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Thomas R. Blair

Bio: Thomas R. Blair is an academic researcher from University of California, Los Angeles. The author has contributed to research in topics: Mental health & Acquired immunodeficiency syndrome (AIDS). The author has an hindex of 8, co-authored 13 publications receiving 268 citations. Previous affiliations of Thomas R. Blair include Kaiser Permanente & Semel Institute for Neuroscience and Human Behavior.

Papers
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Journal ArticleDOI
TL;DR: Involving older adults in PAR, while labor intensive and challenging, may offer promise as an underdeveloped resource for the field of social gerontology, as well as for elders themselves.
Abstract: Purpose: Although participatory action research (PAR) is increasingly viewed as an important complement to traditional investigator-driven research, relatively little PAR has taken place in which older adults have been prominent partners. This article provides a review of the literature on PAR in gerontology, highlighting key studies and their implications. Design and Methods: We searched PubMed, PsycINFO, and ERIC for relevant articles, supplementing our results through the bibliographies of articles identifi ed and consultation with colleagues. This search yielded 75 articles of potential relevance, of which we selected 13 (covering 10 studies) that best adhered to the roles of PAR in gerontology. Results: PAR projects with older adults have utilized a variety of research methodologies in a broad range of social contexts. Each of the 10 studies examined illustrates several core principles of PAR. Furthermore, while suffering from some methodological limitations, each also highlights value added in terms of research quality, elders ’ skill building, and/or action outcomes. Implications: Involving older adults in PAR, while labor intensive and challenging, may offer promise as an underdeveloped resource for the fi eld of social gerontology, as well as for elders themselves.

162 citations

Journal ArticleDOI
TL;DR: Understanding disproportionate psychopathology matters for developing prevention policies and addressing the unique needs of people who have experienced solitary confinement, an extreme element of mass incarceration.
Abstract: Objectives. To specify symptoms and measure prevalence of psychological distress among incarcerated people in long-term solitary confinement.Methods. We gathered data via semistructured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for 106 randomly selected people in solitary confinement in the Washington State Department of Corrections in 2017. We performed 1-year follow-up interviews and BPRS assessments with 80 of these incarcerated people, and we present the results of our qualitative content analysis and descriptive statistics.Results. BPRS results showed clinically significant symptoms of depression, anxiety, or guilt among half of our research sample. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations. Interview content analysis revealed additional symptoms, including social isolation, loss of identity, and sensory hypersensitivity.Conclusions. Our coordinated study of rating scale, interview, and administrative data illustrates the public health crisis of solitary confinement. Because 95% or more of all incarcerated people, including those who experienced solitary confinement, are eventually released, understanding disproportionate psychopathology matters for developing prevention policies and addressing the unique needs of people who have experienced solitary confinement, an extreme element of mass incarceration.

62 citations

Journal ArticleDOI
TL;DR: Examination of the roles of ambassadors in ecologic context as community health workers (CHWs) for clients undergoing late-life acculturation in the CAPS context found hybridity of social roles, integrating familial and professional attributes, but fully achieving neither familial nor professional status.

27 citations

Journal ArticleDOI
09 Oct 2020-PLOS ONE
TL;DR: It is found that solitary confinement is associated not just with mental, but also with physical health problems, and given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations.
Abstract: We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae.

21 citations

Book ChapterDOI
01 Jan 2015
TL;DR: The last week of Bradley Ballard's life, he made a lewd gesture at a female officer and was subsequently placed in total solitary confinement as mentioned in this paper, for several days, he was not allowed to leave his cell, nor was he given medications.
Abstract: Bradley Ballard died of sepsis in May 2014 after he tied a rubber band around his genitals, smeared his body with feres, and passed out in his Rikers Island. New York City jail cell. Ballard had been arrested tor assault and public lewdness in 2013; he had previously served six years in New York state prisons for assault charges. Ballard was known to be severely mentally ill; he had spent 38 days in a prison psychiatric hospital in the weeks before he died, in the last week of his life, he made a lewd gesture at a female officer and was subsequently placed in total solitary confinement. For several days, he was not allowed to leave his cell, nor was he given medications. Because he intentionally stopped up his toilet, the water line supplying his cell was shut off (Pearson 2014).

18 citations


Cited by
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Journal ArticleDOI
TL;DR: This synthetic review is to review the evidence for an association between inflammation and mood disorders, to discuss potential pathophysiologic mechanisms that may explain this association and to present novel therapeutic options currently being investigated that target the inflammatory-mood pathway.
Abstract: Mood disorders have been recognized by the World Health Organization (WHO) as the leading cause of disability worldwide. Notwithstanding the established efficacy of conventional mood agents, many treated individuals continue to remain treatment refractory and/or exhibit clinically significant residual symptoms, cognitive dysfunction, and psychosocial impairment. Therefore, a priority research and clinical agenda is to identify pathophysiological mechanisms subserving mood disorders to improve therapeutic efficacy. During the past decade, inflammation has been revisited as an important etiologic factor of mood disorders. Therefore, the purpose of this synthetic review is threefold: 1) to review the evidence for an association between inflammation and mood disorders, 2) to discuss potential pathophysiologic mechanisms that may explain this association and 3) to present novel therapeutic options currently being investigated that target the inflammatory–mood pathway. Accumulating evidence implicates inflammation as a critical mediator in the pathophysiology of mood disorders. Indeed, elevated levels of pro-inflammatory cytokines have been repeatedly demonstrated in both major depressive disorder (MDD) and bipolar disorder (BD) patients. Further, the induction of a pro-inflammatory state in healthy or medically ill subjects induces ‘sickness behavior’ resembling depressive symptomatology. Potential mechanisms involved include, but are not limited to, direct effects of pro-inflammatory cytokines on monoamine levels, dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, pathologic microglial cell activation, impaired neuroplasticity and structural and functional brain changes. Anti-inflammatory agents, such as acetyl-salicylic acid (ASA), celecoxib, anti-TNF-α agents, minocycline, curcumin and omega-3 fatty acids, are being investigated for use in mood disorders. Current evidence shows improved outcomes in mood disorder patients when anti-inflammatory agents are used as an adjunct to conventional therapy; however, further research is needed to establish the therapeutic benefit and appropriate dosage.

479 citations

Journal ArticleDOI
TL;DR: This is the first international systematic review to focus on the impact of PPI on the people involved in the process, highlighting the importance of optimising the context and processes of involvement, so creating the potential for PPI to impact positively on the research itself.
Abstract: Objective Patient and public involvement (PPI) in research has expanded nationally and internationally over the last decade, and recently there has been significant attention given to understanding its impact on research. Less attention has been given to the impact of PPI on the people involved, yet it has been shown that the success of PPI in research can be reliant on the processes of engagement between these individuals and communities. This paper therefore critically explores the impact of PPI on service users, researchers and communities involved in health and social care research.

430 citations

Journal ArticleDOI
TL;DR: Key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions aimed at facilitating public health intervention co-creation and evaluation by ensuring the process is systematic and reproducible are presented.
Abstract: Background: Society has to cope with a large burden of health issues. There is need to find solutions to prevent diseases and help individuals live healthier lifestyles. Individual needs and circumstances vary greatly and one size fit all solutions do not tend to work well. More tailored solutions centred on individuals’ needs and circumstances can be developed in collaboration with these individuals. This process, known as co-creation, has shown promise but it requires guiding principles to improve its effectiveness. The aim of this study was to identify a key set of principles and recommendations for co-creating public health interventions. Methods: These principles were collaboratively developed through analysing a set of case studies targeting different health behaviours (such as reducing sitting and improving strength and balance) in different groups of people (such as adolescent schoolgirls and older adults living in the community). Results: The key principles of co-creation are presented in four stages: Planning (what is the purpose of the co-creation; and who should be involved?); Conducting (what activities can be used during co-creation; and how to ensure buy-in and commitment?); Evaluating (how do we know the process and the outcome are valid and effective?) and Reporting (how to report the findings?). Three models are proposed to show how co-created solutions can be scaled up to a population level. Conclusions: These recommendations aim to help the co-creation of public health interventions by providing a framework and governance to guide the process. Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible.

165 citations

Journal ArticleDOI
TL;DR: This work described study design and implantation of the PINE study, highlighting strategies in adapting a population-based study design to the Chinese community, including community-engaged recruitment, innovative data collection methods, and culturally and linguistically sensitive study infrastructure.
Abstract: Objective: Multiple barriers in research participation have excluded the Chinese older adults from benefitting the recent advancement of aging sciences. The paucity of systematic understanding of Chinese aging population necessitated the Population-Based Study of ChINese Elderly in Chicago (PINE). Method: Guided by community-based participatory research approach, the PINE study is a population-based epidemiological study of Chinese older adults aged 60 and above in the Greater Chicago area. Results: We described study design and implantation of the PINE study, highlighting strategies in adapting a population-based study design to the Chinese community. These measures included community-engaged recruitment, innovative data collection methods, and culturally and linguistically sensitive study infrastructure. Discussion: The intricate cultural and linguistic diversity among U.S. Chinese older adults, coupled with their demographic characteristics and residential pattern, present challenges and opportunities ...

161 citations