Latent Variable Models for Mixed Discrete and Continuous Outcomes

We propose a latent variable model for mixed discrete and continuous outcomes. The model accommodates any mixture of outcomes from an exponential family and allows for arbitrary covariate effects, as well as direct modelling of covariates on the latent variable. An EM algorithm is proposed for parameter estimation and estimates of the latent variables are produced as a by-product of the analysis. A generalized likelihood ratio test can be used to test the significance of covariates affecting the latent outcomes. This method is applied to birth defects data, where the outcomes of interest are continuous measures of size and binary indicators of minor physical anomalies. Infants who were exposed in utero to anticonvulsant medications are compared with controls.     

Inequality in Life Spans and a New Perspective on Mortality Convergence Across Industrialized Countries

The second half of the twentieth century witnessed substantial convergence in life expectancy around the world. We examine differences in the age pattern of mortality in industrialized countries over time to show that inequality in adult life spans, which we measure with the standard deviation of life table ages at death above age 10 years, S₁₀, is increasingly responsible for the remaining divergence in mortality. We report striking differences in level and trend of S₁₀ across industrialized countries since 1960, which cannot be explained by aggregate socioeconomic inequality or differential external‐cause mortality. Rather, S₁₀ reflects both within‐ and between‐group inequalities in life spans and conveys new information about their combined magnitudes and trends. These findings suggest that the challenge for health policies in this century is to reduce inequality, not just lengthen life.     

The Social Context of Young Children's Peer Victimization

The goal of this study was to investigate differences in the social context of peer victimization for preschoolers and kindergarteners. Data were collected from 168 children. For preschoolers, neither social acceptance nor friendships were significantly related to peer victimization. Instead, playing with peers and exposure to aggressive peers were associated with higher rates of peer victimization. For kindergarteners, exposure to aggressive peers also contributed to the risk for peer victimization, but being liked by peers and having friends were inversely related to victimization, thereby providing a buffering effect. The developmental implications of these findings are discussed.     

Creating more trauma-informed services for children using assessment-focused tools

This article promotes integrating assessment and evidence-based practice in the treatment of traumatized children through a review of two newly developed trauma assessment tools: (1) the Child Welfare Trauma Referral Tool (CWT), and (2) Assessment-Based Treatment for Traumatized Children: A Trauma Assessment Pathway Model (TAP). These tools use pathways and algorithms to increase understanding of individual child trauma victims, and assist professionals working with children to make appropriate referral and treatment decisions within both child welfare and mental health contexts.     

College students use cell phones while driving more frequently than found in government study

OBJECTIVE: Cell phone use while driving is hazardous; it quadruples the risk of a collision and multiplies the risk of a fatality nine-fold. The National Highway Traffic Safety Administration estimates that 8% of young drivers and 5% of all drivers use cell phones while driving. PARTICIPANTS AND METHODS: The authors trained graduate student volunteers to observe the daytime cell phone use of 3,650 drivers leaving the student exits of college parking structures at a large university. RESULTS: The student observers recorded a cell phone usage rate of 11.1%, which was significantly higher than that seen in the National Occupant Protection Use Survey (p<.00001). Female drivers were 1.51 times more likely to be using a cell phone while driving than were men (12.9% vs 8.6%, p<.001), and drivers with passengers were 0.15 times more likely to drive while telephoning than were solo drivers (1.8% vs 12.1%, p<.001). CONCLUSIONS: The authors offer suggestions for possible interventions to reduce this hazardous behavior.     

Beyond Happiness: Minority Stress and Life Meaning Among LGB Individuals

ABSTRACT

Scholars have recently started to examine how minority stressors are associated with wellbeing outcomes among lesbian, gay, and bisexual (LGB) people. Such studies have examined mainly hedonic wellbeing, and those that have investigated eudaimonic wellbeing have tended to use composite measures. The present study draws from this literature to examine how minority stressors are associated with a key indicator of eudaimonic wellbeing: life meaning. Drawing from the minority stress model, we examined these associations using structural equation modeling among 266 LGB adults. Expectations of rejection and identity concealment, but not discrimination or internalized homophobia, had significant negative associations with life meaning. Discrimination had negative indirect associations with life meaning via expectations of rejection and concealment. Our results highlight the nuanced relations that exist between minority stressors and life meaning and highlight the need to move beyond composite measures of wellbeing. Implications for clinical practice and directions for research are discussed.     

Reassessing a Theory of Professional Expertise: A Cross-National Investigation of Expert Mental Health Social Workers

This paper presents the findings from a cross-national studyof expert mental health social workers in Melbourne, Australiaand San Jose, California, USA. In this study, expert socialworkers were selected based on a peer-nomination process andthey were invited to participate in two-hour focus group interviewsin which they described memorable practice situations. Detailedaccounts of these practice situations were gathered from nineteenAustralian and American expert practitioners employed in community-basedmental health settings. The study findings corroborate manyof the dimensions that are explicated in a theory of professionalexpertise developed by Fook et al. (2000). Further, the findingsdescribe the skilful and ethical comportment of these socialworkers in the context of often complex and challenging practicesituations. Narrative accounts are used to demonstrate the distinguishingdimensions and features of expert practice described by Fookand her colleagues, especially when providing services to peoplewith chronic mental illness. In-depth articulation of practiceexpertise using cross-national data enhances social work researchand pedagogy by providing important exemplars that inform morefully the development of empirically based practice theories.     

Practitioners as Rule Using Analysts: A Further Development of Process Knowledge in Social Work

Correspondence to Professor Michael Sheppard, Department of Social Policy and Social Work, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK. E-mail M.Sheppard{at}plymouth.ac.uk Summary A new paradigm of ‘process knowledge’ has emergedin recent years, distinct from the dominant ‘product knowledge’paradigm in social work. While the latter refers to existentknowledge, which may be applied, the former refers to the developmentof knowledge about the ‘methodology of practice decisionmaking’, focusing on the processes by which judgementsare made. At its heart is the emerging idea of a reflexivityfor practice, but studies have been, until recently, theoretical.A very small number of empirical studies have begun to identifysome key elements of process knowledge. These have developeda range of concepts relating to critical appraisal, hypothesisdevelopment and hypothesis testing which characterize socialwork process knowledge. These include, for example, focusedattention, querying information, causal inferences, partialcase, procedural, and speculative hypotheses. A process of quasitriangulation is characteristic of social work practice methodology,together with a combination of inductive and deductive thinking.This paper seeks to develop our understanding by focusing onhow social workers develop and appraise hypotheses, and in particularhow the substantive content of hypotheses emerges (these enablesocial workers to make sense of, define, and respond to, situations).To understand this, the notion of rules is used, and socialworkers emerge as analysts employing three types of rules: substantive,application, and practice rules. A significant link betweenprocess knowledge and the content of product knowledge is identifiedin the form of technical language. The concept of ‘probabilisticcausation’ is identified as a key epistemological dimensionin the conduct of rigorous practice.     

Feasibility,Acceptability, and Initial Efficacy of an Online Sexual Health Promotion Program for LGBT Youth: The Queer Sex Ed Intervention

Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.