Overcoming medication refusal using a patient-centered approach

The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.     

THE HARDER THE TASK,THE HIGHER THE SCORE: FINDINGS OF A DIFFICULTY BIAS

Studies have found that going first or last in a sequential order contest leads to a biased outcome, commonly called order bias (or primacy and recency). Studies have also found that judges have a tendency to reward contestants they recognize with additional points, called reference bias. Controlling for known biases, we test for a new type of bias we refer to as “difficulty bias,” which reveals that athletes attempting more difficult routines receive higher execution scores, even when difficulty and execution are judged separately. Despite some identification challenges, we add to the literature by finding strong evidence of a difficulty bias in gymnastics. We also provide generalizations beyond athletics. (JEL L10, L83, D81, J70, Z1)     

What are Research Expectations? A Comparative Study of Different Academic Disciplines

This paper is intended to assist professors, administrators, librarians and other members of university level committees that must consider research expectations and research quality in academic fields that they lack. While this is not a problem for field experts, it is a difficulty when people are asked to make decisions in areas of study other than their own. This is commonly the case for senior university professors, librarians and administrators in regards to university wide decisions. The paper investigates this gap, through a study of 27 academic fields in 348 highly regarded universities. We find that there are almost always statistically significant differences in activity between academic fields, regardless of the metric one considers. However, it is possible to understand these differences by comparing the distribution of a known academic field to that of a field that one is not familiar with. Tables and information are provided to assist in the comparison of different fields of study on metrics such as: departmental publications and researcher level metrics of publications, citations, H-index, and total number of co-authors. The information can also be used to support decisions associated with promotion to senior posts such as endowed chairs and professorships. Information regarding specific universities and researchers are included in the data supplement.     

Observed and parent‐reported conscience in childhood: Relations with bullying involvement in early primary school

This exploratory study aimed to examine which components of early childhood conscience predicted bullying involvement around school entry. In the population‐based Generation R Study, teacher reports of bullying involvement and parent reports of conscience were available for 3,244 children (M age = 6.7 years). Higher levels of overall conscience predicted lower bullying perpetration scores, independently of intelligence quotient, temperamental traits and sociodemographic characteristics. Particularly, the subscales guilt, confession, and internalized conduct, and to a lesser extent empathy, predicted bullying perpetration. Conscience was not related to victimization. Similar results were found using observations during so‐called ‘cheating games’ (subsample N = 450 children). Findings suggest that improving children's understanding of moral standards and norms may be a potential target for bullying intervention programs in early primary school.     

Introductory Statistics Textbooks and the GAISE Recommendations

The six recommendations made by the Guidelines for Assessment and Instruction in Statistics Education (GAISE) committee were first communicated in 2005 and more formally in 2010. In this article, 25 introductory statistics textbooks are examined to assess how well these textbooks have incorporated the three GAISE recommendations most relevant to implementation in textbooks (statistical literacy and thinking; use of real data; stress concepts over procedures). The implementation of another recommendation (using technology) is described but not assessed. In general, most textbooks appear to be adopting the GAISE recommendations reasonably well in both exposition and exercises. The textbooks are particularly adept at using real data, using real data well, and promoting statistical literacy. Textbooks are less adept—but still rated reasonably well, in general—at explaining concepts over procedures and promoting statistical thinking. In contrast, few textbooks have easy-usable glossaries of statistical terms to assist with understanding of statistical language and literacy development. Supplementary materials for this article are available online.     

Shared frailty model based on reversed hazard rate for left censored data

Frailty models are used in the survival analysis to account for the unobserved heterogeneity in the individual risks to disease and death. To analyze the bivariate data on related survival times (e.g., matched pairs experiments, twin or family data), the shared frailty models were suggested. In this article, we introduce the shared gamma frailty models with the reversed hazard rate. We develop the Bayesian estimation procedure using the Markov chain Monte Carlo (MCMC) technique to estimate the parameters involved in the model. We present a simulation study to compare the true values of the parameters with the estimated values. We apply the model to a real life bivariate survival dataset.     

Assessing the Validity and Reliability of the Perceptions of the Consent to Sex Scale

Although sexual assault prevention education tends to focus on consent promotion as a means to reduce rates of sexual assault, little is known about how college students consent to sexual activity. The current study aimed to better understand college students' consent via the systematic development of the Consent to Sex Scale (CSS), utilizing mixed methods via three phases and two waves of data collection. In Phase 1, qualitative data were collected from college students (n = 185) to provide a foundation for item writing. In Phase 2, closed-ended items were written for a quantitative instrument and reviewed by a team of experts. In Phase 3, a quantitative survey, including items written in Phase 2, was administered to college students (n = 685); the measure was assessed for its psychometric properties. Exploratory factor analysis was utilized, resulting in a five-factor solution. The CSS and corresponding factors demonstrated high internal consistency reliability and expected gender differences, supporting the construct validity of the measure. The CSS assesses college students' cues for indicating consent to sex, a construct not addressed by previous measures. The validated scale may be useful in future research to better understand how consent relates to other behaviors or constructs.