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• 1. [Article] A study of psoriasis : a methodological critique

  According to the National Psoriasis Foundation (1976), psoriasis is a little known and poorly understood skin disease afflicting an estimated eight million victims in the United States. About fifteen thousand ...

  Citation × Citation Citation Abstract Copy Title: A study of psoriasis : a methodological critique Author: Ford, Prudence Craig, Ford, Roberta Jeanne, Swanson, Susan Year: 1979 According to the National Psoriasis Foundation (1976), psoriasis is a little known and poorly understood skin disease afflicting an estimated eight million victims in the United States. About fifteen thousand new cases of psoriasis are diagnosed each year. It affects men and women in equal numbers at any age, most often between the ages of fifteen and thirty-five. Title: A study of psoriasis : a methodological critique Author: Ford, Prudence Craig, Ford, Roberta Jeanne, Swanson, Susan Year: 1979 According to the National Psoriasis Foundation (1976), psoriasis is a little known and poorly understood skin disease afflicting an estimated eight million victims in the United States. About fifteen thousand new cases of psoriasis are diagnosed each year. It affects men and women in equal numbers at any age, most often between the ages of fifteen and thirty-five. Close

• 2. [Article] Impacts of Early Sexual Experience and Associated Risk of Sexually Transmitted Infection (STI) among Teens and Adults in the United States

  This analysis explores incidence rates of sexually transmitted infections (STIs) among minority group teenagers (aged 15-19) and adults aged 20-34 in the United States. The primary research question is ...

  Citation × Citation Citation Abstract Copy Title: Impacts of Early Sexual Experience and Associated Risk of Sexually Transmitted Infection (STI) among Teens and Adults in the United States Author: Garcia-Alexander, Ginny Year: 2008 This analysis explores incidence rates of sexually transmitted infections (STIs) among minority group teenagers (aged 15-19) and adults aged 20-34 in the United States. The primary research question is aimed at whether or not the early onset of sexual activity is directly related to the incidence of STI transmission among Americans. Discussion is given to the current literature with respect to the most recent trends in STIs as well as some historical background on classifications. Also examined are the differing impacts observed for those who are affected by bacterial infections (young minorities) and those who are affected by viral infections (majority group members with higher levels of education). The National Survey of Family Growth, Cycle 6, 2002 was used to obtain descriptive results presented in the form of tabular representations and logistic regressions that model the likelihood of contracting an STI for both teens and adults. Title: Impacts of Early Sexual Experience and Associated Risk of Sexually Transmitted Infection (STI) among Teens and Adults in the United States Author: Garcia-Alexander, Ginny Year: 2008 This analysis explores incidence rates of sexually transmitted infections (STIs) among minority group teenagers (aged 15-19) and adults aged 20-34 in the United States. The primary research question is aimed at whether or not the early onset of sexual activity is directly related to the incidence of STI transmission among Americans. Discussion is given to the current literature with respect to the most recent trends in STIs as well as some historical background on classifications. Also examined are the differing impacts observed for those who are affected by bacterial infections (young minorities) and those who are affected by viral infections (majority group members with higher levels of education). The National Survey of Family Growth, Cycle 6, 2002 was used to obtain descriptive results presented in the form of tabular representations and logistic regressions that model the likelihood of contracting an STI for both teens and adults. Close

• 3. [Article] Trends and Disparities in Postpartum Sterilization following C-Section, 2000-2008

  Objectives. We examined variations in the prevalence of postpartum tubal sterilizations following cesarean sections (C-sections) from 2000 to 2008. Methods. We used data from the National Hospital Discharge ...

  Citation × Citation Citation Abstract Copy Title: Trends and Disparities in Postpartum Sterilization following C-Section, 2000-2008 Author: Garcia-Alexander, Ginny, Richardson, Dawn, Gonzales, Kelly, Cuevas, Adolfo Gabriel Year: 2015 Objectives. We examined variations in the prevalence of postpartum tubal sterilizations following cesarean sections (C-sections) from 2000 to 2008. Methods. We used data from the National Hospital Discharge Survey (NHDS) to estimate odds ratios for patient- (race, marital status, age) and system-level factors (hospital size, type, region) on the likelihood of receiving tubal sterilization after C-section. Results. A disproportionate share of postpartum tubal sterilizations following C-section was covered by Medicaid. The likelihood of undergoing sterilization was increased for Black women, women of older age, and non-single women. Additionally, they were increased in proprietary and government hospitals, smaller hospital settings, and the Midwest and Southern regions of the country. Conclusions. This adds to the growing body of evidence that suggests that tubal sterilization is a disparity issue patterned by multiple factors and calls for greater understanding of the role of patient-, provider-, and system-level characteristics. Title: Trends and Disparities in Postpartum Sterilization following C-Section, 2000-2008 Author: Garcia-Alexander, Ginny, Richardson, Dawn, Gonzales, Kelly, Cuevas, Adolfo Gabriel Year: 2015 Objectives. We examined variations in the prevalence of postpartum tubal sterilizations following cesarean sections (C-sections) from 2000 to 2008. Methods. We used data from the National Hospital Discharge Survey (NHDS) to estimate odds ratios for patient- (race, marital status, age) and system-level factors (hospital size, type, region) on the likelihood of receiving tubal sterilization after C-section. Results. A disproportionate share of postpartum tubal sterilizations following C-section was covered by Medicaid. The likelihood of undergoing sterilization was increased for Black women, women of older age, and non-single women. Additionally, they were increased in proprietary and government hospitals, smaller hospital settings, and the Midwest and Southern regions of the country. Conclusions. This adds to the growing body of evidence that suggests that tubal sterilization is a disparity issue patterned by multiple factors and calls for greater understanding of the role of patient-, provider-, and system-level characteristics. Close

• 4. [Article] Black Women's Health: A Content Analysis of the Journal of the American Medical Association, the American Journal of Public Health, and the New England Journal of Medicine (1989-1998)

  According to the National Vital Statistics Report (1998), Black women age 45-64 are ten times more likely than white women of the same age to die from diseases of the heart. They are five times more likely ...

  Citation × Citation Citation Abstract Copy Title: Black Women's Health: A Content Analysis of the Journal of the American Medical Association, the American Journal of Public Health, and the New England Journal of Medicine (1989-1998) Author: Burkett, Tonia Marie Year: 2003 According to the National Vital Statistics Report (1998), Black women age 45-64 are ten times more likely than white women of the same age to die from diseases of the heart. They are five times more likely to die from diabetes. The goal of this study was to examine how articles published in leading medical journals between 1989 and 1998 accounted for such differences in health outcomes among Black and white women. The explanatory content of the articles was analyzed and coded according to four types of attributions: genetic/biological, cultural/behavioral, structural/socioeconomic and alternative. Each type of explanation derives from different assumptions and operates with different models for understanding why health outcomes vary among groups. Alternative explanations are those that focus on the direct effect of race/gender oppression on Black women's health. Genetic/biological attributions occurred less frequently than structural/socioeconomic and cultural behavioral but were more likely to occur than alternative attributions, which were the least often employed. While alternative attributions are considered in some of the articles about Black women's health and mortality, they are overall rarely employed. The finding that explanations that most directly explore the impact of racism and sexism on Black women's health occur least often has important implications. Articles published in these three journals inform medical practitioners and affect the ability of such practitioners to adequately address the needs of Black women in their care. Title: Black Women's Health: A Content Analysis of the Journal of the American Medical Association, the American Journal of Public Health, and the New England Journal of Medicine (1989-1998) Author: Burkett, Tonia Marie Year: 2003 According to the National Vital Statistics Report (1998), Black women age 45-64 are ten times more likely than white women of the same age to die from diseases of the heart. They are five times more likely to die from diabetes. The goal of this study was to examine how articles published in leading medical journals between 1989 and 1998 accounted for such differences in health outcomes among Black and white women. The explanatory content of the articles was analyzed and coded according to four types of attributions: genetic/biological, cultural/behavioral, structural/socioeconomic and alternative. Each type of explanation derives from different assumptions and operates with different models for understanding why health outcomes vary among groups. Alternative explanations are those that focus on the direct effect of race/gender oppression on Black women's health. Genetic/biological attributions occurred less frequently than structural/socioeconomic and cultural behavioral but were more likely to occur than alternative attributions, which were the least often employed. While alternative attributions are considered in some of the articles about Black women's health and mortality, they are overall rarely employed. The finding that explanations that most directly explore the impact of racism and sexism on Black women's health occur least often has important implications. Articles published in these three journals inform medical practitioners and affect the ability of such practitioners to adequately address the needs of Black women in their care. Close

• 5. [Article] Two Delivery System Contexts for the Elderly:The "Institutional" Approach and the "Community" Approach.

  Theoretically every society has some institutional means which seeks to prevent and alleviate personal misfortune and illness "Institutions are standardized solutions to collective problems." The increasing ...

  Citation × Citation Citation Abstract Copy Title: Two Delivery System Contexts for the Elderly:The "Institutional" Approach and the "Community" Approach. Author: Freer, Mary Sarita Year: 1973 Theoretically every society has some institutional means which seeks to prevent and alleviate personal misfortune and illness "Institutions are standardized solutions to collective problems." The increasing population rate of older persons, many of whom suffer from chronic diseases and disabilities, does pose a collective problem for society. Formerly, the "institutional" approach developed to address the needs of chronic aging patients and society. Today the "community" approach, by which community service agencies whose goal is to help older adults remain independent of total institutional care by supplying supportive services, is achieving recognition . This thesis is an exploratory study to assess similarities and/or dissimilarities between two distinct groups of elderly persons -- those receiving services in a total institution and those living in the community but receiving supportive services via a community-based delivery system. This delivery system is concerned with supplying human services to those people assumed to be "at risk" of institutional care. It is assumed that the clients of such a system are similar to those persons within an institution. The major purpose of this study is to validate this assumption. If this assumption is proved true , it is thought that it could have important consequences on future policies concerning health-care systems for the aged. Title: Two Delivery System Contexts for the Elderly:The "Institutional" Approach and the "Community" Approach. Author: Freer, Mary Sarita Year: 1973 Theoretically every society has some institutional means which seeks to prevent and alleviate personal misfortune and illness "Institutions are standardized solutions to collective problems." The increasing population rate of older persons, many of whom suffer from chronic diseases and disabilities, does pose a collective problem for society. Formerly, the "institutional" approach developed to address the needs of chronic aging patients and society. Today the "community" approach, by which community service agencies whose goal is to help older adults remain independent of total institutional care by supplying supportive services, is achieving recognition . This thesis is an exploratory study to assess similarities and/or dissimilarities between two distinct groups of elderly persons -- those receiving services in a total institution and those living in the community but receiving supportive services via a community-based delivery system. This delivery system is concerned with supplying human services to those people assumed to be "at risk" of institutional care. It is assumed that the clients of such a system are similar to those persons within an institution. The major purpose of this study is to validate this assumption. If this assumption is proved true , it is thought that it could have important consequences on future policies concerning health-care systems for the aged. Close

• 6. [Article] Bidirectional Associations Between Rheumatoid Arthritis and Depression: a Nationwide Longitudinal Study

  Rheumatoid arthritis (RA) and depression may be associated with each other pathophysiologically, but few studies have been conducted on the interplay between these two diseases using longitudinal measurement. ...

  Citation × Citation Citation Abstract Copy Title: Bidirectional Associations Between Rheumatoid Arthritis and Depression: a Nationwide Longitudinal Study Author: Lu, Ming-Chi, Guo, How-Ran, Lin, Miao-Chiu, Livneh, Hanoch, Lai, Ning-Sheng, Tsai, Tzung-Yi Year: 2016 Rheumatoid arthritis (RA) and depression may be associated with each other pathophysiologically, but few studies have been conducted on the interplay between these two diseases using longitudinal measurement. Therefore, we used the National Health Insurance Research Database of Taiwan to investigate the bidirectional associations between RA and depression. One cohort was included to analyze RA predicting the onset of depression and a second cohort for analysis of depression predicting RA. A sex- and age-matched control group was included for both. The incidence of depression in RA subjects was higher than in non-RA subjects [15.69 vs. 8.95 per 1,000 person-years (PYs)], with an adjusted hazard ratios (HRs) of 1.69 [95% confidence interval (CI), 1.51–1.87]. The incidence of RA was higher in depressed than non-depressed individuals (2.07 vs. 1.21 per 1,000 PYs), with an adjusted HRs of 1.65 (95%CI, 1.41–1.77). This population-based cohort study suggested strong bidirectional relationships between RA and depression. Healthcare providers are recommended to facilitate the implementation of more effective therapeutic interventions to achieve favorable prognosis, especially for those with new-onset or younger cases. Title: Bidirectional Associations Between Rheumatoid Arthritis and Depression: a Nationwide Longitudinal Study Author: Lu, Ming-Chi, Guo, How-Ran, Lin, Miao-Chiu, Livneh, Hanoch, Lai, Ning-Sheng, Tsai, Tzung-Yi Year: 2016 Rheumatoid arthritis (RA) and depression may be associated with each other pathophysiologically, but few studies have been conducted on the interplay between these two diseases using longitudinal measurement. Therefore, we used the National Health Insurance Research Database of Taiwan to investigate the bidirectional associations between RA and depression. One cohort was included to analyze RA predicting the onset of depression and a second cohort for analysis of depression predicting RA. A sex- and age-matched control group was included for both. The incidence of depression in RA subjects was higher than in non-RA subjects [15.69 vs. 8.95 per 1,000 person-years (PYs)], with an adjusted hazard ratios (HRs) of 1.69 [95% confidence interval (CI), 1.51–1.87]. The incidence of RA was higher in depressed than non-depressed individuals (2.07 vs. 1.21 per 1,000 PYs), with an adjusted HRs of 1.65 (95%CI, 1.41–1.77). This population-based cohort study suggested strong bidirectional relationships between RA and depression. Healthcare providers are recommended to facilitate the implementation of more effective therapeutic interventions to achieve favorable prognosis, especially for those with new-onset or younger cases. Close

• 7. [Article] Exploring the Effects of Multi-Level Protective and Risk Factors on Child and Parenting Outcomes in Families Participating in Healthy Start/Healthy Families Oregon (HS/HFO)

  While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical ...

  Citation × Citation Citation Abstract Copy Title: Exploring the Effects of Multi-Level Protective and Risk Factors on Child and Parenting Outcomes in Families Participating in Healthy Start/Healthy Families Oregon (HS/HFO) Author: Nygren, Peggy Year: 2013 While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy Families Oregon (HS/HFO) home visitation program (treatment group) who completed a follow-up phone survey at the child’s 12 month birthday (n = 405). Families were offered HS/HFO services prenatally after meeting risk screening eligibility criteria on the New Baby Questionnaire (NBQ). Program mothers having received at least one home visit (n = 248) were included in the final analyses. Families had an average of 3.1 (SD = 1.2) NBQ risk factors at enrollment and 83% reported having trouble paying for basic needs. Families received an average of 16 home visits in the first 6 months of the program. Thirty-one percent of mothers were aged 19 or younger, 60% were White and Non-Hispanic, 31% were Hispanic, and 9% were another race/ethnicity. Hierarchical regression models with main effects (RFI, PFI, race) and an interaction term (RFI X PFI) were developed to predict eight outcomes. Interaction effects models were not significant. Five RFI main effects were significant: higher RFI scores were associated with greater likelihood of child welfare involvement, greater parenting stress, less favorable scores on child health and well-being, lower parent responsiveness and ii acceptance, and less supportive learning environments. One PFI main effect was significant: higher PFI scores predicted lower parenting stress. A trend level result showed higher PFI scores were associated with less child welfare involvement. Race was significant in two models: White/Non-Hispanic families were more likely to have a home visitor report child welfare involvement and had more frequent parent-child activities compared to other race/ethnicity families. Unpacking the results with separate single risk factor (12 items) and protective factor (10 items) regression models followed. Results showed parent’s prior family history of maltreatment and younger maternal age predicted child welfare involvement (home visitor report), while protection was seen for those with access to housing support. Social support and family functioning protectors were linked to lower parenting stress, while maternal depression showed the opposite finding. Better scores on a child health and well-being measure were seen with higher neighborhood cohesion and greater participation in HS/HFO; in contrast, neighborhood violence and frequent mobility were linked to worse scores. Developmentally supportive home environments were seen for families participating in additional parent support programs, in which the mother had greater knowledge of infant milestones and behavior, and if the family had access to housing supports. Unemployment proved to be associated with less enriched home environments. In summary, there was no support for the cumulative PFI in buffering risk for negative outcomes in this model. The RFI was also a more robust predictor of outcomes compared to the PFI in the main effects models. Overall, study findings provide some evidence for the utility of specific protective factors, as well as cumulative and specific single risk factors, for screening families for effectively targeting services and guiding the conceptual development of program and evaluation formats. Title: Exploring the Effects of Multi-Level Protective and Risk Factors on Child and Parenting Outcomes in Families Participating in Healthy Start/Healthy Families Oregon (HS/HFO) Author: Nygren, Peggy Year: 2013 While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy Families Oregon (HS/HFO) home visitation program (treatment group) who completed a follow-up phone survey at the child’s 12 month birthday (n = 405). Families were offered HS/HFO services prenatally after meeting risk screening eligibility criteria on the New Baby Questionnaire (NBQ). Program mothers having received at least one home visit (n = 248) were included in the final analyses. Families had an average of 3.1 (SD = 1.2) NBQ risk factors at enrollment and 83% reported having trouble paying for basic needs. Families received an average of 16 home visits in the first 6 months of the program. Thirty-one percent of mothers were aged 19 or younger, 60% were White and Non-Hispanic, 31% were Hispanic, and 9% were another race/ethnicity. Hierarchical regression models with main effects (RFI, PFI, race) and an interaction term (RFI X PFI) were developed to predict eight outcomes. Interaction effects models were not significant. Five RFI main effects were significant: higher RFI scores were associated with greater likelihood of child welfare involvement, greater parenting stress, less favorable scores on child health and well-being, lower parent responsiveness and ii acceptance, and less supportive learning environments. One PFI main effect was significant: higher PFI scores predicted lower parenting stress. A trend level result showed higher PFI scores were associated with less child welfare involvement. Race was significant in two models: White/Non-Hispanic families were more likely to have a home visitor report child welfare involvement and had more frequent parent-child activities compared to other race/ethnicity families. Unpacking the results with separate single risk factor (12 items) and protective factor (10 items) regression models followed. Results showed parent’s prior family history of maltreatment and younger maternal age predicted child welfare involvement (home visitor report), while protection was seen for those with access to housing support. Social support and family functioning protectors were linked to lower parenting stress, while maternal depression showed the opposite finding. Better scores on a child health and well-being measure were seen with higher neighborhood cohesion and greater participation in HS/HFO; in contrast, neighborhood violence and frequent mobility were linked to worse scores. Developmentally supportive home environments were seen for families participating in additional parent support programs, in which the mother had greater knowledge of infant milestones and behavior, and if the family had access to housing supports. Unemployment proved to be associated with less enriched home environments. In summary, there was no support for the cumulative PFI in buffering risk for negative outcomes in this model. The RFI was also a more robust predictor of outcomes compared to the PFI in the main effects models. Overall, study findings provide some evidence for the utility of specific protective factors, as well as cumulative and specific single risk factors, for screening families for effectively targeting services and guiding the conceptual development of program and evaluation formats. Close

• 8. [Article] Socioeconomic Determinants of Health Disparities by Race and Ethnicity: The Mediating Role of Social, Psychological and Behavioral Factors

  Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by ...

  Citation × Citation Citation Abstract Copy Title: Socioeconomic Determinants of Health Disparities by Race and Ethnicity: The Mediating Role of Social, Psychological and Behavioral Factors Author: Melekin, Amanuel Zimam Year: 2017 Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by which SES may influence health status are not widely studied. Using the Health and Retirement Study (HRS) data, this dissertation examined the pathways by which SES, via social, psychological, and behavioral factors predicted physical impairment and overnight hospitalization, and asked whether these indirect relationships differed by race/ethnicity. The HRS is a nationally representative multistage area probability sample administered biennially to respondents over the age of 51 and their spouses. Data collected between 2002 and 2010, covering five waves of the original HRS cohort born between the years 1931and 1941, were used. Two analysis approaches, Structural Equation Modeling (SEM) and Reconstructability Analysis (RA), were used. Adjustments for the complex survey design were made in the SEM analysis, whereas, data were matched for the RA method using propensity scores. Results of the SEM analyses supported most of the hypothesized indirect relationships between SES variables and physical impairment via social and psychological factors, but the indirect effect of SES on physical impairment via behavioral factors was weak. Multiple group analyses of path equality using nested chi-square tests indicated that the indirect effect of SES on physical impairment status did not vary by race/ethnicity. Social, psychological and behavioral factors were weakly related to overnight hospitalization, and SES was not indirectly related to overnight hospitalization. While these results supported several hypothesized indirect relationships between SES variables and physical health status, the indirect effect sizes were small. However, because this study examined predictive paths across groups rather than compare mean differences, and because indirect effects are products of individual path coefficients, small effect sizes are not uncommon in mediation analysis. Moreover, over a lifetime, small effects may gradually add up increasing group differences in health status with greater benefits accruing to higher SES individuals via social and psychological factors, as observed in this study. The RA results showed that indirect relationships between SES and physical impairment were similar across races/ethnicities for identical variables with a few exceptions. In several cases, however, selected SES variables related to social and psychological variables were different for different groups. Cross-sectional indirect relationships were stronger than longitudinal indirect relationships. As in the SEM study, SES was not related to physical impairment via behavioral factors; and, across groups, SES was also not related to overnight hospitalization either directly or via social, psychological or behavioral factors. Variables predicting physical impairment exhibited differences across groups; these differences were detected because RA, unlike SEM, used disaggregated social, psychological and behavioral factors. Where predictive variables overlapped, the effects of identical independent variable (IV) states on physical impairment were similar across groups with a few exceptions. In summary, both the SEM and RA results indicated that SES was indirectly related to physical impairment via social and psychological factors, and results from both methods also showed that SES was not indirectly related to overnight hospitalization via these factors. SEM did not find that these indirect effects varied by race/ethnicity; RA found a few differences. Title: Socioeconomic Determinants of Health Disparities by Race and Ethnicity: The Mediating Role of Social, Psychological and Behavioral Factors Author: Melekin, Amanuel Zimam Year: 2017 Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by which SES may influence health status are not widely studied. Using the Health and Retirement Study (HRS) data, this dissertation examined the pathways by which SES, via social, psychological, and behavioral factors predicted physical impairment and overnight hospitalization, and asked whether these indirect relationships differed by race/ethnicity. The HRS is a nationally representative multistage area probability sample administered biennially to respondents over the age of 51 and their spouses. Data collected between 2002 and 2010, covering five waves of the original HRS cohort born between the years 1931and 1941, were used. Two analysis approaches, Structural Equation Modeling (SEM) and Reconstructability Analysis (RA), were used. Adjustments for the complex survey design were made in the SEM analysis, whereas, data were matched for the RA method using propensity scores. Results of the SEM analyses supported most of the hypothesized indirect relationships between SES variables and physical impairment via social and psychological factors, but the indirect effect of SES on physical impairment via behavioral factors was weak. Multiple group analyses of path equality using nested chi-square tests indicated that the indirect effect of SES on physical impairment status did not vary by race/ethnicity. Social, psychological and behavioral factors were weakly related to overnight hospitalization, and SES was not indirectly related to overnight hospitalization. While these results supported several hypothesized indirect relationships between SES variables and physical health status, the indirect effect sizes were small. However, because this study examined predictive paths across groups rather than compare mean differences, and because indirect effects are products of individual path coefficients, small effect sizes are not uncommon in mediation analysis. Moreover, over a lifetime, small effects may gradually add up increasing group differences in health status with greater benefits accruing to higher SES individuals via social and psychological factors, as observed in this study. The RA results showed that indirect relationships between SES and physical impairment were similar across races/ethnicities for identical variables with a few exceptions. In several cases, however, selected SES variables related to social and psychological variables were different for different groups. Cross-sectional indirect relationships were stronger than longitudinal indirect relationships. As in the SEM study, SES was not related to physical impairment via behavioral factors; and, across groups, SES was also not related to overnight hospitalization either directly or via social, psychological or behavioral factors. Variables predicting physical impairment exhibited differences across groups; these differences were detected because RA, unlike SEM, used disaggregated social, psychological and behavioral factors. Where predictive variables overlapped, the effects of identical independent variable (IV) states on physical impairment were similar across groups with a few exceptions. In summary, both the SEM and RA results indicated that SES was indirectly related to physical impairment via social and psychological factors, and results from both methods also showed that SES was not indirectly related to overnight hospitalization via these factors. SEM did not find that these indirect effects varied by race/ethnicity; RA found a few differences. Close

• 9. [Article] Conceptualizing Risk and Effectiveness: A Qualitative Study of Women’s and Providers’ Perceptions of Nonsurgical Female Permanent Contraception

  Objective: Novel approaches to nonsurgical permanent contraception (NSPC) for women that are low cost and require no incision or hysteroscope/surgical equipment could improve access to, and the acceptability ...

  Citation × Citation Citation Abstract Copy Title: Conceptualizing Risk and Effectiveness: A Qualitative Study of Women’s and Providers’ Perceptions of Nonsurgical Female Permanent Contraception Author: Harrington, Elizabeth K., Gordon, Diane, Osgood-Roach, Isabel, Jensen, Jeffrey T., Aengst, Jennifer Year: 2015 Objective: Novel approaches to nonsurgical permanent contraception (NSPC) for women that are low cost and require no incision or hysteroscope/surgical equipment could improve access to, and the acceptability of permanent contraception (PC). To better understand opportunities and limitations for NSPC approaches, we examined women's and OB/GYN providers' perceptions of NSPC in Portland, OR. Study Design: Semi-structured, qualitative interviews were conducted with 40 women recruited from outpatient clinics with purposive sampling, and a focus group was conducted with 9 OB/GYNs in academic and community practice. Transcripts were coded and inductively analyzed with a grounded theory approach. Results: The majority of women identified as white (67%) or Latina (25%). They had a median age of 31.5, and median number of children was one. Perspectives on NSPC were closely aligned with women's general attitudes towards PC; over half were considering PC for themselves or partners in the future. Most respondents valued multiple aspects of a nonsurgical approach, with themes of minimizing recovery time, invasiveness, risk, and avoiding hormonal contraception. Many assumed NSPC would be less effective than surgery, however, and felt a confirmation test would be necessary regardless of the failure rate. Providers welcomed efforts to expand contraceptive choice with NSPC, but would require long-term safety and efficacy data before recommending, and voiced concerns that NSPC's potential relative ease of administration could undermine the inherent seriousness of choosing PC. Conclusions: Women’s and providers’ perceptions of NSPC hinged on the ways in which they conceptualized risk and effectiveness. While perceptions were generally favorable, confirmation of safety and effectiveness would be required for a new approach to be accepted. Implications: This hypothesis-generating study elucidates women’s and provider’s perspectives on new methods of NSPC, and contributes to understanding their perceptions of various types of risk. A technique to verify tubal occlusion would be needed for women and providers to accept NSPC. Title: Conceptualizing Risk and Effectiveness: A Qualitative Study of Women’s and Providers’ Perceptions of Nonsurgical Female Permanent Contraception Author: Harrington, Elizabeth K., Gordon, Diane, Osgood-Roach, Isabel, Jensen, Jeffrey T., Aengst, Jennifer Year: 2015 Objective: Novel approaches to nonsurgical permanent contraception (NSPC) for women that are low cost and require no incision or hysteroscope/surgical equipment could improve access to, and the acceptability of permanent contraception (PC). To better understand opportunities and limitations for NSPC approaches, we examined women's and OB/GYN providers' perceptions of NSPC in Portland, OR. Study Design: Semi-structured, qualitative interviews were conducted with 40 women recruited from outpatient clinics with purposive sampling, and a focus group was conducted with 9 OB/GYNs in academic and community practice. Transcripts were coded and inductively analyzed with a grounded theory approach. Results: The majority of women identified as white (67%) or Latina (25%). They had a median age of 31.5, and median number of children was one. Perspectives on NSPC were closely aligned with women's general attitudes towards PC; over half were considering PC for themselves or partners in the future. Most respondents valued multiple aspects of a nonsurgical approach, with themes of minimizing recovery time, invasiveness, risk, and avoiding hormonal contraception. Many assumed NSPC would be less effective than surgery, however, and felt a confirmation test would be necessary regardless of the failure rate. Providers welcomed efforts to expand contraceptive choice with NSPC, but would require long-term safety and efficacy data before recommending, and voiced concerns that NSPC's potential relative ease of administration could undermine the inherent seriousness of choosing PC. Conclusions: Women’s and providers’ perceptions of NSPC hinged on the ways in which they conceptualized risk and effectiveness. While perceptions were generally favorable, confirmation of safety and effectiveness would be required for a new approach to be accepted. Implications: This hypothesis-generating study elucidates women’s and provider’s perspectives on new methods of NSPC, and contributes to understanding their perceptions of various types of risk. A technique to verify tubal occlusion would be needed for women and providers to accept NSPC. Close

• 10. [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