Correlates of Mental Health Smartphone Application Use among Patients with Suicidal Ideation

Abstract

Mental health applications (apps) can improve access to evidence-based, mental health strategies. This study evaluated predictors of use for the Virtual Hope Box (VHB), a smartphone app designed to enhance coping among high-risk mental health populations. We also explored the impact of usage on health outcomes. We analyzed data drawn from the treatment arm of a randomized clinical trial of the VHB (n?=?58). Veterans at high risk of suicide used the app over 12 weeks and completed psychosocial assessments throughout the study. We received usage data from each participant’s smartphone. We then used negative binomial regression to evaluate demographic and clinical predictors of usage and generalized estimating equations to explore the longitudinal association between usage and psychosocial outcomes. The most commonly used subcomponents were designed to provide distractions and reminders of sources of meaning.

Lower levels of usage were associated with younger and having a 2-year college degree or higher. Exploratory findings suggested a possible relationship between usage and protective factors. Certain subgroups had lower VHB usage. The findings suggest usage may be associated with changes in health outcomes. Future studies should recruit larger, more diverse samples to further explore relationships between usage and demographic predictors.     

Designing Service Level Agreements for Inventory Management

Service level agreements (SLAs) are widely employed forms of performance‐based contracts in operations management. They compare performance during a period against a contracted service level and penalize outcomes exceeding some allowed deviation. SLAs have a number of design characteristics that need careful tuning to ensure that incentives are properly aligned. However, there is little theoretical research in this area. Using an example of an SLA for outsourcing inventory management, we make a number of recommendations. First it is preferable, if possible, that penalties be proportional to the underperformance rather than lump‐sum ones. This goes a long way towards mitigating strategic (“gaming”) behavior by the supplier. Second, it might be thought that giving “bonuses for good performance” rather than “penalties for bad performance” are essentially identical apart from the former being a more positive approach to management. This turns out to be incorrect in the case of large percentage service rate targets and that penalties will normally be preferred by the buying firm. Third, in order not to incorrectly penalize underperformance resulting purely from “noise” rather than supplier efforts, management might think it best to make allowed deviations from the target generous. Again intuition is not a helpful guide here: for proportional penalties, acceptable performance deviations should be close to the target. Although these results come from a particular inventory application, it is likely that the lessons are applicable to SLAs in general.     

Meta-analysis: a case study

This article raises some questions about the usefulness of meta-analysis as a means of reviewing quantitative research in the social sciences. When a meta-analytic model for SAT coaching is used to predict results from future studies, the amount of prediction error is quite large. Interpretations of meta-analytic regressions and quantifications of program and study characteristics are shown to be equivocal. The match between the assumptions of the meta-analytic model and the data from SAT coaching studies is not good, making statistical inferences problematic. Researcher subjectivity is no less problematic in the context of a meta-analysis than in a narrative review.     

Towards 1992: A strategy for training

1992 is now 3 years away and much is now being spoken and written on the free market within Europe following the magic date. The need for businesses to think about a strategy for training to equip their staff to take advantage of the new opportunities is ever more important. Training has historically lived under the ‘stop-go’ policy. When business is good, we can afford training; when business is bad, training is the first to suffer. The author has tried to formulate a strategic approach to ensure people become conscious of the necessity of management involvement and commitment in training. The 1990s offer great potential to companies who direct activities to these opportunities, and those who meet the threat will be winners.     

A mixture model with Poisson and zero-truncated Poisson components to analyze road traffic accidents in Turkey

The analysis of traffic accident data is crucial to address numerous concerns, such as understanding contributing factors in an accident''s chain-of-events, identifying hotspots, and informing policy decisions about road safety management. The majority of statistical models employed for analyzing traffic accident data are logically count regression models (commonly Poisson regression) since a count – like the number of accidents – is used as the response. However, features of the observed data frequently do not make the Poisson distribution a tenable assumption. For example, observed data rarely demonstrate an equal mean and variance and often times possess excess zeros. Sometimes, data may have heterogeneous structure consisting of a mixture of populations, rather than a single population. In such data analyses, mixtures-of-Poisson-regression models can be used. In this study, the number of injuries resulting from casualties of traffic accidents registered by the General Directorate of Security (Turkey, 2005–2014) are modeled using a novel mixture distribution with two components: a Poisson and zero-truncated-Poisson distribution. Such a model differs from existing mixture models in literature where the components are either all Poisson distributions or all zero-truncated Poisson distributions. The proposed model is compared with the Poisson regression model via simulation and in the analysis of the traffic data.     

An ‘undeliberate determinacy’? The changing migration strategies of Polish migrants in the UK in times of Brexit

This paper reformulates classical questions regarding the plans and strategies of Polish migrants in the UK – such as decisions to leave or remain in the host country, or be ‘deliberately indeterminate’ about future plans – from a sociologically situated ‘rights-based’ perspective. This approach considers migrants’ attitudes towards specific ‘civic integration’ measures in a medium-term time frame, as well as in the new context created by the UK’s vote to leave the EU. Based on the quantitative analysis of original survey data, we investigate the factors behind Polish migrants’ migration strategies, and we argue that basic socio-economic and demographic factors are inadequate, on their own terms, to explain future migration and civic integration plans. Instead, we find that aspects such as interest in and awareness of one’s rights, as well as anxieties about the ability to maintain one’s rights in the future are stronger determinants.     

The role of sex steroid hormones in benign prostatic hyperplasia

Introduction: The etiology of benign prostatic hyperplasia (BPH) remains a mystery to scientists; estrogen/androgen imbalance in aged men has been implicated.

Methods: Thirty (30) apparently healthy men and newly diagnosed BPH patients were recruited from the Ghana Police Hospital. Lower urinary tract syndrome (LUTS) and prostate volume were assessed via the prostate symptom score sheet (IPSS) and abdominopelvic scan, respectively. Laboratory assays for total prostate specific antigen (tPSA) and hormones [androstenedione (AED), testosterone (T), dihydrotestosterone (DHT), androstanedioladiol (3α-adiol), androstanediol (3β-diol), estrone (E1) and estradiol (E2)] were performed via ELISA techniques. Non-parametric analyses were employed. p?Results: AED was significantly higher in controls compared to the BPH patients. AKRIC2 (3α-diol/DHT) was significantly higher in the BPH group (p?p=?0.029). Age correlated negatively with T, while a negative correlation was observed between TIPSS and 3β-diol and AKRIC1. Also, prostate volume correlated negatively with fT.tPSA correlated positively with E2 and aromatase activity (E2/T) and negatively with fT. On multiple linear regression, DHT and 3β-diol remained independent predictors for TIPSS and fT for tPSA.

Conclusion: Estrogens and androstanediols seem to play a role in BPH development.     

A National Superannuation Scheme for Australia?

It is shown that the cost of pensions represents a significant transfer of funds, and that if pensions are to be increased to the ‘poverty line’ as a minimum at the same time as abolition of the Means Test, it will become essential to adopt a national contribution scheme. It is suggested that Australia adopt the two-tier system of national superannuation such as is now in use in Sweden and is about to be adopted in Canada and the United Kingdom. This would provide for a basic pension for all, to which would be added an Earnings Related Supplement.