Birth Outcome Measures and Infant Mortality

Recent studies have proposed alternative birth outcome measures as means of assessing infant mortality risk; nevertheless, there hasn’t yet been an integrated analysis of these approaches. We review 14 strategies, including various combinations of birth weight, gestational age, fetal growth rate, and Apgar scores—as predictors of early neonatal, late neonatal, and postneonatal mortality, and infant mortality. Using the NCHS linked birth/infant death file for 2001, we construct multivariate logit models and assess the associations between each of the 14 key birth outcome measures and four mortality outcomes. We find that all evaluated birth outcome measures are strong predictors, but Apgar scores are the strongest among all models for all outcomes, independent of birth weight and gestational age. Apgar scores’ predictive power is stronger for Mexican-, white-, and female-infants than for black- and male-infants. Second, all birth outcome measures remain significantly associated with mortality, but their predictive power reduces drastically over time. These findings suggest a rule of thumb for predicting infant mortality odds: when available, Apgar scores should always be included along with birth weight (or LBW status) and gestational age. Additionally, these findings argue for the continued study of low birthweight, gestational age, and Apgar scores as independently salient health outcomes.     

人口计生宣传教育为“先导”的重心和支点

宣传教育为先导的战略决策,是国家人口计生委党组书记、主任李斌同志2007年年底在河南召开全国农村人口文化建设工作现场会和在宁波市召开全国婚育新风进万家活动经验交流会上提出的重大战略思想。宣传教育为先导战略决策的提出,是在科学发展观指引下尊重思想政治工作、精神文明建设和人口计生工作客观规律,总结正反两方面工作经验教训的必然产物,是今后做好人口计生工作的元点工程。本文主要论述了为什么要先导,先什么、导什么,如何先导三个重大问题。     

Characteristics and Outcomes of College-Age Adults Enrolled in Private Residential Treatment: Implications for Practice

Substance use among college-age adults is of interest due to high levels of use and low levels of treatment access and engagement relative to other adults. Data collected from 1,972 clients in residential services were analyzed to investigate differences in use patterns, treatment outcomes, and other life area problems. Participants completed an Addiction Severity Index (ASI) and the University of Rhode Island Change Assessment (URICA) at baseline, and an ASI and Treatment Services Review at 1-month and 6-month postdischarge interviews. Almost a quarter (24.1%) of participants were college age (18–25 years old). They were more likely to be White and male, and less likely to complete treatment although they had a longer average length of stay. College-age adults improved on all outcome measures, and posttreatment service use shows significant difference between college-age and older participants. Implications for practice are discussed.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Intergenerational Remote Exergaming with Family and Friends for Health and Leisure

Global guidelines for physical activity are not being met by most of the world’s youths, adults, and older adults. Family and friends who engage in physical activity across generations derive emotional, social, cognitive, and physical benefits from their interaction. Youths depend on adult assistance to travel long distances, adults are encumbered with obligations to work, and older adults often live more than 200 miles from their extended families. Intergenerational physical activity is difficult because generations are distant and lead busy lifestyles. Remotely played exergames can connect family and friends for intergenerational physical activity. Internet exergaming can help to make physical activity convenient and enjoyable as well as eliminate the effect of distance on playing with family and friends.     

Work and breastfeeding decisions are jointly determined for higher socioeconomic status US mothers

We study postpartum decisions about paid work and breastfeeding using a simultaneous equations model. For our sample of higher socioeconomic status mothers, we find a joint decision process for three sets of decisions modeled: work leave duration and duration of any, as well as of exclusive, breastfeeding, and daily work hours and daily breastfeedings at infant age 3 months. We find that returning to paid work 1 week earlier reduces any breastfeeding duration by about two-thirds of a week while extending breastfeeding by a week delays work participation by about one-third of a week. We find larger elasticities for decisions involving daily work hours and number of breastfeedings at 3 months than for work leave duration and any breastfeeding duration and the smallest elasticities for duration of exclusive breastfeeding and work leave. This marks the first study to find a joint decision-making process for postpartum work and breastfeeding decisions and suggests that, in addition to increased leave impacting breastfeeding behaviors, successful breastfeeding promotion policies can have nontrivial impacts on the US labor market.     

A Cost–Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness

Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs–benefits of a family systems‐based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi‐prospective study compared the 12‐month pre–post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost–benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed.     

Poly-victimization and resilience portfolios: Trends in violence research that can enhance the understanding and prevention of elder abuse

ABSTRACT

This literature review assesses the current state of knowledge about elder abuse and mistreatment, focusing on the lack of incorporation of all forms of elder victimization and the benefits of a poly-victimization framework. This review also includes existing knowledge on risk factors and calls for a greater focus on protective factors and a greater inclusion on family and community factors. Future research, prevention, and intervention would benefit from considering the true burden of elder victimization and a greater implementation of strengths-based approaches to programs.     

Do “Clicker” Educational Sessions Enhance the Effectiveness of a Social Norms Marketing Campaign?

Abstract

Objective: Social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a “standard” social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology (“clickers”). Methods: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. Results: The authors find “clicker” technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. Conclusion: Poster SNM campaigns may be most effective when supported by group “clicker” heath-related sessions.