The role of vulnerability factors in individuals with an at-risk mental state of psychosis

Background Several indicators of heightened vulnerability to psychosis and relevant stressors have been identified. However, it has rarely been studied prospectively to what extent these vulnerability factors are in fact more frequently present in individuals with an at-risk mental state for psychosis. Moreover, it remains unknown whether any of these contribute to the prediction of psychosis onset in at-risk mental state individuals. Methods There were 28 healthy controls, 86 first-episode psychosis patients and 127 at-risk mental state individuals recruited within the Basel “Früherkennung von Psychosen” project. Relative frequencies of selected vulnerability factors for psychosis were compared between healthy controls, psychosis patients, those at-risk mental state individuals with subsequent psychosis onset (n = 31) and those without subsequent psychosis onset (n = 55). Survival analyses were applied to determine associations between time to transition to psychosis and vulnerability factors in all 127 at-risk mental state individuals. Results The vulnerability factors/indicators such as “difficulties during school education or vocational training”, “difficulties during employment”, “being single”, “difficulties with intimate relationships” and “being burdened with specific stressful situations” were more commonly found in the at-risk mental state and first-episode psychosis group than in healthy controls. Conclusions At-risk mental state and first-episode psychosis individuals more frequently present with vulnerability factors. Individual vulnerability factors appear, however, not to be predictive for an onset of psychosis.

Pathways linking socioeconomic position and diabetes: The role of psychosocial factors

Despite increasing interest in the relationship between socioeconomic position (SEP) and health, there remains little understanding of the mechanisms through which SEP is related to chronic disease. This dissertation utilized data from 2,592 U.S. households in the 1995 telephone survey of the Aging, Status, and the Sense of Control study to: (1) investigate potential mediating factors in the association between educational level and prevalence of diabetes and (2) to investigate the association between the three major measures of SEP—income, education, and occupation—and the prevalence of diabetes. Regression analyses were conducted to examine the degree to which sense of personal control and social support mediate the association between level of educational attainment and diabetes and to examine the contribution of each of the SEP measures to diabetes. After adjusting for age, obesity, sex, and race, respondents with less than a high school education had greater odds of having diabetes than those with a college degree or higher level of educational attainment, although the corresponding confidence interval contained the null value (OR = 1.2, 95% CI: 0.7, 2.0). Neither sense of control nor social support significantly mediated the association between education and diabetes. However, sense of control was associated with diabetes status (OR = 0.7, 95% CI: 0.5, 1.0). Compared with income and education, employment status was the most strongly associated measure of SEP with diabetes prevalence. After adjusting for age, obesity, sex, and race, respondents who were unable to work due to disability had fourfold greater odds of having diabetes than those who were employed full time (OR = 4.0; 95% CI: 1.9, 8.3). Adding income and/or education to the model did not improve the fit. Understanding the impact of socioeconomic factors on diabetes requires consideration of multiple measures of SEP as well as the psychosocial pathways through which SEP may influence diabetes. ^

A space-time analysis of reported shigellosis and salmonellosis cases in Texas from 2000 to 2004

Background. The purpose of this study was to describe the risk factors and demographics of persons with salmonellosis and shigellosis and to investigate both seasonal and spatial variations in the occurrence of these infections in Texas from 2000 to 2004, utilizing time series analyses and the geographic information system digital mapping methods. ^ Methods. Spatial Analysis: MapInfo software was used to map the distribution of age-adjusted rates of reported shigellosis and salmonellosis in Texas from 2000–2004 by zip codes. Census data on above or below poverty level, household income, highest level of educational attainment, race, ethnicity, and urban/rural community status was obtained from the 2000 Decennial Census for each zip code. The zip codes with the upper 10% and lower 10% were compared using t-tests and logistic regression to determine whether there were any potential risk factors. ^ Temporal analysis. Seasonal patterns in the prevalence of infections in Texas from 2000 to 2003 were determined by performing time-series analysis on the numbers of cases of salmonellosis and shigellosis. A linear regression was also performed to assess for trends in the incidence of each disease, along with auto-correlation and multi-component cosinor analysis. ^ Results. Spatial analysis: Analysis by general linear model showed a significant association between infection rates and age, with young children aged less than 5 and those aged 5–9 years having increased risk of infection for both disease conditions. The data demonstrated that those populations with high percentages of people who attained a higher than high school education were less likely to be represented in zip codes with high rates of shigellosis. However, for salmonellosis, logistic regression models indicated that when compared to populations with high percentages of non-high school graduates, having a high school diploma or equivalent increased the odds of having a high rate of infection. ^ Temporal analysis. For shigellosis, multi-component cosinor analyses were used to determine the approximated cosine curve which represented a statistically significant representation of the time series data for all age groups by sex. The shigellosis results show 2 peaks, with a major peak occurring in June and a secondary peak appearing around October. Salmonellosis results showed a single peak and trough in all age groups with the peak occurring in August and the trough occurring in February. ^ Conclusion. The results from this study can be used by public health agencies to determine the timing of public health awareness programs and interventions in order to prevent salmonellosis and shigellosis from occurring. Because young children depend on adults for their meals, it is important to increase the awareness of day-care workers and new parents about modes of transmission and hygienic methods of food preparation and storage. ^

Health beliefs and attitudes of HPV among Hispanic parents as predictors of intention to use the HPV vaccine

Human Papillomavirus (HPV) is the most common sexually transmitted disease in the United States. Although HPV prevalence is high in the United States, there are a limited number of research studies that focus on Hispanics, who have higher incidence rates of cervical cancer than their non-Hispanic counterparts. The HPV vaccine introduced in 2006 may offer a feasible solution to the issues surrounding high prevalence of HPV. Due to the high prevalence of HPV infection among adolescents and young adults it has been suggested that HPV vaccination begin prior to onset sexual activity and focus on non-sexually active adolescents and pre-adolescents. Consequently, it has become increasingly important to assess knowledge and awareness of HPV in order to develop effective intervention strategies. This pilot study evaluated the knowledge and health beliefs of Hispanic parents regarding HPV and the HPV vaccine using a newly developed questionnaire based on the constructs of the Health Belief Model. The sample was recruited from an ob-gyn office in El Paso, Texas. Descriptive data show that the majority of the sample was female (94.1%), Hispanic (76.5%), Catholic (64.7%), and had at least a high school education (55.9%). Chi-square analysis revealed that the following variables differed amongst parents who intended to vaccinate their child against HPV and those who did not: religion (p=0.038), perceived severity item "HPV infections are easily treated" (p=0.052), perceived benefits item "It is better to vaccinate a child against an STI before they become sexually active" (p=0.014) and perceived barriers item "The HPV vaccine may have serious side effects that could harm my child" (p=0.004). Univariate logistic regression indicated that religion (OR = 4.8, CI: 1.04, 21.8) and "The HPV vaccine may have serious side effects that could harm my child" (OR = 15.9, CI: 1.73, 145.8) were significant predictors of parental intention to vaccinate. Multivariate logistic regression, using backwards elimination, indicated that religion (OR = 7.7, CI: 1.25, 47.8) and "The HPV vaccine may have serious side effects that may harm my child" (OR = 7.6, CI: 1.15, 50.2) were the best predictive variables for parental intention to vaccinate. ^

Predictive factors for vaginal douching and tampon use among US women: Are these behaviors risk factors for bacterial vaginosis and trichomonas?

The use of feminine products such as vaginal douches, tampons, and sanitary napkins are common among women. Despite the results of some studies that suggest an association between douching and bacterial vaginosis, douching remains a topic that is understudied. The possibility of an association between tampon use and infection has not been significantly investigated since the toxic shock outbreak in the 1980s. The first objective of our study was to evaluate demographic, reproductive health, and sexual behavior variables to establish an epidemiologic profile of menstruating women who reported douching and women who reported using sanitary napkins only. The second objective of our study was to evaluate whether the behaviors of douching and using tampons were associated with an increased risk of bacterial vaginosis or trichomonas. We analyzed these factors, using logistic regression, among the 3,174 women from the NHANES cross sectional data from 2001-2004, who met the inclusion criteria determined for our study. We established an epidemiologic profile for women who had the highest frequency of douching reported as women who were age 36-49, had a high school education or GED, black race, not taking oral contraceptives, reported vaginal symptoms in the last month, two or more sexual partners in the last year, or tested positive for bacterial vaginosis or trichomonas. The profile for those who had the highest frequency of exclusive sanitary napkin use included women with less than a high school education, married women, women classified as black or "other" in race, and women who were not on oral contraceptives. While we were able to establish a significant increase in the odds of douching among women who tested positive for bacterial vaginosis or trichomonas, we did not find any significant difference in the odds of exclusive napkin use and testing negative for bacterial vaginosis or trichomonas.^

Workers and respirators: What factors influence medical clearance? Experience in the petrochemical industry 2004--2008

This retrospective cohort study analyzed data from more than 2200 OSHA-mandated respirator medical evaluations performed between 2004 and 2008, with information initially obtained using an online questionnaire, to determine what factors influence medical clearance and the ability to safely wear respiratory protection in a large petrochemical company.^ The employees were mostly white males with a high school education, ranging in age from 25 to 60 years of age, who had been employed with the company an average of eight years. Their work was typically performed outdoors in a rural or offshore setting. Respirators were typically required for emergency response – escape or rescue only – and/or limited to less than four hours per month.^ Approximately 90% of the population achieved medical clearance by utilizing the online questionnaire. Of the remaining 10%, 66% were cleared after additional "hands-on" medical examination exam; 28% of the individuals' jobs were modified by their supervisor in order to not use a respirator, and 6% of the individuals (n=13) were excluded from wearing a respirator on the basis of the medical examination. The primary causes for exclusion from respirator use were cardiovascular (37.5%) and respiratory (31.3%) issues, followed by psychological (18.8%) and musculoskeletal (12.5%) concerns. Ultimately, over 99% of workers evaluated under this system were found capable of using respiratory protection safely. This questionnaire has proven to be an excellent health screening tool capable of initiating early detection and further investigation of potentially serious medical conditions within a large and diverse population in multiple locations. ^

AN ECONOMIC ANALYSIS OF THE DEMAND FOR CARE IN A FREE-STANDING EMERGENCY CENTER

Free-standing emergency centers (FECs) represent a new approach to the delivery of health care which are competing for patients with more conventional forms of ambulatory care in many parts of the U.S. Currently, little is known about these centers and their patient populations. The purpose of this study, therefore, was to describe the patients who visited two commonly-owned FECs, and determine the reasons for their visits. An economic model of the demand for FEC care was developed to test its ability to predict the economic and sociodemographic factors of use. Demand analysis of other forms of ambulatory services, such as a regular source of care (RSOC), was also conducted to examine the issues of substitution and complementarity.^ A systematic random sample was chosen from all private patients who used the clinics between July 1 and December 31, 1981. Data were obtained by means of a telephone interview and from clinic records. Five hundred fifty-one patients participated in the study.^ The typical FEC patient was a 26 year old white male with a minimum of a high school education, and a family income exceeding $25,000 a year. He had lived in the area for at least twenty years, and was a professional or a clerical worker. The patients made an average of 1.26 visits to the FECs in 1981. The majority of the visits involved a medical complaint; injuries and preventive care were the next most common reasons for visits.^ The analytic results revealed that time played a relatively important role in the demand for FEC care. As waiting time at the patients' regular source of care increased, the demand for FEC care increased, indicating that the clinic serves as a substitute for the patients' usual means of care. Age and education were inversely related to the demand for FEC care, while those with a RSOC frequented the clinics less than those lacking such a source.^ The patients used the familiar forms of ambulatory care, such as a private physician or an emergency room in a more typical fashion. These visits were directly related to the age and education of the patients, existence of a regular source of care, and disability days, which is a measure of health status. ^

Hacia una aproximación multidimensional e innovadora de los pilares de la orientación vocacional

Se estudian cuestiones relativas a la elección de una carrera universitaria por alumnos que finalizan la educación secundaria. La hipótesis es que una complementación de enfoques que recupere dimensiones presentes en la teoría y en los instrumentos derivados, algunos de vieja data, permite anticipar una elección profesional satisfactoria. El objetivo general es analizar la viabilidad de conjugar principios y recursos de diferente origen psicológico-epistemológico, en una perspectiva holística y con proyección al plano aplicado. Para alcanzarlo se abordan cuali y cuantitativamente: intereses vocacionales y personalidad, globalmente considerados (variables independientes) en su relación con la elección de una carrera y se estima la capacidad de anticipar “una buena elección", medida por permanencia en la carrera, satisfacción y convicción de que se la volvería a elegir (variables dependientes). La fuente son registros documentales de procesos de Orientación y una entrevista de seguimiento habiendo transcurrido entre dos y seis años desde la elección. Es un estudio descriptivo, comparativo y en algunas instancias analiza correspondencias. Los resultados corroboran que la complementación de perspectivas e instrumentos sustenta una decisión vocacional que se caracteriza por la satisfacción con la elección, la permanencia en la carrera y la convicción de que se la volvería a elegir. Como corolario se resignifica la conceptualización de Orientación Vocacional sobre bases etimológicas y empíricas, en tanto proceso que realiza “quien se orienta" en cierta dirección.

La educación media superior en México ante el reto de su universalización

En México, se legisló en octubre del 2011 la universalización de la educación media superior. En este contexto el artículo aborda los retos que presenta esta decisión desde la perspectiva de la oferta educativa en sus diferentes modalidades pero también los sentidos del bachillerato para los estudiantes, el nuevo público rural y los problemas de abandono escolar. Discute el tema de la diversificación necesaria y la desigualdad que la acompaña. Caracteriza la Reforma de la Educación Media Superior y la instauración del Sistema Nacional de Bachillerato desde un enfoque administrativo de la gestión y termina apuntando aspectos que habría que fortalecer desde una perspectiva pedagógica y de los sujetos. El escrito se sustenta por un lado en documentos oficiales y en datos del Instituto Nacional para la Evaluación de la Educación y por el otro en hallazgos de la línea de investigación cualitativa "Jóvenes y bachillerato"

La organización de la tarea didáctica : La planificación

La formación en didáctica y práctica de la Geografía de los profesores en la Universidad Nacional del Sur es concebida como un proceso complejo e inacabado de construcción personal del conocimiento, en el que el ejercicio del análisis reflexivo representa la acción vertebradora. La asignatura Didáctica y Práctica de la Geografía se presenta como un saber en construcción que permite conectar la Geografía como ciencia académica con la Geografía como disciplina en la educación secundaria obligatoria, a través del enlace de los diferentes componentes que se conjugan en el proceso de enseñanza-aprendizaje con el sustento epistemológico, nexo fundamental del proceso. Una de las finalidades formativa de la disciplina es promover mediante acciones concretas un proceso que favorezca un posicionamiento del futuro docente como "autor y protagonista" en la enseñanza de la Geografía, y no como mero aplicador o receptor de diseños y líneas de acciones pensadas por otros actores, muchos de los cuales son ajenos al ámbito del trabajo en el aula. En relación con esta aspiración, a través de diferentes propuestas didácticas se aborda, desde el tratamiento teórico y desde el ejercicio de la práctica, la importancia de diagramar contenidos geográficos para la educación secundaria. De este modo, se intenta construir y fortalecer en el alumno un pensamiento consciente y fundamentado a partir del cual sea posible tomar decisiones para organizar la tarea de enseñanza y aprendizaje

Leer y comprender en las clases de Geografía

El objetivo del presente trabajo, en su primera parte, es realizar algunas reflexiones teóricas sobre la lectura como estrategia de enseñanza en las clases de Geografía. Debido a la complejidad conceptual alcanzada en la enseñanza media y en la formación de profesores, es necesario proponer situaciones de aprendizaje que faciliten el conocimiento y la comprensión de los procesos sociales a diferentes escalas de análisis y desde múltiples perspectivas. En este sentido, el docente que incorpora la problematización como metodología de enseñanza necesariamente contempla las diversas miradas en la selección de textos. En un proceso de lectura interactivo se requiere de un lector dinámico que procese la información con el aporte de sus conocimientos previos, experiencias y prácticas en las que pone en juego sus saberes, capacidades y habilidades. De este modo, para finalizar se presentan en la segunda parte del artículo ejemplos que muestran las oportunidades didácticas que brinda la lectura

La enseñanza de las Ciencias Sociales en los profesorados de educación primaria de la provincia de Buenos Aires : La Geografía, gran ausente : Análisis de situación y aporte superador

Alejandro Kaufman (2008) señala que grandes transformaciones se están produciendo desde una perspectiva histórico - cultural en la relación que se establece entre la educación y la sociedad. Y que muchas de las tensiones entre ambas son el producto de lo que denomina "novedades" culturales. Sostiene que la educación se ha sustentado en una cierta previsibilidad y que, en cuanto que la modernidad representa progreso, el cual estaría asociado a la desaparición o transformación de muchas de esas certidumbres, la escuela estaría sufriendo ciertas modificaciones que involucran los propios cimientos de la institución escolar. La formación de los futuros maestros en el área de Ciencias Sociales debe ser ajustada a los requerimientos de esta nueva sociedad. El abordaje de la Didáctica de las Ciencias Sociales debe considerar las nuevas aproximaciones epistemológicas y temáticas relevantes en las propuestas pedagógicas. Es indispensable que, así como existen contenidos de Geografía en los planes de estudio de los profesorados y profusas indicaciones para su tratamiento en los diseños curriculares de Primero y Segundo ciclo, se verifique el desarrollo de los mismos desde una mirada crítica que permita tanto a docentes como alumnos un compromiso con el mundo en el que la escuela está inserta

La re-construcción del sujeto. Procesos de agencia y subjetivación en las prácticas de corporización

Preguntarse en la actualidad sobre el tipo de corporeidad que se construye en la escuela primaria, problematiza una serie de nociones como ser subjetividad, sujeto, identidad, corporeidad etc. entre otros. Los cuales abordados desde enfoques pos estructuralistas y por feministas revierten ciertas categorías fijas y estables en función de la construcción de una corporeidad acorde a las necesidades de los sujetos posibles. Tal vez la antigua idea de la construcción del sujeto desde el "cuidado de si" atendiendo al cuidado del cuerpo desde la dietética (relación entre el cuidado y el régimen general de la existencia del cuerpo y del alma); la economía (relación entre el cuidado de uno mismo y la actividad social) y la erótica (relación entre el cuidado de uno mismo y la relación amorosa) merezca una reconsideración más acorde a los momentos actuales sin olvidar la esencia primaria, que es la construcción de sujetos libres. Sobre algunas de estas cuestiones se abre el debate en este artículo invitando a los lectores a reconsiderar la autorización y agencia de los sujetos corpóreos más allá de la pesada carga limitante de las estructuras sociales.

A cultura escolar da educação física no EJA : O paradoxo entre a ruptura com a noção de atividade e a falta da prática corporal

This paper is the result of a research based on the school culture concept, which object is the specific school culture of the physical education (PE) within a school for youth and adults situated in Curitiba - PR. Methodologically we followed the principles and concepts of the ethnomethodology, that led us to a long immersion in the research field. The main results of the research show the relevance of the teacher identity for constituting the school culture of the PE, as well the paradox resulting of a mere theoretical approach: on the one hand this school culture show us the importance of the disruption with the PE's tradition based on the notion of "activity", and on the other hand reveal the necessity of the body experience as a fundament to build a theoretical construct

La educación media superior en México ante el reto de su universalización

En México, se legisló en octubre del 2011 la universalización de la educación media superior. En este contexto el artículo aborda los retos que presenta esta decisión desde la perspectiva de la oferta educativa en sus diferentes modalidades pero también los sentidos del bachillerato para los estudiantes, el nuevo público rural y los problemas de abandono escolar. Discute el tema de la diversificación necesaria y la desigualdad que la acompaña. Caracteriza la Reforma de la Educación Media Superior y la instauración del Sistema Nacional de Bachillerato desde un enfoque administrativo de la gestión y termina apuntando aspectos que habría que fortalecer desde una perspectiva pedagógica y de los sujetos. El escrito se sustenta por un lado en documentos oficiales y en datos del Instituto Nacional para la Evaluación de la Educación y por el otro en hallazgos de la línea de investigación cualitativa "Jóvenes y bachillerato"