Epidemiology of recreational exposure to freshwater cyanobacteria - an international prospective cohort study

Background: Case studies and anecdotal reports have documented a range of acute illnesses associated with exposure to cyanobacteria and their toxins in recreational waters. The epidemiological data to date are limited; we sought to improve on the design of some previously conducted studies in order to facilitate revision and refinement of guidelines for exposure to cyanobacteria in recreational waters. Methods: A prospective cohort study was conducted to investigate the incidence of acute symptoms in individuals exposed, through recreational activities, to low ( cell surface area < 2.4 mm(2)/mL), medium ( 2.4 - 12.0 mm(2)/mL) and high (> 12.0 mm(2)/mL) levels of cyanobacteria in lakes and rivers in southeast Queensland, the central coast area of New South Wales, and northeast and central Florida. Multivariable logistic regression analyses were employed; models adjusted for region, age, smoking, prior history of asthma, hay fever or skin disease ( eczema or dermatitis) and clustering by household. Results: Of individuals approached, 3,595 met the eligibility criteria, 3,193 (89%) agreed to participate and 1,331 (37%) completed both the questionnaire and follow-up interview. Respiratory symptoms were 2.1 (95% CI: 1.1 - 4.0) times more likely to be reported by subjects exposed to high levels of cyanobacteria than by those exposed to low levels. Similarly, when grouping all reported symptoms, individuals exposed to high levels of cyanobacteria were 1.7 ( 95% CI: 1.0 - 2.8) times more likely to report symptoms than their low-level cyanobacteria-exposed counterparts. Conclusion: A significant increase in reporting of minor self-limiting symptoms, particularly respiratory symptoms, was associated with exposure to higher levels of cyanobacteria of mixed genera. We suggest that exposure to cyanobacteria based on total cell surface area above 12 mm(2)/mL could result in increased incidence of symptoms. The potential for severe, life-threatening cyanobacteria-related illness is likely to be greater in recreational waters that have significant levels of cyanobacterial toxins, so future epidemiological investigations should be directed towards recreational exposure to cyanotoxins.

Using the Internet for Physical Activity Promotion in a Regional Community: Feasibility Study Findings

New communication technologies (websites and email) are believed to hold promise for delivering population health interventions. However, studies on internet-delivered physical activity (PA) programs have encountered difficulties in engaging and retaining participants. Recent PA research has focused on peoples’ perceptions of the local environment and how this relates to PA participation. This study investigated the potential of: 1) reaching people living in a regional community via a locally-based Internet Service Provider (ISP), and 2) using data on the local environment to design a PA intervention relevant to the individual. An online survey was conducted via the ISP’s website over 12 days. ISP clients (approximately 9,000) were invited to participate in the survey via electronic newsletter and direct email. Data on motivational readiness and environmental correlates of PA were collected. 820 surveys were completed, of which 797 were valid (response rate = 9%). Participants had a mean BMI 27.6±8.3, were 55% male, 56% aged >45 years, 57% worked fulltime, and 36% were in the early stages of motivational readiness for PA. Most reported positive perceptions of the local environment in terms of aesthetics, convenience, access, traffic and safety. However, over half did not know about or use local PA facilities. Over 70% were somewhat to extremely interested in having access to a PA promotion website. These data suggest that promoting PA via a locally based ISP is feasible and appealing to some people living in a regional community, but also highlight some of the challenges of using this technology to deliver population health interventions.

Pulse oximetry screening for congenital heart defects in newborn infants:an evaluation of acceptability to mothers

Background: Introducing neonatal screening procedures may not be readily accepted by parents and may increase anxiety. The acceptability of pulse oximetry screening to parents has not been previously reported. Objective: To assess maternal acceptability of pulse oximetry screening for congenital heart defects and to identify factors predictive of participation in screening. Design and setting: A questionnaire was completed by a cross-sectional sample of mothers whose babies were recruited into the PulseOx Study which investigated the test accuracy of pulse oximetry screening. Participants: A total of 119 mothers of babies with false-positive (FP) results, 15 with true-positive and 679 with true-negative results following screening. Main outcome measures: Questionnaires included measures of satisfaction with screening, anxiety, depression and perceptions of test results. Results: Participants were predominantly satisfied with screening. The anxiety of mothers given FP results was not significantly higher than that of mothers given true-negative results (median score 32.7 vs 30.0, p=0.09). White British/Irish mothers were more likely to participate in screening, with a decline rate of 5%; other ethnic groups were more likely to decline with the largest increase in declining being for Black African mothers (21%, OR 4.6, 95% CI 3.8 to 5.5). White British mothers were also less anxious (p<0.001) and more satisfied (p<0.001) than those of other ethnicities Conclusions: Pulse oximetry screening was acceptable to mothers and FP results were not found to increase anxiety. Factors leading to differences in participation and satisfaction across ethnic groups need to be identified so that staff can support parents appropriately.

Molecular identification of 26 syntaxin genes and their assignment to the different trafficking pathways in Paramecium

SNARE proteins have been classified as vesicular (v)- and target (t)-SNAREs and play a central role in the various membrane interactions in eukaryotic cells. Based on the Paramecium genome project, we have identified a multigene family of at least 26 members encoding the t-SNARE syntaxin (PtSyx) that can be grouped into 15 subfamilies. Paramecium syntaxins match the classical build-up of syntaxins, being 'tail-anchored' membrane proteins with an N-terminal cytoplasmic domain and a membrane-bound single C-terminal hydrophobic domain. The membrane anchor is preceded by a conserved SNARE domain of approximately 60 amino acids that is supposed to participate in SNARE complex assembly. In a phylogenetic analysis, most of the Paramecium syntaxin genes were found to cluster in groups together with those from other organisms in a pathway-specific manner, allowing an assignment to different compartments in a homology-dependent way. However, some of them seem to have no counterparts in metazoans. In another approach, we fused one representative member of each of the syntaxin isoforms to green fluorescent protein and assessed the in vivo localization, which was further supported by immunolocalization of some syntaxins. This allowed us to assign syntaxins to all important trafficking pathways in Paramecium.

NOx storage-reduction characteristics of Ba-based lean NOx trap catalysts subjected to simulated road aging

In order to study the effect of washcoat composition on lean NOx trap (LNT) aging characteristics, fully formulated monolithic LNT catalysts containing varying amounts of La-stabilized CeO2 (5 wt% La2O3) or CeO2-ZrO2 (Ce:Zr = 70:30) were subjected to accelerated aging on a bench reactor. Subsequent catalyst evaluation revealed that aging resulted in deterioration of the NOx storage, NOx release and NOx reduction functions, whereas the observation of lean phase NO2 slip for all of the aged catalysts indicated that LNT performance was not limited by the kinetics of NO oxidation. After aging, all of the catalysts showed increased selectivity to NH3 in the temperature range 250–450 °C. TEM, H2 chemisorption, XPS and elemental analysis data revealed two main changes which can explain the degradation in LNT performance. First, residual sulfur in the catalysts, present as BaSO4, decreased catalyst NOx storage capacity. Second, sintering of the precious metals in the washcoat was observed, which can be expected to decrease the rate of NOx reduction. Additionally, sintering is hypothesized to result in segregation of the precious metal and Ba phases, resulting in less efficient NOx spillover from Pt to Ba during NOx adsorption, as well as decreased rates of reductant spillover from Pt to Ba and reverse NOx spillover during catalyst regeneration. Spectacular improvement in LNT durability was observed for catalysts containing CeO2 or CeO2-ZrO2 relative to their non-ceria containing analog. This was attributed to (i) the ability of ceria to participate in NOx storage/reduction as a supplement to the main Ba NOx storage component; (ii) the fact that Pt and CeO2(-ZrO2) are not subject to phase segregation; and (iii) the ability of ceria to trap sulfur, resulting in decreased sulfur accumulation on the Ba component.

Background synaptic activity in rat entorhinal cortex shows a progressively greater dominance of inhibition over excitation from deep to superficial layers

The entorhinal cortex (EC) controls hippocampal input and output, playing major roles in memory and spatial navigation. Different layers of the EC subserve different functions and a number of studies have compared properties of neurones across layers. We have studied synaptic inhibition and excitation in EC neurones, and we have previously compared spontaneous synaptic release of glutamate and GABA using patch clamp recordings of synaptic currents in principal neurones of layers II (L2) and V (L5). Here, we add comparative studies in layer III (L3). Such studies essentially look at neuronal activity from a presynaptic viewpoint. To correlate this with the postsynaptic consequences of spontaneous transmitter release, we have determined global postsynaptic conductances mediated by the two transmitters, using a method to estimate conductances from membrane potential fluctuations. We have previously presented some of this data for L3 and now extend to L2 and L5. Inhibition dominates excitation in all layers but the ratio follows a clear rank order (highest to lowest) of L2>L3>L5. The variance of the background conductances was markedly higher for excitation and inhibition in L2 compared to L3 or L5. We also show that induction of synchronized network epileptiform activity by blockade of GABA inhibition reveals a relative reluctance of L2 to participate in such activity. This was associated with maintenance of a dominant background inhibition in L2, whereas in L3 and L5 the absolute level of inhibition fell below that of excitation, coincident with the appearance of synchronized discharges. Further experiments identified potential roles for competition for bicuculline by ambient GABA at the GABAA receptor, and strychnine-sensitive glycine receptors in residual inhibition in L2. We discuss our results in terms of control of excitability in neuronal subpopulations of EC neurones and what these may suggest for their functional roles. © 2014 Greenhill et al.

Teaching our children when to eat:how parental feeding practices inform the development of emotional eating-a longitudinal experimental design

Background: Emotional eating in children has been related to the consumption of energy-dense foods and obesity, but the development of emotional eating in young children is poorly understood. Objectives: We evaluated whether emotional eating can be induced in 5-7-y-old children in the laboratory and assessed whether parental use of overly controlling feeding practices at 3-5 y of age predicts a greater subsequent tendency for children to eat under conditions of mild stress at ages 5-7 y. Design: Forty-one parent-child dyads were recruited to participate in this longitudinal study, which involved parents and children being observed consuming a standard lunch, completing questionnaire measures of parental feeding practices, participating in a research procedure to induce child emotion (or a control procedure), and observing children's consumption of snack foods. Results: Children at ages 5-7 y who were exposed to a mild emotional stressor consumed significantly more calories from snack foods in the absence of hunger than did children in a control group. Parents who reported the use of more food as a reward and restriction of food for health reasons with their children at ages 3-5 y were more likely to have children who ate more under conditions of negative emotion at ages 5-7 y. Conclusions: Parents who overly control children's food intake may unintentionally teach children to rely on palatable foods to cope with negative emotions. Additional research is needed to evaluate the implications of these findings for children's food intake and weight outside of the laboratory setting. This trial was registered at clinicaltrials.gov as NCT01122290.

A közösségi versenyképesség elméleti keretei = Analytical framework to study competitiveness of communities

Tanulmányunk célja a versenyképesség közösségi beágyazottságának elemzéséhez alkalmas elemzési keretek bemutatása és a versenyképesség fogalmának elemzése a fogalom intézményi, normatív tartalma szempontjából. Célunk a közösségi versenyképesség fogalmának és az ezt elemezni képes megközelítés kidolgozása. A feladat kettős: 1. A versenyképesség értelmezése a döntések közösségi keretei szempontjából 2. A közösségi keretek versenyképességre gyakorolt hatásának elemzése Ennek érdekében a tanulmány első fejezetében az egyéni döntést meghatározó tényezőket és az egyéni döntések jövőbeli interakciók környezetére gyakorolt hatását elemző keretet vázoljuk fel. Megközelítésünk szerint az egyéni döntést négy tényező határozza meg. a közösségi környezet, a természeti környezet, s személyes jellemzők és az interakciós partnerek. Az ez alapján születő döntések formálják a jövőbeli döntési környezetet. A döntések hatásának elemzéséhez a környezetre gyakorolt hatások értékelését orientáló fogalomra van szükség. Elemzésünk esetében ez a fogalom az értékteremtés, amit a következőképp határozunk meg: az értékteremtő tevékenységek során valaki arra törekszik, hogy saját személyes céljait a másokkal való kölcsönösen előnyös együttműködések lehetőségeinek bővítésével, hozamainak növelésével szolgálja. A második fejezetben az egyéni döntések közösségi kereteit és az egyéni döntések közösségre gyakorolt hatását elemezzük részletesen. A formális és informális intézmények világát, a közösségi magatartásokat szabályozó normák és konvenciók rendszerét a következő öt – a valóságban gyakran keveredő - alapelemre bontjuk értékrend, konvenció, közösségi szabály, hivatalos előírás, egyének közötti megállapodás. Ezek közül a magánszereplők együttműködésének az érintett szereplők által módosítható intézményi elemeinek (konvenció, megállapodás) alkalmazkodása a leggyorsabb, a közösség egészét irányító formális intézmények a status quo iránti elfogultságuk miatt lomhábbak, míg a közösség életét informálisan befolyásoló normák a legstabilabb intézményi elemek. A közösségek változása általában lassú, legtöbbször nem szándékolt hatások következménye. Mindezek mellett a közösségi intézmények tudatos alakításában komoly szerepe van (1) a konvenciókat megújító intézményi innovátoroknak, (2) a szerződéses formulákon módosító vállalkozóknak és (3) a hivatalos előírások formálásába bekapcsolódó politikai szereplőknek politikai vállalkozóként, tisztviselőként, vagy közéleti résztvevőként. A harmadik fejezetben a versenyképesség fogalmát elemezzük, és ez alapján határozzuk meg a közösségi versenyképesség fogalmát. Megvizsgáljuk, milyen feltevésekkel él a fogalom a közösségi környezettel kapcsolatban, illetve milyen normatív elemei vannak a definíciónak. A vizsgálathoz a versenyképesség fogalmának egy lecsupaszított változatát használtuk. E szerint a versenyképesség valaki képessége értékteremtő módon bekapcsolódni a gazdasági munkamegosztásba úgy, hogy tevékenysége relatív hozama nem csökken. Az elemzés alapján a versenyképesség a közösségi környezet következő hét elemére épül: 1. A közösség tagjainak és a tagság tartalmának meghatározottsága; 2. a potenciális együttműködő felek közös múltja, jövője, konvenció- és normarendszere; 3. A gazdasági együttműködés intézményeinek (csere, vállalkozás, tulajdon, szerződés) működőképessége; 4. Az értékteremtés normatív koncepciója és az arra épülő részleteiben meghatározott, és részleteiben is közösségi legitimációval bíró szabályrendszer; 5. Az innovációt támogató és a kellően rugalmas értékrend és közösségi szabályok. 6. A gazdasági munkamegosztás igényeihez részleteiben és változásával is igazodó konvenciók, hivatalos előírások és szerződések; 7. A közösségi környezet tudatos alakításával foglalkozó szereplők (közösségi innovátorok, vállalkozók és politikai szereplők) motivációja és lehetősége a hozamok relatív szintjének tartását támogató intézményi környezet karbantartásában. A versenyképesség fogalmának intézményi elemzése rámutat, hogy a fogalom gazdag értéktartalommal és határozott közösségi intézményrendszer-képpel rendelkezik. A közösségi versenyképesség ez alapján a versenyképesség fogalmába kódolt közösségi környezetként határozható meg. A kutatás következő lépése a közösségi versenyképesség meghatározása, az azt befolyásoló mechanizmusok feltárása és javítását támogató elemzési eszközök, gyakorlati segédletek kidolgozása. Ezen feladatok előkészítése érdekében a tanulmány mellékletében két történelmi esettanulmányt mutatunk be, röviden áttekintjük a téma szempontjából releváns irodalom főbb eredményeit és bemutatunk egy praktikus alkalmazásra szánt normatív elemzési eszközt, mellyel az elemezhető, hogy az állami lépések mennyire bátorítják az értékteremtő vállalkozást. _________ This paper (1) introduces an analytical framework to study the impact of the community on competitiveness and (2) analyses the institutional and normative content in the concept of competitiveness. The goal is to elaborate an approach that supports the definition and analysis of the ‘competiveness of community’. This task has two main parts: 1. interpretation of competiveness from social choice perspective 2. assessing the impact of social settings on the competiveness of a community The first chapter of the study draws up an analytical framework to study the social factors of individual decisions and their impact on the environment of future interactions. We focus on four main factors that shape setting of future interactions: social environment, natural environment, personal characteristics and partners in interactions. We use the concept of value creation to assess the impact of individual decisions on these factors. The second chapter discusses the social factors of individual decisions and the impact of individual decisions on the community. Institutions are conceptualized as value systems, conventions, community rules, official rules and contracts in the study. The conventions and contracts can accommodate to the changes of environment more smoothly, formal institutions are less flexible due to their bias toward status quo. Informal rules and value systems resists change more frequently. The formation of social environment is usually slow and based on unintended effects. Altogether (1) innovators who revise social conventions, (2) entrepreneurs who reshape contracts and (4) political entrepreneurs who formulate formal rules have influential roles on the institutional setting. The third chapter discusses the social assumptions included into the definition of competitiveness and we give a definition for the competiveness of communities. A simplified definition of competitiveness is used for this analysis: competiveness is someone’s ability and motivation to participate in the economic division of labor in a way that is based on value creation and maintains the relative return of activities. Our analysis reveals that competitiveness assumes the following features of the community: 1. Defined membership of community: who are the members and what does membership mean. 2. Common past, future, convention and norm system of the potential participants of interactions 3. Functionality of institutions that facilitate division of labor (exchange, entrepreneurship, property, contract) 4. Existing normative concept on value creation and social accepted rules that govern interactions 5. Value system and rules that promote innovation 6. Conventions, official norms and contracts that fits to economic division of labor in a detailed and dynamic way 7. Motivation and potential of actors who shape social environment consciously to maintain institutions in order to sustain the relative return of economic activities This analysis shows that the concept of competitiveness assumes well established values and detailed expectations on institutional settings. Followingly, competiveness of community can be defined with these criteria of social environment. Two historical case studies and the draft of a policy oriented toolkit demonstrate the applicability of the introduced approach in the appendix. The core findings of the literature are also reviewed there.

True and false confessions to an intentional act: A novel experimental paradigm

Due to the powerful nature of confession evidence, it is imperative that we investigate the factors that affect the likelihood of obtaining true and false confessions. Previous research has been conducted with a paradigm limited to the study of false confessions to an act of negligence, thereby limiting the generalizability of the findings. The first goal of the current study was to introduce a novel paradigm involving a more serious, intentional act that can be used in the study of both true and false confessions. The second goal was to explore the effects of two police interrogation tactics, minimization and an offer of leniency, on true and false confession rates. ^ Three hundred and thirty-four undergraduates at a large southeastern university were recruited to participate in a study on problem-solving and decision-making. During the course of the laboratory experiment, participants were induced to intentionally break or not break an experimental rule, an act that was characterized as “cheating.” All participants (i.e., both innocent and guilty) were later accused of the act and interrogated. For half of the participants, the interrogator used minimization tactics, which involved downplaying the seriousness of the offense, expressing sympathy, and providing face-saving excuses, in order to encourage the participant to confess. An offer of leniency was also manipulated in which half the participants were offered a “deal” that involved the option of confessing and accepting a known punishment or not confessing and facing the threat of harsher punishment. Results indicated that guilty persons were more likely to confess than innocent persons, and that the use of minimization and an explicit offer of leniency increased both the true and false confession rates. Furthermore, a cumulative effect of techniques was observed, such that the diagnosticity of the interrogation (the ratio of true confessions to false confessions) decreased as the number of techniques used increased. Taken together, the results suggest that caution should be used when implementing these techniques in the interrogation room. ^

Use of conjoint analysis to examine beliefs related to the practice of early literacy instruction

The purpose of the study was to examine the relationship between teacher beliefs and actual classroom practice in early literacy instruction. Conjoint analysis was used to measure teachers' beliefs on four early literacy factors—phonological awareness, print awareness, graphophonic awareness, and structural awareness. A collective case study format was then used to measure the correspondence of teachers' beliefs with their actual classroom practice. ^ Ninety Project READS participants were given twelve cards in an orthogonal experimental design describing students that either met or did not meet criteria on the four early literacy factors. Conjoint measurements of whether the student is an efficient reader were taken. These measurements provided relative importance scores for each respondent. Based on the relative important scores, four teachers were chosen to participate in a collective case study. ^ The conjoint results enabled the clustering of teachers into four distinct groups, each aligned with one of the four early literacy factors. K-means cluster analysis of the relative importance measurements showed commonalities among the ninety respondents' beliefs. The collective case study results were mixed. Implications for researchers and practitioners include the use of conjoint analysis in measuring teacher beliefs on the four early literacy factors. Further, the understanding of teacher preferences on these beliefs may assist in the development of curriculum design and therefore increase educational effectiveness. Finally, comparisons between teachers' beliefs on the four early literacy factors and actual instructional practices may facilitate teacher self-reflection thus encouraging positive teacher change. ^

Impact of a cognitive-behavioral weight control program on body weight, diet quality, and smoking cessation in weight-concerned female smokers

Many people use smoking as a weight control mechanism and do not want to quit because they fear weight gain. These weight-concerned smokers tend to be female, are significantly less likely to stop smoking, are less likely to join smoking cessation programs, and will relapse more often than smokers who are not weight-concerned. Research suggests that a woman’s confidence in her ability to control her weight after quitting relates positively with her intention to quit smoking. Likewise, success in smoking cessation has been associated with increased self-efficacy for weight control. It has been shown that success in changing one negative health behavior may trigger success in changing another, causing a synergistic effect. Recently research has focused on interventions for weight-concerned smokers who are ready to quit smoking. The present study investigated the effect of a cognitive based weight control program on self-efficacy for weight control and the effect on smoking behavior for a group of female weight concerned smokers. Two hundred and sixteen subjects who wanted to lose weight but who were not ready to quit smoking were recruited to participate in a 12-week, cognitive-behavioral weight control program consisting of twelve one-hour sessions. Subjects were randomly assigned to either (1) the weight-control program (intervention group), or (2) the control group. Results of this study demonstrated that subjects in the intervention group increased self-efficacy for weight control, which was associated with improved healthy eating index scores, weight loss, increased self-efficacy for quitting smoking, a decrease in number of cigarettes smoked and triggered positive movement in stage of change towards smoking cessation compared to the control subjects. For these subjects, positive changes in self-efficacy for one behavior (weight control) appeared to have a positive effect on their readiness to change another health behavior (smoking cessation). Further study of the psychological variables that influence weight-concerned female smokers’ decisions to initiate changes in these behaviors and their ability to maintain those changes are warranted.

An examination of accounting and auditing issues related to strategic environmental initiatives

Although corporate environmental accountability is receiving unprecedented attention in the United States from policy makers, the capital market, and the public at large, extant research is limited in its examination of the implications of strategic corporate environmental initiatives on accounting and auditing. The purpose of my dissertation is to address these implications by examining the association between firm environmental initiatives and audit fees, capital expenditures, and earnings quality using multivariate regression analysis. I find that firms engaged in more strategic environmental initiatives tend to have significantly higher audit fees and capital expenditures, and significantly lower levels of earnings manipulation measured using discretionary accruals. These results support the notion that auditors do recognize the importance of environmental initiatives when conducting the year-end financial statement audit, an idea that positively reflects upon the auditor’s monitoring role. The results also demonstrate the increased amount of capital resources required to participate in strategic environmental initiatives, an anecdotal notion that had yet to be empirically supported. This empirical support provides valuable insights on how environmental initiatives materially impact corporate financial statements. Finally, my results extend the extant literature by demonstrating that the superior financial performance reported by environmentally active firms is less likely driven by earnings manipulation by management, and by implication, more likely a result of real economic gains. Taken together, my dissertation establishes a strong and timely foundation for current and future research to explore corporate environmental initiatives in the United States and globally, a topic increasingly gaining momentum in today’s more eco-conscious world.^

Middle school teachers' intentions to refer eating disorder students for professional counseling

Eating disorders can lead to a negative impact on students' academic growth, nutrition and can cause death (Claude-Pierre, 1997; Manley, Rickson, & Standeven, 2000; Romeo, 1996). Early intervention by referring students to professional counseling might help counter these negative consequences. The teacher is in the position to assist students by providing health information, identifying those with problems, and intervening for a variety of dysfunctions that may include the eating disorders called anorexia nervosa and bulimia nervosa (Myers-Clark & Christopher, 2000). However teachers are in a difficult position to know when to address student concerns and judge what action to take (Ransley, 1999). Teachers' engagement seems crucial (Smolak, Harris, Levine, & Shisslak, 2001) since eating disorders are being identified in younger children. The purpose of this study was to examine (a) the relationships of the theoretical constructs, attitude, subjective norm, and perceived behavioral control of the theory of planned behavior as predictors of behavioral intention (Ajzen & Fishbein, 1980) of middle school teachers to identify and refer suspected anorexia nervosa (AN) and/or bulimia nervosa (BN) students for professional help; and (b) the actual behavior of middle school teachers who reported having ever referred a student suspected of having AN and BN and those teachers who reported not having made such a referral. One hundred fourteen middle school teachers in Broward County, Florida volunteered to participate in the ex post facto research. Data were collected from a questionnaire. Multiple regression analysis revealed that the constructs of subjective norm (perception of what others think about one's performance of behavior combined with motivation to comply) and perceived behavioral control (perception regarding the extent of the difficulty of performing the behavior) were predictive of teachers' intent (likelihood of engaging in a behavior) to refer. However, the analysis revealed that attitude (overall positive or negative feeling with respect to performing the behavior) was not predictive of teachers' intent. Discriminant function analysis revealed that both intent and perceived behavioral control were predictive of group membership, either having referred a student suspected of having an eating disorder for counseling or not having made such a referral. Attitude and subjective norm were not predictive of group membership.

Anxious children who received treatment grow -up: An 8-to-13 year follow-up study

This dissertation examined the long-term efficacy (8-to-13 years, M = 9.54, SD = 1.689) of exposure-based cognitive-behavioral therapy (CBT) for phobic and anxiety disorders in youths. Long-term efficacy was examined in terms of diagnostic recovery, symptom reductions, and clinically significant change. This dissertation also examined predictors of long-term efficacy (e.g., age, gender, and other clinical characteristics) as well as the relative long-term efficacy of CBT for Hispanic/Latino and European American youth. ^ Participants consisted of 67 youth (age range 15–26 years; M = 19.43, SD = 3.02 years at time of follow-up assessment), (47.8% females, 37.3% Hispanic/Latino) who had participated in one of two clinical trials (Silverman et al., 1999a, b). After providing informed consent to participate in the long term follow-up, youths completed a diagnostic interview and a battery of questionnaires. Results indicated that treatment gains were maintained about 9.5 years after treatment was completed. Maintenance of treatment gains was evident in terms of diagnostic recovery, symptom reductions, and clinically significant change. Long-term treatment gains extended to both ethnic groups and the two ethnic groups were functionally equivalent along most indices examined. Analyses of predictors of long-term outcome showed that parent self-reported pre-treatment depression, youth-reported pre-treatment depression, and youths retrospective reports of negative life events were significantly associated with less favorable long-term gains in terms of total symptoms of anxiety at long-term follow-up. In terms of long-term sequelae, youths with less successful post-treatment outcomes reported seeking-out additional treatment as well as using/abused substances and substance dependence significantly more than youths with successful post-treatment outcomes. Results are discussed in terms of the contribution of the present study to knowledge base about the long-term efficacy of exposure-based CBT procedures for phobic and anxiety disorders in youth. Findings also are discussed in terms of the need to modify CBT procedures to target youths with less successful post-treatment outcomes. Limitations and future directions are presented. ^

Addressing deficits and injustices : the potential epistemic contributions of patients to research

Acknowledgments The research for this paper was primarily funded by an Australian Research Council (ARC) grant (DP120101092), How do we know what works? Ethics and evidence in surgical research. Katrina Hutchison’s research was also partly funded by the ARC Centre of Excellence for Electromaterials Science, where she has worked since June 2015. Discussions about the paper were facilitated by Macquarie University funding of a visit by Vikki A. Entwistle to participate in a Centre for Agency, Values and Ethics (CAVE) seminar on Capabilities Approaches to Justice. The authors would like to thank the anonymous reviewers for a number of helpful comments.