Prevalence and Diagnostic Correlates of DSM-IV Pathological Gambling in Psychiatric Outpatients

Studies of the prevalence of pathological gambling (PG) in psychiatric and substance abusing patients suggest that the disorder is not rare. Most studies have been of substance abusers in treatment, and the rate of PG has been found to be several times higher than the rate found in community based epidemiological surveys. However, only one study has examined the prevalence of PG in a heterogeneous sample of patients, and this was a study of psychiatric inpatients. We are not aware of any prior study of the prevalence of PG in a psychiatric outpatient sample. In the present report from the Rhode Island Methods to Improve Diagnosis and Services (MIDAS) project we examined the current and lifetime prevalence of PG in 1,709 psychiatric outpatients interviewed with a semi-structured diagnostic interview that included a module to diagnose DSM-IV PG. Forty (2.3%) patients had a lifetime history of DSM-IV PG, all of whom had at least one other DSM-IV axis I disorder. Patients with PG had significantly more axis I disorders than patients without PG, and had significantly higher rates of bipolar disorder, social phobia, panic disorder with agoraphobia, alcohol use disorder, and other impulse control disorders. Possible reasons for the low prevalence of PG in our sample are discussed.     

Project LIFE: a partnership to increase physical activity in elders with multiple chronic illnesses

The authors describe a medical center-based randomized trial aimed at determining the feasibility and effectiveness of partnering patients and primary-care providers with an exercise health counselor. Study participants included 165 veterans age 70 years and older. The primary end point was change in physical activity at 3 and 6 months comparing patients receiving high-intensity physical activity counseling, attention control counseling, and usual care after receiving standardized clinic-based counseling. We noted a significant Group x Time interaction (p = .041) for physical activity frequency and a similar effect for caloric expenditure (p = .054). Participants receiving high-intensity counseling and usual care increased physical activity over the short term, but those with usual care returned to baseline by the end of the study. The intervention was well received by practitioners and patients. We conclude that partnering primary-care providers with specialized exercise counselors for age- and health-appropriate physical activity counseling is effective.     

Employment transitions for clubhouse members

Using a longitudinal dataset which followed 2195 individuals employed in 3379 separate job placements over a four-year period, this paper explores movement between the employment supports, [Transitional (TE), Supported (SE), and Independent Employment (IE)], offered by clubhouses. Sixty-four percent of employed members held only one job (N=1395) and 36% held multiple jobs during the study (N=791). Patterns of movement were consistent for transitions between the first and second job and subsequent transitions. Forty-six percent of individuals holding multiple jobs moved from one employment type to another. When movement occurred clubhouse members were significantly more likely to move from employment types offering more supports to those that offer less supports.     

Work-related factors contributing to chronic disability in low back pain

Low back pain is a costly and incapacitating musculoskeletal disorder. Prospective studies documenting the capacity of work-related factors to predict chronicity are few in number, the methodology used is very diversified, and the results obtained diverge. The aim of the present study is to investigate the capacity of work-related objective (non-psychosocial) and psychosocial factors to predict chronic disability related to low back pain. A longitudinal prospective study with two measurement times was carried out. The sample (N = 258) consisted of workers with subacute low back pain who were on sick leave and receiving compensation from the CSST (Quebec Workers' Compensation Board). Of all the work-related variables measured, perceived stress and fears and beliefs about work were associated with return to work status at the six-month follow-up. The results obtained show the importance of considering fears and beliefs about work when identifying people in the subacute phase of low back pain who are at risk of developing chronic disability.     

Going the distance: serving the needs of older youth at scale

Few communities have developed successful strategies for attracting large numbers of older youth to their out-of-school-time programs. In addition to meeting the unique developmental and programmatic needs of this population, communities have struggled with the challenge of creating communitywide integrated approaches to service delivery and resource development. Communities wanting to build a system of supports for older youth must do so in the context of a communitywide strategy as opposed to fragmented, individually operating programs and services. A communitywide strategy creates greater opportunity for strategic mobilization of resources, greater funding leverage, evaluation and assessment consistency, and more powerful input into creating a public voice and public will for supporting and serving older youth as they make the transition to adulthood.     

Establishing the R&D agenda for twenty-first century learning

An infusion of twenty-first century skills into American public education necessitates a plan for research and development to further such reform. While the nation agrees that students must obtain critical thinking, problem-solving, and communication skills to succeed in the current global marketplace, this chapter puts forth a long-term, proactive agenda to invest in targeted research to propel and sustain this shift in education. The authors examine the impact such an R&D agenda would have on pedagogy and assessment and the implications for institutions of higher education. As the United States struggles to maintain dominance in the international economy, it faces a great challenge in keeping up with European and Asian competitors' strategies for preparing youth for the global marketplace. The authors hope the global reality will help contextualize the debate around American education--the current trend toward basics and accountability needs to be broadened. Building on frameworks created by the Partnership for 21st Century Skills, this chapter proposes questions to guide research around teaching, professional development, and assessment significant to twenty-first century skills. Knowing that educational change depends on providing teachers with the tools, support, and training to make fundamental changes in their practice, the authors argue for extensive research around best practices. In addition, if assessments are created to measure the desired outcomes, such measuring tools can drive reform. Furthermore, large-scale changes in teacher preparation programs must take place to allow teachers to adequately employ twenty-first century teaching and assessment strategies.