rosa, Ghislaine, Barstow, Christina K., Thomas, Evan A., Clasen, Thomas Year: 2016 Background: In Rwanda, pneumonia and diarrhea are the first and second leading causes of death, respectively, among children under five. Household air pollution (HAP) resultant from cooking indoors with biomass fuels on traditional stoves is a significant risk factor for pneumonia, while consumption of contaminated drinking water is a primary cause of diarrheal disease. To date, there have been no largescale effectiveness trials of programmatic efforts to provide either improved cookstoves or household water filters at scale in a low-income country. In this paper we describe the design of a clusterrandomized trial to evaluate the impact of a national-level program to distribute and promote the use of improved cookstoves and advanced water filters to the poorest quarter of households in Rwanda. Methods/Design: We randomly allocated 72 sectors (administratively defined units) in Western Province to the intervention, with the remaining 24 sectors in the province serving as controls. In the intervention sectors, roughly 100,000 households received improved cookstoves and household water filters through a government-sponsored program targeting the poorest quarter of households nationally. The primary outcome measures are the incidence of acute respiratory infection (ARI) and diarrhea among children under five years of age. Over a one-year surveillance period, all cases of acute respiratory infection (ARI) and diarrhea identified by health workers in the study area will be extracted from records maintained at health facilities and by community health workers (CHW). In addition, we are conducting intensive, longitudinal data collection among a random sample of households in the study area for in-depth assessment of coverage, use, environmental exposures, and additional health measures. Discussion: Although previous research has examined the impact of providing household water treatment and improved cookstoves on child health, there have been no studies of national-level programs to deliver these interventions at scale in a developing country. The results of this study, the first RCT of a large-scale programmatic cookstove or household water filter intervention, will inform global efforts to reduce childhood morbidity and mortality from diarrheal disease and pneumonia. Title: Study Design of a Cluster-Randomized Controlled Trial to Evaluate a Large-scale Distribution of Cook Stoves and Water Filters in Western Province, Rwanda Author: Nagel, Corey L., Kirby, Miles, Zambrano, Laura D., Rosa, Ghislaine, Barstow, Christina K., Thomas, Evan A., Clasen, Thomas Year: 2016 Background: In Rwanda, pneumonia and diarrhea are the first and second leading causes of death, respectively, among children under five. Household air pollution (HAP) resultant from cooking indoors with biomass fuels on traditional stoves is a significant risk factor for pneumonia, while consumption of contaminated drinking water is a primary cause of diarrheal disease. To date, there have been no largescale effectiveness trials of programmatic efforts to provide either improved cookstoves or household water filters at scale in a low-income country. In this paper we describe the design of a clusterrandomized trial to evaluate the impact of a national-level program to distribute and promote the use of improved cookstoves and advanced water filters to the poorest quarter of households in Rwanda. Methods/Design: We randomly allocated 72 sectors (administratively defined units) in Western Province to the intervention, with the remaining 24 sectors in the province serving as controls. In the intervention sectors, roughly 100,000 households received improved cookstoves and household water filters through a government-sponsored program targeting the poorest quarter of households nationally. The primary outcome measures are the incidence of acute respiratory infection (ARI) and diarrhea among children under five years of age. Over a one-year surveillance period, all cases of acute respiratory infection (ARI) and diarrhea identified by health workers in the study area will be extracted from records maintained at health facilities and by community health workers (CHW). In addition, we are conducting intensive, longitudinal data collection among a random sample of households in the study area for in-depth assessment of coverage, use, environmental exposures, and additional health measures. Discussion: Although previous research has examined the impact of providing household water treatment and improved cookstoves on child health, there have been no studies of national-level programs to deliver these interventions at scale in a developing country. The results of this study, the first RCT of a large-scale programmatic cookstove or household water filter intervention, will inform global efforts to reduce childhood morbidity and mortality from diarrheal disease and pneumonia. Close

• 660. [Article] From the Psychosis Prodrome to the First-episode of Psychosis: No Evidence of a Cognitive Decline

  Cognitive deficits have an important role in the neurodevelopment of schizophrenia and other psychotic disorders. However, there is a continuing debate as to whether cognitive impairments in the psychosis ...

  Citation × Citation Citation Abstract Copy Title: From the Psychosis Prodrome to the First-episode of Psychosis: No Evidence of a Cognitive Decline Author: Carrion, Ricardo E., Walder, Deborah J., Auther, Andrea M., McLaughlin, Danielle, Zyla, Heather O., Adelsheim, Steven, Calkins, Roderick, Carter, Cameron S., McFarland, Bentson, Melton, Ryan, Niendam, Tara, Ragland, J. Daniel, Sale, Tamara G., Taylor, Stephan F., McFarlane, William, Cornblatt, Barbara A. Year: 2018 Cognitive deficits have an important role in the neurodevelopment of schizophrenia and other psychotic disorders. However, there is a continuing debate as to whether cognitive impairments in the psychosis prodrome are stable predictors of eventual psychosis or undergo a decline due to the onset of psychosis. In the present study, to determine how cognition changes as illness emerges, we examined baseline neurocognitive performance in a large sample of helping-seeking youth ranging in clinical state from low-risk for psychosis through individuals at clinical high-risk (CHR) for illness to early first-episode patients (EFEP). At baseline, the MATRICS Cognitive Consensus battery was administered to 322 individuals (205 CHRs, 28 EFEPs, and 89 help-seeking controls, HSC) that were part of the larger Early Detection, Intervention and Prevention of Psychosis Program study. CHR individuals were further divided into those who did (CHR-T; n = 12, 6.8%) and did not (CHR-NT, n = 163) convert to psychosis over follow-up (Mean = 99.20 weeks, SD = 21.54). ANCOVAs revealed that there were significant overall group differences (CHR, EFEP, HSC) in processing speed, verbal learning, and overall neurocognition, relative to healthy controls (CNTL). In addition, the CHR-NTs performed similarly to the HSC group, with mild to moderate cognitive deficits relative to the CTRL group. The CHR-Ts mirrored the EFEP group, with large deficits in processing speed, working memory, attention/vigilance, and verbal learning (>1 SD below CNTLs). Interestingly, only verbal learning impairments predicted transition to psychosis, when adjusting for age, education, symptoms, antipsychotic medication, and neurocognitive performance in the other domains. Our findings suggest that large neurocognitive deficits are present prior to illness onset and represent vulnerability markers for psychosis. The results of this study further reinforce that verbal learning should be specifically targeted for preventive intervention for psychosis. Title: From the Psychosis Prodrome to the First-episode of Psychosis: No Evidence of a Cognitive Decline Author: Carrion, Ricardo E., Walder, Deborah J., Auther, Andrea M., McLaughlin, Danielle, Zyla, Heather O., Adelsheim, Steven, Calkins, Roderick, Carter, Cameron S., McFarland, Bentson, Melton, Ryan, Niendam, Tara, Ragland, J. Daniel, Sale, Tamara G., Taylor, Stephan F., McFarlane, William, Cornblatt, Barbara A. Year: 2018 Cognitive deficits have an important role in the neurodevelopment of schizophrenia and other psychotic disorders. However, there is a continuing debate as to whether cognitive impairments in the psychosis prodrome are stable predictors of eventual psychosis or undergo a decline due to the onset of psychosis. In the present study, to determine how cognition changes as illness emerges, we examined baseline neurocognitive performance in a large sample of helping-seeking youth ranging in clinical state from low-risk for psychosis through individuals at clinical high-risk (CHR) for illness to early first-episode patients (EFEP). At baseline, the MATRICS Cognitive Consensus battery was administered to 322 individuals (205 CHRs, 28 EFEPs, and 89 help-seeking controls, HSC) that were part of the larger Early Detection, Intervention and Prevention of Psychosis Program study. CHR individuals were further divided into those who did (CHR-T; n = 12, 6.8%) and did not (CHR-NT, n = 163) convert to psychosis over follow-up (Mean = 99.20 weeks, SD = 21.54). ANCOVAs revealed that there were significant overall group differences (CHR, EFEP, HSC) in processing speed, verbal learning, and overall neurocognition, relative to healthy controls (CNTL). In addition, the CHR-NTs performed similarly to the HSC group, with mild to moderate cognitive deficits relative to the CTRL group. The CHR-Ts mirrored the EFEP group, with large deficits in processing speed, working memory, attention/vigilance, and verbal learning (>1 SD below CNTLs). Interestingly, only verbal learning impairments predicted transition to psychosis, when adjusting for age, education, symptoms, antipsychotic medication, and neurocognitive performance in the other domains. Our findings suggest that large neurocognitive deficits are present prior to illness onset and represent vulnerability markers for psychosis. The results of this study further reinforce that verbal learning should be specifically targeted for preventive intervention for psychosis. Close