Employing policy and purchasing levers to increase the use of evidence-based practices in community-based substance abuse treatment settings: reports from single state authorities

State public health authorities are critical to the successful implementation of science based addiction treatment practices by community-based providers. The literature to date, however, lacks examples of state level policy strategies that promote evidence-based practices (EBPs). This mixed-methods study documents changes in two critical state-to-provider strategies aimed at accelerating use of evidence-based practices: purchasing levers (financial incentives and mechanisms) and policy or regulatory levers. A sample of 51 state representatives was interviewed. Single State Authorities for substance abuse treatment (SSAs) that fund providers directly or through managed care were significantly more likely to have contracts that required or encouraged evidence-based interventions, as compared to SSAs that fund providers indirectly through sub-state entities. Policy levers included EBP-related legislation, language in rules and regulations, and evidence-based criteria in state plans and standards. These differences in state policy are likely to result in significant state level variations regarding both the extent to which EBPs are implemented by community-based treatment providers and the quality of implementation.     

Comparison of a simulated versus work environment lifting task on L5/S1 compression forces

Since a patient's ability to perform simulated work activities guides return-to-work decisions, a significant question to address is whether the simulated work environment accurately reflects the actual work environment. Work hardening programs have been used extensively as a method of rehabilitating workers to return to their pre-injury functioning levels. Re-training workers to lift boxes is a common method used to simulate the work environment. Although very few boxes used in the real work environment have handles, boxes with handles are often used in the simulated work environment. The difference in compression forces at the L5/S1 joint while lifting boxes with and without handles was investigated. The Lift Trak Motion Analysis system was used to estimate lumbar isometric compression forces exerted while lifting a 20-pound (9.07-kg) box. The results indicated that estimates of compression forces when lifting a box without handles were significantly different (p < 0.01) than when lifting the same box with handles. Based on these results, it is recommended that work hardening professionals carefully re-evaluate the simulated work environments currently being used for treatment.     

电子商务与网上买水龙头

介绍电子商务的概念、我国电子商务发展简况、网上购物存在的问题和美国网上购买廉价水龙头的趣闻。     

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.     

Using walker during walking: a pilot study for health elder

Walker operation completely relies on the walker handle, however most marketed walkers possess two horizontal handles. Several researchers have suggested that horizontal handles might lead to wrist injury. Therefore, the purpose of this study is to assess the relevant design aspects of walker for elderly people. 28 elders participated in this study; when the experiment was started, subject walked on the tile for 3 meter distance twice by using walker. Data for analysis were selected at the corresponding wrist deviation and vertical force. The results showed that during walker using, the mean wrist deviation was greater than zero. The largest vertical force is significantly larger than the smallest one, and different wrist deviation occurred at three phases, the largest wrist deviation while raising walker is larger than the smallest one, however, no significant different was found between the largest and smallest wrist deviation while pressing walker. No significant correlation occurred between weight and wrist deviation. The correlation between weight and vertical force was significantly positive. With wrist deviation walker use may cause injury to upper-limb, however wrists remain in a neutral position during hand movement to prevent damage. The findings of this study should improve the design of walker handles to reduce the wrist deviations of users.     

Influence of door handles design in effort perception: accessibility and usability

The application of ergonomics in product design is essential to its accessibility and usability. The development of manual devices should be based on ergonomic principles. Effort perception analysis is an essential approach to understand the physical and subjective aspects of the interface. The objective of the present study was to analyze the effort perception during a simulated task with different door handles by Portuguese subjects of both genders and different ages. This transversal study agreed with ethical aspects. 180 subjects of both genders pertaining to three age groups have participated. Five door handles with different shapes were evaluated. A subjective numeric rating scale of 5 levels was used to evaluate the effort. For statistical analysis it was applied the Friedman non-parametric test. The results have showed no significant differences of effort perception in door handles "A" and "B"; "A" and "D"; and "D" and "C". Door handle "E" presented the lowest values of all. In general, there's an inverse relationship between the results of biomechanical studies and the effort perception of the same task activity. This shows that door handles design influence directly these two variables and can interfere in the accessibility and usability of these kinds of products.     

Longitudinal test of a multiple domain model of adolescent condom use

A comprehensive multiple domain model (MDM) to understand condom use in adolescents was proposed and tested using structural equation modeling of data at three time points. The proposed model integrates social psychological theory, demographic and personality factors, social environment, and situational/contextual variables. Adolescents who were sexually active at time 2 (6 months after baseline) and time 3 (1 year after time 2) and completed surveys at all three time points were included in the analyses (N = 511). An iterative process of model testing resulted in a structural equation model that provided a good fit to the data (CFI = .92, RMSEA = .04). Models comparing gender and race as moderators also were calculated and supported the generalizability of the model. Results provide support for an MDM that goes beyond traditional social psychological models for a broader understanding of condom use in adolescents. Implications for further theory testing and safer sexual interventions are discussed.     

The sign of affection: Balance-theoretic models and incomplete signed digraphs

The initial structural models based on balance theory (structural balance and clusterability) dealt with incomplete signed digraphs. However, newer models (ranked clusters, transitivity, hierarchical M̄-cliques) apply only to zero-one matrices representing either unsigned digraphs or complete signed digraphs. Since empirical networks of affective relations are signed but seldom complete — actors may have neutral feelings towards alters or affections may be unknown to the researcher — the latter models must be redefined if affective relations are to be analysed. It was found that each balance-theoretic model is characterised by a particular type of semicycle or path. Counts of the types of semicycles and paths suffice to identify the models. This approach is more general than triadic analysis because it handles complete as well as incomplete signed digraphs.     

Trajectories of loneliness during COVID-19 pandemic and associations with mental health and substance use

We examined patterns of longitudinal trajectories of loneliness during the COVID-19 pandemic using six time points (January 2020 [pre-pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most-likely loneliness trajectory adjusting for pre-pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre-pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past-month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co-occurring loneliness and cannabis use are needed.     

Longitudinal Test of a Multiple Domain Model of Adolescent Condom Use

A comprehensive multiple domain model (MDM) to understand condom use in adolescents was proposed and tested using structural equation modeling of data at three time points. The proposed model integrates social psychological theory, demographic and personality factors, social environment, and situational/contextual variables. Adolescents who were sexually active at time 2 (6 months after baseline) and time 3 (1 year after time 2) and completed surveys at all three time points were included in the analyses (N = 511). An iterative process of model testing resulted in a structural equation model that provided a good fit to the data (CFI = .92, RMSEA = .04). Models comparing gender and race as moderators also were calculated and supported the generalizability of the model. Results provide support for an MDM that goes beyond traditional social psychological models for a broader understanding of condom use in adolescents. Implications for further theory testing and safer sexual interventions are discussed.     

Exposure to Parent and Peer Alcohol Use and the Risk of Drinking Onset and Escalation Among Adolescents

Although the rate of alcohol use among adolescents has declined, it remains their drug of choice. Parent and peer alcohol use are powerful risk factors for youth alcohol use. However, questions remain about how these factors influence underage drinking. The present study investigates the relationship between exposure to parent or peer alcohol use and two stages of adolescent drinking—onset and escalation—overall and at five age points during adolescence. Participants were 9348 adolescents in Waves I (WI) and II (WII) of the National Longitudinal Study of Adolescent Health, whose parents completed interviews at WI, and who identified themselves as either non-drinkers or experimental drinkers at WI. Reports of WII alcohol use were used to measure onset among WI non-drinkers and escalation among WI experimenters. Risk ratios were calculated to assess the overall impact of exposure to parent or peer alcohol use on onset and escalation, and at five age points (i.e., ≤?13, 14, 15, 16, and ≥?17). Findings show that exposure to either parent or friend alcohol use increased the risk of onset and escalation. Age-based analyses reveal a more nuanced relationship, showing variability in the nature and strength of influence by stage of drinking and by age. This study highlights the relevance of both parent and peer modeling on youth drinking throughout adolescence. Implications in advancing prevention and treatment include parental education about the impact of their own behaviors and the importance of monitoring teens’ friendships.     

America in the Psyche of Bangla Authors: Opening of the Space by Tagore

The essay, divided into five sections, explores how the Cultural Space called ‘America’ (and ‘Americanism’) are reflected in the works of a far-away literary-cultural community called Bangla (or Bengali) in South Asia, and how this inter-relationship was strengthened by Rabindranath Tagore. It begins with the post-Tagore post-WWII literary scene where America occurs as a backdrop and then touches upon Tagore’s contemporaries who referred to America. But it focuses on how Tagore, in his polemical writing, views the role of America in the international arena, or how he conceptualises Indo-American relations while commenting on American Society and its beliefs and practices — especially how it handles linguistic plurality, majority-minority relationships, and less-privileged groups. In particular, it discusses the concepts such as Individuality, Plurality, Diversity, Liberty and Civilization — all relevant for foreign policy initiatives then as well as now, and how America is viewed as a land of promise and opportunity.     

Unplanned sexual activity as a consequence of alcohol use: a prospective study of risk perceptions and alcohol use among college freshmen

OBJECTIVE: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption. PARTICIPANTS: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. METHODS: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. RESULTS: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. CONCLUSIONS: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.     

Evaluation of a cross-cultural training program for Pakistani educators: Lessons learned and implications for program planning

In this paper, we share the results of a summative evaluation of PEILI, a US-based adult professional development/training program for secondary school Pakistani teachers. The evaluation was guided by the theories of cultural competence (American Psychological Association, 2003, Bamberger, 1999, Wadsworth, 2001) and established frameworks for the evaluation of professional development/training and instructional design (Bennett, 1975, Guskey, 2002, King, 2014, Kirkpatrick, 1967). The explicit and implicit stakeholder assumptions about the connections between program resources, activities, outputs, and outcomes are described. Participant knowledge and skills were measured via scores on a pre/posttest of professional knowledge, and a standards-based performance assessment rubric. In addition to measuring short-term program outcomes, we also sought to incorporate theory-driven thinking into the evaluation design. Hence, we examined participant self-efficacy and access to social capital, two evidenced-based determinants or “levers” that theoretically explain the transformative space between an intervention and its outcomes (Chen, 2012). Data about program determinants were collected and analyzed through a pre/posttest of self-efficacy and social network analysis. Key evaluation findings include participant acquisition of new instructional skills, increased self-efficacy, and the formation of a nascent professional support network. Lessons learned and implications for the design and evaluation of cross-cultural teacher professional development programs are discussed.     

Empirical evidence on legal levers aimed at addressing child maltreatment

Law is a powerful tool for combatting public health issues. This article reviews existing empirical research on the effect of eight legal levers on outcomes related to child maltreatment. Laws created with the intent to address child maltreatment are often enacted without empirical basis. Further, following implementation, there is little empirical research on whether such statutes reduce or deter child maltreatment and improve child outcomes. This is in part due to the difficulty in studying the effects of a specific statute on measurable child outcomes.     

The CB Handle: An Announcement Of Adult Identity*

The CB handle is used as a means of exploring voluntary identity-making among adult CBers. While only an exploratory study, gender appeared to be the most deeply embedded adult identification. Other, apparently less deeply embedded, identities were found in occupation (white- versus blue-collar workers and truckers versus non-truckers). Sexual identifications seemed to have increased in importance with time, with ethnic identifications decreasing in importance. Finally, Turner's (1976) distinction between impulse and institutional anchoring of the real self was used to suggest that white-collar workers and new CBers had significantly more impulse-based handles than blue-collar workers and “old-timer” CBers.     

School enrolment and mothers’ labor supply: evidence from a regression discontinuity approach

We analyze the impact on maternal employment of a universal school reform in Norway which lowered the school starting age from seven to six. We use a regression discontinuity approach exploiting exogenous variation in the compulsory school enrollment rule caused by the reform. Our results reveal positive short-term effects on labor supply (approximately five percentage points) and on earnings (about 12600/1350 NOK/Euro). Subgroup analyses show that the positive effects are much stronger for mothers with low wage potential, a group of mothers that were less likely to use formal childcare prior to the reform. The positive effects for this subgroup of mothers suggest that expanding child-care can be an effective tool for increasing labor supply of mothers who previously had relatively low labor market earnings potential.     

Turning Points to Becoming a Tobacco Smoker: Smoking Initiation and Identity Change among Chinese Youth

In this study, we analyzed identity construction among young smokers in China, with three interconnected objectives: to theorize the turning points and career trajectory of smoking initiation; to account for their characteristics with interactionist processes; and to critically evaluate the applicability of classic typologies of identity change by Becker and Strauss. In-depth interviews with 24 late adolescents (ages 18–19) revealed a smoking initiation career path of four interconnected turning points, each characterized by interactionist processes. Smoker peers played a key role in facilitating overall career progression, and shame avoidance was crucial to their social dynamics. We also conclude that classic studies of turning points in general, and substance use specifically, are sufficiently broad and flexible to elucidate tobacco smoker identity construction in China, and facilitate a comparison of commonality and divergence among different “becoming” identities. The implications of these findings for tobacco control in China are discussed.     

社会流动有助于降低健康不平等吗?

关于健康不平等现象主要存在两种理论解释,即社会因果论和健康选择论。以往研究主要通过追踪数据来检验两种理论的基本观点。本研究运用中国综合社会调查数据(CGSS2005),从社会流动的角度分析中国民众的健康不平等状况及其产生机制,并从侧面比较了这两种理论的解释力。本研究强调健康不平等是社会阶层地位不平等的再生产,而社会流动是降低社会阶层地位不平等的重要途径。因而,本研究假设,是否发生社会流动对于改变人们的健康水平具有重要影响,社会上向(下向)流动能够促进(降低)人们的健康水平,并且有助于降低不同社会阶层之间的健康梯度。分析发现,社会流动(方向和距离)对人们的健康水平有显著作用,但只有长距离的社会流动才对人们的健康水平有明显的提升(或抑制)作用。从总体上看,在当前中国背景下,社会因果论的解释力强于健康选择论。社会流动在健康不平等的产生过程中,起到了一定的混合作用,有助于降低健康不平等水平。