Playground Accessibility and Neighbourhood Social Interaction Among Parents

While the positive association between social interaction and access to green space is well accepted, little research has sought to understand the role of children??s playgrounds in facilitating social interaction within a community. Playgrounds are spaces designed to facilitate play and the interaction of children, but may also be important places of interaction between parents. In this paper we examine how access to playground spaces is related to social interaction between parents. We use two measures of accessibility (1) walking distance to the closest playground and (2) playground service area, a measure of the number of potential users of a playground based on population density. We use generalized estimating equations, an extension of generalized linear models, to control for the confounding effects of socio-economic status (income, education), neighbourhood dynamics (neighbourhood location, years in neighbourhood) and free time (daily outdoor activity, marital status, number of children) on the independent relationship between social interaction and access to playground spaces. Our results suggest that while accessibility to playgrounds is associated with social interaction among parents, the direction of the effect is opposite to existing literature on green space and social interaction; parents with low accessibility to playgrounds are more likely to interact socially with their neighbours than parents with high accessibility. Our results suggest a pattern of spatial behaviour in which the burden of poor access to some resources may actually encourage greater neighbourhood engagement. Future research studying the relationship between health and green space may benefit from studying the specific role of playground spaces.     

Overcoming medication refusal using a patient-centered approach

The refusal of psychotropic medication is a challenge faced by many healthcare providers when treating patients with mental illness. Controversy surrounds medication refusal because some mental health professionals believe that psychiatric patients should be forced to take medications for the safety of the general public, while patients are often acutely aware of potential lifelong adverse side effects and are sometimes reluctant to comply. The proposed alternative to this problem begins with developing the patient-provider relationship through a patient-centered approach. This approach emphasizes the individual needs of patients and creates opportunities for input from patients about their care, which helps form relationships of mutual trust and respect between patients and providers. This article explores the literature to: (1) understand some of the challenges and controversies involved in patient medication refusal from a clinical and societal level; (2) identify some issues in a patient-centered approach; and (3) make some brief clinical and policy recommendations that might help to bring about an increase in the use of patient-centered care. Hopefully, as efforts are made toward a patient-centered approach, increased psychotropic medication adherence and decreased medication coercion will result as providers listen and act upon the needs of their patients.     

The Value of Information in Decision‐Analytic Modeling for Malaria Vector Control in East Africa

Decision analysis tools and mathematical modeling are increasingly emphasized in malaria control programs worldwide to improve resource allocation and address ongoing challenges with sustainability. However, such tools require substantial scientific evidence, which is costly to acquire. The value of information (VOI) has been proposed as a metric for gauging the value of reduced model uncertainty. We apply this concept to an evidenced‐based Malaria Decision Analysis Support Tool (MDAST) designed for application in East Africa. In developing MDAST, substantial gaps in the scientific evidence base were identified regarding insecticide resistance in malaria vector control and the effectiveness of alternative mosquito control approaches, including larviciding. We identify four entomological parameters in the model (two for insecticide resistance and two for larviciding) that involve high levels of uncertainty and to which outputs in MDAST are sensitive. We estimate and compare a VOI for combinations of these parameters in evaluating three policy alternatives relative to a status quo policy. We find having perfect information on the uncertain parameters could improve program net benefits by up to 5–21%, with the highest VOI associated with jointly eliminating uncertainty about reproductive speed of malaria‐transmitting mosquitoes and initial efficacy of larviciding at reducing the emergence of new adult mosquitoes. Future research on parameter uncertainty in decision analysis of malaria control policy should investigate the VOI with respect to other aspects of malaria transmission (such as antimalarial resistance), the costs of reducing uncertainty in these parameters, and the extent to which imperfect information about these parameters can improve payoffs.     

Restructuring of the Financial Industry: The Disappearance of Locally Owned Traditional Financial Services in Rural America

Restructuring in the financial services industry has altered the relationship between small business owners and capital. In the past small businesses have relied on relational, or soft data, lending from locally owned banks for capital. The proliferation of absentee‐owned local branch networks brought standardized practices, thus eliminating the autonomy of local loan officers to utilize soft data in loan decisions. In this article we examine the changes in the percentage of traditional financial services that are locally owned in three county types: metropolitan, micropolitan, and noncore. We utilize the Longitudinal Business Database at the U.S. Census Bureau Center for Economic Studies. We examine changes in local ownership of traditional financial services between 1976 and 2007. We find that the rate of decline of local ownership has been greatest in the noncore (most rural) counties. We also explore to what extent these patterns are related to the emergence of alternative financial services during the same period. We find that such alternative services are growing in all three county types, but at rates not significantly different than the population growth for these county types. We supplement our analysis with data from qualitative interviews with small business owners throughout rural Texas. We conclude with a discussion of implications and plans for future research.     

Validating Work Discrimination and Coping Strategy Models for Sexual Minorities

The purpose of this study was to validate and expand on Y. B. Chung's (2001) models of work discrimination and coping strategies among lesbian, gay, and bisexual persons. In semistructured individual interviews, 17 lesbians and gay men reported 35 discrimination incidents and their related coping strategies. Responses were coded based on Chung's models. Results supported the validity of the Work Discrimination model and two coping strategy models (Vocational Choice and Identity Management). The Discrimination Management coping strategy model was expanded. Implications for practice and research are discussed.     

Employment status of women with disabilities from the Behavioral Risk Factor Surveillance Survey (1995-2002)

Among working aged adults (18-64) with disabilities, three out of 10 (32%) work full or part-time, compared to eight out of 10 (81%) of those without disabilities [9]. In addition, 24.7% of women with a severe disability and 27.8% of men with a severe disability are employed, while women with a non-severe disability have an employment rate of 68.4% and men with a non-severe disability have an employment rate of 85.1% [14]. This study examined data from the Behavioral Risk Factor Surveillance Survey from 1995-2002 to determine whether or not disparities exist in the rate of unemployment for women with disabilities, compared to men with disabilities and women and men without disabilities. In addition, regression analysis looked at the how disability and gender predict the outcome of unemployment. Results showed that there has been essentially no change with regard to employment for any of these populations. In addition, disability and gender were found to be the strongest predictors of unemployment for women with disabilities. Possible explanations were discussed as to the reasons for the results and issues were presented for future research.     

Adolescent self-mutilation: diagnosis & treatment

Self-mutilation is complicated and difficult to diagnose. Its incidence among adolescents has increased during the past 10 years. Most mental health professionals discover that the behavior has been part of patients' lives long before their initial visit and that patients have become very good at hiding their behavior. The literature on self-mutilation is increasing, but newer statistics, specifically about cutting and picking behaviors, need to be assessed. The disorder often co-exists with another disorder that requires psychotropic medications, the administration of which should be managed by psychiatric clinicians who specialize in children and adolescents. A multidisciplinary team is necessary to achieve the best outcomes.     

Trajectories of Interracial Heterosexual Couples: A Longitudinal Analysis of Relationship Quality and Separation

Minimal research has examined interracial couples’ relationship satisfaction and dissolution patterns over time. Using dyadic data across 8 years, we examined potential differences in relationship quality trajectories through latent growth curve modeling with 1,336 couples as well as differential risks for relationship dissolution through logistic regression between same‐race and interracial relationships using a different subset of 2,370 couples. Results indicated that women in interracial relationships were significantly lower in initial relationship quality than women in same‐race relationships. Further, interracial couples of Black‐Hispanic partnerings were twice as likely to separate across 8 years than same‐race couples. These results suggest that despite interracial relationships not substantively differing from same‐race couples in trajectories of relationship quality, specific Black‐Hispanic interracial couples are at a higher risk of eventual separation.     

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.     

An Evaluation of Staff Preference for Graphic Characteristics

The purpose of the current study was to assess staff preference for how data were displayed on graphs. Specifically, preference for line versus bar graphs was assessed, as well as preference for data displayed as one date in time versus multiple dates showing performance trends. A secondary purpose of the study was to assess staff comprehension of the data presented across different graphic displays. Participants included 60 entry-level direct care staff and 25 seasoned therapists. Therapists had more advanced training in applied behavior analysis than the direct care staff. The vast majority of direct care staff preferred data depicted as a bar graph versus data depicted as a line graph, even preferring a single bar graph over a time-series line graph. The therapists preferred time-series line graphs to bar graphs. Most staff demonstrated understanding of the data, regardless of how it was depicted.