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.     

A new aging concept derived from the increasing convex ordering

In this paper, a comparison between the life distribution of a new unit with that of a used unit in the increasing convex order is made leading to a new class of life distributions which we call “new better than used in convex ordering of second order”. This class includes as subclasses the NBU and the NBUC and is a subclass of the NBUCA class. Preservation properties under convolution, random maxima, mixing and formation of coherent structures are established. Stochastic comparisons of the excess lifetime when the inter-arrival times belong to the NBUC(2) class are developed. Some applications of Poisson shock models and a test of exponentiality against NBUC(2) alternative are presented.     

Multiple hypothesis tests based On conditional differences in means

Many hypothesis tests are univariate tests and cannot cope with multiple hypothesis without an auxiliary procedure as e. g. the Bonferroni-Holm-procedure. At the same time, there is an urgent need for testing multiple hypothesis due to the very simple existing methods as the Bonferroni-correction or the Bonferroni-Holm-procedure, which suffers from a very small local significance level to detect statistical inferences or the drawback that logical and statistical dependencies among the test statistics are not used, whereby its detection is NP-hard. In honour of this occasion, we present a multiple hypothesis test for i.i.d. random variables based on conditional differences in means, which is capable to cope with multiple hypothesis and does not suffer on such drawbacks as the Bonferroni-correction or the Bonferroni-Holm-procedure. Thereby, the computation time can be neglected.     

On a control chart for the Gini index with simulations

In this work we suggest the use of the Gini index on control charts. The asymptotic properties of Gini index are presented and the control charts based on appropriate confidence intervals are constructed. The suitability of the proposed charts are investigated by means of extensive simulations.     

A reflected feature space for CART

We present an algorithm for learning oblique decision trees, called HHCART(G). Our decision tree combines learning concepts from two classification trees, HHCART and Geometric Decision Tree (GDT). HHCART(G) is a simplified HHCART algorithm that uses linear structure in the training examples, captured by a modified GDT angle bisector, to define splitting directions. At each node, we reflect the training examples with respect to the modified angle bisector to align this linear structure with the coordinate axes. Searching axis parallel splits in this reflected feature space provides an efficient and effective way of finding oblique splits in the original feature space. Our method is much simpler than HHCART because it only considers one reflected feature space for node splitting. HHCART considers multiple reflected feature spaces for node splitting making it more computationally intensive to build. Experimental results show that HHCART(G) is an effective classifier, producing compact trees with similar or better results than several other decision trees, including GDT and HHCART trees.     

Trajectories of Limitations with Activities of Daily Living Among Older Adults of Mexican Descent: The Role of Widowhood

Using seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly (1993–2011), this study applies multiphase growth models to examine changes in limitations with activities of daily living (ADL) across widowhood experience among 385 older adults of Mexican descent. This study also investigates the implications of demographic characteristics, health, socioeconomic status, living arrangements, and social involvement. ADL limitations increased pre-widowhood, were at higher levels immediately before and especially during the transition to widowhood, and increased at a steeper rate post-widowhood. Age and partially depressive symptoms accounted for these trends in ADL limitations pre-widowhood and to a lesser extent during the transition to widowhood and post-widowhood. Older age, being female, chronic conditions, financial strain, lower educational attainment, coresidence with children and others, and less frequent church attendance were risk factors for higher levels of and greater increases in these functional limitations throughout widowhood experience.     

Life Balance and Work Addiction Among NCAA Administrators and Coaches

Intercollegiate athletics represent an industry prone to challenges of work addiction and life balance. Work addiction and life balance domains in male and female intercollegiate athletic coaches and administrators (N = 245) were examined using multiple regression analysis. Higher levels of stress/anxiety, sleep disturbance, and career satisfaction and lower levels of quality of relationships and friendships were the strongest predictors of work addiction. Counseling focused on reducing the negative aspects of work addiction, while maintaining job performance, may benefit this population.     

Improving medicolegal death investigative gaps of fatal elder abuse

The purpose of this brief is to present several case vignettes that illustrate omissions in the investigation of elder deaths. These vignettes demonstrate the need for a standardized approach in the conduct of medicolegal investigations of fatal elder abuse. For each of the described oversights, a recommendation is offered to address the gap in investigation processes, which in turn could improve the determination of cause and manner of elder death. Inherent limitations of resources and practical realities of death investigation are discussed and recommendations are made for future research. Viewed broadly, deficiencies in elder death investigations can lead to the underreporting of elder abuse and the reduction of legal options for victims, which may reflect a systemic pattern of social injustice.