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Articles 1831 - 1860 of 33641
Full-Text Articles in Social and Behavioral Sciences
Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland
Identifying Barriers And Place-Based Solutions To Physical Activity For Older Adults In East Tennessee, Lydia Hoskins, Jodi Southerland
Journal of Appalachian Health
Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.
Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).
Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. …
Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson
Radon Environmental Health Literacy Among Health Council Participants In Northeast Tennessee, Kawther Al Ksir, Stacy Stanifer, Hadii M. Mamudu, Megan Quinn, Deborah L. Slawson
Journal of Appalachian Health
Introduction: Radon, a radioactive gas, poses significant health risks, including lung cancer, and is prevalent in indoor environments. Understanding radon testing behavior and Environmental Health Literacy (EHL) is crucial for individuals to take appropriate preventive measures.
Purpose: This study assessed radon-related EHL among Health Council participants in seven Northeast Tennessee (NETN) counties and examined associations between sociodemographic factors and EHL levels. Understanding radon knowledge and behaviors within this influential group is critical, as they often serve as trusted public health advocates.
Methods: A cross-sectional survey was conducted from September – November 2023 among Health Council participants across seven counties in …
Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener
Prevalence Of Screening Patients For Alcohol Use In West Virginia: A Cross-Sectional Observational Study, Bayan Abuhalimeh, Christopher Waters, R. Constance Wiener
Journal of Appalachian Health
Introduction: Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.
Purpose: The purpose of this cross-sectional study is to determine the likelihood …
Finding Community: A Thematic Analysis Of Resilience During The Pandemic, Myles Kwitny, Quinn Richards, Grace Digirolamo, Shannon Freedman, Sophie Wenzel
Finding Community: A Thematic Analysis Of Resilience During The Pandemic, Myles Kwitny, Quinn Richards, Grace Digirolamo, Shannon Freedman, Sophie Wenzel
Journal of Appalachian Health
Introduction: The Covid-19 pandemic impacted those within rural Appalachian communities, particularly people with marginalized identities.
Purpose: Through interviewing 44 participants from New River Valley, an Appalachian community in Virginia, this study sought to understand how resilience impacted individuals' experiences during the pandemic.
Methods: Participants belonged to one of the following groups: African American, Hispanic, older adults, or people who use drugs. Participants were required to reside in the New River Valley and be older than 18. Each participant was interviewed either in person, by phone, or over video call. Interviews were recorded, transcribed, then thematically analyzed for themes of resilience. …
Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold
Addressing The Root Causes Of Population Health In Central Appalachian Virginia, David L. Driscoll, Kol Gold
Journal of Appalachian Health
Introduction: The Southwest Virginia Health Authority (SWVHA) recently commissioned a community health needs assessment (CHNA) to reduce the high rate of preventable health problems in Virginia’s (VA) Appalachian Region. The CHNA took place over a two-year period from 2023 – 2025.
Purpose: This iterative, mixed-method CHNA informed the development of a new iteration of the regional Blueprint for Health Improvement and Health-Enabled Prosperity identifying and prioritizing health issues and develop strategic planning to address them in VA’s three westernmost regional health districts.
Methods: The CHNA followed a sequential mixed methods design to assess the regional health status, the contextual factors …
Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow
Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow
Journal of Appalachian Health
State and local governments across Appalachia are allocating opioid-settlement dollars over the coming years. This funding opportunity can support lasting public health infrastructure or be spent on short-term programs anchored in the opioid crisis of the past. Evidence indicates that emerging synthetic drugs such as nitazenes and xylazine are altering overdose risk patterns in ways that require urgent policy attention.
Dynamical Regulation Of Blood Pressure And Cognitive Function, Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P. Sloan
Dynamical Regulation Of Blood Pressure And Cognitive Function, Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P. Sloan
Psychology Faculty Articles and Research
BACKGROUND
Blood pressure (BP) is not steady. It varies over intervals from months to consecutive cardiac cycles, and this variation contains meaningful information beyond mean BP. Variability over multiple clinic visits (VVV-BP) and during 24-h ambulatory monitoring (ABPV) is positively related to risk of stroke and coronary artery disease and negatively associated with cognitive performance. Beat-to-beat BP variation, often quantified as low frequency variability (0.04–0.15 Hz, LF-BPV), is less well-studied. Here, we examine the relationship between LF-BPV and cognitive outcomes in 1953 participants from the Midlife in the US study.
METHODS
Participants completed the Brief Test of Adult Cognition by …
Creating The Thomas Mcrae Sanitorium For Negros: Race, Contagion, And Space In Jim Crow Arkansas, Shauna Gibbons
Creating The Thomas Mcrae Sanitorium For Negros: Race, Contagion, And Space In Jim Crow Arkansas, Shauna Gibbons
The Ozark Historical Review
The Thomas McRae Memorial Sanatorium for Negroes, located in Alexander, Arkansas, opened its doors in 1931 as the only resource for the entire state’s population of consumptive African Americans. It was touted as one of the best of its kind under the supervision of Dr Hugh A. Browne. But its “kind” was a facility intended for individuals whom whites in the medical and political establishment viewed not only as second class citizens but as biologically and medically different.
Medical Students’ Perspectives On Dobbs V Jackson Women’S Health Organization, Victoria Lazarov, Cecilia Mastrogiacomo, Mikaela Koch, Kirsten Wohlars, Tova Ablove, Student Perspectives On Reproductive Rights Research Group
Medical Students’ Perspectives On Dobbs V Jackson Women’S Health Organization, Victoria Lazarov, Cecilia Mastrogiacomo, Mikaela Koch, Kirsten Wohlars, Tova Ablove, Student Perspectives On Reproductive Rights Research Group
Cooper Rowan Medical Journal
Background: In June 2022, the Dobbs v Jackson Women’s Health Organization ruling overturned the previously upheld constitutional right to abortion. The resulting impact on medical training and student decision-making remains uncertain. This study aims to assess the nationwide impact of the Dobbs decision on medical students’ geographic residency preferences, specialty selection, and level of concern regarding civil and criminal charges for physicians providing abortion and fertility care.
Methods: An anonymous IRB-approved REDCap survey was distributed to American accredited medical schools across the United States and Israel between December 2022 and May 2023. Participants indicated specialty interests and geographic preferences for …
P.L.A.Y. For All Pilot: Effects Of A Community-Based, Inclusive After-School Program On Physical Activity And Motor-Skill Outcomes, Allison R. Tsuchida, Karl-Richard Hennebach, Erin E. Centeio
P.L.A.Y. For All Pilot: Effects Of A Community-Based, Inclusive After-School Program On Physical Activity And Motor-Skill Outcomes, Allison R. Tsuchida, Karl-Richard Hennebach, Erin E. Centeio
International Journal of Physical Activity and Health
After-school programs for physical activity (PA) can contribute to helping children and youth achieve the suggested 60 minutes a day of PA. Previous research also suggests that developing motor competency can positively impact long-term PA participation. Additionally, parent and peer support can help children and youth overcome barriers to PA participation. The primary purpose of this pilot research study was to determine the effects of an inclusive after-school program on PA levels and motor-skill outcomes for children with and without disabilities. A secondary purpose was to examine parental support for physical activity and children’s physical activity and motor skills. 38 …
Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis
Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis
Psychology: Faculty Scholarship
Anhedonia is increasingly recognized as a transdiagnostic risk factor for psychopathology. New evidence demonstrates that anhedonia is present in infancy and early childhood. Structural variability in striatal regions involved in reward processing and pleasure seeking is concurrently linked to anhedonia, yet few studies have examined whether striatal differences presage anhedonia, and none have examined prospective associations before middle childhood. The present study examined whether neuroanatomical markers that confer risk for anhedonia can be detected as early as the neonatal period. Specifically, we tested whether the volume of striatal regions in neonates predicted the emergence of infant anhedonic behaviors at six …
Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis
Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis
Psychology Faculty Articles and Research
Anhedonia is increasingly recognized as a transdiagnostic risk factor for psychopathology. New evidence demonstrates that anhedonia is present in infancy and early childhood. Structural variability in striatal regions involved in reward processing and pleasure seeking is concurrently linked to anhedonia, yet few studies have examined whether striatal differences presage anhedonia, and none have examined prospective associations before middle childhood. The present study examined whether neuroanatomical markers that confer risk for anhedonia can be detected as early as the neonatal period. Specifically, we tested whether the volume of striatal regions in neonates predicted the emergence of infant anhedonic behaviors at six …
Use Of Eagala Model–Based Psychotherapy For Youth Psychological Disorders, Kimberley D. Ryan, Tammy L.B. Mckenzie
Use Of Eagala Model–Based Psychotherapy For Youth Psychological Disorders, Kimberley D. Ryan, Tammy L.B. Mckenzie
People and Animals: The International Journal of Research and Practice
Global youth psychological disorder prevalence has increased exponentially. Therefore, a drastic increase in mental health care utilization is expected. Since traditional approaches to the treatment of adult psychological disorders are ineffective with youth, alternative approaches to treatment of youth psychological disorders must be considered. One such approach is equine assisted psychotherapy (EAP), a person-centered, experiential approach using horses during the treatment of psychological disorders and the basis of the Equine Assisted Growth and Learning Association (Eagala) model–based programming. This article presents the quantitative research findings of a study investigating the effectiveness of the Eagala model–based EAP programming in the treatment …
09.02.2025 Ored Connect, Liz Williamson
09.02.2025 Ored Connect, Liz Williamson
ORED Newsletter
- NIH Specific Aims Statement RED Talk
- NSF Research Security Training
Learning In Virtual Environments With Varying Levels Of Sensory Information, Maryam Derayati Far
Learning In Virtual Environments With Varying Levels Of Sensory Information, Maryam Derayati Far
Psychology Theses and Dissertations
The sensory environment plays a critical role in shaping learners’ attention, engagement, and retention. This thesis investigates how varying levels of sensory input in virtual reality (VR) classrooms influence learning for two age groups—children and young adults—and explores how individual differences in sensory processing moderate these effects. Using immersive VR technology to simulate classroom settings, two experimental studies were conducted. Study One involved 60 children aged 6–15 years, recruited primarily through a university-run summer camp. Study Two included 57 undergraduate students aged 18–36 years, recruited through a research participation pool. In both studies, participants were randomly assigned to either a …
Towards Accessibility In Healthcare For Individuals With And Without Hearing Loss: Evaluation Of Usability, Fit, And Communicative Effectiveness Of A Transparent N95 Mask Prototype, Samuel R. Atcherson, Brooklyn Schultes, Jeanne Hahne, Barbara Debaun, Chris Showell
Towards Accessibility In Healthcare For Individuals With And Without Hearing Loss: Evaluation Of Usability, Fit, And Communicative Effectiveness Of A Transparent N95 Mask Prototype, Samuel R. Atcherson, Brooklyn Schultes, Jeanne Hahne, Barbara Debaun, Chris Showell
JADARA
The COVID-19 pandemic has underscored the necessity of effective face masks in both public and healthcare settings for mitigating the spread of disease. However, traditional face masks impede communication, posing significant challenges for approximately 13% of the general population and 10% of healthcare and social assistance workers who have hearing loss and who rely on lipreading and other non-verbal cues. Traditional surgical masks and N95 respirator masks serve important roles in healthcare, but they differ in levels of protection. Currently, a transparent surgical mask is available, but not an N95 version. Thus, this study aimed to evaluate the usability, fit, …
Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar
Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar
Institute for Human Development, East Africa
Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.
Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …
Himmelfarb Headlines - September/October 2025, The George Washington University, Himmelfarb Health Sciences Library
Himmelfarb Headlines - September/October 2025, The George Washington University, Himmelfarb Health Sciences Library
Himmelfarb Headlines (2009 - present)
News, information, and resources relating to Himmelfarb Library that is of interest to patrons.
Applying Artificial Intelligence And Chatbots To Enhance Collection Development In Health Sciences Libraries, Ivan Portillo, David Carson
Applying Artificial Intelligence And Chatbots To Enhance Collection Development In Health Sciences Libraries, Ivan Portillo, David Carson
Library Presentations, Posters, and Audiovisual Materials
The continuous advancement of artificial intelligence (AI) and large language models (LLMs) has presented several opportunities for librarians to reduce their workload and become more efficient. This session will explore the potential of generative AI chatbots in assisting health sciences librarians with collection development. Two methods that will be discussed include the potential of AI to help discover new titles and how AI can evaluate your library collection for any potential gaps based on a college program’s curriculum.
The Wellness Connection September 2025, Roger Williams University School Of Law
The Wellness Connection September 2025, Roger Williams University School Of Law
Life of the Law School (1993- )
No abstract provided.
Himmelfarb Library Liaison Letter - September 2025, The George Washington University, Himmelfarb Health Sciences Library
Himmelfarb Library Liaison Letter - September 2025, The George Washington University, Himmelfarb Health Sciences Library
Himmelfarb Library Liaison Letters
No abstract provided.
The Blacker The Berry: Food Environments And Intake Associated With Perinatal Depression And Secondary Breastfeeding Outcomes Among Black Americans In The St. Louis Metropolitan Area, Najjuwah S. Walden
Brown School Graduate Student Theses and Dissertations
The relationship between the food environment, intake, and health is complex. The purpose of this study was to evaluate if food environments in proximity to Black pregnant women in the St. Louis Metropolitan Area were associated with prenatal eating habits and if these eating habits were associated with the risk of developing depressive symptoms in pregnancy and postpartum. The study also aimed to understand if there was a relationship between prenatal eating habits and the decision to breastfeed and if the onset of postpartum depressive symptoms has any effect on this relationship. Due to the importance of nutrient-dense, anti-inflammatory foods …
A Word From The Writing Team (September 2025), Pam Walter, Mfa
A Word From The Writing Team (September 2025), Pam Walter, Mfa
A Word From the Writing Team (Newsletter)
This issue includes:
- Our New Editor!
- Publications Spotlight
- Check out these Free Workshops Wiley is Offering in September
- Sign up for the First Friday Writing Retreat (Online)
- Did you Know Jefferson Provides Funding Support for Article Processing Charges (APC)?
Strategies And Considerations For Forming And Managing Community Advisory Boards From Health Research With Transgender And Nonbinary Communities, Mannat Malik, Anushka Aqil, Jennifer L. Glick, Jean Michel Brevelle, Anthony Black, Kellan Baker, Arjee Restar, Molly Gribbin, Colin Flynn, Danielle German
Strategies And Considerations For Forming And Managing Community Advisory Boards From Health Research With Transgender And Nonbinary Communities, Mannat Malik, Anushka Aqil, Jennifer L. Glick, Jean Michel Brevelle, Anthony Black, Kellan Baker, Arjee Restar, Molly Gribbin, Colin Flynn, Danielle German
School of Public Health Faculty Publications
Purpose: There is limited research on the use of community advisory boards (CABs) in health research with transgender and nonbinary communities. Transgender communities are navigating challenging histories of health researcher exploitation and research distrust alongside exponential research growth. We explored strategies for forming and managing CABs when conducting transgender community-informed health research. Methods: We used purposive and snowball sampling to identify key informants (KIs): research leaders, implementing staff, and community partners engaging in transgender health research. Between October 2018 and December 2020, we conducted 30 semi-structured in-depth interviews. We used coding followed byiterative thematic analysis and memoing to identify themes. …
Outcomes Of Bio-Psycho-Social-Spiritual Communitybased Drug Rehabilitation Program For Voluntary Vs. Court-Mandated Clients In The Philippines, Maria Regina M. Hechanova, Trixie Anne Co, Fessa R. Egusquiza
Outcomes Of Bio-Psycho-Social-Spiritual Communitybased Drug Rehabilitation Program For Voluntary Vs. Court-Mandated Clients In The Philippines, Maria Regina M. Hechanova, Trixie Anne Co, Fessa R. Egusquiza
Psychology Department Faculty Publications
This study sought to evaluate the outcomes of a community- based rehabilitation program for voluntary and court-mandated drug users in the Philippines. Participants went through a bio-psycho-social-spiritual group-based program that aimed to develop their recovery skills and life skills. The program also included family modules to enhance their knowledge of drug use, its effects, and the role of family in recovery. A cohort design was used with pre- and posttest surveys administered before and immediately after the program. The sample consisted of 105 voluntary clients and 118 court-mandated clients who underwent screening or drug dependency evaluation and were recommended for …
Understanding Why Individuals Maltreated As Children Do Not Retrospectively Self-Report, Kristin S. Lynch
Understanding Why Individuals Maltreated As Children Do Not Retrospectively Self-Report, Kristin S. Lynch
Dissertations, Theses, and Capstone Projects
Individuals with documented histories of childhood maltreatment who do not retrospectively self-report these childhood experiences demonstrate better emotional and psychological outcomes in adulthood. Understanding why these individuals do not retrospectively self-report is important for the development of effective interventions focused on mitigating the long-term consequences of maltreatment. The current study compared maltreated individuals who did not retrospectively self-report (O-R group) to those who did retrospectively self-report (O+R group) to examine theoretical explanations related to intentional nondisclosure (i.e., social desirability and discomfort during the interview) and memory processes (i.e. infantile amnesia, use of mental health services, avoidant coping …
The Ethics Of Clinical Ethics, Matthew Shea
The Ethics Of Clinical Ethics, Matthew Shea
Center for Medical Ethics and Health Policy Staff Publications
The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional …
Old Frames On New Media: Health Misinformation In Black Digital Communities, Merriah Croston
Old Frames On New Media: Health Misinformation In Black Digital Communities, Merriah Croston
Brown School Graduate Student Theses and Dissertations
Growing evidence suggests that health misinformation has the potential to proliferate on social media. However, our understanding of the problem’s magnitude continues to evolve. Despite several studies on health misinformation and Black communities in the United States (U.S.), few of these studies characterize misinformation within digital settings. This dissertation seeks to address this gap by: 1) synthesizing the literature on health misinformation and Black communities to identify prevalent misinformation topics and claims, characteristics of exposure to and belief in these topics and claims, and successful intervention strategies; 2) quantifying and characterizing the volume of COVID-19 misinformation on Black Twitter during …
Public Support For And Reactive Behavior Toward Technological Risk Interventions: An Extension Of Secondary Risk Theory, Hye Kyung Kim, Rui Gu, Fiona Goh, Sonny Rosenthal, Shirley S. Ho
Public Support For And Reactive Behavior Toward Technological Risk Interventions: An Extension Of Secondary Risk Theory, Hye Kyung Kim, Rui Gu, Fiona Goh, Sonny Rosenthal, Shirley S. Ho
Research Collection College of Integrative Studies
Project Wolbachia is a dengue control initiative in Singapore. Guided by Secondary Risk Theory, this study examined how primary (dengue) and secondary (Wolbachia) threat and coping appraisals shape public support and reactive behavior toward the project. A nationally representative survey of 1,000 Singaporeans showed that support was positively linked to the perceived primary risk, the efficacy of the project and the government, while negatively related to the perceived secondary risk. Reactive behavior was positively associated with perceptions of both primary and secondary risk. Media attention and trust in the government indirectly influenced support and behavior moderated by knowledge.
Policy Evaluation With Nonlinear Trended Outcomes: Covid-19 Vaccination Rates In The United States, Lynn Bergeland Morgan, Peter C. B. Phillips, Donggyu Sul
Policy Evaluation With Nonlinear Trended Outcomes: Covid-19 Vaccination Rates In The United States, Lynn Bergeland Morgan, Peter C. B. Phillips, Donggyu Sul
Research Collection School Of Economics
This paper discusses pitfalls in two way fixed effects (TWFE) regressions when the outcome variables contain nonlinear and possibly stochastic trend components. If a policy change shifts trend paths of outcome variables, TWFE estimation can distort results and invalidate inference, especially in a context of evolving policy decisions. A robust solution is proposed by allowing for dynamic club membership empirically using a relative convergence test procedure. The determinants of respective club memberships are assessed by panel ordered logit regressions. The approach allows for policy evolution and shifts in outcomes according to a convergence cluster framework with transitions over time and …