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.     

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.     

Quitter l’entreprise pour renouer avec le travail ? Les parcours de désengagement de cadres d’un institut d’études

Little explored in terms of work, the world of pollsters is a good example of the transformations affecting the contemporary world of labor. At the intersection of sociology of work, itineraries and gender, this ethnographic survey of one of the companies of the sector and its executives gets beyond the expressions of discomfort or withdrawal classically observed in that category, by focusing on those who rebel against their company and their work. The study reveals the process by which certain employees, women in particular, knowingly leave all the benefits included in their employment and status. Their silent disaffiliation is however temporary because the people I met are forced to work, yet they have the possibility of branching off towards a job rewarding in terms of identity albeit less prestigious and safe. These bifurcations also reveal inequalities among managers and, especially in the case of women, a weakening of their itineraries in the longer run.     

Object Relations Family Therapy: Articulating the Inchoate

In recent years there has been a renewed interest in psychodynamic ideas within the family therapy literature. While some authors have explored the usefulness of psychodynamic concepts in the systemic context (Byng-Hall, 1995; Flaskas, 1993, 1996; Luepnitz, 1988, 1997), others have argued that psychodynamic models of family therapy should be given more credence in systemic work with families (Guttman, 1991). This paper describes Object Relations Family Therapy (ORFT), a psychoanalytic model of family therapy, in plain English in order to minimise the obscurity of some of the existing terminology and to emphasise the utility of more contemporary formulations. ORFT addresses the interface between psychoanalytic and systemic theories. It offers a way of conceptualising complex family dynamics at both the interpersonal and intrapsychic levels. It also integrates an understanding of nonverbal, unstated and often implicit processes in its formulation of problem development. The unique contribution of ORFT is elaborated using a clinical example.     

On the trimmed mean and minimax-variance L-estimation in Kolmogorov neighbourhoods

We consider the properties of the trimmed mean, as regards minimax-variance L-estimation of a location parameter in a Kolmogorov neighbourhood K() of the normal distribution: We first review some results on the search for an L-minimax estimator in this neighbourhood, i.e. a linear combination of order statistics whose maximum variance in K_t() is a minimum in the class of L-estimators. The natural candidate – the L-estimate which is efficient for that member of K_t,() with minimum Fisher information – is known not to be a saddlepoint solution to the minimax problem. We show here that it is not a solution at all. We do this by showing that a smaller maximum variance is attained by an appropriately trimmed mean. We argue that this trimmed mean, as well as being computationally simple – much simpler than the efficient L-estimate referred to above, and simpler than the minimax M- and R-estimators – is at least “nearly” minimax.     

Medicaid Home and Community-Based Services: How Consumer Access Is Restricted by State Policies

State Medicaid programs have expanded home and community-based services (HCBS). This article compares trends and variations in state policies for Medicaid HCBS programs in 2005 and 2010. State limitations on financial eligibility criteria and service benefits have remained stable. Although the use of consumer direction, independent providers, and family care providers has increased, some states do not have these options. The increased adoption of state cost control policies have led to large increases in persons on waiver wait lists. Access could be improved by standardizing and liberalizing state HCBS policies, but state fiscal concerns are barriers to rebalancing between HCBS and institutional services.