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To describe the anthropometry, socioeconomic circumstances, diet and screen time usage of adolescents in India and Africa as context to a qualitative study of barriers to healthy eating and activity.
Cross-sectional survey, including measured height and weight and derived rates of stunting, low BMI, overweight and obesity. Parental schooling and employment status, household assets and amenities, and adolescents’ dietary diversity, intake of snack foods, mobile/smartphone ownership and TV/computer time were obtained via a questionnaire.
Four settings each in Africa (rural villages, West Kiang, The Gambia; low-income urban communities, Abidjan, Cote D’Ivoire; low/middle-class urban communities, Jimma, Ethiopia; low-income township, Johannesburg, South Africa) and India (rural villages, Dervan; semi-rural villages, Pune; city slums, Mumbai; low-middle/middle-class urban communities, Mysore).
Convenience samples (n 41–112 per site) of boys and girls, half aged 10–12 years and another half aged 15–17 years, were recruited for a qualitative study.
Both undernutrition (stunting and/or low BMI) and overweight/obesity were present in all settings. Rural settings had the most undernutrition, least overweight/obesity and greatest diet diversity. Urban Johannesburg (27 %) and Abidjan (16 %), and semi-rural Pune (16 %) had the most overweight/obesity. In all settings, adolescents reported low intakes of micronutrient-rich fruits and vegetables, and substantial intakes of salted snacks, cakes/biscuits, sweets and fizzy drinks. Smartphone ownership ranged from 5 % (West Kiang) to 69 % (Johannesburg), higher among older adolescents.
The ‘double burden of malnutrition’ is present in all TALENT settings. Greater urban transition is associated with less undernutrition, more overweight/obesity, less diet diversity and higher intakes of unhealthy/snack foods.
To explore adolescents’ perceptions, knowledge and behaviours regarding nutrition and physical activity in low-income districts of Abidjan, Côte d’Ivoire, taking into consideration their caregivers’ perspectives.
Two investigators conducted six focus group discussions.
The study was carried out in two low-income suburbs, Yopougon and Port-Bouët, in Abidjan, Côte d’Ivoire.
Adolescents and their caregivers were recruited into the study via local head teachers and heads of settlement.
Overall, seventy-two participants, including forty-six adolescents and twenty-six caregivers, took part. Participants demonstrated good nutrition knowledge, relating nutritional health to a balanced diet and hygiene. Sustained physical activity was reported. However, adopting good practices was challenging due to participant’s economic circumstances. Their environment was a barrier to improving health due to dirtiness and violence, with a lack of space limiting the possibility to practice sport. Adolescents and their caregivers differed in their response to these constraints. Many caregivers felt powerless and suggested that a political response was the solution. Alternatively, adolescents were more likely to suggest new creative solutions such as youth-friendly centres within their community.
Participants were aware that their nutritional habits were not in line with what they had learnt to be good nutritional practices due to socio-economic constraints. Physical activity was part of adolescent life, but opportunities to exercise were restricted by their environment. Strategies for improving adolescent health in these settings need to be developed in collaboration with adolescents in a manner that accommodates their opinions and solutions.
This article positions multidisciplinary artist Friedl Dicker-Brandeis at the center of a web that spans Vienna 1900, the Weimar Bauhaus, and interwar Vienna. Using a network metaphor to read her work, she is understood here as specialist of the ars combinatoria, in which she recombines genre and media in unexpected ways. She translates the language of photograms into painting, ecclesiastical subject matter into a machine aesthetic, adds found objects to abstract paintings, and paints allegories and scenes of distortion in the idiom of New Objectivity, all the while designing stage sets, costumes, modular furniture, toys, and interiors. While she has been the subject of renewed attention, particularly in the design world, much of her fine art has yet to be assessed. She used the idioms of twentieth-century art movements in unusual contexts, some of these very brave: in interwar Vienna, where she created Dadaistic posters to warn of fascism, she was imprisoned and interrogated. Always politically engaged, her interdisciplinary and multimedia approach to art bridged the conceptual divide between the utopian and critical responses to war during the interwar years. Such engagement with both political strains of twentieth-century modernism is rare. After integrating the interdisciplinary lessons of Vienna and the Weimar Bauhaus into her life's work, she shared these lessons with children at Terezín.
OBJECTIVES/SPECIFIC AIMS: Compare effectiveness of a patient case-based, interactive teaching approach that included optional student genotyping with traditional didactic teaching strategies for increasing students’ knowledge and ability to effectively use pharmacogenomic data in clinical decision making. METHODS/STUDY POPULATION: The UF College of Pharmacy offers a required Personalized Medicine (PM) course for pharmacy students as well as an elective course, Clinical Applications of Personalized Medicine (CAPM). Students dual enrolled in the PM and elective CAPM courses comprised the intervention (INT) group, with interactive patient case-based teaching and the option to undergo personal genotyping, whereas students enrolled in PM alone comprised the control (CTR) group, which primarily used a traditional didactic teaching format and did not include personal genotyping. Both groups completed a pre- and post-course patient case-based test (15 questions/1 point each) to evaluate their knowledge and abilities to apply genotype and other patient-specific data to drug therapy recommendations. Pre- and post-course test scores for knowledge were compared between the INT and CTR groups using the Student t-test. RESULTS/ANTICIPATED RESULTS: In total, 52 students completed surveys (INT group, n=21; CTR group, n=31). Race was similar between groups, but there were fewer females in the INT compared with CTR group (8 vs. 22, p=0.02). Pre-course knowledge scores did not differ between INT and CTR groups (6.8±2.2 vs. 6.3±1.6 respectively, p=0.34), however, post-course scores were significantly higher in the INT Versus CTR group (10.0±2.3 vs. 7.5±1.7, p<0.0001). DISCUSSION/SIGNIFICANCE OF IMPACT: There have been significant advancements in the clinical applications of pharmacogenomic and genomic data, however, barriers to routine clinical adoption of genomic medicine persist. Developing education and training methods that equip practitioners to effectively translate genomic data into evidence-based clinical recommendations has been identified as a key strategy to overcome such barriers. Our data suggest that a personalized medicine course that employs patient-centered, case-based teaching strategies and includes optional personal genotyping for students compared with traditional didactic instruction improves students’ knowledge and abilities to apply pharmacogenomic data in practice-based scenarios. These results can inform future strategies for educating healthcare professionals on the clinical use of pharmacogenomic and genomic data.
OBJECTIVES/SPECIFIC AIMS: Obesity is a rapidly growing epidemic and long-term interventions aimed to reduce body weight are largely unsuccessful due to an increased drive to eat and a reduced metabolic rate established during weight loss. Previously, our lab demonstrated that exercise has beneficial effects on weight loss maintenance by increasing total energy expenditure above and beyond the cost of an exercise bout and reducing the drive to eat when allowed to eat ad libitum (relapse). We hypothesized that exercise’s ability to counter these obesogenic-impetuses are mediated via improvements in skeletal muscle oxidative capacity, and tested this using a mouse model with augmented oxidative capacity in skeletal muscle. METHODS/STUDY POPULATION: We recapitulated the exercise-induced improvements in oxidative capacity using FVB mice that overexpress lipoprotein lipase in skeletal muscle (mLPL). mLPL and wild type (WT) mice were put through a weight-loss-weight-regain paradigm consisting of a high fat diet challenge for 13 weeks, with a subsequent 1-week calorie-restricted medium fat diet to induce a ~15% weight loss. This newly established weight was maintained for 2 weeks and followed with a 24-hour relapse. Metabolic phenotype was characterized by indirect calorimetry during each phase. At the conclusion of the relapse day, mice were sacrificed and tissues were harvested for molecular analysis. RESULTS/ANTICIPATED RESULTS: During weight loss maintenance, mLPL mice had a higher metabolic rate (p=0.0256) that was predominantly evident in the dark cycle (p=0.0015). Furthermore, this increased metabolic rate was not due to differences in activity (p=0.2877) or resting metabolic rate (p=0.4881). During relapse, mLPL mice ingested less calories and were protected from rapid weight regain (p=0.0235), despite WT mice exhibiting higher metabolic rates during the light cycle (p=0.0421). DISCUSSION/SIGNIFICANCE OF IMPACT: These results highlight the importance of muscular oxidative capacity in preventing a depression in total energy expenditure during weight loss maintenance, and in curbing overfeeding and weight regain during a relapse. Moreover, our data suggest that the thermic effect of food is responsible for the differences in metabolic rate, because no differences were found in activity or resting metabolic rate. Additional studies are warranted to determine the molecular mechanisms driving the ability of oxidative capacity to assist with weight loss maintenance.
Objectives: Intraindividual cognitive variability (IICV) has been shown to differentiate between groups with normal cognition, mild cognitive impairment (MCI), and dementia. This study examined whether baseline IICV predicted subsequent mild to moderate cognitive impairment in a cognitively normal baseline sample. Methods: Participants with 4 waves of cognitive assessment were drawn from the Wisconsin Registry for Alzheimer’s Prevention (WRAP; n=684; 53.6(6.6) baseline age; 9.1(1.0) years follow-up; 70% female; 74.6% parental history of Alzheimer’s disease). The primary outcome was Wave 4 cognitive status (“cognitively normal” vs. “impaired”) determined by consensus conference; “impaired” included early MCI (n=109), clinical MCI (n=11), or dementia (n=1). Primary predictors included two IICV variables, each based on the standard deviation of a set of scores: “6 Factor IICV” and “4 Test IICV”. Each IICV variable was tested in a series of logistic regression models to determine whether IICV predicted cognitive status. In exploratory analyses, distribution-based cutoffs incorporating memory, executive function, and IICV patterns were used to create and test an MCI risk variable. Results: Results were similar for the IICV variables: higher IICV was associated with greater risk of subsequent impairment after covariate adjustment. After adjusting for memory and executive functioning scores contributing to IICV, IICV was not significant. The MCI risk variable also predicted risk of impairment. Conclusions: While IICV in middle-age predicts subsequent impairment, it is a weaker risk indicator than the memory and executive function scores contributing to its calculation. Exploratory analyses suggest potential to incorporate IICV patterns into risk assessment in clinical settings. (JINS, 2016, 22, 1016–1025)
There is a growing body of literature describing the characteristics of patients who plan for the end of life, but little research has examined how caregivers influence patients' advance care planning (ACP). The purpose of this study was to examine how patient and caregiver characteristics are associated with advance directive (AD) completion among patients diagnosed with a terminal illness. We defined AD completion as having completed a living will and/or identified a healthcare power of attorney.
A convenience sample of 206 caregiver–patient dyads was included in the study. All patients were diagnosed with an advanced life-limiting illness. Trained research nurses administered surveys to collect information on patient and caregiver demographics (i.e., age, sex, race, education, marital status, and individual annual income) and patients' diagnoses and completion of AD. Multivariate logistic regression was employed to model predictors for patients' AD completion.
Over half of our patient sample (59%) completed an AD. Patients who were older, diagnosed with amyotrophic lateral sclerosis, and with a caregiver who was Caucasian or declined to report an income level were more likely to have an AD in place.
Significance of results:
Our results suggest that both patient and caregiver characteristics may influence patients' decisions to complete an AD at the end of life. When possible, caregivers should be included in advance care planning for patients who are terminally ill.
Objectives: Visuospatial processing deficits have been reported in Huntington’s disease (HD). To date, no study has examined associations between visuospatial cognition and posterior brain findings in HD. Methods: We compared 119 premanifest (55> and 64<10.8 years to expected disease onset) and 104 early symptomatic (59 stage-1 and 45 stage-2) gene carriers, with 110 controls on visual search and mental rotation performance at baseline and 12 months. In the disease groups, we also examined associations between task performance and disease severity, functional capacity and structural brain measures. Results: Cross-sectionally, there were strong differences between all disease groups and controls on visual search, and between diagnosed groups and controls on mental rotation accuracy. Only the premanifest participants close to onset took longer than controls to respond correctly to mental rotation. Visual search negatively correlated with disease burden and motor symptoms in diagnosed individuals, and positively correlated with functional capacity. Mental rotation (“same”) was negatively correlated with motor symptoms in stage-2 individuals, and positively correlated with functional capacity. Visual search and mental rotation were associated with parieto-occipital (pre-/cuneus, calcarine, lingual) and temporal (posterior fusiform) volume and cortical thickness. Longitudinally, visual search deteriorated over 12 months in stage-2 individuals, with no evidence of declines in mental rotation. Conclusions: Our findings provide evidence linking early visuospatial deficits to functioning and posterior cortical dysfunction in HD. The findings are important since large research efforts have focused on fronto-striatal mediated cognitive changes, with little attention given to aspects of cognition outside of these areas. (JINS, 2016, 22, 595–608)
The fact that crime and disorder are concentrated at a few places is interesting and deserves an explanation. It is also interesting that places show up in other criminological theories and in other disciplines. And it is useful to understand the methods for studying places. However, a primary reason we are interested in high-crime places is that it might be possible to do something about crime by addressing these places. We are convinced that focusing on places can substantially reduce crime and disorder. Our conviction is not a matter of faith, but is based on over twenty-five years of accumulating evidence.
This chapter summarizes the research evidence examining whether focusing on crime places reduces crime. We first discuss a broad range of place-based prevention strategies examined by Eck and Guerrette (2012). This review provides strong evidence for a place-based approach to crime prevention. We then turn to a specific form of place-based crime prevention – hot spots policing (Sherman and Weisburd 1995). Again, we have a strong body of evidence supporting a place-based approach. Having reviewed hot spots policing, we turn to the importance of place managers and third parties in controlling problem places. We then examine an extension of the third-party approach to argue that a place-based approach to crime may free crime control policy from the police monopoly. Then we describe how a place-based approach to crime could be incorporated in community corrections to improve probation and parole outcomes. Finally, we review the larger body of research on the potential threat of crime displacement, and its opposite, the diffusion of crime control benefits. Consistently, the evidence described in this chapter clearly shows the substantial utility of a place-based approach for reducing crime.
SITUATIONAL CRIME PREVENTION AT PLACES
In Chapter 3 we argued for the importance of social disorganization theories for understanding crime places. This is an area where basic research suggests promise (e.g., see Weisburd et al. 2012; Weisburd et al. 2014), but where there is little evidence of effectiveness of specific practices. Such evidence is beginning to be developed, but we can say little at this juncture. In contrast, the evidence regarding opportunity reduction and crime has grown systematically over the last few decades.
Take a moment to imagine a crime occurring – perhaps a street robbery or a bag snatch. When you do this, it is difficult not to visualize the crime occurring in a particular setting or place. So, you might imagine a dark street corner with dim street lighting or seating in the outside area of a public bar. It seems intuitively sensible to analyze and understand crime at this unit of analysis – in other words, to investigate how criminals behave and crime concentrates at small microplaces. However, engaging in such microlevel analysis has tended to be a more recent criminological undertaking, and there are still many fruitful avenues to explore in terms of advancing both our knowledge and the sophistication of the methods that we use in this research area.
In this chapter, we raise and endeavor to answer a number of questions concerning the appropriate scale of analysis of criminological enquiry. To do this, we will start by defining what we mean by place and how this differs from other geographic concepts. Next, we highlight what has become the key catalyst for the criminology of place – the tremendous concentration of crime at microgeographic units of analysis. The strong and consistent concentration of crime at addresses, street segments, and other microgeographic units across cities is key to understanding why it is important to study the criminology of place and why it has such strong policy implications. We then turn to some additional statistical benefits of studying crime at microgeographic units that have to do with what is often termed “spatial interaction effects.” Finally, we examine problems that crime and place researchers will need to consider, and recommend some future directions for research exploring crime concentration at places.
PLACE AND SPACE
Geographic concepts are sometimes used in criminological research without a clear understanding of their meaning. Place and space are two such concepts. The subtle difference between them is important to keep in mind, as they can be a guide to establishing a carefully constructed study and influence the interpretation of findings. Furthermore, as will become apparent later in this chapter, a confusion of these concepts can mislead the reader in the interpretation of an argument. For example, it is important to keep in mind that place does not necessarily mean small units of analysis, nor does space necessarily refer to large areas.
Over the last two decades, there has been increased interest in the distribution of crime and other antisocial behavior at lower levels of geography. The focus on micro geography and its contribution to the understanding and prevention of crime has been called the 'criminology of place'. It pushes scholars to examine small geographic areas within cities, often as small as addresses or street segments, for their contribution to crime. Here, the authors describe what is known about crime and place, providing the most up-to-date and comprehensive review available. Place Matters shows that the study of criminology of place should be a central focus of criminology in the twenty-first century. It creates a tremendous opportunity for advancing our understanding of crime, and for addressing it. The book brings together eighteen top scholars in criminology and place to provide comprehensive research expanding across different themes.
This chapter explores the importance of place in theory and research in both mainstream criminology and other disciplines. As we noted in earlier chapters, traditional criminology has focused primarily on understanding why people commit crime. This focus on criminality has generally inhibited study of microgeographies and their role in producing crime. However, more recently there has been a trend toward integrating microgeographic places into traditional theorizing about criminality. In the first part of the chapter we discuss this trend, focusing on some recent innovations in understanding criminality that have incorporated place-based perspectives. In the second part of the chapter we focus on how other disciplines have influenced thinking in this area, focusing in particular on contributions in psychology, economics, and public health. Finally, we explore how trends in other disciplines might influence future directions of study in the criminology of place.
THE GROWING ROLE OF MICROGEOGRAPHIC PLACES IN TRADITIONAL THEORIZING OF CRIMINALITY
As we noted in Chapter 1, places, at least at a macro level, played a key part in the development of criminology in the nineteenth and early twentieth centuries. But despite the role of place in crime in empirical study in Europe and theoretical development in the Chicago School through social disorganization theory, microgeographic places were mostly ignored. This was not because early criminologists failed to recognize the role of place in crime. Crime occurs in specific environments, and this was apparent to observers of the crime problem. Nonetheless, as we noted in Chapter 1, early criminologists did not see “crime places” – small discrete areas within communities – as a relevant focus of criminological study. This was the case, in part, because crime opportunities provided by places were assumed to be so numerous as to make concentration on specific places of little utility for theory or policy. What is the point of focusing theory or research on the opportunities offered by specific places if such opportunities can be found throughout the urban context?
Moreover, criminologists did not see the utility in focusing in on situational opportunities when criminal motivation was the key to understanding crime rates. Criminologists traditionally assumed that situational factors played a relatively minor role in explaining crime as compared with the “driving force of criminal dispositions” (Clarke and Felson 1993, 4; Trasler 1993).
In the previous chapter, we showed that crime is concentrated at very small geographic units, substantially smaller than neighborhoods, and that these concentrations, on average, are relatively stable. This is true whether examining high- or low-crime neighborhoods. Although high-crime places do cluster, they seldom form a homogeneous block of high-crime places. Rather, interspersed within concentrations of high-crime places are many low- and modest-crime places.
Why is crime concentrated in a relatively small number of places? Standard criminology has not asked this question, largely because standard criminology focuses on criminality and implicitly assumes that the density of offenders explains crime density. Recognition that place characteristics matter is the starting point for this chapter. We look at two perspectives on crime place characteristics. We use the term “perspective” because each type of explanation is comprised of multiple theories linked by a common orientation. The first perspective arises from opportunity theories of crime. The second perspective arises from social disorganization theories of crime.
We begin by contrasting two ways of thinking about how a place becomes a crime hot spot and suggest that the process by which high-crime places evolve must involve place characteristics. In the next sections, we examine opportunity and social disorganization explanations. In the final section of the chapter, we examine possible ways researchers might link these two perspectives.
PROCESSES THAT CREATE CRIME PLACES
Before we look for explanations of why places become hot spots of crime it is important to consider two processes that might lead to such an outcome. Criminologists have generally proposed two generic models to account for the processes that lead to variation in place susceptibility to crime. One model suggests that places may start with reasonably similar risks of an initial criminal attack, but once attacked the risk of a subsequent attack on the place rises. Over time, places diverge in their crime risk, and consequently in their crime counts. This temporal contagion model is also known as a boost model (see Chapter 2) or a state-dependence model. It puts the emphasis on offenders’ willingness to return to a previously successful crime site (Johnson et al. 2007; Townsley et al. 2000). It suggests that irrespective of initial crime risk the occurrence of a crime will lead to changes in risk of crime at a place.
We began this book by noting that criminologists have largely ignored the involvement of microgeographic places in crime. Mainstream criminologists have focused on “who done it?” and not “where done it?” (Sherman 1995). At least for the last century the key inquiries of crime and the key prevention approaches have looked to doing something about criminal motivation (Sutherland 1947; Reiss 1981). Why people commit crime has been the main focus of criminology (Brantingham and Brantingham 1990; Weisburd 2002), and catching and processing offenders has been the main focus of crime prevention (Weisburd 2008). In contrast, the criminology of place (Sherman et al. 1989; Weisburd et al. 2012), which began to develop in the 1980s and 1990s (Brantingham and Brantingham 1981; 1984; Eck 1994; Eck and Weisburd 1995; Roncek and Bell 1981; Weisburd and Green 1995a), provides an alternative vision of how we can understand crime and the crime problem. Like the emergence of community criminology during the same period (Bursik 1988; Morenoff et al. 2001; Sampson 2008; Sampson et al. 1997) the criminology of place has offered a new set of mechanisms for crime study and a new set of methods for doing something about the crime problem.
Theory has been a driving force in criminological study, and as we note below, we think that more not less attention to theory is important for advancing the criminology of place. However, theories are about something and try to explain something. When we change the unit of analysis, we are changing the target for theory. The criminology of place proposes a new target. It focuses on places, rather than people. Its goal is to explain the criminal involvement of microgeographic units rather than trying to explain the criminal involvement of people. This does not mean we ignore the role of individuals in the crime problem. But it does mean that we begin our inquiries with the place and see the individuals as only one part of the crime equation at places.
We have illustrated in the preceding chapters the extent to which theory, method, and empirical evidence about crime places have been developing over the last three decades. In this concluding chapter, we want to draw from our review of what is known some key themes that we think our work has identified, and key questions that still need to be answered.