Violent Crime In the United States

 

Relating Violent Crime in America to the Social Learning Criminological Theory

Introduction

In criminology, there are different ways in which different individuals serve their purpose in the criminal justice system. For instance, magistrates and judges usually look at the law, facts and evidence to ensure that their decisions are in accordance to the tenets of justice. The selected occupation I have chosen is that of a law enforcement officer. The strict definition of a law enforcement officer refers to the person with the legal mandate to enforce the law for the jurisdiction they are serving (Police Executive Research Forum, 2014). For instance, a law enforcement officer may be a police officer mandated to carry out operations on drug trafficking individuals in a particular place. The role of the law enforcement officer is to therefore look at ways in which he will investigate suspects, apprehend them and prepare the necessary court documents for charging the suspect.

Definition of Theory

The theory of choice for this paper will be the social learning theory. Simply defined, the social learning theory refers to a crime trait that is learned from the criminal leaning criminal traits from the people they spend time with. The social learning theory avers that where an individual grows up in a lower socio-economic background with heightened criminal activity, then the child’s company of the adults in the area will slowly transform him into a criminal (Gagnon, 2018). For instance, a male adolescent growing up in the projects with the company of criminals may inevitably dispose him to have criminal tendencies. In addition, the lack of basic supplies may also be a motivation to the criminal tendencies the individual will be showing.

Identify Victims and Offenders affected by the concepts of the theory.

Characteristics of crime Victims

The victims are usually acquaintances of the criminal. They may be neighbors or people the criminal has spend time with who become the targets. In most instances, victims of a crime are neighbors and the people that the victim has learnt to understand to be her close associates. In the case of rape, the people that carry out the illegalities are usually the known contacts of the individual. For instance, it is important to mention that the person perpetrating the crime of rape will a work mate, an acquaintance they were drinking with or even a family member. It is therefore important to note the different character of a person in law enforcement because reports of such kind of crimes are rare and marred with secretive blackmail.

The victims are usually shocked by the sudden change of behavior in the aggressor. For instance, they may be in shock to come into terms with their neighbors robbing them.in most instances, the victims do not believe that they have been robbed by the person that robbed them or stolen from them. Due to the incapacities created by the accused person, the victim may have had the belief that the perpetrator would not harm them. However, it is noteworthy to mention that there are different ways in which the perpetrator acts that traumatizes the victim. In an incident such as rape there are various actions a law enforcement officer will be responsible for. The collection of evidence is key in building the case for the complainant and the state for the successful prosecution of the case.

The physical effects of crime on the victims are usually mild. Depending on the aggressor, they may be fatal. In the first instance, criminal attacks on the victim may happen in a variety of ways. Where the incident is a simple pickpocketing, the victim may not even realize they have been robbed. In other instances, the incidence happens where the attacker is bearing a weapon. In such a case, the injuries to the victim may be mild if the aggressor uses it as such. In the case where there is a shooting incidence, it is important to consider the facts that will involve the victim. She may be dangerously harmed. In the worst-case scenarios where, criminal gangs are fighting for territorial control, it is murder that is committed.

The effect of criminal activity on society relates to the distaste of the aggressor. The society and the community the victim lives in influences the manner in which a crime victim will respond to a matter of concern or crime committed. If the victim distastes the aggressor based on the perceptions identified by their immediate environment, the mental condition of the individual is bound to deteriorate. The importance of psychological assessment is not to be avoided.

 

Characteristics of offenders

Typical offender characteristics include changing from the responsible individual they once were to become the criminal they have become. In the beginning, the offender may have kept the company of responsible individuals in the society. With time, they begin associating with social misfits who influence that they run their lives. In most instances, these offenders may have come from backgrounds in which their families may have abandoned them. In social understanding of the criminal tendencies of the people close to others, the motivation may be the lack of attention and direction from people that are higher than them. In families with absentee parents, the children may elect to go out to the hoodlums to learn street skills so they can get the recognition they are seeking.

Most of the offenders in the social learning theory are male. They range from the age of adolescence to their middle ages. They are mostly drop outs although some have a good background in education. In today’s criminal research field, criminal tendencies are changing with each passing crime (Besemer, Farrington, & Bijleveld, 2017). In the past, criminal activities used o be perpetrated by school drop outs who had no means to earn a living. Today however, organized crime has different professionals involved in the running of different types of crime. Cyber crime requires a lot of skill and intelligence that will ensure the crime goes untraceable. The importance of having skilled criminals is to avoid the hands of justice. As a law enforcement officer however, the important consideration will be to look at all the characteristics of criminal activity with an open eye to avoid unconjurable events in future.

Most criminals are males. The biological contribution to the affinity to crime is not scientific. However, statistics have continuously reported that males in the adolescent to middle ages are likely to be engaged in criminal activity more than other ages would. At this age, these youth are energetic. Coupled with the lack of a stable source of income and activity to enage in, crime is usually the next alternative in line.

Research examples of the Social Learning theory

There are various studies conducted in the criminology concerning the manner in which criminal activities and perpetrators operate. In the first instance, the criminal justice system is required to enable a benchmarking strategy to ensure that all members are properly guided on the progress of the fight against crime. Ridgeway & MacDonald (2014) argues for different ways in which the police department can strategize to ensure that they are learning the various characteristics of criminal theory. Through the social learning theory, it is identified that the character traits of the environment that one grows in will automatically influence the manner in which they will relate to society. Through social learning, adolescent males to the middle ages usually learn from those above them. If they spend a lot to time with different individuals who commit crime for a living, then these adolescents are most likely to start dealing in drugs and the criminal activities that the seniors are carrying out.

 

Victimization is an important ideology to discuss in this section. In criminal gangs, victimization is usually used in criminal gangs to extend the loyalty and the operations of the gang (Gagnon 2018). For instance, one new member of the gang may be tired of the criminal activities that they are engaging in. in his bid to quit, one of the gang members realizes after which he informs the leader of the gang of the dire consequences of his actions once out. In the ensuing encounters, the victimization will lead the individual to commit criminal activity to save himself. In addition, such criminal activity is bound to dangerous as it involves the directions of one sadistic soul.

Rosenfeld, (2018) identified different criminal trends that must be identified to ensure that they can ably respond to the concerns of the public. The social learning theory explained states that criminals are bound to learn from the criminal tendencies of the people they are living with. In identifying the different stages of criminal activity in a certain environment, the law enforcement officer is not required to go for the obvious traits of criminal tendencies. The law enforcement officer should look at new developments in criminal activity. The manner in which cybercrime is conducted is discreet but the risks are weighty. To identify such activities, law enforcement officers need to create a plan through which they can identify the crimes before moving to solving them in the long run.

Gun violence in the United is at an all time high. There have been different cases of shooting in different states in the United States which have necessitated criminological evaluation on their occurrence and solution.

One example of a practical application of the social learning theory can be inferred from the data focusing on crime rates in lower socio-economic areas. The social learning theory proves that in a situation where the social structure does not absolutely prohibit criminal activity, then most of that society will have the criminal tendencies innate in them. In application to a law enforcement officer, the social learning theory prematurely concludes the criminal tendencies of different people as situated in a particular area. As such many innocent victims are charged with wrongful crimes and sentences. Occupational detractors include criminal attacks on officers especially in areas with inadequate security measures in place.

To overcome drawbacks, the law enforcement professional must have back up while on operations (Ridgeway & McDonald, 2014). In addition, sanitization of crime prone areas and public education is important to reduce the happenstance of criminal risks. Law enforcement officers need to look at he development of crime and how it is organized in the new digital dispensation. Law enforcement officers must be in touch with what is happening on the ground to ensure that they have all the necessary intelligence they require to carry out their job responsibilities.

Conclusion

I would use the social learning theory in my law enforcement career for various reasons. The reason for the application is to understand the criminal tendencies in particular areas of my jurisdiction. For instance, understanding particular crime hotspots will be instrumental in rooting out criminal characters from society into correctional facilities.

 

 

 

References

Besemer, S., Farrington, D. P., & Bijleveld, C. C. (2017). Labeling and intergenerational transmission of crime: The interaction between criminal justice intervention and a convicted parent. PloS one12(3), e0172419.

Gagnon, A. (2018). Extending social learning theory to explain victimization among gang and ex-gang offenders. International journal of offender therapy and comparative criminology, 0306624X18763761.

Monod, S. W. (2017). Portraying those we condemn with care: Extending the ethics of representation. Critical Criminology25(3), 343-356.

Police Executive Research Forum, (author.). (2014). Future trends in policing. Office of Community Oriented Policing Services, US Department of Justice.

Ridgeway, G., & MacDonald, J. M. (2014). A method for internal benchmarking of criminal justice system performance. Crime & Delinquency60(1), 145-162.Salisbury, E. J. (2013). Social learning and crime. The Oxford handbook of criminological theory, 116-130.

Rosenfeld, R. (2018). STUDYING CRIME TRENDS: NORMAL SCIENCE AND EXOGENOUS SHOCKS. Criminology56(1), 5-26.

 

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Reducing Asthma related Deaths in the United States

Name

Institutional Affiliation

 

 

 

 

 

 

 

Table of Contents

Abstract ……………………………………………………………………………………. 3

Introduction …………………………………………………………………………………4

Discussion.……………………………………………………………………………………7

Conclusion ………………………………………………………………………………… 12

Recommendations ………………………………………………………………………… 14

References ………………………………………………………………………………….17

 

 

 

 

 

 

 

 

 

 

 

 

Abstract

The rate of asthma related deaths in minority groups in the United States has been on an upward trend and raised concerns of it being an epidemic. In minority such as the Latino and the African-American population, the rates of infection and deaths is three times that of the white community. The rates in children has been marked at 9.5% with adult rates reaching 12%. Healthcare remains one of the most controversial topic issues to deal with in the American public. This proposal seeks to highlight the national concern on the prevalence of Asthma in the American public. The proposal will begin by a brief background of asthma prevalence in the American public, the denture the same leaves on the national expenditure, the need to keep most Americans safe and have a better living environment. The proposal will feature a background study which will then be followed by a discussion of the effect the disease has had on the national budget. Closer home the proposal will look at the prevalence rates in California and the rates in children. With a budget of $100,000, it is important to limit the proposal to a particular area of California (properly identified) and offer solution to individual solutions to a number of people. A cost analysis will precede the implementation of the project. The sociological model calls for collection of information in different areas. The proposal will evaluate different literature on how different countries and communities have implemented their practices. The appeal is that you fund the project so as the journey to having an asthma free America is realized.

 

 

 

 

Introduction

In the year 2015, almost over 2.5 million non-Hispanic blacks reported that they were living with asthma. The rate of asthma prevalence in African- American women was reported to be 20 percent more likely to be more than that of non-Hispanic whites. African Americans have been reported to be three times more likely to die from asthma related complications than whites in 2014. African American children were reported o be ten times more likely to die from asthma related complications in the United States in 2015 than white children and other non-black communities. Hospital admission rates for African American children are four times more than that of their non-black counterparts. There are many causes of asthma although the major reason is yet to be scientifically proven. However, studies have shown that children who were exposed to second hand tobacco had an increased risk of contamination. They were likely to contract diseases such as bronchitis owing the fact that they have lower respiratory tract infections. For children living below the poverty level, high levels of blood cotinine were identified and were a risk for their exposure to asthma.

 

 

 

 

 

 

 

Table 1: Rate of asthma prevalence

Current asthma prevalence percentage, adults ages 18 and over, 2015
  Non-Hispanic Black Non-Hispanic White Non-Hispanic Black/Non-Hispanic White Ratio
Men 6.0 5.6 1.1
Women 11.7 10.1 1.2
Both Sexes 9.1 7.9 1.2

Source: CDC 2017. National Health Interview Survey Data 2015.

 

There are staggering facts on the problem that asthma has brought into the United States. For black communities, the problem causes identified are sometimes so frivolous that the lives lost could have been saved were the officials to take steps to remedy the situation. For those living below the poverty line, it was understood that the risk factors were numerous. As such, steps need to be taken to remedy the problem for the betterment of community healthcare. The solution to the problem in children is strict adherence to asthma medication at the required periods of time. In African American communities, parents are usually compromised by their beliefs and will generally be reluctant in adhering to asthma medication instructions for their children. For adults, the same beliefs have been reported to be the reason behind the high asthma related deaths in the United States. Coupled with poor literacy, the problem has been advanced by individualized cultural sensitivities that communication on addressing the issue is not possible.

The use of long-term control medications is also key in ensuring that disparities between the races is effected. In such a way, the burden of asthma is reduced. Through the consistent use of long-term control medication and other asthma related medications helps in the reduction of emergency care issues and deaths in the United States. The burden of childhood asthma properly identifies the general way in which minorities are affected. It is therefor important to include asthma education programs to ensure that they poor communities have adequate information on the treatment and care for people living with the disease. Identifying other environmental triggers calls for different ways in which asthma is to be dealt with. This proposal seeks to bring the prayer that education programs are created to advance the education of black and Latino communities in the United States. The education programs will run through a period of six months whereupon there will be an evaluation of the different impacts of the different methodologies of dealing with the problem at hand. The education programs in California will be conducted through radio, television, the internet and live door to door education programs that will be run through the enabling power of the funds requested.

 

 

 

 

 

Discussion

In the Unite States, the prevalence of asthma is not only triple for the minority groups but also comes with higher asthma associated morbidity and deaths in the black community than in other races. Numerous factors including lower socio-economic status, levels of education, genetics, health maintenance behavior, obesity and the quality of air are attributed to the increased deaths in the communities. The complexity of the risk factors is yet to be understood by most members of the public and it is in the same stance that increased deaths have been reported. According to the American statistics on the levels of asthma related deaths in the United States, most of the problems identified are ones that could be easily avoided.

Asthma Facts and Figures

Asthma is a disease that affects the airways where a blockage occurs and air from the nose or mouth will have difficulty reaching the lungs. As a result, the individual will have problems breathing and they will also have allergies. Irritating things will often affect the individual and they will need to adapt to new ways of dealing with the disease. In the United States, asthma classified among the costliest diseases. According to the Centers for Disease Control and Prevention (CDC) every one in thirteen people is infected with asthma (CDC, 2018). At the beginning of 2018, more that 25 million Americans are suffering from asthma. For adults, this translates into 8.3 with a similar margin for children. Since the early 1980s, asthma has been on the increase and affects virtually every racial group in the United States.

Some of the characteristic’s asthma has taken in THE United States today include;

  1. Asthma is reported to be more common in American women than men
  2. African Americans in the United today die at a higher rate than other races in cases related to asthma.
  3. In 2015, more that 11 million people admitted to have experienced asthma periods.
  4. In American children, asthma is the most chronic disease.
  5. Boys are more affected by asthma in the United States than girls.
  6. Asthma is more common in children than adults.
  7. Asthma is more common in boys than girls.
  8. More than 6 million children under the age of majority are suffering from asthma.

Asthma was also reported as the major reason why children did not attend school in 2015 than other health related issue in the United States. On a daily basis, close to 10 Americans die from asthma related complications. In 2015 alone, 3,615 people died from the disease. Form research and policy, it has been indicated that most of the deaths occasioned by asthma could have been prevented. Through proper care and treatment, most Americans could avoid the many risks that are brought about by asthma. The sad fact about the deaths caused by asthma is that different people will have different ways in which they respond t asthma. As a disease, asthma can be controlled. For the African American community, some areas have low to poor quality education and as such will not be in a position to tell when a child starts to show the symptoms of asthma. Importantly, it must be mentioned that there are different factors that affect different people living with asthma. For instance, a person living with asthma is required to have adequate measures to ensure that all things they carry out do not affect the lives they are leading. Most of the deaths occasioned by asthma may be due to the lack of information. If a family were to be aware of the medical condition of different people in the family, there would be better control and maintenance of the disease.

In African American communities, the cultural preferences do not allow for a child or family member to get medical attention once they notice a mishap with the body. It is important that education reaches the different areas of low socio-economic status for them to be a fast-responsive mechanism in cases of asthma attack periods. For instance, asthma attacks can be reduced through the education programs developed for the community in accordance to the way of life that these people choose to live. There have been reported cases an individual experience an asthma attack and du to the lack of available personnel to care for the individual, the attack leads to their death. Community health programs in this proposal argue that all Americans with cancer must have adequate ways of ensuring that they are around people who might help them in case any problem arises. In the present setting, most family members lack the knowledge and skills to take care of asthma patients. In the public media, there are rare occasions where asthma is identified as one of the leading causes of death for Americans.

 

The Costs of Asthma

From the year 2008 to the 2013, the US exchequer had spent close to 82 billion in asthma related expenditure. Medical costs and the loss of work and school have also been reported to be high in different areas in the United States. A continued loss of working time and loss of life is not healthy for the growth of the United States. At a glance, the United States has lost close to $3 billion in lost school and work days. In addition, $29 billion has been lost due to deaths caused by asthma.$3 billion in losses due to missed work and school days. $50.3 billion has been spent on the treatment of asthma and related diseases. Every individual in the United States has an increased medical cost by $3,266 annually. There are different reasons why asthma is a concern that requires heightened attention. An example is where 13.8 million children miss school due to complications brought about by asthma.

The real costs associated with the treatment of asthma are increasing by the year. In the 1980s, asthma was not much of a threat as it is today. An example of 13.8 million children missing school is alarming. There should be ways in which different individuals look at ways in which they can properly identify the problems caused and the manner in which they are solved. Children are the future of America. Most of their education is usually affected by different ways in which they live their lives. Because of environmental factors, some children have the high likelihood of being affected by asthma. The air quality in lower income areas for instance is a threat to the health of the child. Where a child lives within an environment where smoking is tolerated, the kid will be at a higher risk of being infected. In the first instance, the loss of class time will not be noted. However, their counterparts in upper socio-economic areas will have the adequate environment for them to live a risk-free lifestyle. As a result, they are bound to attend all school sessions which increases their likelihood of better performance and educational advancement.

On the other side, children from lower socio-economic background will miss school hours which will mean that thy are bound to fail in examinations owing to the fact that they did not properly cover the important topics in the school curriculum syllabus. It is important to ensure that different individuals find a way to ensure that the loss of hours is not translated. With enough funding to educate the public on how small events in a child’ life affects them, then the responsive mechanisms will stand in to show the different areas of engagement that the individual requires. A discussion about the initial cost compared to the long-term costs that asthma bring in to America. In future, the government has to spend billions of dollars in ensuring that different needs are met. Due to the many challenges that many economies have today, it is important to mention the different factors that different people have in a group or setting. A reduction f this risk will properly input more funds in the hands of many Americans which means that they will have the opportunity to identify with the needs of most part of the population.

 

Asthma frequency list and deaths- causes

  1. Poverty – most of the families where members are affected by asthma are poor. Due to poverty, these individuals are not able to properly access education on asthma, its prevention, characteristics and symptoms, and the way that different people are focusing on the subject. Most of these individuals do not understand the right channels to follow to ensure that their family members have been properly attended to. It is important to look at the different ways in which families have been affected by asthma. For parents with inadequate knowledge of the disease, the result will be death if no proper care is administered.
  2. City air quality – Most of the families affected by high rates and risk of asthma live in cities. Due to a lack of sufficient clean air for breathing, these individuals inhale toxic air on the daily which increases their risk of asthma. In the long run, the population being affected by asthma will increase.
  3. Education – education plays a pivotal role in the understanding of the risk asthma poses to the United States. Education guides the individual on how they can approach the issue and make sure that the issue is properly taken care of. Among patients, there appears to be a lack of proper education on how to use the breathing equipment given to patients. With lack of knowledge to use an apparatus that will save one’s lives; the rates of death will be increased.
  4. Poor health care – poor healthcare is a result of the incapacities in dieting and the choice of life. Most black populations are affected by drug problems. Individuals affected by drugs will often disregard their personal hygiene and feeding. Due to the lack of taking medicine at the required time, it is important to lay claim on the reality of findings mentioning the different ways of engagement with the disease.
  5. Puerto Ricans ae the most affected with asthma. The reasoning behind this reality s that most of them are not engaged in the day to day running of American affairs. For instance, their business and culture allow them to smoke and engage in unhealthy activities so that they are able to fend for themselves. The solution to this problem is in public education. Through allocating money for public education, community health programs will have the general insistence on treatment rather than the death by the disease. Learning how to take asthma medication and living with and infected individual will highly the care of the disease.
  6. African American children have the highest rates of asthma infection in the United States. The African American culture in the projects attracts asthma attacks. Most those who live in the project drop out of school to deal in drugs and that is the reason why most of them are affected by the disease. The genetic composition of the African American community will definitely have a bearing on their risk attacks.

 

 

 

Commitments to treat Asthma in the past

In the past, there have various concerted efforts in fighting asthma. The first case where asthma has been treated is through case management by data by parent or guardian of the individual affected by the disease. There should be different reports on the prevalence and the death rates associated by asthma. Importantly, there should be a way in which different people look at the manner in which the disease affects the African American population. Through hospital administration data, there should be ways in which government learns about the different character traits of those most affected by asthma. The CAI model was adopted in many different cities and states which makes every effort trackable. The proposal is to look at the solutions that have been preferred in the past and capitalize on their strengths and avoid weaknesses at all costs.

An understanding of the different ways in which patient risks are responded to is important. For instance, it is possible that through public education, there will be different ways in which many of the communities will learn how to care about patient and administer treatment at home. In this way, the risk of constantly having to worry will be reduced.  There have been multi-level efforts to deal with different stages of asthma and the risks that are associated with the disease. For instance, it is important to mention that there are different risks that are associated with treating a disease without the requisite personnel. The proposal argues for a training model where members of the public are educated on the various ways in which they can identify their issues and attend to them. In so doing, the community will be in a better place to understand the various ways of dealing with asthma.

 

Conclusion

Asthma is a chronic disease to children and affects all racial groups in the United States. However, the African American population is at a higher risk of having asthma than any other race in the country. The Latino community is also highly affected by the asthma problem. On a national average, asthma affects close to 10 percent of the population. As discussed in the paper, there are different causes of asthma. The genetics of an individual may be the cause of that person suffering from asthma. Another reason is the manner in which the person carries their life. Education and air quality have also been discussed as some of the main causes of asthma. As discussed, most of the black and Latino community are affected by the disease and it is due to the above that concerns have been raised on how to remedy the situation. Importantly, the paper has dealt with public education as one way to ensure that the high death rates of asthma are controlled. In industry practice and according to the available data on the different subjects to be discussed concerning asthma, the important consideration has been the purification of the education system, cultural beliefs and the manner in which different communities are concerned.

 

 

 

 

 

 

 

Recommendations

The major recommendation that will help fight asthma prevalence and death is related to economic empowerment and the manner in which different individuals look at ways to g around the problem. The first solution is to lobby the government to provide more funding to areas that affected by asthma. Through funding, there will be an opportunity to conduct public education in local communities insisting on the value of adequate information while dealing and caring for a person affected by asthma.

 

 

 

 

 

References

CDC 2017. National Health Interview Survey Data 2015.

CDC.gov. (2018). CDC – Asthma. [online] Available at: https://www.cdc.gov/asthma/default.htm [Accessed 10 Nov. 2018].

CDC.gov. (2018). CDC – Asthma – Data and Surveillance – Asthma Surveillance Data. [online] Available at:http://www.cdc.gov/asthma/asthmadata.htm [Accessed 10 Nov. 2018].

National Health Interview Survey. (2018). [ebook] Centers for Disease Control and Prevention, National Center for Health Statistics. Available at:https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2015_SHS_Table_A-2.pdf [Accessed 10 Nov. 2018].

CDC.gov. (2018). CDC – Asthma – Most Recent Asthma Data. [online] Available at: https://www.cdc.gov/asthma/most_recent_data.htm [Accessed 10 Nov. 2018].

CDC.gov. (2018). Asthma | Healthy Schools | CDC. [online] Available at: https://www.cdc.gov/healthyschools/asthma [Accessed 10 Nov. 2018].

Zahran, H., Bailey, C., Damon, S., Garbe, P. and Breysse, P. (2018). Vital Signs: Asthma in Children — United States, 2001–2016. DOI:http://dx.doi.org/10.15585/mmwr.mm6705e1. [Accessed 10 Nov. 2018]

CDC.gov. (2018). CDC Vital Signs. [online] Available at: https://www.cdc.gov/vitalsigns (Retrieved 10 Nov, 2018).

Centers for Disease Control and Prevention. (2018). Asthma in Children. [online] Available at: https://www.cdc.gov/vitalsigns/childhood-asthma/index.html [Accessed 10 Nov. 2018].

United States Environmental Protection Agency. Asthma Facts. May 2016 https://www.epa.gov/sites/production/files/2016-05/documents/asthma_fact_sheet_english_05_2016.pdf [Accessed 10 Nov. 2018].

Atsjournals.org. (2018). The Economic Burden of Asthma in the United States, 2008 – 2013 | Annals of the American Thoracic Society | Articles in Press. [online] Available at: https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201703-259OC  [Accessed 10 Nov. 2018].