In sickness but not in health: self-ratings, identity, and mortality

Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study (NHEFS) data for respondents with circulatory system disease (N = 3,709) and respondents with no diagnosable disorders (N = 1,127) at baseline, we test the idea that individuals with experience of chronic disease of the circulatory system will have more predictive self-ratings of health than healthy individuals. Poor or fair self-rated health increased the adjusted hazard of all-cause mortality for respondents with circulatory system disease, but not for respondents who were healthy. Additional analyses confirm that poor or fair self-rated health is particularly predictive for respondents with self-reported history of circulatory system diagnoses and perception of symptoms, but not for respondents without symptoms or diagnoses prior to the NHANES physical exam.     

Family member response to violent infant kidnapping

All family members interviewed suffered from chronic posttraumatic stress disorder 5 or more years after an infant kidnapping. Psychiatric nurses should routinely assess for secondary victimization related to any type of traumatic stressor. Nurses should refer parents and families to materials available from the National Center for Missing and Exploited Children (NCMEC) (http://www.missingkids.com/).     

Physical and mental health effects of being stalked for men and women

Stalking is relatively common yet little is known of the longer-term health effects of stalking. Using the National Violence Against Women survey, we estimated lifetime stalking victimization among women and men, ages 18 to 65, identified correlates of being stalked, and explored the association between being stalked and mental and physical health status. With a criterion of being stalked on more than one occasion and being at least "somewhat afraid," 14.2% of women and 4.3% of men were victims. Among those stalked, 41% of women and 28% of men were stalked by an intimate partner. Women were more than 13 times as likely to be "very afraid" of their stalker than men. Negative health consequences of being stalked were similar for men and women; those stalked were significantly more likely to report poor current health, depression, injury, and substance use. Implications for victims, service providers, and the criminal justice system were reviewed.     

Implementation issues for consumer-directed programs: comparing views of policy experts, consumers, and representatives

An increasing number of aging community providers and consumers support consumer-direction (CD) in long-term care services. In regard to devolution, consumer-direction goes beyond the usual approach of shifting responsibilities from the federal government to state governments to bring programs "closer to the people." Consumer-direction goes even further by placing resources directly in the hands of consumers. Yet, many questions remain unanswered regarding how to implement CD personal assistance services in general, and especially for older persons. This article describes the importance of examining views from multiple key stakeholders involved in implementing CD programs. We report on three background studies that have informed the Cash and Counseling Demonstration and Evaluation (CCDE) design and implementation-policy expert interviews as well as surveys and focus groups with consumers and representatives. As a fourth data source, we drew upon experiences in designing the CCDE and initial results from the first year of implementation. Each of the three studies on its own provided essential information for planning the CCDE. However, when we examined the studies together, and added CCDE design and implementation experiences, views expressed by the different stakeholders formed a type of multi-perspective "dialogue" that expanded our knowledge about implementing CD services. We hope this increased knowledge will help expand the availability of such services for consumers of any age who want to direct their own care.     

An attribution model of public discrimination towards persons with mental illness

In this study, we build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. Using survey data containing responses to hypothetical vignettes, we examine these relationships in a sample of 518 community college students. Consistent with attribution theory, causal attributions affect beliefs about persons' responsibility for causing their condition, beliefs which in turn lead to affective reactions, resulting in rejecting responses such as avoidance, coercion, segregation, and withholding help. However, consistent with a danger appraisal hypothesis, the effects of perceptions of dangerousness on helping and rejecting responses are unmediated by responsibility beliefs. Much of the dangerousness effects operate by increasing fear, a particularly strong predictor of support for coercive treatment. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.     

Resolution of depression among victims of intimate partner violence: is cessation of violence enough?

The objective of this article is to assess the effect of abuse cessation on depressive symptoms among women abused by a male intimate partner. This prospective cohort study of Seattle women with a history of intimate partner violence (IPV) who were classified by history of abuse and abuse status at 3 month, 9 month, and 2 year follow-up interviews. Relative risks (RR) were calculated using generalized estimating equations. Among subjects with a history of psychological abuse only, cessation of abuse was associated with a nonsignificant reduction in the likelihood of depression compared to subjects whose abuse continued (aRR = 0.88; 95%CI: 0.75,1.03). Among subjects with a history of physical/sexual abuse and psychological abuse, cessation of physical/sexual abuse only was associated with a 27% decline, and cessation of both types of abuse was associated with a 35% decline in the likelihood of depression (aRR = 0.73, 95%CI: 0.63,0.86; and aRR = 0.65; 95%CI: 0.55,0.76; respectively). Cessation of abuse among victims of IPV is associated with a decreased prevalence of depression.     

克拉多·帕塞拉：领导变革

迄今为止，很少有执行官能够成功地在一家陷入困境的大型组织内部实现变革，克拉多·帕塞拉就是为数不多的成功者之一，不仅如此，他还先后成功地领导两家大型企业完成了变革。     

Engaging Intercollegiate Athletes in Preventing and Intervening in Sexual and Intimate Partner Violence

Abstract

Objective: The object of this exploratory evaluation was to evaluate the “Bringing in the Bystander” sexual and intimate partner violence prevention program with a new sample of intercollegiate athletes. Participants and Methods: Fifty-three male and female athletes participated in the program (experimental group), and 86 were in the control group. All completed pretest, posttest, and 2-month follow-up surveys, including assessment of rape myth acceptance, intent to engage in bystander behaviors, bystander confidence, and bystander behaviors. Results: The program worked overall and for both women and men, improved bystander confidence and intent to engage in bystander behaviors, and did not create significant backlash effects (ie, worsening of attitudes as a result of program). Conclusions: The program fits with the intent of the National Collegiate Athletic Association CHAMPS/Life Skills program regarding its focus on the overall development of student-athletes and demonstrates the promising bystander approach compatible with the 2007 American College Health Association toolkit, Shifting the Paradigm: Primary Prevention of Sexual Violence.