The effect of prophylactic hemoclips on the risk of delayed post-endoscopic mucosal resection bleed for upper and lower gastrointestinal lesions: a retrospective cohort study.

BACKGROUND: Endoscopic mucosal resection (EMR) is a minimally invasive procedure used for the treatment of lesions in the gastrointestinal (GI) tract. There is increased usage of hemoclips during EMR for the prevention of delayed bleeding. This study aimed to evaluate the effect of hemoclips in the prevention of delayed bleeding after EMR of upper and lower GI tract lesions. METHOD: This is a retrospective cohort study using the Kaiser Permanente Southern California (KPSC) EMR registry. Lesions in upper and lower GI tracts that underwent EMR between January 2012 and December 2015 were analyzed. Rates of delayed bleeding were compared between the hemoclip and no-hemoclip groups. Analysis was stratified by upper GI and lower GI lesions. Lower GI group was further stratified by right and left colon. We examined the relationship between clip use and several clinically-relevant variables among the patients who exhibited delayed bleeding. Furthermore, we explored possible procedure-level and endoscopist-level characteristics that may be associated with clip usage. RESULTS: A total of 18 out of 657 lesions (2.7%) resulted in delayed bleeding: 7 (1.1%) in hemoclip group and 11 (1.7%) in no-hemoclip group (p = 0.204). There was no evidence that clip use moderated the effects of the lesion size (p = 0.954) or lesion location (p = 0.997) on the likelihood of delayed bleed. In the lower GI subgroup, clip application did not alter the effect of polyp location (right versus left colon) on the likelihood of delayed bleed (p = 0.951). Logistic regression analyses showed that the clip use did not modify the likelihood of delayed bleeding as related to the following variables: use of aspirin/NSAIDs/anti-coagulants/anti-platelets, pathologic diagnoses (including different types of colon polypoid lesions), ablation, piecemeal resection. The total number of clips used was 901 at a minimum additional cost of $173,893. CONCLUSION: Prophylactic hemoclip application did not reduce delayed post-EMR bleed for upper and lower GI lesions in this retrospective study performed in a large-scale community practice setting. Routine prophylactic hemoclip application during EMR may lead to significantly higher healthcare cost without a clear clinical benefit.

The association between environmental and psychosocial factors towards physical activity and screen time of children: an application of the Integrative Behavioural Model.

Physical activity is beneficial at all stages of life, and has been linked as a protective factor from obesity, and other chronic health conditions. Despite the benefits of physical activity, less than half of US children meet the current recommendations, and activity levels decline with age. When planning physical activity interventions, behavioural theories should be utilised, given the inherent benefits theory-based approaches possess. The purpose of this study was to investigate how constructs of the Integrative Theoretical Model (IM) are associated with physical activity and screen time among children (9 years ±1.2; n = 264). Using structural equation modeling, a final model proved to have a good fit (CFI = 0.989; TLI = 0.975; RMSEA = 0.043), and results indicated intentions and perceived behavioural control (PBC) explained 19.4% of the variance for physical activity, and attitudes, perceived norms, and PBC accounted for 62% of the variance of intentions. Furthermore, attitudes and perceived norms were negatively associated with total screen time, and accounted for 10% of the variance. Results suggest that IM is a useful framework for explaining physical activity and screen time among children.

Does Self-Silencing Behavior Mediate the Relation Between Rejection Sensitivity and Sexual Violence Victimization?

Previous research reveals that rejection sensitivity is associated with both sexual violence victimization and self-silencing behavior, yet the association among these variables has not been examined. As the foundation for this study, we propose a theoretical model that integrates these constructs. Using mediational analyses with bootstrapping, the results from a sample of 241 heterosexual college women revealed that consistent with the proposed model, self-silencing mediated the link between rejection sensitivity and reports of unwanted sexual contact and rape. The implications of the findings for the prevention of victimization/revictimization and interventions with victimized women are discussed.

Symptomatic but not Asymptomatic COVID-19 Impairs Conditioned Pain Modulation in Young Adults.

Pain is a common symptom reported in COVID-19 patients. Impaired endogenous pain-modulatory mechanisms such as conditioned pain modulation (CPM), and exercise-induced hypoalgesia (EIH) have been found in chronic pain conditions but is often overlooked in acute conditions that evoke painful symptoms, such as COVID-19. The purpose was to compare pressure-pain sensitivity, CPM, and EIH function among individuals who previously had COVID-19, both symptomatically and asymptomatically, and a healthy control group. Pressure pain thresholds of 59 participants were assessed in the forearm and leg using a pressure algometer before and after 1) submersion of their dominant foot in cold water (2°C) for 1min; and 2) isometric knee extension performed to task-failure at 25% of their maximal contraction. The CPM response was attenuated in individuals who were infected with symptomatic COVID-19 (N = 26) compared to asymptomatic COVID-19 (N = 13) in arm (-1.0% ± 20.3 vs 33.3% ± 26.2; P < .001) and leg (12.8% ± 22.0 vs 33.8% ± 28.2; P = .014) and compared to controls (N = 20) in arm only (-1.0% ± 26.2 vs 23.4% ± 28.2; P = .004). The EIH response was not different between groups. CPM was impaired in individuals who had symptomatic COVID-19, which may have long-term implications on pain modulation. PERSPECTIVE: This study reveals that CPM was impaired in individuals who had symptomatic COVID-19 during the first wave of COVID-19, pre vaccine. These findings present a preliminary motive to study the long-term implications of COVID-19 and its effects on pain modulation.

Prejudice against international students: the role of threat perceptions and authoritarian dispositions in U.S. students.

International students provide a variety of benefits to higher education institutions within the United States (J. J. Lee, 2007; J. J. Lee & C. Rice, 2007). Despite these benefits, many international students experience prejudice and discrimination by American students. The purpose of the present study was to examine several potential predictors of prejudice against international students: perceptions of international students as symbolic and realistic threats, right-wing authoritarianism, and social dominance orientation. A simultaneous regression analysis that the authors based on 188 students at a Southwestern university revealed that perceptions of symbolic and realistic threats and social dominance orientation were each positive and significant predictors of prejudice. Mediation analyses suggested that the effects of right-wing authoritarianism on prejudice is fully mediated through perceived symbolic threat and partially mediated by realistic threat.

Predicting community opposition to inclusion in schools: the role of social dominance, contact, intergroup anxiety, and economic conservatism.

This study addresses community members' attitudes toward inclusion, the practice of including students with disabilities in regular education classroom settings. Participants in Study 1 were 271 community adults, completing measures of prior contact with people with disabilities, social dominance orientation (SDO), economic conservatism, intergroup anxiety, prejudice, and opposition to inclusion. Results from structural equation modeling indicated that amount of intergroup anxiety predicted opposition to inclusion via the mediator, prejudice toward people with disabilities, and that amount of prior contact indirectly predicted prejudice toward people with disabilities through intergroup anxiety. SDO positively predicted both intergroup anxiety and prejudice in the model, with prejudice also mediating between SDO and opposition to inclusion. Both SDO and economic conservatism failed to exhibit direct predictive relationships with opposition to inclusion. Participants in Study 2 were 161 community adults. Contact was shown to exert an indirect effect on prejudice via intergroup anxiety, whereas intergroup anxiety impacted inclusive attitudes via prejudice. SDO exerted both direct and indirect (via prejudice) effects on opposition to inclusion.

Does the DOG scale measure dogmatism? Another look at construct validity.

The author addressed the construct validity of B. Altemeyer's (1996) Dogmatism (DOG) scale. Confirmatory factor analyses of the scale provided evidence of unidimensionality, despite apparent method effects related to item wording. DOG scale scores correlated strongly and positively with the belief that knowledge is certain, providing convergent validity evidence for the measure. Scores on the DOG scale appeared empirically distinguishable from measures of need for cognition, need for structure, and need to evaluate. Criterion-related validity evidence came in the form of theoretically predictable relationships between the DOG scale and measures of religious fundamentalism, quest orientation, national identification, conservative ideology, dangerous world beliefs, and reactions to individuals and groups who hold worldview-incongruent beliefs and values.

Are all conservatives alike? A study of the psychological correlates of cultural and economic conservatism.

The author addresses the question of whether cultural and economic conservatism differ among American citizens in their relation to measures of epistemic beliefs and motives, dogmatism, death-related anxiety, and the tendency to exhibit dogmatic aggression against those who hold beliefs and values that diverge from one's own. Data from this study suggest that these types of conservative attitudes exhibit different correlational patterns with the aforementioned measures. Research participants who held more culturally conservative attitudes were more likely to score higher on measures of the belief that knowledge is certain, dogmatism, need to evaluate, and fear of death. They also scored lower on need for cognition than did their less conservative counterparts. Moreover, participants who scored higher on cultural conservatism were more likely to exhibit dogmatic aggression. Economic conservatism was largely unrelated to measures of epistemic beliefs and motives, fear of death, dogmatism, and aggressiveness. Ancillary regression analyses revealed that belief that knowledge is certain and dogmatism were the strongest predictors of cultural conservatism. Cultural conservatism, fear of death, and need for structure were significant predictors of dogmatic aggression.

Political identification and the defining issues test: reevaluating an old hypothesis.

Research on the association between the development of moral judgment (as measured by the Defining Issues Test [DIT]; J. R. Rest, 1979) and political attitudes has demonstrated that these factors are often reliably related. N. Emler (1987, 1990) and colleagues have asserted that DIT scores actually measure test-takers' political identity rather than their developmental level. To test this claim, these researchers have designed "faking studies" in which respondents are asked to complete the DIT as if they were of a particular political orientation, regardless of their real political views. These faking studies have yielded contradictory conclusions, whereas tests of the incremental validity of the DIT have provided some evidence for its empirical distinctiveness. In the present study, the authors reexamined this issue by pitting scores on the DIT, Version 2 (DIT-2; J. R. Rest, D. Narvaez, S. J. Thoma, & M. J. Bebeau, 1999) against several more concrete measures of political identification in several predictive models of attitudes toward human rights and civil liberties. DIT-2 scores and political identification emerged as significant predictors in nearly all regression analyses.

Belief, motivational, and ideological correlates of human rights attitudes.

Many people believe that an informed and thoughtful citizenry is essential to the maintenance of democratic ideals within the United States and the spread of those ideals abroad. Since the September 11, 2001, terrorist attacks, the evidence that Americans consider issues of human dignity and rights when making judgments about the U.S. government's war on terror has been mixed. In our study, we assessed the relative contributions of ideological, belief, and cognitive-motivational factors to the prediction of human rights and civil liberties attitudes. Individuals scoring high on measures of right-wing authoritarianism (RWA) and the belief that the structure of knowledge is simple were the most likely to support restrictions on human rights and civil liberties as part of the war on terror. In a subsequent regression analysis, individuals scoring higher on personal need for structure or exhibiting lower levels of epistemological belief complexity tended to score higher on RWA. Additionally, men were generally more likely to support restrictions on rights and liberties and to score higher on RWA than were women.

Influences on cognitive engagement: epistemological beliefs and need for closure.

BACKGROUND: Research indicates that achievement goals influence cognitive engagement, which, in turn, influences academic achievement. We believe that there are other individual difference variables in the realm of personal epistemology that may also directly or indirectly influence cognitive engagement; specifically, epistemological beliefs and epistemological motives (e.g. need for closure). AIMS: This study proposed and tested a conceptual model of relationships among epistemological variables (epistemological beliefs and need for closure), achievement goals (mastery, performance-approach, performance-avoidance) and cognitive engagement. SAMPLE: Two hundred and fifty-nine students attending university in the US volunteered to participate in the study. Students represented a variety of academic disciplines and ranged from 18 to 58 years. METHODS: The participants completed three paper-and-pencil surveys: the Epistemological Beliefs Inventory; the Attitudes, Beliefs, and Experiences Inventory (a measure of need for closure); and the Approaches to Learning Survey (a measure of achievement goals and cognitive engagement). RESULTS: Structural equation modelling supported the model in general, although not all proposed paths were significant. Correlational analyses further indicated that epistemological beliefs and need for closure are both potentially important variables for understanding learners' treatment of knowledge in instructional settings. CONCLUSIONS: There are individual differences in epistemological beliefs and motives that may influence the goals students pursue in learning settings and the nature of their cognitive engagement.

The role of authoritarianism, perceived threat, and need for closure or structure in predicting post-9/11 attitudes and beliefs.

The authors examined relationships among authoritarianism, personal need for closure or structure, perceived threat, and post-9/11 attitudes and beliefs. Participants were 159 undergraduate students in the Southeastern United States. The authors collected data 1 week before the U.S.-led invasion of Iraq in March 2003. Correlation and regression analyses revealed that right-wing authoritarianism and social dominance orientation were significant predictors of support for restricting human rights during the U.S.-led War on Terror, support for U.S. President George W. Bush, and support for U.S. military involvement in Iraq. Right-wing authoritarianism and perceived threat emerged as the strongest predictors of the belief that Saddam Hussein supported terrorism.

Is political conservatism synonymous with authoritarianism?

The authors performed 2 studies that tested the distinction between conservative political ideology and right-wing authoritarianism (RWA). Across these studies, moderate relationships emerged between RWA and our measures of cognitive rigidity, whereas the relationship between rigidity and mainstream conservative ideology was not as strong. The authors used partial-correlation and path analyses to assess the possibility that RWA mediates the relationship between (a) cognitive rigidity and (b) mainstream conservative attitudes and self-identified conservatism. The results indicated that conservatism is not synonymous with RWA. Additionally, RWA appeared to partially mediate the relationship between cognitive rigidity and mainstream conservatism.