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OBJECTIVE: To estimate the impact of implementing prescription drug monitoring program (PDMP) best practices on prescription opioid use. DATA SOURCES: 2007–2012 Medicare claims for noncancer pain patients, and PDMP attributes from the Prescription Drug Abuse Policy System. STUDY DESIGN: We derived PDMP composite scores using the number of best practices adopted by states (range: 0‐14), classifying states as either no PDMP, low strength (0

African American caregivers in low-income, urban communities have high rates of food insecurity. Unemployment, education, smoking, stress, and depressive symptoms are associated with household food insecurity. A cumulative risk model suggests that accumulation of risk may compound food insecurity risk, and certain risk factors are more likely to co-occur. This study utilizes two approaches to examine food insecurity risk among African American caregivers with an adolescent daughter—a cumulative risk index to examine accumulation of risk and food insecurity risk; latent class analysis (LCA) to determine if certain risk profiles exist and their relation to food insecurity risk. Caregivers completed surveys including demographic, psychosocial, and behavioral questions (to create a cumulative risk index) and a validated 2-item food insecurity screen. LCA was used to identify risk profiles. Logistic regression was used to examine relations between cumulative risk, risk profiles, and food insecurity risk. Each additional cumulative risk index factor was associated with a 54% increase in odds of risk of food insecurity. LCA identified three subgroups: high stress/depression (class #1), low education/low stress and depression (class #2), and low risk overall (class #3). Odds of food insecurity risk were 4.7 times higher for class #1, and 1.5 times higher for class #2 compared with class #3. This study contributes to understanding of how food insecurity risk relates to cumulative risk and risk profiles. Findings can be used to improve food insecurity risk screening in clinical settings, enhancing intervention/referral for food security risk and mental health among African American caregivers and their households.

OBJECTIVE: The purpose of this study was to examine the factor structure of the Medical Outcomes Study Social Support Survey (MOS-SSS) in a sample of low-income, urban caregivers of African American children with poorly controlled asthma. Although the MOS-SSS is a commonly used measure of social support, its psychometric properties have not been studied in this population. METHODS: Confirmatory factor analysis was conducted to determine the most appropriate factor structure for the MOS-SSS in caregivers of African American children with frequent Emergency Department visits for uncontrolled asthma. The following models were tested and compared using established fit statistics: an 18-item second-order four factor model, an 18-item four factor model, a bifactor model, and an 18-item one factor model with nested models. RESULTS: Participating caregivers were single (75.6%) and female (97%). An 18-item one factor version of the scale had the best fit statistics compared to the other models tested: χ(2)(142) = 308.319, p > 0.001; Root Mean Square Error of Approximation (RMSEA) = 0.077; CFI (Comparative Fit Index) = 0.990; and Tucker-Lewis Index (TLI) = 0.988. Construct validity was supported by a statistically significant negative relationship between our final MOS-SSS model and caregiver depressive symptoms (β = −0.374, p < 0.001). CONCLUSIONS: The 18-item one factor MOS-SSS may be appropriate for use in research and clinical practice with caregivers of African American children with poorly controlled asthma. It appears promising as a mechanism to advance understanding of relationships between social support and asthma outcomes in this vulnerable population.

The transition into motherhood is a life stressor, and it can be more stressful for non-U.S. born mothers because of the intersections among migration, limited financial capabilities, and less social and family support to take care of children ( Dreby, 2015 ; Falicov, 2007 ; Paris, 2008 ). This study examined the predictors of non-U.S. born mothers' parenting stress across early childhood using data from the Fragile Families and Child Well-Being Study. Results of the longitudinal multilevel analysis indicated that support from extended family and friends; mothers' involvement, depression, age, and education; children's temperaments; and Asian race were significant predictors of maternal parenting stress over time. However, fathers' involvement did not significantly predict maternal parenting stress. Implications for research and practice are discussed.

Many children with unsubstantiated reports of child abuse and neglect repeatedly return to the child protection system, indicating that unsubstantiated reports may represent actual child maltreatment or risk for future maltreatment. Identifying patterns of re-reporting and predictors that may be associated with later substantiated re-reporting could help to identify children who are very likely to be maltreated. This knowledge may guide the development of policies and interventions to prevent further maltreatment and the risk for re-reports. The aims of this study were to: (1) measure the period between the time of the initial reports that were not substantiated and the time of first substantiated re-reports; and (2) identify factors associated with the risk of later substantiated re-reporting. The study analyzed secondary data from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN) through survival analysis. Of the 378 children with initially unsubstantiated reports, 81% were re-reported, of which almost two-thirds were substantiated. Children who were younger, non-white, and had caregivers with more depressive symptoms were at increased risk of a substantiated re-report. Among those that were later substantiated, 20% were substantiated within one year. Findings suggest that targeted preventative services should be developed and provided for families who are reported for the first time, even if not substantiated.

Background and aims Prescription Drug Monitoring Programs (PDMPs) are a principal strategy used in the United States to address prescription drug abuse. We (1) compared opioid use pre- and post-PDMP implementation and (2) estimated differences of PDMP impact by reason for Medicare eligibility and plan type. Design Analysis of opioid prescription claims in US states that implemented PDMPs relative to non-PDMP states during 2007-12. Setting Florida, Louisiana, Nebraska, New Jersey, Vermont, Georgia, Wisconsin, Maryland, New Hampshire and Arkansas, USA. Participants A total of 310 105 disabled and older adult Medicare enrolees. Measurements Primary outcomes were monthly total opioid volume, mean daily morphine milligram equivalent (MME) dose per prescription and number of opioid prescriptions dispensed. The key predictors were PDMP status and time. Tests for moderation examined PDMP impact by Medicare eligibility (disability versus age) and drug plan [privately provided Medicare Advantage (MAPD) versus fee-for-service (PDP)]. Findings Overall, PDMP implementation was associated with reduced opioid volume [-2.36 kg/month, 95% confidence interval (CI) = -3.44, -1.28] and no changes in mean MMEs or opioid prescriptions 12 months after implementation compared with non-PDMP states. We found evidence of strong moderation effects. In PDMP states, estimated monthly opioid volumes decreased 1.67 kg (95% CI = -2.38, -0.96) and 0.75 kg (95% CI = -1.32, -0.18) among disabled and older adults, respectively, and 1.2 kg, regardless of plan type. MME reductions were 3.73 mg/prescription (95% CI = -6.22, -1.24) in disabled and 3.02 mg/prescription (95% CI = -3.86, -2.18) in MAPD beneficiaries, but there were no changes in older adults and PDP beneficiaries. Dispensed prescriptions increased 259/month (95% CI = 39, 479) among the disabled and decreased 610/month (95% CI = -953, -257) among MAPD beneficiaries. Conclusions Prescription drug monitoring programs (PDMPs) are associated with reductions in opioid use, measured by volume, among disabled and older adult Medicare beneficiaries in the United States compared with states that do not have PDMPs. PDMP impact on daily doses and daily prescriptions varied by reason for eligibility and plan type. These findings cannot be generalized beyond the 10 US states studied.

본 연구는 미국내의 이민 청소년들의 정신 건강적 특징과 이민 경험을 파악하고, 이들의 심리적 피로감에 영향을 미치는 요인을 생태체계적 관점에서 분석하는 것이다. 캘리포니아 헬스 인터뷰 서베이(CHIS)로부터 미국에서 태어나지 않은 이민청소년 348명에 대한 데이터 정보를 분석에 사용하였다. 이민 청소년들의 심리적 피로감에 영향을 미칠 수 있는 개인 특성(나이, 성별, 인터뷰 언어, 미국 거주 기간), 가정(어른의 보살핌, 가정에서 사용하는 언어), 학교(학교에서의 지지, 또래 괴롭힘 유무), 그리고 지역사회 수준의 변수(이웃간 응집도)들을 위계적 다중 회귀모형을 통하여 분석하였다. 이민청소년들의 평균연령은 14.5세(표준편차= 1.7)이고 여성이 53.4%를 차지하였다. 응답자들 가운데 31.6%가 인터뷰 언어로 영어가 아닌 다른 언어를 사용하였고, 72.7%가 집에서 영어를 사용하지 않는 것으로 나타났다. 또한 대상자의 거의 절반에 가까운 48.6%가 미국에서 10년이상 거주하는 것으로 보고하였고, Kessler 등(2004)이 제시한 기준을 적용하면, 약 2%의 이민 청소년들이 심리적 피로감 검사에서 점수 13점 이상의 심각한 심리적 피로감을 가지고 있는 것으로 나타났다. 인터뷰 언어로 영어가 아닌 다른 언어를 사용했을 경우, 집에서는 영어를 사용하는 경우, 학교에서 지지와 지원이 높은 수준일 경우, 또래 괴롭힘을 당한 경험이 없는 경우, 그리고 이웃간의 응집도가 높은 수준일 경우 이민청소년들은 심리적 피로감이 낮게 나타났다. 본 연구의 결과들은 이민청소년들의 정신건강에 영향을 미치는 사용 언어, 그리고 학교와 이웃관련 요인들을 다룬 선행 연구와 이론에 함의를 제공한다. 또한 학교와 지역사회의 실천현장에서 이민청소년의 새로운 환경에 대한 적응 과정에서 겪게 되는 심리적 피로감을 감소시키기 위한 효과적인 프로그램과 서비스 개발의 필요성 또한 강조한다.

In this study, we examined the effects of individual-level and area-level characteristics on advanced prostate cancer diagnosis among Medicare eligible older men (ages 70+ years). We analyzed patients from the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2000-2007) linked to US Census and County Business Patterns data. Cluster-adjusted logistic regression models were used to quantify the effects of individual preventive health behavior, clinical and demographic characteristics, area-level health services supply, and socioeconomic characteristics on stage at diagnosis. The fully adjusted model was used to estimate county-specific effects and predicted probabilities of advanced prostate cancer. In the adjusted analyses, low intensity of annual prostate-specific antigen (PSA) testing and other preventive health behavior, high comorbidity, African American race, and lower county socioeconomic and health services supply characteristics were statistically significantly associated with a higher likelihood of distant prostate cancer diagnosis. The fully adjusted predicted proportions of advanced prostate cancer diagnosis across 158 counties ranged from 3% to 15% (mean: 6%, SD: 7%). County-level socioeconomic and health services supply characteristics, individual-level preventive health behavior, demographic and clinical characteristics are determinants of advanced stage prostate cancer diagnosis among older Medicare beneficiaries; other health care-related factors such as family history, lifestyle choices, and health-seeking behavior should also be considered as explanatory factors.

We aimed to identify the correlates with not seeking help among working-age adults with suicidal ideation. By adapting the integrated model of suicide help-seeking, we examined help-seeking behavior in the following 3 stages: problem recognition, decision to seek help, and sources of help. We used a sample of working-age adults between 26 and 64 years old, who reported suicidal ideation in the past year (N = 1414). Data were drawn from the 2011 and 2012 National Survey on Drug Use and Health, and multinomial logistic regression analyses were applied. Findings suggested that being male, being nonwhite, being employed full-time, having lower levels of general mental health needs, and not having health insurance were associated with not seeking help. Results also indicated how each factor was related in the help-seeking pathway. Strategies to help problem recognition can be effective in enhancing help-seeking behavior among men, racial/ethnic minorities, and those without serious clinical conditions. Help-seeking interventions for working-age adults with suicidal ideation should also consider that race/ethnic minorities and those with lower levels of functional impairment might rely on alternative sources of help, such as family, friends, and religious advisors.

Despite the emphasis on evidence-based practice (EBP) in child welfare services (CWS) as an emerging and inevitable trend, implementation factors such as child welfare worker attitudes towards implementing EBP have received little attention in CWS. Aaron's (2004) Evidence Based Practice Attitudes Scale (EBPAS) has been used in multiple studies across mental health and healthcare settings. However, it has rarely been used in CWS. A-Mid Atlantic State implemented the EBPAS in all child welfare jurisdictions to measure workers' performance. The purpose of this study is to examine the EBPAS applied in a large urban child welfare services setting using a confirmatory factor analysis. Based on prior literature, three models were tested: a four factor model, a five factor model, and a second order four factor model. The second order model provided the best fit to the data, suggesting the EBPAS can measure workers' global attitudes, as well as four attitude types, towards EBP in a CWS setting. This study validates the use of the EBPAS with child welfare workers. Implications for effective evidence based practice in child welfare are discussed.

ObjectiveTo determine whether living in a food swamp (≥4 corner stores within 0·40 km (0·25 miles) of home) or a food desert (generally, no supermarket or access to healthy foods) is associated with consumption of snacks/desserts or fruits/vegetables, and if neighbourhood-level socio-economic status (SES) confounds relationships.DesignCross-sectional. Assessments included diet (Youth/Adolescent FFQ, skewed dietary variables normalized) and measured height/weight (BMI-for-age percentiles/Z-scores calculated). A geographic information system geocoded home addresses and mapped food deserts/food swamps. Associations examined using multiple linear regression (MLR) models adjusting for age and BMI-for-ageZ-score.SettingBaltimore City, MD, USA.SubjectsEarly adolescent girls (6th/7th grade,n634; mean age 12·1 years; 90·7 % African American; 52·4 % overweight/obese), recruited from twenty-two urban, low-income schools.ResultsGirls’ consumption of fruit, vegetables and snacks/desserts: 1·2, 1·7 and 3·4 servings/d, respectively. Girls’ food environment: 10·4 % food desert only, 19·1 % food swamp only, 16·1 % both food desert/swamp and 54·4 % neither food desert/swamp. Average median neighbourhood-level household income: $US 35 298. In MLR models, girls living in both food deserts/swamps consumed additional servings of snacks/dessertsv. girls living in neither (β=0·13,P=0·029; 3·8v. 3·2 servings/d). Specifically, girls living in food swamps consumed more snacks/desserts than girls who did not (β=0·16,P=0·003; 3·7v. 3·1 servings/d), with no confounding effect of neighbourhood-level SES. No associations were identified with food deserts or consumption of fruits/vegetables.ConclusionsEarly adolescent girls living in food swamps consumed more snacks/desserts than girls not living in food swamps. Dietary interventions should consider the built environment/food access when addressing adolescent dietary behaviours.

This study examined how various types of resources influence perceived health of caregivers. Guided by the conservation of resources theory, a caregiver health model was built and tested using structural equation modeling. The caregiver health model consisted of caregiving situations (functional limitations and cognitive impairments of older adults and caregiving time), resources (financial resources, mastery, social support, family harmony, and service utilization), caregiver burden, and perceived health of caregivers. The sample included 1,837 unpaid informal caregivers drawn from the 2004 National Long-Term Caregiver Survey. The model fit indices indicated that the first structural model did not fit well; however, the revised model yielded an excellent model fit. More stressful caregiving situations were associated with fewer resources and higher burden, whereas greater resources were associated with lower burden and better perceived health of caregivers. The results suggest explicit implications for social work research and practice on how to protect the health of caregivers.

Objective: This study examined the latent constructs of delirium symptoms among nursing home (NH) residents in the United States. Method: Cross-sectional NH assessment data (Minimum Data Set 2.0) from the 2009 Medicare Current Beneficiary Survey were used. Data from two independent, randomly selected subsamples of residents ≥65 years were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: There were 367 and 366 individuals in the EFA and CFA, respectively. Assessment of multiple model fit statistics in CFA indicated that the two-factor structure provided better fit for the data than a one-factor solution. The two factors represented cognitive and behavioral latent constructs as suggested by the related literature. A correlation of .72 between these constructs suggested moderate discriminant validity. Conclusion: This finding emphasizes the importance of health care providers to be attentive to both cognitive and behavioral symptoms when diagnosing, treating, and managing delirium.

This article presents and discusses the results of a national survey of social work PhD students, faculty, and administrators (n = 416), conducted by the Group for the Advancement of Doctoral Education in Social Work (GADE), in December 2012. The survey was undertaken to inform the updating of GADE’s 2003 Guidelines for Quality in Social Work Doctoral Programs, which is intended to facilitate the development, evaluation, and improvement of social work PhD programs. Results indicate areas of agreement and divergence among key stakeholder groups regarding the perceived importance of various indicators of quality as well as their expectations concerning student outcomes. Implications for PhD program assessment and development are discussed.

Objective Children are at risk for adverse outcomes during parental military deployments. We aim to determine the impact of parental deployment and combat injury on young children's postdeployment mental health, injuries, and maltreatment. Method This is a population-based, retrospective cohort study of young children of active duty military parents during fiscal years (FY) 2006 to 2007, a high deployment period. A total of 487,460 children, 3 to 8 years of age, who received Military Health System care, were included. The relative rates of mental health, injury, and child maltreatment visits of children whose parents deployed and children of combat-injured parents were compared to children unexposed to parental deployment. Results Of the included children, 58,479 (12%) had a parent deploy, and 5,405 (1%) had a parent injured during deployment. Relative to children whose parents did not deploy, children of deployed and combat-injured parents, respectively, had additional visits for mental health diagnoses (incidence rate ratio [IRR] = 1.09 [95% CI = 1.02–1.17], IRR = 1.67 [95% CI = 1.47–1.89]), injuries (IRR = 1.07 [95% CI = 1.04–1.09], IRR = 1.24 [95% CI = 1.17–1.32]), and child maltreatment (IRR = 1.21 [95% CI = 1.11–1.32], IRR 2.30 = [95% CI 2.02–2.61]) postdeployment. Conclusion Young children of deployed and combat-injured military parents have more postdeployment visits for mental health, injuries, and child maltreatment. Mental health problems, injuries, and maltreatment after a parent's return from deployment are amplified in children of combat-injured parents. Increased preventive and intervention services are needed for young children as parents return from deployments. Child health and mental health providers are crucial to effective identification of these at-risk children to ensure effective care provision.

Background Millions of Americans are burdened by out-of-pocket prescription costs. Although many survey measures have been developed to assess this burden, the construct validity and the factor structure of these instruments have not been rigorously assessed. Objectives To characterize the factor structure and the construct validity of items assessing cost-related medication burden. Methods We applied exploratory factor and confirmatory factor analyses to the 2009 Medicare Current Beneficiary Survey, focusing on 10 items assessing cost-related mediation burden among a nationally representative sample of community-dwelling Medicare beneficiaries. The fit of competing models was compared using several indices. Results The study population (N=8777) was predominantly aged over 65 years (83.3%), female (54.4%), and white (84.3%). Two distinct factors were present for the medication cost-reduction strategies: (1) cost-related medication nonadherence and (2) drug-shopping behaviors, not directly impacting medication compliance. The two factors were moderately correlated (r=0.55), highlighting the presence of a 2 distinct but related constructs for cost-related medication burden. An item assessing the use of mail or internet pharmacies did not load well on either factor and may not necessarily measure medication-related cost burden. An item assessing reduced spending on basic needs loaded strongly on the same factor with the cost-related medication nonadherence items, suggesting they together may represent extreme compensatory behaviors that may adversely affect health outcomes. Conclusions Two distinct constructs were derived from these items examining cost-related medication burden. Although cost-related medication burden is often associated with nonadherence, drug-shopping behaviors that do not directly impact adherence are also important measure of this burden.

Objectives Postpartum anxiety (PPA) is as prevalent and disruptive as postpartum depression (PPD), although less commonly addressed. The Edinburgh Postnatal Depression Scale (EPDS), originally created to screen for PPD, was found to include anxiety and depression subscales. This study examined the construct validity of the EPDS PPD and PPA subscales by examining differential predictors of both in a structural regression model. Methods Women (n = 969) were recruited from a maternity ward in Jerusalem, Israel and completed a demographic survey; 715 (74%) women were screened for PPD and PPA at 6 weeks postpartum using the EPDS. Results History of depression was a significant predictor of PPD symptoms and PPA symptoms. Income and number of past pregnancies were significant predictors of PPA symptoms. Conclusions for practice PPD and PPA have different predictors, suggesting that the EPDS depression and anxiety subscales should be scored separately. Further assessment and treatment should be tailored to specific symptoms of depression and/or anxiety reported.

Background: The optimal performance of nurses in healthcare settings plays a critical role in care quality and patient safety. Despite this importance, few measures are provided in the literature that evaluate nursing performance as an independent construct from competencies. The nine-item Nursing Performance Instrument (NPI) was developed to fill this gap. Purpose: The aim of this study was to examine and confirm the underlying factor structure of the NPI in registered nurses. Method: The design was cross-sectional, using secondary data collected between February 2008 and April 2009 for the ＂Fatigue in Nursing Survey＂ (N = 797). The sample was predominantly dayshift female nurses working in acute care settings. Using Mplus software, exploratory and confirmatory factor analyses were applied to the NPI data, which were divided into two equal subsamples. Multiple fit indices were used to evaluate the fit of the alternative models. Results: The three-factor model was determined to fit the data adequately. The factors that were labeled as ＂physical/ mental decrements,＂ ＂consistent practice,＂ and ＂behavioral change＂ were moderately to strongly intercorrelated, indicating good convergent validity. The reliability coefficients for the subscales were acceptable. Conclusions/Implications for Practice: The NPI consists of three latent constructs. This instrument has the potential to be used as a self-monitoring instrument that addresses nurses' perceptions of performance while providing patient care.

Although prior literature has shown the plausibility of combining the Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) items to form an expanded scale for measuring the degree of functional decline, this has not been shown in older adults with diabetes who are disproportionately affected by functional disability. Using the 2009 Medicare Current Beneficiary Survey data, we evaluated the factor structure of the pooled ADL and IADL items. Based on our study comprising 2,158 community-dwelling older adults (≥65 years) with diabetes, the unidimensional model exhibited good fit. Despite well-fitting indices, high correlations were observed between the latent constructs (>.70) of the multi-factor models, suggesting a lack of discriminant validity. These findings provide empirical support for a combined scale that can comprehensively and efficiently characterize the extent of functional disability in older adults with diabetes for research, risk adjustment, and evaluation in patient-centered medical homes.

Objectives: There has been little examination of the structural validity of the Parenting Stress Index–Short Form (PSI-SF) for minority populations in clinical contexts in the Unites States. This study aimed to test prespecified factor structures (one-factor, two-factor, and three-factor models) of the PSI-SF. Methods: This study used confirmatory factor analysis in a sample of 240 predominantly Black and Latino caregivers of children with behavioral difficulties. Results: The three-factor model fit was reasonable, and the criterion validity for the subscale and total scores was good supporting continued cautious use of the PSI-SF for clinical minority populations. Conclusions: The PSI-SF could be integrated as part of screening and intake assessment procedures, which could allow social work practitioners to make more informed decisions about treatment planning, as well as facilitate conversations with caregivers around identifying sources of stress and developing healthy coping strategies.

Remake, Remodel: Women's Magazines in the Digital Age. Brooke Erin Duffy. Urbana: University of Illinois Press, 2013. 208 pp. $85 hbk. $25 pbk.Women's magazines-those overtly gendered media spaces-have played a role in shaping concepts of female identity since Godey's 's Lady's 's Book began offering advice on domestic ideologies in the 1830s. But what is a woman's magazine in an age of iPads and tablets, social media, and fashion blogs? How are convergent media technologies and their concomitant economic pressures reshaping the industry? What happens when a woman's magazine positions itself as (to use the industry's new mantra) a brand rather than a physical text?In Remake, Remodel: Women's s Magazines in the Digital Age, Brooke Erin Duffy, an assistant professor in the School of Media and Communication at Temple University, surveys the shifting media landscape of today's women's magazines, skillfully tracing the recent seismic shifts in the industry, including the rise of participatory culture, the need to produce copy for multiple platforms, and the pressures convergent technologies put on the magazine industry's already-close relationship with advertisers. Looking largely through the lens of magazine producers-publishers, digital directors, editors, graphic designers, and other creatives-Duffy blends theory with extensive field interviews, attendance at trade shows and professional conferences, and a thorough review of the discourse on digital disruption found in the industry's professional and trade publications. In doing so, she provides a thoughtful-and thought-changing-look into a specific segment of a specific media industry as well as a compelling case for a research methodology that blends political economy with cultural studies.The early chapters of Remake, Remodel establish the necessary context for Duffy's analysis, both in terms of media theory and magazine history. Later chapters-the most compelling of the study-focus on the complexities of the industry as it works to incorporate digital practices. For example, Chapter 4, "Rethinking Readership: The Digital Challenge of Audience Construction," explores one of the industry's formerly unassailable principles-audience segmentation. Relying heavily on demographic and psychographic data, consumer magazines in general ( and women's magazines in particular) have long targeted niche audiences based on factors such as age, marital status, and household income, building the magazine's content and tone around those specific readers and, perhaps more importantly, attracting advertisers based on that reader profile.But new digital technologies, Duffy shows, have put pressure on the way magazine publishers think about their audiences. Thanks to digital technologies, for example, today's magazine publishers can combine demographic data with detailed information about consumer purchases (so-called transactional data) from sophisticated customer databases, making cross-marketing opportunities easier to sell to advertisers, but also raising issues of editorial creativity and reader privacy. …

The Group for the Advancement of Doctoral Educationin Social Work (GADE) adopted a new version of quality guidelines for PhD social work programs at its annual meeting in April 2013. These guidelines are reprinted in this article, together with a discussion of the context in which they were developed and approved. They are offered with the aim of advancing excellence in research-focused doctoral education and continuing the decades-long conversation about what constitutes excellence in those programs.

This study examines the factor structure of 8 questions regarding parent and adopted child relationships from the National Study of Adoptive Parents (NSAP). The study sample consists of 2,089 adoptive parents whose adopted child is between the 6 months and 17 years of age. The sample was randomly split into two groups to conduct exploratory and confirmatory analyses. An exploratory factor analysis conducted on the first subsample (n = 1,045) yielded single and 2-factor structures. Confirmatory analyses were conducted on the second subsample (n = 1,044) for both models. The single factor and 2-factor models demonstrate good fit, with all items loading significantly on the factor(s). However, the 2-factor structure is a better fit based on the literature that highlights the importance of closeness in the parent—child relationship and preadoptive expectations of that relationship, as well as the model’s ability to represent both constructs effectively. Thus, the 8 items from the NSAP study can be used as a 2...

Objective Psychological distress is common among Parkinson disease (PD) patients. Screening tools, such as the Brief Symptom Inventory-18 (BSI-18), help clinicians to identify and manage PD patients with psychiatric symptoms. The objective of this study is to test the factor structure of the BSI-18 in PD patients. Methods Analysis was conducted on PD patients who had initial visits at a movement disorders center from 2004 to 2015. Univariate analysis was used to describe the distribution of socio-demographic and clinical characteristics. The BSI-18 was used to determine the prevalence of clinically significant psychological distress. Confirmatory factor analyses (CFA) treating BSI-18 items as ordered categorical data were conducted. Five competing models were tested. Multiple fit indices, parsimony, and past theory were used to select the final model. Results In the study sample (n = 1067), 18.7%, 22.5%, 15.4%, and 15.0% of patients had BSI-18 T-scores indicative of clinically significant global psychological distress, somatization, depression, and anxiety, respectively. Of the competing models, the final model chosen was the second-order three-factor structure with somatization, depression, and anxiety loaded on psychological distress. Conclusion The original proposed factor structure of the BSI-18 was validated in this patient population. Consequently, this study confirms the construct validity of the BSI-18 for screening of psychological distress in PD patients. Findings highlight somatization as a particularly important component of psychological distress in PD patients.

Prescription Drug Monitoring Programs (PDMPs) are a principal strategy used in the United States to address prescription drug abuse. We (1) compared opioid use pre- and post-PDMP implementation and (2) estimated differences of PDMP impact by reason for Medicare eligibility and plan type.Analysis of opioid prescription claims in US states that implemented PDMPs relative to non-PDMP states during 2007-12.Florida, Louisiana, Nebraska, New Jersey, Vermont, Georgia, Wisconsin, Maryland, New Hampshire and Arkansas, USA.A total of 310 105 disabled and older adult Medicare enrolees.Primary outcomes were monthly total opioid volume, mean daily morphine milligram equivalent (MME) dose per prescription and number of opioid prescriptions dispensed. The key predictors were PDMP status and time. Tests for moderation examined PDMP impact by Medicare eligibility (disability versus age) and drug plan [privately provided Medicare Advantage (MAPD) versus fee-for-service (PDP)].Overall, PDMP implementation was associated with reduced opioid volume [-2.36 kg/month, 95% confidence interval (CI) = -3.44, -1.28] and no changes in mean MMEs or opioid prescriptions 12 months after implementation compared with non-PDMP states. We found evidence of strong moderation effects. In PDMP states, estimated monthly opioid volumes decreased 1.67 kg (95% CI = -2.38, -0.96) and 0.75 kg (95% CI = -1.32, -0.18) among disabled and older adults, respectively, and 1.2 kg, regardless of plan type. MME reductions were 3.73 mg/prescription (95% CI = -6.22, -1.24) in disabled and 3.02 mg/prescription (95% CI = -3.86, -2.18) in MAPD beneficiaries, but there were no changes in older adults and PDP beneficiaries. Dispensed prescriptions increased 259/month (95% CI = 39, 479) among the disabled and decreased 610/month (95% CI = -953, -257) among MAPD beneficiaries.Prescription drug monitoring programs (PDMPs) are associated with reductions in opioid use, measured by volume, among disabled and older adult Medicare beneficiaries in the United States compared with states that do not have PDMPs. PDMP impact on daily doses and daily prescriptions varied by reason for eligibility and plan type. These findings cannot be generalized beyond the 10 US states studied.