The use of antidepressant medications in substance abuse treatment: the public-private distinction, organizational compatibility, and the environment

Many studies of innovation adoption in health care organizations focus either on organizational characteristics or the institutional environment, but not both. Furthermore, these perspectives are rarely employed simultaneously in both public and private health care organizations. This research considers the public-private distinction, organizational compatibility, and interorganizational referral relationships in the use of selective serotonin reuptake inhibitors (SSRIs) by substance abuse treatment organizations. Using data from nationally representative samples of 363 publicly funded and 403 privately funded substance abuse treatment centers, a four-category typology of public and private organizations initially predicted variation in SSRI use. However some differences were no longer significant once organizational and environmental characteristics were added to the statistical model. These data support hypotheses about the associations between organizational characteristics and SSRI use as well as hypotheses regarding the external environment. Future research should continue to integrate both internal and external factors in theoretical explanations of innovation adoption.     

The underreporting gap in aggressive incidents from geriatric patients against certified nursing assistants

Staff in the health care industry experience workplace aggression at a much higher rate than the general workforce. However, a large proportion of aggressive incidents go unreported, and the source of many of these incidents is patients. This study investigates aggressive incidents from patients against certified nursing assistants (CNAs; n = 76) in a sample of six geriatric care facilities. The results indicate that CNAs experienced a median of 26 aggressive incidents over the course of the 2-week study and that approximately 95% of these incidents were not reported to the facility. The present study also empirically examines reasons why nursing staff decide to report incidents. Finally, this study reveals that the experience of aggression from patients is related to subsequent organizational commitment, job satisfaction, and intent to leave the job.     

A Capture–Recapture Approach to Estimation of Refugee Populations

The debate over immigration continues to be one of the most politically charged policy issues in the United States (US). Given the charged nature of this topic, it is vitally important to have reliable data on not only the number of US foreign nationals but also the characteristics of this extremely heterogeneous group – a population comprised not only of immigrants but also of refugees. There exist a small number of data sources for informing policy and practice at the national level. However, such data are often lacking for smaller geographical areas. This paper describes a recent effort to generate serviceable data on the immigrant and refugee population for a medium‐sized metropolitan area in the US. The objectives of this research were twofold. Our first goal was to provide local stakeholders with information to assist them with resettling and obtaining funding for immigrants and refugees. The second aim was to develop better techniques for tabulating diverse refugees and immigrants in a medium‐sized community. By comparing and contrasting three data sources – that is, refugee services, public schools and a local health plan – we are able to generate estimates of the local refugee and immigrant population. During the period from 2005 to 2007, we estimate the total number of immigrants and refugees in the community to be somewhere between 10,938 and 13,282. Although perhaps a bit on the high end due to methodological assumptions, these estimates seem plausible, based on previously cited figures for the region. While such estimates are valuable, a number of shortcomings related to the data prevent us from painting a more complete picture of these populations. We conclude this paper with a number of recommendations that will assist others in planning research designed to inform migration policy and practice in medium‐sized metropolitan areas.     

An ecological synthesis of research on older women's experiences of intimate partner violence

In this systematic literature review, we synthesized the current knowledge of intimate partner violence experienced by older women. We identified 32 studies that included data collected from older women and synthesized the findings using the ecological model as an organizing framework. Themes in the microsystem included the immediate context in which the abuse takes place and impacts on older women. The mesosystem included themes on the older woman's relationships with her social network. Themes in the exosystem encompassed community-based services. Finally, themes in the macrosystem encompassed broad ideologies, mores, and influences of the geographic location. We used the ecological model to frame a discussion of implications for future research, policy, and practice.     

A Comparison Study of Low Trauma Disclosure Participants and Their Partners in Army Couples

Intimate partner relationships provide unique conditions for examining how the interpersonal and/or systemic impact of trauma exposure and post-trauma responses can impact both the primary and secondary trauma survivors and the interpersonal dynamics of the couple. The current study explored qualitative and quantitative data from low trauma disclosure individuals (n?=?15) and their partners to understand the experiences of low trauma disclosure to spouses in a sample of Army couples. Contrary to the original hypothesis, the results indicated mixed trauma disclosure partners seemed to be functioning at lower individual and relationship functioning levels than the low or high trauma disclosure partners. Implications for practice and future research also are described.     

Prevalence of Depression and Anxiety Among Bisexual People Compared to Gay,Lesbian, and Heterosexual Individuals:A Systematic Review and Meta-Analysis

Over the past decade, evidence has accumulated to suggest that bisexual people experience higher rates of poor mental health outcomes compared to both heterosexual and gay/lesbian individuals. However, no previous meta-analyses have been conducted to establish the magnitude of these disparities. To address this research gap, we conducted a systematic review and meta-analysis of studies that reported bisexual-specific data on standardized measures of depression or anxiety. Of the 1,074 full-text articles reviewed, 1,023 were ineligible, predominantly because they did not report separate data for bisexual people (n = 562 studies). Ultimately, 52 eligible studies could be pooled in the analysis. Results indicate that across both outcomes, there is a consistent pattern of lowest rates of depression and anxiety among heterosexual people, while bisexual people exhibit higher or equivalent rates in comparison to lesbian/gay people. On the basis of empirical and theoretical literature, we propose three interrelated contributors to these disparities: experiences of sexual orientation-based discrimination, bisexual invisibility/erasure, and lack of bisexual-affirmative support. Implications for interventions to improve the health and well-being of bisexual people are proposed.     

AN ADAPTIVE DECISION SUPPORT SYSTEM FOR ACADEMIC RESOURCE PLANNING

Institutions of higher learning are growing increasingly interested in the use of model-based approaches to their resource allocation problems. Recent modeling approaches, however, have failed to consider that resource allocation planning is not a well-structured decision process. Additionally, many decision makers are necessarily involved in the academic planning process and may assume dissimilar perspectives on the importance of achieving different goals and objectives. Furthermore, satisfactory allocation solutions can be expected to vary considerably from decision maker to decision maker as the individual's cognitive processes, perceptions, and evaluations are taken into consideration. This paper describes a decision support system (DSS) approach that attempts to adapt to a variety of academic decision makers with differing planning views in an environment of multiple conflicting objectives. This DSS, which was successfully tested on four academic decision makers in a large midwestern university, shows considerable promise for providing decision support to decision makers with varied problem-solving styles.     

Adolescent Work Experiences and Family Formation Behavior

A long-standing critique of adolescent employment is that it engenders a precocious maturity of more adult-like roles and behaviors, including school disengagement, substance use, sexual activity, inadequate sleep and exercise, and work-related stress. Though negative effects of high-intensity work on adolescent adjustment have been found, little research has addressed whether such work experiences are associated with precocious family formation behaviors in adolescence, such as sexual intercourse, pregnancy, residential independence, and union formation. Using data from the National Longitudinal Study of Adolescent Health, we find that teenagers who spend long hours on the job during the school year are more likely to experience these family formation behaviors earlier than youth who work moderately or not at all.