Mental health program evaluation: Where you start?

Seduced by the elegance, sophistication and jargon characteristic of new developments in applied research, practicing evaluators are in danger of becoming distracted from achievement of their evaluative goal: that of providing timely, reliable and useful data to program management to facilitate rational data-based decision-making. To avoid such seduction, the author advocates adaptation of simple, inexpensive and efficient evaluative methods tailored to organizational needs and presentation of findings in language readily understood by constituent groups. Likewise, insistance by evaluators upon maintenance of a strict role boundary — that is, limiting role functioning exclusively to those tasks considered evaluation — may be dysfunctional. Rather than detract from accomplishment of his goals, the author maintains that such participation allows development of skills, insights and staff relationships which enhance the evaluator's effective functioning within the organizational context and contribute to organizational acceptance and use of his evaluative results.     

The validity of indices for rural health manpower needs assessment

Population-to-practitioner ratios have long been the primary index in the designation of health manpower shortage areas. This paper documents that application of the widely used population-to-dentist index results in understatement of the need for dental health manpower in rural areas. Through the analysis of utilization data collected from a statewide health screening program in Colorado, the practice of sole reliance on the population-to-dentist indices as an indicator of need was tested. Another measure, the area-(square miles) to-dentist ratio was formulated, examined, and found to be a more useful referent of the need for additional health manpower in rural areas. Utilization of dental services in sparsely settled rural counties of Colorado was unrelated to population-to-dentist ratios. A strong, statistically significant association of utilization with land area-to-dentist ratios was found. The findings of this analysis suggest a need for reevaluation of needs assessment methodologies used in the designation of health manpower shortage areas. Indices more sensitive to consumer circumstance than to the number of health care providers available must be considered.     

On the limiting properties of social indicators

Characteristics of the population and economic measures that constitute traditional social indicators are compared with more recent “quality of life” measures to demonstrate that social indicators are always value statements at the policy level. The possibility of alternative perspectives is illustrated. It is suggested that an awareness of the assumptions implicit in any given indicator is as important as the data they provide.     

Consumer trust in B2C e-Commerce and the importance of social presence: experiments in e-Products and e-Services

Reducing social uncertainty—understanding, predicting, and controlling the behavior of other people—is a central motivating force of human behavior. When rules and customs are not sufficient, people rely on trust and familiarity as primary mechanisms to reduce social uncertainty. The relative paucity of regulations and customs on the Internet makes consumer familiarity and trust especially important in the case of e-Commerce. Yet the lack of an interpersonal exchange and the one-time nature of the typical business transaction on the Internet make this kind of consumer trust unique, because trust relates to other people and is nourished through interactions with them.This study validates a four-dimensional scale of trust in the context of e-Products and revalidates it in the context of e-Services. The study then shows the influence of social presence on these dimensions of this trust, especially benevolence, and its ultimate contribution to online purchase intentions.     

Early Pregnancy Assessment Services in Australia: What psychosocial support is available? A qualitative study

ProblemWomen commonly experience emotional distress following miscarriage but do not receive the support they need from healthcare providers.BackgroundMiscarriage can result in psychological morbidity; however, appropriate support at the time of a miscarriage can lead to better psychological outcomes. Early Pregnancy Assessment Services (EPASs) are dedicated outpatient services considered the “gold standard” for miscarriage care. Little is known about the psychosocial support EPASs provide in Australia.AimsThe aim of this study was to explore the provision of psychosocial support in Australian EPASs.MethodsSemi-structured interviews were conducted with 29 purposively sampled key-informants from 13 EPASs. Interviews were audio-recorded, transcribed, and thematically analysed.FindingsConsiderable variation was found in how EPASs functioned and their provision of psychosocial support. Many services were co-located with antenatal services, run by doctors with limited experience and most did not offer any psychosocial training to staff specific to EPAS. Referrals for additional support were generally not offered for first trimester miscarriages, and follow-up typically focused on physical management rather than emotional wellbeing. All EPAS staff demonstrated a strong commitment to providing best possible care to women within their own clinical setting and acknowledged the need for improved psychosocial support.ConclusionThis study provides the first exploration of Australian EPASs’ provision of psychosocial support. It has shown that while health care professionals working in EPASs are dedicated to providing the best possible care to women within their clinical setting, psychosocial support is very limited and could be improved.     

Assessing Risk‐Based Upper Limits of Melamine Migration from Food Containers

Melamine contamination of food has become a major food safety issue because of incidents of infant disease caused by exposure to this chemical. This study was aimed at establishing a safety limit in Taiwan for the degree of melamine migration from food containers. Health risk assessment was performed for three exposure groups (preschool children, individuals who dine out, and elderly residents of nursing homes). Selected values of tolerable daily intake (TDI) for melamine were used to calculate the reference migration concentration limit (RMCL) or reference specific migration limit (RSML) for melamine food containers. The only existing values of these limits for international standards today are 1.2 mg/L (0.2 mg/dm²) in China and 30 mg/L (5 mg/dm²) in the European Union. The factors used in the calculations included the specific surface area of food containers, daily food consumption rate, body weight, TDI, and the percentile of the population protected at a given migration concentration limit (MCL). The results indicate that children are indeed at higher risk of melamine exposure at toxic levels than are other groups and that the 95th percentile of MCL (specific surface area = 5) for children aged 1–6 years should be the RMCL (0.07 mg/dm²) for protecting the sensitive and general population.     

十月革命与中国共产党的初心构建

十月革命是影响世界历史进程的重大事件，中国共产党从来都把自己的事业看作是十月革命的继续。澄清唯心史观和历史虚无主义对十月革命的错误解读，对于补好理想信念的精神之钙具有重要的理论价值和现实意义。学习和借鉴十月革命的宝贵经验、坚持社会主义的前进方向、坚守共产主义的远大理想，共同构成了中国共产党初心的核心意蕴。     

Trauma and health risk behaviors in people with severe mental illness

The current study tests the association between a composite measure of unsafe sex and sharing syringes for drug use with six of the more common lifetime traumatic/stressful events in 421 community mental health clients with severe mental illness (SMI) while controlling for psychiatric symptoms and related problems. A small but significant proportion of respondents said they had injected drugs with a shared needle in their lifetime (30, 7.2%), and a much larger proportion of respondents had engaged in unprotected sex (165, 39.2%). Unprotected sex and needle sharing were significantly correlated (Spearman’s rho = .20, p < .01). Frequency of lifetime traumatic events that occurred at least once was reported by one third to three quarters of clients depending on type of trauma. Regression analysis revealed that substance abuse and lifetime homelessness were significantly correlated with health risk behaviors. Practitioners need to be continuously vigilant to comorbid substance use and the housing needs of people with SMI. Limitations of the study include its cross-sectional design.     

A latent variable model for analyzing mixed longitudinal (k,l)-inflated count and ordinal responses

A random effects model for analyzing mixed longitudinal count and ordinal data is presented where the count response is inflated in two points (k and l) and an (k,l)-Inflated Power series distribution is used as its distribution. A full likelihood-based approach is used to obtain maximum likelihood estimates of parameters of the model. For data with non-ignorable missing values models with probit model for missing mechanism are used.The dependence between longitudinal sequences of responses and inflation parameters are investigated using a random effects approach. Also, to investigate the correlation between mixed ordinal and count responses of each individuals at each time, a shared random effect is used. In order to assess the performance of the model, a simulation study is performed for a case that the count response has (k,l)-Inflated Binomial distribution. Performance comparisons of count-ordinal random effect model, Zero-Inflated ordinal random effects model and (k,l)-Inflated ordinal random effects model are also given. The model is applied to a real social data set from the first two waves of the national longitudinal study of adolescent to adult health (Add Health study). In this data set, the joint responses are the number of days in a month that each individual smoked as the count response and the general health condition of each individual as the ordinal response. For the count response there is incidence of excess values of 0 and 30.     

Introduction. Ce que les écrits font au travail

As is known, large numbers of writings circulate within every kind of professional environment. As a result, there is extensive research on the formats, uses and roles of writings in work. However, the approach taken here is not to describe what is done with writings in work. The central hypothesis rests on a performative vision of writings, one that gives them the power to act, agency. It can be summed up as follows: what do writings “do” to work? Studying work through its writings is a way to connect two dimensions that are too often kept separate: situated activities on the one hand, organizational functions on the other. Indeed, writings are material and robust — though not always lasting — traces of concrete activities, and they provide a handhold for the rigorous analysis of work as close as possible to its conditions of realization. However, writings travel and circulate. They form links between workers, groups, workshops, services, firms, without which production could not take place. They stretch work beyond its source. To track them is therefore to shift the field of enquiry to moments other than the present of the observed situation, and also to other nearby, surrounding workspaces. This brings out the procedural and interactive dimensions of organizations, their integrating capacity. Exploring what writings do to work is therefore not only to place oneself at an intermediate level between situated action and organized action. For the sociologist, it is a way of connecting these two perspectives “on paper”, by embedding the analysis of the actual work in spatially and temporally broader collective actions, and by documenting organizational analysis on the basis of observed work situations. It is a way of contributing to a more extensive ecology of activity, more clearly anchored within its organizational envelope.