Parents living with HIV in a high-income country: do patients need specific support?

The number of HIV-infected persons with children and caregiving duties is likely to increase. From this statement, the present study was designed to establish how HIV infected caregivers organise their parenting routines and to determine their support needs. A further aim was to ascertain caregivers' perception of conspicuous behaviours displayed by their children. Finally, it sought to determine the extent to which the caregivers' assessment of their parenting activity is influenced by the required support and their children's perceived conspicuous behaviours. The study design was observational and cross-sectional. Sampling was based on the 7 HIV Outpatient Clinics associated with the national population-based Swiss HIV Cohort Study. It focused on persons living with HIV who are responsible for raising children below the age of 18. A total of 520 caregivers were approached and 261 participated. An anonymous, standardised, self-administered questionnaire was used for data collection. The data were analysed using descriptive statistical procedures and backward elimination multiple regression analysis. The 261 respondents cared for 406 children and adolescents under 18 years of age; the median age was 10 years. The caregivers' material resources were low. 70% had a net family income in a range below the median of Swiss net family income and 30% were dependent on welfare assistance. 73% were undergoing treatment with 86% reporting no physical impairments. The proportion of single caregivers was 34%. 92% of the children were living with their HIV infected caregivers. 80% of the children attended an institution such as a school or kindergarten during the day. 89% of the caregivers had access to social networks providing support. Nevertheless, caregivers required additional support in performing their parenting duties and indicated a need for assistance on the material level, in connection with legal problems and with participation in the labour market. 46% of the caregivers had observed one or more conspicuous behaviours displayed by their children, which indicates a challenging situation. However, most of these caregivers assessed their parenting activity very favourably. Backward elimination multiple regression analysis indicated that a smaller number of support needs, younger age of the eldest child and fewer physical impairments on the part of the caregiver enhance the caregivers' assessment of their parenting activity. Physicians should speak to caregivers living with HIV about their parenting responsibilities and provide the necessary scope for this subject in their consultation sessions. Physicians are in a position to draw their patients' attention to the services available to them.

Comparing potentially avoidable hospitalization rates related to ambulatory care sensitive conditions in Switzerland: the need to refine the definition of health conditions and to adjust for population health status.

BACKGROUND: Regional rates of hospitalization for ambulatory care sensitive conditions (ACSC) are used to compare the availability and quality of ambulatory care but the risk adjustment for population health status is often minimal. The objectives of the study was to examine the impact of more extensive risk adjustment on regional comparisons and to investigate the relationship between various area-level factors and the properly adjusted rates. METHODS: Our study is an observational study based on routine data of 2 million anonymous insured in 26 Swiss cantons followed over one or two years. A binomial negative regression was modeled with increasingly detailed information on health status (age and gender only, inpatient diagnoses, outpatient conditions inferred from dispensed drugs and frequency of physician visits). Hospitalizations for ACSC were identified from principal diagnoses detecting 19 conditions, with an updated list of ICD-10 diagnostic codes. Co-morbidities and surgical procedures were used as exclusion criteria to improve the specificity of the detection of potentially avoidable hospitalizations. The impact of the adjustment approaches was measured by changes in the standardized ratios calculated with and without other data besides age and gender. RESULTS: 25% of cases identified by inpatient main diagnoses were removed by applying exclusion criteria. Cantonal ACSC hospitalizations rates varied from to 1.4 to 8.9 per 1,000 insured, per year. Morbidity inferred from diagnoses and drugs dramatically increased the predictive performance, the greatest effect found for conditions linked to an ACSC. More visits were associated with fewer PAH although very high users were at greater risk and subjects who had not consulted at negligible risk. By maximizing health status adjustment, two thirds of the cantons changed their adjusted ratio by more than 10 percent. Cantonal variations remained substantial but unexplained by supply or demand. CONCLUSION: Additional adjustment for health status is required when using ACSC to monitor ambulatory care. Drug-inferred morbidities are a promising approach.

Mentorships and co-op placements as a means of heightening the need for a secondary school diploma to the education of at-risk students.--

Both educators and politicians appear to be quite concerned about a dropout rate in Ontario's public schools of some 30 percent. With the basic understanding that a high dropout rate is costly both in economic terms and in human terms, something quite obviously needs to be done to reduce the dropout rate in Ontario schools and, in doing so, ensuring Ontario and its graduates an active role in a growing global economy. This study is an exploratory pilot study in that it examined mentoring and the role that mentoring can play in assisting a student in staying in school and graduating from secondary school. Also incorporated in this is co-operative education and the role it can play, through mentoring, in making students aware of lifestyle level of employment, and of the skills necessary to obtain gainful, meaningful employment. In order to gain information on student attitudes, needs and expectations of a mentoring situation, a series of three questionnaires was used. Also, a questionnaire was distributed to the various co-operative education employers. The intent of this questionnaire was to probe the attitudes, needs and expectations of a mentoring situation from the perspective of an employer. The findings of this study indicated that co-operative education and mentoring are a very valuable and useful component in education. There exist certain factors in a co-operative education setting that serve to enhance and to augment the traditional or "theoretical" setting of the classroom. In addition, a mentoring situation tends to add a sense of relevance to education that students seem to require. Also, an opportunity is offered that allows a student to practice and further refine the skills that have been taught over the course of the student's academic life. Results from this study suggested that a mentoring situation, occurring through a co-operative education situation, adds relevance and a sense of "application" to the traditional or classroom schooling situation. The whole idea of mentoring bodes well for the future of education and of the student. Many advantages are identified in a mentoring situation. One of the advantages is that the schools are able to work quite closely with the community and business in order to stay current and informed on the needs and expected needs of the business community. Co-operative education has now gone beyond being an "experimental" mode of education. All students can benefit from being involved in the program. Certainly at-risk students are aided with staying in school. Those students who are said to be not at-risk can also benefit from being enrolled in the program by gaining hands-on work experience and some of the necessary skills to ensure a place in a growing world economy.

An after-school literacy program : investigating the experiences of students with literacy difficulties, their volunteer tutors, and the tutors' transition into the teaching profession

This research responds to a pervasive call for our educational institutions to provide students with literacy skills, and teachers with the instructional supports necessary to facilitate this skill acquisition. Questions were posed to gain information concerning the efficacy ofteaching literacy strategies to students with learning difficulties, the impact of this training on their volunteer tutors, and the influence of this experience on these tutors' ensuing instructional practice as teacher candidates in a preservice education program. Study #1 compared a nontreatment group of students with literacy difficulties who participated in the program and found that program participants were superior at reading letter patterns and at comprehending the elements of story grammar. Concurrently, the second study explored the experiences of 19 volunteer tutors and uncovered that they acquired instructional skills as they established a knowledge base in teaching reading and writing, and they affirmed personal goals to become future teachers. Study #3 tracked 6 volunteer tutors into their pre-service year and identified their constructions, and beliefs about literacy instruction. These teacher candidates discussed how they had intended to teach reading and writing strategies based on their position that effective teaching ofthese skills in the primary grades is integral to academic success. The teacher candidates emphasized the need to build rapport with students, and the need to exercise flexibility in lesson plan delivery while including activities to meet emotional and developmental requirements of students. The teacher candidates entered their pre-service education with an initial cognition set based on the limited teaching context of tutoring. This foundational ii perception represented their prior knowledge of literacy instruction, a perception that appeared untenable once they were immersed in a regular instructional setting. This disparity provoked some of the teacher candidates to denounce their teacher mentors for not consistently employing literacy strategies and individualized instruction. This critical perspective could have been a demonstration of cognitive dissonance. In the end, when the teacher candidates began to look toward the future and how they would manage the demands of an inclusive classroom, they recognized the differences in the contexts. With an appreciation for the need for balance between prior and present knowledge, the teacher candidates remained committed to implementing their tutoring strategies in future teaching positions. This document highlights the need for teacher candidates with instructional experience prior to teacher education, to engage in cognitive negotiations to assimilate newly acquired pedagogies into existing pedagogies.

Sex education for individuals who have a developmental disability : the need for assessment

This study was an evaluation of the sexual knowledge of individuals who have '"a developmental disability and the effect of sex education. This was also a pilot study involving the evaluation of the Socio-Sexual Knowledge and Attitudes Assessment Tool (SSKAAT; Griffiths & Lunsky, in press). This tool is a revised version of the Socio-Sexual Knowledge and Attitudes Test (SSKAT; Wish, Fiechtl McCombs, & Edmonson, 1980). Thirty-two individuals participated in the study (20 males and 12 females), who were receiving supports from local community agencies. Participants were assessed using the SSKAAT and SSKAT in an initial assessment and in a 6-week follow-up. Sixteen participants received a 6-week sex education program, Life Horizons I and II (Kempton & Stanfield, 1988a, 1988b), between the assessments, while 16 participants served as a control group. It was found that sex education was successful at increasing knowledge regarding sexuality, as demonstrated by increased scores on both the SSKAT and SSKAAT. However, the current study did not demonstrate any significant effect of gender on knowledge about sexuality. It was also found that IQ did not have a significant effect on knowledge regarding sexuality. The present study found the SSKAAT to be very reliable, with test-retest reliabilities ranging from .87 to .99. This appeared to be an improvement over the original SSKAT, whose reliability ranged from .72 to .90. Furthennore, the revised SSKAAT was fOlmd to provide a much more in-depth assessment of sexual knowledge and attitudes for individuals who have a developmental disability.

Motivation and psychological need salience in the experiences of initiating and maintaining exercise as an older female adult

Objectives: The primary objective ofthis study was to explore motivation and psychological need salience in the initiatory and maintenance experiences of older female exercIsers. Methods: Female initiates (n = 3) and reflective maintainers (n = 3) 65 years of age or older (M = 76 years; SD = 5.37) participated in semi-structured interviews. Data were analyzed holistically and categorically, following a hermeneutic approach to inquiry. Results: Perceived importance of exercise benefits appeared to be the strongest motive for initiates at this stage of life and connections to others were perceived as valued, but less important in exercise contexts. Also, listening to one's body over instructions from the exercise leader emerged as a key factor to success. Conclusions: Overall, the results ofthis study implicate more self-determined than controlled motives as sources of regulation in older females' exercise initiation experiences. Evidence for psychological needs was more heterogeneous and less conclusive.

Collegiate volleyball players' need fulfillment, balance and well-being

Proponents of Basic Needs Theory (BNT; Deci & Ryan, 2002) contend that the mechanism underpinning psychological well-being is the fulfillment of basic psychological needs with their fulfillment addressed in an independent (Deci & Ryan, 2002) or balanced manner (Sheldon & Niemiec, 2006). The purpose of this investigation was to explore the associations between the fulfillment of basic psychological needs and two forms of psychological well-being, namely hedonic and eudaimonic indices. Employing purposive sampling and a cross-sectional design, collegiate volleyball players (N = 219; nfemales = 127) completed a battery of self-report instruments assessing psychological need satisfaction and well-being toward the mid-to-end portion oftheir competitive season. Aligned with BNT (Deci & Ryan, 2002) tenets and study hypotheses, results demonstrated that basic psychological need fulfillment was associated with psychological well-being in the context of volleyball. Albeit minimal, balanced need fulfillment was generally predictive of well-being indices beyond independent need contributions with suppressor effects noted. In sum, the results of the present investigation generally coincide with previous sport based BNT (e.g., Reinboth & Duda, 2006) and balanced need satisfaction (e.g., Sheldon & Niemiec, 2006) literature. Additional BNT support has been garnished and suggests that the fulfillment of the basic psychological needs for competence, autonomy, and relatedness may be targeted as the mechanisms to facilitate athletes' psychological well-being. Along with Ryan and Deci's (2007) recommendations, the outcomes of this investigation highlight the need for further empirical study ofBNT's tenets in the realm of sport including assessments of balanced need satisfaction as well as varied hedonic and eudaimonic indices.

Electrocortical indices of cognitive control in working memory : exploring the effects of proactive interference, cognitive load, and aging

Cognitive control involves the ability to flexibly adjust cognitive processing in order to resist interference and promote goal-directed behaviour. Although frontal cortex is considered to be broadly involved in cognitive control, the mechanisms by which frontal brain areas implement control functions are unclear. Furthermore, aging is associated with reductions in the ability to implement control functions and questions remain as to whether unique cortical responses serve a compensatory role in maintaining maximal performance in later years. Described here are three studies in which electrophysiological data were recorded while participants performed modified versions of the standard Sternberg task. The goal was to determine how top-down control is implemented in younger adults and altered in aging. In study I, the effects of frequent stimulus repetition on the interference-related N450 were investigated in a Sternberg task with a small stimulus set (requiring extensive stimulus resampling) and a task with a large stimulus set (requiring no stimulus resampling).The data indicated that constant stimulus res amp ling required by employing small stimulus sets can undercut the effect of proactive interference on the N450. In study 2, younger and older adults were tested in a standard version of the Sternberg task to determine whether the unique frontal positivity, previously shown to predict memory impairment in older adults during a proactive interference task, would be associated with the improved performance when memory recognition could be aided by unambiguous stimulus familiarity. Here, results indicated that the frontal positivity was associated with poorer memory performance, replicating the effect observed in a more cognitively demanding task, and showing that stimulus familiarity does not mediate compensatory cortical activations in older adults. Although the frontal positivity could be interpreted to reflect maladaptive cortical activation, it may also reflect attempts at compensation that fail to fully ameliorate agerelated decline. Furthermore, the frontal positivity may be the result of older adults' reliance on late occurring, controlled processing in contrast to younger adults' ability to identify stimuli at very early stages of processing. In the final study, working memory load was manipulated in the proactive interference Sternberg task in order to investigate whether the N450 reflects simple interference detection, with little need for cognitive resources, or an active conflict resolution mechanism that requires executive resources to implement. Independent component analysis was used to isolate the effect of interference revealing that the canonical N450 was based on two dissociable cognitive control mechanisms: a left frontal negativity that reflects active interference resolution, , but requires executive resources to implement, and a right frontal negativity that reflects global response inhibition that can be relied on when executive resources are minimal but at the cost of a slowed response. Collectively, these studies advance understanding of the factors that influence younger and older adults' ability to satisfy goal-directed behavioural requirements in the face of interference and the effects of age-related cognitive decline.

Hot cognition and activation of the medial prefrontal cortex: Self-regulating in contexts involving motivational pressures

The medial prefrontal cortex (mPFC) is involved in performance-monitoring and has been implicated in the generation of several electrocortical responses associated with self-regulation. The error-related negativity (ERN), the inhibitory Nogo N2 (N2), and the feedback-related negativity (FRN) are event-related potential (ERP) components which reflect mPFC activity associated with feedback to behavioural (ERN, N2) and environmental (FRN) consequences. Our main goal was to determine whether or not rnPFC activation varies as a function of motivational context (e.g., those involving performance-related incentives) or the use of internally versus externally generated feedback signals (i.e., errors). Additionally, we assessed medial prefrontal activity in relation to individual differences in personality and temperament. Participants completed a combination of tasks in which performance-related incentives were associated with task performance and feedback generated from internal versus external responses. MPFC activity was indexed using both ERP scalp voltage peaks and intracerebral current source density (CSD) of dorsal and ventral regions. Additionally, participants completed several questionnaires assessing personality and temperament styles. Given previous studies have shown that enhanced mPFC activity to loss (or negative) feedback, we expected that activity in the mPFC would generally be greater during the Loss condition relative to the Win condition for both the ERN and N2. Also, due to the evidence that the (vmPFC) is engaged in arousing contexts, we hypothesized that activity in the ventromedial prefrontal cortex (vmPFC) would be greater than activity in the dorsomedial prefrontal cortex (dmPFC), especially in the Loss condition of the GoNogo task (ERN). Similarly, loss feedback in the BART (FRN) was expected to engage the vmPFC more than the dmPFC. Finally, we predicted that persons rating themselves as more willing to engage in approach-related behaviours or to exhibit rigid cognitive styles would show reduced activity of the mPFC. Overall, our results emphasize the role of affective evaluations of behavioural and environmental consequences when self-regulating. Although there were no effects of context on brain activity, our data indicate that, during the time of the ERN and N2 on the MW Go-Nogo task and the FRN on the BART, the vrnPFC was more active compared to the dmPFC. Moreover, regional recruitment in the mPFC was similar across internally (ERN) and externally (FRN) generated errors signals associated with loss feedback, as reflected by relatively greater activity in the vmPFC than the dmPFC. Our data also suggest that greater activity in the mPFC is associated with better inhibitory control, as reflected by both scalp and CSD measures. Additionally, deactivation of the subgenual anterior cingulate cortex (sgACC) and lower levels of self-reported positive affect were both related to increased voluntary risk-taking on the BART. Finally, persons reporting higher levels of approach-related behaviour or cognitive rigidity showed reduced activity of the mPFC. These results are in line with previous research emphasizing that affect/motivation is central to the processes reflected by mediofrontal negativities (MFNs), that the vmPFC is involved in regulating demands on motivational/affective systems, and that the underlying mechanisms driving these functions vary across both individuals and contexts.

The Kids Need Hip-Hop: Reengaging Students through Culturally Relevant Pedagogy

My thesis advocates for critically-conscious hip-hop in classrooms to promote student engagement and culturally relevant pedagogical practices. This proposed approach to educating youth offsets the harmful effects of a normalized curriculum that limits students’ creativity and discounts their experiences as lifelong learners. My thesis gathers data from research literature on hip-hop and education, critically-conscious hip-hop lyrics, and also includes my own hip-hop muse to illustrate the positive tenets of critically-conscious hip-hop. The research literature in my thesis is gathered from multiple studies within North American high schools. My hip-hop muse interrelates with critically-conscious hip-hop lyrics because they both address contemporary issues through social commentary and critical awareness. The element of social commentary in my hip-hop muse is displayed through short poems and verses that outline my experiences in a normalized schooling environment. Throughout my thesis, I uncover the causes of student disengagement in classrooms, the ways in which critically-conscious hip-hop music serves as a tool for reengaging youth, and the approaches that must be taken in order to adequately integrate hip-hop into today’s classrooms. My thesis is important within the context of Canadian classrooms because it acts as an agent for social change and cultural relevance through a critical lens. The purpose of this approach, then, is to demonstrate an understanding of the complexity of our society and schooling system through social critique and proposals for change. More importantly, my thesis is grounded in equity; in which critically-conscious hip-hop serves as a bridge for students’ experiences, interests, and independent identities.

We need to have a conversation about OpenURL, a close look at a corpus of error reports from the 2013 academic year. Or, How I learned to stop worrying and give up on clean metadata.

Presented at Access 2014, winner of poster contest.

Peer Victimization and the Need to Belong within the Context of Recess

Within the school setting, recess is often reported as a frequent context for bullying (Vaillancourt et al. 2010), but is currently understudied. The present study utilized a mixed-methods approach in order to examine the frequency of peer victimization at recess and explore how the current context of recess relates to children’s sense of belonging. Participants included 464 students between grades 4 to 8 from nine Southern Ontario elementary schools. Self-report measures on peer victimization and belongingness were completed, along with open-ended questions regarding the recess context. Results demonstrated the frequencies of peer victimization at recess, the relationship between victimization and belonging, contextual factors that promote and impede belongingness at recess, and solutions to support children who feel left out.These findings provide further insight for educators and administrators in order to better support children who experience victimization within the recess context.

Cognition in Seemingly Riskless Choices and Judgments.

We instillate rational cognition and learning in seemingly riskless choices and judgments. Preferences and possibilities are given in a stochastic sense and based on revisable expectations. the theory predicts experimental preference reversals and passes a sharp econometric test of the status quo bias drawn from a field study.