Five-Hundred Life-Saving Interventions and Their Cost-Effectiveness

We gathered information on the cost-effectiveness of life-saving interventions in the United States from publicly available economic analyses. "Life-saving interventions" were defined as any behavioral and/or technological strategy that reduces the probability of premature death among a specified target population. We defined cost-effectiveness as the net resource costs of an intervention per year of life saved. To improve the comparability of cost-effectiveness ratios arrived at with diverse methods, we established fixed definitional goals and revised published estimates, when necessary and feasible, to meet these goals. The 587 interventions identified ranged from those that save more resources than they cost, to those costing more than 10 billion dollars per year of life saved. Overall, the median intervention costs $42,000 per life-year saved. The median medical intervention costs $19,000/life-year; injury reduction $48,000/life-year; and toxin control $2,800,000/life-year. Cost/life-year ratios and bibliographic references for more than 500 life-saving interventions are provided.     

Corporate divestiture and performance: an institutional view

In this study, we investigate how the institutional environment affects shareholders’ reaction to a firm’s announcement of divestitures. Traditionally, divestiture research has adhered to a financial economics perspective, in which shareholders anticipate certain economic outcomes from corporate divestitures and react accordingly. However, this research has not delivered a distinct understanding of the performance effects of corporate divestitures. To structure and integrate previous work, we apply a neo-institutional perspective of the stock market. We argue that at certain times, the institutional support for corporate diversification is relatively low. During these periods, there is a high rate of divestitures. The high divestiture activity legitimizes this corporate action and leads to a positive reaction of the stock market to new divestiture announcements. This means that individual evaluations of the possible performance outcomes of divestments are not the only factor determining the stock market reaction to a corporate divestiture announcement. Rather, investors might consider the perceived institutionalization of this corporate action when making their purchasing decisions. Using a meta-analytical technique, we find support for our prediction that different performance effects of divestitures, as revealed by previous studies, can be attributed to different conditions of the macro-economic environment. We discuss the implications of this result for research and management practice.     

Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma

The potential effects of maternal trauma on mother–infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother–infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4–6 months. Split‐screen videotaped interaction was coded on a one‐second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self‐contingency and interactive contingency of behavior by time‐series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper‐contingent, high‐arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.     

"All my friends are doing it:" the impact of the perception of peer sexuality on adolescents' intent to have sex

The purpose of the authors in this study was to determine if the proportionality of peers who believe other youth are having oral sex or vaginal/anal intercourse influence the youth's intention to also have oral sex or vaginal/anal intercourse in the next three months. The results supported the hypothesis that the proportionality of perceiving one's peers as sexually active was correlated with one's intent to have oral sex in the next three months (r = .34 and .39, p < .01) and one's intent to have vaginal or anal sex within the next three months (r = .51 and r = .65, p < .01). Approximately 50% of youth who intent to have oral sex are also likely to have vaginal/anal sex. The results were not moderated by age, gender, or Hispanic/White status, but were moderated by being in a special/committed relationship.     

Critical Flaws in the Female Sexual Function Index and the International Index of Erectile Function

The Female Sexual Function Index (FSFI; Rosen et al., 2000 Rosen , R. C. , Brown , C. , Heiman , J. , Leiblum , S. , Meston , C. , Shabsigh , R. , … D'Agostino , R. ( 2000 ). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function . Journal of Sex and Marital Therapy , 26 , 191 – 208 . doi: 10.1080/009262300278597 [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) and International Index of Erectile Function (IIEF; Rosen et al., 1997 Rosen , R. C. , Riley , A. , Wagner , G. , Osterloh , I. H. , Kirkpatrick , J. , &; Mishra , A. ( 1997 ). The International Index of Erectile Dysfunction (IIEF): A multidimensional scale for assessment of erectile dysfunction . Urology , 49 , 822 – 830 . doi: 10.1016/S0090-4295(97)00238-0 [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) are two of the most widely used measures of sexual dysfunction. However, they have potential measurement and psychometric flaws that have not been addressed in the literature. This article examines the measurement capabilities of these measures based on data collected from an online study in 2010. A convenience sample of 518 sexually active adults (65% female) drawn from the general community were included in the analyses. Both measures displayed critical theoretical and measurement problems for the assessment of sexual problems beyond sexual arousal, and for the sexual desire domains in particular. Based on these results, we encourage clinicians and researchers to think critically about whether the FSFI and IIEF are appropriate measures for their practice and research. In particular, these measures are inappropriate for use among individuals who are not currently sexually active, and research with a focus other than sexual arousal should consider supplementary measures of sexual function. The psychometric properties of these measures should be reassessed in clinical samples, but the theoretical issues with the measures raised in this article are relevant across clinical and research contexts.     

Preservation of self in the nursing home: Contradictory practices within two models of care

Researchers have identified several aspects of nursing home care that interfere with residents' preservation of self. This paper examines how different models of care shape residents' opportunities for preserving a sense of self, adult identity, and agency. Using ethnographic data, I analyze staff practices in two facilities that reflect the contrast between the home and hospital models of long-term care. Previous research on long-term care suggests that an informal, “home-like” approach to care creates more opportunities for residents to preserve a sense of self-identity, whereas a formal, “institutional” approach fosters depersonalizing practices that interfere with residents' psychosocial well-being. My research suggests, however, that both approaches can have contradictory effects on residents' preservation of self. I analyzed patterns of objectification and infantilization that emerged in the social interactions between residents and staff members, as well as practices that mitigated these patterns. This study highlights how a larger culture of ageism and stigma surrounding dependency can become embedded in micro-level practices and underscores the challenges of defining and implementing “good” care.     

Sexual Quality of Life and Aging: A Prospective Study of a Nationally Representative Sample

Unlike other life domains, sexual quality of life (SQoL) has a negative relationship with age. This study disentangled the effect of age in this relationship from confounding sociocultural influences (e.g., the period of time in which data were collected, and cohort differences) and aimed to understand the roles of other sexual domains (i.e., frequency, perceived control, thought and effort invested in sex, and number of sexual partners). We analyzed data from the longitudinal Midlife in the United States study (n = 6,278; age range 20–93), which were collected between 1995 and 2013. Repeated measures linear mixed-effects models showed that age was the most robust time-related predictor of declining SQoL. However, after the sexual domains were included in the model, age had a positive relationship with SQoL and older adults’ SQoL was differentially influenced by the quality—not quantity—of sex. When partnership characteristics were included in the model, age was no longer related to SQoL. These findings suggest that aging may be associated with the acquisition of skills and strategies that can buffer age-related declines in SQoL, particularly in the context of a positive relationship. We summarize these findings as sexual wisdom.     

A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology

Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or “spectra”). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.     

Creating caring institutions for community informatics

This paper explores the potential affordances of applying a feminist ethics of care approach to community informatics practices in public internet access facilities. As feminist technology scholars have long observed, technology and technoculture are strongly encoded as masculine, privileging traits such as scientific knowledge, rationality, objectivity, and distance. These characteristics are expressed in traditional infomediary practices in a variety of ways, including notions of expertise, ways of conceptualizing technology, emphasis on skills attainment, and deficit-based models of user behavior. In contrast, ethics of care emphasizes the importance of relational and situated knowledge, pluralistic voices and experiences, and relationships bound by mutual interdependence. Traditionally, caring has been feminized and thus necessarily excluded from technoculture and relegated to invisible and unpaid labor. Caring and associated affective labor practices remain an under-examined subject in infomediary practices. Public libraries and community technology centers are logical places to explore for care work, given that they share many characteristics of the spaces where care work has historically been performed. We argue that an ethics of care framework has several possible affordances for infomediary practices in these institutions, including highlighting the gendered power dynamics that define and shape existing practices; distributing care work and making existing care work visible; and envisioning a more holistic and ethical approach to engaging diverse publics. We translate Tronto’s seven warning signs for ‘bad care’ in institutions into seven positive guidelines for providing ‘good care’ in public internet access facilities, then contextualize these for community informatics institutions and practices.