Confirmatory factor analysis of the School Refusal Assessment Scale – Revised in an African American community sample

PubMed Central

Lyon, Aaron R.

2010-01-01

The current study used confirmatory factor analysis techniques to investigate the construct validity of the child version of the School Refusal Assessment Scale – Revised (SRAS-R) in a community sample of low socioeconomic status, urban, African American fifth and sixth graders (n = 174). The SRAS-R is the best-researched measure of school refusal behavior in youth and typically yields four functional dimensions. Results of the investigation suggested that a modified version of the four-factor model, in which three items from the tangible reinforcement dimension are removed, may have construct validity in the current sample of youth. In addition, youth endorsement of the dimension measuring avoidance of social and/or evaluative situations was positively associated with unexcused absences. Implications for further psychometric research and early identification and prevention of problematic absenteeism in low-SES, ethnic minority community samples are highlighted. PMID:20567603

Increasing In-School Food Consumption of an Elementary Student with Emotional/Behavioral Disorders: A Case Study

ERIC Educational Resources Information Center

Wood, Brenna K.; Flanagan, Timothy F.

2013-01-01

Researchers conducted the present case study to address the immediate need of a student who consumed food at home and refused all food and liquids in her elementary school setting. In order to increase in-school food consumption, researchers developed a multicomponent treatment package that included antecedent adjustments (time and place food was…

Academic Self-Attributions for Success and Failure in Mathematics and School Refusal

ERIC Educational Resources Information Center

Gonzálvez, Carolina; Sanmartín, Ricardo; Vicent, María; Inglés, Cándido J.; Aparicio-Flores, M. Pilar; García-Fernández, José M.

2018-01-01

The aim of this research is twofold: to analyze the mean differences scores in mathematic self-attributions based on school refusal and to verify its predictive capability on high scores in school refusal. The Sydney Attribution Scale and the School Refusal Assessment Scale-Revised were administered to 1078 Spanish students (50.8% boys) aged…

[The relationship between smoking behavior and self-esteem among elementary and junior high school students].

PubMed

Kawabata, T; Shimai, S; Nishioka, N

1998-01-01

This study examined the relationship between smoking behavior and self-esteem among Japanese early adolescents. The study sample comprised 1,486 fourth through ninth grade students from 10 elementary schools and six junior high schools throughout nine prefectures. Data were collected using an anonymous self-administered questionnaire which included items measuring smoking behavior, self-esteem, intention to smoke in the future, self-efficacy to refuse peer pressure to smoke, the smoking behaviors of their parents, siblings and friends. Self-esteem was measured using the Harter Perceived Competence Scale which includes four areas: cognitive, social, physical, and general. The main results were as follows: 1) Ever smokers had lower cognitive and general competence scores, but a higher physical competence score than never smokers, especially among males. 2) Ever smokers had more smoking parents, siblings and friends than never smokers. 3) Ever smokers had stronger intention to smoke in the future than never smokers. 4) Ever smokers had lower self-efficacy to refuse peer pressure to smoke than never smokers. The results of this study about the relationship between smoking behavior and self-esteem were consistent with those of some previous studies in the U.S. Therefore, it is suggested that effective smoking prevention programs for Japanese early adolescents should include strategies to enhance self-esteem.

School Refuser Child Identities

ERIC Educational Resources Information Center

Stroobant, Emma; Jones, Alison

2006-01-01

"School refuser" is an always-already negative child identity. The term is used to categorize children or adolescents who appear to dislike and fear school (or aspects of school) and persistently refuse to attend or attend very unwillingly. Given that school attendance is generally considered a necessary social good, regular and anxious…

The parent-adolescent relationship education (PARE) program: a curriculum for prevention of STDs and pregnancy in middle school youth.

PubMed

Lederman, Regina P; Mian, Tahir S

2003-01-01

The Parent-Adolescent Relationship Education (PARE) Program, designed for parents and middle school students, focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy, human immunodeficiency virus (HIV), and other sexually transmitted diseases (STDs). The program includes content about reproduction, STDs and Acquired Immune Deficiency Syndrome (AIDS), contraception, sex risks, and safe-sex behaviors. The course uses social learning and cognitive behavioral concepts to enhance decision-making, refusal, and resistance skills. A randomized treatment or control group design is used to assign parent-child dyads to an experimental education group (social learning) or an attention-control group (traditional didactic teaching). Three post-program maintenance or booster sessions are held at 6-month intervals and at times prior to peak teen conception periods to reinforce the knowledge and skills learned. Pre- and posttests for parents and students assess group differences in parental involvement and communication, contraception, sex attitudes and intentions, sex behaviors (initiation of sexual intercourse, frequency, number of partners, contraceptive practices, refusal skills), and the incidence of pregnancy.

Using a Preventive Social Work Program for Reducing School Refusal

ERIC Educational Resources Information Center

Elsherbiny, Mohamed Mohamed

2017-01-01

This article describes a study aimed at solving the problem of school refusal by implementing a preventive program and raising the awareness of parents, social workers, and school personnel. The school children involved in this study were reported by their parents and school social workers to refuse to go to school, and according to the children's…

Impact of HealthWise South Africa on polydrug use and high-risk sexual behavior.

PubMed

Tibbits, Melissa K; Smith, Edward A; Caldwell, Linda L; Flisher, Alan J

2011-08-01

This study was designed to evaluate the efficacy of the HealthWise South Africa HIV and substance abuse prevention program at impacting adolescents' polydrug use and sexual risk behaviors. HealthWise is a school-based intervention designed to promote social-emotional skills, increase knowledge and refusal skills relevant to substance use and sexual behaviors, and encourage healthy free time activities. Four intervention schools in one township near Cape Town, South Africa were matched to five comparison schools (N = 4040). The sample included equal numbers of male and female participants (Mean age = 14.0). Multiple regression was used to assess the impact of HealthWise on the outcomes of interest. Findings suggest that among virgins at baseline (beginning of eighth grade) who had sex by Wave 5 (beginning of 10th grade), HealthWise youth were less likely than comparison youth to engage in two or more risk behaviors at last sex. Additionally, HealthWise was effective at slowing the onset of frequent polydrug use among non-users at baseline and slowing the increase in this outcome among all participants. Program effects were not found for lifetime sexual activity, condomless sex refusal and past-month polydrug use. These findings suggest that HealthWise is a promising approach to HIV and substance abuse prevention.

Impact of HealthWise South Africa on Polydrug Use and High-Risk Sexual Behavior

ERIC Educational Resources Information Center

Tibbits, Melissa K.; Smith, Edward A.; Caldwell, Linda L.; Flisher, Alan J.

2011-01-01

This study was designed to evaluate the efficacy of the HealthWise South Africa HIV and substance abuse prevention program at impacting adolescents' polydrug use and sexual risk behaviors. HealthWise is a school-based intervention designed to promote social-emotional skills, increase knowledge and refusal skills relevant to substance use and…

Effective Intervention for School Refusal Behaviour

ERIC Educational Resources Information Center

Nuttall, Clare; Woods, Kevin

2013-01-01

Evaluation of successful professional intervention for two case studies of female adolescents' school refusal behaviour is presented. Data gathered from the young person, professionals, and parents in each case are synthesised to propose a multi-level, ecologically situated model of intervention for school refusal behaviour. The proposed model…

[The parents' experience of school refusal in adolescence].

PubMed

Bussard, Dewi; Harf, Aurélie; Sibeoni, Jordan; Radjack, Rahmeth; Benoit, Jean Pierre; Moro, Marie Rose

2015-01-01

While today's society places considerable importance on schooling and performances, school absenteeism is currently very high. One of the causes is anxiety-based school refusal. This phenomenon affects the adolescent but also has an impact on their family. Exploring the experience of the parents of teenagers presenting anxiety-based school refusal enables these families to be given better support. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Frequent fliers, school phobias, and the sick student: school health personnel's perceptions of students who refuse school.

PubMed

Torrens Armstrong, Anna M; McCormack Brown, Kelli R; Brindley, Roger; Coreil, Jeannine; McDermott, Robert J

2011-09-01

This study explored school personnel's perceptions of school refusal, as it has been described as a "common educational and public health problem" that is less tolerated due to increasing awareness of the potential socioeconomic consequences of this phenomenon. In-depth interviews were conducted with school personnel at the middle school (N = 42), high school (N = 40), and district levels (N = 10). The findings focus on emergent themes from interviews with school health personnel (N = 12), particularly those themes related to their perceptions of and role in working with school-refusing students. Personnel, especially school health services staff, constructed a typification of the school-refusing student as "the sick student," which conceptualized student refusal due to reasons related to illness. Personnel further delineated sick students by whether they considered the illness legitimate. School health personnel referenced the infamous "frequent fliers" and "school phobics" within this categorization of students. Overarching dynamics of this typification included parental control, parental awareness, student locus of control, blame, and victim status. These typifications influenced how personnel reacted to students they encountered, particularly in deciding which students need "help" versus "discipline," thus presenting implications for students and screening of students. Overall, findings suggest school health personnel play a pivotal role in screening students who are refusing school as well as keeping students in school, underscoring policy that supports an increased presence of school health personnel. Recommendations for school health, prevention, and early intervention include the development of screening protocols and staff training. © 2011, American School Health Association.

Longitudinal changes in adolescent cigarette smoking behavior: onset and cessation.

PubMed

Ary, D V; Biglan, A

1988-08-01

Employing a 1-year longitudinal design, this study examined factors related to change in adolescent smoking. Predictors of smoking onset differed from predictors of continued smoking, underscoring the importance of studying factors related to adolescent smoking onset separately from mechanisms associated with changes in smoking among current smokers. Peer smoking predicted continuation of smoking after smoking initiation. Smokers received over 26 times more offers to smoke than did nonsmokers, suggesting that smokers attempting to quit need effective refusal skills to be successful. Habitual smoking was found to develop slowly, providing a substantial time window for refusal skill training and other prevention efforts. Predictors of smoking onset differed by developmental level. Peer smoking, and marijuana use were stronger predictors of smoking onset for high-school students, and number of cigarette offers predicted better among middle-school students. Parent variables were not significant predictors of later smoking. Intention to smoke was unrelated to onset and was redundant with pretest smoking behavior in predicting cessation.

Treatment for School Refusal among Children and Adolescents: A Systematic Review and Meta-Analysis

ERIC Educational Resources Information Center

Maynard, Brandy R.; Heyne, David; Brendel, Kristen Esposito; Bulanda, Jeffery J.; Thompson, Aaron M.; Pigott, Terri D.

2018-01-01

Objective: School refusal is a psychosocial problem associated with adverse short- and long-term consequences for children and adolescents. The authors conducted a systematic review and meta-analysis to examine the effects of psychosocial treatments for children and adolescents with school refusal. Method: A comprehensive search process was used…

Parental psychological symptoms and familial risk factors of children and adolescents who exhibit school refusal.

PubMed

Bahali, K; Tahiroglu, A Y; Avci, A; Seydaoglu, G

2011-12-01

To assess the levels of psychological symptoms in the parents of children with school refusal and determine the familial risk factors in its development. This study was performed on 55 pairs of parents who had children exhibiting school refusal and were compared with a control group. A socio-demographic data form, the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Symptom Checklist-90 revised were applied to these parents. Parents of the school refusal group had higher anxiety and depression scores than the controls. Among the risk factors for school refusal, physical punishment by the parents, a history of organic disease in the parents or children, and a history of psychiatric disorders in the parents or other relatives were found to be significant. Depending on genetic and environmental factors, parents with psychiatric disorders appeared to be associated with development of psychiatric disorders in their children. Moreover, psychiatric disorders in parents negatively affected the treatment of their children and adolescents who exhibited school refusal. It is therefore vital to treat psychiatric disorders of parents with the children having psychiatric disorders, and thus increase parent participation in their children's therapeutic process.

Belief About Mandatory School Vaccinations and Vaccination Refusal Among Ohio Appalachian Parents: Do Demographic and Religious Factors, General Health, and Political Affiliation Play a Role?

PubMed

Krok-Schoen, Jessica L; Bernardo, Brittany M; Weier, Rory C; Peng, Juan; Katz, Mira L; Reiter, Paul L; Richardson, Morgan S; Pennell, Michael L; Tatum, Cathy M; Paskett, Electra D

2017-11-14

To examine how demographic, general health, religious, and political characteristics influenced beliefs about mandatory school vaccinations and history of vaccination refusal for children among Ohio Appalachian parents. In 2013 and 2014, baseline data were obtained from parents (n = 337) of girls aged 9-17 from 12 counties in rural Ohio Appalachia enrolled in the Community Awareness, Resources and Education (CARE II) Project. Multivariate logistic regression models were used to identify correlates of parental beliefs about mandatory school vaccinations and history of refusing a doctor-recommended vaccine for their child(ren). About 47% of parents agreed that parents should have the right to refuse mandatory school vaccinations for their child(ren). Participants who reported their political affiliation as Republican (OR = 2.45, 95% CI: 1.28-4.66) or Independent (OR = 3.31, 95% CI: 1.70-6.44) were more likely to agree that parents should have the right to refuse school-mandated vaccinations than parents who reported their political affiliation as Democrat. Approximately 39% of parents reported ever refusing a vaccine for their child(ren). Participants who were female (OR = 3.90, 95% CI: 1.04-14.58) and believed that parents should have the right to refuse mandatory school vaccinations (OR = 3.27, 95% CI: 1.90-5.62) were more likely to report ever refusing a vaccine for their child(ren). The study findings provide information to better understand factors related to vaccination refusal among parents in Appalachia Ohio that can be used to design interventions to improve vaccination uptake. © 2017 National Rural Health Association.

[School refusal and dropping out of school: positioning regarding a Swiss perspective].

PubMed

Walitza, Susanne; Melfsen, Siebke; Della Casa, André; Schneller, Lena

2013-01-01

This article deals with refusal to attend school and dropping out of school from the point of view of child and adolescent psychiatry and psychology, in German speaking countries and from the perspective of Swiss schools and their administrative bodies. General epidemiological data on refusal to attend school show that approximately 5% of children and adolescents are likely to try to avoid attending school at some point. There is very little data available on the frequency of school drop-out. In the past two years (2011 and 2012), approximately 2% of all patients seen for the first time at the department of Child and Adolescent Psychiatry, University Zurich, were referred because of failure to attend school, making this phenomenon one of the most common reasons for referral in child and adolescent psychiatry. After a discussion of the epidemiology, symptomatology, causes and its risk factors, the article presents examples drawn from practice and guidelines for intervention in cases of refusal to attend school, and discusses ways of preventing school drop-out from the point of view of schools, hospitals and bodies such as educational psychology services in Switzerland.

School Factors Associated with School Refusal- and Truancy-Related Reasons for School Non-Attendance

ERIC Educational Resources Information Center

Havik, Trude; Bru, Edvin; Ertesvåg, Sigrun K.

2015-01-01

The primary aim of this study was to investigate how students' perceptions of relationships with peers at school and teachers' classroom management are associated with school refusal-related reasons and truancy-related reasons for school non-attendance. The study included controls for emotional stability and relevant parental variables. A student…

Frequent Fliers, School Phobias, and the Sick Student: School Health Personnel's Perceptions of Students Who Refuse School

ERIC Educational Resources Information Center

Torrens Armstrong, Anna M.; McCormack Brown, Kelli R.; Brindley, Roger; Coreil, Jeannine; McDermott, Robert J.

2011-01-01

Background: This study explored school personnel's perceptions of school refusal, as it has been described as a "common educational and public health problem" that is less tolerated due to increasing awareness of the potential socioeconomic consequences of this phenomenon. Methods: In-depth interviews were conducted with school personnel…

School Characteristics that Influence Student Attendance: Experiences of Students in a School Avoidance Program

ERIC Educational Resources Information Center

Wilkins, Julia

2008-01-01

This study examined the reasons that four high school students who had previously refused to attend school willingly attended an alternative K-12 school for students with special needs. The two research questions that framed this study were (a) why do students who refused to attend their regular schools willingly attend Brookfield Park? and (b) in…

Psychosocial Interventions for School Refusal with Primary and Secondary Students: A Systematic Review. Campbell Systematic Reviews 2015:12

ERIC Educational Resources Information Center

Maynard, Brandy R.; Brendel, Kristen E.; Bulanda, Jeffery J.; Heyne, David; Thompson, Aaron M.; Pigott, Therese D.

2015-01-01

School refusal is a psychosocial problem characterized by a student's difficulty attending school and, in many cases, substantial absence from school (Heyne & Sauter, 2013). It is often distinguished from truancy, in part because of the severe emotional distress associated with having to attend school and the absence of severe antisocial…

Parental Perspectives of the Role of School Factors in School Refusal

ERIC Educational Resources Information Center

Havik, Trude; Bru, Edvin; Ertesvåg, Sigrun K.

2014-01-01

The aim of this study was to explore parents' perspectives on the role of school factors in school refusal (SR). Semi-structured interviews were conducted with 17 parents who had experienced SR with their own child. They identified several school factors related to SR. Some of these findings suggest that students who are prone to SR need more…

Reasons Given by High School Students for Refusing Sexually Transmitted Disease Screening

ERIC Educational Resources Information Center

Sanders, Ladatra S.; Nsuami, Malanda; Cropley, Lorelei D.; Taylor, Stephanie N.

2007-01-01

Objective: To determine reasons given by high school students for refusing to participate in a school-based noninvasive chlamydia and gonorrhea screening that was offered at no cost to students, using the health belief model as theoretical framework. Design: Cross-sectional survey. Setting: Public high schools in a southern urban United States…

"Media addiction" in a 10-year-old boy.

PubMed

Brown, Scott; Scharf, Michael A; Bustos, Cristina; Chavira, Denise; Stein, Martin T

2013-06-01

Bryan is a 10-year-old boy who is brought to his pediatrician by his parents with concerns about oppositional behaviors. Bryan's parents report that he has always been hyperactive and oppositional since a very young age. He has been previously diagnosed with attention-deficit hyperactivity disorder and has been treated with appropriate stimulant medications for several years; however, despite this, his parents feel increasingly unable to manage his difficult behaviors. He refuses to do chores or follow through with household routines. He refuses to go to bed at night. His family feels unable to take him to public places because he "climbs all over everything." At school, he acts up in class, is often disruptive, and requires close supervision by teachers. He was recently kicked off of the school bus. He has very few friends, and his parents state that other children do not enjoy to be around him. Bryan's parents also report that he is "obsessed" with electronics. He spends most his free time watching TV and movies and playing computer games. He has a television in his bedroom because otherwise he "monopolizes" the family television. The family also owns several portable electronic devices that he frequently uses. Bryan insists on watching TV during meals and even that the TV stays on in an adjacent room while showering. He gets up early each morning and turns on the television. He refuses to leave the house unless he can take a portable screen device with him. His parents admit to difficulty placing limits on this behavior because they feel it is the only way to keep his other behaviors under control. His mother explains "it is our only pacifier" and that attempts to place restrictions are met with explosive tantrums and have thus been short lived. These efforts have also been impeded due to the habits of his parents and older sibling, who also enjoy spending a significant amount of time watching television.

"Media Addiction" in a 10-Year-Old Boy.

PubMed

Brown, Scott; Scharf, Michael A; Bustos, Cristina; Chavira, Denise; Stein, Martin T

Bryan is a 10-year-old boy who is brought to his pediatrician by his parents with concerns about oppositional behaviors. Bryan's parents report that he has always been hyperactive and oppositional since a very young age. He has been previously diagnosed with attention-deficit hyperactivity disorder and has been treated with appropriate stimulant medications for several years; however, despite this, his parents feel increasingly unable to manage his difficult behaviors. He refuses to do chores or follow through with household routines. He refuses to go to bed at night. His family feels unable to take him to public places because he "climbs all over everything." At school, he acts up in class, is often disruptive, and requires close supervision by teachers. He was recently kicked off of the school bus. He has very few friends, and his parents state that other children do not enjoy to be around him.Bryan's parents also report that he is "obsessed" with electronics. He spends most his free time watching TV and movies and playing computer games. He has a television in his bedroom because otherwise he "monopolizes" the family television. The family also owns several portable electronic devices that he frequently uses. Bryan insists on watching TV during meals and even that the TV stays on in an adjacent room while showering. He gets up early each morning and turns on the television. He refuses to leave the house unless he can take a portable screen device with him. His parents admit to difficulty placing limits on this behavior because they feel it is the only way to keep his other behaviors under control. His mother explains "it is our only pacifier" and that attempts to place restrictions are met with explosive tantrums and have thus been short lived. These efforts have also been impeded due to the habits of his parents and older sibling, who also enjoy spending a significant amount of time watching television.

Teaching refusal skills to sexually active adolescents.

PubMed

Warzak, W J; Page, T J

1990-06-01

Refusal skills training was extended to sexually active handicapped female adolescents who lacked an effective refusal strategy. Role-plays for assessment and training were developed using the who, what, when and where of situations which resulted in unwanted intercourse. Refusal skills were trained following the format of rationale, modeling, rehearsal, feedback, and reinforcement. Baseline rates of most target behaviors were quite low. High frequencies of target behaviors were observed as each behavior became the focus of training. Generalization across staff and time was also observed. The skillfulness and effectiveness of the subjects' refusal skills were judged to be improved as a function of training. One-year follow-up showed decreased sexual activity for each girl.

Functional Assessment of School Attendance Problems: An Adapted Version of the School Refusal Assessment Scale-Revised

ERIC Educational Resources Information Center

Heyne, David A.; Vreeke, Leonie J.; Maric, Marija; Boelens, Harrie; Van Widenfelt, Brigit M.

2017-01-01

The "School Refusal Assessment Scale" (SRAS) was developed to identify four factors that might maintain a youth's school attendance problem (SAP), and thus be targeted for treatment. There is still limited support for the four-factor model inherent to the SRAS and its revision (SRAS-R). Recent studies indicate problems with the wording…

Psychological Factors behind Truancy, School Phobia, and School Refusal: A Literature Study

ERIC Educational Resources Information Center

Ek, Hans; Eriksson, Rikard

2013-01-01

Truancy is a problem that normally leads to treatment interventions within different organizations. Within these organizations different perspectives on the causes and consequences of the above problem can be found. The purpose of this literature study is to map out and describe the current state of research within the fields of school refusal,…

Using Descriptive Assessment in the Treatment of Bite Acceptance and Food Refusal

ERIC Educational Resources Information Center

Casey, Sean D.; Perrin, Christopher J.; Lesser, Aaron D.; Perrin, Stefanie H.; Casey, Cheryl L.; Reed, Gregory K.

2009-01-01

The feeding behaviors of two children who maintained failure to thrive diagnoses and displayed food refusal are assessed in their homes. Descriptive assessments are used to identify schedules of consequence provided by each child's care providers for bite acceptance and food refusal behaviors. Assessments reveal rich schedules of praise and access…

Preferred Information Platforms for Parents Choosing to Refuse Mandatory PARCC Testing in a Southern New Jersey School District

ERIC Educational Resources Information Center

Benson, Lauren

2017-01-01

This executive position paper identifies preferred modes of communication for parents and guardians in a small New Jersey Public School District. Research was conducted because there has been an unprecedented test refusal initiative by parents and guardians of New Jersey Public School Students who are mandated to sit for Partnership for Assessment…

Competence skills help deter smoking among inner city adolescents

PubMed Central

Epstein, J.; Griffin, K.; Botvin, G.

2000-01-01

OBJECTIVE—To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents.
METHODS—Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11-14 years) and junior high (ages 12-15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period.
RESULTS—Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory.
CONCLUSIONS—Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.


Keywords: adolescent smoking; competence skills; refusal assertiveness; peer pressure PMID:10691756

Competence skills help deter smoking among inner city adolescents.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2000-03-01

To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents. Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11-14 years) and junior high (ages 12-15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period. Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory. Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.

Mediators of sexual revictimization risk in adult sexual assault victims.

PubMed

Ullman, Sarah E; Vasquez, Amanda L

2015-01-01

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse, emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior and sexual refusal assertiveness mediational pathways by which child sexual abuse severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to child sexual abuse severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the child sexual abuse severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women.

Mediators of Sexual Revictimization Risk in Adult Sexual Assault Victims

PubMed Central

Ullman, Sarah E.; Vasquez, Amanda L.

2015-01-01

This study examined sexual risk behaviors and sexual refusal assertiveness in relationship to child sexual abuse (CSA), emotion dysregulation, and adult sexual revictimization. Path analyses of 1,094 survivors who had sex in the past year were done to examine sexual risk behavior, and sexual refusal assertiveness mediational pathways by which CSA severity and emotion dysregulation may affect revictimization over one year in adult female sexual assault survivors. Exchanging sex for money and sexual refusal assertiveness were significantly associated with emotion dysregulation, whereas exchanging sex for money, and not sexual refusal assertiveness, was only significantly related to CSA severity. Both exchanging sex for money and sex refusal assertiveness mediated the relationship between emotion dysregulation and adult sexual revictimization. Exchanging sex for money mediated the CSA severity-revictimization relationship. These findings demonstrate the importance of considering both risky and protective sexual behaviors in research and prevention programming that address sexual revictimization in women. PMID:25942287

Mental health consequences of abortion and refused abortion.

PubMed

Watter, W W

1980-02-01

There is no scientific evidence to support the hypothesis put forth by Dr. Philip Ney in a recent article published in the Canadian Journal of Psychiatry that induced abortion is associated with an increase in child abuse. There are, however, numerous studies which support the contention that mandatory motherhood adversely affects the mental health of both the mother and the offspring. Studies conducted in Sweden, Scotland, and Czechoslovakia revealed that women who were refused abortions frequently experienced serious psychosocial difficulties for long periods of time following abortion refusal. Case controlled follow-up studies, conducted in Sweden and Czechoslovakia, of offspring born to women who were refused abortions demonstrated that a higher proportion of the unwanted children required psychiatric services, engaged in criminal behavior, and did less well in school than the controlled children. These studies have implications for the current Canadian law which permits a woman to obtain an abortion if pregnancy continuation will endanger her health. In view of the above statistical evidence, and the fact that mortality and morbidity are known to be lower for abortion than for childbirth, any person who denies a woman the right to have an abortion is increasing the risk that the health of the woman will be endangered. By law, therefore, all abortion requests should be honored.

Drink refusal training as part of a combined behavioral intervention: Effectiveness and mechanisms of change

PubMed Central

Witkiewitz, Katie; Donovan, Dennis M.; Hartzler, Bryan

2012-01-01

Objective Many trials have demonstrated the effectiveness of cognitive behavioral interventions for alcohol dependence, yet few studies have examined why particular treatments are effective. This study was designed to evaluate whether drink refusal training was an effective component of a combined behavioral intervention (CBI) and whether change in self-efficacy was a mechanism of change following drink refusal training for individuals with alcohol dependence. Method The current study is a secondary analysis of data from the COMBINE study, a randomized clinical trial that combined pharmacotherapy with behavioral intervention in the treatment of alcohol dependence. The goal of the current study was to examine whether a drink refusal skills training module, administered as part of a 16-week CBI (n=776; 31% female, 23% non-White, average age=44) predicted changes in drinking frequency and self-efficacy during and following the CBI, and whether changes in self-efficacy following drink refusal training predicted changes in drinking frequency up to one year following treatment. Results Participants (n=302) who received drink refusal skills training had significantly fewer drinking days during treatment (d=0.50) and up to one year following treatment (d=0.23). In addition the effect of the drink refusal skills training module on drinking outcomes following treatment was significantly mediated by changes in self-efficacy, even after controlling for changes in drinking outcomes during treatment (proportion mediated = 0.47). Conclusions Drink refusal training is an effective component of CBI and some of the effectiveness may be attributed to changes in client self-efficacy. PMID:22289131

School, Friends, and Substance Use: Gender Differences on the Influence of Attitudes Toward School and Close Friend Networks on Cannabis Involvement.

PubMed

Zaharakis, Nikola; Mason, Michael J; Mennis, Jeremy; Light, John; Rusby, Julie C; Westling, Erika; Crewe, Stephanie; Flay, Brian R; Way, Thomas

2018-02-01

The school environment is extremely salient in young adolescents' lives. Adolescents who have unfavorable attitudes toward school and teachers are at elevated risk for dropping out of school and engaging in behavioral health risks. Peer network health-a summation of the positive and negative behaviors in which one's close friend group engages-may be one way by which attitudes toward school exert influence on youth substance use. Utilizing a sample of 248 primarily African-American young urban adolescents, we tested a moderated mediation model to determine if the indirect effect of attitude to school on cannabis involvement through peer network health was conditioned on gender. Attitude toward school measured at baseline was the predictor (X), peer network health measured at 6 months was the mediator (M), cannabis involvement (including use, offers to use, and refusals to use) measured at 24 months was the outcome (Y), and gender was the moderator (W). Results indicated that negative attitudes toward school were indirectly associated with increased cannabis involvement through peer network health. This relationship was not moderated by gender. Adolescents in our sample with negative attitudes toward school were more likely to receive more offers to use cannabis and to use cannabis more frequently through the perceived health behaviors of their close friends. Implications from these results point to opportunities to leverage the dynamic associations among school experiences, friends, and cannabis involvement, such as offers and use.

A Family-Centered Positive Behavior Support Approach to the Amelioration of Food Refusal Behavior: An Empirical Case Study

ERIC Educational Resources Information Center

Binnendyk, Lauren; Lucyshyn, Joseph M.

2009-01-01

The purpose of this study was to evaluate the effectiveness of a family-centered positive behavior support approach to the amelioration of food refusal behavior in a child with autism. The study was conducted with the child and his family in their home. It employed an empirical case study design with one meal routine: snack time. Following…

Solid waste management problems in secondary schools in Ibadan, Nigeria.

PubMed

Ana, G R E E; Oloruntoba, E O; Shendell, D; Elemile, O O; Benjamin, O R; Sridhar, M K C

2011-09-01

Inappropriate solid waste management practices in schools in less-developed countries, particularly in major urban communities, constitute one of the major factors leading to declining environmental health conditions. The objective of the authors' descriptive, cross-sectional study was to assess solid waste management problems in selected urban schools in Ibadan, Nigeria. Eight secondary schools with average pupil populations not less than 500 per school were selected randomly. Four hundred questionnaires (50 per school) were administered. In addition, an observational checklist was used to assess the physical environment. Paper and plastics were the most frequently generated wastes. Common methods of solid waste disposal reported were use of dustbins for collection and open burning. Major problems perceived with current refuse disposal methods by the study students were odors, pest infestation, and spillages. Littering and spillages of solid waste were also common features reported. Data suggested inadequate waste management facilities and practices in study schools. The lack of refuse bins may have contributed to waste spillages and the burning practices. Odors may have arisen from both the decay of overstored organic waste rich in moisture and emissions from refuse burning. This scenario poses a community environmental health nuisance and may compromise school environmental quality.

Making Sense of Iconic Symbols: A Study of Preschool Children Conducting a Refuse-Sorting Task

ERIC Educational Resources Information Center

Ljung-Djärf, Agneta; Åberg-Bengtsson, Lisbeth; Ottosson, Torgny; Beach, Dennis

2015-01-01

This article is part of a larger project focusing upon explanatory illustrations that children encounter in pre- and primary school education. The research questions concerned (a) how preschool children make sense of iconic symbols when placing items of refuse on illustrations of refuse bins in a sorting task and (b) what stumbling blocks they…

Arab dentists' refusal to treat HIV positive patients: a survey of recently graduated dentists from three Arab dental schools.

PubMed

Arheiam, Arheiam; El Tantawi, Maha; Al-Ansari, Asim; Ingafou, Mohamed; El-Howiti, Asma; Gaballah, Kamis; AbdelAziz, Wafaa

2017-07-01

To assess intended refusal of recent graduates from three Arab dental schools to treat HIV + patients and factors associated with this intention. In 2015, convenience samples of recent dental graduates were included from Libya, Egypt and the United Arab Emirates. Participants responded to a questionnaire assessing personal background, knowledge of oral manifestations and fluids transmitting HIV, perceived adequacy of training and self-efficacy to manage blood exposures, attitude to risk of infection, moral beliefs and willingness to treat HIV + patients. Logistic regression assessed factors associated with intended refusal to treat HIV + patients. The overall response rate was 552/710 (77.8%), mean age = 23.7 years with 41.8% males. The mean (SD) scores for knowledge of oral manifestations and fluids transmitting HIV were 5.5 (1.3)/8 and 4.2 (1.7)/7. The mean (SD) scores for attitude to risk of infection and moral beliefs were 2.9 (1.0)/4 and 2 (0.9)/3, respectively. One-third of respondents indicated intention to refuse treating HIV + patients. Knowledge of body fluids transmitting HIV and moral beliefs were associated with lower odds of refusing to treat HIV + patients (OR = 0.86 and 0.38) whereas attitude indicating greater concern for risk of infection was associated with higher odds (OR = 1.54). One third of dentists from three Arab dental schools indicated they would refuse to treat HIV + patients. Adequate knowledge and moral beliefs reflecting professional ethics were associated with lower odds of refusal counterbalancing the association with attitude indicating increased concern for risk of infection with implications for dentist education and training.

Integrating life skills into a theory-based drug-use prevention program: effectiveness among junior high students in Taiwan.

PubMed

Huang, Chiu-Mieh; Chien, Li-Yin; Cheng, Chin-Feng; Guo, Jong-Long

2012-07-01

Drug use has been noted among students in Taiwan during the past decade and schools have a role in preventing or delaying students' drug use. We developed and evaluated a school-based, drug-use prevention program integrating the theory of planned behavior (TPB) and life skills for junior high school students. We recruited 441 seventh graders from randomly selected schools: N = 143 experimental groups, N = 142 conventional groups, and N = 156 control groups. The experimental group received ten 45-minute sessions of theory-based interventions. The conventional group got traditional didactic teaching and drug refusal skills. The control group received no intervention. Compared to the control group, experimental group students showed greater improvement in attitude, subjective norm, perceived behavioral control, life skills, and intention not to use drugs. Compared to the conventional group, the experimental group had significantly higher posttest scores for 4 of the 5 outcomes, including life skills (96.53 vs. 90.92, p < .001), attitude (27.43 vs. 24.40, p = .012), subjective norm (29.51 vs. 28.06, p = .002), and perceived behavioral control (18.59 vs. 16.81, p < .001). The conventional group scored significantly higher in behavioral intention than did the control group. Study results demonstrated the effectiveness of a drug-use prevention program integrating the TPB and life skills. © 2012, American School Health Association.

Self-Efficacy About Sexual Risk/Protective Behaviors: Intervention Impact Trajectories Among American Indian Youth.

PubMed

Mitchell, Christina M; Kaufman, Carol E; Whitesell, Nancy Rumbaugh; Beals, Janette; Keane, Ellen M

2017-09-01

For adolescents, normative development encompasses learning to negotiate challenges of sexual situations; of special importance are skills to prevent early pregnancy, HIV, and other sexually transmitted diseases. Disparities in sexual risk among American Indian youth point to the importance of intervening to attenuate this risk. This study explored the impact of Circle of Life (COL), an HIV prevention intervention based on social cognitive theory, on trajectories of self-efficacy (refusing sex, avoiding sexual situations) among 635 students from 13 middle schools on one American Indian reservation. COL countered a normative decline of refusal self-efficacy among girls receiving the intervention by age 13, while girls participating at age 14 or older, girls in the comparison group, and all boys showed continuing declines. © 2017 The Authors. Journal of Research on Adolescence © 2017 Society for Research on Adolescence.

[The efficacy of care as perceived by adolescents presenting anxiety-based school refusal].

PubMed

Sibeoni, Jordan; Orri, Massimiliano; Campredon, Sophie; Revah-Levy, Anne

School refusal is a complex disorder which is sometimes difficult to treat and which has potentially significant consequences on the child's schooling and mental health. A qualitative study was carried out in 2014-2015 on the feelings of adolescents and their parents with regard to the efficacy of care. The results show that, while adolescents and parents do not share the same representation of the care objectives, they agree on the therapeutic levers identified as been effective: time and relationships. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Parental Refusal of Childhood Vaccines and Medical Neglect Laws.

PubMed

Parasidis, Efthimios; Opel, Douglas J

2017-01-01

To examine the relation of vaccine refusal and medical neglect under child welfare laws. We used the Westlaw legal database to search court opinions from 1905 to 2016 and identified cases in which vaccine refusal was the sole or a primary reason in a neglect proceeding. We also delineated if religious or philosophical exemptions from required school immunizations were available at the time of adjudication. Our search yielded 9 cases from 5 states. Most courts (7 of 9) considered vaccine refusal to constitute neglect. In the 4 cases decided in jurisdictions that permitted religious exemptions, courts either found that vaccine refusal did not constitute neglect or considered it neglect only in the absence of a sincere religious objection to vaccination. Some states have a legal precedent for considering parental vaccine refusal as medical neglect, but this is based on a small number of cases. Each state should clarify whether, under its laws, vaccine refusal constitutes medical neglect.

Self-reporting and measurement of body mass index in adolescents: refusals and validity, and the possible role of socioeconomic and health-related factors.

PubMed

Chau, Nearkasen; Chau, Kénora; Mayet, Aurélie; Baumann, Michèle; Legleye, Stéphane; Falissard, Bruno

2013-09-08

Body mass index assessment using self-reported height and weight (BMIsr) can encounter refusals and under/over-reporting while for assessment with measured data (BMIm) refusals can be more frequent. This could relate to socioeconomic and health-related factors. We explored these issues by investigating numerous potential factors: gender, age, family structure, father's occupation, income, physical/sports activity, subjective weight perception, school performance, unhealthy behaviours, physical/psychological health, social relationships, living environment, having sustained violence, sexual abuse, and involvement in violence. The sample included 1559 adolescents from middle schools in north-eastern France. They completed a questionnaire including socioeconomic and health-related data, self-reported height/weight, measured height/weight, and weight perception (participation rate 94%). Data were analysed using logistic regression models. BMIsr encountered under-reporting (with change in BMI category, 11.8%), over-reporting (6.0%), and reporting refusals (3.6%). BMIm encountered more numerous refusals (7.9%). Reporting refusal was related to living with a single parent, low school performance, lack of physical/sports activity, sustained violence, poor psychological health, and poor social relationships (gender/age-adjusted odds ratios 1.95 to 2.91). Further to these factors, measurement refusal was related to older age, having divorced/separated parents, a father being a manual worker/inactive, insufficient family income, tobacco/cannabis use, involvement in violence, poor physical health, and poor living environment (1.30 to 3.68). Under-reporting was related to male gender, involvement in violence, poor psychological health, and overweight/obesity (as assessed with BMIm) (1.52 to 11). Over-reporting was related to male gender, younger age, alcohol consumption, and underweight (1.30 to 5.35). Weight perception was linked to reporting refusals and under/over-reporting, but slightly linked to measurement refusal. The contributions of socioeconomic and health-related factors to the associations of weight perception with reporting refusal and under/over-reporting ranged from -82% to 44%. There were substantial discrepancies in the associations between socioeconomic/health-related factors and overweight/obesity assessed with BMIsr and BMIm. BMIsr and BMIm were affected by numerous biases related to vulnerability which were also obesity risk factors. BMIsr encountered under/over-reporting which were related to some socioeconomic and health-related factors, weight perception, and BMIm. BMIm was more affected by refusals than BMIsr due to socioeconomic and health-related factors. Further research is needed.

Additive, Multi-Component Treatment of Emerging Refusal Topographies in a Pediatric Feeding Disorder

ERIC Educational Resources Information Center

Sharp, William G.; Jaquess, David L.; Bogard, Jennifer D.; Morton, Jane F.

2010-01-01

This case study describes inter-disciplinary treatment of chronic food refusal and tube dependency in a 2-year-old female with a pediatric feeding disorder. Evidence-based behavioral components--including escape extinction (EE), differential reinforcement of alterative mealtime behavior (DRA), and stimulus fading--were introduced sequentially as…

A comparison of refuse attenuation in laboratory and field scale lysimeters.

PubMed

Youcai, Zhao; Luochun, Wang; Renhua, Hua; Dimin, Xu; Guowei, Gu

2002-01-01

For this study, small and middle scale laboratory lysimeters, and a large scale field lysimeter in situ in Shanghai Refuse Landfill, with refuse weights of 187,600 and 10,800,000 kg, respectively, were created. These lysimeters are compared in terms of leachate quality (pH, concentrations of COD, BOD and NH3-N), refuse composition (biodegradable matter and volatile solid) and surface settlement for a monitoring period of 0-300 days. The objectives of this study were to explore both the similarities and disparities between laboratory and field scale lysimeters, and to compare degradation behaviors of refuse at the intensive reaction phase in the different scale lysimeters. Quantitative relationships of leachate quality and refuse composition with placement time show that degradation behaviors of refuse seem to depend heavily on the scales of the lysimeters and the parameters of concern, especially in the starting period of 0-6 months. However, some similarities exist between laboratory and field lysimeters after 4-6 months of placement because COD and BOD concentrations in leachate in the field lysimeter decrease regularly in a parallel pattern with those in the laboratory lysimeters. NH3-N, volatile solid (VS) and biodegradable matter (BDM) also gradually decrease in parallel in this intensive reaction phase for all scale lysimeters as refuse ages. Though the concrete data are different among the different scale lysimeters, it may be considered that laboratory lysimeters with sufficient scale are basically applicable for a rough simulation of a real landfill, especially for illustrating the degradation pattern and mechanism. Settlement of refuse surface is roughly proportional to the initial refuse height.

The effects of psychotherapy on behavior problems of sexually abused deaf children.

PubMed

Sullivan, P M; Scanlan, J M; Brookhouser, P E; Schulte, L E; Knutson, J F

1992-01-01

This study assessed the effectiveness of a broad based psychotherapeutic intervention with a sample of 72 children sexually abused at a residential school for the deaf. An untreated comparison group emerged when about half of their parents refused the offer for psychotherapy provided by the school. Treated and untreated children were randomly assigned to two assessment groups: those who participated in a pretreatment assessment and those who did not. Houseparents at the residential school used the Child Behavior Checklist (CBC) to rate the pretreatment assessment children before treatment and all 72 children one year after the implementation of psychotherapy. Children receiving therapy had significantly fewer behavior problems than children not receiving therapy. There was a differential response to therapy on the basis of sex. Boys receiving therapy had significantly lower scores on the following CBC scales than the no treatment group: Total, Internal, External, Somatic, Uncommunicative, Immature, Hostile, Delinquent, Aggressive, and Hyperactive. There were no differences on the Schizoid and Obsessive scales. Girls receiving therapy had significantly lower scores than the no treatment group on the following CBC scales: Total, External, Depressed, Aggressive, and Cruel. There were no differences on the Internal, Anxious, Schizoid, Immature, Somatic, and Delinquent scales.

Resisting Colonial Education: Zitkala-Sa and Native Feminist Archival Refusal

ERIC Educational Resources Information Center

Terrance, Laura L.

2011-01-01

This paper examines resistance through a Native Feminist lens, employing the boarding school memoirs of Zitkala-Sa. Within a "story" of appropriation in methodology, it considers protest and parody, and presents archival refusal as modes of resistance to colonial education. (Contains 1 figure.)

The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study.

PubMed

Sibeoni, Jordan; Orri, Massimiliano; Podlipski, Marc-Antoine; Labey, Mathilde; Campredon, Sophie; Gerardin, Priscille; Revah-Levy, Anne

2018-01-01

Anxiety-based school refusal in adolescence is a complex, sometimes difficult to treat disorder that can have serious academic and psychiatric consequences. The objective of this qualitative study was to explore how teens with this problem and their parents experience the psychiatric care received. This qualitative multicenter study took place in France, where we conducted semi-structured interviews with adolescents receiving psychiatric care for anxiety-based school refusal and with their parents. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic. This study included 20 adolescents aged 12 to 18 years and 21 parents. Two themes emerged from the analysis: (1) the goals of psychiatric care with two sub-themes, " self-transformation " and problem solving ; and, (2) the therapeutic levers identified as effective with two sub-themes: time and space and relationships . Our results show a divergence between parents and teens in their representations of care and especially of its goals. Therapeutic and research implications about the terms of return to school within psychiatric care and also the temporality of care are discussed.

Herpes labialis and Nigerian dental health care providers: knowledge, attitudes, behaviors, and refusal to treat.

PubMed

Azodo, Clement Chinedu; Umoh, Agnes O

2015-09-15

The few existing studies on herpes labialis among health care workers have been predominantly among non-dental health care workers. The purpose of this study was to determine Nigerian dental health care providers' knowledge of, attitudes toward, preventive behaviors for, and refusal to treat patients with herpes labialis. This cross-sectional study was conducted among final-year dental students at the University of Benin, dental house officers, and residents at the University of Benin Teaching Hospital, Benin City, Nigeria. Data collection was via a self-administered questionnaire. Bivariate statistics and logistic regression were used to relate the dependent and independent variables. Of the 120 questionnaires distributed, 110 were completed and returned, giving a 91.7% retrieval rate. However, 15 of the returned questionnaires were discarded because they were improperly completed, leaving a total of 95 questionnaires for final analysis in this study. The majority of participants were over 28 years old (54.7%), male (67.4%), unmarried (66.3%), and postgraduate dental health care providers (51.6%). Less than half (43.2%) of participants demonstrated adequate overall knowledge of herpes labialis. About one-tenth (10.5%) and more than three-quarters (87.4%) of participants reported a positive attitude and performance of adequate preventive behaviors, respectively. A total of 16.8% of participants reported a high tendency to refuse treatment to patients with herpes labialis. Although not statistically significant, young, unmarried, male undergraduate participants reported a greater likelihood to refuse treatment to herpes labialis patients. We found a statistically significant positive correlation between attitude and refusal to treat patients with herpes labialis. However, marital status and the attitude of participants toward these patients emerged as the determinants for refusal to treat patients with herpes labialis. Data from this study revealed a high level of inadequate knowledge, negative attitudes, and reasonably adequate preventive behaviors with respect to herpes labialis. One out of every six dental health care workers studied reported having refused to treat patients with herpes labialis. Unmarried dental health care providers and those with negative attitudes toward herpes labialis patients were more prone to refuse treatment to these patients.

Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal.

PubMed

Chi, Donald L

2014-07-01

The aim of this study was to examine caregivers' refusal of preventive medical and dental care for children. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). Caregiver refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children.

Gender-Focused HIV and Pregnancy Prevention for School-Going Adolescents: The Mpondombili Pilot Intervention in KwaZulu-Natal, South Africa

PubMed Central

Harrison, Abigail; Hoffman, Susie; Mantell, Joanne E.; Smit, Jennifer A.; Leu, Cheng-Shiun; Exner, Theresa M.; Stein, Zena A.

2016-01-01

This pilot study evaluated a 15 session classroom intervention for HIV and pregnancy prevention among grade 8–10 boys and girls (ages 14–17) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. Main outcome: condom use at last sex; secondary outcomes: partner communication; gender beliefs and values; perceived peer behaviors; self-efficacy for safer sex. At five months post-intervention, change in condom use did not differ between intervention and comparison schools. Intervention school youth had greater increases in self-efficacy for unsafe sex refusal [OR=1.61; 95% CI=1.01, 2.57] and condom use [OR=1.76; 95% CI=1.07, 2.89], partner communication [OR=2.42; 95% CI=1.27, 4.23], and knowledge of HIV testing opportunities [OR=1.76; 95% CI=1.08, 2.87]. This gender-focused pilot intervention increased adolescents’ self-efficacy and partner communication, and has potential to improve preventive behaviors. PMID:27642267

Intentional tanning among adolescents in seven Canadian provinces: Provincial comparisons (CRAYS 2015).

PubMed

Nadalin, V; Marrett, L D; Cawley, C; Minaker, L M; Manske, S

2018-06-01

This report explores intentional tanning behaviors among Canadian high school students in light of provincial restrictions on UV tanning device use among youth. Data are from the Cancer Risk Assessment in Youth Survey (CRAYS), collected from January to December 2015, at randomly selected high schools in 7 provinces. Relevant variables were: tanning methods ever used, demographics, and location and refusal of UV tanning device (beds, lamps) use in the past 12 months. Data were weighted so total survey weights by male/female, grade and province equal actual enrolments in these groups. Analyses were conducted in SAS, mostly for grades 10 and 11. Rao-Scott chi squared tests and p-values were calculated. Among 6803 grade 10 and 11 participants, 82% tanned intentionally, mostly by being/playing outside, or laying in the sun. Spray/self-tanners were used by 15% of participants. UV tanning device use was uncommon (4.4%), lowest in Ontario (2.7%) and British Columbia (3.8%), which have legislation against use among youth. Of 202 who used UV tanning devices in the past 12 months, most did at salons/studios (85%), 35% at home and 30% at a gym. Two hundred and forty-nine participants (3.4%) were refused use of UV tanning devices in the past 12 months. While legislation appears to deter UV tanning device use, it appears to have no impact on UV exposure among high school students overall. Greater prevention efforts are required to deter intentional tanning among high school students. Copyright © 2018 Elsevier Inc. All rights reserved.

Using a Nonaversive Procedure to Decrease Refusals.

ERIC Educational Resources Information Center

Spooner, Fred; And Others

1990-01-01

A nonaversive technique was used to teach a severely handicapped woman to decrease her refusals. The technique employed precision teaching via precise daily measurement strategies, environmental analysis, and a focus on building appropriate behavior. (JDD)

Trait mindfulness helps shield decision-making from translating into health-risk behavior.

PubMed

Black, David S; Sussman, Steve; Johnson, C Anderson; Milam, Joel

2012-12-01

The cognitive tendency toward mindfulness may influence the enactment of health and risk behaviors by its bringing increased attention to and awareness of decision-making processes underlying behavior. The present study examined the moderating effect of trait mindfulness on associations between intentions to smoke (ITS)/smoking refusal self-efficacy (SRSE) and smoking frequency. Self-reports from Chinese adolescents (N = 5,287; mean age = 16.2 years, standard deviation = .7; 48.8% female) were collected in 24 schools. Smoking frequency was regressed on latent factor interactions Mindful Attention Awareness Scale*ITS and Mindful Attention Awareness Scale*SRSE, adjusting for school clustering effects and covariates. Both interaction terms were significant in cross-sectional analyses and showed that high ITS predicted higher smoking frequency among those low, relative to high, in trait mindfulness, whereas low SRSE predicted higher smoking frequency among those low, relative to high, in trait mindfulness. Findings suggest trait mindfulness possibly shields against decision-making processes that place adolescents at risk for smoking. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Many Superintendents Privately Contend School Board "Meddling" Is More Like It.

ERIC Educational Resources Information Center

Trotter, Andrew; Downey, Gregg W.

1989-01-01

School board members refuse to honor the elusive line separating governance and management, policy and administration. Reviews the influence of women board members, accountability, and parental pressure on school boards. (MLF)

Effects of a school-based sexuality education program on peer educators: the Teen PEP model.

PubMed

Jennings, J M; Howard, S; Perotte, C L

2014-04-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May 2008. The sample consisted of 96 intervention (i.e. Teen PEP peer educators) and 61 comparison students from five high schools in New Jersey. Baseline and 12-month follow-up surveys were conducted. Summary statistics were generated and multiple regression analyses were conducted. In the primary intent-to-treat analyses, and secondary non-intent-to-treat analyses, Teen PEP peer educators (versus comparison students) reported significantly greater opportunities to practice sexual risk reduction skills and higher intentions to talk with friends, parents, and sex partners about sex and birth control, set boundaries with sex partners, and ask a partner to be tested for STIs including HIV. In addition in the secondary analysis, Teen PEP peer educators (as compared with the comparison students) had significantly higher scores on knowledge of sexual health issues and ability to refuse risky sexual situations. School-based sexuality education programs offering comprehensive training to peer educators may improve sexual risk behavior knowledge, attitudes and behaviors among high school students.

Effects of a school-based sexuality education program on peer educators: the Teen PEP model

PubMed Central

Jennings, J. M.; Howard, S.; Perotte, C. L.

2014-01-01

This study evaluated the impact of the Teen Prevention Education Program (Teen PEP), a peer-led sexuality education program designed to prevent unintended pregnancy and sexually transmitted infections (STIs) including HIV among high school students. The study design was a quasi-experimental, nonrandomized design conducted from May 2007 to May 2008. The sample consisted of 96 intervention (i.e. Teen PEP peer educators) and 61 comparison students from five high schools in New Jersey. Baseline and 12-month follow-up surveys were conducted. Summary statistics were generated and multiple regression analyses were conducted. In the primary intent-to-treat analyses, and secondary non-intent-to-treat analyses, Teen PEP peer educators (versus comparison students) reported significantly greater opportunities to practice sexual risk reduction skills and higher intentions to talk with friends, parents, and sex partners about sex and birth control, set boundaries with sex partners, and ask a partner to be tested for STIs including HIV. In addition in the secondary analysis, Teen PEP peer educators (as compared with the comparison students) had significantly higher scores on knowledge of sexual health issues and ability to refuse risky sexual situations. School-based sexuality education programs offering comprehensive training to peer educators may improve sexual risk behavior knowledge, attitudes and behaviors among high school students. PMID:24488649

Who are the adolescents saying "No" to cannabis offers.

PubMed

Burdzovic Andreas, Jasmina; Pape, Hilde; Bretteville-Jensen, Anne Line

2016-06-01

Adolescents who refuse direct cannabis offers and remain non-users represent a potentially very informative, yet surprisingly understudied group. We examined a range of risk and protective factors putatively associated with this poorly understood "cannabis-resilient" profile. Paper-and-pencil questionnaires assessing substance use, peer and family relations, and behavioral and personality characteristics were completed by 19,303 middle- and high-school students from 82 schools in Norway (response rate 84%) The lifetime prevalence of cannabis use was 7.6%. Another 10.4% reported no use of the drug despite having received recent cannabis offers. Results from the multinomial logistic regression revealed a set of characteristics differentiating adolescents who resisted such offers from those who: (a) neither received the offers nor used, and, more importantly, (b) used the drug. Specifically, parent-child relationship quality, negative drug-related beliefs, absence of close relationships with cannabis-users, low delinquency, no regular tobacco use, and infrequent alcohol intoxication were all associated with increased odds of being in the cannabis-resilient vs. cannabis-user group. This pattern of results was comparable across middle- and high-school cohorts, but the parent-child relationship quality and delinquency were significantly associated with cannabis-resilient vs. cannabis-use outcome only among younger and older adolescents, respectively. Among other low-risk characteristics, better relationships with parents and beliefs that drug use is problematic were associated with adolescents' refusals to accept cannabis offers. These results may have implications for novel preventive strategies targeting cannabis-exposed adolescents. Copyright © 2016. Published by Elsevier Ireland Ltd.

Caregivers Who Refuse Preventive Care for Their Children: The Relationship Between Immunization and Topical Fluoride Refusal

PubMed Central

2014-01-01

Objectives. The aim of this study was to examine caregivers’ refusal of preventive medical and dental care for children. Methods. Prevalence rates of topical fluoride refusal based on dental records and caregiver self-reports were estimated for children treated in 3 dental clinics in Washington State. A 60-item survey was administered to 1024 caregivers to evaluate the association between immunization and topical fluoride refusal. Modified Poisson regression models were used to estimate prevalence rate ratios (PRRs). Results. The prevalence of topical fluoride refusal was 4.9% according to dental records and 12.7% according to caregiver self-reports. The rate of immunization refusal was 27.4%. In the regression models, immunization refusal was significantly associated with topical fluoride refusal (dental record PRR = 1.61; 95% confidence interval [CI] = 1.32, 1.96; P < .001; caregiver self-report PRR = 6.20; 95% CI = 3.21, 11.98; P < .001). Caregivers younger than 35 years were significantly more likely than older caregivers to refuse both immunizations and topical fluoride (P < .05). Conclusions. Caregiver refusal of immunizations is associated with topical fluoride refusal. Future research should identify the behavioral and social factors related to caregiver refusal of preventive care with the goal of developing multidisciplinary strategies to help caregivers make optimal preventive care decisions for children. PMID:24832428

The Experience of Psychiatric Care of Adolescents with Anxiety-based School Refusal and of their Parents: A Qualitative Study

PubMed Central

Sibeoni, Jordan; Orri, Massimiliano; Podlipski, Marc-Antoine; Labey, Mathilde; Campredon, Sophie; Gerardin, Priscille; Revah-Levy, Anne

2018-01-01

Objective Anxiety-based school refusal in adolescence is a complex, sometimes difficult to treat disorder that can have serious academic and psychiatric consequences. The objective of this qualitative study was to explore how teens with this problem and their parents experience the psychiatric care received. Methods This qualitative multicenter study took place in France, where we conducted semi-structured interviews with adolescents receiving psychiatric care for anxiety-based school refusal and with their parents. Data collection by purposive sampling continued until we reached theoretical sufficiency. Data analysis was thematic. Results This study included 20 adolescents aged 12 to 18 years and 21 parents. Two themes emerged from the analysis: (1) the goals of psychiatric care with two sub-themes, “self-transformation” and problem solving; and, (2) the therapeutic levers identified as effective with two sub-themes: time and space and relationships. Conclusion Our results show a divergence between parents and teens in their representations of care and especially of its goals. Therapeutic and research implications about the terms of return to school within psychiatric care and also the temporality of care are discussed. PMID:29375632

Objecting To Dissection: A College Student's Handbook.

ERIC Educational Resources Information Center

National Anti-Vivisection Society, Chicago, IL.

In a number of states, students from kindergarten through high school have won the right to refuse to dissect or kill animals and the right to substitute an alternative project. This booklet was designed to help college science students take an ethical stand by refusing to participate in dissection exercises. The booklet begins with an overview of…

Why Some Students Refuse Additional Learning Support: Transition at a Further Education College

ERIC Educational Resources Information Center

Smith, Andrew

2006-01-01

In a specialist further education college, it was recognised that students aged 16/17 transferring to vocational study after their compulsory schooling were refusing to take up their entitlement to additional learning support. This created a shortfall in the college's predicted units of funding; also, course managers reported that several of these…

A Mandatory, High-Stakes National Teacher Evaluation System: Perceptions and Attributions of Teachers Who Actively Refuse to Participate

ERIC Educational Resources Information Center

Tornero, Bernardita; Taut, Sandy

2010-01-01

This study examines why some public elementary school teachers openly refuse participation in a mandatory national, standards-based teacher evaluation program. We describe the perceptions these "rebel" teachers have of the evaluation system, studying their open resistance based on the meanings they construct, and elaborated an…

How Some School Boards Are Fighting (and Why More Are Tolerating) Junk Foods in Schools

ERIC Educational Resources Information Center

Aburdene, Patricia

1977-01-01

While some school boards refuse to ban junk foods because of the loss of revenue that would result, other boards and administrators are successfully banning junk foods and finding alternatives to them. (IRT)

Reconceptualizing Efficacy in Substance Use Prevention Research: Refusal Response Efficacy and Drug Resistance Self-Efficacy in Adolescent Substance Use

PubMed Central

Choi, Hye Jeong; Krieger, Janice L.; Hecht, Michael L.

2014-01-01

The purpose of this study is to utilize the Extended Parallel Process Model (EPPM) to expand the construct of efficacy in the adolescent substance use context. Using survey data collected from 2,129 seventh-grade students in 39 rural schools, we examined the construct of drug refusal efficacy and demonstrated relationships among response efficacy (RE), self-efficacy (SE), and adolescent drug use. Consistent with the hypotheses, confirmatory factor analyses of a 12-item scale yielded a three-factor solution: refusal RE, alcohol-resistance self-efficacy (ASE), and marijuana-resistance self-efficacy (MSE). Refusal RE and ASE/MSE were negatively related to alcohol use and marijuana use, whereas MSE was positively associated with alcohol use. These data demonstrate that efficacy is a broader construct than typically considered in drug prevention. Prevention programs should reinforce both refusal RE and substance-specific resistance SE. PMID:23330857

Refusal skill ability: an examination of adolescent perceptions of effectiveness.

PubMed

Nichols, Tracy R; Birnel, Sara; Graber, Julia A; Brooks-Gunn, Jeanne; Botvin, Gilbert J

2010-06-01

This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays (N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the second by a group of high school interns. Consistency with programming criteria was found for interns' ratings of several indicators of verbal and non-verbal assertiveness. However, a strategy previously defined by the program as effective was perceived as ineffective by adolescents while another deemed ineffective and problematic by intervention developers was viewed as effective. Interns endorsed presenting detailed and reasonable arguments as an effective refusal strategy while short, simple statements were deemed ineffective. This study suggests the importance of including adolescent perspectives in the design, delivery, and evaluation of drug prevention strategies.

"Planned Parenthood v. Clark County School District": First Amendment Rights in Public Schools Continue to Erode.

ERIC Educational Resources Information Center

Walden, John C.

1990-01-01

The Ninth Circuit Court of Appeals decision in "Planned Parenthood" supported school officials who refused to publish certain advertisements in school-sponsored newspapers. Contends that school officials' desire to avoid any possible controversy was the underlying motive for the decision to not publish the advertisement. (MLF)

Ending School Avoidance

ERIC Educational Resources Information Center

Casoli-Reardon, Michele; Rappaport, Nancy; Kulick, Deborah; Reinfeld, Sarah

2012-01-01

School truancy--defined by a student's refusal to attend part or all of the school day, along with a defined number of unexcused absences--is an increasingly frustrating and complex problem for teachers and school administrators. Although statistics on the prevalence of truancy in the United States do not exist due to lack of uniformity among…

Out of School: A Phenomenological Exploration of Extended Non-Attendance

ERIC Educational Resources Information Center

Baker, Matt; Bishop, Felicity L.

2015-01-01

The concept of "extended non-attendance" ("school phobia" or "school refusal") was distinguished from truancy early in the twentieth century, and refers to children who fear school and avoid attending. Despite much subsequent research, outcomes for those affected remain poor, and their voices remain largely absent…

Student Health Policies of U.S. Medical Schools.

ERIC Educational Resources Information Center

Diekema, Daniel J.; And Others

1996-01-01

A survey of student affairs deans at 108 medical schools found most schools required hepatitis vaccination, evidence of immunity, or waiver refusing vaccination. Nearly all required health insurance, and usually offered a plan, but fewer offered disability insurance. Schools often held students responsible for costs of vaccination, serologic…

Differential segmentation responses to an alcohol social marketing program.

PubMed

Dietrich, Timo; Rundle-Thiele, Sharyn; Schuster, Lisa; Drennan, Judy; Russell-Bennett, Rebekah; Leo, Cheryl; Gullo, Matthew J; Connor, Jason P

2015-10-01

This study seeks to establish whether meaningful subgroups exist within a 14-16 year old adolescent population and if these segments respond differently to the Game On: Know Alcohol (GOKA) intervention, a school-based alcohol social marketing program. This study is part of a larger cluster randomized controlled evaluation of the GOKA program implemented in 14 schools in 2013/2014. TwoStep cluster analysis was conducted to segment 2,114 high school adolescents (14-16 years old) on the basis of 22 demographic, behavioral, and psychographic variables. Program effects on knowledge, attitudes, behavioral intentions, social norms, alcohol expectancies, and drinking refusal self-efficacy of identified segments were subsequently examined. Three segments were identified: (1) Abstainers, (2) Bingers, and (3) Moderate Drinkers. Program effects varied significantly across segments. The strongest positive change effects post-participation were observed for Bingers, while mixed effects were evident for Moderate Drinkers and Abstainers. These findings provide preliminary empirical evidence supporting the application of social marketing segmentation in alcohol education programs. Development of targeted programs that meet the unique needs of each of the three identified segments will extend the social marketing footprint in alcohol education. Copyright © 2015 Elsevier Ltd. All rights reserved.

38 CFR 52.70 - Participant rights.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., to refuse to participate in patient activities, to refuse to participate in experimental research... with respect to the behavior of other participants. (f) Examination of survey results. A participant has the right to— (1) Examine the results of the most recent VA survey with respect to the program...

38 CFR 52.70 - Participant rights.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., to refuse to participate in patient activities, to refuse to participate in experimental research... with respect to the behavior of other participants. (f) Examination of survey results. A participant has the right to— (1) Examine the results of the most recent VA survey with respect to the program...

38 CFR 52.70 - Participant rights.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., to refuse to participate in patient activities, to refuse to participate in experimental research... with respect to the behavior of other participants. (f) Examination of survey results. A participant has the right to— (1) Examine the results of the most recent VA survey with respect to the program...

38 CFR 52.70 - Participant rights.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., to refuse to participate in patient activities, to refuse to participate in experimental research... with respect to the behavior of other participants. (f) Examination of survey results. A participant has the right to— (1) Examine the results of the most recent VA survey with respect to the program...

38 CFR 52.70 - Participant rights.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., to refuse to participate in patient activities, to refuse to participate in experimental research... with respect to the behavior of other participants. (f) Examination of survey results. A participant has the right to— (1) Examine the results of the most recent VA survey with respect to the program...

Refusing Relevance: School Administrator Resistance to Offering Professional Development Addressing LGBTQ Issues in Schools

ERIC Educational Resources Information Center

Payne, Elizabethe C.; Smith, Melissa J.

2018-01-01

Purpose: The purpose of this article is to provide insight to the multiple ways that school leaders resist, avoid, or block LGBTQ (lesbian, gay, bisexual, and transgender, queer, and questioning) professional development for their staff and, thus, resist the conversations around school responsibility to these students and families. Research…

Subclassification of School Phobic Disturbances.

ERIC Educational Resources Information Center

Atkinson, Leslie; And Others

The confusion surrounding all aspects of school refusal may rest partly on the misguided assumption that the disturbance represents a single syndrome. Five consistently emerging variables which may help distinguish among school phobic types were abstracted from the literature: extensiveness of disturbance, mode of onset, age, fear source, and…

Descriptive Analyses of Pediatric Food Refusal and Acceptance

ERIC Educational Resources Information Center

Borrero, Carrie S. W.; Woods, Julia N.; Borrero, John C.; Masler, Elizabeth A.; Lesser, Aaron D.

2010-01-01

Functional analyses of inappropriate mealtime behavior typically include conditions to determine if the contingent delivery of attention, tangible items, or escape reinforce food refusal. In the current investigation, descriptive analyses were conducted for 25 children who had been admitted to a program for the assessment and treatment of food…

"I No Like Get Caught Using Drugs": Explanations for Refusal as a Drug-Resistance Strategy for Rural Native Hawaiian Youths

ERIC Educational Resources Information Center

Okamoto, Scott K.; Helm, Susana; Giroux, Danielle; Kaliades, Alexis

2011-01-01

This exploratory study examines the use of explanations for refusal as a drug-resistance strategy for rural Native Hawaiian youths. Fourteen gender-specific focus groups were conducted within seven middle or intermediate schools on the Island of Hawai'i (N = 64). Participants were asked to describe drug-resistance strategies in response to 15…

Use of a School Referendum to Deter Teen-Age Tobacco Use.

ERIC Educational Resources Information Center

Males, Mike

1992-01-01

Montana's school tobacco referendum includes youth in decisions regarding tobacco and health, demonstrating peer disapproval of tobacco use. The referendum, which asked students whether vendors should refuse tobacco sales to minors, follows the example of the Bozeman, Montana, school district in which secondary students and staff supported tobacco…

Profiles of Change: Lessons for Improving High School Physical Education

ERIC Educational Resources Information Center

Doolittle, Sarah

2014-01-01

This feature has told stories of high school physical educators who have refused to accept the status quo of high school physical education programs. They have identified problems, initiated innovations in their own classes, implemented changes beyond their classes, and moved toward institutionalizing improvements throughout their programs and…

Mapping a Teacher Boycott in Seattle

ERIC Educational Resources Information Center

Zeichner, Noah

2013-01-01

The author, a teacher in the Seattle public schools, tells the story of a movement begun by teachers at Garfield High School who in January 2013 voted unanimously to refuse to administer the Measures of Academic Progress (MAP) test. The MAP boycott spread to seven more Seattle schools, and teachers at 10 more schools signed statements of support.…

BEHAVIOR AND ASSIMILATION OF ORGANIC AND INORGANIC PRIORITY POLLUTANTS CODISPOSED WITH MUNICIPAL REFUSE. A Project Summary. (EPA/SR-93/137)

EPA Science Inventory

Research was undertaken to demonstrate and evaluate the capacity of landfill systems to assimilate and attenuate inorganic and organic priority pollutants loadings codisposed with municipal refuse and to determine the fate and effect of the codisposed pollutants as landfill stabi...

Perceptions and Implications of No-Fee School Policy: School-Based Management Perspectives

ERIC Educational Resources Information Center

Naong, M. N.

2013-01-01

The inception of no-fee schools and a school-fee exemption policy has become a contentious issue but also an exciting one for school managers in South Africa. Managers opposed to the policy have cited amongst others things, academic standards dropping, as well as parents who can afford to pay jumping on the bandwagon and refusing to pay. While the…

The Minor Suit Awards IV.

ERIC Educational Resources Information Center

Zirkel, Perry A.

2002-01-01

Description of trivial and frivolous education litigation between 1995 and 2001. For example, parents of middle-school student sued Oregon school district for monetary damages for refusing to allow their daughter, whose name is Abby, to use her nickname, Boo. (Contains 21 references.) (PKP)

The Sonoma Case of Cristofer Barajas.

ERIC Educational Resources Information Center

Billeci, Cameron; Johnson, Rudy

A rural Sonoma County (California) school district refused to allow Cristofer Barajas, a migrant child, to enter kindergarten because he would be enrolling too late in the school year and would disrupt the instruction of the other children. The case was taken to court and six issues were considered. The court determined that the school district…

Tales of Refusal, Adoption, and Maintenance: Evidence-Based Substance Abuse Prevention via School-Extension Collaborations

ERIC Educational Resources Information Center

St. Pierre, Tena L.; Kaltreider, D. Lynne

2004-01-01

Despite availability of empirically supported school-based substance abuse prevention programs, adoption and implementation fidelity of such programs appear to be low. A replicated case study was conducted to investigate school adoption and implementation processes of the EXSELS model (Project ALERT delivered by program leaders through Cooperative…

Transition from Tube to Oral Feeding in the School Setting

ERIC Educational Resources Information Center

McKirdy, Laura S.; Sheppard, Justine J.; Osborne, Mary L.; Payne, Pamela

2008-01-01

Purpose: A school-based treatment program for tube-fed children with medically complex conditions and food refusal was implemented to facilitate the children's transition to oral feeding and advance their eating skills. Method: The program combined educational and therapeutic goals. It was implemented in a regional public school for children with…

Parental Refusal to Consent for Evaluation: A Legal Analysis with Implications for School Psychologists

ERIC Educational Resources Information Center

Etscheidt, Susan; Clopton, Kerri; Haselhuhn, Charlotte

2012-01-01

The decision to begin the process for special education eligibility has complexities impacting children, parents, teachers, and schools. The Individuals with Disabilities Education Improvement Act (IDEA) eligibility provisions specify the need to obtain consent prior to evaluation and options when consent cannot be obtained. School psychologists…

Refusing to Leave Desegregation Behind: From Graduates of Racially Diverse Schools to the Supreme Court

ERIC Educational Resources Information Center

Wells, Amy Stuart; Duran, Jacquelyn; White, Terrenda

2008-01-01

Background/Context: In light of the June 2007 U.S. Supreme Court decision in the Louisville and Seattle voluntary school desegregation cases, making it more difficult for district officials to racially balance their schools, this article presents an analysis of prior research on the long-term effects of attending racially diverse schools on their…

Epidemic of Hysteria in a School of Rural Eastern Nepal: A Case Report

ERIC Educational Resources Information Center

Shakya, Rabi

2005-01-01

Introduction: The headmaster of a school (NRMV) in rural eastern Nepal, pleaded for help from the public health Department of Psychiatry, BKIHS, Dharan, Nepal, to prevent closure of his school as guardians of many students refused to send their children to his school, which was supposedly haunted by evil spirits. The author, along with his staff,…

Universal school-based substance abuse prevention programs: Modeling targeted mediators and outcomes for adolescent cigarette, alcohol and marijuana use.

PubMed

Stephens, Peggy C; Sloboda, Zili; Stephens, Richard C; Teasdale, Brent; Grey, Scott F; Hawthorne, Richard D; Williams, Joseph

2009-06-01

We examined the relationships among targeted constructs of social influences and competence enhancement prevention curricula and cigarette, alcohol and marijuana use outcomes in a diverse sample of high school students. We tested the causal relationships of normative beliefs, perceptions of harm, attitudes toward use of these substances and refusal, communication, and decision-making skills predicting the self-reported use of each substance. In addition, we modeled the meditation of these constructs through the intentions to use each substance and tested the moderating effects of the skills variables on the relationships between intentions to use and self-reported use of each of these substances. Logistic regression path models were constructed for each of the drug use outcomes. Models were run using the Mplus 5.0 statistical application using the complex sample function to control for the sampling design of students nested within schools; full information maximum likelihood estimates (FIML) were utilized to address missing data. Relationships among targeted constructs and outcomes differed for each of the drugs with communication skills having a potentially iatrogenic effect on alcohol use. Program targets were mediated through the intentions to use these substances. Finally, we found evidence of a moderating effect of decision-making skills on perceptions of harm and attitudes toward use, depending upon the outcome. Prevention curricula may need to target specific drugs. In addition to normative beliefs, perceptions of harm, and refusal and decision-making skills, programs should directly target constructs proximal to behavioral outcomes such as attitudes and intentions. Finally, more research on the effects of communication skills on adolescent substance use should be examined.

School Refusal Assessment Scale-Revised: Factorial Invariance and Latent Means Differences across Gender and Age in Spanish Children

PubMed Central

Gonzálvez, Carolina; Inglés, Cándido J.; Kearney, Christopher A.; Vicent, María; Sanmartín, Ricardo; García-Fernández, José M.

2016-01-01

The aim of this study was to analyze the factorial invariance and latent means differences of the Spanish version of the School Refusal Assessment Scale-Revised for Children (SRAS-R-C) in a sample of 1,078 students (50.8% boys) aged 8–11 years (M = 9.63, SD = 1.12). The results revealed that the proposed model in this study, with a structure of 18 items divided into four factors (Negative Affective, Social Aversion and/or Evaluation, To Pursue Attention and Tangible Reinforcements), was the best-fit model with a tetra-factorial structure, remaining invariant across gender and age. Analysis of latent means differences indicated that boys and 11-year-old students scored highest on the Tangible Reinforcements subscale compared with their 8- and 9-year-old peers. On the contrary, for the subscales of Social Aversion and/or Evaluation and to Pursue Attention, the differences were significant and higher in younger age groups compared to 11-year-olds. Appropriate indexes of reliability were obtained for SRAS-R-C subscales (0.70, 0.79, 0.87, and 0.72). Finally, the founded correlation coefficients of scores of the SRAS-R-C revealed a predictable pattern between school refusal and positive/negative affect and optimism/pessimism. PMID:28082938

Alternative Fuels Data Center: Glacier-Waterton Park Powers Buses With

Science.gov Websites

Photo of a truck Natural Gas Fuels School Buses and Refuse Trucks in Tulsa, Oklahoma Feb. 18, 2017 Photo of buses Baton Rouge School District Adds Propane Buses to Its Fleet Dec. 23, 2016 photo of a truck Buses to Its Fleet Nov. 11, 2016 photo of a propane school bus Propane Powers School Buses in Tuscaloosa

Along Freedom Road. Hyde County, North Carolina and the Fate of Black Schools in the South.

ERIC Educational Resources Information Center

Cecelski, David S.

The 1968-69 school boycott in Hyde County (North Carolina) was one of the most sustained and successful protests of the civil rights movement. For a year, the county's black citizens refused to send their children to school in protest of a desegregation plan that required closing two historically black schools in their remote coastal community.…

An Examination of Year-Round Education: Pros and Cons That Challenge Schooling in America.

ERIC Educational Resources Information Center

Howell, Vicki T.

The idea of converting to year-round education (YRE) comes from different sources, such as communities concerned about idle youth and taxpayer groups upset about empty buildings during the summer. The most prevalent reasons are overcrowded schools and unavailable construction funds, due to failed school bond proposals or refusal to raise taxes.…

29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

Code of Federal Regulations, 2013 CFR

2013-07-01

...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2013-07-01 2013-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

Code of Federal Regulations, 2011 CFR

2011-07-01

...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2011-07-01 2011-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

Code of Federal Regulations, 2012 CFR

2012-07-01

...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2012-07-01 2012-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

Code of Federal Regulations, 2014 CFR

2014-07-01

...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2014-07-01 2014-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

29 CFR 1602.43 - Commission's remedy for school systems' or districts' failure to file report.

Code of Federal Regulations, 2010 CFR

2010-07-01

...' failure to file report. Any school system or district failing or refusing to file report EEO-5 when... 29 Labor 4 2010-07-01 2010-07-01 false Commission's remedy for school systems' or districts' failure to file report. 1602.43 Section 1602.43 Labor Regulations Relating to Labor (Continued) EQUAL...

To Bond or Not to Bond? That Is the Question

ERIC Educational Resources Information Center

Balzer, Wayne E.

2015-01-01

This case, inspired by a real school district scenario, was developed for use in a graduate-level course in school finance. James Spencer had just been selected as the new superintendent of a low-income, 400-student, rural school district in need of many capital improvements. The previous superintendent had refused to hold a bond election because…

Performing coolness: smoking refusal and adolescent identities.

PubMed

Plumridge, E W; Fitzgerald, L J; Abel, G M

2002-04-01

The implications of smoking refusal for personal identity style were studied through conversations in six small focus groups or dyads of 13- and 14-year-old non-smokers from an urban New Zealand secondary school. The approach to analyzing their talk was informed by notions of 'performativity' and 'social space' to focus on the connections between identity and social relations. Smoking emerged as a key signifier of power and status. It was salient at both top and bottom ends of the social hierarchy depending upon the competence displayed in smoking as part of a larger ensemble of personal deportment and behavior. Being a non-smoker therefore inevitably carried connotations of being 'average' or 'in the middle', presenting non-smoking adolescents with the problem of accrediting themselves against superior 'smoker cool' groups. A discourse analytic approach was used to examine the resources and strategies participants brought to bear on this 'problem', which was then seen to be solved differently by boys and girls. Boys could establish alternatives to 'smoker cool' through physical activity, girls had little recourse but to accept their inferior status. The implications of this for health education and promotion are discussed.

[Refusal of application to care in Alzheimer's disease and related diseases: establishment of a mobile unit hospital extra].

PubMed

Collignon, Julien; Rouch, Isabelle; Gonthier, Régis; Corbin-Seguin, Aude; Combe, Lorraine; Trombert-Paviot, Béatrice; Laurent, Bernard; Girtanner, Chantal

2013-03-01

Refusal of care and support in these patients with Alzheimer's disease and related illnesses at home is a cause of accelerated loss of autonomy and increases the risk of a crisis with early institutionalization. Factors contributing to the denial of care are poorly understood and very few epidemiological data exist. we compared age, diagnosis, level of severity of the disease, the type of behavioral, family status of 101 patients living in denial of care and support as seen by a mobile home (group UPEPc) to 136 control patients seen at the memory clinic (group CM). Patients living in denial of care appear to significantly low age [82/80.5, p<0.0001], with more advanced disease [average MMSE 18/22, p<0.0001], the presence family conflicts and behavioral disorders [delirious--hallucination, agitation--aggression, depression, apathy, p<0.05]. the profile of patients refusing home care is specific and it is important to educate GPs conditions that favor an obstacle to medicalization. The advantage of a mobile extramural to analyze risk factors for refusal of care and propose alternatives should be further investigated.

The influence of the perceived consequences of refusing to share injection equipment among injection drug users: Balancing competing risks

PubMed Central

Wagner, Karla D.; Lankenau, Stephen E.; Palinkas, Lawrence A.; Richardson, Jean L.; Chou, Chih-Ping; Unger, Jennifer B.

2011-01-01

Injection drug users (IDUs) are at risk for HIV and other bloodborne pathogens through receptive syringe sharing (RSS) and receptive paraphernalia sharing (RPS). Research into the influence of the perceived risk of HIV infection on injection risk behavior has yielded mixed findings. One explanation may be that consequences other than HIV infection are considered when IDUs are faced with decisions about whether or not to share equipment. We investigated the perceived consequences of refusing to share injection equipment among 187 IDUs recruited from a large syringe exchange program in Los Angeles, California, assessed their influence on RSS and RPS, and evaluated gender differences. Two sub-scales of perceived consequences were identified: structural/external consequences and social/internal consequences. In multiple linear regression, the perceived social/internal consequences of refusing to share were associated with both RSS and RPS, after controlling for other psychosocial constructs and demographic variables. Few statistically significant gender differences emerged. Assessing the consequences of refusing to share injection equipment may help explain persistent injection risk behavior, and may provide promising targets for comprehensive intervention efforts designed to address both individual and structural risk factors. PMID:21498004

Short-term mediating factors of a school-based intervention to prevent youth substance use in Europe.

PubMed

Giannotta, Fabrizia; Vigna-Taglianti, Federica; Rosaria Galanti, Maria; Scatigna, Maria; Faggiano, Fabrizio

2014-05-01

To investigate factors mediating the effects of a European school-based intervention (Unplugged) based on a social influence approach to youths' substance use. Schools in seven European countries (n = 143, including 7,079 pupils) were randomly assigned to an experimental condition (Unplugged curriculum) or a control condition (usual health education). Data were collected before (pretest) and 3 months after the end of the program (posttest). Multilevel multiple mediation models were applied to the study of effect mediation separately for tobacco, alcohol, and cannabis use. Analyses were conducted on the whole sample, and separately on baseline users and nonusers of each substance. Compared with the control group, participants in the program endorsed less positive attitudes toward drugs; positive beliefs about cigarettes, alcohol, and cannabis; and the normative perception of peers using tobacco and cannabis. They also increased in knowledge about all substances and refusal skills toward tobacco. Decreased positive attitudes toward drugs, increase in refusal skills, and reappraisal of norms about peer using tobacco and cannabis appeared to mediate the effects of the program on the use of substances. However, mediating effects were generally weak and some of them were only marginally significant. This study lends some support to the notion that school-based programs based on a social influence model may prevent juvenile substance use through the modification of attitudes, refusal skills, and normative perceptions. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Role of general and specific competence skills in protecting inner-city adolescents from alcohol use.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2000-05-01

The purpose of this longitudinal investigation was to test whether higher levels of general competence are linked to greater refusal assertiveness that is, in turn, related to less subsequent alcohol use among inner-city adolescents. A large sample of students attending 22 middle and junior high schools in New York City participated. Students completed surveys at baseline, at 1-year follow-up and at 2-year follow-up (N = 1,459; 54% female). The students self-reported alcohol use. decision-making skills, self-efficacy and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardized protocol. The data were collected in school during a regular 40-minute class period. According to the tested structural equation model, Decision Making (beta = .07, p < .05) and Self-Efficacy (beta = .24, p < .001) predicted higher Refusal Assertiveness and this greater assertiveness predicted less drinking at the 2-year follow-up (beta = -.21, p < .001). Earlier drinking predicted 2-year follow-up drinking (beta = .40, p < .001). Goodness-of-fit indices were excellent (chi2 = 1107.9, 238 df, N = 1,438, p < .001; NFI = .93, NNFI = .94, CFI = .95). The tested model had a good fit and was parsimonious and consistent with theory. This research highlights the importance of addressing decision-making skills, self-efficacy and refusal assertiveness within adolescent alcohol prevention programs.

Report on Task Force Division of School Facilities, School District of Philadelphia: Commission to Investigate Relationships between Educational Performance and Size of Student Body, May 11, 1970.

ERIC Educational Resources Information Center

Philadelphia School District, PA.

The Philadelphia Art Commission refused to approve the proposed Eastwick/Pepper Educational Complex that combines a high school and a middle school into one facility. Their rejection was based on (1) the prohibitively large numbers of children the school is to serve, (2) the overly broad age span of the students, and (3) the inadequate outside…

Observations of adolescent peer resistance skills following a classroom-based healthy relationship program: a post-intervention comparison.

PubMed

Wolfe, David A; Crooks, Claire V; Chiodo, Debbie; Hughes, Raymond; Ellis, Wendy

2012-04-01

This study examines peer resistance skills following a 21-lesson classroom-based intervention to build healthy relationships and decrease abusive and health-risk behaviors among adolescents. The Fourth R instructs students in positive relationship skills, such as negotiation and delay, for navigating challenging peer and dating scenarios. Observational data from 196 grade 9 students participating in a larger cluster randomized controlled trial were used to evaluate post-intervention acquisition of peer resistance skills. Pairs of students engaged in a role play paradigm with older student actors, where they were subjected to increasing pressure to comply with peer requests related to drugs and alcohol, bullying, and sexual behavior. Specific and global measures of change in peer resistance responses were obtained from two independent sets of observers, blinded to condition. Specific peer resistance responses (negotiation, delay, yielding to pressure, refusal, and compliance) were coded by research assistants; global peer resistance responses were rated by teachers from other schools (thinking / inquiry, application, communication, and perceived efficacy). Students who received the intervention were more likely to demonstrate negotiation skills and less likely to yield to negative pressure relative to controls. Intervention students were also more likely to use delay than controls; control girls were more likely to use refusal responses; the number of times students complied with peer requests did not differ. Teacher ratings demonstrated significant main effects favoring intervention youth on all measures. Program and research implications are highlighted.

Open air refuse burning video: Proton Dan the science man explores open air refuse burning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eastburn, M.D.; Sipple, J.L.; Deramo, A.R.

The goal of this video is to educate school children to the potential hazards of open air trash burning; to demonstrate alternative ways to dispose of trash; and to motivate students to take action to change the behavior of their parents with regard to trash burning. The burning of household trash, although illegal, is still a common practice in rural areas of Delaware. Enforcement has been difficult because the practice is often performed at night and is done across a wide rural area that is difficult to patrol on a continuing basis. The prohibition on trash burning (revised Regulation 13more » of The Delaware Code of Regulations Governing The Control of Air Pollution) has been in effect since 1968, but the public has been slow to comply because trash burning has been practiced for many generations and because much of the public is unaware of the environmental impacts and/or the human health risks. This video may be valuable for other States to use as a public outreach tool regarding their problems with open air refuse burning. The focus of the video is a 7th grade science class is given various assignments relating to Earth Day and preservation of natural resources. Two children in particular are given the assignment to research and report on the hazards of open air trash burning and are asked to investigate alternative ways to dispose of refuse. Upon brainstorming how to find information on the topic, the kids decide to contact the host of a popular children's science show on broadcast television named Proton Dan the Science Man (a fictitious character and show based on Bill Nye the Science Guy). The host then invites the kids to the studio where he films his show and takes them through the topic. The TV host character takes the children to several external locations like a landfill, recycling centers, etc..« less

Grades: Review of Academic Evaluations in Law Schools.

ERIC Educational Resources Information Center

Doniger, Thomas

1980-01-01

Lack of independent review process in professional schools and refusal of courts to review errors not resulting from arbitrariness, caprice, or bad faith leave student and societal interests in accurate grading inadequately protected. (Journal availability: University of the Pacific, 3201 Donner Way, Sacramento, CA 95817.) (MSE)

Determinants of non-participation in a mass screening program for colorectal cancer in Finland.

PubMed

Artama, M; Heinävaara, S; Sarkeala, T; Prättälä, R; Pukkala, E; Malila, N

2016-07-01

For an effective colorectal cancer (CRC) screening program, high participation rate is essential. However, non-participation in CRC screening program has increased in Finland. The study was based on a population-based nationwide cohort of persons invited for CRC screening in 2004-2011. Information on the first round of the CRC screening participation and related background factors was obtained from the Finnish Cancer Registry, and information about health behavior factors from the Health Behavior Survey (HBS) in 1978-1999. Non-participation in CRC screening was analyzed with Poisson regression as incidence rate ratios (IRR) with 95% confidence intervals (95% CI). Of all persons invited for CRC screening (79 871 men and 80 891 women) 35% of men and 21% of women refused. Of those invited for screening, 2456 men (3.1%) and 2507 women (3.1%) were also invited to the HBS. Persons, who declined HBS, were also more likely to refuse CRC screening (men IRR 1.40, 95% CI 1.26-1.56, women 1.75, 1.52-2.02) compared to HBS participants. Never married persons had about a 75% higher risk for refusing than married ones. The youngest age group (60 years) was more likely to refuse screening than the older age groups (62 or >64 years). Smoking was associated with non-participation in screening (current smokers, men: IRR 1.32, 95% CI 1.05-1.67, women: 2.10, 1.61-2.73). Participation in CRC screening was affected by gender, age, and marital status. Persons, who refused the HBS, were also more likely to refuse CRC screening. Smoking was a risk factor for non-participation in CRC screening.

Perceptions of sexual assertiveness among adolescent girls: initiation, refusal, and use of protective behaviors.

PubMed

Auslander, Beth A; Perfect, Michelle M; Succop, Paul A; Rosenthal, Susan L

2007-06-01

We describe adolescent girls' perceptions of sexual assertiveness and examine the relationship of these perceptions with developmental and interpersonal variables. Cross-sectional analysis. Participants were recruited from a school-based health clinic and local colleges, and through snowballing to participate in a 6-month study examining microbicide acceptability. 106 sexually experienced girls (ages 14 through 21 years). Girls described their demographics, sexual history, and romantic relationships and completed the Sexual Assertiveness Scale for Women (SAS-W), which assesses perceptions of sexual assertiveness: Initiation of Sex, Refusal of Unwanted Sex, and Pregnancy-STD Prevention. Girls perceived themselves as asserting themselves between 50% and 75% of the time with their current or most recent partner. The Initiation subscale was not related to the other two subscales. In final models, girls with a prior pregnancy perceived themselves as initiating sex more than girls without a prior pregnancy. Having a greater number of lifetime partners was related to perceptions of less refusal, whereas greater number of partners, being sexually experienced longer, and engaging in more unprotected sex were related to perceptions of less implementation of preventive methods. None of the relationship variables were related to scores on any subscale. Most of these girls perceived themselves as sexually assertive. Given that sexual experience, not relationship factors, were related to perceptions of sexual assertiveness, the design of counseling messages should incorporate sexual experience. These messages should find effective ways to help girls both to communicate their sexual desires and to enhance their ability to protect themselves.

Perceptions of Sexual Assertiveness among Adolescent Girls: Initiation, Refusal, and Use of Protective Behaviors

PubMed Central

Auslander, Beth A.; Perfect, Michelle M.; Succop, Paul A.; Rosenthal, Susan L.

2007-01-01

Study Objective: We describe adolescent girls' perceptions of sexual assertiveness and examine the relationship of these perceptions with developmental and interpersonal variables. Design: Cross-sectional analysis Setting: Participants were recruited from a school-based health clinic, local colleges, and through snowballing to participate in a 6-month study examining microbicide acceptability. Participants: 106 sexually experienced girls (ages 14 through 21 years). Methods: Girls described their demographics, sexual history, and romantic relationships and completed the Sexual Assertiveness Scale for Women (SAS-W), which assesses perceptions of sexual assertiveness: Initiation of Sex, Refusal of Unwanted Sex, and Pregnancy-STD Prevention. Results: Girls perceived themselves as asserting themselves between 50 and 75% of the time with their current or most recent partner. The Initiation subscale was not related to the other two subscales. In final models, girls with a prior pregnancy perceived themselves as initiating sex more than girls without a prior pregnancy. Having a greater number of lifetime partners was related to perceptions of less refusal and greater number of partners, being sexually experienced longer, and engaging in more unprotected sex were related to perceptions of less implementation of preventive methods. None of the relationship variables were related to scores on any subscale. Conclusions: Most of these girls perceived themselves as sexually assertive. Given that sexual experience not relationship factors were related to perceptions of sexual assertiveness, the design of counseling messages should incorporate sexual experience. These messages should find effective ways to help girls communicate both their sexual desires and enhance their ability to protect themselves. PMID:17561183

Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences

PubMed Central

Gilkey, Melissa B.; Calo, William A.; Marciniak, Macary W.

2017-01-01

ABSTRACT Background: We sought to estimate the national prevalence of HPV vaccine refusal and delay in a nationally-representative sample of parents of adolescents. We also compared parents who refused versus delayed HPV vaccine in terms of their vaccination beliefs and clinical communication preferences. Methods: In 2014 to 2015, we conducted an online survey of 1,484 US parents who reported on an 11- to 17-year-old child in their household. We used weighted multinomial logistic regression to assess correlates of HPV vaccine refusal and delay. Results: Overall, 28% of parents reported that they had ever “refused or decided not to get” HPV vaccine for their child, and an additional 8% of parents reported that they had “delayed or put off getting” HPV vaccine. Compared to no refusal/delay, refusal was associated with lower confidence in adolescent vaccination (relative risk ratio [RRR] = 0.66, 95% confidence interval [CI], 0.48–0.91), lower perceived HPV vaccine effectiveness (RRR = 0.68, 95% CI, 0.50–0.91), and higher perceived harms (RRR = 3.49, 95% CI, 2.65–4.60). In contrast, delay was associated with needing more information (RRR = 1.76, 95% CI, 1.08–2.85). Most parents rated physicians and information sheets as helpful for making decisions about HPV vaccination, although parents who reported refusal endorsed these resources less often. Conclusions: Our findings suggest that HPV vaccine refusal is common among parents of adolescents and may have increased relative to previous estimates. Because the vaccination beliefs and communication preferences of parents who refuse appear to differ from those who delay, targeted communication strategies may be needed to effectively address HPV vaccine hesitancy. PMID:27763818

"Sticking Together!" Policy Activism from within a UK Coal-Mining Community

ERIC Educational Resources Information Center

Bright, N. Geoffrey

2012-01-01

This article reflects on some aspects of a doctoral ethnographic study of young people disaffected from schooling in a post-industrial space of ruin in a former coal-mining community in England. It considers how their experiences of resistance and refusal of schooling can, in the relational ethos of non-school support settings, come to speak back…

Alberta High School, College Elevate Learning with Rare Joint Venture

ERIC Educational Resources Information Center

Pearson, George

2012-01-01

The refusal by a group of parents in Olds, Alberta, in 2003 to accept a provincial grant to renovate their high school set in motion a remarkable collaboration that spawned an innovative learning campus for an entire community and beyond. The new Olds High School, which opened in 2010, is part of a new Community Learning Campus (CLC), a joint…

An Empirical Study on Pragmatic Transfer in Refusal Speech Act Produced by Chinese High School EFL Learners

ERIC Educational Resources Information Center

Jiang, Lingyun

2015-01-01

Pragmatic competence plays a very significant role in cross-cultural communication. In Chinese high school, many English teachers focus more on lexical and syntactic aspects of English. The aspect of pragmatics, however, is relatively neglected by high school English teachers. The aim of this research is to investigate pragmatic transfer in…

Test-retest reliability and predictors of unreliable reporting for a sexual behavior questionnaire for U.S. men.

PubMed

Nyitray, Alan G; Harris, Robin B; Abalos, Andrew T; Nielson, Carrie M; Papenfuss, Mary; Giuliano, Anna R

2010-12-01

Accurate knowledge about human sexual behaviors is important for increasing our understanding of human sexuality; however, there have been few studies assessing the reliability of sexual behavior questionnaires designed for community samples of adult men. A test-retest reliability study was conducted on a questionnaire completed by 334 men who had been recruited in Tucson, Arizona. Reliability coefficients and refusal rates were calculated for 39 non-sexual and sexual behavior questionnaire items. Predictors of unreliable reporting for lifetime number of female sexual partners were also assessed. Refusal rates were generally low, with slightly higher refusal rates for questions related to immigration, income, the frequency of sexual intercourse with women, lifetime number of female sexual partners, and the lifetime number of male anal sex partners. Kappa and intraclass correlation coefficients were substantial or almost perfect for all non-sexual and sexual behavior items. Reliability dropped somewhat, but was still substantial, for items that asked about household income and the men's knowledge of their sexual partners' health, including abnormal Pap tests and prior sexually transmitted diseases (STD). Age and lifetime number of female sexual partners were independent predictors of unreliable reporting while years of education was inversely associated with unreliable reporting. These findings among a community sample of adult men are consistent with other test-retest reliability studies with populations of women and adolescents.

Big Business and the Blackboard: A Winning Combination for the Classroom.

ERIC Educational Resources Information Center

Vaughn, Jason

1997-01-01

Reviews corporate involvement in education, highlighting partnership efforts of Channel One, Turner Communications, Pizza Hut, and School Properties, a professional fund-raising company. School can best utilize corporate America by refusing to become beggars. Instead, a system should be established (from the federal level down to individual…

Censorship in Schools: A Missouri Community's Experience.

ERIC Educational Resources Information Center

Edwards, Christie Lou

When parents called for the removal of certain classroom and library materials from the Mexico, Missouri, public schools in 1982, the Mexico Board of Education unanimously refused their request. After separate complaints about the magazine "Humanist," a film of Shirley Jackson's story "The Lottery," as well as her book…

Preserving Our Liberty.

ERIC Educational Resources Information Center

Glasser, Ira

1992-01-01

By law and example, school boards must govern within scope of Bill of Rights. Cites West Virginia State Board of Education v Barnette, in which Supreme Court in 1943 upheld two Jehovah's Witness children's right to refuse to participate in daily flag salute ceremony. Urges schools to teach students principles of democracy and also of individual…

"It's Being Done": Academic Success in Unexpected Schools

ERIC Educational Resources Information Center

Chenoweth, Karin

2007-01-01

This straightforward and inspiring book takes readers into schools where educators believe--and prove--that all children, even those considered "hard-to-teach," can learn to high standards. Their teachers and principals refuse to write them off and instead show how thoughtful instruction, high expectations, stubborn commitment, and…

The Behavioral Function of Feeding Problems as Assessed by the Questions about Behavioral Function (QABF)

ERIC Educational Resources Information Center

Matson, Johnny L.; Mayville, Stephen B.; Kuhn, David E.; Sturmey, Peter; Laud, Rinita; Cooper, Chris

2005-01-01

Differences in subscale scores on the questions about behavioral function (QABF) were assessed for participants identified with pica, rumination, food stealing, food refusal, and mealtime behavior problems (e.g., aggression, self-injurious behavior). The QABF was administered to informants for 125 individuals identified with problematic feeding…

Self-efficacy for AIDS preventive behaviors among tenth grade students.

PubMed

Kasen, S; Vaughan, R D; Walter, H J

1992-01-01

To guide acquired immunodeficiency syndrome (AIDS) prevention program planning, 181 tenth grade students residing in or near an AIDS epicenter completed a survey measuring past year involvement in sexual intercourse and condom use, beliefs about self-efficacy for AIDS preventive behaviors, and beliefs about susceptibility to and severity of AIDS, and outcome efficacy of AIDS preventive actions. A degree of uncertainty existed for all areas of self-efficacy surveyed: refusing sexual intercourse under a variety of circumstances, questioning sex partners about past risky behaviors, and correct and consistent condom use. Students were most uncertain of their ability to refuse sex with a desirable partner, under pressure, or after drinking alcohol or using marijuana; to purchase condoms, or use them consistently after drinking alcohol or using marijuana; and to question partners about past homosexual history. Those students with lower self-efficacy for refusing sex were twice as likely to have had sexual intercourse. Similarly, those students with lower self-efficacy for correct, consistent condom use were five times less likely to have used condoms consistently. These associations remained even after adjusting for the influence of other AIDS-related beliefs. Implications of these findings focus on exploiting the link between self-efficacy and behavior by building a prevention program that emphasizes skills-building rather than the traditional knowledge-only approach.

Resilience and Refusal: African-Caribbean Young Men's Agency, School Exclusions, and School-Based Mentoring Programmes

ERIC Educational Resources Information Center

Warren, Simon

2005-01-01

In this paper I attempt to do three things. Firstly, I explore the concept of resistance in the sociology of youth and education. I raise questions about the power of this concept to provide a descriptive language for understanding the way young people generally, and in this paper, young African-Caribbean men in London schools, deal with the…

What Not to Wear and Other Stories: Addressing Religious Diversity in Schools

ERIC Educational Resources Information Center

Blair, Ann; Aps, Will

2005-01-01

This article considers the position of religion in schools in England and Wales in light of the recent decision in "The Queen on the application of SB v Headteacher and Governors of Denbigh High School". This held that the refusal to allow a pupil to wear the jilbab was a breach of her rights under the European Convention for the…

Research on promotion of management of children with psychosomatic and psychosocial disorders in Japan.

PubMed

Ishizaki, Yuko; Kobayashi, Yohnosuke; Yamagata, Zentaro; Eto, Takashi; Hoshika, Akinori; Kano, Yukiko; Koeda, Tatsuya; Miike, Teruhisa; Oki, Junichi; Tanaka, Hidetaka; Watanabe, Hisako

2005-06-01

The number of children with psychosomatic and psychosocial disorders has been increasing in Japan. There are, however, few trained pediatricians who have adequate knowledge of the treatment needed. The Research Group on the Promotion of Management of Children with Psychosomatic and Psychosocial Disorders carried out the present study to (i) disseminate knowledge about psychosomatic and psychosocial disorders of children; and (ii) establish a community-based network model to ensure effective communication among relevant institutions. To disseminate knowledge of the psychosocial and psychosomatic disorders, the Research Group compiled the Handbook for Psychosomatic Disorders of Children and distributed it to pediatricians throughout Japan. A follow-up questionnaire survey was then carried out. Also, in order to examine the current status of the communication network between pediatricians and the related institutions, the Research Group conducted a questionnaire survey on general pediatricians. Sixty-five percent of the respondents indicated that they were actually using the Handbook. The topics in the Handbook that were most frequently referred to by the respondents were attention deficit hyperactivity disorders, school refusal, eating disorders, and orthostatic dysregulation. Thirty-seven percent of the participants indicated changes in their behavior towards psychosomatic and psychosocial problems. The results of the survey on communication networks found that the pediatricians generally collaborated with different institutions depending on the nature of the problems, such as school refusal and bullying, developmental disorders, child abuse and maltreatment, and others. Promotion of the Handbook would greatly contribute to improving the management of children with psychosomatic and psychosocial disorders, together with the construction of the basic network model for management of these children.

Resisting the Orthodox Smart Label: High School Latinas and the Redefinition of Smartness on the Western Frontier

ERIC Educational Resources Information Center

Chang, Aurora

2017-01-01

Drawing from Chicana feminist epistemology and counter-storytelling, this article argues that Latina high school students' refusal to attach the culturally constructed and hegemonically imposed label of smartness to themselves, while easily identifying that label within others, stems from a resistance to associate themselves with traditional…

CHRONOLOGY OF EVENTS (SEPTEMBER 23, 1955, TO APRIL 14, 1958) NASHVILLE SCHOOL DESEGREGATION.

ERIC Educational Resources Information Center

HOLDEN, ANNA

ON SEPTEMBER 23, 1955, PARENTS AND GUARDIANS OF 21 NEGRO CHILDREN WHO WERE REFUSED ADMISSION TO NEIGHBORHOOD PUBLIC SCHOOLS FILED SUIT. EARLY IN 1956, COMMUNITY ORGANIZATIONS SPONSORED A DESEGREGATION WORKSHOP. PARTICIPANTS REPORTED THAT THE COMMUNITY SEEMED POSITIVELY ORIENTED TOWARD THE SUPREME COURT DECISION OF 1954, BUT THAT THERE WAS NO…

The predictive utility of drinking refusal self-efficacy and alcohol expectancy: a diary-based study of tension reduction.

PubMed

Young, R M; Oei, T P

2000-01-01

The potential tension reduction effects of alcohol may be most appropriately tested by examining the role of alcohol related beliefs regarding alcohol's anxiolytic properties. The relationship between affective change drinking refusal self-efficacy, tension reduction alcohol expectancies, and ongoing drinking behavior was examined amongst 57 regular drinkers. Alcohol consumption, antecedent, and consequent mood states were monitored prospectively by diary, Social learning theory hypothesizes that low drinking refusal self-efficacy when experiencing a negative mood state should be associated with more frequent drinking when tense. Strong alcohol expectancies of tension reduction were hypothesized to predict subsequent tension reduction. Contrary to this hypothesis, the present study found that alcohol expectancies were more strongly related to antecedent mood states. Only a weak relationship between drinking refusal self-efficacy and predrinking tension, and between alcohol expectancy and subsequent tension reduction, was evident.

State Right to Refuse Medication Laws and Procedures: Impact on Homicide and Suicide.

PubMed

Edwards, Griffin

2016-09-01

As part of the expansive overhaul of the mental health system that occurred in the latter half of the 20th Century, many states passed laws that allow, under certain conditions, voluntary and involuntarily committed patients to refuse medication. While some predicted the consequences of these laws would be dire, the effect on violent behavior remains untested. The aim is to decipher any differences state right to refuse medication laws may have on violence. Using the homicide rate of every US state between 1972 and 2001 (N = 1,479), and the suicide rate between 1981 and 2001 (N = 1,071). The study compares the difference in homicide/suicide rates before and after a law change to that same difference in a set of control states to estimate the effect of laws aimed at extending the right to refuse medication to both voluntary and involuntarily committed mental health patients. Laws designed to allow voluntarily committed patients to refuse medication are associated with a 0.8 increase in homicides per 100,000 of the state population while laws dictating an involuntarily committed patient's right to request refusal of medication are negative but statistically insignificant using standard t test. Laws designed to allow voluntarily committed patients to refuse medication have no statistically significant effect on suicides while laws dictating an involuntarily committed patient's right to request refusal of medication, specifically when the request is reviewed by independent mental health professionals, are associated with a statistically significant reduction in suicides. Allowing voluntarily committed patients to refuse medication may entice some to enter in-patient facilities, but the brief and optional exposure to medication and their side effects may actually discourage treatment and increase violence.

Suicidal Behavior in Long-Term Care Facilities.

ERIC Educational Resources Information Center

Osgood, Nancy J.; Brant, Barbara A.

1990-01-01

Surveyed administrators of 463 long-term care facilities concerning overt suicides and intentional life-threatening behaviors. Data revealed that White males were highest risk group. Refusal to eat, drink, or take medications were most common suicidal behaviors. Depression, loneliness, feelings of family rejection, and loss were significant…

The role of positive/negative outcome expectancy and refusal self-efficacy of Internet use on Internet addiction among college students in Taiwan.

PubMed

Lin, Min-Pei; Ko, Huei-Chen; Wu, Jo Yung-Wei

2008-08-01

Based on Bandura's social cognitive theory, this study was designed to examine positive and negative outcome expectancy and refusal self-efficacy of Internet use and their contribution to Internet addiction among college students by using hierarchical multiple regression analyses in a cross-sectional study design. Schools were first stratified into technical or nontechnical colleges and then into seven majors. A cluster random sampling by department was further applied to randomly choose participants from each major. A representative sample of 4,456 college students participated in this study. The Outcome Expectancy and Refusal Self-Efficacy of Internet Use Questionnaire and the Chen Internet Addiction Scale were used to assess the cognitive factors and the levels of Internet addiction. Results showed that both positive outcome expectancy and negative outcome expectancy were significantly and positively correlated with Internet addiction, and refusal self-efficacy of Internet use was significantly and negatively related to Internet addiction. Further analyses revealed that refusal self-efficacy of Internet use directly and negatively predicted Internet addiction. Moreover, we discovered that positive outcome expectancy positively predicted Internet addiction via refusal self-efficacy of Internet use; however, surprisingly, negative outcome expectancy had both a direct and indirect positive relationship in predicting Internet addiction via the refusal self-efficacy of Internet use. These results give empirical evidence to verify the theoretical effectiveness of the three cognitive factors to Internet addiction and should be incorporated when designing prevention programs and strategies for Internet addicted college students.

[Participation refusal by probands in an epidemiologic long-term study--sociodemographic, clinical and psychometric findings].

PubMed

Franz, M; Schepank, H; Wirth, T; Schellberg, D

1992-11-01

Usually little is known about probands who participated in an epidemiological longitudinal field survey but refused participation in follow-up investigations. For reasons of data protection and on account of the fact that investigative instruments used in longterm field surveys or panel studies are more focused on well defined issues (opinions, attitudes, assessment of behaviors) and less on personality variables, differentiated statements on probands who explicitly refused cooperation can hardly be made. In our epidemiological longitudinal field study on prevalence and course of psychogenic disorders we have a different situation. Within the limits of our study we had the unique opportunity to gain far-reaching information on probands who refused to participate in preceding investigations in regard to sociodemographic, psychometric and clinical variables. The clientele of refusers we present in our paper mainly comprises elderly, married, rather obsessive-compulsive structured, lower-class females. According to our data interactive aspects are equally responsible for reduced cooperativeness. The significance of our findings for the planning and carrying out of epidemiological longitudinal field surveys is discussed.

Alcohol marketing, drunkenness, and problem drinking among Zambian youth: findings from the 2004 Global School-Based Student Health Survey.

PubMed

Swahn, Monica H; Ali, Bina; Palmier, Jane B; Sikazwe, George; Mayeya, John

2011-01-01

This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangers of alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Zambia (2004) of students primarily 11 to 16 years of age (N = 2257). Four statistical models were computed to test the associations between alcohol marketing and education and alcohol use, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09-2.02) and problem drinking (AOR = 1.41; 95% CI: 1.06-1.87) among youth after controlling for demographic characteristics, risky behaviors, and alcohol education. However, alcohol education was not associated with drunkenness or problem drinking. These findings underscore the importance of restricting alcohol marketing practices as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth.

A Behavior Analysis Approach toward Chronic Food Refusal in Children with Gastrostomy-Tube Dependency.

ERIC Educational Resources Information Center

Luiselli, James K.; Luiselli, Tracy Evans

1995-01-01

This report describes a behavior analysis treatment approach to establishing oral feeding in children with multiple developmental disabilities and gastrostomy-tube dependency. Pretreatment screening, functional assessment, and treatment are reported as implemented within a behavioral consultation model. A case study illustrates the sequence and…

Clinical Characteristics of the Suicide Attempters Who Refused to Participate in a Suicide Prevention Case Management Program.

PubMed

Park, Soyoung; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk

2015-10-01

Case management interventions for suicide attempters aimed at helping adjust their social life to prevent reattempts have high nonparticipation and dropout rates. We analyzed the clinical characteristics of the group who refused to participate in the suicide prevention program in Korea. A total of 489 patients with a suicide attempt who visited Uijeongbu St. Mary's Hospital, the Catholic University of Korea, from December 2009 to December 2013 were analyzed. All patients were divided into the participation group (n = 262) and the refusal group (n = 227) according to their participation in the case management program. Demographic and clinical characteristics of each group were examined. Results showed that the refusal group had low risks for suicide in terms of risk factors related with psychopathologies and presenting suicide behavior. That is, the refusal group had less patients with co-morbid medical illnesses and more patients with mild severity of depression compared to the participation group. However, the refusal group had more interpersonal conflict, more isolation of social integrity, and more impaired insight about suicide attempt. The results suggest that nonparticipation in the case management program may depend upon the patient's impaired insight about the riskiness of suicide and lack of social support.

Severe Feeding Problems Secondary to Anatomical Disorders: Effectiveness of Behavioural Treatment in Three School-Aged Children

ERIC Educational Resources Information Center

de Moor, Jan; Didden, Robert; Tolboom, Jules

2005-01-01

In the present study, behavioural treatment is described of three school-aged children with severe feeding problems caused by (surgically corrected) anatomical disorders of the digestive system. Two children showed food refusal and were tube-fed whereas the third child showed extreme food selectivity. During treatment, shaping, (non)verbal…

Alternative Fuels Data Center: Natural Gas Fuels School Buses and Refuse

Science.gov Websites

Efficiency March 8, 2014 Renzenberger Inc Saves Money With Propane Vans Feb. 1, 2014 Photo of a school bus Buses Help Kansas City Save Money Nov. 12, 2011 Metropolitan Utilities District Fuels Vehicles With Electric Shuttle Buses Offer Free Rides in Maryland June 18, 2010 Fisher Coachworks Develops Plug-In

Adolescents' responses to peer smoking offers: the role of sensation seeking and self-esteem.

PubMed

Greene, Kathryn; Banerjee, Smita C

2008-01-01

This article deals with an important topic (youth smoking) and makes a contribution to the literature by validating existing research and extending our understanding of smoking resistance strategies. This study classified adolescent reports of their responses to cigarette smoking offers utilizing four drug refusal strategies of refuse, explain, avoid, and leave (REAL) and explored how personality factors explain adolescents' use of cigarette refusal strategies. Participants were predominantly Hispanic junior high students (6th-8th grades) from schools in the Northeast United States who participated in a survey design (N = 260). The strategy of explain was reported most frequently for initial and follow-up smoking offers. Adolescents with a greater number of friends who smoked were more likely to use the avoid strategy for initial smoking offers. Sensation seeking was positively related to the use of leave and avoid strategies for initial smoking offers and leave strategy for follow-up smoking offers. No association was found between self-esteem and use of smoking refusal strategies. Implications and directions for future research are discussed.

Process evaluation of a national school-based iron supplementation program for adolescent girls in Iran.

PubMed

Kheirouri, Sorayya; Alizadeh, Mohammad

2014-09-16

Iron deficiency anemia remains as one of the most common nutritional problems in Iran, especially in women and girls. A process evaluation study of the national iron supplementation program targeting girls attending high schools was conducted to examine degree of exposure and satisfaction of the targets with the intervention components, and to assess the delivery (quantity), fidelity (quality), and environmental mediators of the intervention. Three assessment tools were developed and used for the process evaluation. A total of 8 schools were selected using a simple randomization method. Data were collected from students (n = 658 of 661 participants), teachers (n = 80), and school principals (n = 7 of 8). For the qualitative measures semi-structured interviews were conducted with the three study groups. Mean continuous compliance was 62.3%. Intolerance to pills and no water supply in classrooms accounted for 47.72% and 36.21% of the refusals, respectively. The refusal rate was significantly correlated (p < 0.001) with the absence of a classroom water supply, and with each student's knowledge of iron deficiency issues (p < 0.05). The odds of refusal in the absence of a classroom water supply were 2.02 (95% CI 1 · 044 to 3 · 900) times greater than for those classrooms with a water supply. Student exposure to the program's goal was satisfactory; however, delivery and fidelity of educational materials and training sessions were inadequate. The findings suggest that the methods of delivery and the fidelity of the program components, education materials and training sessions were insufficient and need to be improved. Additionally, specific attention has to be given to contextual factors to ensure the success of the program.

Drinking Refusal Self-Efficacy and Intended Alcohol Consumption During a Mass-Attended Youth Event.

PubMed

Jongenelis, Michelle I; Pettigrew, Simone; Biagioni, Nicole

2018-04-16

Mass-attended youth events represent a substantial public health challenge due to high levels of alcohol consumption and corresponding high rates of alcohol-related harm. Although previous research has documented the protective effect of high drinking refusal self-efficacy (DRSE) on alcohol consumption in general, there is a lack of research examining the role of DRSE in reducing consumption during mass-attended youth events and the factors associated with DRSE in these contexts. This study aimed to identify potentially modifiable factors that influence DRSE and drinking intentions to inform interventions designed to reduce alcohol-related harm during mass-attended events. Australian secondary school students (n = 586; 70% female) in their final two years of high school completed an online survey assessing their alcohol consumption intentions for Schoolies, their perceived degree of DRSE, and other individual and environmental factors. Path analysis was used to assess a mediational model examining factors associated with DRSE and alcohol consumption intentions. DRSE was found to be significantly associated with intended alcohol consumption during Schoolies. Specifically, leavers who believed they would not be able to refuse others' offers of alcoholic drinks reported significantly greater alcohol consumption intentions. Results also revealed that DRSE was enhanced in those respondents who believed there would be a variety of non-drinking activities and non-alcoholic beverages available to them during Schoolies. Results suggest the need to increase leavers' confidence in their ability to refuse unwanted alcoholic beverages and highlight the importance of providing celebration options that do not involve alcohol consumption.

Physician switching after drug request refusal.

PubMed

Lee, Doohee; Begley, Charles E

2011-10-01

Physician switching is a barometer of the quality of the relationship between a patient and a physician. Understanding the factors associated with physician switching in the context of direct-to-consumer advertising (DTCA) of prescription drugs has been largely unexamined. A total of 818 of 2,988 participants in a national telephone survey (27.4%) who had received DTCA reported asking their physician for a prescription drug, and 196 (24.0%) reported that their physician refused to prescribe the drug. Of those whose physicians refused, 13.9% (n = 27 of 194 with data) switched doctors. We found that individuals with regular medical-seeking behavior, full prescription drug coverage, with certain chronic conditions, and of African American origin were significantly more likely to switch physicians in this context.

Stop Thief!

ERIC Educational Resources Information Center

American School and University, 1984

1984-01-01

A large urban school board has solved the security problem for electronically stored student records by refusing to file them on a dialup system and by requiring a notarized affidavit of custody before release to a parent or guardian. (TE)

Rape myth acceptance and rape acknowledgment: The mediating role of sexual refusal assertiveness.

PubMed

Newins, Amie R; Wilson, Laura C; White, Susan W

2018-05-01

Unacknowledged rape, defined as when an individual experiences an event that meets a legal or empirical definition of rape but the individual does not label it as such, is prevalent. Research examining predictors of rape acknowledgment is needed. Sexual assertiveness may be an important variable to consider, as an individual's typical behavior during sexual situations may influence rape acknowledgment. To assess the indirect effect of rape myth acceptance on rape acknowledgment through sexual refusal assertiveness, an online survey of 181 female rape survivors was conducted. The indirect effects of two types of rape myths (He didn't mean to and Rape is a deviant event) were significant and positive. Specifically, acceptance of these two rape myths was negatively related to sexual refusal assertiveness, which was negatively associated with likelihood of rape acknowledgment. The results of this study indicate that sexual refusal assertiveness is associated with lower likelihood of rape acknowledgment among rape survivors. As a result, it appears that, under certain circumstances, women high in rape myth acceptance may be more likely to acknowledge rape when it results in decreased sexual refusal assertiveness. Copyright © 2018 Elsevier B.V. All rights reserved.

Shallow Environmentalism: A Preliminary Eco-Critical Discourse Analysis of Secondary School English as a Foreign Language (EFL) Texts in China

ERIC Educational Resources Information Center

Xiong, Tao

2014-01-01

The school textbooks have been a useful site for inquiry into ways environmentalism is communicated. Rooted in the dominant social value of exploiting nature to satisfy human desire, shallow environmentalism treats environmental and ecological destruction by addressing immediate physical symptoms but refuses to reflect critically on the underlying…

Gendered Perceptions of Drugs, Aggression, and Violence

PubMed Central

Helm, Susana; Okamoto, Scott K.

2016-01-01

Objective Drug use has been linked empirically with aggression and violence among youth in national and State of Hawai‘i samples. In addition, aggression and violence appear to be gendered experiences perceived differently by girls and boys. This paper explores the intersection of drug offers/drug refusals with aggression and violence with specific attention paid to gendered perceptions of drug use situations as a context for aggression and violence. Methods A qualitative study, in which fourteen sex-specific focus group discussions were held, focused on rural Native Hawaiian middle school students (N=64). Students were asked to discuss drug refusal strategies in a variety of drug offer contexts. Feminist theories and approaches were used to examine the role of aggression and violence in drug refusal as perceived by Native Hawaiian girls as compared to boys. Results Girls and boys differed in their perceptions of aggression and violence in drug offer situations, initially as evidenced by the extent to which the girls groups focused on the intersection of drugs and violence. Further, qualitative analyses reflected gender norms and stereotypes about aggression and violence perpetration, and girls' apparently unique concerns about sexual violence victimization. Conclusions Implications are discussed in terms of prevention research and practice, specifically in terms of school-based prevention curricula. PMID:27456534

The Strongsville Decision

ERIC Educational Resources Information Center

School Library Journal, 1976

1976-01-01

The suit claimed violation of First and Fourteenth Amendment rights in that the school board, disregarding the recommendation of faculty, refused to approve Joseph Heller's "Catch 22" and Kurt Vonnegut's "God Bless You, Mr. Rosewater" as texts or library books. (Author)

Treatment guidelines for primary nonretentive encopresis and stool toileting refusal.

PubMed

Kuhn, B R; Marcus, B A; Pitner, S L

1999-04-15

Nonretentive encopresis refers to inappropriate soiling without evidence of fecal constipation and retention. This form of encopresis accounts for up to 20 percent of all cases. Characteristics include soiling accompanied by daily bowel movements that are normal in size and consistency. An organic cause for nonretentive encopresis is rarely identified. The medical assessment is usually normal, and signs of constipation are noticeably absent. A full developmental and behavioral assessment should be made to establish that the child is ready for intervention to correct encopresis and to identify any barriers to success, particularly disruptive behavior problems. Successful interventions depend on the presence of soft, comfortable bowel movements and addressing toilet refusal behavior. Daily scheduled positive toilet sits are recommended. Incentives may be used to reinforce successful defecation during these sits. A plan for management of stool withholding should be agreed on by the parents/caretakers and the family physician before intervention.

Empathy and Drug Use Behaviors among African-American Adolescents

ERIC Educational Resources Information Center

Nguyen, Anh B.; Clark, Trenette T.; Belgrave, Faye Z.

2011-01-01

The current study proposed that empathy may indirectly play a protective role for adolescents in drug use behaviors and that this relationship will be mediated by self-regulatory strategies found in drug refusal efficacy. We predict that empathy will be linked to prosocial behavior and aggression, though we do not believe that they will mediate…

Child Maltreatment and Risky Sexual Behavior.

PubMed

Thompson, Richard; Lewis, Terri; Neilson, Elizabeth C; English, Diana J; Litrownik, Alan J; Margolis, Benyamin; Proctor, Laura; Dubowitz, Howard

2017-02-01

Risky sexual behavior is a serious public health problem. Child sexual abuse is an established risk factor, but other forms of maltreatment appear to elevate risky behavior. The mechanisms by which child maltreatment influence risk are not well understood. This study used data from 859 high-risk youth, followed through age 18. Official reports of each form of maltreatment were coded. At age 16, potential mediators (trauma symptoms and substance use) were assessed. At age 18, risky sexual behavior (more than four partners, unprotected sex, unassertiveness in sexual refusal) was assessed. Neglect significantly predicted unprotected sex. Substance use predicted unprotected sex and four or more partners but did not mediate the effects of maltreatment. Trauma symptoms predicted unprotected sex and mediated effects of emotional maltreatment on unprotected sex and on assertiveness in sexual refusal and the effects of sexual abuse on unprotected sex. Both neglect and emotional maltreatment emerged as important factors in risky sexual behavior. Trauma symptoms appear to be an important pathway by which maltreatment confers risk for risky sexual behavior. Interventions to reduce risky sexual behavior should include assessment and treatment for trauma symptoms and for history of child maltreatment in all its forms.

Childhood and Adolescent Predictors of Alcohol Abuse and Dependence in Young Adulthood*

PubMed Central

Guo, Jie; Hawkins, J. David; Hill, Karl G.; Abbott, Robert D

2007-01-01

Objective To provide a comprehensive examination of childhood and adolescent predictors of alcohol abuse and dependence at age 21, theoretically guided by the social development model. Method Data were taken from an ethnically diverse urban sample of 808 students [51% male), surveyed at age 10 and followed prospectively to age 21 in 1996. Potential predictors of alcohol abuse and dependence at age 21 were measured at ages 10, 14 and 16. Relationships between these predictors and alcohol abuse and dependence were examined at each age, to assess changes in their patterns of prediction over time. Results Strong bonding to school, close parental monitoring of children and clearly defined family rules for behavior, appropriate parental rewards for good behaviors, high level of refusal skills and strong belief in the moral order predicted a lower risk for alcohol abuse and dependence at age 21. Of these, strong bonding to school consistently predicted lower alcohol abuse and dependence from all three ages (10, 14 and 16). By contrast, youths who had a higher risk of alcohol abuse and dependence at age 21 engaged in more problem behaviors, had more opportunities to be involved with antisocial individuals and spent more time with and were more bonded to those individuals, viewed fewer negative consequences from antisocial behaviors and held more favorable views on alcohol use. Of these, prior problem behaviors and antisocial opportunities and involvements at ages 10, 14 and 16 consistently predicted alcohol abuse and dependence at age 21. Conclusions These important malleable predictors, identifiable as early as age 10, provide potential intervention targets for the prevention of alcohol abuse and dependence in early adulthood. PMID:11838912

Assessment of Feeding and Mealtime Behavior Problems in Persons with Mental Retardation

ERIC Educational Resources Information Center

Kuhn, David E.; Matson, Johnny L.

2004-01-01

Feeding and mealtime behavior problems are commonly observed among individuals with developmental disabilities. These problems include, but are not limited to, food refusal, food selectivity, mealtime aggression, rumination, pica, and insufficient feeding skills. Difficulties of this type can be associated with life-threatening consequences of…

At the Intersection of Faith, Culture, and Family Dynamics: A Complex Case of Refusal of Treatment for Childhood Cancer.

PubMed

Brown, Amy E Caruso

2017-01-01

Refusing treatment for potentially curable childhood cancers engenders much discussion and debate. I present a case in which the competent parents of a young Amish child with acute myeloid leukemia deferred authority for decision making to the child's maternal grandfather, who was vocal in his opposition to treatment. I analyze three related concerns that distinguish this case from other accounts of refused treatment. First, I place deference to grandparents as decision makers in the context of surrogate decision making more generally. Second, the maternal grandfather's ardent refusal of treatment and his rationale appeared to be inconsistent with the beliefs expressed by other family members and by members of the same Amish community, leading members of the medical team to question whether refusal of treatment should be treated differently when it appears to be based on the idiosyncratic beliefs of an individual rather than on community-wide values. Third, the medical team perceived tension and dissension between the nonverbal behavior of some family members and the verbal statements made by the maternal grandfather, leading the team to question the parents' true wishes and debate how to weigh nonverbal and indirect forms of communication. Finally, building upon the conclusions of these queries, I explore whether, if the child's prognosis was less favorable or if he were to relapse later, the maternal grandfather should have been permitted to drive a decision to refuse further treatment. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Contribution of patient, physician, and environmental factors to demographic and health variation in colonoscopy follow-up for abnormal colorectal cancer screening test results.

PubMed

Partin, Melissa R; Gravely, Amy A; Burgess, James F; Haggstrom, David A; Lillie, Sarah E; Nelson, David B; Nugent, Sean M; Shaukat, Aasma; Sultan, Shahnaz; Walter, Louise C; Burgess, Diana J

2017-09-15

Patient, physician, and environmental factors were identified, and the authors examined the contribution of these factors to demographic and health variation in colonoscopy follow-up after a positive fecal occult blood test/fecal immunochemical test (FOBT/FIT) screening. In total, 76,243 FOBT/FIT-positive patients were identified from 120 Veterans Health Administration (VHA) facilities between August 16, 2009 and March 20, 2011 and were followed for 6 months. Patient demographic (race/ethnicity, sex, age, marital status) and health characteristics (comorbidities), physician characteristics (training level, whether primary care provider) and behaviors (inappropriate FOBT/FIT screening), and environmental factors (geographic access, facility type) were identified from VHA administrative records. Patient behaviors (refusal, private sector colonoscopy use) were estimated with statistical text mining conducted on clinic notes, and follow-up predictors and adjusted rates were estimated using hierarchical logistic regression. Roughly 50% of individuals completed a colonoscopy at a VHA facility within 6 months. Age and comorbidity score were negatively associated with follow-up. Blacks were more likely to receive follow-up than whites. Environmental factors attenuated but did not fully account for these differences. Patient behaviors (refusal, private sector colonoscopy use) and physician behaviors (inappropriate screening) fully accounted for the small reverse race disparity and attenuated variation by age and comorbidity score. Patient behaviors (refusal and private sector colonoscopy use) contributed more to variation in follow-up rates than physician behaviors (inappropriate screening). In the VHA, blacks are more likely to receive colonoscopy follow-up for positive FOBT/FIT results than whites, and follow-up rates markedly decline with advancing age and comorbidity burden. Patient and physician behaviors explain race variation in follow-up rates and contribute to variation by age and comorbidity burden. Cancer 2017;123:3502-12. Published 2017. This article is a US Government work and is in the public domain in the USA. © 2017 American Cancer Society.

Potential bias in the bank: what distinguishes refusers, nonresponders and participants in a clinic-based biobank?

PubMed

Ridgeway, J L; Han, L C; Olson, J E; Lackore, K A; Koenig, B A; Beebe, T J; Ziegenfuss, J Y

2013-01-01

Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in terms of attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to electronic health record information, we compared patient characteristics and self-reported information among participants, nonresponders and refusers. We also compared reasons for nonparticipation between refusers and nonresponders to elucidate potential pathways to reduce nonparticipation and any uncovered bias. We mailed recruitment packets to 1,600 adult patients with upcoming appointments at Mayo Clinic (Rochester, Minn., USA) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 nonresponders and 26 refusers to collect self-reported information, including reasons for nonparticipation. Participants were asked to complete a mailed questionnaire. We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% nonresponse (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns, while nonresponders more often identified time constraints as the reason for nonparticipation. For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation among less-represented groups. Copyright © 2013 S. Karger AG, Basel.

Potential Bias in the Bank: What Distinguishes Refusers, Non-responders and Participants in a Clinic-based Biobank?

PubMed Central

Ridgeway, Jennifer L; Han, Leona C; Olson, Janet E; Lackore, Kandace A; Koenig, Barbara A; Beebe, Timothy J; Ziegenfuss, Jeanette Y

2013-01-01

Background Biobanks are an important resource for genetic and epidemiologic research, but bias may be introduced if those who accept the recruitment invitation differ systematically from those who do not in attributes important to health-related investigations. To understand potential bias in a clinic-based biobank of biological samples, including genetic data linked to Electronic Medical Record information, we compared patient characteristics and self-reported information among participants, non-responders, and refusers. We also compared reasons for non-participation between refusers and non-responders to elucidate potential pathways to reduce non-participation and any uncovered bias. Methods We mailed recruitment packets to 1600 adult patients with upcoming appointments at Mayo Clinic (Rochester, MN) and recorded their participation status. Administrative data were used to compare characteristics across groups. We used phone interviews with 26 non-responders and 26 refusers to collect self-reported information, including reasons for non-participation. Participants were asked to complete a mailed questionnaire. Results We achieved 26.2% participation (n=419) with 12.1% refusing (n=193) and 61.8% non-response (n=988). In multivariate analyses, sex, age, region of residence, and race/ethnicity were significantly associated with participation. The groups differed in information-seeking behaviors and research experience. Refusers more often cited privacy concerns while non-responders more often identified time constraints as the reason for non-participation. Conclusion For genomic medicine to advance, large, representative biobanks are required. Significant associations between patient characteristics and nonresponse, as well as systematic differences between refusers and nonresponders, could introduce bias. Oversampling or recruitment changes, including heightened attention to privacy protection and participation burden, may be necessary to increase participation among less-represented groups. PMID:23595106

[Narcolepsy in childhood and adolescence: symptoms, diagnosis, and therapy. A case report].

PubMed

Gehrmann, Jochen; Siegler, Dominik; Ignacy, Evelin; Reimer, Inga

2017-03-01

Narcolepsy is a rare, multifactorial disease of the hypothalamus characterized by its leading symptoms of excessive daytime sleepiness and cataplexy. Sleep-EEG and a HLA-DR-genotype serve to secure the diagnosis. We report here on a 14-year-old girl suffering from anxieties, depression, school refusal, social withdrawal as well as very frequent attacks of sleep during the day and cataplexy. Currently, there is no approved drug for children and adolescents suffering from narcolepsy. Our patient benefited significantly and quickly from an off-label treatment with methylphenidate in combination with psychoeducation, cognitive behavioral therapy, and family therapy. Narcolepsy is a very rare but probably underestimated differential diagnosis applied to unclear daytime sleepiness, anxieties, or depression in childhood and adolescence. Both the key symptoms and the comorbid symptoms improve significantly under treatment with stimulants, albeit at a higher dosage.

Alcohol Marketing, Drunkenness, and Problem Drinking among Zambian Youth: Findings from the 2004 Global School-Based Student Health Survey

PubMed Central

Swahn, Monica H.; Ali, Bina; Palmier, Jane B.; Sikazwe, George; Mayeya, John

2011-01-01

This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangers of alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Zambia (2004) of students primarily 11 to 16 years of age (N = 2257). Four statistical models were computed to test the associations between alcohol marketing and education and alcohol use, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09–2.02) and problem drinking (AOR = 1.41; 95% CI: 1.06–1.87) among youth after controlling for demographic characteristics, risky behaviors, and alcohol education. However, alcohol education was not associated with drunkenness or problem drinking. These findings underscore the importance of restricting alcohol marketing practices as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth. PMID:21647354

Positive practice routines in overcoming resistance to the treatment of school phobia: a case study with follow-up.

PubMed

Kolko, D J; Ayllon, T; Torrence, C

1987-09-01

The treatment is described of a 6-year-old first grade girl who refused to attend her classroom without adult accompaniment. For eight weeks an attempt was made, using different adult escorts, to prompt/shape classroom attendence through classroom exposure. However, the outcome was the development of an unwavering preference to remain in the principal's office after the child would not tolerate separation from these adults. Rather then continue to take her to the classroom, an intervention was initiated designed to structure her daily experiences and provide instruction. In this she was expected to practice several educational activities at designated times in the principal's office. This intervention resulted in a complete elimination of the child's classroom avoidance within five weeks and concomitant improvements in both social and academic functioning. Although the child's mother suddenly died during intervention, follow-up at one and 12 months in a different school indicated the maintenance of all therapeutic gains. Unique aspects of the procedures pertaining to refractory problems and some tentative behavioral guidelines to overcoming resistance to treatment are discussed.

Toilet Phobia and Toilet Refusal In Children.

PubMed

Wagner, Catharina; Niemczyk, Justine; von Gontard, Alexander

2017-01-01

Objective: Toilet refusal syndrome (TRS) is a common disorder in toddlers, defined by use of diapers and refusal of toilet for defecation, while toilet phobia (TP) is a rare disorder in which toilets are avoided completely. Both disorders have not been described systematically in children, yet. Therefore, the aim was to present typical case vignettes illustrating different clinical presentations of TP and TRS. Methods: 5 typical cases were selected from all patients presented at a specialized outpatient clinic for incontinence at a tertiary university hospital during the last 3 years. Results: The first case is a girl with incontinence and no behavioral comorbidities, for whom treatment was more complicated than expected because of her TP. Second, a boy with an IQ on the border to mild intellectual disability will be presented, who revealed phobias regarding the toilet. Case 3 is exemplary for a group of patients with TRS, who also have ODD and show oppositional behavior in different situations. Cases 4 and 5 show "classical" TRS with constipation following painful defecation. Similarities and differences of TRS and TP, the current state of research, diagnostic and management recommendations are presented in detail. Conclusion: TRS in preschool children is a common condition, associated with high rates of constipation and behavioral problems. In contrast, TP is rarer and harder to recognize for pediatricians, but is often accompanied with somatic and behavioral problems, as well. Although there is a paucity of studies on these pediatric disorders, pediatricians should keep them in mind. © Georg Thieme Verlag KG Stuttgart · New York.

Situation testing: the case of health care refusal.

PubMed

Després, C; Couralet, P-E

2011-04-01

Situation testing to assess physicians' refusal to provide healthcare is increasingly used in research studies. This paper aims to explain the relevance and limits of this method. Conducted in 2008-2009, this study was designed to assess the rate of healthcare refusal among several categories of private practitioners toward patients covered by the French public means-tested complementary health insurance (CMUc) when they requested a first appointment by phone. The other objectives were to study the determinants of healthcare refusal and assess the method. The study was conducted on a representative sample of Paris-based dentists and physicians in five categories: general practitioners, medical gynecologists, ophthalmologists, radiologists, and dentists. The method was based on two protocols. In the first scenario, an actor pretended to be a CMUc beneficiary and, in the second one, he did not give information about his health coverage but hinted at a low socioeconomic status. The two protocols were compared and procedures checking the relation between refusal and CMUc coverage were implemented in each of them. In the scenario in which the patient declared being a CMUc beneficiary, the results showed different refusal rates depending on the type of practitioner, physician, or dentist, their specialty, and whether or not, they charge more than the standard set fee. In the second scenario, refusal rates were much lower. The comparison of the two protocols seems to confirm the existence of discrimination based on CMUc affiliation rather than patients' socioeconomic status. The discussion presents the limits of situation testing, which remains an experimental instrument because it does not observe reality but reveals behaviors in situation. The findings cannot be extrapolated and are limited in time. The statistical analysis is only valid if the procedure followed is precise and applied consistently using a preset scenario. In addition, the discriminatory nature of the refusal (CMUc coverage) must be confirmed by a validation procedure (unless clearly stated by the interlocutor). Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Risk factors associated with treatment refusal in lung cancer

PubMed Central

Suh, Won Na; Kong, Kyoung Ae; Han, Yeji; Kim, Soo Jung; Lee, Su Hwan; Ryu, Yon Ju; Lee, Jin Hwa; Shim, Sung Shine; Kim, Yookyung

2017-01-01

Background The incidence of lung cancer is increasing with longer life expectancy. Refusal of active treatment for cancer is prone to cause patients to experience more severe symptoms and shorten survival. The purpose of this study was to define the factors related to refusal or abandonment of active therapy in lung cancer. Methods We retrospectively reviewed the data of 617 patients from medical records from 2010 to 2014. Two groups were formed: 149 patients who refused anti‐cancer treatment and allowed only palliative care were classified into the non‐treatment group, while the remaining 468 who received anti‐cancer treatment were classified into the treatment group. Results The groups differed significantly in age, employment, relationship status, number of offspring, educational status, body mass index, presence of chest and systemic symptoms, Charlson Comorbidity Index, Eastern Cooperative Oncology Group score, and tumor node metastasis stage (P < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07–1.13), educational status lower than high school (OR 1.95, 95% CI 1.2–3.2), no history of surgery (OR 2.29, 95% CI 1.4–3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3–4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3–10.8) were significant factors for refusal of cancer treatment. Conclusion Individual factors, such as old age, low educational status, low weight, and poor performance status can influence refusal of cancer treatment in patients with lung cancer, and should be considered prior to consultation with patients. PMID:28627788

Risk factors associated with treatment refusal in lung cancer.

PubMed

Suh, Won Na; Kong, Kyoung Ae; Han, Yeji; Kim, Soo Jung; Lee, Su Hwan; Ryu, Yon Ju; Lee, Jin Hwa; Shim, Sung Shine; Kim, Yookyung; Chang, Jung Hyun

2017-09-01

The incidence of lung cancer is increasing with longer life expectancy. Refusal of active treatment for cancer is prone to cause patients to experience more severe symptoms and shorten survival. The purpose of this study was to define the factors related to refusal or abandonment of active therapy in lung cancer. We retrospectively reviewed the data of 617 patients from medical records from 2010 to 2014. Two groups were formed: 149 patients who refused anti-cancer treatment and allowed only palliative care were classified into the non-treatment group, while the remaining 468 who received anti-cancer treatment were classified into the treatment group. The groups differed significantly in age, employment, relationship status, number of offspring, educational status, body mass index, presence of chest and systemic symptoms, Charlson Comorbidity Index, Eastern Cooperative Oncology Group score, and tumor node metastasis stage ( P < 0.05). In logistic regression analysis, age (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.07-1.13), educational status lower than high school (OR 1.95, 95% CI 1.2-3.2), no history of surgery (OR 2.29, 95% CI 1.4-3.7), body mass index < 18.5 (OR 2.49, 95% CI 1.3-4.7), and a high Eastern Cooperative Oncology Group score of 3 or 4 (OR 5.02, 95% CI 2.3-10.8) were significant factors for refusal of cancer treatment. Individual factors, such as old age, low educational status, low weight, and poor performance status can influence refusal of cancer treatment in patients with lung cancer, and should be considered prior to consultation with patients. © 2017 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

A Video-Based Intervention on and Evaluation of Nursing Aides' Therapeutic Communication and Residents' Agitation During Mealtime in a Dementia Care Unit.

PubMed

Levy-Storms, Lené; Harris, Lesley M; Chen, Xiao

2016-01-01

The researchers conducted a communication training intervention for certified nursing assistants (CNAs). The intervention aimed at improving CNAs' therapeutic techniques for relating to agitated residents during care. This study focused on an in-depth evaluation of mealtime interactions using videos. Sixteen CNAs and 16 residents living with dementia from one long-term care facility were videotaped during mealtime interactions before and after a therapeutic communication training program. Mixed-effect Poisson regression revealed no effect of the intervention as a whole on residents' refusals, but the intervention did improve CNAs' communication. Additional analyses using specific CNAs' therapeutic communication behaviors indicated a significant negative association with refusals at post-test but not pretest. The findings suggest some communication mechanisms for how the intervention positively influenced residents' refusals.

An eight-year follow-up national study of medical school and general hospital ethics committees in Japan

PubMed Central

Akabayashi, Akira; Slingsby, Brian T; Nagao, Noriko; Kai, Ichiro; Sato, Hajime

2007-01-01

Background Ethics committees and their system of research protocol peer-review are currently used worldwide. To ensure an international standard for research ethics and safety, however, data is needed on the quality and function of each nation's ethics committees. The purpose of this study was to describe the characteristics and developments of ethics committees established at medical schools and general hospitals in Japan. Methods This study consisted of four national surveys sent twice over a period of eight years to two separate samples. The first target was the ethics committees of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan (n = 1457 in 1996 and n = 1491 in 2002). Instruments contained four sections: (1) committee structure, (2) frequency of annual meetings, (3) committee function, and (4) existence of a set of guidelines for the refusal of blood transfusion by Jehovah's Witnesses. Results Committee structure was overall interdisciplinary. Frequency of annual meetings increased significantly for both medical school and hospital ethics committees over the eight years. The primary activities for medical school and hospital ethics committees were research protocol reviews and policy making. Results also showed a significant increase in the use of ethical guidelines, particularly those related to the refusal of blood transfusion by Jehovah's Witnesses, among both medical school and hospital ethics committees. Conclusion Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. PMID:17598923

Trends in age verification among U.S. adolescents attempting to buy cigarettes at retail stores, 2000-2009.

PubMed

Filippidis, Filippos T; Agaku, Israel T; Connolly, Gregory N; Vardavas, Constantine I

2014-04-01

This study assessed trends in age verification prior to cigarette sales to U.S. middle and high school students, and refusal to sell cigarettes to students aged <18 years during 2000-2009. Data were obtained from the 2000-2009 National Youth Tobacco Survey. Trends during 2000-2009 were assessed using binary logistic regression (p<0.05). The proportion of all students, who reported being asked to show proof of age prior to a cigarette purchase in the past 30 days did not change significantly between 2000 (46.9%) and 2009 (44.9%) (p=0.529 for linear trend). No significant trend in the proportion of students aged < 18 years who were refused a sale when attempting to buy cigarettes was observed between 2000 (39.8%) and 2009 (36.7%) (p=0.283 for linear trend). Refusal of a cigarette sale was significantly higher among under-aged boys compared to girls (adjusted odds ratio=1.48; 95% confidence interval: 1.28-1.70). About half of U.S. middle and high school students who reported making a cigarette purchase were not asked for proof of age, and about three of five under-aged buyers successfully made a cigarette purchase in 2009. Intensified implementation and enforcement of policies requiring age verification among youths is warranted to reduce access and use of tobacco products. Copyright © 2014 Elsevier Inc. All rights reserved.

Salad Daze.

ERIC Educational Resources Information Center

Jones, Rebecca

1996-01-01

Some young people refuse to eat anything that once had a face. Since a vegetarian child can make food choices just as unhealthy as those of a meat-eating child, nutritionists recommend that school food-service directors adapt traditional nutritional foods that children like to a vegetarian menu. (MLF)

Oh Darn! I'd Love to Come, but I Already Have Plans: Television Invitations as Conversational Models.

ERIC Educational Resources Information Center

Salzman, Ann

1989-01-01

The degree to which television conversations follow the rules of naturally occurring conversation is investigated. The occurrences of 1 type of pragmatic behavior (the dispreferred behavior of refusing social invitations) in 25 television conversations are compared with a theoretical description of such conversational strategies. (seven…

Behavioral Assessment of Feeding Problems of Individuals with Severe Disabilities.

ERIC Educational Resources Information Center

Munk, Dennis D.; Repp, Alan C.

1994-01-01

A behavioral assessment procedure was evaluated with five children with severe/profound mental retardation who exhibited feeding problems of limited intake. Subjects were fed various types of foods. Results indicated each subject fit into one of four categories: (1) total food refusal, (2) food type selectivity, (3) food texture selectivity, or…

Use of Analog Functional Analysis in Assessing the Function of Mealtime Behavior Problems.

ERIC Educational Resources Information Center

Girolami, Peter A.; Scotti, Joseph R.

2001-01-01

This study applied the methodology of an analog experimental (functional) analysis of behavior to the specific interaction between parents and three children with mental retardation exhibiting food refusal and related mealtime problems. Analog results were highly consistent with other forms of functional assessment data, including interviews,…

Prevalence and correlates of anal sex among secondary school students in Cape Town, South Africa.

PubMed

Ybarra, Michele; Price-Feeney, Myeshia; Mwaba, Kelvin

2018-07-01

Research efforts have overlooked anal sex as a risk factor for adolescents' acquisition of HIV despite the high rates of HIV among South African youth. Here, we report findings from a survey conducted in 2012 among secondary school youth, ages 16-24, in Cape Town. 937 adolescents completed a pencil-and-paper survey. Eleven and 31% of female and male youth, respectively, reported ever having anal sex. By comparison, 59% and 78% of female and male youth reported ever having vaginal sex. The percentage of youth reporting lifetime rates of anal sex increased with age: 32% of 20-to-24 year olds had anal sex compared to 16% of 16-to-17-year olds. When the sample was stratified by sex, this difference appeared to be driven by older male, but not female, sexual behavior. Despite noted differences in prevalence rates by sex, both boys and girls who had anal sex were more likely than their same-sex peers who had vaginal sex to report sexual coercion victimization and perpetration experiences and inconsistent condom use. Interestingly, some differences in HIV motivation, information, and behavioral skills were noted for youth who had vaginal sex versus youth who had never had sex; scores were largely similar for youth who had anal sex versus youth who had never had sex however. Together, these findings suggest that anal sex is not uncommon and may be an important marker for other HIV risk behaviors in at least one lower income South African community. Anal sex needs to be explicitly discussed in adolescent HIV prevention and healthy sexuality programing, incorporating age-relevant scenarios about negotiating condoms and other healthy relationship behaviors (e.g., refusing sex when it is not wanted).

Promoting mental health and preventing substance abuse and violence in elementary students: a randomized control study of the Michigan Model for Health.

PubMed

O'neill, James M; Clark, Jeffrey K; Jones, James A

2011-06-01

In elementary grades, comprehensive health education curricula mostly have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on multiple health issues, including social and emotional skills, prosocial behavior, and drug use and aggression. Schools (N = 52) were randomly assigned to intervention and control conditions. Participants received 24 lessons in grade 4 (over 12 weeks) and 28 more lessons in grade 5 (over 14 weeks), including material focusing on social and emotional health, interpersonal communication, social pressure resistance skills, drug use prevention, and conflict resolution skills. The 40-minute lessons were taught by the classroom or health teacher who received curriculum training and provided feedback on implementation fidelity. Self-report survey data were collected from the fourth-grade students (n = 2512) prior to the intervention, immediately after the intervention, and 6 weeks after the intervention, with the same data collection schedule repeated in fifth grade. Students who received the curriculum had better interpersonal communication skills, social and emotional skills, and drug refusal skills than the control group students. Intervention students also reported lower intentions to use alcohol and tobacco, less alcohol and tobacco use initiated during the study and in the past 30 days, and reduced levels of aggression. The effectiveness of the MMH in promoting mental health and preventing drug use and aggression supports the call for integrated strategies that begin in elementary grades, target multiple risk behaviors, and result in practical and financial benefits to schools. © 2011, American School Health Association.

Adolescents' knowledge and opinions about smoking: a qualitative study from the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur District, Nepal.

PubMed

Povlsen, Lene; Aryal, Umesh Raj; Petzold, Max; Krettek, Alexandra

2016-04-09

The use of tobacco products among adolescents in Southeast Asia represents a major public health burden. Two out of ten adolescents attending school are tobacco users and several factors influence them to initiate tobacco use. Most studies related to tobacco use are quantitative, whereas qualitative studies exploring adolescents' smoking behavior and their views, knowledge and experiences are scarce. To gain a deep understanding of Nepalese adolescents' knowledge and opinions about smoking and reasons for smoking initiation. Adolescents from four secondary schools in the Bhaktapur district, Nepal. Eight focus-group discussions were conducted with 71 adolescents aged 13-16 years and from grades 8-10. Data were analyzed using manifest qualitative content analysis. The participants knew that smoking represents health risks as well as socio-economic risks, but few described the addictive nature of tobacco and health risks related to passive smoking. Most participants related smoking initiation to the smoking behavior of peers and family members, but easy accessibility to cigarettes, ineffective rules and regulations, and exposure to passive smoking also created environments for smoking. Some expressed confidence to resist peer pressure and refuse to start smoking, but also expressed the need for prevention strategies in schools and for governmental initiatives, such as more strict implementation of tobacco control and regulations to prevent and reduce smoking. Curbing the tobacco epidemic in Nepal requires healthy public policies and multifaceted interventions to address the knowledge gap on health consequences associated with smoking among adolescents, teachers and parents/adults.

Vaccine refusal - what we need to know.

PubMed

Succi, Regina Célia de Menezes

2018-04-12

Opposition to vaccines is not a new event, and appeared soon after the introduction of the smallpox vaccine in the late 18th century. The purpose of this review is to educate healthcare professionals about vaccine hesitancy and refusal, its causes and consequences, and make suggestions to address this challenge. A comprehensive and non-systematic search was carried out in the PubMed, LILACS, and ScieLo databases from 1980 to the present day, using the terms "vaccine refusal," "vaccine hesitancy," and "vaccine confidence." The publications considered as the most relevant by the author were critically selected. The beliefs and arguments of the anti-vaccine movements have remained unchanged in the past two centuries, but new social media has facilitated the dissemination of information against vaccines. Studies on the subject have intensified after 2010, but the author did not retrieve any published studies to quantify this behavior in Brazil. The nomenclature on the subject (vaccine hesitancy) was standardized by the World Health Organization in 2012. Discussions have been carried out on the possible causes of vaccine hesitancy and refusal, as well as on the behavior of families and health professionals. Proposals for interventions to decrease public doubts, clarify myths, and improve confidence in vaccines have been made. Guides for the health care professional to face the problem are emerging. The healthcare professional is a key element to transmit information, resolve doubts and increase confidence in vaccines. They must be prepared to face this new challenge. Copyright © 2018 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Should I or shouldn't I: decision making, knowledge and behavioral effects of quadrivalent HPV vaccination in men who have sex with men.

PubMed

Thomas, Emily A; Goldstone, Stephen E

2011-01-10

Prior to FDA licensure in men, a surgical practice (SG) offered the quadrivalent HPV vaccine (qHPV) off-label to men who have sex with men (MSM). We administered a written or telephone survey to MSM to elicit drivers and barriers to vaccination, sexual behavior changes post-vaccination, and knowledge. 191 subjects enrolled: 68 refused qHPV, 71 received qHPV <1 year ago, and 52 received qHPV >1 year ago. History of HPV infection (86%, n=164) and level of HPV and qHPV knowledge were high, with a mean of 10.8 of 13 knowledge questions correct. Ninety-seven percent of participants understood that qHPV does not cure present infection or disease. MSM refused qHPV for reasons including cost and not FDA approved; prevention of future HPV infection was the paramount driver for immunization. Vaccination did not affect sexual behavior. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evaluation of the effects of a designated program on illegal drug cessation among adolescents who experiment with drugs.

PubMed

Chang, Chiu-Ching; Liao, Jung-Yu; Huang, Chiu-Mieh; Hsu, Hsiao-Pei; Chen, Chih-Che; Guo, Jong-Long

2018-01-16

Studies indicate that adolescent-onset drug users experience a greater likelihood of dependence that continues into adulthood. The importance of early intervention was evident in treating adolescents before their substance use progressed. We examined the effectiveness of an intervention program that prevents students who experiment with drugs from reusing them. The study was based on 10 out of 18 invited schools that were randomly assigned to either the intervention group (5 schools, n = 43) or the comparison group (5 schools, n = 41). The intervention group received an E-course program that comprised a main intervention course (12 sessions) and a booster course (2 sessions). By reducing the burden of teaching content during the 14 sessions, the in-class counselor had opportunities for face-to-face discussions with students on their ambivalence toward quitting illegal drugs. The comparison group received the conventional didactic drug prevention course (2 sessions). Outcomes in terms of stress management, refusal skills, pros of drug use, cons of drug use, and drug use resistance self-efficacy were measured via structured questionnaires conducted thrice: at baseline, after the main intervention sessions, and after the booster sessions. A linear mixed model (LMM) was employed to investigate the effects of time and groups on the outcome variables with group, time, and group × time as fixed effects. Subjects and schools were selected as random effects in order to consider both within-subject and within-school correlations. There was a significant group × time interaction with regard to stress management, refusal skills, pros of drug use, and drug use resistance self-efficacy, excluding cons of drug use. The intervention group displayed better stress management compared to the comparison group after the booster intervention. Similar between-group differences were identified in that the intervention group displayed better refusal skills and drug use resistance self-efficacy compared to that of the comparison group. The intervention group favored using drugs less (a decrease in the pros of drug use score) compared to the comparison group after the booster intervention. Our program provided an example of the results of early intervention among students who experiment with illegal drugs.

Social context factors, refusal self-efficacy, and alcohol use among female sex workers in China.

PubMed

Su, Shaobing; Li, Xiaoming; Lin, Danhua; Zhang, Chen; Qiao, Shan; Zhou, Yeujiao

2015-01-01

Excessive alcohol use is considered as a health-risk behavior that may produce negative health outcomes. Examining predictors of alcohol use in social and individual contexts can advance understanding of why people indulge in alcohol use. Our research on female sex workers (FSWs) examined associations among several social context factors (alcohol use by family members, alcohol use by peers, and client-perpetrated pressure or violence), refusal self-efficacy, and alcohol use. Seven hundred FSWs were recruited from two cities in southern China. Structural equation modeling (SEM) was used to analyze the direct effects of alcohol use by family members, alcohol use by peers, and client-perpetrated pressure or violence on FSWs' alcohol use. In addition, the mediation effects of refusal self-efficacy were also examined in the SEM model. Results showed that alcohol use by family members and alcohol use by peers significantly predicted FSWs' alcohol use; the prediction effect of alcohol use by peers on FSWs' alcohol use was stronger than that of alcohol use by family members; client-perpetrated pressure or violence directly predicted FSWs' alcohol use and indirectly influenced FSWs' alcohol use through refusal self-efficacy; refusal self-efficacy directly predicted FSWs' alcohol use. Administrators of effective intervention programs focused on alcohol use in China should adopt a multilevel approach to reduce negative social influences, particularly the influence from peer and sex work establishments on FSWs' alcohol use. Meanwhile, training to improve refusal self-efficacy should also be included in the intervention programs to reduce FSWs' alcohol use.

Money, Money, Money.

ERIC Educational Resources Information Center

Splitt, David A.

1988-01-01

Summarizes several U.S. Supreme Court actions, including decisions to review a North Dakota case concerning fees for rural bus students and a Florida case involving differential contributions and benefits for male and female employees. The Court refused to hear certain cases involving school consolidation (Kansas City), mainstreaming of retarded…

[Economic evaluation of a manual-based, multimodal cognitive behavioural therapy for school avoiding children with psychiatric disorder].

PubMed

Weschenfelder, Ann-Kathrin; Reissner, Volker; Knollmann, Martin; Hebebrand, Johannes; Wasem, Jürgen; Neumann, Anja

2018-01-01

Untreated school refusal increases the risk of a premature discontinuation of the educational career. The aim of this study is the economic evaluation of a manual-based treatment for school refusal in comparison to the standard treatment. Within the cost-minimisation analysis, resource use is measured retrospectively for six months using the CSSRI questionnaire. Unit costs for most health care services are derived from published standard prices. Costs are calculated from the societal perspective based on prices compiled in 2011. The cost comparison during the one-year intervention period applies a difference in differences Approach. The most common diagnoses among the 112 participants are phobic and emotional disorders. The average cost per patient during the intervention period amounts to 7197 € (95 %-CI: 4746 € – 10 079 €) for the manual group and 9294 € (95 %-CI: 6313 € – 12 878 €) for the control group. The difference in adjusted costs of 1453 € in favour of the manual group is not statistically relevant. The manual-based treatment is equivalent if not slightly advantageous compared to the standard treatment considering the clinical outcomes and cost of illness.

Entertainment-Education Videos as a Persuasive Tool in the Substance Use Prevention Intervention "keepin' it REAL".

PubMed

Shin, YoungJu; Miller-Day, Michelle; Hecht, Michael L; Krieger, Janice L

2018-07-01

Based on social cognitive theory and narrative engagement theory, the current study examined hypothesized indirect effects of engagement with keepin' it REAL (kiR) curriculum entertainment-education (E-E) videos on youth alcohol use via youth drug offer refusal efficacy. Students in 7th grade (N = 1,464) at 25 public schools in two Midwestern states were randomly assigned to one of the two versions of the kiR curriculum, the kiR urban version and the kiR rural version. Each version had their own set of five culturally-grounded E-E videos depicting communicative skills to refuse drug offers. Differential effects for engagement components were expected depending on the degree of cultural matching. Pre/post surveys were administered at the beginning and the end of 7th grade. Structural equation modeling analysis resulted in partial support for the research hypotheses. Rural youth receiving the urban curriculum who reported higher interest in the E-E videos were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Rural youth receiving the rural curriculum who identified with the E-E video main characters were more likely to report having higher refusal efficacy, and in turn, less likely to use alcohol. Implications for E-E health promotion are discussed.

Education rights and the special needs child.

PubMed

Dalton, Margaret A

2002-10-01

A child with a disability has a federally protected right to special education and related services when he or she needs them to benefit from education. The term "disability" is not limited to physical disability but rather includes mental disability, including mental retardation, serious emotional disturbance, autism, traumatic brain injury, specific learning disabilities, and other health impairments. A parent may request that a child be evaluated by the school district for special education and related services. The law sets forth specific guidelines for the evaluation, assessment, and eligibility determination. Unique to each child, the IEP is the written plan that documents the child's special education and related services. The initial IEP is developed at a meeting among parents, various school personnel, and others whom the parents may wish to invite. Parents are an integral part of the team and are involved in all decisions by the team. The IEP must be reviewed annually, with attention given to whether educational objectives have been met. For a child with mental health issues, the IEP likely contains "related services," such as counseling, and measurable goals to improve behaviors in the school setting. When a child's condition is such that he or she cannot benefit from education in the regular school setting, other placements are considered. The school district maintains the ultimate responsibility of the cost of all such education placements, including residential care. A child with behaviors that result in frequent suspensions should have a functional analysis assessment by the school psychologist. The results of the assessment can be used to create a behavioral intervention plan. (If the school refuses to perform an assessment or develop a plan, the usual remedy of a due process hearing is available to the parents.) This plan should address problem behaviors and include strategies for redirecting the child's behavior. Even if a special education child is "expelled" from school, the district maintains the responsibility of providing FAPE. For this reason, districts--even in their own interests--should be proactive in dealing with these children, which often has not been the case. The Supreme Court has said that a child with services under IDEA (a child with an IEP) must receive some benefit from his or her education [31]. The issue of "how much benefit is enough benefit" is still troubling to parents and schools alike. The court also has ruled that related services, even costly ones such as a one-to-one nursing aide, must be provided if a qualifying child needs such services to access education [29]. Children with disabilities were long excluded from the public education system in this country. Obvious exclusion rarely occurs in the current education system, although exclusion through isolation does. Children with disabilities, especially mental disabilities, need and deserve the same educational benefit offered to children without those differences.

Comparing maternal styles in bonobos (Pan paniscus) and chimpanzees (Pan troglodytes).

PubMed

De Lathouwers, Mieke; Van Elsacker, Linda

2004-12-01

Studies on Cercopithecine primate maternal styles, using factor analysis on a set of maternal behaviors, commonly render two factors that describe separate dimensions of maternal behavior: protectiveness and rejection. The aims of this study were to 1) investigate whether this method for determining maternal styles in Cercopithecine species can be applied to bonobos (Pan paniscus) and chimpanzees (Pan troglodytes), 2) determine whether they follow the same pattern, and 3) assess whether species differences in maternal style are apparent. We performed a factor analysis on nine maternal behaviors using data on eight mother-infant pairs of each species. This resulted in three factors: protectiveness, distance, and refusal. Protectiveness is positively correlated with time spent in ventral contact, making contact, approaching, and restraining. Distance is positively related with breaking contact and leaving. Refusal is positively correlated with rejecting and nipple-rejecting. The pattern of protectiveness corresponds with the pattern found in Cercopithecine species, suggesting a high consistency of this dimension across species and higher taxa. The retention of the other two factors indicates that in the Pan species, breaking contact and leaving represent another dimension, apart from rejecting and nipple-rejecting, which usually fall under one dimension in Cercopithecine species. An interspecific comparison of the factor scores for each dimension of maternal behavior reveals that, on average, bonobos and chimpanzees score equally on protectiveness. Scores on distance increase positively with infant age in chimpanzees, and negatively in bonobos, and on average bonobos have higher scores on refusal. These interspecies differences in maternal style are discussed in the light of interspecies differences in infant development, infant vulnerability to aggression, interbirth intervals, and female sociality. Copyright 2004 Wiley-Liss, Inc.

Teaching Independent Eating to a Developmentally Handicapped Child Showing Chronic Food Refusal and Disruption at Mealtimes.

ERIC Educational Resources Information Center

MacArthur, Judy; And Others

1986-01-01

A successful intervention to establish independent eating behaviors in a developmentally handicapped, autistic-like three-year-old involved teaching appropriate behavior in a hospital setting (where he was being treated for dehydration and malnutrition) and then teaching his mother to implement the strategies at home. Skills were maintained at…

On Chomsky's Appraisal of Skinner's "Verbal Behavior": A Half Century of Misunderstanding

ERIC Educational Resources Information Center

Palmer, D. C.

2006-01-01

The history of the writing of "Verbal Behavior" (Skinner, 1957), Chomsky's review (1959), and MacCorquodale's rebuttal (1970) are briefly summarized. Chomsky's recent reflections on his review are analyzed: Chomsky's refusal to acknowledge the review's errors or its aggressive tone is consistent with his polemical style but comes at a minor cost…

New Circuits or Short Circuits?

ERIC Educational Resources Information Center

McLaughlin, Frank

1967-01-01

Schools must refuse to contribute to this age of "information overload" and, through an interdisciplinary approach, assist students to become receptive to humane feelings and to understand the complexities of a culture. To these ends, educators must "re-program" the entire educational system by relinquishing their attachment to their own…

10 CFR 5.415 - Access to course offerings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... refuse participation therein by any of its students on such basis, including health, physical education... respect to classes and activities in physical education at the elementary school level, the recipient... from September 29, 2000. With respect to physical education classes and activities at the secondary and...

7 CFR 15a.34 - Access to course offerings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... refuse participation therein by any of its students on such basis, including health, physical education... respect to classes and activities in physical education at the elementary school level, the recipient... from the effective date of this regulation. With respect to physical education classes and activities...

29 CFR 36.415 - Access to course offerings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... refuse participation therein by any of its students on such basis, including health, physical education... respect to classes and activities in physical education at the elementary school level, the recipient... from September 29, 2000. With respect to physical education classes and activities at the secondary and...

44 CFR 19.415 - Access to course offerings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... refuse participation therein by any of its students on such basis, including health, physical education... respect to classes and activities in physical education at the elementary school level, the recipient... from September 29, 2000. With respect to physical education classes and activities at the secondary and...

Liability and Letters of Recommendation.

ERIC Educational Resources Information Center

Sendor, Benjamin

1997-01-01

Analyzes the California Supreme Court case "Randi W. v. Muroc Joint Unified School District." The court determined that letters of recommendation, which had omitted mentioning allegations of improper sexual conduct with students, were deceptively incomplete. Writers of letters have three choices: refuse to write a letter, write a fully…

Discipline and Due Process.

ERIC Educational Resources Information Center

Collins, Mildred; Dowell, Mary L.

1998-01-01

Increasing numbers of parents do not accept a school's discipline policy and are refusing to permit their children to comply with disciplinary sanctions. According to the California Education Code, educators have the right to expect parents to accept disciplinary decisions made in compliance with required procedures. Parental defiance might worsen…

[Play therapy for a child with separation anxiety disorder].

PubMed

Wu, Y Y; Chiu, Y N; Soong, W T

1995-06-01

Separation anxiety disorder is characterized by severe and exceeding anxiety and fear when a child is facing separation with attachment objects. More over, it affected the child in language, emotional and social interest and development. These children usually brought to physician's attention due to refusal to go to school, social withdraw or multiple somatic complaints with attachment behavior wanted to be nearby or closed to the attachment objects. A child's early attachment relationship and previous separation experience play a major role in the formation of separation anxiety disorder. This report presents a psychoanalytically-oriented play therapy for a 2-year-8-month-old boy in 17 months period total of 54 sessions. According to the main themes in each session the process can be divided into 4 stages, namely establishing therapeutic relationship, expressing repressed emotions, management of transference, attachment and conflict in therapy, and self growth and termination. The formulation of this case and management were discussed.

A Meta-Analysis of the Effectiveness of Interactive Middle School Cannabis Prevention Programs

PubMed Central

Lize, Steven E.; Iachini, Aidyn L.; Tang, Weizhou; Tucker, Joshua; Seay, Kristen D.; Clone, Stephanie; DeHart, Dana; Browne, Teri

2017-01-01

This meta-analysis examines the effectiveness of interactive middle school-based drug prevention programs on adolescent cannabis use in North America, as well as program characteristics that could moderate these effects. Interactive programs, compared to more didactic, lecture style programs, involve participants in skill-building activities and focus on interaction among participants. A systematic literature search was conducted for English-language studies from January 1998 to March 2014. Studies included evaluations using random assignment or a quasi-experimental design of interactive school-based substance use prevention programs delivered to adolescents (aged 12–14) in North American middle schools (grades 6–8). Data were extracted using a coding protocol. The outcomes of interest were post-treatment cannabis use, intent to use, and refusal skills compared across intervention and control groups. Effect sizes (Cohen’s d) were calculated from continuous measures, and dichotomous measures were converted to the d index. A total of 30 studies yielding 23 independent samples were included. The random effects pooled effect size for cannabis use (k=21) was small (d̄=−0.07, p<0.01) and favorable for the prevention programs. The pooled effect sizes for intention to use (k=3) and refusal skills (k=3) were not significant. Moderator analyses indicated significant differences in program effectiveness between instructor types, with teachers found to be most effective (d̄ =−0.08, p=0.02). The findings provide further support for the use of interactive school-based programs to prevent cannabis use among middle school students in North America. PMID:27785662

A Meta-analysis of the Effectiveness of Interactive Middle School Cannabis Prevention Programs.

PubMed

Lize, Steven E; Iachini, Aidyn L; Tang, Weizhou; Tucker, Joshua; Seay, Kristen D; Clone, Stephanie; DeHart, Dana; Browne, Teri

2017-01-01

This meta-analysis examines the effectiveness of interactive middle school-based drug prevention programs on adolescent cannabis use in North America, as well as program characteristics that could moderate these effects. Interactive programs, compared to more didactic, lecture style programs, involve participants in skill-building activities and focus on interaction among participants. A systematic literature search was conducted for English-language studies from January 1998 to March 2014. Studies included evaluations using random assignment or a quasi-experimental design of interactive school-based substance use prevention programs delivered to adolescents (aged 12-14) in North American middle schools (grades 6-8). Data were extracted using a coding protocol. The outcomes of interest were post-treatment cannabis use, intent to use, and refusal skills compared across intervention and control groups. Effect sizes (Cohen's d) were calculated from continuous measures, and dichotomous measures were converted to the d index. A total of 30 studies yielding 23 independent samples were included. The random effects pooled effect size for cannabis use (k = 21) was small ([Formula: see text]= -0.07, p < 0.01) and favorable for the prevention programs. The pooled effect sizes for intention to use (k = 3) and refusal skills (k = 3) were not significant. Moderator analyses indicated significant differences in program effectiveness between instructor types, with teachers found to be most effective ([Formula: see text]= -0.08, p = 0.02). The findings provide further support for the use of interactive school-based programs to prevent cannabis use among middle school students in North America.

To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School-Based Vaccination Program in Sweden.

PubMed

Grandahl, Maria; Tydén, Tanja; Westerling, Ragnar; Nevéus, Tryggve; Rosenblad, Andreas; Hedin, Erik; Oscarsson, Marie

2017-01-01

Parents' beliefs about human papillomavirus (HPV) vaccination influence whether they allow their daughters to be vaccinated. We examined the association between parents' refusal and sociodemographic background, knowledge and beliefs about HPV, and the HPV vaccination in relation to the Health Belief Model. The sample consisted of 200 (55%) parents of children aged 11-12 years in the Swedish national vaccination program. Data were collected using a self-reported questionnaire. Most parents (N = 186) agreed to the vaccination. Pearson's chi-square, Fisher's exact test, and the Mann-Whitney U test were used to analyze data. Declining parents saw more risks and fewer benefits of HPV vaccination but no differences in beliefs regarding the severity or young girls' susceptibility to HPV were found. There was an association between refusing the HPV vaccine and lower acceptance of previous childhood vaccinations, and their main source of information was the Internet. Parents who declined the vaccine believed it could adversely affect condom use, the age of their daughter's sexual debut, and the number of sexual partners. Parents should have the possibility to discuss HPV and HPV vaccine with a school nurse or other health care professionals, and should have access to evidence-based information on the Internet. © 2016 The Authors. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

School based sex education and HIV prevention in low- and middle-income countries: a systematic review and meta-analysis.

PubMed

Fonner, Virginia A; Armstrong, Kevin S; Kennedy, Caitlin E; O'Reilly, Kevin R; Sweat, Michael D

2014-01-01

School-based sex education is a cornerstone of HIV prevention for adolescents who continue to bear a disproportionally high HIV burden globally. We systematically reviewed and meta-analyzed the existing evidence for school-based sex education interventions in low- and middle-income countries to determine the efficacy of these interventions in changing HIV-related knowledge and risk behaviors. We searched five electronic databases, PubMed, Embase, PsycInfo, CINAHL, and Sociological Abstracts, for eligible articles. We also conducted hand-searching of key journals and secondary reference searching of included articles to identify potential studies. Intervention effects were synthesized through random effects meta-analysis for five outcomes: HIV knowledge, self-efficacy, sexual debut, condom use, and number of sexual partners. Of 6191 unique citations initially identified, 64 studies in 63 articles were included in the review. Nine interventions either focused exclusively on abstinence (abstinence-only) or emphasized abstinence (abstinence-plus), whereas the remaining 55 interventions provided comprehensive sex education. Thirty-three studies were able to be meta-analyzed across five HIV-related outcomes. Results from meta-analysis demonstrate that school-based sex education is an effective strategy for reducing HIV-related risk. Students who received school-based sex education interventions had significantly greater HIV knowledge (Hedges g = 0.63, 95% Confidence Interval (CI): 0.49-0.78, p<0.001), self-efficacy related to refusing sex or condom use (Hedges g = 0.25, 95% CI: 0.14-0.36, p<0.001), condom use (OR = 1.34, 95% CI: 1.18-1.52, p<0.001), fewer sexual partners (OR = 0.75, 95% CI:0.67-0.84, p<0.001) and less initiation of first sex during follow-up (OR = 0.66, 95% CI: 0.54-0.83, p<0.001). The paucity of abstinence-only or abstinence-plus interventions identified during the review made comparisons between the predominant comprehensive and less common abstinence-focused programs difficult. Comprehensive school-based sex education interventions adapted from effective programs and those involving a range of school-based and community-based components had the largest impact on changing HIV-related behaviors.

The effect of vitamin-mineral supplementation on juvenile delinquency among American schoolchildren: a randomized, double-blind placebo-controlled trial.

PubMed

Schoenthaler, S J; Bier, I D

2000-02-01

Numerous studies conducted in juvenile correctional institutions have reported that violence and serious antisocial behavior have been cut almost in half after implementing nutrient-dense diets that are consistent with the World Health Organization's guidelines for fats, sugar, starches, and protein ratios. Two controlled trials tested whether the cause of the behavioral improvements was psychological or biological in nature by comparing the behavior of offenders who either received placebos or vitamin-mineral supplements designed to provide the micronutrient equivalent of a well-balanced diet. These randomized trials reported that institutionalized offenders, aged 13 to 17 years or 18 to 26 years, when given active tablets produced about 40% less violent and other antisocial behavior than the placebo controls. However, generalization could not be made to typical schoolchildren without a controlled trial examining violence and antisocial behavior in public schools. To determine if schoolchildren, aged 6 to 12 years, who are given low dose vitamin-mineral tablets will produce significantly less violence and antisocial behavior in school than classmates who are given placebos. A stratified randomized, double-blind, placebo-controlled trial with pretest and post-test measures of antisocial behavior on school property. Two "working class," primarily Hispanic elementary schools in Phoenix, Arizona. Approximately half of the potential schoolchildren participated, i.e., 468 students aged 6 to 12 years. Daily vitamin-mineral supplementation at 50% of the U.S. recommended daily allowance (RDA) for 4 months versus placebo. The supplement was designed to raise vitamin-mineral intake up to the levels currently recommended by the National Academy of Sciences for children aged 6 to 11 years. Violent and nonviolent delinquency as measured by official school disciplinary records. Of the 468 students randomly assigned to active or placebo tablets, the 80 who were disciplined at least once between September 1st and May 1st served as the research sample. During intervention, the 40 children who received active tablets were disciplined, on average, 1 time each, a 47% lower mean rate of antisocial behavior than the 1.875 times each for the 40 children who received placebos (95% confidence interval, 29% to 65%, < 5 .020). The children who took active tablets produced lower rates of antisocial behavior in 8 types of recorded infractions: threats/fighting, vandalism, being disrespectful, disorderly conduct, defiance, obscenities, refusal to work or serve, endangering others, and nonspecified offenses. Poor nutritional habits in children that lead to low concentrations of water-soluble vitamins in blood, impair brain function and subsequently cause violence and other serious antisocial behavior. Correction of nutrient intake, either through a well-balanced diet or low-dose vitamin-mineral supplementation, corrects the low concentrations of vitamins in blood, improves brain function and subsequently lowers institutional violence and antisocial behavior by almost half. This paper adds to the literature by enabling previous research to be generalized from older incarcerated subjects with a history of antisocial behavior to a normal population of younger children in an educational setting.

A Framework for Ethical Deliberation in Special Education.

ERIC Educational Resources Information Center

Howe, Kenneth R.; Miramontes, Ofelia B.

1991-01-01

The case of a school district refusing to supply an interpreter for an above-average student with a hearing impairment is used as a point of departure for this discussion of a framework for ethical deliberation and the special role-related obligations that help define the ethics of special education. (PB)

34 CFR 106.34 - Access to classes and schools.

Code of Federal Regulations, 2011 CFR

2011-07-01

... EDUCATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 106... or activities separately on the basis of sex, or require or refuse participation therein by any of...

34 CFR 106.34 - Access to classes and schools.

Code of Federal Regulations, 2013 CFR

2013-07-01

... EDUCATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 106... or activities separately on the basis of sex, or require or refuse participation therein by any of...

34 CFR 106.34 - Access to classes and schools.

Code of Federal Regulations, 2014 CFR

2014-07-01

... EDUCATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 106... or activities separately on the basis of sex, or require or refuse participation therein by any of...

34 CFR 106.34 - Access to classes and schools.

Code of Federal Regulations, 2012 CFR

2012-07-01

... EDUCATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 106... or activities separately on the basis of sex, or require or refuse participation therein by any of...

Refusing To Play the Blame Game.

ERIC Educational Resources Information Center

Dowd, JoAnne

1997-01-01

Frustrated by her ninth graders' misbehavior with a substitute teacher, a high school English teacher shelved her recriminations and engaged miscreants in a problem-solving exercise examining the incident. Establishing a protocol to talk about problems openly, without fear of retribution, made a big difference. Boys admitted to some poor choices;…

Is There an Honorary Doctor in the House?

ERIC Educational Resources Information Center

Freiherr, Gregory T.

1979-01-01

The practice of awarding honorary degrees by American colleges and universities is examined. Topics include the background of the practice, schools that refuse to participate, the selection process used by some institutions, possible financial and other reasons for granting honorary degrees, and benefits gained by those honored. (JMD)

The Other Side of Fear

ERIC Educational Resources Information Center

Madeloni, Barbara; Hoogstraten, Rachel

2013-01-01

In the spring of 2012 students at the University of Massachusetts Amherst School of Education received national attention when they refused to participate in the field test of a teacher performance assessment being run by Pearson Incorporated and Stanford University. Students, led by their professor, demanded they be given informed consent about…

No Deserving Poor Refused: Providing Evaluation Services During Hard Times. Draft Copy.

ERIC Educational Resources Information Center

Kean, Michael H.

Following an examination of alternative means of providing evaluation services in the absence of additional resources, the Small Project Assessment Service (SPAS) is described. Two types of cooperative research endeavors had been considered--those involving outside (non-school district) organizations such as universities, and those involving…

Energy efficacy used to score organic refuse pretreatment processes for hydrogen anaerobic production.

PubMed

Ruggeri, Bernardo; Luongo Malave, Andrea C; Bernardi, Milena; Fino, Debora

2013-11-01

The production of hydrogen through Anaerobic Digestion (AD) has been investigated to verify the efficacy of several pretreatment processes. Three types of waste with different carbon structures have been tested to obtain an extensive representation of the behavior of the materials present in Organic Waste (OW). The following types of waste were selected: Sweet Product Residue (SPR), i.e., confectionary residue removed from the market after the expiration date, Organic Waste Market (OWM) refuse from a local fruit and vegetable market, and Coffee Seed Skin (CSS) waste from a coffee production plant. Several pretreatment processes have been applied, including physical, chemical, thermal, and ultrasonic processes and a combination of these processes. Two methods have been used for the SPR to remove the packaging, manual (SPR) and mechanical (SPRex). A pilot plant that is able to extrude the refuse to 200atm was utilized. Two parameters have been used to score the different pretreatment processes: efficiency (ξ), which takes into account the amount of energy produced in the form of hydrogen compared with the available energy embedded in the refuse, and efficacy (η), which compares the efficiency obtained using the pretreated refuse with that obtained using the untreated refuse. The best result obtained for the SPR was the basic pretreatment, with η=6.4, whereas the thermal basic pretreatment gave the highest value, η=17.0 for SPRex. The best result for the OWM was obtained through a combination of basic/thermal pretreatments with η=9.9; lastly, the CSS residue with ultrasonic pretreatment produced the highest quantity of hydrogen, η=5.2. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sexually Related Behaviors as Predictors of HPV Vaccination Among Young Rural Women

PubMed Central

Mills, Laurel A.; Vanderpool, Robin C.; Crosby, Richard A.

2016-01-01

Purpose To explore whether sexually related behaviors predict refusal of the human papillomavirus (HPV) vaccine among a sample of women aged 18–26 in Appalachian Kentucky. Methods Using a convenience sample, young women attending health clinics and a community college in southeastern Kentucky were recruited to participate in a Women’s Health Study. After completing a questionnaire, women received a free voucher for the three-dose HPV vaccine series. Completion of dose one served as the outcome variable. Results Women with a history of an abnormal Pap test were almost two times more likely to decline the HPV vaccine (adjusted odds ratio [AOR] 1.91, 95% confidence interval [CI] 1.14–3.20, p = 0.015), and women who reported they had never had a Pap test were four times more likely to decline the vaccine (AOR 4.02, 95% CI 1.13–14.32, p = 0.032). Women engaging in mutual masturbation were nearly two times more likely to decline the free vaccine (AOR 1.91, 95% CI 1.17–3.10, p = 0.009). Use of hormonal birth control showed a protective effect against refusal of the free HPV vaccine (AOR 0.593, 95% CI 0.44–0.80, p = 0.001). Conclusions Among this sample of Appalachian women, those engaging in behaviors that increase their risk for HPV infection were more likely to refuse the vaccine. Conversely, those women engaging in protective health behaviors were more likely to accept the vaccine. These findings suggest that those women not being vaccinated may be the very group most likely to benefit from vaccination. Cervical cancer prevention programs need to be creative in efforts to reach young women most in need of the vaccine based on a higher profile of sexually related behaviors and the proxy measure of this risk (having an abnormal Pap test result). PMID:22136319

The Use of Descriptive Analysis to Identify and Manipulate Schedules of Reinforcement in the Treatment of Food Refusal

ERIC Educational Resources Information Center

Casey, Sean D.; Cooper-Brown, Linda J.; Wacker, David P.; Rankin, Barbara E.

2006-01-01

The feeding behaviors of a child diagnosed with failure to thrive were assessed using descriptive analysis methodology to identify the schedules of reinforcement provided by the child's parents. This analysis revealed that the child's appropriate feeding behaviors (i.e., bite acceptance, self-feeding) were on a lean schedule of positive…

Assessing Adolescents' Anticipated Behavioral and Emotional Responses to Offers of Alcohol and Marijuana

ERIC Educational Resources Information Center

Pristas, Erica V.; Rosenberg, Harold

2010-01-01

The Adolescent Responses to Alcohol and Drug Offers Scale (ARADOS) is a self-report questionnaire designed to assess a respondent's anticipated emotional reactions and intended use of cognitive-behavioral refusal skills in response to an offer of alcohol or other drug. A sample of 267 students enrolled in the 11th and 12th grades of four public…

[THE INDIVIDUAL AND SOCIAL FACTORS EFFECTING REFUSAL FROM VACCINATION OF CHILDREN IN THE TOWN OF SEMEII OF THE REPUBLIC OF KAZAKHSTAN].

PubMed

Baibusinova, A J; Musakhanova, A K; Shalgumbaeva, G M; Dauletiarova, M A; Tokanova, Sh E; Nurtasina, S K

2015-01-01

The number of cases of refusal from vaccination increases all over the world. In the Republic of Kazakhstan many studies are devoted to epidemiology of propagation of vaccine-controllable infections, medical aspects ofimmunization, analysis of immunological status and complications of immunization. The issues of awareness of population of the Republic of Kazakhstan about vaccination and refusal of it are investigated insufficiently. This occurrence became a cause of studying the given problem. The study was carried out to investigate attitude ofpopulation to vaccination and main factors of risk of refusal from vaccination of children residing in the city of Semeii and rural districts of the Eastern Kazakhstan oblast. The single-stage longitudinal study was carried out in the Centers of primary medical social care ofpopulation ofcity of Semeii and in polyclinic of the Abaiiskii district of the Eastern Kazakhstan oblast. The period of study continued from April 7 2015 to May 31 2015. The criteria of inclusion were conditionally healthy children. The questionnaire survey included 1184 respondents (mothers) with average age of 27.2 years. The sampling predominantly consisted ofKazakhs (805), Russians (307), representatives ofother nationalities (72). Among mothers, most of them had specialized secondary education (43.7%), the higher education had 30.5%, undergraduate higher education - 1.4%, secondary education - 21.6% and basic school education --2.8%. The results of study demonstrated that families refused from vaccination have negative attitude to vaccination in general though they are satisfied with functioning of vaccination room. The refusal of vaccination is more characterized to urban full families with satisfied income and having girls as children. The respondents consider that information about vaccination received by themfrom medical personnel contains surplus data concerning complications. They are not enouzh for activities in case of deterioration of health of child after vaccination.

Use of an interactive game to increase food acceptance--a pilot study.

PubMed

Gillis, L

2003-09-01

Techniques to improve food selection in healthy children with long standing food refusal are limited. The use of educational games has been successful in getting children to increase knowledge in healthy eating, but it is uncertain whether this translates into behaviour change. Therefore the purpose of this study was to test the use of an interactive food game to increase food acceptance in healthy-weight school-age children with chronic food refusal. Children attended an outpatient clinic and played an interactive game with a therapist and one parent during which non-preferred foods were consumed. Weekly recording of food consumption occurred with diet analysis by a Registered Dietitian three times during a 1-year time span. The children increased their repertoire of foods and had a more balanced intake. The changes in intake were incorporated into their daily meal patterns in the home setting and were maintained for 1 year. An interactive food game is a successful tool for increasing food variety in healthy children with chronic food refusal. As this report included only three subjects, the results will be used for subsequent work on this topic.

Reflections upon an "Atheist Epic": Madalyn Murray O'Hair and "Baltimore Sun" Reporters Comment about Coverage of the First Incidents Leading to the Supreme Court's Banning of Compulsory Prayer in Public Schools.

ERIC Educational Resources Information Center

Bowman, Jim; Kahan, Bob

In 1960 a teenage boy, Bill Murray, refused to participate in Bible reading, and the result was a series of court cases that culminated in the 1963 United States Supreme Court decision banning compulsory prayer in public schools. To gain insight into the dynamics of journalism practiced during controversy, a case study attempts to examine the…

On the relative contributions of positive reinforcement and escape extinction in the treatment of food refusal.

PubMed

Piazza, Cathleen C; Patel, Meeta R; Gulotta, Charles S; Sevin, Bari M; Layer, Stacy A

2003-01-01

We compared the effects of positive reinforcement alone, escape extinction alone, and positive reinforcement with escape extinction in the treatment of the food and fluid refusal of 4 children who had been diagnosed with a pediatric feeding disorder. Consumption did not increase when positive reinforcement was implemented alone. By contrast, consumption increased for all participants when escape extinction was implemented, independent of the presence or absence of positive reinforcement. However, the addition of positive reinforcement to escape extinction was associated with beneficial effects (e.g., greater decreases in negative vocalizations and inappropriate behavior) for some participants.

Prevalence of risk factors for acquiring measles during the 2011 outbreak in Quebec and impact of the province-wide school-based vaccination campaign on population immunity.

PubMed

Billard, Marie-Noëlle; De Serres, Gaston; Gariépy, Marie-Claude; Boulianne, Nicole; Toth, Eveline; Landry, Monique; Skowronski, Danuta M

2017-01-01

A large measles outbreak occurred in Quebec, Canada, in 2011. Although nearly two-thirds of the cases occurred in only two health districts, a mass vaccination campaign targeting all Quebec elementary and high school students without valid two-dose history was undertaken to prevent future outbreaks. We compared rates of non-vaccination and age at first measles vaccine dose among students in the two most-affected districts and the rest of the province and estimated the improvement in overall student measles immunity due to the mass school-based vaccination campaign. Data were extracted from the provincial vaccination registry for students in kindergarten to grade 11 during the 2011/2012 school year. A telephone survey was conducted in three sub-groups: students whose first measles vaccine dose recorded in the vaccination registry was received during the 2011 school vaccination campaign; students with no dose recorded in the registry whose parents refused receipt during the school campaign; and students with no dose recorded in the registry and no information about parental consent/refusal during the school campaign. Neither the prevalence of being non-vaccinated nor a younger age at first pediatric dose were higher in the two most-affected districts versus the rest of the province. The school campaign vaccinated nearly 8% of all students including 7% who previously received at least one dose. Before the outbreak, 3% of students were not vaccinated and one-third of these (1%/3%) were vaccinated during the campaign. The campaign likely increased the absolute school population immunity by just 1.7%. The concentration of measles cases in the two most-affected health districts during the large Quebec outbreak is not explained by more students who were unvaccinated or who had received their first vaccine dose at a younger age. The vaccination campaign reached one-third of unvaccinated students and only marginally improved population immunity.

Psychological Abuse of Children: Implications for Malpractice and Dismissals of Teachers.

ERIC Educational Resources Information Center

Lynch, Patrick D.

This article defines psychological abuse of students in school settings and describes legal aspects of the problem, particularly with respect to possible action in negligence. The following four categories of psychological abuse are examined: verbal abuse, refusal to communicate, physical acts (and sexual abuse) that cause psychological damage,…

Creating Greener Citizens: Political Liberalism and a Robust Environmental Education

ERIC Educational Resources Information Center

Stevens, David

2014-01-01

Proponents of environmentalist views often urge the teaching of such views and the inculcation of "green" values within the educational curriculum of schools as a key component of achieving their ends. It might seem that modern versions of political morality that refuse to take a stance on controversial questions--religious, ethical,…

Reflections of a Latina Student-Teacher: Refusing Low Expectations for Latina/o Students

ERIC Educational Resources Information Center

Cavazos, Alyssa G.

2009-01-01

This narrative provides a personal account of the author's student-teaching experience in a primarily Latina/o high school. In an analysis of the journal in which observations were during the experience, the following themes emerged: (a) high expectations before the semester, (b) conflicting messages, (c) teachers' expectations for standard…

Refusing the Stereotype: Decoding Negative Gender Imagery through a School-Based Digital Media Literacy Program

ERIC Educational Resources Information Center

Berman, Naomi; White, Alexandra

2013-01-01

The media plays a significant role in shaping cultural norms and attitudes, concomitantly reinforcing "body" and "beauty" ideals and gender stereotypes. Unrealistic, photoshopped and stereotyped images used by the media, advertising and fashion industries influence young people's body image and impact on their feelings of body…

Family Psychology and Family Therapy in Japan.

ERIC Educational Resources Information Center

Kameguchi, Kenji; Murphy-Shigematsu, Stephen

2001-01-01

Reviews the development of family psychology and family therapy in Japan, tracing the origins of these movements, explaining how these fields were activated by the problem of school refusal, and describing an approach to family therapy that has been developed to work with families confronting this problem, as well as preventive programs of family…

Resisting Punitive School Discipline: Perspectives and Practices of Exemplary Urban Elementary Teachers

ERIC Educational Resources Information Center

Hambacher, Elyse

2018-01-01

Drawing on the literature related to classroom management, and culturally relevant critical teacher care, and effective teaching for students of color, this paper uses interview and observation data to explore the perspectives and practices of two exemplary fifth-grade teachers who refuse to rely on punitive discipline with their students of…

Whispers in the Walls: Unspoken Words in the Public School Fortress

ERIC Educational Resources Information Center

Barton, Colleen

2007-01-01

Teenage pregnancy is not a new issue, and though policymakers have made token efforts toward curtailing the problem, current preventative and support programs have little effect. Their failure can be attributed to an institutional refusal to acknowledge teenagers as sexual beings, thus limiting the scope of sex education curricula. Abstinence-only…

Negotiating What Matters Most: Collective Bargaining and Student Achievement

ERIC Educational Resources Information Center

Kerchner, Charles Taylor; Koppich, Julia E.

2007-01-01

Despite a statutorily narrow scope of bargaining, the scope of topics of union-management discussions has widened over the last 20 years, resulting in the birth of reform, or professional, unionism. But over the last half decade, professional unionism has waned. School management often refuses to see unions as partners, politicians fail to view…

Disorders of Behavioral and Emotional Regulation in the First Years of Life: Early Risks and Intervention in the Developing Parent-Infant Relationship

ERIC Educational Resources Information Center

Papousek, Mechthild, Ed.; Schieche, Michael, Ed.; Wurmser, Harald, Ed.

2007-01-01

For every five healthy babies and infants, there is at least one who brings unusual stresses for its parents with behaviors such as inconsolable crying, sleep disorders, refusal to eat, chronic moodiness, incessant demands for attention, fearful clinging, or tantrums. Available for the first time in English, this influential German collection…

The Social Basis of Vaccine Questioning and Refusal: A Qualitative Study Employing Bourdieu’s Concepts of ‘Capitals’ and ‘Habitus’

PubMed Central

Meyer, Samantha B.

2018-01-01

This article is an in-depth analysis of the social nature of vaccine decision-making. It employs the sociological theory of Bourdieu and Ingram to consider how parents experience non-vaccination as a valued form of capital in specific communities, and how this can affect their decision-making. Drawing on research conducted in two Australian cities, our qualitative analysis of new interview data shows that parents experience disjuncture and tugs towards ‘appropriate’ forms of vaccination behavior in their social networks, as these link to broader behaviors around food, school choices and birth practices. We show how differences emerge between the two cities based on study designs, such that we are able to see some parents at the center of groups valorizing their decisions, whilst others feel marginalized within their communities for their decisions to vaccinate. We draw on the work of philosopher Mark Navin to consider how all parents join epistemic communities that reward compliance and conformity with the status quo and consider what this means for interventions that seek to influence the flow of pro-vaccine information through vaccine-critical social groups. PMID:29789482

Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

PubMed

Gilkey, Melissa B; McRee, Annie-Laurie; Magnus, Brooke E; Reiter, Paul L; Dempsey, Amanda F; Brewer, Noel T

2016-01-01

To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents. We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR), varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. A substantial minority of parents reported a history of vaccine refusal (15%) or delay (27%). Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63) as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86). Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68), varicella (OR = 1.54, 95% CI, 1.42-1.66), and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42). Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

The relation between child feeding problems as measured by parental report and mealtime behavior observation: A pilot study.

PubMed

van Dijk, Marijn; Bruinsma, Eke; Hauser, M Paulina

2016-04-01

Because feeding problems have clear negative consequences for both child and caretakers, early diagnosis and intervention are important. Parent-report questionnaires can contribute to early identification, because they are efficient and typically offer a 'holistic' perspective of the child's eating in different contexts. In this pilot study, we aim to explore the concurrent validity of a short screening instrument (the SEP, which is the Dutch MCH-FS) in one of its target populations (a group of premature children) by comparing the total score with the observed behavior of the child and caretaker during a regular home meal. 28 toddlers (aged 9-18 months) and their caretakers participated in the study. Video-observations of the meals were coded for categories of eating behavior and parent-child interaction. The results show that the total SEP-score correlates with food refusal, feeding efficiency, and self-feeding, but not with negative affect and parental instructions. This confirms that the SEP has a certain degree of concurrent validity in the sense that its total score is associated with specific 'benchmark' feeding behaviors: food refusal, feeding efficiency and autonomy. Future studies with larger samples are needed to generalize the findings from this pilot to a broader context. Copyright © 2016 Elsevier Ltd. All rights reserved.

Raising Standards: What Do We Really Want?

ERIC Educational Resources Information Center

Peacock, Alison

2005-01-01

When taking up her headship of a one-form entry primary school in "special measures" Alison Peacock's approach was to begin to rekindle joy amongst teachers in order to nurture and enhance the natural love of life and learning in children. She refused to label children by ability, preferring to value all individuals and celebrate success. Applying…

A Model to Predict Educators' Attitudes towards Technology and Thus Technology Adoption

ERIC Educational Resources Information Center

Govender, D. W.

2012-01-01

"Technology," the buzz word for the last ten to fifteen years in South Africa. Technology availability is quite often mistaken for technology adoption and use. Technology has been made available to almost all tertiary institutions and at least some public schools. However, in most tertiary institutions many professors still refuse to use…

Battle for the Soul: Metis Children Encounter Evangelical Protestants at Mackinaw Mission, 1823-1837.

ERIC Educational Resources Information Center

Widder, Keith R.

In 1823, evangelical missionaries William and Amanda Ferry opened a boarding school for Metis children on Mackinac Island, Michigan Territory, hoping to convert and transform the Metis people through their children. Instead, they helped bring about a revival of Catholicism, and their students refused to abandon the fur trading lifestyle. Chapter 1…

College? No Thanks, Mom and Dad

ERIC Educational Resources Information Center

Ruark, Jennifer

2009-01-01

Robin Wagner, director of the library at Gettysburg College, remembers a few years ago when her son, Ben, was a high-school senior. While all his friends were talking about their college plans, Ben, who had been accepted to the University of Pittsburgh's engineering program, refused to return the offer card. On the band-room whiteboard where kids…

Districts Shun Stimulus Bids

ERIC Educational Resources Information Center

Maxwell, Lesli A.

2010-01-01

In the final sprint to polish Race to the Top applications, hundreds of school districts shunned a shot at a share of $4 billion in grants by refusing to sign on to their states' plans for the federal competition. California officials had secured the signatures of 790 local education agencies (leas) late last week, including most of the state's…

A qualitative study to assess school nurses' views on vaccinating 12-13 year old school girls against human papillomavirus without parental consent.

PubMed

Stretch, Rebecca; McCann, Rosemary; Roberts, Stephen A; Elton, Peter; Baxter, David; Brabin, Loretta

2009-07-21

In the UK, parental consent for the routine vaccination of 12-13 year olds schoolgirls against human papillomavirus (HPV) is recommended, although legally girls may be able to consent themselves. As part of a vaccine study conducted ahead of the National HPV Vaccine Programme we sought the views of school nurses on vaccinating girls who did not have parental consent. HPV vaccination was offered to all 12 year old girls attending schools in two Primary Care Trusts in Greater Manchester. At the end of the study semi-structured, tape-recorded interviews were conducted with school nurses who had delivered the vaccine (Cervarix). The interview template was based on concepts derived from the Theory of Planned Behaviour. Transcripts were analysed thematically in order to understand school nurses' intentions to implement vaccination based on an assessment of Gillick competency. School nurses knew how to assess the competency of under-16s but were still unwilling to vaccinate if parents had refused permission. If parents had not returned the consent form, school nurses were willing to contact parents, and also to negotiate with parents who had refused consent. They seemed unaware that parental involvement required the child's consent to avoid breaking confidentiality. Nurses' attitudes were influenced by the young appearance and age of the school year group rather than an individual's level of maturity. They were also confused about the legal guidelines governing consent. School nurses acknowledged the child's right to vaccination and strongly supported prevention of HPV infection but ultimately believed that it was the parents' right to give consent. Most were themselves parents and shared other parents' concerns about the vaccine's novelty and unknown long-term side effects. Rather than vaccinate without parental consent, school nurses would defer vaccination. Health providers have a duty of care to girls for whom no parental consent for HPV vaccination has been given, and in the UK, this includes conducting, and acting upon, an assessment of the maturity and competence of an adolescent minor. To facilitate this, policies, training and support structures for health providers should be implemented.

A qualitative study to assess school nurses' views on vaccinating 12–13 year old school girls against human papillomavirus without parental consent

PubMed Central

Stretch, Rebecca; McCann, Rosemary; Roberts, Stephen A; Elton, Peter; Baxter, David; Brabin, Loretta

2009-01-01

Background In the UK, parental consent for the routine vaccination of 12–13 year olds schoolgirls against human papillomavirus (HPV) is recommended, although legally girls may be able to consent themselves. As part of a vaccine study conducted ahead of the National HPV Vaccine Programme we sought the views of school nurses on vaccinating girls who did not have parental consent. Methods HPV vaccination was offered to all 12 year old girls attending schools in two Primary Care Trusts in Greater Manchester. At the end of the study semi-structured, tape-recorded interviews were conducted with school nurses who had delivered the vaccine (Cervarix™). The interview template was based on concepts derived from the Theory of Planned Behaviour. Transcripts were analysed thematically in order to understand school nurses' intentions to implement vaccination based on an assessment of Gillick competency. Results School nurses knew how to assess the competency of under-16s but were still unwilling to vaccinate if parents had refused permission. If parents had not returned the consent form, school nurses were willing to contact parents, and also to negotiate with parents who had refused consent. They seemed unaware that parental involvement required the child's consent to avoid breaking confidentiality. Nurses' attitudes were influenced by the young appearance and age of the school year group rather than an individual's level of maturity. They were also confused about the legal guidelines governing consent. School nurses acknowledged the child's right to vaccination and strongly supported prevention of HPV infection but ultimately believed that it was the parents' right to give consent. Most were themselves parents and shared other parents' concerns about the vaccine's novelty and unknown long-term side effects. Rather than vaccinate without parental consent, school nurses would defer vaccination. Conclusion Health providers have a duty of care to girls for whom no parental consent for HPV vaccination has been given, and in the UK, this includes conducting, and acting upon, an assessment of the maturity and competence of an adolescent minor. To facilitate this, policies, training and support structures for health providers should be implemented. PMID:19622145

BEHAVIOR AND ASSIMILATION OF ORGANIC AND INORGANIC PRIOIRTY POLLUTANTS CODISPOSED WITH MUNICIPAL REFUSE - VOLUME II - APPENDICES

EPA Science Inventory

Organic and inorganic priority pollutants codisposed with municipal solid waste (MSW) in ten pilot-scale simulated landfill columns, operated under single pass leaching or leachate recycle, were capable of being attenuated by microbially-mediated landfill stabilization processes....

Physicians' duties and the non-identity problem.

PubMed

Hope, Tony; McMillan, John

2012-01-01

The non-identity problem arises when an intervention or behavior changes the identity of those affected. Delaying pregnancy is an example of such a behavior. The problem is whether and in what ways such changes in identity affect moral considerations. While a great deal has been written about the non-identity problem, relatively little has been written about the implications for physicians and how they should understand their duties. We argue that the non-identity problem can make a crucial moral difference in some circumstances, and that it has some interesting implications for when it is or is not right for a physician to refuse to accede to a patient's request. If a physician is asked to provide an intervention (identity preserving) that makes a person worse off, then such harm provides a good reason for the physician to refuse to provide the intervention. However, in cases where different (identity-altering) interventions result in different people having a better or worse life, physicians should normally respect patient choice.

The Impact of Rapid HIV Home Test Use with Sexual Partners on Subsequent Sexual Behavior among Men Who Have Sex with Men

PubMed Central

Balán, Iván C.; Carballo-Diéguez, Alex; Frasca, Timothy; Dolezal, Curtis; Ibitoye, Mobolaji

2013-01-01

This study explores the sexual behavior 27 men who have sex with men (MSM) who regularly engage in unprotected anal intercourse (UAI), in the context of HIV home test (HT) use with potential sex partners. Participants were given 16 HT kits to use over three months. Among 40 sexual occasions following HIV-negative HT results, there were 25 UAI occasions (16 based on not typically using condoms and nine on HT results), 15 occasions in which condoms were used, and three in which sex did not occur. In the seven occasions where a potential partner received HIV-positive HT results, the sexual encounter ended. Almost all participants encountered potential partners who refused HT. Over half of these participants ended sexual encounters when HT was refused, perceiving these partners as HIV-positive or too high risk. Some participants reported that HT use heightened their awareness of HIV risk and their commitment to reducing it. PMID:23657758

The impact of rapid HIV home test use with sexual partners on subsequent sexual behavior among men who have sex with men.

PubMed

Balán, Iván C; Carballo-Diéguez, Alex; Frasca, Timothy; Dolezal, Curtis; Ibitoye, Mobolaji

2014-02-01

This study explores the sexual behavior of 27 men who have sex with men (MSM) who regularly engage in unprotected anal intercourse (UAI), in the context of HIV home test (HT) use with potential sex partners. Participants were given 16 HT kits to use over 3 months. Among 40 sexual occasions following HIV-negative HT results, there were 25 UAI occasions (16 based on not typically using condoms and nine on HT results), 15 occasions in which condoms were used, and three in which sex did not occur. In the seven occasions where a potential partner received HIV-positive HT results, the sexual encounter ended. Almost all participants encountered potential partners who refused HT. Over half of these participants ended sexual encounters when HT was refused, perceiving these partners as HIV-positive or too high risk. Some participants reported that HT use heightened their awareness of HIV risk and their commitment to reducing it.

The Impact of PTSD Symptoms on Women's Safer-Sex Negotiation: Influence of Ethnicity

PubMed Central

Horsey, Katie J.; Palmieri, Patrick A.; Hobfoll, Stevan E.

2010-01-01

PTSD has been shown to predict later self reported sexual risk behavior, yet behavioral research is lacking in this area. The present study investigated the impact of PTSD severity on negotiation and interpersonal skills effectiveness in simulated high-risk sexual situations among 368 inner-city women. Participants engaged in role-play scenarios involving 1) refusing sex without a condom, 2) abstaining from drinking prior to sex, and 3) refusing sex until both partners were tested for HIV. Interviews were audio taped and rated along dimensions of negotiation effectiveness by blind raters. Hierarchical linear regression analyses were conducted to investigate the impact of PTSD and ethnicity on 4 theoretically derived skill sets 1) assertiveness, 2) using health and preparedness skills 3) social joining skills and 4) higher order negotiation skills. Generally, results indicated that PTSD severity predicted poorer rated negotiation effectiveness among European Americans, but not African Americans. African Americans' expectations that may prepare them for facing more hardship may help explain ethnic differences. PMID:22267974

Evaluating Retailer Behavior in Preventing Youth Access to Harmful Legal Products: A Feasibility Test*

PubMed Central

Courser, Matthew W.; Holder, Harold D.; Collins, David; Johnson, Knowlton; Ogilvie, Kristen A.

2008-01-01

This paper reports results from a feasibility study of a community effort to reduce the availability of legal products that youth can use to get “high”. The study evaluated the potential of youth purchase attempts to detect actual changes in retail availability of harmful legal products. These results were triangulated with self-reports from retailers themselves about their own policies and practices. Before the intervention less than half of retailers reported using any of six possible strategies identified as ways to reduce youth access to harmful products and less than 7% of baseline youth attempts to purchase potentially harmful legal products were refused or questioned. After the low dosage intervention, retailers reported increased use of three strategies and a statistically significant increase in the percentage of purchase attempts that were either questioned or refused by retail clerks. These findings (1) demonstrate the potential feasibility of retailer focused environmental strategies and (2) support continued use of youth purchase attempts as a measure of actual retailer behavior. PMID:18660467

[School absenteeism: Preliminary developments and maintaining persisting challenges].

PubMed

Lenzen, Christoph; Brunner, Romuald; Resch, Franz

2016-01-01

A first step when considering school absenteeism is to understand the meaning and definition of the term. School absenteeism encompasses several terms such as school refusal, truancy and school phobia, all of which have been used inconsistently and confusingly in the past. Furthermore, the question of how many days of absence can be seen as problematic remains unclear. Due to these definitional problems, available data is inconsistent. Therefore, the prevalence rates of school absenteeism can only be estimated (about 5 % of all students). School absenteeism affects not only individual students, but also family, school and society structures. In order to establish appropriate support and intervention programs, a multimodal as well as an individual approach should be considered to address this interdependency. The primary goal, however, should be the students’ resumption of a regular school attendance, which requires a strong cooperation between parents, schools, youth welfare services and psychotherapeutic offers. If therapeutic interventions are required, it is highly recommended to start with outpatient treatment. If school attendance still remains irregular an inpatient treatment should follow.

Bounded rationality alters the dynamics of paediatric immunization acceptance.

PubMed

Oraby, Tamer; Bauch, Chris T

2015-06-02

Interactions between disease dynamics and vaccinating behavior have been explored in many coupled behavior-disease models. Cognitive effects such as risk perception, framing, and subjective probabilities of adverse events can be important determinants of the vaccinating behaviour, and represent departures from the pure "rational" decision model that are often described as "bounded rationality". However, the impact of such cognitive effects in the context of paediatric infectious disease vaccines has received relatively little attention. Here, we develop a disease-behavior model that accounts for bounded rationality through prospect theory. We analyze the model and compare its predictions to a reduced model that lacks bounded rationality. We find that, in general, introducing bounded rationality increases the dynamical richness of the model and makes it harder to eliminate a paediatric infectious disease. In contrast, in other cases, a low cost, highly efficacious vaccine can be refused, even when the rational decision model predicts acceptance. Injunctive social norms can prevent vaccine refusal, if vaccine acceptance is sufficiently high in the beginning of the vaccination campaign. Cognitive processes can have major impacts on the predictions of behaviour-disease models, and further study of such processes in the context of vaccination is thus warranted.

Bounded rationality alters the dynamics of paediatric immunization acceptance

PubMed Central

Oraby, Tamer; Bauch, Chris T.

2015-01-01

Interactions between disease dynamics and vaccinating behavior have been explored in many coupled behavior-disease models. Cognitive effects such as risk perception, framing, and subjective probabilities of adverse events can be important determinants of the vaccinating behaviour, and represent departures from the pure “rational” decision model that are often described as “bounded rationality”. However, the impact of such cognitive effects in the context of paediatric infectious disease vaccines has received relatively little attention. Here, we develop a disease-behavior model that accounts for bounded rationality through prospect theory. We analyze the model and compare its predictions to a reduced model that lacks bounded rationality. We find that, in general, introducing bounded rationality increases the dynamical richness of the model and makes it harder to eliminate a paediatric infectious disease. In contrast, in other cases, a low cost, highly efficacious vaccine can be refused, even when the rational decision model predicts acceptance. Injunctive social norms can prevent vaccine refusal, if vaccine acceptance is sufficiently high in the beginning of the vaccination campaign. Cognitive processes can have major impacts on the predictions of behaviour-disease models, and further study of such processes in the context of vaccination is thus warranted. PMID:26035413

EXPANDING URBAN AMERICAN INDIAN YOUTHS’ REPERTOIRE OF DRUG RESISTANCE SKILLS: PILOT RESULTS FROM A CULTURALLY ADAPTED PREVENTION PROGRAM

PubMed Central

Kulis, Stephen; Dustman, Patricia A.; Brown, Eddie F.; Martinez, Marcos

2013-01-01

This article examines changes in the drug resistance strategies used by urban American Indian (UAI) middle school students during a pilot test of a substance use prevention curriculum designed specifically for UAI youth, Living in 2 Worlds (L2W). L2W teaches four drug resistance strategies (refuse, explain, avoid, leave [R-E-A-L]) in culturally appropriate ways. Data come from 57 UAI students (53% female; mean age = 12.5 years) who participated in L2W during an academic enrichment class for Native youth at two Phoenix schools. Students completed a pre-test questionnaire before the L2W lessons and a post-test 7 months later. Questions assessed the use of R-E-A-L and alternative strategies commonly reported by UAI youth (change the subject, use humor). Tests of mean differences from pre-test to post-test showed significant increases in use of refuse, R-E-A-L repertoire. Use of more passive strategies (avoid, use humor) did not change significantly, except for change the subject, which increased. Changes in the use of strategies did not differ significantly by gender, age, school grades, parental education, or length of urban residence. The L2W curriculum appears effective in teaching culturally relevant communication strategies that expand UAI youths’ repertoire of drug resistance skills. PMID:23529769

Examining the Protective Effects of Brand Equity in the keepin’ it REAL Substance Use Prevention Curriculum

PubMed Central

Lee, Jeong Kyu; Hecht, Michael L.

2011-01-01

While branding appears to be an effective health prevention strategy, it is less clear how successful brands have protective effects. To better understand the role of branding in health prevention and promotion, it is necessary to examine how the persuasive mechanisms of branding function in health campaigns (e.g., modeling socially desirable behaviors). Using a cross-sectional data (N = 709), the current study uncovered the mechanisms explaining branding’s effects on adolescent substance use in a school-based substance use intervention, keepin’ it REAL (kiR) curriculum. Consistent with our predictions, a confirmatory factor analysis suggested that kiR brand equity had a higher-order, multidimensional factor structure. In addition, a path analysis revealed that brand equity affected adolescent substance use directly and through the predicted social cognitive processes including refusal efficacy and resistance skills. Thus it is concluded that kiR brand equity serves as a protective factor for adolescent substance use. Practical implications, research limitations and future directions are discussed. PMID:21512924

Social context of premarital fertility in rural South-Africa.

PubMed

Zwang, Julien; Garenne, Michel

2008-08-01

A qualitative study was conducted in Agincourt, a rural area of South Africa, to document the perceptions and attitudes towards premarital fertility and late marriage among young adults of both sexes. Two focus groups and 35 individual interviews were conducted among 17-30 year olds, randomly selected. Most interviewees perceived premarital fertility as undesirable, and a new phenomenon in a context of major social changes, in particular loss of authority of parents and increasing freedom of the youth. In contrast, late marriage was perceived as positive, by both sexes, primarily for economic reasons. Much stigma was associated with premarital fertility, from friends, institutions and families who occasionally apply mild or severe sanctions. Consequences of premarital fertility were numerous: school abandonment, economic adversity, health risks, stigmatization. In extreme cases, premarital fertility might lead to exclusion and deviant behavior. Premarital fertility was ultimately due to a lack of contraception among young women, and to refusal of abortion for religious reasons, and is associated with the risk of contracting STD's.

Examining the protective effects of brand equity in the keepin' it REAL substance use prevention curriculum.

PubMed

Lee, Jeong Kyu; Hecht, Michael L

2011-10-01

While branding appears to be an effective health prevention strategy, it is less clear how successful brands have protective effects. To better understand the role of branding in health prevention and promotion, it is necessary to examine how the persuasive mechanisms of branding function in health campaigns (e.g., modeling socially desirable behaviors). Using cross-sectional data (n = 709), the current study uncovered the mechanisms explaining branding's effects on adolescent substance use in a school-based substance use intervention, the keepin' it REAL (kiR) curriculum. Consistent with our predictions, a confirmatory factor analysis suggested that kiR brand equity had a higher order, multidimensional factor structure. In addition, a path analysis revealed that brand equity affected adolescent substance use directly and through the predicted social cognitive processes, including refusal efficacy and resistance skills. Thus, it is concluded that kiR brand equity serves as a protective factor for adolescent substance use. Practical implications, research limitations, and future directions are discussed.

The Re-Think Tree.

ERIC Educational Resources Information Center

Gear, Jim

1993-01-01

The Re-Think Tree is a simple framework to help individuals assess and improve their behaviors related to environmental issues. The branches of the tree in order of priority are refuse, reduce, re-use, and recycle. Roots of the tree include such things as public opinion, education, and watchdog groups. (KS)

School Based Sex Education and HIV Prevention in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

PubMed Central

Fonner, Virginia A.; Armstrong, Kevin S.; Kennedy, Caitlin E.; O'Reilly, Kevin R.; Sweat, Michael D.

2014-01-01

Objectives School-based sex education is a cornerstone of HIV prevention for adolescents who continue to bear a disproportionally high HIV burden globally. We systematically reviewed and meta-analyzed the existing evidence for school-based sex education interventions in low- and middle-income countries to determine the efficacy of these interventions in changing HIV-related knowledge and risk behaviors. Methods We searched five electronic databases, PubMed, Embase, PsycInfo, CINAHL, and Sociological Abstracts, for eligible articles. We also conducted hand-searching of key journals and secondary reference searching of included articles to identify potential studies. Intervention effects were synthesized through random effects meta-analysis for five outcomes: HIV knowledge, self-efficacy, sexual debut, condom use, and number of sexual partners. Results Of 6191 unique citations initially identified, 64 studies in 63 articles were included in the review. Nine interventions either focused exclusively on abstinence (abstinence-only) or emphasized abstinence (abstinence-plus), whereas the remaining 55 interventions provided comprehensive sex education. Thirty-three studies were able to be meta-analyzed across five HIV-related outcomes. Results from meta-analysis demonstrate that school-based sex education is an effective strategy for reducing HIV-related risk. Students who received school-based sex education interventions had significantly greater HIV knowledge (Hedges g = 0.63, 95% Confidence Interval (CI): 0.49–0.78, p<0.001), self-efficacy related to refusing sex or condom use (Hedges g = 0.25, 95% CI: 0.14–0.36, p<0.001), condom use (OR = 1.34, 95% CI: 1.18–1.52, p<0.001), fewer sexual partners (OR = 0.75, 95% CI:0.67–0.84, p<0.001) and less initiation of first sex during follow-up (OR = 0.66, 95% CI: 0.54–0.83, p<0.001). Conclusions The paucity of abstinence-only or abstinence-plus interventions identified during the review made comparisons between the predominant comprehensive and less common abstinence-focused programs difficult. Comprehensive school-based sex education interventions adapted from effective programs and those involving a range of school-based and community-based components had the largest impact on changing HIV-related behaviors. PMID:24594648

Importance of alcohol-related expectations and emotional expressivity for prediction of motivation to refuse alcohol in alcohol-dependent patients.

PubMed

Slavinskienė, Justina; Žardeckaitė-Matulaitienė, Kristina

2014-01-01

The aim of this study was to evaluate the importance of alcohol-dependent patients' emotional expressivity, alcohol-related expectations and socio-demographic factors for prediction of motivation to refuse alcohol consumption. The study sample consisted of 136 alcohol-dependent patients (100 men and 36 women) undergoing treatment in Kaunas center for addictive disorders. Only higher expression of negative alcohol-related expectations (std. beta=0.192, P=0.023), higher emotional impulse intensity (std. beta=0.229, P=0.021) and higher expression of positive emotional expressiveness (std. beta=0.021, P=0.020) as well as gender (std. beta=0.180, P=0.049), education (std. beta=-0.137, P=0.038) and alcohol dependency treatment conditions (members of support group after rehabilitation program) (std. beta=0.288, P=0.001; std. beta=0.608, P=0.001) were significant factors for predicting the different level of alcohol-dependent patients motivation to refuse alcohol consumption. Negative alcohol-related expectations, emotional impulse intensity and positive emotional expressiveness were significant even though quite weak triggers for alcohol-dependent patients' different level of motivation to refuse alcohol consumption. An assumption could be made that by changing these triggers it is possible to change addictive behavior. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Anoxia-Reoxygenation Regulates Mitochondrial Dynamics through the Hypoxia Response Pathway, SKN-1/Nrf, and Stomatin-Like Protein STL-1/SLP-2

PubMed Central

Tabakin, Alexandra; Salazar-Vasquez, Nathaly; Rongo, Christopher

2013-01-01

Many aerobic organisms encounter oxygen-deprived environments and thus must have adaptive mechanisms to survive such stress. It is important to understand how mitochondria respond to oxygen deprivation given the critical role they play in using oxygen to generate cellular energy. Here we examine mitochondrial stress response in C. elegans, which adapt to extreme oxygen deprivation (anoxia, less than 0.1% oxygen) by entering into a reversible suspended animation state of locomotory arrest. We show that neuronal mitochondria undergo DRP-1-dependent fission in response to anoxia and undergo refusion upon reoxygenation. The hypoxia response pathway, including EGL-9 and HIF-1, is not required for anoxia-induced fission, but does regulate mitochondrial reconstitution during reoxygenation. Mutants for egl-9 exhibit a rapid refusion of mitochondria and a rapid behavioral recovery from suspended animation during reoxygenation; both phenotypes require HIF-1. Mitochondria are significantly larger in egl-9 mutants after reoxygenation, a phenotype similar to stress-induced mitochondria hyperfusion (SIMH). Anoxia results in mitochondrial oxidative stress, and the oxidative response factor SKN-1/Nrf is required for both rapid mitochondrial refusion and rapid behavioral recovery during reoxygenation. In response to anoxia, SKN-1 promotes the expression of the mitochondrial resident protein Stomatin-like 1 (STL-1), which helps facilitate mitochondrial dynamics following anoxia. Our results suggest the existence of a conserved anoxic stress response involving changes in mitochondrial fission and fusion. PMID:24385935

Media Literacy Education for Elementary School Substance Use Prevention: Study of Media Detective

PubMed Central

Kupersmidt, Janis B.; Scull, Tracy M.; Austin, Erica Weintraub

2017-01-01

OBJECTIVES Media Detective is a 10-lesson elementary school substance use prevention program developed on the basis of the message interpretation processing model designed to increase children’s critical thinking skills about media messages and reduce intent to use tobacco and alcohol products. The purpose of this study was to conduct a short-term, randomized, controlled trial to evaluate the effectiveness of Media Detective for achieving these goals. METHODS Elementary schools were randomly assigned to conditions to either receive the Media Detective program (n = 344) or serve in a waiting list control group (n = 335). RESULTS Boys in the Media Detective group reported significantly less interest in alcohol-branded merchandise than boys in the control group. Also, students who were in the Media Detective group and had used alcohol or tobacco in the past reported significantly less intention to use and more self-efficacy to refuse substances than students who were in the control group and had previously used alcohol or tobacco. CONCLUSIONS This evaluation provides evidence that Media Detective can be effective for substance use prevention in elementary school–aged children. Notably, media-related cognitions about alcohol and tobacco products are malleable and relevant to the development and maintenance of substance use behaviors during late childhood. The findings from this study suggest that media literacy– based interventions may serve as both a universal and a targeted prevention program that has potential for assisting elementary school children in making healthier, more informed decisions about use of alcohol and tobacco products. PMID:20732940

Factors Associated with HPV Vaccine Refusal among Young Adult Women after Ten Years of Vaccine Implementation.

PubMed

Restivo, Vincenzo; Costantino, Claudio; Fazio, Tiziana Francesca; Casuccio, Nicolò; D'Angelo, Claudio; Vitale, Francesco; Casuccio, Alessandra

2018-04-17

In Italy, the Human Papillomavirus (HPV) vaccination was implemented for twelve years old girls in 2007, but its coverage was lower than the recommended level. Sicily is one of the Italian administrative regions with lower vaccination coverage, with a value of 59% for those born in 1996 increasing to 62% coverage for those born in 1999. The aim of the study was to investigate factors associated with the refusal of HPV vaccination among young adult women of Palermo, Italy. The study was approved by the Ethics Committee of the Policlinico “Paolo Giaccone” Hospital (Palermo 1) and the questionnaire was validated in a convenience sample representing 10% of the young women. A cross-sectional study was conducted through the administration of a telephone questionnaire, consisting of 23 items on HPV infection and vaccination knowledge based on the Health Belief Model framework. The eligible population were young women (18–21 years old) who had at least a vaccination among all included in the Sicilian vaccination schedule, without starting or completing HPV vaccination. Overall, 141 young women were enrolled (response rate 22%). Among them, 84.4% were unvaccinated and 15.6% had at least one dose of the HPV vaccine. In multivariate analysis, the factors associated with the refusal of the HPV vaccination were a bachelor’s as the education level (OR = 10.2, p = 0.041), lower participation at school seminar on HPV (OR = 0.2, p = 0.047) and lower perception of HPV vaccine benefits (OR = 0.4, p = 0.048). Public health educational program focusing and tailored on benefits perception of HPV vaccine and HPV disease severity, carried out at school or during medical visits, can be useful to improve HPV vaccination uptake.

Sale of cigarettes to school children aged 14 and 15 years in New Zealand.

PubMed

Ford, D J; Scragg, R; Weir, J

1997-06-27

To determine the sources of cigarettes and extent of illegal sales to 14 and 15 year old children, and to examine associated risk factors in order to more effectively reduce tobacco access to children. Nationwide cross sectional survey of fourth form school children in New Zealand by means of an anonymous self administered questionnaire. Questionnaires from 14,097 fourteen and fifteen years olds were analysed, with over one third smokers. Twenty four percent of the whole group (3432) had bought cigarettes in the last year. Of smokers, 59.9% bought their own, with the great majority (68.9%) from dairies, particularly females. Ninety five percent said it was "easy" or "very easy" to buy cigarettes, and this was a major risk factor for this behaviour (relative risk (RR) = 2.01, 95% confidence interval (CI) 1.74, 2.32, RR = 2.54, CI 2.28, 2.83, respectively). Only 24.6% children had ever been refused cigarettes because of age and all points of sale were comparable in this respect. Heavy smokers and males were more likely to have been refused. While refusal was associated with a fourfold increase in the perception that it was difficult to buy cigarettes, there was only a minimal reduction in the risk of children buying their own cigarettes (RR = 0.95, CI 0.91, 1.00). We have shown that the illegal sale of cigarettes to children is unacceptably easy and accurately perceived as such by children who smoke. The active enforcement of existing or future legislation is essential, with prosecution of offending retailers, if we are to make any progress to reduce the high prevalence of smoking in New Zealand children.

Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines

PubMed Central

Gilkey, Melissa B.; McRee, Annie-Laurie; Magnus, Brooke E.; Reiter, Paul L.; Dempsey, Amanda F.; Brewer, Noel T.

2016-01-01

Objective To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents. Methods We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children’s vaccination status for vaccines including measles, mumps, and rubella (MMR), varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents’ mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. Results A substantial minority of parents reported a history of vaccine refusal (15%) or delay (27%). Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54–0.63) as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76–0.86). Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40–1.68), varicella (OR = 1.54, 95% CI, 1.42–1.66), and flu vaccines (OR = 1.32, 95% CI, 1.23–1.42). Conclusions Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children. PMID:27391098

Our Families, Our Children: The Lesbian and Gay Child Care Task Force Report on Quality Child Care.

ERIC Educational Resources Information Center

Dispenza, Mary

The Lesbian and Gay Child Care Task Force documented anecdotal evidence of homophobia in child care and school age communities, including: (1) refusal to accept children from lesbian, gay, bisexual, and transgender (LGBT) families into child care; (2) biased attitudes expressed to children when they speak about their families; and (3) demonstrated…

Effectiveness of Morita Therapy-Based Consultation for a School-Refusing Adolescent with Psychogenic Fever

ERIC Educational Resources Information Center

Maeda, Naoki

2017-01-01

Morita therapy, developed by Shoma Morita (1874-1938) in Japan, is a type of psychotherapy that has been applied to deal with neurotic symptoms. This therapeutic approach is based on the conviction that neurotic symptoms are universal issues that eventually subside if the symptoms are accepted and everyday activities are carried out. By examining…

To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School-Based Vaccination Program in Sweden

ERIC Educational Resources Information Center

Grandahl, Maria; Tydén, Tanja; Westerling, Ragnar; Nevéus, Tryggve; Rosenblad, Andreas; Hedin, Erik; Oscarsson, Marie

2017-01-01

Background: Parents' beliefs about human papillomavirus (HPV) vaccination influence whether they allow their daughters to be vaccinated. We examined the association between parents' refusal and sociodemographic background, knowledge and beliefs about HPV, and the HPV vaccination in relation to the Health Belief Model. Methods: The sample consisted…

Effects of a Single-Lesson Tobacco Prevention Curriculum on Knowledge, Skill Identification and Smoking Intention

ERIC Educational Resources Information Center

Brown, Stephen; Birch, David; Thyagaraj, Sujan; Teufel, James; Phillips, Cheryl

2007-01-01

One in five students report experimenting with tobacco before the age of 13 and most prevention efforts take place in the school setting. This study measures the effect of a single-lesson tobacco prevention curriculum, conducted by a health education center, focusing on knowledge of tobacco, ability to identify refusal techniques, and intent not…

Social Skills Training: Teacher Practices and Perceptions

ERIC Educational Resources Information Center

Battalio, Rosemary; Stephens, J. Todd

2005-01-01

Speaking out without raising a hand, interrupting conversations, refusing to complete work or to follow directions, becoming aggressive toward peers or teachers with the slightest provocation, and generally having poor peer relations are only some of the myriad of problematic behaviors presented in classrooms at any given time. The historical…

Descriptive Analyses of Pediatric Food Refusal: The Structure of Parental Attention

ERIC Educational Resources Information Center

Woods, Julia N.; Borrero, John C.; Laud, Rinita B.; Borrero, Carrie S. W.

2010-01-01

Mealtime observations were conducted and occurrences of appropriate and inappropriate mealtime behavior and various forms of parental attention (e.g., coaxing, reprimands) were recorded for 25 children admitted to an intensive feeding program and their parents. Using the data from the observations, lag sequential analyses were conducted to…

Rudolph Hess, A Strategic Move or Ethical Dilemma?

DTIC Science & Technology

1990-03-09

seek help from uncrthodox healers. His mystic beliefs were manifested in his strange behavior. Some examples are: Per Felix Kersten , Himmler’s...the Rus- sians refused to consider Hess’s release. They were adamant that he remain incarcerated to the point that their former leader Leonid Brezhnev

Actual Readers versus Implied Readers: Role Conflicts in Office 97.

ERIC Educational Resources Information Center

Shroyer, Roberta

2000-01-01

Explains the controversy surrounding the Office Assistant ("Paper-Clip") in Microsoft's Office 97. Discusses why actual readers rejected the default Office Assistant's role as implied writer and rebelled against the reader role implied for them. Notes users resented its intrusive behavior, rejected its implied writer role, and refused to…

Education Reform as a "Weapon of Mass (Education) Destruction" versus Artful Resistance as a "Weapon of Mass Creation"

ERIC Educational Resources Information Center

McDermott McNulty, Morna

2014-01-01

For the purposes of this article, I am advocating for a set of creative educational practices that are artistic in process and product, which are established with the intent of resisting, refusing, and revolutionizing the ways in which we conceive of, or embody, education praxis in public schools. As predatory reformers attempt to colonize public…

The Modular Clock Algorithm for Blind Rendezvous

DTIC Science & Technology

2009-03-26

and Computer Engineering Graduate School of Engineering and Management Air Force Institute of Technology Air University Air Education and Training...capabilities in spectrum management and particularly in harvesting unused portions of pre-allocated band- width under DSA. The term “cognitive radio” was...of rendezvous and our role as the waiter . However, if the “child” refuses to move from non-common spectrum, rendezvous cannot occur. Bluetooth

Assimilation, Segregation, or Integration? A Teaching Project Examining Approaches to Religious and Ideological Diversity in the Classroom

ERIC Educational Resources Information Center

Bender-Szymanski, Dorothea

2012-01-01

In this article, we describe the multiple phases of a project that was constructed around the real case of a young Muslim student who wished to be exempted from coeducational physical education on religious grounds. When the school refused her initial request, she decided to take legal measures which ended up in the German Federal Administrative…

A Study of Proctors' Involvement in National Examination Cheating: The Case of "Collège Privé MBF d'Abobo" Exam Center

ERIC Educational Resources Information Center

Ettien, Assoa

2018-01-01

This research aimed at trying to understand why proctors, whose role and duty is normally to watch over candidates in order to prevent them from cheating, can suddenly become candidates' protectors against official exam supervisors. Our investigations revealed that most secondary school teachers refuse to partake in exam proctoring because the…

An Overview of the Caribbean Region: Education in Cultural Context and a Portrait of C. L. R. James of Trinidad.

ERIC Educational Resources Information Center

Dardaine-Ragguet, Patricia; And Others

1994-01-01

Born in Trinidad in 1901, C. L. R. James challenged the formal education system--resisting authority, refuting colonial historical writing, and refusing to seek tertiary schooling. A self-made scholar and activist, he started his own university and struggled to help peasant workers; the poor; and non-Caucasians cheated by colonialism, capitalism,…

Alternative Fuels Data Center: Kentucky Charges Forward with All-Electric

Science.gov Websites

Partnership. Download QuickTime Video QuickTime (.mov) Download Windows Media Video Windows Media (.wmv) Video Fuel Cell Vehicles in California Nov. 18, 2017 Photo of a car Smart Car Shopping Nov. 4, 2017 Image of Photo of a truck Natural Gas Fuels School Buses and Refuse Trucks in Tulsa, Oklahoma Feb. 18, 2017 Photo

Expanding Urban American Indian Youths' Repertoire of Drug Resistance Skills: Pilot Results from a Culturally Adapted Prevention Program

ERIC Educational Resources Information Center

Kulis, Stephen; Dustman, Patricia A.; Brown, Eddie F.; Martinez, Marcos

2013-01-01

This article examines changes in the drug resistance strategies used by urban American Indian (UAI) middle school students during a pilot test of a substance use prevention curriculum designed specifically for UAI youth, "Living in 2 Worlds" (L2W). L2W teaches four drug resistance strategies (refuse, explain, avoid, leave [R-E-A-L]) in…

The Power of Chameleonic Ideas in the Policy Decision-Making Process: The Case of the "Students' Revolution" in Chile

ERIC Educational Resources Information Center

Cabieses, Baltica; Espinoza, Manuel

2012-01-01

Chile is facing a major intellectual revolution: organised college students are arguing for the most significant educational reform since the period of dictatorship (1973-1990). Thousands of high-school and university students have refused to go to lessons since early June 2011, calling for better and more affordable education and an end to a…

Help-Negation and Suicidal Ideation: The Role of Depression, Anxiety and Hopelessness

ERIC Educational Resources Information Center

Wilson, Coralie J.; Deane, Frank P.

2010-01-01

Help-negation is expressed behaviorally by the refusal or avoidance of available help and cognitively by the inverse relationship between self-reported symptoms of psychological distress and help-seeking intentions. The current study examined the association between suicidal ideation and intentions to seek help from friends, family and…

We Shared Something Special: The Moral Discourse of Incest Perpetrators.

ERIC Educational Resources Information Center

Gilgun, Jane F.

1995-01-01

Analyzed narrative accounts of incest perpetrators (10 men, 1 woman) using the concepts of justice and care. Almost all perpetrators defined incest as love and care and viewed their behavior as considerate and fair, although this care and love were contradicted by adults' refusal to stop when children wanted them to stop. (RJM)

Helping Behavior: Effects of Sex and Sex-Typing.

ERIC Educational Resources Information Center

Basow, Susan A.; Crawley, Donna M.

1982-01-01

Male and female experimenters requested adult shoppers (N=178) to fill out a questionnaire. Refusal data showed shoppers helping other-sex more than same-sex experimenters. Other results showed a significant three-way interaction among helper and helpee sex and sex-typing and situation sex-typing and that helper sex-typing did not have significant…

Current Behavioral Models of Client and Consultee Resistance: A Critical Review

ERIC Educational Resources Information Center

Cautilli, Joe; Riley-Tillman, T. Chris; Axelrod, Saul; Hineline, Phil

2005-01-01

Resistance is the phenomena that occurs in the therapeutic relationship when the patient refuses to complete tasks assigned by the therapist which would benefit the patient in improving their psychological situation. Resistance is also used to describe situations in the consulting relationship where the consultee does not do what the consultant…

Assessment and Intervention for Young Children with Nonphysiological Feeding Concerns

ERIC Educational Resources Information Center

Olive, Melissa

2004-01-01

Among families who have young children, feeding concerns are quite common (Brazelton, 1992). Feeding concerns can include, but are not limited to, inappropriate mealtime behaviors, lack of self-feeding, food selectivity, and food refusal (Kerwin, 1999). Given the complex nature of assessment of and intervention for feeding concerns in young…

Striking the Right Balance: Fusion Centers and Privacy

DTIC Science & Technology

2010-09-01

LAPD Los Angeles Police Department MDPD Miami-Dade Police Department MOU Memorandum of Understanding NCISP...Stanley, the Los Angeles Police Department issued a department directive requiring officers to report 65 behaviors, including “innocuous, clearly...Virginia State Police for refusing to provide requested information concerning the agency’s interaction with the Department of

Law & Order, CSI, and NCIS: The Association Between Exposure to Crime Drama Franchises, Rape Myth Acceptance, and Sexual Consent Negotiation Among College Students.

PubMed

Hust, Stacey J T; Marett, Emily Garrigues; Lei, Ming; Ren, Chunbo; Ran, Weina

2015-01-01

Previous research has identified that exposure to the crime drama genre lowers rape myth acceptance and increases sexual assault prevention behaviors such as bystander intervention. However, recent content analyses have revealed marked differences in the portrayal of sexual violence within the top three crime drama franchises. Using a survey of 313 college freshmen, this study explores the influence of exposure to the three most popular crime drama franchises: Law & Order, CSI, and NCIS. Findings indicate that exposure to the Law & Order franchise is associated with decreased rape myth acceptance and increased intentions to adhere to expressions of sexual consent and refuse unwanted sexual activity; whereas exposure to the CSI franchise is associated with decreased intentions to seek consent and decreased intentions to adhere to expressions of sexual consent. Exposure to the NCIS franchise was associated with decreased intentions to refuse unwanted sexual activity. These results indicate that exposure to the specific content of each crime drama franchise may have differential results on sexual consent negotiation behaviors.

Elaborations on sexual assault on dates among Israeli students: risk, detrimental effect, and resilience factors.

PubMed

Shechory Bitton, Mally; Ben-David, Sarah

2014-12-01

The current study of 668 Israeli male and female students examines the prevalence of gendered risk factors for sexual assault (SA) on dates, posttraumatic stress disorder (PTSD) as a detrimental effect of SA, and self-efficacy as resiliency to refuse unwanted sex following SA. Two different sets of risk factors that increased the likelihood of SA on dates emerged from the hierarchical regression. Sexual experience, use of drugs, and private location increased the risk of being SA victims among males, whereas sexual experience, perceived provocative behavior, and alcohol use increased the risk among females. In addition, PTSD and self-efficacy to refuse unwanted sex following SA on dates were predicted by the extent of coercive sexual victimization. PTSD was also predicted by subjective perception of sexual behavior and rape myths, whereas efficacy was predicted by private location. The findings contribute to the literature by showing the contribution of various risk factors to experiencing SA, and by showing SA effect on PTSD and self-efficacy. © The Author(s) 2013.

What the better half is thinking: A comparison of men’s and women’s responses and agreement between spouses regarding reported sexual and reproductive behaviors in Rwanda

PubMed Central

Hageman, Kathy M; Karita, Etienne; Kayitenkore, Kayitesi; Bayingana, Roger; van der Straten, Ariane; Stephenson, Rob; Conkling, Martha; Tichacek, Amanda; Mwananyanda, Lawrence; Kilembe, William; Haworth, Alan; Chomba, Elwyn; Allen, Susan A

2009-01-01

Objective To compare responses to a sexual behavioral survey of spouses in cohabiting heterosexual relationships in Kigali, Rwanda. Design Cross-sectional survey. Methods Husbands and wives in 779 cohabiting couples were interviewed separately with parallel questionnaires. Participants were recruited from a three-year old cohort of 1458 antenatal clinic attendees enrolled in a prospective study in 1988. Analyses compared responses at the gender- and couple-level for agreement and disagreement. Results Couples were in disagreement more than agreement. Women reported occasionally refusing sex, suggesting condom use, and believing married men were unfaithful. Men reported being in a faithful relationship, greater condom use, and being understanding when wives refused sex. Agreement included relationship characteristics, safety of condoms, and whether condoms had ever been used in the relationship. Disagreement included the preferred timing of next pregnancy, desire for more children, and whether a birth control method was currently used and type of method. Conclusions Rwandan husbands and wives differed in sexual behavior and reproductive-related topics. Couple-level reporting provides the most reliable measure for relationship aspects as couples’ agreement cannot be assumed among cohabiting partnerships. Furthermore, HIV prevention programs for couples should incorporate communication skills to encourage couple agreement of HIV-related issues. PMID:22110321

School refusal in adolescent young man: could this be an idiopathic amotivational syndrome?

PubMed

Ding, Jonathan; Gadit, Amin Muhammad; Peer, Syed Bakhtiar

2014-04-01

This is the case of a 17-year-old male student who presented to an outpatient clinic with a 3-year episode of increasing anxiety and amotivation related to attending school. Initially affecting only his school work and attendance, the amotivation grew to affect his activities of daily living such as personal hygiene maintenance. There were no discernible psychosocial stressors. The patient did not report any bullying at school or any sort of abuse. At the time of presentation, there were also some depressive symptoms and visual perceptual abnormalities; both appeared subsequent to the amotivation. Escitalopram treated the depressive symptoms and risperidone minimised the perceptual disturbances; methylphenidate was not effective for this patient. The medications did not improve the patient's motivation. At the time of writing, the patient remained in stable state in terms of mood but unable to return to school.

Applying lessons from behavioral economics to increase flu vaccination rates.

PubMed

Chen, Frederick; Stevens, Ryan

2017-12-01

Seasonal influenza imposes an enormous burden on society every year, yet many people refuse to obtain flu shots due to misconceptions of the flu vaccine. We argue that recent research in psychology and behavioral economics may provide the answers to why people hold mistaken beliefs about flu shots, how we can correct these misconceptions, and what policy-makers can do to increase flu vaccination rates. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Combining sensory reinforcement and texture fading procedures to overcome chronic food refusal.

PubMed

Luiselli, J K; Gleason, D J

1987-06-01

Previous research has demonstrated behavioral programs to be effective in treating children with selective food preferences. However, there are few examples of interventions for the child displaying almost total food refusal. The present program combined sensory reinforcement and texture fading procedures to treat a 4-year-old deaf, visually impaired child who only consumed milk and, occasionally, pureed baby food. Sensory reinforcement consisted of the contingent presentation of light and rocking motion following consummatory responses. Texture fading entailed gradually increasing food composition. Results indicated that treatment was associated with substantial increases in the consumption of solid foods. Effects were maintained following the withdrawal of sensory reinforcement and with meals presented outside of the original treatment settings. Various features of the program are highlighted and discussed.

Intimate partner violence victims' acceptance and refusal of on-site counseling in emergency departments: Predictors of help-seeking behavior explored through a 5-year medical chart review.

PubMed

Choi, Anna Wai-Man; Wong, Janet Yuen-Ha; Lo, Ruby Tsz-Fung; Chan, Pik-Ying; Wong, John Kit-Shing; Lau, Chu-Leung; Kam, Chak-Wah

2018-03-01

Healthcare services constitute the first formal support that many intimate partner violence (IPV) victims receive and a link to formal welfare and psychological support. The help-seeking behavior for psychosocial support, e.g., Accident and Emergency Departments (AED) onsite counseling, is key to developing effective support for IPV victims. This study aimed to strengthen the health-welfare support link to aid IPV prevention in AEDs by investigating the acceptance and refusal of on-site counseling by IPV victims. A retrospective cohort study retrieved and reviewed all records of IPV victims presenting at the AEDs of two Hong Kong hospitals between 2010 and 2014. A total of 157 male and 823 female IPV victims were identified, 295 of whom refused on-site counseling. Bivariate and multivariate analyses were performed to examine the association between help-seeking and demographic and violent injury-related factors. The odds of help-seeking via on-site counseling were significantly lower for victims with mental illness (aOR=0.49; 95% CI=0.27, 0.88). After controlling for all demographic characteristics, mental illness, and drug abuse information, sex remained an independent predictor of help-seeking (aOR=2.62; 95% CI=1.45, 4.74); victims who had experienced >2 abuse incidents were more likely to seek help than those who had experienced ≤2 abuse incidents (aOR=1.90; 95% CI=1.11, 3.26). The factors associated with help-seeking from on-site services by IPV victims reflect the need for multidisciplinary collaborative work aimed at IPV prevention. Healthcare professionals require training on how to promote help-seeking behavior targeted specifically for male and female IPV victims according to their needs and preferences. Copyright © 2018 Elsevier Inc. All rights reserved.

Refusing to Treat Sexual Dysfunction in Sex Offenders.

PubMed

Douglas, Thomas

2017-01-01

This article examines one kind of conscientious refusal: the refusal of healthcare professionals to treat sexual dysfunction in individuals with a history of sexual offending. According to what I call the orthodoxy, such refusal is invariably impermissible, whereas at least one other kind of conscientious refusal-refusal to offer abortion services-is not. I seek to put pressure on the orthodoxy by (1) motivating the view that either both kinds of conscientious refusal are permissible or neither is, and (2) critiquing two attempts to buttress it.

A narrative review of studies of refusal of psychotropic medication in acute inpatient psychiatric care.

PubMed

Owiti, J A; Bowers, L

2011-09-01

This paper offers a narrative review of the 22 studies of medication refusal in acute psychiatry. Because of varied definitions of medication refusal, diverse methodologies and few rigorous studies, it has not been possible to draw firm conclusions on the average rate of refusal of psychotropic medications in acute psychiatry. However, it is clear that medication refusal is common and leads to poor outcomes characterized by higher rates of seclusion, restraint, threats of, and actual, assaults and longer hospitalizations. There are no statistically significant differences between refusers and acceptors in gender, marital status and preadmission living arrangements. Although no firm conclusions on the influence of ethnicity, status at admission and diagnosis on refusal, the refusers are more likely to have higher number of previous hospitalizations and history of prior refusal. The review indicates that staff factors such as the use of temporary staff, lack of confidence in ward staff and ineffective ward structure are associated with higher rates of medication refusal. Comprehensive knowledge of why, and how, patients refuse medication is lacking. Research on medication refusal is still fragmented, of variable methodological quality and lacks an integrating model. © 2011 Blackwell Publishing.

It's Your Game-Tech: Toward Sexual Health in the Digital Age.

PubMed

Shegog, Ross; Peskin, Melissa F; Markham, Christine; Thiel, Melanie; Karny, Efrat; Addy, Robert C; Johnson, Kimberly A; Tortolero, Susan

2014-08-01

Adolescent sexually transmitted infection (STI) and birth rates indicate a need for effective middle school HIV/STI, and pregnancy prevention curricula to delay, or mitigate consequences of, early sexual activity. Individual and organizational barriers to adoption, implementation, and maintenance, however, can hamper dissemination of evidence-based sexual health curricula, adversely impacting fidelity and reach. Internet-based approaches may help mitigate these barriers. This paper describes the development and feasibility testing of It's Your Game ( IYG )-Tech, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing effective sexual health curriculum-It's Your Game… Keep it Real ( IYG ). IYG -Tech development adaptation steps were to: 1) Select a suitable effective program and gather the original program materials; 2) Develop "proof of concept" lessons and test usability and impact; 3) Develop the program design document describing the core content, scope, and methods and strategies; and 4) produce the new program. Lab- and school-based tests with middle school students demonstrated high ratings on usability parameters and immediate impact on selected psychosocial factors related to sexual behavior-perceptions of friends' beliefs, reasons for not having sex, condom use self-efficacy, abstinence intentions, negotiating with others to protect personal rules, and improved knowledge about what constitutes healthy relationships (all p < .05). Youth rated IYG -Tech is favorably compared to other learning channels (>76.2% agreement) and rated the lessons as helpful in making healthy choices, selecting personal rules, detecting challenges to those rules, and protecting personal rules through negotiation and refusal skills (89.5% - 100%). Further efficacy testing is indicated for IYG -Tech as a potential strategy to deliver effective HIV/STI, and pregnancy prevention to middle school youth.

Conveying Environmental Issues with and through Art

NASA Astrophysics Data System (ADS)

Abeles, K. V.

2016-12-01

Art has the ability to convey serious environmental issues, inspiring people to respond personally Kim Abeles is an artist who crosses disciplines and media to explore and map urban and global environments. She has exhibited with a unique range of collaborators including smog control agencies, science and natural history museums, and educational and healthcare professionals. Her work has been exhibited across the world. Since 1985, her art projects have explored topics including air and water pollution, refuse and recycling, and consumption. This presentation will discuss three unconventional art projects from inspiration to impact including results. Most can be replicated in any educational or community setting to increase understanding of environmental issues. Abeles's Smog Collector series makes images from polluted air, helping viewers to see the air they breathe in an accessible, engaging, and visceral way. In addition to exhibitions of this work in art museums and galleries, it has been displayed in vehicle emissions testing booths to increase awareness and behavior change, and the process has been taught as curriculum in schools. Abeles sees consumption as a primary problem that leads to environmental decay. Her Paper Person was made from the California Science Center's paper trash that was generated on a single day by their visitors (Earth Day 2009). The 40' x 48' sculpture is in the permanent collection of the CSC, and the text accompanying the artwork prompts visitors to consider bringing their lunches next time instead of buying fast food. Similarly, Paper Person (Harvard Westlake School) is a figurative sculpture made of one week of students' paper trash. Exhibited in the school's gallery, students were able to identify their own scraps, and to see how their consumption and trash adds up. When the artwork was exhibited, the school decided to change the way they handled their lunch preparation, bottled water, and trash. gallery-of-solutions was a recent Luckman Program project with students at California State University Los Angeles. It gave students the opportunity to create solutions in the form of visual art. By involving them in a physical, creative experience, several of them changed their own behaviors, responding to what they had learned.

Refusal of medical treatment in the pediatric emergency service: analysis of reasons and aspects.

PubMed

Gündüz, Ramiz Coşkun; Halil, Halit; Gürsoy, Cüneyt; Çifci, Atilla; Özgün, Seher; Kodaman, Tuğba; Sönmez, Mehtap

2014-01-01

Refusal of treatment for acutely ill children is still an important problem in the emergency service. When families refuse medical treatment for their acutely ill children, healthcare professionals may attempt to provide information and negotiate with the family concerning treatment refusal and its possible adverse outcomes, and request consent for refusal of medical treatment. There is insufficient data about refusal of treatment in our country. The purpose of this study was to analyze the causes of treatment refusal in the pediatric emergency service. We collected data recorded on informed consent forms. During a 2-year-study period, 215 patients refused treatment recommended by acute health care professionals. The majorty of patients were in the 0-2 year age group. Hospitalization was the type of treatment most commonly refused; restrictions regarding family members staying with their children during hospitalization and admission to another hospital were the major reasons for refusal of treatment. Clarifying the reasons for treatment refusal may help us to overcome deficiencies, improve conditions, resolve problems and build confidence between healthcare providers and service users, increasing users' satisfaction in the future.

Influence of family and friend smoking on intentions to smoke and smoking-related attitudes and refusal self-efficacy among 9-10 year old children from deprived neighbourhoods: a cross-sectional study.

PubMed

McGee, Ciara E; Trigwell, Joanne; Fairclough, Stuart J; Murphy, Rebecca C; Porcellato, Lorna; Ussher, Michael; Foweather, Lawrence

2015-03-07

Smoking often starts in early adolescence and addiction can occur rapidly. For effective smoking prevention there is a need to identify at risk groups of preadolescent children and whether gender-specific intervention components are necessary. This study aimed to examine associations between mother, father, sibling and friend smoking and cognitive vulnerability to smoking among preadolescent children living in deprived neighbourhoods. Cross-sectional data was collected from 9-10 year old children (n =1143; 50.7% girls; 85.6% White British) from 43 primary schools in Merseyside, England. Children completed a questionnaire that assessed their smoking-related behaviour, intentions, attitudes, and refusal self-efficacy, as well as parent, sibling and friend smoking. Data for boys and girls were analysed separately using multilevel linear and logistic regression models, adjusting for individual cognitions and school and deprivation level. Compared to girls, boys had lower non-smoking intentions (P = 0.02), refusal self-efficacy (P = 0.04) and were less likely to agree that smoking is 'definitely' bad for health (P < 0.01). Friend smoking was negatively associated with non-smoking intentions in girls (P < 0.01) and boys (P < 0.01), and with refusal self-efficacy in girls (P < 0.01). Sibling smoking was negatively associated with non-smoking intentions in girls (P < 0.01) but a positive association was found in boys (P = 0.02). Boys who had a smoking friend were less likely to 'definitely' believe that the smoke from other people's cigarettes is harmful (OR 0.57, 95% CI: 0.35 to 0.91, P = 0.02). Further, boys with a smoking friend (OR 0.38, 95% CI: 0.21 to 0.69, P < 0.01) or a smoking sibling (OR 0.45, 95% CI: 0.21 to 0.98) were less likely to 'definitely' believe that smoking is bad for health. This study indicates that sibling and friend smoking may represent important influences on 9-10 year old children's cognitive vulnerability toward smoking. Whilst some differential findings by gender were observed, these may not be sufficient to warrant separate prevention interventions. However, further research is needed.

Interventions to prevent HIV/AIDS among adolescents in less developed countries: are they effective?

PubMed

Magnussen, Lesley; Ehiri, John E; Ejere, Henry O D; Jolly, Pauline E

2004-01-01

The objective of this study was to summarize and critically assess the effects of interventions to prevent HIV/AIDS among adolescents in less developed countries. Reports of studies that evaluated interventions for preventing HIV/AIDS/STDs among persons aged 11-25 years were obtained from online computer databases, by searching conference proceedings and relevant journals, and by following up references cited in published reports. Studies were included if they investigated any educational, behavioral, psychosocial or other intervention that aimed to prevent or reduce HIV/AIDS/STD among persons aged 11-25 years in a less developed country. Only studies that included a control group, and which involved pre- and post-intervention assessments were included. Outcome measures included: (i) changes in safe sex practices (abstinence, condom use, limitation of sexual partners, avoidance of casual sex), (ii) knowledge about HIV/AIDS transmission and prevention methods, (iii) perception of HIV/AIDS/STD risks, (iv) self-efficacy with regard to condom negotiation and refusal of sex, (v) uptake of voluntary counseling and testing (VCT), and (vi) reduction in incidence of HIV/AIDS/STDs. Studies were assessed in terms of intervention format (e.g., education, role-play, video), duration, and setting (school or community). Reported improvements in outcome measures in intervention versus control groups were assessed. Sixteen studies met the inclusion criteria. Thirteen of these were conducted in Africa and three in Latin America. Twelve of the sixteen studies were school-based, and four were community-based. The interventions reviewed were not resoundingly successful in achieving their goals of increasing knowledge of HIV/AIDS, altering attitudes, improving negotiation and communication skills, or in influencing positive behavior evidenced through consistent condom use, abstinence, or reducing the number of partners. Considering the importance of HIV/AIDS prevention among adolescents, design of evaluation studies of programs in less developed countries need to be improved. The use of randomized controlled trials or other rigorous approaches for evaluating population-based behavioral interventions (e.g., Solomon Four design) is recommended.

Relative Advantage: Strength for Favorable Conflict Resolution

DTIC Science & Technology

2014-05-22

Director, School of Advanced Military Studies Henry A. Arnold III, COL, IN Accepted this 22nd day of May 2014 by...refused to continue negotiations, led to a decision by President Nixon to conduct a 12- day strategic bombing campaign focused on Hanoi and North...Vietnamese garrisons for a period of twelve days starting December 18, 1972. Anxiety continued to rise as the United States deduced that “if Hanoi did

Preadoption adversity and long-term clinical-range behavior problems in adopted Chinese girls.

PubMed

Tan, Tony Xing; Camras, Linda A; Kim, Eun Sook

2016-04-01

In this study, we report findings on the role of preadoption adversity on long-term clinical-range problems in adopted Chinese girls. Four waves (2005, 2007, 2009 and 2011) of problem behavior data on 1,223 adopted Chinese girls (M = 4.86 years, SD = 2.82 in 2005) were collected from the adoptive mothers with the Child Behavior Checklist (CBCL). At Wave 1 (2005), data on the following indicators of preadoption adversity was collected: age at adoption, physical signs/symptoms (e.g., sores) of preadoption adversity, developmental delays at arrival, refusal/avoidance behaviors and crying/clinging behaviors toward adoptive parents during the first 3 weeks of adoption. We found that the percentage of clinical-range internalizing problems was 11.1%, 16.5%, 11.3%, and 16.1% at Wave 1, Wave 2, Wave 3, and Wave 4, respectively; the corresponding percentage of clinical-range externalizing problems was 8.4%, 10.5%, 8.4% and 9.9% respectively; and the corresponding percentage of clinical-range total CBCL problems was 9.3%, 13.0%, 9.8% and 12.6% respectively. Analyses with Mplus showed that controlling for demographic variables, indicators of preadoption adversity, except age at adoption, increased the odds for clinical-range behavior problems. Longitudinal path models revealed that controlling for demographic variables and the children's adjustment status in the previous wave, refusal/avoidance remained significant in predicting clinical-range internalizing, externalizing and total CBCL problems at Wave 2, delays at arrival and signs/symptoms were significant in predicting clinical-range internalizing problems at Wave 3. Overall, adoptees with clinical-range CBCL problems in earlier waves were 9-28 times as likely to show clinical-range CBCL problems in subsequent waves. (c) 2016 APA, all rights reserved).

Response problems in a vacation panel study

Treesearch

Christine A. Vogt; Susan I. Stewart

2001-01-01

This paper investigates response problems encountered in a panel study of travel behavior. Though the overall response rate to the three-wave panel study was acceptable (over 60%), three types of response problems were encountered: refusal, non-response, and attrition. In a follow-up phone survey, a sample of individuals from each problem response group was questioned...

Religious identity, beliefs, and views about climate change

Treesearch

Sonya Sachdeva

2016-01-01

People can take extraordinary measures to protect that which they view as sacred. They may refuse financial gain, engage in bloody, inter-generational conflicts, mount hunger strikes and even sacrifice their lives. These behaviors have led researchers to propose that religious values shape our identities and give purpose to our lives in a way that secular incentives...

Information Seeking by Rhesus Monkeys ("Macaca mulatta") and Capuchin Monkeys ("Cebus apella")

ERIC Educational Resources Information Center

Beran, Michael J.; Smith, J. David

2011-01-01

Animal metacognition is an active, growing research area, and one part of metacognition is flexible information-seeking behavior. In Roberts et al. (2009), pigeons failed an intuitive information-seeking task. They basically refused, despite multiple fostering experiments, to view a sample image before attempting to find its match. Roberts et al.…

Sanitation and hygiene practices among primary school learners in Ngamiland district, Botswana

NASA Astrophysics Data System (ADS)

Thakadu, Olekae T.; Ngwenya, Barbara N.; Phaladze, Nthabiseng A.; Bolaane, Benjamin

2018-06-01

Improved sanitation and personal hygienic practices are considered important towards reducing the risks of spreading communicable diseases and improving public health. Diarrheal related deaths amongst adolescents are reported to be amongst the top ten for the age groups 10-19 year olds and second among the age group 10-14 year olds globally. Primary school learners in developing countries are among the most vulnerable sub-population. These mortalities and illnesses can be reduced by addressing personal hygiene among school children and simultaneously promoting better school attendance and improved learning. In order to facilitate improved health and educational outcomes, it is necessary therefore to effectively address water, sanitation and hygiene matters within the school environment. This study explored hygiene education, personal hygiene practices among learners, environmental sanitation and hygiene within three primary schools in the Ngamiland district, Botswana. From the three schools, a total sample of 285 pupils was selected using proportionate stratified random sampling technique, and 15 teachers purposively selected as key informants. Data was collected using semi-structured questionnaires with key informants and social survey instrument for learners. Results show that very few learners linked poor hygiene to the following diseases; diarrhea/upset stomach (31.7%); malaria (23%); bilharzia (16.4%), and cholera (14.8%), demonstrating low hygiene knowledge. Hygiene education in schools is infused in the curriculum, and teacher training on hygiene education is only through in-service training workshops. Regarding personal hygiene practices, over 70% of the learners indicated that they 'always' wash their hands before and after eating, with slightly over one-fifth indicating 'sometimes'. Overwhelming majority of learners dispose solid waste in dustbins (99.3%, n = 284), use refuse bags (80.8%, n = 231), open skips (64%, n = 183) and very few throw trash anywhere either on the school compound or classroom (9.1%, n = 26 and 8.7%, n = 25 respectively). The current low levels of hygiene knowledge among learners in the study area has potential to affect learners' performance at school as risky hygiene practices make them vulnerable to contracting infectious diseases and missing school. This prompts the need to think beyond the infusion approach used in schools. Extra-curricular clubs in schools should be established to promote pro-hygiene behaviors and to facilitate adolescence meaningful and sustained participation.

Ways to say no: refusal skill strategies among urban adolescents.

PubMed

Nichols, Tracy R; Graber, Julia A; Brooks-Gunn, Jeanne; Botvin, Gilbert J

2006-01-01

To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer refusal skills. Differences were found by situation with students demonstrating greater use of Simple No in the smoking refusal and Alternatives in the shoplifting refusal. Nonverbal assertiveness was similar across situations and was associated with Declarative Statements, but only in the smoking refusal. Prevention programs should tailor refusal skills practice to cover multiple situations.

Drinking outcomes following drink refusal skills training: differential effects for African American and non-Hispanic White clients.

PubMed

Witkiewitz, Katie; Villarroel, Nadia Aracelliz; Hartzler, Bryan; Donovan, Dennis M

2011-03-01

Determining whether a particular treatment works for specific groups of people can help tailor dissemination of evidence-based alcohol treatments. It has been proposed that individuals from different racial groups might have better outcomes in treatments that are sensitive to sociocultural issues that impact alcohol use among these groups. The current study was a secondary analysis of data from the combined behavioral intervention (CBI) condition of the COMBINE study. Those randomly assigned to CBI (n = 776) had the opportunity to receive up to 9 skills training modules, which were chosen by the therapist. The goal of the current study was to determine whether receiving 1 of the CBI modules, drink refusal and social pressure skills training, predicted differential outcomes among African American clients. Results indicated that African American clients who received the drink refusal skills training module (n = 25) had significantly fewer heavy drinking days (d = 0.79) 1 year following treatment than African Americans clients who did not receive the module (n = 35). African American clients who received the module also had significantly fewer heavy drinking days (d = 0.86) than non-Hispanic White clients who received the module (n = 241). Good clinical outcomes at 1 year posttreatment were observed among 80% of African Americans who received the module, compared with 54% of African Americans who did not receive the module and 52% of non-Hispanic White clients who did receive the module. Although small sample size limits interpretation, findings provide preliminary evidence supporting the inclusion of drink refusal skills training as part of alcohol interventions for African American clients.

30 CFR 77.215-4 - Refuse piles; abandonment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; abandonment. 77.215-4 Section 77... MINES Surface Installations § 77.215-4 Refuse piles; abandonment. When a refuse pile is to be abandoned... refuse pile shall be abandoned in accordance with a plan submitted by the operator and approved by the...

The right not to be treated or to refuse treatment.

PubMed

Deutsch, E

1989-01-01

The corollary to the right to refuse treatment is the requirement that, in general, informed consent be obtained before treatment. The Declaration of Lisbon recognises this: "The patient has the right to accept or to refuse treatment after receiving adequate information." The information to be given to the patient is of three kinds, but a special problem in relation to the doctrine of informed refusal places a special duty on the doctor to inform the patient about the possible consequences of refusing treatment. Related topics, such as refusal in part, refusal by a parent or guardian, the novus actus interveniens, the living will, and contributory negligence are touched upon.

Drink refusal self-efficacy and implicit drinking identity: an evaluation of moderators of the relationship between self-awareness and drinking behavior.

PubMed

Foster, Dawn W; Neighbors, Clayton; Young, Chelsie M

2014-01-01

This study evaluated the roles of drink refusal self-efficacy (DRSE), implicit drinking identity, and self-awareness in drinking. Self-awareness (assessed by public and private self-consciousness), DRSE, and implicit drinking identity (measured via an implicit association test; IAT) were expected to interact in predicting self-reported drinking. This research was designed to consider mixed findings related to self-awareness and drinking. Hypotheses were: 1) alcohol-related outcomes would be negatively associated with self-awareness; 2) implicit drinking identity would moderate the association between self-awareness and alcohol consumption; and 3) this association would depend on whether participants were higher or lower in drink refusal self-efficacy. Participants included 218 undergraduate students. Results revealed that drinking behavior was not associated with self-awareness but was positively associated with implicit drinking identity. Of the four drinking variables (peak drinking, drinking frequency, drinks per week, and alcohol-related problems), only alcohol-related problems were positively associated with self-awareness. Furthermore, a significant two-way interaction emerged between private (but not public) self-consciousness and drinking identity to predict drinking. Consistent with expectations, three-way interactions emerged between self-awareness, implicit drinking identity, and DRSE in predicting drinking. For participants low in DRSE: 1) high implicit drinking identity was associated with greater drinking frequency when private self-consciousness was low; and 2) high implicit drinking identity was associated with greater drinks per week and peak drinks when public self-consciousness was low. This suggests that alcohol-related IATs may be useful tools in predicting drinking, particularly among those low in self-awareness and DRSE. © 2013.

The Refusal of Palliative Radiation in Metastatic Non-Small Cell Lung Cancer and Its Prognostic Implications.

PubMed

Stavas, Mark J; Arneson, Kyle O; Ning, Matthew S; Attia, Albert A; Phillips, Sharon E; Perkins, Stephanie M; Shinohara, Eric T

2015-06-01

Patients with metastatic non-small cell lung cancer (NSCLC) have limited survival. Population studies have evaluated the impact of radiation refusal in the curative setting; however, no data exist concerning the prognostic impact of radiation refusal in the palliative care setting. To investigate the patterns of radiation refusal in newly diagnosed patients with metastatic NSCLC. Patients with Stage IV NSCLC diagnosed between 1988 and 2010 were identified in the Surveillance, Epidemiology, and End Results database. Univariate and multivariate analyses were used to identify predictors for refusal of radiation and the impact of radiation and refusal on survival in the palliative setting. A total of 285,641 patients were initially included in the analysis. Palliative radiation was recommended in 42% and refused by 3.1% of patients. Refusal rates remained consistent across included years of study. On multivariate analysis, older, nonblack/nonwhite, unmarried females were more likely to refuse radiation (P < 0.001 in all cases). Median survival for patients refusing radiation was three months vs. five months for those receiving radiation and two months for those whom radiation was not recommended. Patients with metastatic NSCLC who refuse recommended palliative radiation have a poor survival. Radiation refusal or the recommendation against treatment can serve as a trigger for integrating palliative care services sooner and contributes greatly to prognostic awareness. Further investigation into this survival difference and the factors behind refusal are warranted. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Feminine ideology and sexual assault: are more traditional college women at greater risk?

PubMed

Wigderson, Sara; Katz, Jennifer

2015-05-01

Previous research has not conclusively determined whether traditional femininity increases women's risk for sexual assault. Certain femininity beliefs, such as valuing deference, may increase risk for sexual assault by discouraging sexual refusal assertiveness (SRA). Other femininity beliefs, such as valuing purity, may promote self-protective behaviors. College women (N = 254) provided self-report data on these beliefs, risk and protective behaviors, and sexual assault experiences. Traditional femininity was not directly associated with experiencing sexual assault. However, specific traditional beliefs were related to behaviors directly associated with risk. High SRA and sexual abstinence simultaneously reduced the odds for sexual assault. © The Author(s) 2015.

Effects of the culturally-sensitive comprehensive sex education programme among Thai secondary school students.

PubMed

Thato, R; Jenkins, R A; Dusitsin, N

2008-05-01

This paper reports on a study to evaluate the effectiveness of a culturally-sensitive comprehensive sex education programme among Thai secondary school students. Increasing number of adolescents in Thailand have been engaging in premarital sex. No theory-based, abstinence-oriented models of sex education have been evaluated in this population. A quasi-experimental study was conducted in 2006-2007. Outcome measures included sexual behaviour, condom use, intention to refuse sex, intention to use condoms, and knowledge regarding sexually transmitted infections/human immunodeficiency virus/acquired immunodeficiency syndrome and pregnancy. Students in the experimental group had lower levels of reported sexual intercourse at 3- and 6-month follow-ups, compared with those in control group (P < 0.01). Students participating in the programme had significantly greater intention to refuse sex in the future across time than controls (P < 0.05). Sexually active adolescents participating in the programme reported significantly lower frequencies of sexual intercourse across time than controls (P < 0.01). However, the programme did not influence consistent condom use (P > 0.05), although the intervention was associated with increased intention to use condoms (P < 0.01). Knowledge about sexually transmitted infections/human immunodeficiency virus/acquired immunodeficiency syndrome and pregnancy among students in the intervention group was significantly greater than that of the controls (P < 0.05). School nurses can play a major role by applying this kind of sex education programme. For nurse researchers, it would be useful to extend this research by considering alternative ways to foster condom use in the non-commercial partnerships that have become common among adolescents.

When and where do youths have sex? The potential role of adult supervision.

PubMed

Cohen, Deborah A; Farley, Thomas A; Taylor, Stephanie N; Martin, David H; Schuster, Mark A

2002-12-01

Interventions to reduce high-risk behaviors such as sex and substance use among youths have focused mainly on promoting abstinence, refusal skills, and negotiation skills, yet the frequency of high-risk behaviors among youths may also be influenced by opportunity, particularly the amount of time during which they are not supervised by adults. In this study, we examined when and where youths have sex and whether there is a relationship between unsupervised time and sex, sexually transmitted diseases (STDs), and substance use. A cross-sectional survey was conducted in 6 public high schools in an urban school district. Participants were 1065 boys and 969 girls from a school-based STD screening program. Ninety-eight percent of students were black, and 79% were in the free or reduced lunch program. Most students reported living with 1 parent only, primarily the mother (52%); only 27% lived in 2-parent families. Sexual activity, substance use, and the prevalence of gonorrhea or chlamydia as determined by a ligase-chain reaction test on a urine sample were measured. Fifty-six percent reported being home without an adult present 4 or more hours per day after school. There was no difference in the number of unsupervised after-school hours between children in 1- and 2-parent families. Fifty-five percent of boys and 41% of girls were participating in or planned to participate in after-school activities during the school year. Boys were more likely than girls to report having had sex for the first time before age 14 (42% vs 9%) and had a greater number of lifetime sex partners (mean: 4.2 vs 2.4 partners). Among the respondents who had had intercourse, 91% said that the last time had been in a home setting, including their own home (37%), their partner's home (43%), and a friend's home (12%), usually after school. Boys were more likely than girls to report having had sex in their own homes (43% vs 28%) and less likely than girls to report having had sex in their partner's homes (30% vs 59%). Fifty-six percent of youths who had had intercourse reported that the last time was on a weekday: 18% before 3:00, 17% between 3:00 and 6:00, and 21% after 6:00. There were no gender differences in the day of the week or time of day during which students reported having had intercourse. Youths who were unsupervised for 30 or more hours per week were more likely to be sexually active compared with those who were unsupervised for 5 hours a week or less (80% vs 68%). In addition, for boys, the greater the amount of unsupervised time, the higher the number of lifetime sex partners. Among girls but not among boys, sexual activity was associated with nonparticipation in after-school programs; 71% of those who were not participating in an after-school activity were sexually active compared with 59% of those who were participating. Tobacco and alcohol use were associated with unsupervised time among boys but not among girls. Boys who were unsupervised >5 hours per week after school were twice as likely to have gonorrhea or chlamydial infection as boys who were unsupervised for 5 hours or less. We found that substantial numbers of youths currently spend long periods of time without adult supervision and have limited opportunities to participate in after-school activities. More than half of sexually active youths reported that they had sex at home after school, and, particularly for boys, sexual-and drug-related risks increased as the amount of unsupervised time increased. As youths come of age, parents probably believe that it is appropriate to leave them increasingly on their own, and, accordingly, prevention approaches have concentrated on providing information and motivation for abstinence or safer sex. However, given the independent association between the amount of unsupervised time and sexual behaviors (with STD rates suggestive of particularly risky sexual behaviors) and substance use behaviors, it is worth considering increasing youth supervision, if not by parents, then by programs organized at schools organized at school or other community settings. Parents and community members should consider increasing opportunities for supervised activities to determine whether this will reduce risk-taking among youths.

United States Armed Forces Celebrating 60 Years of Integration: 1948-2008

DTIC Science & Technology

2008-01-01

Native Americans and believed that a removal policy would benefit the Indians. Consequently, in 1830, just a year after taking office, Jackson...military leaders refused to pay her for her services. Eventually, Dr. Walker gained experience in military medicine and went back to school where...sell, hold, and convey real and personal property, and to full and equal benefit of all laws and proceedings for the security of person and property

The Effect of N-Length on the Development of Cooperative and Non-Cooperative Behavior in a Two-Person Game. Part of the Final Report on Head Start Evaluation and Research: 1968-69 to the Office of Economic Opportunity.

ERIC Educational Resources Information Center

Manning, Brad A.; Pierce-Jones, John

In this study of cooperative behavior and its antecedents, the main experimental tool was a two-person, two-choice game. The subjects, 80 Negro males ranging in age from 4 1/2 to 6 years, could choose either to cooperate by giving a piece of candy or not to cooperate by refusing to give a piece of candy to the other child during an acquisition…

The Influence of Marijuana and Alcohol Use on Condom Use Behavior: Findings from a Sample of Young Adult Female Bar Drinkers

PubMed Central

Parks, Kathleen A.; Collins, R. Lorraine; Derrick, Jaye L.

2012-01-01

Prevalence data indicate that alcohol and marijuana are frequently used intoxicants among young adults in the United States. In a number of studies, both alcohol use and marijuana use have been associated with failure to use condoms, a high risk sexual behavior. The purpose of the current study was to assess the individual and additive effects of alcohol and marijuana use on this risky sexual behavior among 251, young adult, female, bar drinkers. Multi-level modeling was used to assess the likelihood of condom use during sexual events that occurred as a function of substance use (none, only alcohol, only marijuana, or both) prior to and partner type during the event, as well as individual differences in sexual assertiveness. Initial model testing (level 1 and 2) revealed that there were significant main effects for partner type (known), substance use (alcohol and marijuana) and sexual assertiveness (refusal, pregnancy/STI prevention) on risky sex. Final model testing indicated that sexual assertiveness interacted with substance use to influence risky sex. Women who were low in sexual assertiveness refusal were more likely to engage in risky sex on days when they had consumed both alcohol and marijuana prior to the sexual activity. These findings highlight the complex nature of the relationship between substance use and risky sex. PMID:22612253

Sexual Self-Efficacy and Gender: A Review of Condom Use and Sexual Negotiation Among Young Men and Women in Sub-Saharan Africa.

PubMed

Closson, Kalysha; Dietrich, Janan J; Lachowsky, Nathan J; Nkala, Busiwe; Palmer, Alexis; Cui, Zishan; Beksinska, Mags; Smit, Jennifer A; Hogg, Robert S; Gray, Glenda; Miller, Cari L; Kaida, Angela

Sexual self-efficacy (SSE), one's perceived control of or confidence in the ability to perform a given sexual outcome, predicts sexual behavior; however, important questions remain regarding whether gender modifies observed associations. In a comprehensive review of peer-reviewed HIV-prevention literature focusing on youth (ages 10 to 25) in sub-Saharan Africa, we measured and assessed the influence of SSE on condom use and sexual refusal, overall and by gender. Our results, after reviewing 63 publications, show that SSE is inconsistently measured. Most studies measured condom use self-efficacy (CUSE) (96.8%) and/or sexual refusal self-efficacy (SRSE) (63.5%). On average, young men had higher CUSE than young women, while young women had higher SRSE than young men. While cross-sectional studies reported an association between high SSE and sexual behaviors, this association was not observed in interventions, particularly among young women who face a disproportionate risk of HIV acquisition. In all, 25% of intervention studies demonstrated that fostering CUSE increased condom use among young men only, and one of two studies demonstrated that higher SRSE led to reduced frequency of sexual activity for both men and women. Future research and HIV-prevention interventions must be gender targeted, consider improving CUSE for young men, and move beyond limited individual-level sexual behavior change frameworks.

IMPACT OF INTERNET GAMBLING ON MENTAL AND PSYCHOLOGICAL HEALTH OF CHILDREN OF VARIOUS AGES.

PubMed

Khundadze, M; Geladze, N; Kapanadze, N

2017-03-01

The aim of the study was to assess the impact of internet gambling on children's mental and physical health and find correlation between the age, duration of internet use and type of comorbidity associated with internet gambling. The study assessed 50 patients with internet gambling (35 boys, 15 girls) from 2013-2016 y. The age range was 3-15 years. 15 patients were from 3-7 y of age, 20 patients from 7-12 y and 15 - from 12-15 y of age. The core problem common for all patients were internet overuse by computer games, mobile device and other gadgets. The main problem occurring in these children were insomnia, language delay, stuttering, behavioral disturbances, aggressive behavior phobias. These complaints were correlated with age of patients. The group of patients from 3-7 years of age exhibited sleep disturbances and language impairment, mainly presented with stuttering. The complaints occurring in children from 7-12 y of age are: tics, insomnia, phobias, emotional disturbances, daily fatigue, and attention-deficit. The group of children aged 12-15 years mainly revealed poor academic performance, refuse to play sport games, refuse to play music, insomnia, aggressive behavior, attention deficit, conflict with parents, coprolalia. Thus internet overuse affects physical and psychological aspects of child development which has to be managed by parental and psychologist's joint effort.

Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance.

PubMed

Marcewicz, Lauren H; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

2017-05-01

Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011-2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation.

Variation in Common Preschool Sleep Problems as an Early Predictor for Depression and Anxiety Symptom Severity across Time

ERIC Educational Resources Information Center

Whalen, Diana J.; Gilbert, Kirsten E.; Barch, Deanna M.; Luby, Joan L.; Belden, Andy C.

2017-01-01

Background: Child and adolescent psychopathology has been linked to increased sleep problems, but there has been less investigation of this relationship in younger samples with early-onset psychopathology. This study examined three specific but commonly observed aspects of sleep behaviors in young children--(i) Sleep onset latency, (ii) Refusal to…

Risk versus direct protective factors and youth violence: Seattle social development project.

PubMed

Herrenkohl, Todd I; Lee, Jungeun; Hawkins, J David

2012-08-01

Numerous studies have examined predictors of youth violence associated with the individual child, the family, school, and the surrounding neighborhood or community. However, few studies have examined predictors using a systematic approach to differentiate and compare risk and direct protective factors. This study examines risk and protective factors associated with youth violence in an ongoing longitudinal panel study of 808 students from 18 Seattle public elementary schools followed since 1985 when they were in 5th grade. Predictors span the individual, family, school, peer, and neighborhood domains. Data were collected annually, beginning in 1985, to age 16 years, and then again at age 18 years. This paper provides findings of analyses in which continuous predictor variables, measured at ages 10-12 years, were trichotomized to reflect a risk end of the variable, a direct protective end, and a middle category of scores. Youth violence was measured at ages 13-14 years and 15-18 years. Bivariate analyses of risk and direct protective factors identified the following predictors of violence at ages 13-14 years and 15-18 years. Risk for violence was increased by earlier antisocial behavior (e.g., prior violence, truancy, nonviolent delinquency), attention problems, family conflict, low school commitment, and living in a neighborhood where young people were in trouble. Direct protective factors at ages 10-12 years include a low level of attention problems, low risk-taking, refusal skills, school attachment, and low access and exposure to marijuana at ages 10-12 years. Multivariate regressions showed neighborhood risk factors to be among the most salient and consistent predictors of violence after accounting for all other variables in the tested models. Relatively few direct protective factors were identified in these statistical tests, suggesting the need for further review and possible refinement of the measures and methods that were applied. Implications provide important information for programs and policy. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Refusal of postoperative radiotherapy and its association with survival in head and neck cancer.

PubMed

Schwam, Zachary G; Husain, Zain; Judson, Benjamin L

2015-11-01

Administering postoperative radiotherapy (PORT) is associated with improved survival and slower disease progression in select head and neck cancer patients. Predictive factors for PORT refusal have not been described in this population. Retrospective analysis of 6127 head and neck cancer patients who received or refused PORT in the National Cancer Database (2003-2006) was performed. Statistical analysis included Chi-square, multivariable logistic regression, Kaplan-Meier, and Cox proportional hazards analysis. In total, 247 patients (4.0%) refused PORT. Three-year overall survival was 62.8% versus 53.4% for those who received and refused PORT, respectively. PORT refusers were more likely to have negative nodes than those who underwent PORT (37.4% versus 20.1%, p<.001). In multivariate analysis, predictive factors for refusing PORT included living far from the treatment facility (OR 1.92), having negative nodes (OR 2.14), and Charlson score of ⩾ 2 (OR 2.14) (all p ⩽.001). PORT refusal was associated with increased mortality (hazard ratio 1.20, p=.044). A significant proportion of head and neck cancer patients refused PORT; this was associated with compromised overall survival. Predictive factors for PORT refusal included socioeconomic, demographic, and pathologic variables. Elucidating root causes of refusal may lead to interventions that improve long-term outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Delay and refusal of human papillomavirus vaccine for girls, national immunization survey-teen, 2010.

PubMed

Dorell, Christina; Yankey, David; Jeyarajah, Jenny; Stokley, Shannon; Fisher, Allison; Markowitz, Lauri; Smith, Philip J

2014-03-01

Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine's effectiveness, and believing the vaccine is not needed.

Parental Refusal of Vitamin K and Neonatal Preventive Services: A Need for Surveillance

PubMed Central

Marcewicz, Lauren H.; Clayton, Joshua; Maenner, Matthew; Odom, Erika; Okoroh, Ekwutosi; Christensen, Deborah; Goodman, Alyson; Warren, Michael D.; Traylor, Julie; Miller, Angela; Jones, Timothy; Dunn, John; Schaffner, William; Grant, Althea

2017-01-01

Objectives Vitamin K deficiency bleeding (VKDB) in infants is a coagulopathy preventable with a single dose of injectable vitamin K at birth. The Tennessee Department of Health (TDH) and Centers for Disease Control and Prevention (CDC) investigated vitamin K refusal among parents in 2013 after learning of four cases of VKDB associated with prophylaxis refusal. Methods Chart reviews were conducted at Nashville-area hospitals for 2011–2013 and Tennessee birthing centers for 2013 to identify parents who had refused injectable vitamin K for their infants. Contact information was obtained for parents, and they were surveyed regarding their reasons for refusing. Results At hospitals, 3.0% of infants did not receive injectable vitamin K due to parental refusal in 2013, a frequency higher than in 2011 and 2012. This percentage was much higher at birthing centers, where 31% of infants did not receive injectable vitamin K. The most common responses for refusal were a belief that the injection was unnecessary (53%) and a desire for a natural birthing process (36%). Refusal of other preventive services was common, with 66% of families refusing vitamin K, newborn eye care with erythromycin, and the neonatal dose of hepatitis B vaccine. Conclusions for Practice Refusal of injectable vitamin K was more common among families choosing to give birth at birthing centers than at hospitals, and was related to refusal of other preventive services in our study. Surveillance of vitamin K refusal rates could assist in further understanding this occurrence and tailoring effective strategies for mitigation. PMID:28054156

Gender Differences in Drug Resistance Skills of Youth in Guanajuato, Mexico

PubMed Central

Marsiglia, Flavio F.; Ayers, Stephanie L.; Calderón-Tena, Carlos O.; Nuño-Gutiérrez, Bertha L.

2011-01-01

Research is limited or absent on Mexican adolescents’ exposure to substance offers, ways of dealing with these offers, and possible gender differences in responses to offers. Extending U.S.-based research, this study examines how youth living in the Mexican state of Guanajuato employ the four drug resistance strategies—refuse, explain, avoid, and leave—that are part of the Keepin’ It REAL evidence-based drug prevention intervention. The analysis uses cross-sectional survey data from 702 students enrolled in eight alternative secondary education sites in 2007. Participants reported the drug resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Using multivariate regression, findings indicate most youth had developed repertoires of drug resistance strategies that involved multiple REAL strategies and some other strategy as well. For those receiving offers, the most common strategy was to refuse the offer with a simple ‘‘no.’’ However, males used all the strategies significantly more often than females for situations involving cigarettes and marijuana as well as when using refuse and non-REAL strategies for alcohol. Possible reasons for the gender difference in use of strategies are discussed. The findings can help inform effective prevention programs based on teaching culturally appropriate drug resistance and communication skills. PMID:21424398

Self-concept and adolescents' refusal of unprotected sex: a test of mediating mechanisms among African American girls.

PubMed

Salazar, Laura F; DiClemente, Ralph J; Wingood, Gina M; Crosby, Richard A; Harrington, Kathy; Davies, Susan; Hook, Edward W; Oh, M Kim

2004-09-01

During adolescence, girls form self-concepts that facilitate the transition to adulthood. This process may entail engaging in risky sexual behaviors resulting in STD infection and pregnancy. This study assessed the relation between self-concept and unwanted, unprotected sex refusal among 335 African American adolescent girls. The second aim was to determine whether attributes of partner communication about sex would act as a mediating mechanism on this hypothesized relationship. These assessments were made within the context of several theoretical models (social cognitive theory and theory of gender and power). Self-concept was composed of self-esteem, ethnic identity, and body image, whereas attributes of partner communication about sex was conceptualized as frequency of communication, fear of condom use negotiation, and self-efficacy of condom use negotiation. Structural equation modeling was used to analyze data. The results showed that self-concept was associated with partner communication attributes about sex, which in turn, was associated with frequency of unprotected sex refusal. The hypothesized mediating role of partner communication was also supported. STD-HIV preventive interventions for this population may be more effective if they target self-concept as opposed to only self-esteem, incorporate an Afrocentric approach, and focus on enhancing several attributes of partner communication about sex.

Prostate Cancer Patients' Refusal of Cancer-Directed Surgery: A Statewide Analysis

PubMed Central

Islam, K. M.

2015-01-01

Introduction. Prostate cancer is the most common cancer among men in USA. The surgical outcomes of prostate cancer remain inconsistent. Barriers such as socioeconomic factors may play a role in patients' decision of refusing recommended cancer-directed surgery. Methods. The Nebraska Cancer Registry data was used to calculate the proportion of prostate cancer patients recommended the cancer-directed surgery and the surgery refusal rate. Multivariate logistic regression was applied to analyze the socioeconomic indicators that were related to the refusal of surgery. Results. From 1995 to 2012, 14,876 prostate cancer patients were recommended to undergo the cancer-directed surgery in Nebraska, and 576 of them refused the surgery. The overall refusal rate of surgery was 3.9% over the 18 years. Patients with early-stage prostate cancer were more likely to refuse the surgery. Patients who were Black, single, or covered by Medicaid/Medicare had increased odds of refusing the surgery. Conclusion. Socioeconomic factors were related to the refusal of recommended surgical treatment for prostate cancer. Such barriers should be addressed to improve the utilization of surgical treatment and patients' well-being. PMID:25973276

Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2001-09-01

Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

49 CFR 219.213 - Unlawful refusals; consequences.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Unlawful refusals; consequences. 219.213 Section 219.213 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD... § 219.213 Unlawful refusals; consequences. (a) Disqualification. An employee who refuses to cooperate in...

Children of divorce: the differential diagnosis of contact refusal.

PubMed

Freeman, Bradley W

2011-07-01

Contact refusal is a common phenomenon that can occur during the course of, or after, divorce, which affects the relationship between a child and the parent. This article defines the concept of contact refusal and discusses the importance of its recognition. The concept is further narrowed to focus on the child as the one refusing contact, not the parent, which can happen as well. Various types of contact refusals are illustrated in the article through clinical vignettes, and an approach to categorizing the various types of contact refusal is presented. Copyright © 2011 Elsevier Inc. All rights reserved.

Critical dynamics in population vaccinating behavior.

PubMed

Pananos, A Demetri; Bury, Thomas M; Wang, Clara; Schonfeld, Justin; Mohanty, Sharada P; Nyhan, Brendan; Salathé, Marcel; Bauch, Chris T

2017-12-26

Vaccine refusal can lead to renewed outbreaks of previously eliminated diseases and even delay global eradication. Vaccinating decisions exemplify a complex, coupled system where vaccinating behavior and disease dynamics influence one another. Such systems often exhibit critical phenomena-special dynamics close to a tipping point leading to a new dynamical regime. For instance, critical slowing down (declining rate of recovery from small perturbations) may emerge as a tipping point is approached. Here, we collected and geocoded tweets about measles-mumps-rubella vaccine and classified their sentiment using machine-learning algorithms. We also extracted data on measles-related Google searches. We find critical slowing down in the data at the level of California and the United States in the years before and after the 2014-2015 Disneyland, California measles outbreak. Critical slowing down starts growing appreciably several years before the Disneyland outbreak as vaccine uptake declines and the population approaches the tipping point. However, due to the adaptive nature of coupled behavior-disease systems, the population responds to the outbreak by moving away from the tipping point, causing "critical speeding up" whereby resilience to perturbations increases. A mathematical model of measles transmission and vaccine sentiment predicts the same qualitative patterns in the neighborhood of a tipping point to greatly reduced vaccine uptake and large epidemics. These results support the hypothesis that population vaccinating behavior near the disease elimination threshold is a critical phenomenon. Developing new analytical tools to detect these patterns in digital social data might help us identify populations at heightened risk of widespread vaccine refusal. Copyright © 2017 the Author(s). Published by PNAS.

Electroconvulsive therapy in a patient on chronic hemodialysis.

PubMed

Wille, Phyllis D

2007-01-01

ECT is an effective treatment for patients with the diagnosis of major depression unresponsive to an antidepressant drug regimen, refusal of oral intake, hypokinesia, and suicidal ideation with the need for urgent intervention. A.B. benefited from ECT with an improvement of mood and appetite. Unfortunately, he experienced cognitive deficits, which prevented him from returning to his career as a high school physics teacher, and to this day he continues to live in an extended care facility.

Drug Offers as a Context for Violence Perpetration and Victimization

PubMed Central

Helm, Susana; Okamoto, Scott; Kaliades, Alexis; Giroux, Danielle

2014-01-01

Objective Drug use has been linked empirically with aggression and violence among youth in national and State of Hawai`i samples. However, the nature of this link and its implications for prevention are unclear. Therefore, this paper explores the intersection of drugs with aggression and violence by using the drug offer context as the unit of analysis. Method Native Hawaiian youth are sampled because substance use rates tend to be higher and onset tends to be earlier than their non-Hawaiian peers. Fourteen sex-specific focus group discussions were held with rural Native Hawaiian middle school students (N=64). Students discussed what they thought they would do in terms of drug refusal strategies in a variety of drug offer contexts. Results While aggression and violence were perceived to be socially inappropriate, students nonetheless felt drug use would be less socially competent. Narrative analyses indicated aggression and violence were perceived to function as potential drug refusal strategies. As proximal drug resistance, aggression and violence perpetration served as an immediate deterrent to the drug offerer, and thus drug use. As distal drug resistance, victimization served as a rationale for avoiding drug using contexts. Conclusions Implications are discussed in terms of prevention policy and practice, specifically in terms of a school-based prevention curriculum. Future research in Hawaiian epistemology and gendered approaches are warranted. PMID:24564559

A 9-Year-Old Girl With Persistent Obsessive and Compulsive Behaviors in a Primary Care Pediatric Practice.

PubMed

Gist, Lauren; Mathews, Carol; Williams, Katherine N; Stein, Martin T

Chloe is a 9-year-old gal whose mother made an initial visit to a new pediatrician for concerns about her behavior. Chloe is apprehensive about the visit and frequently hides behind her mother.Her parents first noticed Chloe becoming angry and more emotional 3 years ago, which her parents did not initially understand. However, over the past year, she has started to have more worries and unusual behavior.Chloe and her mother report that when she walks through doorways, she will almost always go back and walks through again. At home, she will walk through doorways multiple times and at school, she will pretend she forgot something so her friends do not notice. She often will not walk downstairs and occasionally her mother has to carry her. Clothes are problematic for Chloe. If her father touches something of a specific color and then touches Chloe, she will have to change her clothes or take a shower. Sometimes, she will never be able to wear those clothes again. She had a recent episode where she could not stop tapping a red paper, because if she stopped, she said it would burst into flame. During the 2 weeks before the pediatric visit, symptoms increased to the point that she is now refusing to go to school. When she stays home, she lays in 1 place all day.Chloe is a fourth grade student. The family does not report academic concerns. She has friends. She denies any appetite or sleep problems. She endorses periods of sadness, lack of energy, and decreased interest in social activities, mostly because she worries and is embarrassed. She kept her behaviors hidden from her 5 siblings for the past year, and she talked only to her mother about them. She is worried her friends might discover her behaviors.The family history is notable for multiple paternal family members with anxiety and bipolar disorder and depression on mother's side. A few months ago, Chloe's family adopted a 7-year-old child with special needs from China.Her growth, vital signs, and physical examination are unremarkable. Her mother filled out the Short Mood and Feelings Questionnaire and the Screen for Child Anxiety-Related Emotional Disorders, which both had elevated scores.

A 9-year-old girl with persistent obsessive and compulsive behaviors in a primary care pediatric practice.

PubMed

Gist, Lauren; Mathews, Carol; Williams, Katherine N; Stein, Martin T

2015-04-01

Chloe is a 9-year-old gal whose mother made an initial visit to a new pediatrician for concerns about her behavior. Chloe is apprehensive about the visit and frequently hides behind her mother.Her parents first noticed Chloe becoming angry and more emotional 3 years ago, which her parents did not initially understand. However, over the past year, she has started to have more worries and unusual behavior.Chloe and her mother report that when she walks through doorways, she will almost always go back and walks through again. At home, she will walk through doorways multiple times and at school, she will pretend she forgot something so her friends do not notice. She often will not walk downstairs and occasionally her mother has to carry her. Clothes are problematic for Chloe. If her father touches something of a specific color and then touches Chloe, she will have to change her clothes or take a shower. Sometimes, she will never be able to wear those clothes again. She had a recent episode where she could not stop tapping a red paper, because if she stopped, she said it would burst into flame. During the 2 weeks before the pediatric visit, symptoms increased to the point that she is now refusing to go to school. When she stays home, she lays in 1 place all day.Chloe is a fourth grade student. The family does not report academic concerns. She has friends. She denies any appetite or sleep problems. She endorses periods of sadness, lack of energy, and decreased interest in social activities, mostly because she worries and is embarrassed. She kept her behaviors hidden from her 5 siblings for the past year, and she talked only to her mother about them. She is worried her friends might discover her behaviors.The family history is notable for multiple paternal family members with anxiety and bipolar disorder and depression on mother's side. A few months ago, Chloe's family adopted a 7-year-old child with special needs from China.Her growth, vital signs, and physical examination are unremarkable. Her mother filled out the Short Mood and Feelings Questionnaire and the Screen for Child Anxiety-Related Emotional Disorders, which both had elevated scores.

Reasons why undergraduate women comply with unwanted, non-coercive sexual advances: A serial indirect effect model integrating sexual script theory and sexual self-control perspectives.

PubMed

Quinn-Nilas, Christopher; Kennett, Deborah J

2018-01-16

This study explored the predictors of young women's compliance with unwanted sexual activities, integrating the social with the cognitive and behavioral correlates of sexual compliance. In total, 222 young heterosexual women completed measures examining the Sexual Self-Control model, including reasons for consenting, sexual resourcefulness, and compliance with unwanted sex, as well as gender role measures pertaining to sexual script theory, including the sexual double standard, gender role stress, and virginity scripts. An exploratory analysis of serial indirect effects demonstrated that women scoring lower in sexual resourcefulness endorsed higher female gender role stress, which in turn was associated with higher endorsement of reasons for consent, translating into more frequent compliance with unwanted sexual activities. The relationship between one's ability to refuse and their decision to refuse appears quite complex. Understanding one's decision requires consideration of the social aspects of gender role endorsement.

Refusal of Medical and Surgical Interventions by Older Persons with Advanced Chronic Disease

PubMed Central

Van Ness, Peter H.; O’Leary, John R.; Fried, Terri R.

2007-01-01

BACKGROUND Patients with advanced chronic disease are frequently offered medical and surgical interventions with potentially large trade-offs between benefits and burdens. Little is known about the frequency or outcomes of treatment refusal among these patients. OBJECTIVE To assess the frequency of, reasons for, factors associated with, and outcomes of treatment refusal among older persons with advanced chronic disease. DESIGN Observational cohort study. PARTICIPANTS Two hundred twenty-six community-dwelling persons with advanced cancer, chronic obstructive pulmonary disease, or congestive heart failure, interviewed at least every 4 months for up to 2 years. MEASUREMENTS Participants were asked if they had refused any treatments recommended by their physicians, and why. RESULTS Thirty-six of 226 patients (16%) reported refusing 1 or more medical or surgical treatments recommended by their physician. The most frequently refused interventions were cardiac catheterization and surgery. The most common reason for refusal was fear of side effects (41%). Treatment refusal was more frequent among patients who wanted prognostic information (10% vs 2%, p = .02) or estimated their own longevity at 2 years or less (18% vs 5%, p = .02). There was an increased risk of mortality among refusers compared with non-refusers (HR 1.98, 95% CI 1.02–3.86). CONCLUSIONS Refusal of medical and surgical interventions other than medications is common among persons with advanced chronic disease, and is associated with a greater desire for, and understanding of, prognostic information. PMID:17483977

The cost of refusing treatment and equality of outcome.

PubMed Central

Savulescu, J

1998-01-01

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care. PMID:9752624

Perceived Quality of Informed Refusal Process: A Cross-Sectional Study from Iranian Patients' Perspectives.

PubMed

Farzandipour, Mehrdad; Sheikhtaheri, Abbas; Sadeqi Jabali, Monireh

2015-12-01

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. © 2014 John Wiley & Sons Ltd.

Refusal of treatment in obstetrics - A maternal-fetal conflict.

PubMed

Ohel, Iris; Iris, Ohel; Levy, Amalia; Amalia, Levy; Mazor, Moshe; Moshe, Mazor; Wiznitzer, Arnon; Arnon, Wiznitzer; Sheiner, Eyal; Eyal, Sheiner

2009-07-01

Clinical studies about the necessity of standard obstetric interventions raise questions, making refusal by pregnant women of treatment a legitimate choice. The present study was aimed at characterising patients refusing medical treatment during pregnancy and delivery, and to examine whether refusal of treatment in obstetrics is associated with adverse perinatal outcome. A population-based study, comparing patients who refused (1898) and did not refuse (164,064) medical intervention during pregnancy and delivery, was conducted. Deliveries occurred between the years 1988 and 2002 in a tertiary medical centre. Patients refusing medical intervention tended to be older (30.5 +/- 5.0 vs. 28.4 +/- 5.9, p < 0.001) and of higher parity (above parity 5: 52.5% vs. 32.4%; parity 1: 10.2% vs. 20.0%; p < 0.001) than the controls. Parturients refusing medical treatment experienced significantly higher rates of adverse perinatal outcome including low Apgar scores (less than 7, in 1 and 5 min: 12.4% vs. 4.4%, p < 0.001 and 1.9% vs. 0.6%, p < 0.001, respectively). Moreover, higher rates of perinatal mortality in general and intra-partum death, in particular, were documented among women refusing medical treatment (3.3% vs. 1.5%, p < 0.001; 0.8% vs. 0.1%, p < 0.001). When using a multiple logistic regression model of risk factors for perinatal mortality, refuse of treatment was an independent risk factor for perinatal mortality (OR = 1.5; 95% CI = 1.1-2.0; p = 0.010). Patients refusing a medically indicated intervention have higher rates of pregnancy- and labour- related complications. Refusal of treatment is an independent risk factor for perinatal mortality.

Central Nervous System Disease, Education, and Race Impact Radiation Refusal in Pediatric Cancer Patients.

PubMed

Patel, Chirayu G; Stavas, Mark; Perkins, Stephanie; Shinohara, Eric T

2017-07-01

To investigate the determinants of radiation therapy refusal in pediatric cancer, we used the Surveillance, Epidemiology, and End Results registry to identify 24,421 patients who met the eligibility criteria, diagnosed between 1974 and 2012. Patients had any stage of cancer, were aged 0 to 19, and received radiation therapy or refused radiation therapy when it was recommended. One hundred twenty-eight patients (0.52%) refused radiation therapy when it was recommended. Thirty-two percent of patients who refused radiation therapy ultimately died from their cancer, at a median of 7 months after diagnosis (95% confidence interval, 3-11 mo), as compared with 29.0% of patients who did not refuse radiation therapy died from their cancer, at a median of 17 months after diagnosis (95% confidence interval, 17-18 mo). On multivariable analysis, central nervous system (CNS) site, education, and race were associated with radiation refusal. The odds ratio for radiation refusal for patients with CNS disease was 1.62 (P=0.009) as compared with patients without CNS disease. For patients living in a county with ≥10% residents having less than ninth grade education, the odds ratio for radiation refusal was 1.71 (P=0.008) as compared with patients living in a county with <10% residents having less than ninth grade education. Asian, Pacific Islander, Alaska Native, and American Indian races had an odds ratio of 2.12 (P=0.002) for radiation refusal as compared with black or white race. Although the radiation refusal rate in the pediatric cancer population is low, we show that CNS site, education level, and race are associated with a significant difference in radiation refusal.

A girl with tuberous sclerosis complex presenting with severe epilepsy and electrical status epilepticus during sleep, and with high-functioning autism and mutism.

PubMed

Pacheva, Iliyana; Panov, Georgi; Gillberg, Christopher; Neville, Brian

2014-06-01

Most patients with tuberous sclerosis complex (TSC) suffer from epilepsy, and many have cognitive and behavioral problems like severe intellectual disability, autism, and hyperactivity. Only rare patients with TSC and autism have a normal intelligence quotient. We report a 13-year-old girl with definite TSC who had early-onset severe epilepsy, autistic behavior, and moderate developmental delay. By school age, however, she had normal intelligence; her intelligence quotient was at least 70 based on a Stanford-Binet test that she refused to complete. She showed good reading, writing, and language comprehension skills, and the special abilities of hyperlexia, hypermnesia, and hypercalculia. However, she did not speak. Criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and her Childhood Autism Rating Scale score of 36 indicated mild to moderate autism. She had severe electroencephalographic abnormalities: hypsarrhythmia, multifocal or generalized epileptiform discharges, and electrical status epilepticus during sleep, with a continuous left temporal focus. Magnetic resonance imaging showed many cortical tubers in all brain lobes, and subependymal nodules. We discuss possible explanations for her lack of speech. Considered as speech apraxia, her mutism could be either a symptom of her TSC or a component of her autism. Another possibility is that long-lasting electrical status epilepticus during sleep led to her autistic behavior and language arrest. Still another possibility is that a disinhibited mammalian target of rapamycin (mTOR) pathway was at the root of all of her neuropsychiatric symptoms.

Refusal of curative radiation therapy and surgery among patients with cancer.

PubMed

Aizer, Ayal A; Chen, Ming-Hui; Parekh, Arti; Choueiri, Toni K; Hoffman, Karen E; Kim, Simon P; Martin, Neil E; Hu, Jim C; Trinh, Quoc-Dien; Nguyen, Paul L

2014-07-15

Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008. Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life-saving care. Copyright © 2014 Elsevier Inc. All rights reserved.

Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aizer, Ayal A., E-mail: aaaizer@partners.org; Chen, Ming-Hui; Parekh, Arti

Purpose: Surgery and radiation therapy represent the only curative options for many patients with solid malignancies. However, despite the recommendations of their physicians, some patients refuse these therapies. This study characterized factors associated with refusal of surgical or radiation therapy as well as the impact of refusal of recommended therapy on patients with localized malignancies. Methods and Materials: We used the Surveillance, Epidemiology, and End Results program to identify a population-based sample of 925,127 patients who had diagnoses of 1 of 8 common malignancies for which surgery and/or radiation are believed to confer a survival benefit between 1995 and 2008.more » Refusal of oncologic therapy, as documented in the SEER database, was the primary outcome measure. Multivariable logistic regression was used to investigate factors associated with refusal. The impact of refusal of therapy on cancer-specific mortality was assessed with Fine and Gray's competing risks regression. Results: In total, 2441 of 692,938 patients (0.4%) refused surgery, and 2113 of 232,189 patients (0.9%) refused radiation, despite the recommendations of their physicians. On multivariable analysis, advancing age, decreasing annual income, nonwhite race, and unmarried status were associated with refusal of surgery, whereas advancing age, decreasing annual income, Asian American race, and unmarried status were associated with refusal of radiation (P<.001 in all cases). Refusal of surgery and radiation were associated with increased estimates of cancer-specific mortality for all malignancies evaluated (hazard ratio [HR], 2.80, 95% confidence interval [CI], 2.59-3.03; P<.001 and HR 1.97 [95% CI, 1.78-2.18]; P<.001, respectively). Conclusions: Nonwhite, less affluent, and unmarried patients are more likely to refuse curative surgical and/or radiation-based oncologic therapy, raising concern that socioeconomic factors may drive some patients to forego potentially life-saving care.« less

The Secret Drama at the Patient's Bedside-Refusal of Treatment Because of the Practitioner's Ethnic Identity: The Medical Staff 's Point of View.

PubMed

Popper-Giveon, Ariela; Keshet, Yael

2018-04-01

Patients' refusal of treatment based on the practitioner's ethnic identity reveals a clash of values: neutrality in medicine versus patient-centered care. Taking the Israeli-Palestinian conflict into account, this article aims at examining Israeli health care professionals' points of view concerning patients' refusal of treatment because of a practitioner's ethnic identity. Fifty in-depth interviews were conducted with 10 managers and 40 health care professionals, Jewish and Arab, employed at 11 public hospitals. Most refusal incidents recorded are unidirectional: Jewish patients refusing to be treated by Arab practitioners. Refusals are usually directed toward nurses and junior medical staff members, especially if recognizable as religious Muslims. Refusals are often initiated by the patients' relatives and occur more frequently during periods of escalation in the conflict. The structural competency approach can be applied to increase awareness of the role of social determinants in shaping patients' ethnic-based treatment refusals and to improve the handling of such incidents.

Immunofluorescence Approach to the Study of the Ecology of Thermoplasma acidophilum In Coal Refuse Material

PubMed Central

Bohlool, B. B.; Brock, T. D.

1974-01-01

Specific immunofluorescence staining was applied to the study of the localization, distribution, and growth of Thermoplasma acidophilum in its natural habitat, the coal refuse pile. Different antigenic groups of T. acidophilum could be isolated from the same refuse pile, and the same antigenic groups were isolated from piles from different geographical areas. No correlation could be established between the antigenic groups and the pH or temperature of the habitats. Brightly fluorescing cells of T. acidophilum were detected on microscope slides buried in contact with the coal refuse material or immersed in the water in the stream draining a refuse pile. T. acidophilum grew when inoculated into either coal refuse material and/or an aqueous extract of coal refuse when incubated at its optimal temperature of 55 C, but not when incubated at room temperature or 37 C. The coal refuse pile appears to be a primary habitat for T. acidophilum. PMID:4602306

A plea for uniform European definitions for organ donor potential and family refusal rates.

PubMed

Jansen, Nichon E; Haase-Kromwijk, Bernadette J J M; van Leiden, Hendrik A; Weimar, Willem; Hoitsma, Andries J

2009-11-01

Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of donor potential and refusal rates for organ donation in intensive care units. We found 14 articles pertinent to this study. There is an enormous diversity among the performed studies. The definitions of potential organ donors and family refusal differed substantially. We tried to re-calculate the refusal rates. This method failed because of the influence caused by the registered will on donation in the Donor Register. We therefore calculated the total refusal rate. This strategy was also less satisfactory considering possible influence of the legal consent system on the approach of family. Because of lack of uniform definitions, we can conclude that the refusal rates for organ donation can not be used for a sound comparison among countries. To be able to learn from well-performing countries, it is necessary to establish uniform definitions regarding organ donation and registration of all intensive care deaths.

Influenza vaccine refusal in Israeli young adults.

PubMed

Balicer, Ran D; Grotto, Itamar; Huerta, Michael; Levian, Yardena; Davidovitch, Nadav

2007-10-01

The purpose of this study was to identify correlates of noncompliance with influenza immunization among young adults and to determine the reasons leading to immunization refusal. Self-administered questionnaires were distributed in 10 military bases during two consecutive annual Israel Defense Force influenza vaccination campaigns. Multivariate logistic regression was performed to identify independent correlates. Of 2,000 questionnaires distributed over two seasons, 942 were completed and returned. Of those, 401 respondents were not vaccinated either because of medical contraindication or for administrative reasons. The remaining 541 respondents who reported either receiving the vaccine or refusing to receive it were analyzed. Risk groups for vaccine refusal included older age (17.9% vs. 3.5% refusal rate) and officer rank (25.9% vs. 13.8% refusal rate). The main reasons for vaccine refusal differed significantly between officers and nonofficers (chi2 = 7.587, p = 0.023). Officers refused mainly (60%) because of fear of possible vaccine adverse effects, whereas nonofficers refused mainly (44.2%) because of disbelief in the vaccine's efficacy in preventing illness. Officers serve as a negative role model in this case, and efforts directed toward dissemination of evidence-based information regarding vaccine-related adverse effects should be introduced to increase vaccination rates in this group.

Outcomes of nighttime refusal of admission to the intensive care unit: The role of the intensivist in triage.

PubMed

Hinds, Nicholas; Borah, Amit; Yoo, Erika J

2017-06-01

To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. Retrospective, observational study of patients refused MICU admission at an urban university hospital. Of 294 patients, 186 (63.3%) were refused admission overnight compared to 108 (36.7%) refused during the day. Severity-of-illness by the Mortality Probability Model was similar between the two groups (P=.20). Daytime triage refusals were more likely to be staffed by an intensivist (P=.01). After risk-adjustment, daytime refusals had a lower odds of subsequent ICU admission (OR 0.46, 95% CI 0.22-0.95, P=.04) than patients triaged at night. There was no evidence for interaction between time of triage and intensivist staffing of the patient (P=.99). Patients refused MICU admission overnight are more likely to be later admitted to an ICU than patients refused during the day. However, the mechanism for this observation does not appear to depend on the intensivist's direct evaluation of the patient. Further investigation into the clinician-specific effects of ICU triage and identification of potentially modifiable hospital triage practices will help to improve both ICU utilization and patient safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Physicians' evaluations of patients' decisions to refuse oncological treatment

PubMed Central

van Kleffens, T; van Leeuwen, E

2005-01-01

Objective: To gain insight into the standards of rationality that physicians use when evaluating patients' treatment refusals. Design of the study: Qualitative design with indepth interviews. Participants: The study sample included 30 patients with cancer and 16 physicians (oncologists and general practitioners). All patients had refused a recommended oncological treatment. Results: Patients base their treatment refusals mainly on personal values and/or experience. Physicians mainly emphasise the medical perspective when evaluating patients' treatment refusals. From a medical perspective, a patient's treatment refusal based on personal values and experience is generally evaluated as irrational and difficult to accept, especially when it concerns a curative treatment. Physicians have a different attitude towards non-curative treatments and have less difficulty accepting a patient's refusal of these treatments. Thus, an important factor in the physician's evaluation of a treatment refusal is whether the treatment refused is curative or non-curative. Conclusion: Physicians mainly use goal oriented and patients mainly value oriented rationality, but in the case of non-curative treatment refusal, physicians give more emphasis to value oriented rationality. A consensus between the value oriented approaches of patient and physician may then emerge, leading to the patient's decision being understood and accepted by the physician. The physician's acceptance is crucial to his or her attitude towards the patient. It contributes to the patient's feeling free to decide, and being understood and respected, and thus to a better physician–patient relationship. PMID:15738431

Refusal of Vitamin K by Parents of Newborns: A Survey of the Better Outcomes Through Research for Newborns Network

PubMed Central

Loyal, Jaspreet; Taylor, James A.; Phillipi, Carrie A.; Goyal, Neera K.; Dhepyasuwan, Niramol; Shapiro, Eugene D.; Colson, Eve

2018-01-01

Objective To survey newborn clinicians in the United States regarding the frequency of intramuscular (IM) vitamin K refusal by a parent, reasons for refusal, and approaches of clinicians to refusals. Methods An electronic survey was administered to the clinician site representative (nursery director or designee knowledgeable about site-specific nursery policies) at all newborn nurseries in the Better Outcomes through Research for Newborns (BORN) network of newborn nurseries. Results Of 92 BORN sites, 85 (92%) respondents completed the survey. Frequency of IM vitamin K refusal during the past 5 years was reported as increased by 52% of respondents, unchanged by 42%, and 6% did not know. Reported frequencies of refusal of IM vitamin K was weekly (9%), a few times a month (31%), once a month (13%), once every 3 to 4 months (20%), once or twice a year (26%), or never (1%). The overall distribution of the reported frequencies of refusal differed among regions in the United States (higher in the West and the South; P < .05). Reported reasons for refusal by parents included perceptions of parents that the injection was unnecessary, lack of knowledge about vitamin K deficiency bleeding, and concern about preservatives. Approaches to refusal included attempts to educate parents, enlisting support from community clinicians, a state mandate, and prescription of oral vitamin K. Conclusions Respondents from a national sample of newborn nursery clinicians reported an increase in refusal of IM vitamin K in the past 5 years with regional variation. Approaches to refusals need further investigation to determine effectiveness. PMID:28277269

30 CFR 77.215-1 - Refuse piles; identification.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; identification. 77.215-1 Section... COAL MINES Surface Installations § 77.215-1 Refuse piles; identification. A permanent identification marker, at least six feet high and showing the refuse pile identification number as assigned by the...

76 FR 29796 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Refuse...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-23

... for OMB Review; Comment Request; Refuse Piles and Impounding Structures, Recordkeeping and Reporting... Administration (MSHA) sponsored information collection request (ICR) titled, ``Refuse Piles and Impounding... to submit annual reports and certification on refuse piles and impoundments to the agency and to keep...

21 CFR 316.14 - Refusal to provide written recommendations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Refusal to provide written recommendations. 316.14... (CONTINUED) DRUGS FOR HUMAN USE ORPHAN DRUGS Written Recommendations for Investigations of Orphan Drugs § 316.14 Refusal to provide written recommendations. (a) FDA may refuse to provide written recommendations...

37 CFR 1.295 - Review of decision finally refusing to publish a statutory invention registration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... refusing to publish a statutory invention registration. 1.295 Section 1.295 Patents, Trademarks, and... decision finally refusing to publish a statutory invention registration. (a) Any requester who is dissatisfied with the final refusal to publish a statutory invention registration for reasons other than...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 42.81 - Procedure in refusing individual visas.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Procedure in refusing individual visas. 42.81 Section 42.81 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF IMMIGRANTS UNDER THE... Procedure in refusing individual visas. (a) Issuance or refusal mandatory. When a visa application has been...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

22 CFR 41.121 - Refusal of individual visas.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Refusal of individual visas. 41.121 Section 41.121 Foreign Relations DEPARTMENT OF STATE VISAS VISAS: DOCUMENTATION OF NONIMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED Refusals and Revocations § 41.121 Refusal of individual visas. (a...

9 CFR 439.50 - Refusal of accreditation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ACCREDITATION OF NON-FEDERAL CHEMISTRY LABORATORIES § 439.50 Refusal of accreditation. Upon a determination by the Administrator, a laboratory will be refused accreditation for the following reasons: (a) A laboratory will be refused accreditation for failure to meet the requirements of § 439.5 or § 439.10 of this...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

42 CFR 493.567 - Refusal to cooperate with validation inspection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Refusal to cooperate with validation inspection... § 493.567 Refusal to cooperate with validation inspection. (a) Laboratory with a certificate of accreditation. (1) A laboratory with a certificate of accreditation that refuses to cooperate with a validation...

Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries.

PubMed

LaMontagne, D Scott; Barge, Sandhya; Le, Nga Thi; Mugisha, Emmanuel; Penny, Mary E; Gandhi, Sanjay; Janmohamed, Amynah; Kumakech, Edward; Mosqueira, N Rocio; Nguyen, Nghi Quy; Paul, Proma; Tang, Yuxiao; Minh, Tran Hung; Uttekar, Bella Patel; Jumaan, Aisha O

2011-11-01

To assess human papillomavirus (HPV) vaccination coverage after demonstration projects conducted in India, Peru, Uganda and Viet Nam by PATH and national governments and to explore the reasons for vaccine acceptance or refusal. Vaccines were delivered through schools or health centres or in combination with other health interventions, and either monthly or through campaigns at fixed time points. Using a two-stage cluster sample design, the authors selected households in demonstration project areas and interviewed over 7000 parents or guardians of adolescent girls to assess coverage and acceptability. They defined full vaccination as the receipt of all three vaccine doses and used an open-ended question to explore acceptability. Vaccination coverage in school-based programmes was 82.6% (95% confidence interval, CI: 79.3-85.6) in Peru, 88.9% (95% CI: 84.7-92.4) in 2009 in Uganda and 96.1% (95% CI: 93.0-97.8) in 2009 in Viet Nam. In India, a campaign approach achieved 77.2% (95% CI: 72.4-81.6) to 87.8% (95% CI: 84.3-91.3) coverage, whereas monthly delivery achieved 68.4% (95% CI: 63.4-73.4) to 83.3% (95% CI: 79.3-87.3) coverage. More than two thirds of respondents gave as reasons for accepting the HPV vaccine that: (i) it protects against cervical cancer; (ii) it prevents disease, or (iii) vaccines are good. Refusal was more often driven by programmatic considerations (e.g. school absenteeism) than by opposition to the vaccine. High coverage with HPV vaccine among young adolescent girls was achieved through various delivery strategies in the developing countries studied. Reinforcing positive motivators for vaccine acceptance is likely to facilitate uptake.

Human papillomavirus vaccine delivery strategies that achieved high coverage in low- and middle-income countries

PubMed Central

Barge, Sandhya; Le, Nga Thi; Mugisha, Emmanuel; Penny, Mary E; Gandhi, Sanjay; Janmohamed, Amynah; Kumakech, Edward; Mosqueira, N Rocio; Nguyen, Nghi Quy; Paul, Proma; Tang, Yuxiao; Minh, Tran Hung; Uttekar, Bella Patel; Jumaan, Aisha O

2011-01-01

Abstract Objective To assess human papillomavirus (HPV) vaccination coverage after demonstration projects conducted in India, Peru, Uganda and Viet Nam by PATH and national governments and to explore the reasons for vaccine acceptance or refusal. Methods Vaccines were delivered through schools or health centres or in combination with other health interventions, and either monthly or through campaigns at fixed time points. Using a two-stage cluster sample design, the authors selected households in demonstration project areas and interviewed over 7000 parents or guardians of adolescent girls to assess coverage and acceptability. They defined full vaccination as the receipt of all three vaccine doses and used an open-ended question to explore acceptability. Findings Vaccination coverage in school-based programmes was 82.6% (95% confidence interval, CI: 79.3–85.6) in Peru, 88.9% (95% CI: 84.7–92.4) in 2009 in Uganda and 96.1% (95% CI: 93.0–97.8) in 2009 in Viet Nam. In India, a campaign approach achieved 77.2% (95% CI: 72.4–81.6) to 87.8% (95% CI: 84.3–91.3) coverage, whereas monthly delivery achieved 68.4% (95% CI: 63.4–73.4) to 83.3% (95% CI: 79.3–87.3) coverage. More than two thirds of respondents gave as reasons for accepting the HPV vaccine that: (i) it protects against cervical cancer; (ii) it prevents disease, or (iii) vaccines are good. Refusal was more often driven by programmatic considerations (e.g. school absenteeism) than by opposition to the vaccine. Conclusion High coverage with HPV vaccine among young adolescent girls was achieved through various delivery strategies in the developing countries studied. Reinforcing positive motivators for vaccine acceptance is likely to facilitate uptake. PMID:22084528

On Chomsky's Appraisal of Skinner's Verbal Behavior: A Half Century of Misunderstanding

PubMed Central

Palmer, David C

2006-01-01

The history of the writing of Verbal Behavior (Skinner, 1957), Chomsky's review (1959), and MacCorquodale's rebuttal (1970) are briefly summarized. Chomsky's recent reflections on his review are analyzed: Chomsky's refusal to acknowledge the review's errors or its aggressive tone is consistent with his polemical style but comes at a minor cost in consistency and plausibility. However, his remarks about the place of Skinner's work in science reveal misunderstandings so great that they undercut the credibility of the review substantially. The gradual growth in the influence of Skinner's book suggests that its legacy will endure. PMID:22478467

Cognitive Therapy of Obsessive Compulsive Disorder with Chronic Tic Disorder

PubMed Central

Hebbar, Sudhir

2013-01-01

The gold standard of therapy for obsessive compulsive disorder, exposure with response prevention, may not be suitable to obsessional sub-type. Live exposure is not possible and response prevention is difficult. These obsessions (sexual, religious or aggressive) are repugnant and resisted. Negative attitude against obsessions leads to treatment refusal or dropout from therapy. In Cognitive therapy (CT) these attitudes can be corrected and exposure can be administered in the form of behavioral experiments (using behavioral tasks to change the dysfunctional attitudes). Such a case is treated with CT, weaned off medications and remains improved at 9 months. PMID:23833351

Attention-Deficit/Hyperactivity Disorder-Related Impulsivity and Cyberbullying in Social Media.

PubMed

Reilly, Marie; Fogler, Jason; Selkie, Ellen; Augustyn, Marilyn

2016-01-01

Sarah is a 13-year-old eighth grader who was recently diagnosed for the first time with attention-deficit/hyperactivity disorder (ADHD)-inattentive type, and the family elected to treat her with behavioral interventions to help her organization and attention. She had struggled with distractibility and disorganization since the fourth grade. At home, Sarah's mother described her as "spacey" and unable to complete the morning routine without constant supervision. Over time, her mother observed that it seemed as if Sarah had given up on school.As Sarah became an adolescent, her self-esteem suffered because of her academic struggles, and she placed increasing emphasis on her appearance, including focus on remaining thin and refusing to leave the house without makeup. It was in this context that Sarah recently posted photographs of herself in various stages of undress and/or drinking alcohol on Snapchat, a photograph-sharing application in which users can send "snaps"-photographs that disappear soon after opening. However, snap recipients can take a screenshot or photograph of the snap, thereby saving the image. For unknown reasons, Sarah's close female friend took screenshots of these provocative photographs and sent them to their classmates and Sarah's older brother.Sarah's family contacted the police and has been working with her school to address this incident. This experience resulted in significant family stress and distrust of Sarah. For example, her mother took away her cell phone and laptop and has "grounded her" for a month from all out of school activities.Sarah's family seeks guidance regarding teaching Sarah about using social media responsibly and preventing this from happening again. Sarah's mom comes to your urgent care session asking for help because she does not feel that Sarah has "learned her lesson." What would you do next?

Method of extracting coal from a coal refuse pile

DOEpatents

Yavorsky, Paul M.

1991-01-01

A method of extracting coal from a coal refuse pile comprises soaking the coal refuse pile with an aqueous alkali solution and distributing an oxygen-containing gas throughout the coal refuse pile for a time period sufficient to effect oxidation of coal contained in the coal refuse pile. The method further comprises leaching the coal refuse pile with an aqueous alkali solution to solubilize and extract the oxidized coal as alkali salts of humic acids and collecting the resulting solution containing the alkali salts of humic acids. Calcium hydroxide may be added to the solution of alkali salts of humic acid to form precipitated humates useable as a low-ash, low-sulfur solid fuel.

Informal medicine: ethical analysis

PubMed Central

Leavitt, F; Peleg, R; Peleg, A

2005-01-01

Context: Doctors have been known to treat or give consultation to patients informally, with none of the usual record keeping or follow up. They may wish to know whether this practice is ethical. Objective: To determine whether this practice meets criteria of medical ethics. Design: Informal medicine is analysed according to standard ethical principles: autonomy, beneficence and non-maleficence, distributive and procedural justice, and caring. Setting: Hospital, medical school, and other settings where patients may turn to physicians for informal help. Conclusion: No generalisation can be made to the effect that informal medicine is or is not ethical. Each request for informal consultation must be considered on its own merits. Guidelines: Informal medicine may be ethical if no payment is involved, and when the patient is fully aware of the benefits and risks of a lack of record keeping. When an informal consultation does not entail any danger to the patient or others, the physician may agree to the request. If, however, any danger to the patient or others is foreseen, then the physician must insist on professional autonomy, and consider refusing the request and persuading the patient to accept formal consultation. If a reportable infectious disease, or other serious danger to the community, is involved, the physician should refuse informal consultation or treatment, or at least make a proper report even if the consultation was informal. If agreeing to the request will result in an unfair drain on the physician's time or energy, he or she should refuse politely. PMID:16319228

The Space Station integrated refuse management system

NASA Technical Reports Server (NTRS)

1988-01-01

The University of Central Florida's design of an Integrated Refuse Management System for the proposed International Space Station is addressed. Four integratable subsystems capable of handling an estimated Orbiter shortfall of nearly 40,000 lbs of refuse produced annually are discussed. The subsystems investigated were: (1) collection and transfer; (2) recycle and reuse; (3) advanced disposal; and (4) propulsion assist in disposal. Emphasis is placed on the recycling or reuse of those materials ultimately providing a source of Space Station refuse. Special consideration is given to various disposal methods capable of completely removing refuse from close proximity of the Space Station. There is evidence that pyrolysis is the optimal solution for disposal of refuse through employment of a Rocket Jettison Vehicle. Additionally, design considerations and specifications of the Refuse Management System are discussed. Optimal and alternate design solutions for each of the four subsystems are summarized. Finally, the system configuration is described and reviewed.

Parental Vaccine Acceptance: A Logistic Regression Model Using Previsit Decisions.

PubMed

Lee, Sara; Riley-Behringer, Maureen; Rose, Jeanmarie C; Meropol, Sharon B; Lazebnik, Rina

2017-07-01

This study explores how parents' intentions regarding vaccination prior to their children's visit were associated with actual vaccine acceptance. A convenience sample of parents accompanying 6-week-old to 17-year-old children completed a written survey at 2 pediatric practices. Using hierarchical logistic regression, for hospital-based participants (n = 216), vaccine refusal history ( P < .01) and vaccine decision made before the visit ( P < .05) explained 87% of vaccine refusals. In community-based participants (n = 100), vaccine refusal history ( P < .01) explained 81% of refusals. Over 1 in 5 parents changed their minds about vaccination during the visit. Thirty parents who were previous vaccine refusers accepted current vaccines, and 37 who had intended not to vaccinate choose vaccination. Twenty-nine parents without a refusal history declined vaccines, and 32 who did not intend to refuse before the visit declined vaccination. Future research should identify key factors to nudge parent decision making in favor of vaccination.

30 CFR 77.215-2 - Refuse piles; reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; reporting requirements. 77.215-2... COAL MINES Surface Installations § 77.215-2 Refuse piles; reporting requirements. (a) The proposed location of a new refuse pile shall be reported to and acknowledged in writing by the District Manager...

30 CFR 77.214 - Refuse piles; general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuse piles; general. 77.214 Section 77.214... Installations § 77.214 Refuse piles; general. (a) Refuse piles constructed on or after July 1, 1971, shall be..., tipples, or other surface installations and such piles shall not be located over abandoned openings or...

38 CFR 17.100 - Refusal of treatment by unnecessarily breaking appointments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Refusal of treatment by... VETERANS AFFAIRS MEDICAL Breaking Appointments § 17.100 Refusal of treatment by unnecessarily breaking... informed that breaking an additional appointment will be deemed to be a refusal to accept VA treatment. If...

Alternative Fuels Data Center: Renewable Natural Gas From Landfill Powers

Science.gov Websites

Refuse Vehicles Renewable Natural Gas From Landfill Powers Refuse Vehicles to someone by E-mail Share Alternative Fuels Data Center: Renewable Natural Gas From Landfill Powers Refuse Vehicles on Facebook Tweet about Alternative Fuels Data Center: Renewable Natural Gas From Landfill Powers Refuse

22 CFR 40.6 - Basis for refusal.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Basis for refusal. 40.6 Section 40.6 Foreign Relations DEPARTMENT OF STATE VISAS REGULATIONS PERTAINING TO BOTH NONIMMIGRANTS AND IMMIGRANTS UNDER THE IMMIGRATION AND NATIONALITY ACT, AS AMENDED General Provisions § 40.6 Basis for refusal. A visa can be refused...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

9 CFR 98.9 - Embryos refused entry.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Embryos refused entry. 98.9 Section 98... EMBRYOS AND ANIMAL SEMEN Ruminant and Swine Embryos from Regions Free of Rinderpest and Foot-and-Mouth Disease; and Embryos of Horses and Asses § 98.9 Embryos refused entry. Any embryo refused entry into the...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

21 CFR 211.50 - Sewage and refuse.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Sewage and refuse. 211.50 Section 211.50 Food and... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Buildings and Facilities § 211.50 Sewage and refuse. Sewage, trash, and other refuse in and from the building and immediate premises shall be...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

25 CFR 135.6 - Refusal of water delivery.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Refusal of water delivery. 135.6 Section 135.6 Indians... INDIAN IRRIGATION PROJECT Charges Assessed Against Irrigation District Lands § 135.6 Refusal of water delivery. The right is reserved to the United States to refuse the delivery of water to each of the said...

25 CFR 135.23 - Refusal of water delivery.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true Refusal of water delivery. 135.23 Section 135.23 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CONSTRUCTION ASSESSMENTS, CROW... District § 135.23 Refusal of water delivery. The right is reserved to refuse the delivery of water to any...

Refusal Skill Ability: An Examination of Adolescent Perceptions of Effectiveness

ERIC Educational Resources Information Center

Nichols, Tracy R.; Birnel, Sara; Graber, Julia A.; Brooks-Gunn, Jeanne; Botvin, Gilbert J.

2010-01-01

This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays (N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the…

Social Skills, Competence, and Drug Refusal Efficacy as Predictors of Adolescent Alcohol Use.

ERIC Educational Resources Information Center

Scheier, Lawrence M.; Botvin, Gilbert J.; Diaz, Tracy; Griffin, Kenneth W.

1999-01-01

Examines the extent to which assertiveness and related social skills, personal competence, and refusal efficacy predict alcohol involvement in adolescents. Males were at higher risk for poor refusal skills and reported higher alcohol involvement. Youth characterized by poor social skill development reported lower refusal efficacy, lower grades,…

Miami-Dade County Hydraulic Hybrid Refuse Truck Testing | Transportation

Science.gov Websites

Research | NREL Miami-Dade County Hydraulic Hybrid Refuse Truck Evaluation Miami-Dade County Hydraulic Hybrid Refuse Truck Evaluation Photo of garbage truck with view of lake and city in background. As hydraulic hybrid refuse vehicles, with 29 more on order. Photo courtesy of Parker Hannifin NREL is

Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in

Science.gov Websites

Refuse Collection Hydraulic Hybrid Pressed into Service in Refuse Collection to someone by E -mail Share Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in Refuse Collection on Facebook Tweet about Alternative Fuels Data Center: Hydraulic Hybrid Pressed into Service in Refuse

Persian Speakers' Use of Refusal Strategies across Politeness Systems

ERIC Educational Resources Information Center

Salmani Nodoushan, Mohammad Ali

2016-01-01

This study aimed at investigating the preferred refusal strategies in Persian. 3047 refusals collected by 108 field workers as well as 376 refusals collected through face to face interviews were analyzed and classified according to the descriptions proposed by Liao (1994) and Liao and Bresnahan (1996). The frequencies of the resulting direct and…

Recycling of aged refuse from a closed landfill.

PubMed

Zhao, Youcai; Song, Liyan; Huang, Renhua; Song, Lijie; Li, Xiong

2007-04-01

In this study, refuse excavated from a typical refuse landfill in Shanghai after 8-10 years of placement was characterized in terms of particle size, total nitrogen, total phosphorus, and biodegradable matter. The refuse contained a large and diverse population of micro-organisms with a high capacity for decomposing refractory organic matter present in some wastewaters, including leachate. It was found that the aged refuse was quite stable after about a decade of decomposition in the warm, humid climate of southern China. The fine fractions resembled and had the properties of black soil, a medium that is suitable for green construction, organic fertilizer, or as bioreactor media for biological treatment of organic wastewaters. Excavation of the aged refuse would make about 50% of the space available for fresh refuse. The plastics, glass, textiles, and cans can be readily mechanically separated and recycled after cleaning. It is estimated that at least 200 millions tonnes of such aged refuse are available in China alone, and at least 10 times that much is buried worldwide. Hence, the evaluation of mined landfill waste and consideration of its potential uses is of great significance.

What happens after a request for euthanasia is refused? Qualitative interviews with patients, relatives and physicians.

PubMed

Pasman, H Roeline W; Willems, Dick L; Onwuteaka-Philipsen, Bregje D

2013-09-01

Obtaining in-depth information from both patient and physician perspectives about what happens after a request for euthanasia or physician-assisted suicide (EAS) is refused. In-depth interviews with nine patients whose EAS request was refused and seven physicians of these patients, and with three relatives of patients who had died after a request was refused and four physicians of these patients. Interviews were conducted at least 6 months after the refusal. A wish to die remained in all patients after refusal, although it sometimes diminished. In most cases patient and physician stopped discussing this wish, and none of the physicians had discussed plans for the future with the patient or evaluated the patient's situation after their refusal. Physicians were aware of patients' continued wish to die. Patients who are refused EAS may subsequently be silent about a wish to die without abandoning it. Open communication about wishes to die is important, even outside the context of EAS, because if people feel unable to talk about them, their quality of life may be further diminished. Follow up appointments after refusal could give patients the opportunity to discuss their feelings and physicians to support them. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Clinical practice guidelines of the French Association for Supportive Care in Cancer and the French Society for Psycho-oncology: refusal of treatment by adults afflicted with cancer.

PubMed

Faivre, J C; Adam, V; Block, V; Metzger, M; Salleron, J; Dauchy, S

2017-11-01

The study's purpose was to develop practical guidelines for assessment and management of refusal of treatment by adults afflicted with cancer. The French Association for Supportive Care in Cancer and the French Society for Psycho-oncology gathered a task force that applied a consensus methodology to draft guidelines studied predisposing situations, the diagnosis, regulatory aspects, and the management of refusal of treatment by adults afflicted with cancer. We propose five guidelines: (1) be aware of the conditions/profiles of patients most often associated with refusal of treatment so as to adequately underpin the care and support measures; (2) understand the complexity of the process of refusal and knowing how to accurately identify the type and the modalities of the refused treatments; (3) apply a way to systematically analyze refusal, thereby promoting progression from a situation of disaccord toward a consensual decision; (4) devise procedures, according to the legal context, to address refusal of treatment that safeguards the stakeholders in situations of sustained disaccord; and (5) know the indications for ethical collective decision-making. The quality of the relationship between patients and health professionals, and the communication between them are essential components involved in reaching a point of consent or refusal of treatment. A process of systematic analysis of refusal is recommended as the only way to ensure that all of the physiological, psychological, and contextual elements that are potentially involved are taken into account.

A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children.

PubMed

Hubbard, Kristie L; Anderson, Sarah E; Curtin, Carol; Must, Aviva; Bandini, Linda G

2014-12-01

Parents of children with autism spectrum disorder (ASD) frequently report child food refusal based on characteristics of food. Our study sought to determine whether parent report of food refusal based on the characteristics of food was greater in children with ASD than in typically developing children, associated with a greater percentage of foods refused of those offered, and associated with fruit and vegetable intake. A modified food frequency questionnaire was used to determine overall food refusal as well as fruit and vegetable intake. Parent-reported food refusal related to characteristics of food (eg, texture/consistency, temperature, brand, color, shape, taste/smell, foods mixed together, or foods touching other foods) was compared between 53 children with ASD and 58 typically developing children aged 3 to 11 years in the Children's Activity and Meal Patterns Study (2007-2008). Children with ASD were significantly more likely to refuse foods based on texture/consistency (77.4% vs 36.2%), taste/smell (49.1% vs 5.2%), mixtures (45.3% vs 25.9%), brand (15.1% vs 1.7%), and shape (11.3% vs 1.7%). No differences between groups were found for food refusal based on temperature, foods touching other foods, or color. Irrespective of ASD status, the percentage of foods refused of those offered was associated with parent reports of food refusal based on all characteristics examined, except temperature. Food refusal based on color was inversely associated with vegetable consumption in both groups. Routine screening for food refusal among children with ASD is warranted to prevent dietary inadequacies that may be associated with selective eating habits. Future research is needed to develop effective and practical feeding approaches for children with ASD. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

New Methods for Strategic Analysis: Automating the Wargame,

DTIC Science & Technology

1982-04-01

reproducibility.[lJ CONCEPTUAL APPROACH The conceptual approach started with the structure of a game but replaced the free - play teams with programmed...solely by a desire to codify behavior. It sprang in equal measure from some of the perceived shortcomings of free - play political- military gaming. In...some actions that teams will just not initiate. For example, free - play teams exhibit extreme reluctance (amounting to refusal) to initiate nuclear

Proceedings of Users’ Stress Workshop (8th) Held San Antonio, Texas on September 24 - 27, 1991

DTIC Science & Technology

1991-09-01

EMOR’can be interwoven with other clinical procedures (e.g., relaxation training, hypnosis , visualization exercises) and integrated into one’s...testimony in forensic cases for Air Force members who refused to be deployed. One staff psychologist was interviewed by a local television station regarding...application of behavioral medicine Interventions to Include biofeedback, relaxation techniques, performance enhancement techniques, hypnosis , altered states

Predicting sex offender treatment entry among individuals convicted of sexual offense crimes.

PubMed

Jones, Nicole; Pelissier, Bernadette; Klein-Saffran, Jody

2006-01-01

This study examined what factors were predictive of who volunteers for sex offender treatment (self-selection) as well as who enters treatment after volunteering (administration selection). Research participants included 404 treatment volunteers and 387 nonvolunteers to treatment who were convicted of a sexual offense involving minors within the federal prison system. Maximum likelihood probit estimation procedures indicated that when compared with nonvolunteers, treatment volunteers were more likely to be recommended by a judge to receive treatment at the time of sentencing, had received prior treatment for sexually deviant behavior, reported higher levels of motivation to change their sexually deviant behavior, and had lower rates of a substance use disorder in the year prior to incarceration. Of those persons who initially volunteered, 62% were accepted and entered treatment, 16% were denied entry to treatment by program staff, and 22% refused treatment after being accepted to the waiting list. When compared with those who were accepted and entered treatment, motivation was the only predictor of being denied admission into treatment by program staff and for refusal of treatment once accepted. The findings emphasize the need to control for selection bias in treatment outcome studies and the importance of examining the role of motivation in treatment volunteerism and treatment entry for sexual offenders.

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 816.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Coal mine waste: Refuse piles. 816.83 Section... ACTIVITIES § 816.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 816.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

30 CFR 817.83 - Coal mine waste: Refuse piles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Refuse piles. 817.83 Section... ACTIVITIES § 817.83 Coal mine waste: Refuse piles. Refuse piles shall meet the requirements of § 817.81, the... removed from the disposal area prior to placement of coal mine waste. Topsoil shall be removed, segregated...

Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse

Science.gov Websites

Trucks Virginia Cleans up With Natural Gas Refuse Trucks to someone by E-mail Share Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Facebook Tweet about Alternative Fuels Data Center: Virginia Cleans up With Natural Gas Refuse Trucks on Twitter Bookmark Alternative

The Moderating Role of Close Friends in the Relationship Between Conduct Problems and Adolescent Substance Use

PubMed Central

Glaser, Beate; Shelton, Katherine H.; van den Bree, Marianne B.M.

2010-01-01

Purpose Conduct problems and peer effects are among the strongest risk factors for adolescent substance use and problem use. However, it is unclear to what extent the effects of conduct problems and peer behavior interact, and whether adolescents' capacity to refuse the offer of substances may moderate such links. This study was conducted to examine relationships between conduct problems, close friends' substance use, and refusal assertiveness with adolescents' alcohol use problems, tobacco, and marijuana use. Methods We studied a population-based sample of 1,237 individuals from the Cardiff Study of All Wales and North West of England Twins aged 11–18 years. Adolescent and mother-reported information was obtained. Statistical analyses included cross-sectional and prospective logistic regression models and family-based permutations. Results Conduct problems and close friends' substance use were associated with increased adolescents' substance use, whereas refusal assertiveness was associated with lower use of cigarettes, alcohol, and marijuana. Peer substance use moderated the relationship between conduct problems and alcohol use problems, such that conduct problems were only related to increased risk for alcohol use problems in the presence of substance-using friends. This effect was found in both cross-sectional and prospective analyses and confirmed using the permutation approach. Conclusions Reduced opportunities for interaction with alcohol-using peers may lower the risk of alcohol use problems in adolescents with conduct problems. PMID:20547290

What girls won't do for love: human immunodeficiency virus/sexually transmitted infections risk among young African-American women driven by a relationship imperative.

PubMed

Raiford, Jerris L; Seth, Puja; DiClemente, Ralph J

2013-05-01

Rates of Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) continue to increase among African-American youth. Adolescents who have a stronger identity in relation to others (relational identity) rather than to themselves (self-identity) may view intimate relationships as imperative to a positive self-concept, which may lead to risky sexual behavior and abuse. Therefore, the present study assessed the associations among a relationship imperative and HIV/STI-related risk factors and behaviors. Participants were 715 African-American adolescent females, aged 15 to 21 years. They completed measures that assessed how important a relationship was to them and HIV-related risk factors and behaviors. Participants also provided vaginal swab specimens for STI testing. Multivariate logistic regression analyses, controlling for covariates, were conducted. Females who endorsed a relationship imperative (29%), compared to those who did not, were more likely to report: unprotected sex, less power in their relationships, perceived inability to refuse sex, anal sex, sex while their partner was high on alcohol/drugs, and partner abuse. Furthermore, participants with less power, recent partner abuse, and a perceived ability to refuse sex were more likely to test STI positive. These results indicate that if African-American adolescent females believe a relationship is imperative, they are more likely to engage in riskier sexual behaviors. Additionally, less perceived power and partner abuse increases their risk for STIs. HIV/STI prevention programs should target males and females and address healthy relationships, sense of self-worth, self-esteem and the gender power imbalance that may persist in the community along with HIV/STI risk. Published by Elsevier Inc.

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2014 CFR

2014-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2011 CFR

2011-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2010 CFR

2010-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2013 CFR

2013-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

9 CFR 93.806 - Animals refused entry.

Code of Federal Regulations, 2012 CFR

2012-01-01

... FOR MEANS OF CONVEYANCE AND SHIPPING CONTAINERS Elephants, Hippopotami, Rhinoceroses, and Tapirs § 93.806 Animals refused entry. Any elephant, hippopotamus, rhinoceros, or tapir refused entry into the...

20 CFR 229.81 - Refusal to accept vocational rehabilitation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... disabled employee refuses, without good reason, to accept vocational rehabilitation services available... in which the child refuses, without good reason, to accept such vocational rehabilitation services...

20 CFR 401.70 - Appeals of refusals to correct records or refusals to allow access to records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... explaining the decision on your appeal. The time limit for making our decision after we receive your appeal... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Appeals of refusals to correct records or refusals to allow access to records. 401.70 Section 401.70 Employees' Benefits SOCIAL SECURITY...

Tobacco Access and Availability for Vietnamese School Children (aged 13-15): Results from the Global Youth Tobacco Use Survey (GYTS) 2014 in Viet Nam.

PubMed

Anh, Le Thi Kim; Quyen, Bui Thi Tu; Minh, Hoang Van; Giang, Kim Bao; Hai, Phan Thi; Huyen, Doan Thu; Khue, Luong Ngoc; Lam, Nguyen Tuan; Nga, Pham Thi Quynh

2016-01-01

Efforts to reduce tobacco use among school children need to be based on understanding of access to cigarettes by these subjects because previous studies indicated that enforcement of laws for controlling tobacco sales seems to not affect teen/school children because they can obtain cigarettes from different sources. This paper aims to describe access to and availability of cigarettes among school students (aged 13-15 years old) according to the data from GYTS Vietnam 2014. In GYTS, a national school-based survey of students of grades 8-10, our findings showed that about 15% school children are current smokers who smoke at home, and that they could easily buy cigarettes from stores (63.2%), or someone else (27.8%), or street vendors (9%). Notably, over 85% of school children answered that they were not refused because of their age. This high percentage was nearly the same in the North (85.7%), the Centre (92.5%), and the South (89.7%) of Viet Nam. These findings show that it is quite easy for school children to obtain cigarettes and this is a crucial challenge for policy makers aiming to reduce tobacco use among youth in general and school-age students in particular.

The Legal Ethical Backbone of Conscientious Refusal.

PubMed

Munthe, Christian; Nielsen, Morten Ebbe Juul

2017-01-01

This article analyzes the idea of a legal right to conscientious refusal for healthcare professionals from a basic legal ethical standpoint, using refusal to perform tasks related to legal abortion (in cases of voluntary employment) as a case in point. The idea of a legal right to conscientious refusal is distinguished from ideas regarding moral rights or reasons related to conscientious refusal, and none of the latter are found to support the notion of a legal right. Reasons for allowing some sort of room for conscientious refusal for healthcare professionals based on the importance of cultural identity and the fostering of a critical atmosphere might provide some support, if no countervailing factors apply. One such factor is that a legal right to healthcare professionals' conscientious refusal must comply with basic legal ethical tenets regarding the rule of law and equal treatment, and this requirement is found to create serious problems for those wishing to defend the idea under consideration. We conclude that the notion of a legal right to conscientious refusal for any profession is either fundamentally incompatible with elementary legal ethical requirements, or implausible because it undermines the functioning of a related professional sector (healthcare) or even of society as a whole.

Estimates and determinants of HPV non-vaccination and vaccine refusal in girls 12 to 14 y of age in Canada: Results from the Childhood National Immunization Coverage Survey, 2013

PubMed Central

Gilbert, Nicolas L.; Gilmour, Heather; Dubé, Ève; Wilson, Sarah E.; Laroche, Julie

2016-01-01

ABSTRACT Since the introduction of HPV vaccination programs in Canada in 2007, coverage has been below public health goals in many provinces and territories. This analysis investigated the determinants of HPV non-vaccination and vaccine refusal. Data from the Childhood National Immunization Coverage Survey (CNICS) 2013 were used to estimate the prevalence of HPV non-vaccination and parental vaccine refusal in girls aged 12–14 years, for Canada and the provinces and territories. Multivariate logistic regression was used to examine factors associated with non-vaccination and vaccine refusal, after adjusting for potential confounders. An estimated 27.7% of 12–14 y old girls had not been vaccinated against HPV, and 14.4% of parents reported refusing the vaccine. The magnitude of non-vaccination and vaccine refusal varied by province or territory and also by responding parent's country of birth. In addition, higher education was associated with a higher risk of refusal of the HPV vaccine. Rates of HPV non-vaccination and of refusal of the HPV vaccine differ and are influenced by different variables. These findings warrant further investigation. PMID:26942572

Heroin refusal self-efficacy and preference for medication-assisted treatment after inpatient detoxification.

PubMed

Kenney, Shannon R; Bailey, Genie L; Anderson, Bradley J; Stein, Michael D

2017-10-01

An individual's self-efficacy to refuse using heroin in high-risk situations is believed to minimize the likelihood for relapse. However, among individuals completing inpatient heroin detoxification, perceived refusal self-efficacy may also reduce one's perceived need for medication-assisted treatment (MAT), an effective and recommended treatment for opioid use disorder. In the current study, we examined the relationship between heroin refusal self-efficacy and preference for MAT following inpatient detoxification. Participants (N=397) were interviewed at the start of brief inpatient opioid detoxification. Multiple logistic regression was used to estimate the adjusted association of background characteristics, depressed mood, and perceived heroin refusal self-efficacy with preference for MAT. Controlling for other covariates, depressed mood and lower perceived refusal self-efficacy were associated with a significantly greater likelihood of expressing preference for MAT (versus no MAT). Perceived ability to refuse heroin after leaving detox is inversely associated with a heroin user's desire for MAT. An effective continuum of care model may benefit from greater attention to patient's perceived refusal self-efficacy during detoxification which may impact preference for MAT and long-term recovery. Copyright © 2017. Published by Elsevier Ltd.

Assessment and analysis of aged refuse as ammonium-removal media for the treatment of landfill leachate.

PubMed

He, Yan; Li, Dan; Zhao, Youcai; Huang, Minsheng; Zhou, Gongming

2017-11-01

This is the first attempt to explore the sustainability of aged refuse as ammonium-removal media. Batch experiments combined with the aged-refuse-based reactor were performed to examine how the adsorption and desorption processes are involved in the ammonia removal via aged refuse media in this research. The results showed that the adsorption of ammonium by aged refuse occurred instantly and the adsorbed ammonium was stable and less exchangeable. The adsorption data fit the Freundlich isotherms well and the n value of 0.1-0.5 indicated that the adsorption of ammonium occurred easily. The maximum adsorbed ammonium occupied less than 10% of the cation exchange capacity in aged-refuse-based reactors owing to the high solid/liquid ratios (50:1-120:1). The synergistic transformations of ammonium within the aged-refuse-based reactor indicated that the cation exchange sites only provide temporary storage of ammonium, and the subsequent nitrification process can be considered the predominant restoration pathway of ammonium adsorption capacity of the reactor. It seems reasonable to assume that there is no expiry for the aged-refuse-based reactor in terms of ammonium removal owing to its bioregeneration via nitrification.

Disposable containers as larval habitats for Aedes aegypti in a city with regular refuse collection: a study in Marília, São Paulo State, Brazil.

PubMed

Mazine, C A; Macoris, M L; Andrighetti, M T; Yasumaro, S; Silva, M E; Nelson, M J; Winch, P J

1996-09-01

In Marília, Brazil, refuse is collected at least every other day, yet non-useful, non-returnable containers such as cans, plastic bottles and tires account for almost half of the container habitats found positive for the Aedes aegypti mosquito. A study was therefore conducted to investigate why these containers exist despite regular refuse collection and a high level of awareness of dengue prevention, and how the control program could most effectively respond. Differing community perceptions as to what constitutes refuse were found to lead people to store a variety of containers in their yard. Other dimensions of the problem include the presence of informal refuse collectors in search of saleable materials, and dumping of refuse in vacant lots and along roads. An intervention based on these data will involve the informal refuse collectors in implementation of a community-based recycling project.

ACOG Committee Opinion No. 306. Informed refusal.

PubMed

2004-12-01

Informed refusal is a fundamental component of the informed consent process. Informed consent laws have evolved to the "materiality or patient viewpoint" standard. A physician must disclose to the patient the risks, benefits, and alternatives that a reasonable person in the patient's position would want to know to make an informed decision. Throughout this process, the patient's autonomy, level of health literacy, and cultural background should be respected. The subsequent election by the patient to forgo an intervention that has been recommended by the physician constitutes informed refusal. Documentation of the informed refusal process is essential. It should include a notation that the need for the intervention, as well as risks, benefits, and alternatives to the intervention, and possible consequences of refusal, have been explained. The patient's reason for refusal also should be documented.

Do you feel powerless when a patient refuses medication?

PubMed

Carey, N; Jones, S L; O'Toole, A W

1990-10-01

1. Because a client legally has the right to refuse medication, the nurse can only recommend, advise, suggest, or urge the patient to comply. Consequently, it is important to understand the nurse's response to patient refusal of medication. 2. Overall, nurses were more apt to identify with indirect indicators than they were to identify words that address the concept directly (control and powerlessness). 3. The most common hazard identified in a medication refusal event was the potential for injury, and the individuals most at risk were the nurse giving the medication and other personnel on the unit. 4. The most prominent nursing response to medication refusal was counseling. Nearly all the nurse subjects believed that the medication refusal event negatively influenced nursing care, the patient/nurse interaction, and patient teaching.

Self-control, self-regulation, and doping in sport: a test of the strength-energy model.

PubMed

Chan, Derwin K; Lentillon-Kaestner, Vanessa; Dimmock, James A; Donovan, Robert J; Keatley, David A; Hardcastle, Sarah J; Hagger, Martin S

2015-04-01

We applied the strength-energy model of self-control to understand the relationship between self-control and young athletes' behavioral responses to taking illegal performance-enhancing substances, or "doping." Measures of trait self-control, attitude and intention toward doping, intention toward, and adherence to, doping-avoidant behaviors, and the prevention of unintended doping behaviors were administered to 410 young Australian athletes. Participants also completed a "lollipop" decision-making protocol that simulated avoidance of unintended doping. Hierarchical linear multiple regression analyses revealed that self-control was negatively associated with doping attitude and intention, and positively associated with the intention and adherence to doping-avoidant behaviors, and refusal to take or eat the unfamiliar candy offered in the "lollipop" protocol. Consistent with the strength-energy model, athletes with low self-control were more likely to have heightened attitude and intention toward doping, and reduced intention, behavioral adherence, and awareness of doping avoidance.

Complex social contagion makes networks more vulnerable to disease outbreaks.

PubMed

Campbell, Ellsworth; Salathé, Marcel

2013-01-01

Social network analysis is now widely used to investigate the dynamics of infectious disease spread. Vaccination dramatically disrupts disease transmission on a contact network, and indeed, high vaccination rates can potentially halt disease transmission altogether. Here, we build on mounting evidence that health behaviors - such as vaccination, and refusal thereof - can spread across social networks through a process of complex contagion that requires social reinforcement. Using network simulations that model health behavior and infectious disease spread, we find that under otherwise identical conditions, the process by which the health behavior spreads has a very strong effect on disease outbreak dynamics. This dynamic variability results from differences in the topology within susceptible communities that arise during the health behavior spreading process, which in turn depends on the topology of the overall social network. Our findings point to the importance of health behavior spread in predicting and controlling disease outbreaks.

Primary care pediatricians' perceptions of vaccine refusal in europe.

PubMed

Grossman, Zachi; van Esso, Diego; Del Torso, Stefano; Hadjipanayis, Adamos; Drabik, Anna; Gerber, Andreas; Miron, Dan

2011-03-01

An electronic survey assessing primary care pediatricians' estimations and practices regarding parents' vaccination refusal was sent to 395 members of the European Academy of Pediatrics Research in Ambulatory Setting network, with a response rate of 87%. Of respondents who vaccinate in the clinic, 93% estimated the total vaccine refusal rate as <1%. Of all respondents, 69% prefer a shared decision-making approach to handle refusing parents.

25 CFR 171.420 - Can I dispose of sewage, trash, or other refuse on a BIA irrigation project?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can I dispose of sewage, trash, or other refuse on a BIA... AND WATER IRRIGATION OPERATION AND MAINTENANCE Irrigation Facilities § 171.420 Can I dispose of sewage, trash, or other refuse on a BIA irrigation project? No. Sewage, trash, or other refuse are considered...

PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE

PubMed Central

FS, Vahidy; MH, Rahbar; AP, Lal; JC, Grotta; SI, Savitz

2012-01-01

Objective To determine factors associated with patients refusing IV t-PA for suspected acute ischemic stroke (AIS), and to compare the outcomes of patients who refused t-PA (RT) with those treated with t-PA. Methods Patients who were treated with and refused t-PA at our stroke center were identified retrospectively. Demographics, clinical presentation, and outcome measures were collected and compared. Clinical outcome was defined as excellent (mRS: 0–1), good (mRS: 0–2), and poor (mRS: 3–6). Results Over 7.5 years, thirty (4.2%) patients refused t-PA. There were no demographic differences between the treated and RT groups. The rate of RT decreased over time (OR 0.63, 95% CI 0.50 – 0.79). Factors associated with refusal included a later symptom onset to emergency department presentation time (OR 1.02, 95% CI 1.01 – 1.03), lower NIHSS (OR 1.11, 95% CI 1.03 – 1.18), a higher proportion of stroke mimics (OR 17.61, 95% CI 6.20 – 50.02) and shorter hospital stay (OR 1.32, 95% CI 1.09 – 1.61). Among patients who were subsequently diagnosed with ischemic stroke, only length of stay was significantly shorter for refusal patients (OR 1.37, 95% CI 1.06 – 1.78). After controlling for mild strokes and stroke mimics, clinical outcome was not different between the groups (OR 1.61, 95% CI 0.69 – 3.73). Conclusion The incidence of patients refusing t-PA has decreased over time, yet it may be a cause for t-PA under-utilization. Patients with milder symptoms were more likely to refuse t-PA. Refusal patients presented later to the hospital and had shorter hospital stays. One out six refusal patients (16.6%) had a stroke mimic. PMID:23227830

Informed, advance refusals of treatment by people with severe mental illness in a randomised controlled trial of joint crisis plans: demand, content and correlates.

PubMed

Henderson, Claire; Farrelly, Simone; Flach, Clare; Borschmann, Rohan; Birchwood, Max; Thornicroft, Graham; Waheed, Waquas; Szmukler, George

2017-11-24

In the UK, crisis planning for mental health care should acknowledge the right to make an informed advance treatment refusal under the Mental Capacity Act 2005. Our aims were to estimate the demand for such treatment refusals within a sample of service users who had had a recent hospital admission for psychosis or bipolar disorder, and to examine the relationship between refusals, and service user characteristics. To identify refusals we conducted content analysis of Joint Crisis Plans, which are plans formulated by service users and their clinical team with involvement from an external facilitator, and routine care plans in sub-samples from a multi-centre randomised controlled trial of Joint Crisis Plans (plus routine mental health care) versus routine care alone (CRIMSON) in England. Factors hypothesised to be associated with refusals were identified using the trial data collected through baseline interviews of service users and clinicians and collection of routine clinical data. Ninety-nine of 221 (45%) of the Joint Crisis Plans contained a treatment refusal compared to 10 of 424 (2.4%) baseline routine care plans. No Joint Crisis Plans recorded disagreement with refusals on the part of clinicians. Among those with completed Joint Crisis Plans, adjusted analyses indicated a significant association between treatment refusals and perceived coercion at baseline (odds ratio = 1.21, 95% CI 1.02-1.43), but not with baseline working alliance or a past history of involuntary admission. We demonstrated significant demand for written treatment refusals in line with the Mental Capacity Act 2005, which had not previously been elicited by the process of treatment planning. Future treatment/crisis plans should incorporate the opportunity for service users to record a treatment refusal during the drafting of such plans. ISRCTN11501328 Registered 13th March 2008.

37 CFR 211.7 - Reconsideration procedure for refusals to register.

Code of Federal Regulations, 2010 CFR

2010-07-01

... CONGRESS COPYRIGHT OFFICE AND PROCEDURES MASK WORK PROTECTION § 211.7 Reconsideration procedure for... refusals to register copyright claims are applicable to requests to reconsider refusals to register mask...

Refusal bias in HIV prevalence estimates from nationally representative seroprevalence surveys.

PubMed

Reniers, Georges; Eaton, Jeffrey

2009-03-13

To assess the relationship between prior knowledge of one's HIV status and the likelihood to refuse HIV testing in populations-based surveys and explore its potential for producing bias in HIV prevalence estimates. Using longitudinal survey data from Malawi, we estimate the relationship between prior knowledge of HIV-positive status and subsequent refusal of an HIV test. We use that parameter to develop a heuristic model of refusal bias that is applied to six Demographic and Health Surveys, in which refusal by HIV status is not observed. The model only adjusts for refusal bias conditional on a completed interview. Ecologically, HIV prevalence, prior testing rates and refusal for HIV testing are highly correlated. Malawian data further suggest that amongst individuals who know their status, HIV-positive individuals are 4.62 (95% confidence interval, 2.60-8.21) times more likely to refuse testing than HIV-negative ones. On the basis of that parameter and other inputs from the Demographic and Health Surveys, our model predicts downward bias in national HIV prevalence estimates ranging from 1.5% (95% confidence interval, 0.7-2.9) for Senegal to 13.3% (95% confidence interval, 7.2-19.6) for Malawi. In absolute terms, bias in HIV prevalence estimates is negligible for Senegal but 1.6 (95% confidence interval, 0.8-2.3) percentage points for Malawi. Downward bias is more severe in urban populations. Because refusal rates are higher in men, seroprevalence surveys also tend to overestimate the female-to-male ratio of infections. Prior knowledge of HIV status informs decisions to participate in seroprevalence surveys. Informed refusals may produce bias in estimates of HIV prevalence and the sex ratio of infections.

Predictors of intensive care unit refusal in French intensive care units: a multiple-center study.

PubMed

Garrouste-Orgeas, Maité; Montuclard, Luc; Timsit, Jean-François; Reignier, Jean; Desmettre, Thibault; Karoubi, Philippe; Moreau, Delphine; Montesino, Laurent; Duguet, Alexandre; Boussat, Sandrine; Ede, Christophe; Monseau, Yannick; Paule, Thierry; Misset, Benoit; Carlet, Jean

2005-04-01

To identify factors associated with granting or refusing intensive care unit (ICU) admission, to analyze ICU characteristics and triage decisions, and to describe mortality in admitted and refused patients. Observational, prospective, multiple-center study. Four university hospitals and seven primary-care hospitals in France. None. Age, underlying diseases (McCabe score and Knaus class), dependency, hospital mortality, and ICU characteristics were recorded. The crude ICU refusal rate was 23.8% (137/574), with variations from 7.1% to 63.1%. The reasons for refusal were too well to benefit (76/137, 55.4%), too sick to benefit (51/137, 37.2%), unit too busy (9/137, 6.5%), and refusal by the family (1/137). In logistic regression analyses, two patient-related factors were associated with ICU refusal: dependency (odds ratio [OR], 14.20; 95% confidence interval [CI], 5.27-38.25; p < .0001) and metastatic cancer (OR, 5.82; 95% CI, 2.22-15.28). Other risk factors were organizational, namely, full unit (OR, 3.16; 95% CI, 1.88-5.31), center (OR, 3.81; 95% CI, 2.27-6.39), phone admission (OR, 0.23; 95% CI, 0.14-0.40), and daytime admission (OR, 0.52; 95% CI, 0.32-0.84). The Standardized Mortality Ratio was 1.41 (95% CI, 1.19-1.69) for immediately admitted patients, 1.75 (95% CI, 1.60-1.84) for refused patients, and 1.03 (95% CI, 0.28-1.75) for later-admitted patients. ICU refusal rates varied greatly across ICUs and were dependent on both patient and organizational factors. Efforts to define ethically optimal ICU admission policies might lead to greater homogeneity in refusal rates, although case-mix variations would be expected to leave an irreducible amount of variation across ICUs.

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2013 CFR

2013-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

49 CFR 219.505 - Refusals.

Code of Federal Regulations, 2014 CFR

2014-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Pre-Employment Tests § 219.505 Refusals. An applicant who has refused to submit to pre-employment testing under this section may not be employed in covered service...

Denial of service to same-sex and interracial couples: Evidence from a national survey experiment.

PubMed

Powell, Brian; Schnabel, Landon; Apgar, Lauren

2017-12-01

Legislatures and courts are debating whether businesses can deny services to same-sex couples for religious reasons. Yet, little is known about public views on this issue. In a national survey experiment, Americans ( n = 2035) responded to an experimental vignette describing a gay or interracial couple refused service. Vignettes varied the reason for refusal (religion/nonreligious) and by business type (individual/corporation). Results confirm greater support of service refusal by the self-employed than by corporations and to gay couples than to interracial couples. However, religious reasons for refusal to gay couples elicit no more support than do nonreligious reasons. In the first national study to experimentally analyze views on service refusal to sexual minorities, we demonstrate that views vary by several factors but not by whether the refusal was for religious reasons.

The space station integrated refuse management system

NASA Technical Reports Server (NTRS)

Anderson, Loren A.

1988-01-01

The design and development of an Integrated Refuse Management System for the proposed International Space Station was performed. The primary goal was to make use of any existing potential energy or material properties that refuse may possess. The secondary goal was based on the complete removal or disposal of those products that could not, in any way, benefit astronauts' needs aboard the Space Station. The design of a continuous living and experimental habitat in space has spawned the need for a highly efficient and effective refuse management system capable of managing nearly forty-thousand pounds of refuse annually. To satisfy this need, the following four integrable systems were researched and developed: collection and transfer; recycle and reuse; advance disposal; and propulsion assist in disposal. The design of a Space Station subsystem capable of collecting and transporting refuse from its generation site to its disposal and/or recycling site was accomplished. Several methods of recycling or reusing refuse in the space environment were researched. The optimal solution was determined to be the method of pyrolysis. The objective of removing refuse from the Space Station environment, subsequent to recycling, was fulfilled with the design of a jettison vehicle. A number of jettison vehicle launch scenarios were analyzed. Selection of a proper disposal site and the development of a system to propel the vehicle to that site were completed. Reentry into the earth atmosphere for the purpose of refuse incineration was determined to be the most attractive solution.

Influence of retail cigarette advertising, price promotions, and retailer compliance on youth smoking-related attitudes and behaviors.

PubMed

Kim, Annice E; Loomis, Brett R; Busey, Andrew H; Farrelly, Matthew C; Willett, Jeffrey G; Juster, Harlan R

2013-01-01

Exposure to retail tobacco marketing is associated with youth smoking, but most studies have relied on self-reported measures of exposure, which are prone to recall bias. To examine whether exposure to retail cigarette advertising, promotions, and retailer compliance is associated with youth smoking-related outcomes using observational estimates of exposure. Data on retail cigarette advertising and promotions were collected from a representative sample of licensed tobacco retailers in New York annually since 2004. County-level estimates of retail cigarette advertising and promotions and retailer compliance with youth access laws were calculated and linked to the New York Youth Tobacco Survey, administered to 54,671 middle and high school students in 2004, 2006, and 2008. Regression models examined whether cigarette advertising, promotions, and retailer compliance were associated with youth's awareness of retail cigarette advertising, attitudes about smoking, susceptibility to smoking, cigarette purchasing behaviors, and smoking behaviors. Living in counties with more retail cigarette advertisements is associated with youth having positive attitudes about smoking (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.03-1.19, P < .01). Living in counties with more retail cigarette promotions is associated with youth current smoking (OR = 1.57, 95% CI = 1.01-2.44, P < .05). Living in counties with higher retailer compliance with youth access laws is associated with higher odds of youth being refused cigarettes when attempting to buy in stores (OR = 1.12, 95% CI = 1.01-1.25, P < .05) and lower odds of retail stores being youth's usual source of cigarettes (OR = 0.88, 95% CI = 0.80-0.97, P < .01). Strong retailer compliance programs and policies that eliminate cigarette advertising and promotions may help reduce youth smoking.

The Global Context of Vaccine Refusal: Insights from a Systematic Comparative Ethnography of the Global Polio Eradication Initiative.

PubMed

Closser, Svea; Rosenthal, Anat; Maes, Kenneth; Justice, Judith; Cox, Kelly; Omidian, Patricia A; Mohammed, Ismaila Zango; Dukku, Aminu Mohammed; Koon, Adam D; Nyirazinyoye, Laetitia

2016-09-01

Many of medical anthropology's most pressing research questions require an understanding how infections, money, and ideas move around the globe. The Global Polio Eradication Initiative (GPEI) is a $9 billion project that has delivered 20 billion doses of oral polio vaccine in campaigns across the world. With its array of global activities, it cannot be comprehensively explored by the traditional anthropological method of research at one field site. This article describes an ethnographic study of the GPEI, a collaborative effort between researchers at eight sites in seven countries. We developed a methodology grounded in nuanced understandings of local context but structured to allow analysis of global trends. Here, we examine polio vaccine acceptance and refusal to understand how global phenomena-in this case, policy decisions by donors and global health organizations to support vaccination campaigns rather than building health systems-shape local behavior. © 2016 by the American Anthropological Association.

The Global Context of Vaccine Refusal: Insights from a Systematic Comparative Ethnography of the Global Polio Eradication Initiative.

PubMed

Closser, Svea; Rosenthal, Anat; Maes, Kenneth; Justice, Judith; Cox, Kelly; Omidian, Patricia A; Mohammed, Ismaila Zango; Dukku, Aminu Mohammed; Koon, Adam D; Nyirazinyoye, Laetitia

2015-06-18

Many of medical anthropology's most pressing research questions require an understanding how infections, money and ideas move around the globe. The Global Polio Eradication Initiative (GPEI) is a $9 billion project that has delivered 20 billion doses of oral polio vaccine in campaigns across the world. With its array of global activities, it cannot be comprehensively explored by the traditional anthropological method of research at one field site. This paper describes an ethnographic study of the GPEI, a collaborative effort between researchers at eight sites in seven countries. We developed a methodology grounded in nuanced understandings of local context but structured to allow analysis of global trends. Here, we examine polio vaccine acceptance and refusal to understand how global phenomena-in this case, policy decisions by donors and global health organizations to support vaccination campaigns rather than building health systems-shape local behavior. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Preferential partner selection in an evolutionary study of Prisoner's Dilemma.

PubMed

Ashlock, D; Smucker, M D; Stanley, E A; Tesfatsion, L

1996-01-01

Partner selection is an important process in many social interactions, permitting individuals to decrease the risks associated with cooperation. In large populations, defectors may escape punishment by roving from partner to partner, but defectors in smaller populations risk social isolation. We investigate these possibilities for an evolutionary Prisoner's Dilemma in which agents use expected payoffs to choose and refuse partners. In comparison to random or round-robin partner matching, we find that the average payoffs attained with preferential partner selection tend to be more narrowly confined to a few isolated payoff regions. Most ecologies evolve to essentially full cooperative behavior, but when agents are intolerant of defections, or when the costs of refusal and social isolation are small, we also see the emergence of wallflower ecologies in which all agents are socially isolated. Between these two extremes, we see the emergence of ecologies whose agents tend to engage in a small number of defections followed by cooperation thereafter. The latter ecologies exhibit a plethora of interesting social interaction patterns.

Alcohol expectancies and social self-efficacy as mediators of differential intervention outcomes for college hazardous drinkers with social anxiety.

PubMed

Black, Jessica J; Tran, Giao Q; Goldsmith, Abigail A; Thompson, Rachel D; Smith, Joshua P; Welge, Jeffrey A

2012-03-01

The current pilot study examined the roles of two cognitive factors - positive alcohol expectancies of social anxiety reduction and drink refusal self-efficacy relevant to social situations - in mediating greater reduction in alcohol behaviors by the Brief Intervention for Socially Anxious Drinkers (BISAD; n=21) compared to an alcohol psychoeducation (n=20) in a sample of college hazardous drinkers with social anxiety. Mediation analysis results indicated that decreased positive alcohol expectancies and increased drink refusal self-efficacy relevant to social situations accounted for an average of 67% of the variance in treatment outcomes as measured by total quantity of alcohol consumption, heavy drinking days and problems related to alcohol use in the past month. Study results may enhance the understanding of cognitive factors' role in alcohol treatment outcomes, which could in turn improve the efficacy of interventions aimed to reduce hazardous drinking and comorbid social anxiety. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Evaluation of the factorial and metric equivalence of the Sexual Assertiveness Scale (SAS) by sex].

PubMed

Sierra, Juan Carlos; Santos-Iglesias, Pablo; Vallejo-Medina, Pablo

2012-05-01

Sexual assertiveness refers to the ability to initiate sexual activity, refuse unwanted sexual activity, and use contraceptive methods to avoid sexually transmitted diseases, developing healthy sexual behaviors. The Sexual Assertiveness Scale (SAS) assesses these three dimensions. The purpose of this study is to evaluate, using structural equation modeling and differential item functioning, the equivalence of the scale between men and women. Standard scores are also provided. A total of 4,034 participants from 21 Spanish provinces took part in the study. Quota sampling method was used. Results indicate a strict equivalent dimensionality of the Sexual Assertiveness Scale across sexes. One item was flagged by differential item functioning, although it does not affect the scale. Therefore, there is no significant bias in the scale when comparing across sexes. Standard scores show similar Initiation assertiveness scores for men and women, and higher scores on Refusal and Sexually Transmitted Disease Prevention for women. This scale can be used on men and women with sufficient psychometric guarantees.

Audio computer-assisted self interview compared to traditional interview in an HIV-related behavioral survey in Vietnam.

PubMed

Le, Linh Cu; Vu, Lan T H

2012-10-01

Globally, population surveys on HIV/AIDS and other sensitive topics have been using audio computer-assisted self interview for many years. This interview technique, however, is still new to Vietnam and little is known about its application and impact in general population surveys. One plausible hypothesis is that residents of Vietnam interviewed using this technique may provide a higher response rate and be more willing to reveal their true behaviors than if interviewed with traditional methods. This study aims to compare audio computer-assisted self interview with traditional face-to-face personal interview and self-administered interview with regard to rates of refusal and affirmative responses to questions on sensitive topics related to HIV/AIDS. In June 2010, a randomized study was conducted in three cities (Ha Noi, Da Nan and Can Tho), using a sample of 4049 residents aged 15 to 49 years. Respondents were randomly assigned to one of three interviewing methods: audio computer-assisted self interview, personal face-to-face interview, and self-administered paper interview. Instead of providing answers directly to interviewer questions as with traditional methods, audio computer-assisted self-interview respondents read the questions displayed on a laptop screen, while listening to the questions through audio headphones, then entered responses using a laptop keyboard. A MySQL database was used for data management and SPSS statistical package version 18 used for data analysis with bivariate and multivariate statistical techniques. Rates of high risk behaviors and mean values of continuous variables were compared for the three data collection methods. Audio computer-assisted self interview showed advantages over comparison techniques, achieving lower refusal rates and reporting higher prevalence of some sensitive and risk behaviors (perhaps indication of more truthful answers). Premarital sex was reported by 20.4% in the audio computer-assisted self-interview survey group, versus 11.4% in the face-to-face group and 11.1% in the self-administered paper questionnaire group. The pattern was consistent for both male and female respondents and in both urban and rural settings. Men in the audio computer-assisted self-interview group also reported higher levels of high-risk sexual behavior--such as sex with sex workers and a higher average number of sexual partners--than did women in the same group. Importantly, item refusal rates on sensitive topics tended to be lower with audio computer-assisted self interview than with the other two methods. Combined with existing data from other countries and previous studies in Vietnam, these findings suggest that researchers should consider using audio computer-assisted self interview for future studies of sensitive and stigmatized topics, especially for men.

[Acceptance of a total smoking ban in schools: students' attitudes].

PubMed

Morgenstern, M; Wiborg, G; Hanewinkel, R

2008-06-01

The purpose of this study was to measure students' attitudes towards a total smoking ban in schools and towards impositions in cases of violation. Cross-sectional survey of 1 738 students of 12 public schools in Schleswig-Holstein (grades 7-13, age 11-20 years). Data were collected by means of written questionnaires administered during class time. The following variables were assessed: attitude towards smoking ban, attitude towards impositions, age, sex, citizenship, perceived school climate, current smoking, lifetime smoking; for smokers, and additionally, the "Heaviness of Smoking Index". 76.5% of all students agreed with a total smoking ban, 66.4% agreed with the punishment of violations. Higher acceptance rates were found among girls, young students (11-15 years of age), for never-smokers, and for students who feel comfortable at school. Acceptance of the smoking ban is closely related to current smoking status: 93% of the non-smoking students, but only 14% of the daily smoking students agreed with the regulations. Refusal of the ban increased with increasing physical dependence. The intensification of the smoking ban in public schools meets approval by the majority of students. Smoking students should be more strongly involved in the implementation process, e.g., by supplemental cessation programmes.

Legislation and refusal of blood transfusion by a minor Jehovah-Witness in Belgium.

PubMed

Deneyer, M; Matthys, D; Ramet, J; Michel, L; Holsters, D; Vandenplas, Y

2011-01-01

The refusal of blood transfusion by Jehovah's Witnesses in critical situations constitutes an ethical and juridical dilemma. The refusal to receive blood products by Jehovah's Witnesses is based on biblical verses. Recurring arguments to sustain this refusal regard the right to self-determination and the right to freedom of faith. If minors are involved, the problem is rendered even more difficult as the parental authority over young children needs to be taken into account. When adolescents are concerned, the situation if even more ambiguous since adolescents might be considered as mature enough to provide autonomous consent. On the basis of three cases, the most frequent bottlenecks that can come up in paediatric emergency services are highlighted: (1) the refusal of a blood transfusion by the parents of a young child; (2) the refusal by an adolescent and (3) prior refusal based on a "No Blood"-document. Regarding minors, the law on patients' rights in Belgium contains safety mechanisms concerning the preservation of physical integrity. Therefore, a key responsibility has been assigned to the physician. A step-by-step plan and a synoptic diagram are presented.

Neural mechanisms associated with treatment decision making: An fMRI study.

PubMed

Abidi, Malek; Bruce, Jared; Le Blanche, Alain; Bruce, Amanda; Jarmolowicz, David P; Csillik, Antonia; Thai, N Jade; Lim, Seung-Lark; Heinzlef, Olivier; de Marco, Giovanni

2018-04-23

Great progress has been made in understanding how people make financial decisions. However, there is little research on how people make health and treatment choices. Our study aimed to examine how participants weigh benefits (reduction in disease progression) and probability of risk (medications' side effects) when making hypothetical treatment decisions, and to identify the neural networks implicated in this process. Fourteen healthy participants were recruited to perform a treatment decision probability discounting task using MRI. Behavioral responses and skin conductance responses (SCRs) were measured. A whole brain analysis were performed to compare activity changes between "mild" and "severe" medications' side effects conditions. Then, orbitofrontal cortex (OFC), ventral striatum (VS), amygdala and insula were chosen for effective connectivity analysis. Behavioral data showed that participants are more likely to refuse medication when side effects are high and efficacy is low. SCRs values were significantly higher when people made medication decisions in the severe compared to mild condition. Functionally, OFC and VS were activated in the mild condition and were associated with increased likehood of choosing to take medication (higher area under the curve "AUC" side effects/efficacy). These regions also demonstrated an increased effective connectivity when participants valued treatment benefits. By contrast, the OFC, insula and amygdala were activated in the severe condition and were associated with and increased likelihood to refuse treatment. These regions showed enhanced effective connectivity when participants were confronted with increased side effects severity. This is the first study to examine the behavioral and neural bases of medical decision making. Copyright © 2018 Elsevier B.V. All rights reserved.

Critical dynamics in population vaccinating behavior

PubMed Central

Pananos, A. Demetri; Bury, Thomas M.; Wang, Clara; Schonfeld, Justin; Mohanty, Sharada P.; Nyhan, Brendan; Bauch, Chris T.

2017-01-01

Vaccine refusal can lead to renewed outbreaks of previously eliminated diseases and even delay global eradication. Vaccinating decisions exemplify a complex, coupled system where vaccinating behavior and disease dynamics influence one another. Such systems often exhibit critical phenomena—special dynamics close to a tipping point leading to a new dynamical regime. For instance, critical slowing down (declining rate of recovery from small perturbations) may emerge as a tipping point is approached. Here, we collected and geocoded tweets about measles–mumps–rubella vaccine and classified their sentiment using machine-learning algorithms. We also extracted data on measles-related Google searches. We find critical slowing down in the data at the level of California and the United States in the years before and after the 2014–2015 Disneyland, California measles outbreak. Critical slowing down starts growing appreciably several years before the Disneyland outbreak as vaccine uptake declines and the population approaches the tipping point. However, due to the adaptive nature of coupled behavior–disease systems, the population responds to the outbreak by moving away from the tipping point, causing “critical speeding up” whereby resilience to perturbations increases. A mathematical model of measles transmission and vaccine sentiment predicts the same qualitative patterns in the neighborhood of a tipping point to greatly reduced vaccine uptake and large epidemics. These results support the hypothesis that population vaccinating behavior near the disease elimination threshold is a critical phenomenon. Developing new analytical tools to detect these patterns in digital social data might help us identify populations at heightened risk of widespread vaccine refusal. PMID:29229821

Gastrointestinal motility and sensory abnormalities may contribute to food refusal in medically fragile toddlers.

PubMed

Zangen, Tsili; Ciarla, Carla; Zangen, Samuel; Di Lorenzo, Carlo; Flores, Alex F; Cocjin, Jose; Reddy, Sarabudla Narasimha; Rowhani, Anita; Schwankovsky, Lenore; Hyman, Paul E

2003-09-01

In chronically ill children who refuse to eat, surgery to correct anatomic problems and behavioral treatments to overcome oral aversion often succeed. A few patients fail with standard treatments. The aims of the study were to: 1) investigate motility and gastric sensory abnormalities and 2) describe treatment that was individualized based on pathophysiology in children who failed surgery and behavioral treatments. We studied 14 patients (age 1.5-6; mean 2.5; M/F: 7/7). All had a lifelong history of food aversion and retching or vomiting persisting after feeding therapy and fundoplication. All were fed through gastrostomy or gastro-jejunostomy tubes. We studied esophageal and antroduodenal manometry, and gastric volume threshold for retching. We identified when gastric antral contractions were associated with retching and pain. A multidisciplinary treatment program included a variable combination of continuous post-pyloric feedings, drugs to decrease visceral pain, drugs for motility disorders, and behavioral, cognitive, and family therapy. We interviewed parents 2-6 months following testing to evaluate symptoms, mode of feeding and emotional health. We found a motility disorder alone in 2, decreased threshold for retching alone in 5 and both motility and sensory abnormalities in 7. After treatment, 6 of 14 (43%) began eating orally and 80% had improved emotional health. Retching decreased from 15 episodes per day to an average of 1.4 per day (p <0.01). Upper gastrointestinal motor and/or sensory disorders contributed to reduced quality of life for a majority of children and families with persistent feeding problems. A multidisciplinary approach improved symptoms and problems in these children

A Web-based survey on students' conceptions of 'accident'.

PubMed

Blank, Danilo; Hohgraefe Neto, Guilherme; Grando, Elisa; Siqueira, Pauline Z; Lunkes, Roberta P; Pietrobeli, João Leonardo; Marzola, Norma Regina; Goldani, Marcelo Z

2009-12-01

To report the implementation of an open source web survey application and a case study of its first utilisation, particularly as to aspects of logistics and response behaviour, in a survey of Brazilian university students' conceptions about injury causing events. We developed an original application capable of recruiting respondents, sending personal e-mail invitations, storing responses and exporting data. Students of medical, law, communication and education schools were asked about personal attributes and conceptions of the term accident, as to associations and preventability. The response rate was 34.5%. Half of the subjects responded by the second day, 66.3% during the first week. Subjects around 4.2% (95% CI 3.3-5.4) refused to disclose religious persuasion, and 19.2% (95% CI 17.2-21.3) refused to disclose political persuasion, whereas only 2.8% (95% CI 2.1-3.8), on average, refused to answer questions on conceptions and attitudes. There was no significant difference between early and late respondents in respect to selected attributes and conceptions of accident (P-value varied from 0.145 to 0.971). The word accident evoked the notion of preventability to 85.1% (95% CI 83.2 to 87.0) of the subjects, foreseeability to 50.3% (95% CI 47.7-53.0), fatality to 15.1% (95% CI 13.3-17.1) and intentionality to 2.3% (95% CI 1.6-3.2). Web surveying university students' conceptions about injuries is feasible in a middle-income country setting, yielding response rates similar to those found in the literature.

Implied consent refusal impact

DOT National Transportation Integrated Search

1991-09-01

This report examines the extent to which persons suspected of DWI refuse to take a chemical test as required by law, describes implied consent laws in 50 States, analyzes the relation of law features to refusal rate, and analyzes the characteristics ...

Patient Experience Of Provider Refusal Of Medicaid Coverage And Its Implications.

PubMed

Bhandari, Neeraj; Shi, Yunfeng; Jung, Kyoungrae

2016-01-01

Previous studies show that many physicians do not accept new patients with Medicaid coverage, but no study has examined Medicaid enrollees' actual experience of provider refusal of their coverage and its implications. Using the 2012 National Health Interview Survey, we estimate provider refusal of health insurance coverage reported by 23,992 adults with continuous coverage for the past 12 months. We find that among Medicaid enrollees, 6.73% reported their coverage being refused by a provider in 2012, a rate higher than that in Medicare and private insurance by 4.07 (p<.01) and 3.68 (p<.001) percentage points, respectively. Refusal of Medicaid coverage is associated with delaying needed care, using emergency room (ER) as a usual source of care, and perceiving current coverage as worse than last year. In view of the Affordable Care Act's (ACA) Medicaid expansion, future studies should continue monitoring enrollees' experience of coverage refusal.

The silence.

PubMed

Millenson, Michael L

2003-01-01

Despite several well-crafted Institute of Medicine (IOM) reports, there remains within health care a persistent refusal to confront providers' responsibility for severe quality problems. There is a silence of deed--failing to take corrective actions--and of word--failing to discuss openly the true consequences of that inertia. These silences distort public policy, delay change, and, by leading (albeit inadvertently) to thousands of patient deaths, undermine professionalism. The IOM quality committee, to retain its moral authority, should forgo issuing more reports and instead lead an emergency corrective-action campaign comparable to Flexner's crusade against charlatan medical schools.

Uncertainty: the Curate's egg in financial economics.

PubMed

Pixley, Jocelyn

2014-06-01

Economic theories of uncertainty are unpopular with financial experts. As sociologists, we rightly refuse predictions, but the uncertainties of money are constantly sifted and turned into semi-denial by a financial economics set on somehow beating the future. Picking out 'bits' of the future as 'risk' and 'parts' as 'information' is attractive but socially dangerous, I argue, because money's promises are always uncertain. New studies of uncertainty are reversing sociology's neglect of the unavoidable inability to know the forces that will shape the financial future. © London School of Economics and Political Science 2014.

Mandating doctors to attend counter-terrorism workshops is medically unethical.

PubMed

Summerfield, Derek

2016-04-01

This is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s USA. We should refuse to attend.

[Refusal of treatments by an adult cancer patient].

PubMed

Dauchy, Sarah; Faivre, Jean-Christophe; Block, Véronique; Metzger, Maude; Salleron, Julia; Charles, Cécile; Adam, Virginie

2018-03-01

Refusal of treatment questions the treatment's adequacy as well as the quality of the care relationship. A rigorous analysis of these situations is necessary in order to respect the patient's fundamental right to decide for him/herself while preventing a potential loss of chance. This paper proposes practical guidelines for assessment and management of the refusal of treatment by adult cancer patients. The French Association for Supportive Care in Cancer and the French Society for Psycho-Oncology formed a task force that applied a consensus methodology to draft guidelines. We propose five guidelines: (1) be informed of the conditions most often associated with refusal of treatment so as to reinforce adequate support measures; (2) understand the complexity of the process of refusal and accurately identify what is precisely refused; (3) apply an approach of systematic analysis to refusal, to try and increase the possibilities of finding an agreement while reinforcing the respect of the patient's position; (4) establish a legal procedure to address refusal of treatment that safeguards the stakeholders when no accord can be found; and (5) know the indications for ethical collective decision-making. A systematic assessment procedure of treatment refusal is necessary in order to ensure that all the physical, psychological and contextual aspects of it are taken into account, and to provide patients with the best treatment possible. The setting of good care relationship, the improvement of communication skills training and of comprehensive multidisciplinary care are all crucial elements in the prevention of these situations. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Associations between parents' satisfaction with provider communication and HPV vaccination behaviors.

PubMed

Kornides, Melanie L; Fontenot, Holly B; McRee, Annie-Laurie; Panozzo, Catherine A; Gilkey, Melissa B

2018-05-03

Despite increasing awareness of the importance of a provider recommendation for HPV vaccine, the U.S. has yet to achieve the Healthy people 2020 goal of 80% series completion among adolescents. This failure indicates a need for further examination of the modifiable influences on parents' decision-making. Healthcare providers can influence parents' HPV vaccination decision-making, but little is known about parents' perspectives on the counseling they receive. We sought to assess U.S. parents' satisfaction with provider communication about HPV vaccine and associations with vaccination behaviors. Parents of 11-to-17-year-old adolescents who discussed HPV vaccination with a healthcare provider at least once (n = 795) completed our online survey in Fall 2016. We assessed their satisfaction with the discussion using the HPV Vaccine Communication Satisfaction Scale (α = 0.94). We examined associations between satisfaction (categorized as low, moderate, or high), and three vaccination behaviors: refusal/delay, series initiation (≥1 dose), and continuation (≥2 doses among initiators) using multivariable logistic regression. Most parents reported high (36%) or moderate (38%) satisfaction with provider communication about HPV vaccination; fewer reported low (26%) satisfaction. Moderately satisfied parents (vs. low) had lower odds of refusal/delay (aOR = 0.59, 95% CI: 0.38-0.89), and higher odds of initiation (aOR = 1.71, 95% CI:1.15-2.55) and continuation (aOR = 2.05, 95% CI: 1.24-3.40). The associations were stronger for highly satisfied parents (refusal/delay aOR = 0.45, 95% CI: 0.29-0.70, initiation aOR = 3.59, 95% CI: 2.23-5.78, and continuation aOR = 4.08, 95% CI: 2.38-7.01). Our study suggests that parent satisfaction with provider communication may play an important role in HPV vaccination decision-making. Yet, communication satisfaction has been largely unexamined in the HPV-vaccine literature to date. We introduce a brief, 7-item HPV Vaccine Communication Scale that can be used to assess parents' level of satisfaction with their provider's communication specific to HPV vaccine. We identify communication areas for providers to prioritize when discussing HPV vaccine with parents. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of a sport-for-health intervention (SmokeFree Sports) on smoking-related intentions and cognitions among 9-10 year old primary school children: a controlled trial.

PubMed

McGee, Ciara E; Trigwell, Joanne; Fairclough, Stuart J; Murphy, Rebecca C; Porcellato, Lorna; Ussher, Michael; Foweather, Lawrence

2016-05-26

Preventing children from smoking is a public health priority. This study evaluated the effects of a sport-for-health smoking prevention programme (SmokeFree Sports) on smoking-related intentions and cognitions among primary school children from deprived communities. A non-randomised-controlled trial targeted 9-10 year old children from Merseyside, North-West England. 32 primary schools received a programme of sport-for-health activities over 7 months; 11 comparison schools followed usual routines. Data were collected pre-intervention (T0), and at 8 months (T1) and one year post-intervention (T2). Smoking-related intentions and cognitions were assessed using an online questionnaire. Intervention effects were analysed using multi-level modelling (school, student), adjusted for baseline values and potential confounders. Mixed-sex focus groups (n = 18) were conducted at T1. 961 children completed all assessments and were included in the final analyses. There were no significant differences between the two study groups for non-smoking intentions (T1: β = 0.02, 95 % CI = -0.08-0.12; T2: β = 0.08, 95 % CI = -0.02-0.17) or for cigarette refusal self-efficacy (T1: β = 0.28, 95 % CI = -0.11-0.67; T2: β = 0.23, 95 % CI = -0.07-0.52). At T1 there was a positive intervention effect for cigarette refusal self-efficacy in girls (β = 0.72, 95 % CI = 0.21-1.23). Intervention participants were more likely to 'definitely' believe that: 'it is not safe to smoke for a year or two as long as you quit after that' (RR = 1.19, 95 % CI = 1.07-1.33), 'it is difficult to quit smoking once started' (RR = 1.56, 95 % CI = 1.38-1.76), 'smoke from other peoples' cigarettes is harmful' (RR = 1.19, 95 % CI = 1.20-2.08), 'smoking affects sports performance' (RR = 1.73, 95 % CI = 1.59-1.88) and 'smoking makes 'no difference' to weight' (RR = 2.13, 95 % CI = 1.86-2.44). At T2, significant between-group differences remained just for 'smoking affects sports performance' (RR = 1.57, 95 % CI = 1.43-1.72). Focus groups showed that SFS made children determined to remain smoke free and that the interactive activities aided children's understanding of smoking harms. SFS demonstrated short-term positive effects on smoking attitudes among children, and cigarette refusal self-efficacy among girls. Although no effects were observed for non-smoking intentions, children said that SFS made them more determined not to smoke. Most children had strong intentions not to smoke; therefore, smoking prevention programmes should perhaps target early adolescents, who are closer to the age of smoking onset.

Microbial community structure of leaf-cutter ant fungus gardens and refuse dumps.

PubMed

Scott, Jarrod J; Budsberg, Kevin J; Suen, Garret; Wixon, Devin L; Balser, Teri C; Currie, Cameron R

2010-03-29

Leaf-cutter ants use fresh plant material to grow a mutualistic fungus that serves as the ants' primary food source. Within fungus gardens, various plant compounds are metabolized and transformed into nutrients suitable for ant consumption. This symbiotic association produces a large amount of refuse consisting primarily of partly degraded plant material. A leaf-cutter ant colony is thus divided into two spatially and chemically distinct environments that together represent a plant biomass degradation gradient. Little is known about the microbial community structure in gardens and dumps or variation between lab and field colonies. Using microbial membrane lipid analysis and a variety of community metrics, we assessed and compared the microbiota of fungus gardens and refuse dumps from both laboratory-maintained and field-collected colonies. We found that gardens contained a diverse and consistent community of microbes, dominated by Gram-negative bacteria, particularly gamma-Proteobacteria and Bacteroidetes. These findings were consistent across lab and field gardens, as well as host ant taxa. In contrast, dumps were enriched for Gram-positive and anaerobic bacteria. Broad-scale clustering analyses revealed that community relatedness between samples reflected system component (gardens/dumps) rather than colony source (lab/field). At finer scales samples clustered according to colony source. Here we report the first comparative analysis of the microbiota from leaf-cutter ant colonies. Our work reveals the presence of two distinct communities: one in the fungus garden and the other in the refuse dump. Though we find some effect of colony source on community structure, our data indicate the presence of consistently associated microbes within gardens and dumps. Substrate composition and system component appear to be the most important factor in structuring the microbial communities. These results thus suggest that resident communities are shaped by the plant degradation gradient created by ant behavior, specifically their fungiculture and waste management.

The Effects of Satisfaction of Basic Psychological Needs at School on Children’s Prosocial Behavior and Antisocial Behavior: The Mediating Role of School Satisfaction

PubMed Central

Tian, Lili; Zhang, Xiao; Huebner, E. Scott

2018-01-01

Grounded in Basic Psychological Need Theory, we examined the direct effects of the satisfaction of three basic psychological needs at school (i.e., satisfaction of autonomy needs at school, satisfaction of relatedness needs at school, and satisfaction of competence needs at school) on prosocial behavior and antisocial behavior as well as the mediation effects of school satisfaction on the relations between the satisfaction of three basic psychological needs at school and prosocial behavior as well as antisocial behavior. We employed a sample of 801 Chinese children (429 males; Mage = 9.47) in a three-wave longitudinal study, with each wave occurring 6 months apart. Direct and indirect effects were estimated by Structural Equation Modeling. Results indicated that: (1) Satisfaction of relatedness needs at school and competence needs at school, but not satisfaction of autonomy needs at school, displayed direct effects on prosocial behavior. Also, satisfaction of relatedness needs at school, but not satisfaction of autonomy needs at school or competence needs at school, displayed direct effects on antisocial behavior. (2) Both satisfaction of relatedness needs at school and competence needs at school displayed indirect effects on prosocial behavior and antisocial behavior via school satisfaction as a mediator. However, satisfaction of autonomy needs at school failed to have indirect effects on prosocial behavior or antisocial behavior via school satisfaction. These findings suggest differential predictors of children’s prosocial and antisocial behavior, supporting the separability of the two constructs. The findings also suggest developmental differences in need satisfaction, with the satisfaction of autonomy needs playing a relatively less important role in school-age children. We also discussed limitations and practical applications of the study. PMID:29719523

The Effects of Satisfaction of Basic Psychological Needs at School on Children's Prosocial Behavior and Antisocial Behavior: The Mediating Role of School Satisfaction.

PubMed

Tian, Lili; Zhang, Xiao; Huebner, E Scott

2018-01-01

Grounded in Basic Psychological Need Theory, we examined the direct effects of the satisfaction of three basic psychological needs at school (i.e., satisfaction of autonomy needs at school, satisfaction of relatedness needs at school, and satisfaction of competence needs at school) on prosocial behavior and antisocial behavior as well as the mediation effects of school satisfaction on the relations between the satisfaction of three basic psychological needs at school and prosocial behavior as well as antisocial behavior. We employed a sample of 801 Chinese children (429 males; M age = 9.47) in a three-wave longitudinal study, with each wave occurring 6 months apart. Direct and indirect effects were estimated by Structural Equation Modeling. Results indicated that: (1) Satisfaction of relatedness needs at school and competence needs at school, but not satisfaction of autonomy needs at school, displayed direct effects on prosocial behavior. Also, satisfaction of relatedness needs at school, but not satisfaction of autonomy needs at school or competence needs at school, displayed direct effects on antisocial behavior. (2) Both satisfaction of relatedness needs at school and competence needs at school displayed indirect effects on prosocial behavior and antisocial behavior via school satisfaction as a mediator. However, satisfaction of autonomy needs at school failed to have indirect effects on prosocial behavior or antisocial behavior via school satisfaction. These findings suggest differential predictors of children's prosocial and antisocial behavior, supporting the separability of the two constructs. The findings also suggest developmental differences in need satisfaction, with the satisfaction of autonomy needs playing a relatively less important role in school-age children. We also discussed limitations and practical applications of the study.

A quality of life quandary: a framework for navigating parental refusal of treatment for co-morbidities in infants with underlying medical conditions.

PubMed

Kunz, Sarah N; McAdams, Ryan M; Diekema, Douglas S; Opel, Douglas J

2015-01-01

Parental refusal of a recommended treatment is not an uncommon scenario in the neonatal intensive care unit. These refusals may be based upon the parents' perceptions of their child's projected quality of life. The inherent subjectivity of quality of life assessments, however, can exacerbate disagreement between parents and healthcare providers. We present a case of parental refusal of surgical intervention for necrotizing enterocolitis in an infant with Bartter syndrome and develop an ethical framework in which to consider the appropriateness of parental refusal based upon an infant's projected quality of life. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.

Problem Solving: Helping Students Move From Novices Toward Experts

NASA Astrophysics Data System (ADS)

Harper, Kathleen A.

2010-10-01

When introductory physics students engage in problem solving, they often exhibit behaviors that can frustrate their teachers. Some well-known examples of these habits include refusing to draw free-body diagrams, hunting through the book to find an example problem to use as a (perhaps inappropriate) template, and the classic ``plug-n-chug'' mentality. Studies in science education and cognitive science have yielded rational explanations for many of these novice behaviors and lay a groundwork for instructors to aid their students in beginning to develop more expert-like skills and behaviors. A few examples of these studies, as well as curricular tools that have developed as a result, will be shared. These tools not only encourage students to try more expert-like strategies, but also prime them for developing conceptual understanding.