Demographic differences in response rates for PHQ9 in a university student population

Objective: To examine differences in complete response rates for depression screening questions based on demographic characteristics. Methods: Cross-sectional study examining associations between demographic characteristics and completely responding depression-screening questions. Participants: “Healthy Minds Study” data, collected in a public University in February 2016, where 7,326 students participated. Results: women (AOR: 0.69; 95% CI =0.57–0.83) and gay/lesbian students (AOR: 0.24; 95% CI =0.10–0.60) had better complete response rates. Non-US (AOR: 1.46; 95% CI =1.03–2.07), black (AOR: 3.32; 95% CI =1.92–5.77), and Middle-Eastern students (AOR: 3.73; 95% CI =1.73–8.02) had lower complete response rates. Conclusions: Our study shows sex, gender, citizenship, and race categories have significant differences in complete response rates for the outcome. Our findings have several implications; including recognizing interventions for depression based on responders may not target those that tend to be “partial-responders”. Efforts in survey design, recruiting and completion of surveys should be maximized.     

Implementing a college mental health program – an overview of the first twelve months

Objective: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). Participants: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. Methods: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. Results: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. Conclusions: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.     

Wanting To Be Remembered: Intrinsically Rewarding Work and Generativity in Early Midlife

Previous research on generativity, the desire to leave a legacy through establishing and guiding the next generation, has focused primarily on family life and civic engagement as pathways to midlife generativity. This paper proposes that intrinsically rewarding work can also be associated with a heightened sense of generativity in midlife. We test this hypothesis with data (n = 369 employed individuals, approximately 43 years old) from the 2010 wave of the Edmonton Transitions Study. Civic engagement was positively associated with midlife generativity, as predicted, but the hypothesized positive relationship between generativity and perceived parenting success was not found. Taking into account civic engagement and perceived parenting success, and controlling on a range of other variables, intrinsically rewarding work was positively associated with midlife feelings of generativity.     

Hypothesis Testing of CNA Perceptions of Organizational Culture in Long Term Care

This commentary for the special issue on research that went wrong describes a study that explored factors that contribute to variability within Certified Nursing Assistants (CNAs) on organizational safety culture. We know from previous research that CNAs provide most direct care in nursing homes and that direct care workers often experience agency culture differently from agency management (Wolf et al., 2014). We were looking for factors that nursing homes could alter to improve the culture for CNAs, and thus, residents. We conducted a secondary analysis of data collected via a multi-component paper survey of CNAs employed in long term care. We used results from the Nursing Home Survey on Patient Safety Culture and primary shift, type of unit, and years as a CNA to identify modifiable characteristics that would explain variability in the perceptions of patient safety culture. The final sample included n = 106 from three nursing homes. Dimension scores were compared using bivariate tests appropriate to the scale and ordinal logistic regression. Despite support in the literature for the hypothesis, we found few significant differences on the total scale within groups. Differences in perceptions have implications for quality of care and the experiences of residents within nursing homes.     

第16届国际人类学与民族学大会有感

2009年7月27-31日,"国际人类学与民族学联合会第16届大会"在中国云南省昆明市召开,4000多名学者参加了会议.本次大会由中国人类学与民族学联合会、云南大学和云南民族大学共同主办.     

From Foster Care to Adoption and Guardianship: A Twenty-First Century Challenge

For nearly four decades, child welfare policy and practice have focused on the achievement of legal permanence for children in foster care. Although federal child welfare policy has resulted in the movement of children from state custody to legally permanent adoptive or guardianship families, little is known about the quality and enduring nature of these placements. A significant challenge of the twenty-first century child welfare system is how to ensure the well-being of children currently living with adoptive parents or guardians. This paper discusses child welfare policy and trends related to post-permanency well-being, including the decrease in Title IV-E foster care caseloads nationwide and the simultaneous increase in Title IV-E adoptive and guardianship caseloads. We highlight the needs of a twenty-first century child welfare system, including increased federal efforts to ensure child permanence and well-being after legal adoption or guardianship has been achieved, as well as more rigorous longitudinal and interdisciplinary research focused on the post-permanency adjustment of children and their families.     

Using relative utility curves to evaluate risk prediction

Summary.  Because many medical decisions are based on risk prediction models that are constructed from medical history and results of tests, the evaluation of these prediction models is important. This paper makes five contributions to this evaluation: the relative utility curve which gauges the potential for better prediction in terms of utilities, without the need for a reference level for one utility, while providing a sensitivity analysis for misspecification of utilities, the relevant region, which is the set of values of prediction performance that are consistent with the recommended treatment status in the absence of prediction, the test threshold, which is the minimum number of tests that would be traded for a true positive prediction in order for the expected utility to be non-negative, the evaluation of two-stage predictions that reduce test costs and connections between various measures of performance of prediction. An application involving the risk of cardiovascular disease is discussed.     

Social Background Differences in Early Family Behavior

Social background has historically been recognized as a major factor influencing family behavior, though recent work has largely emphasized racial/ethnic influences. Here we use 1994 – 1995 and 2001 – 2002 Add Health data to examine the cohabitation, first marriage, and first birth experience of young women. In a multistate life table context, hypothetical cohorts specified in terms of race and mother’s education are followed, from age 11 to age 24, as they move through 6 family‐related statuses. The results indicate that, for both Black and White women, a higher level of maternal education is generally associated with less cohabitation, less marriage, fewer first births, and a higher percentage of women who experience none of those transitions before age 24. Racial and social background differences are conceptually and empirically distinct. Because mother’s education is associated with substantially different trajectories of early family behavior for both Blacks and Whites, we argue that social background merits increased attention in research on contemporary American family patterns.     

Relation Between Maternal Contingent Responsiveness and Infant Social Expectations

This study investigated the relation between maternal contingent responsiveness and 4‐ and 5‐month‐old infants' (N = 64) social expectation behavior in a still‐face procedure. Mothers were asked to interact with their infants for 2 min (interactive phase), remain still‐faced for 1 min (still‐face phase), and resume interaction for 2 min. Mother and infant behavior was assessed for the frequency of infant and mother smiles, mother smiles that were contingent to infant smiles and infant smiles were contingent to mother smiles during the interactive phase, and infant social bids to mother during the still‐face phase. Hierarchical regression showed that mother contingent smiles during the interactive phase accounted for unique variance in infant social bids during the still‐face phase beyond that accounted for by the frequency of mother and infant smiles during the interactive phase. These results support the view that young infants' social expectations and sense of self‐efficacy are formed within their interactions with their caregivers.