Vitamin D and the postmenopausal population

Vitamin D, a hormone critical to the body's maintenance of serum calcium and phosphorus concentrations, is currently the subject of much scientific interest. Low levels of vitamin D have been observed in many populations and epidemiological studies have suggested a link between this biochemical state and a range of diseases, such as cancer, diabetes and multiple sclerosis. While the consequence of vitamin D deficiency is well documented for bone (rickets and osteomalacia), with mixed findings relating to falls and fractures, a causal link between vitamin D deficiency and these wider health outcomes has not been established. If these relationships were found to be causal, the morbidity and mortality resulting from low levels of vitamin D could be substantial; the current evidence base, however, most robustly supports the assessment of serum 25(OH)-vitamin D in the context of specific symptoms, low bone mineral density or biochemical abnormalities, rather than as an entity to treat in its own right or as the basis for a population-wide screening programme.     

Joint physical custody and neighborhood friendships in middle childhood

Almost half of first marriages end in divorce, which in turn may produce joint physical custody arrangements. Seen by many states to be in the best interest of the child, joint physical custody is increasingly common. Yet much is unknown about its consequences for children. This article considers how joint physical custody arrangements affect children’s neighborhood friendships, an important component of child well-being because of their contributions to social and cognitive development. Thirteen parents and 17 children (aged 5–11) in 10 families, selected via convenience and snowball sampling, participated in semistructured interviews. The findings suggest that joint physical custody arrangements do not imperil children’s neighborhood friendships; indeed, most children and parents interviewed voiced contentment in this area.     

Nursing home deficiency citations for safety

Deficiency citations for safety violations in U.S. nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). Internal (i.e., operating characteristics of the facility), organizational factors (i.e., characteristics of the facility itself), and external factors (i.e., characteristics outside of the influence of the organization) associated with these deficiency citations are examined. The findings show that nursing homes increasingly receive deficiency citations for resident safety issues. Low staffing levels, poor quality of care, and an unfavorable Medicaid mix (occupancy and reimbursement) are associated with the likelihood of receiving deficiency citations for safety violations. In many cases, this likely influences the quality of life and quality of care of residents.     

Pediatric Emergency Department Visits for Mental Health Crisis: Prevalence of Cyber-Bullying in Suicidal Youth

The objective of this work is to (1) study the prevalence of cyber-bullying amongst adolescents referred by Pediatric Emergency Department (PED) for urgent psychiatric assessment and (2) to examine the association between cyber-bullying and suicidal behavior to assist emergency department professionals in screening for risk and triage. This is a retrospective study of patients referred by PED to an urgent psychiatric clinic. Data was extracted for those with bullying victimization. Clinical variables included demographics, reason for referral, type of bullying, substance use, abuse, past psychiatric history, diagnosis and outcome. The cyber-bullying group was compared to those with traditional bullying and a group with no-bullying. Data analysis was conducted using Chi squares, multinomial and bimodal logistic regression. The urgent psychiatric clinic assessed 805 patients in 24 months, the prevalence of bullying was 26.9 % (n = 217). The prevalence of Cyber-bullying was 13.5 % (n = 109) and traditional bullying was 13.4 % (n = 108). Cyber-bullying victims have more suicidal ideation (χ² = 7.82, p = .005; 85.3  vs. 69.4 %), more sexual abuse (χ² = 5.75, p = .02; 29.4  vs. 15.7 %), more emotional abuse (χ² = 10.8, p = .01; 30.3  vs. 12.0 %) and physical abuse (χ² = 6.13, p = .01; 27.5  vs. 13.9 %) and a higher inpatient admission rate. Suicidal ideation is the presenting problem in more than two-thirds of patients, especially females, with history of cyber-bullying who present to the PED. Screening questions about cyber-bullying could assist emergency room professionals in establishing risk and making triage decisions.     

From Separate Corners to Dialogue and Action

How can higher education programs engage students in building a shared commons to address inequalities and foster commitment to intergroup collaboration? Intergroup dialogue is one such possibility to provide forums for meaningful engagement among students from diverse backgrounds. Findings from field experiments at nine colleges and universities show that students in intergroup dialogues increased significantly more than counterparts in control groups and social science comparison groups in their critiques of inequality and their commitments to post-college action to redress inequalities. Further, students in intergroup dialogues rated the frequency of the core communication processes more highly than the social science comparison students. The communication processes help account for the greater increase in students’ critiques of inequality and commitment to post-college actions.     

Working for Patients? The Right Approach?

This paper is a slightly revised version of a Memorandum requested by the House of Commons Social Services Select Committee to assist the Committee in its analysis of the White Paper Working for Patients (Cm 555). It was submitted to the Committee on 28 February 1989. The paper follows up the authors'earlier study of the reform of the NHS (Barr, Glennerster and Le Grand, 1988), prepared at the request of the Select Committee prior to the publication of the White Paper.
The success or failure of the White Paper depends crucially on the precise details of the way in which its proposals are implemented. The Working Papers, although providing some more information as to how the White Paper's proposals will be implemented, do not in the main address the issues that concern us here.
Given the inescapable tension between cost and quality, quality control will be absolutely critical if the incentives to economize on the use of resources are not on occasion to lead to unacceptable reductions in quality — reductions which might well apply differentially by socioeconomic group.     

Bayesian estimation of the latent dimension and communities in stochastic blockmodels

Statistics and Computing - Spectral embedding of adjacency or Laplacian matrices of undirected graphs is a common technique for representing a network in a lower dimensional latent space, with...