Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone
Penguin Press, 2012
Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone
Penguin Press, 2012
Is severity of obesity associated with diagnosis or health education practices?
Int J Obes (Lond). 2012 Jan 24. doi: 10.1038/ijo.2012.1.
Leventer-Roberts M, Patel A and Leonardo Trasande.
To assess the association of the severity of obesity with diagnosis and health education, and to identify any differences within demographic or other subgroups.
Clinician visits for 2-18 year olds from the 2005-2008 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey were combined. Descriptive, bivariate and multivariate analyses were used to compare diagnosis of obesity and health education (nutrition, exercise and weight reduction) across elevated body mass index (BMI) groups (overweight, obese and extreme or very obese, defined as >120% of the 95th percentile for age and gender), patient socio-demographic characteristics, physician specialty and type of visit (well child visits (WCV) versus non-well child visits (non-WCV).
A total of 17 808 visits had a calculated BMI, of which 5.8% were extremely obese, 13% were obese and 15.2% were overweight, with the highest percentages among older children, blacks and Hispanics. Diagnosis and weight reduction education were higher among children with an extreme BMI. Nutrition and exercise education were not correlated with severity of obesity. Race, ethnicity or gender biases were not identified. Severity of obesity was significantly associated with presentation to a non-WCV rather than a WCV.
Extremely obese children have higher, but still insufficient, rates of diagnosis and health education. Nutrition and exercise education are not prevalent throughout all age groups. Providers may be relying inconsistently and insufficiently on visual cues to drive their obesity prevention practices. Furthermore, lower rates of diagnosis and education at non-WCV may result in a missed opportunity to prevent comorbidities. This is of particular concern as overweight children are less likely to be seen at WCV than non-WCV.International Journal of Obesity advance online publication, 24 January 2012; doi:10.1038/ijo.2012.1.
The Long-Term Effects of Military Conscription on Mortality: Estimates From the Vietnam-Era Draft Lottery
Conley, Dalton and Jennifer Heerwig.
Research on the effects of Vietnam military service suggests that Vietnam veterans experienced significantly higher mortality than the civilian population at large. These results, however, may be biased by nonrandom selection into the military if unobserved background differences between veterans and nonveterans affect mortality directly. To generate unbiased estimates of exposure to conscription on mortality, the present study compares the observed proportion of draft-eligible male decedents born 1950–1952 to the (1) expected proportion of draft-eligible male decedents given Vietnam draft-eligibility cutoffs; and (2) observed proportion of draft-eligible decedent women. The results demonstrate no effect of draft exposure on mortality, including for cause-specific death rates. When we examine population subgroups—including splits by race, educational attainment, nativity, and marital status—we find weak evidence for an interaction between education and draft eligibility. This interaction works in the opposite direction of putative education-enhancing, mortality-reducing effects of conscription that have, in the past, led to concern about a potential exclusion restriction violation in instrumental variable (IV) regression models. We suggest that previous research, which has shown that Vietnam-era veterans experienced significantly higher mortality than nonveterans, might be biased by nonrandom selection into the military and should be further investigated.
Geographic Variations in Health Care Workforce Training in the US: The Case of Registered Nurses (RNs)
Med Care. 2011 Aug;49(8):769-74.
Background: In the United States, registered nurses [RNs] are trained through one of three educational pathways: a diploma course; an associate's degree, or a baccalaureate degree in nursing (the BSN). A national consensus has emerged that the proportion of RNs that are baccalaureate-trained should be substantially increased. Yet achieving that goal may be difficult in areas where college graduates are unlikely to reside.
Objectives: To determine whether the level of training of the hospital registered nurse [RN] workforce varies geographically, along with the education of the local general workforce.
Research design: Cross sectional, ecological study.
Subjects: Hospital nurses who participated in the National Sample Survey of Registered Nurses [NSSRN] in 2004 (n = 16,567).
Measures. Registered Nurse training was measured as Diploma, Associates degree, or Baccalaureate degree or above. County-level general workforce quality was assessed as the adult college graduation rate. Counties were divided into US population quartiles, with the highest quartile (Q4) having more than 29.3% college graduates, and the lowest quartile (Q1) having fewer than 16.93% college graduates.
Results: Hospital RNs have a higher level of training in counties where the general population is better
educated. For example, in Q4, 55.2% of hospital RNs are baccalaureate-trained, in Q3, 50.2%; in Q2,45.2%; and in Q1, 34.9% (p < .001 for all pairwise comparisons). The association between RN training and general workforce education is found in cities, towns and rural areas.
Conclusions: Nationwide, there are substantial geographic variations in the training of hospital RNs. Educational segregation (the tendency for educated people to cluster geographically) may make it more difficult to achieve a BSN-rich nursing workforce in some areas of the US. Further work is needed to assess whether educational segregation similarly influences the distribution of other health care professionals, and whether it leads to variations in the local quality of care.
Leveraging Technology to Educate New Healthcare IT Leaders
Journal of Healthcare Infomation Management
The increasing need to educate healthcare IT leaders will require the use of other educational methods in addition to classroom instruction, seminars at conferences and webinars. The author has 12 years experience offering a "blended" course on healthcare IT for managers and clinicians in an MBA program. The course combines face-to-face classroom instruction with on-line discussion. This reduces the time away from work and travel required. But it has far greater benefits, including the development of a capacity to analyze situations and develop and defen solutions. Participants share knowledge and begin to grasp the differences in their environments that require attention. This method is compared with other teaching methods and its advantages are explained.
School District Pension Bond Issuance and the Influence on Spending Behavior
Association for Education Finance and Policy
Calabrese, T., Ely, T. L.
In Political and Civic Leadership. Edr., R. Couto. Vol II. Thousand Oaks: Sage (Second Author with W. El Hadidy and A Hofman-Pinilla
School Cost Accounting: What Do We Know and How Do We Get There?
Public Performance & Management Review, 35 (1): 29-53.
Denison, Dwight, William Hartman, Leanna Stiefel and Michele Deegan
This paper describes a model for assessing and reporting schoollevel resources. State and local decision-makers have been seeking ways to obtain such information for more than a decade, but there is as yet no easy, accessible way to do so and no way to satisfy both internal and external users of the information. The model, based on case studies in Pennsylvania (with successful replication in New York), resolves many of the issues. The seven principles that guide the model are explained, challenges in developing school-level reports are generalized, and resolutions to the challenges in three states are compared. The conclusion draws out implications for the future of regularly collected school resource data.
A School-Randomized Clinical Trial of an Integrated Social-Emotional Learning and Literacy Intervention: Impacts on Third-Grade Outcomes
Journal of Consulting and Clinical Psychology, 78(6): 829-842
Jones, S.M., Brown, J.L, Hoglund, W.L.G., & J.L. Aber.
Objective: To report experimental impacts of a universal, integrated school-based intervention in social–emotional learning and literacy development on change over 1 school year in 3rd-grade children's social–emotional, behavioral, and academic outcomes. Method: This study employed a school-randomized, experimental design and included 942 3rd-grade children (49% boys; 45.6% Hispanic/Latino, 41.1% Black/African American, 4.7% non-Hispanic White, and 8.6% other racial/ethnic groups, including Asian, Pacific Islander, Native American) in 18 New York City public elementary schools. Data on children's social–cognitive processes (e.g., hostile attribution biases), behavioral symptomatology (e.g., conduct problems), and literacy skills and academic achievement (e.g., reading achievement) were collected in the fall and spring of 1 school year. Results: There were main effects of the 4Rs Program after 1 year on only 2 of the 13 outcomes examined. These include children's self-reports of hostile attributional biases (Cohen's d = 0.20) and depression ( d = 0.24). As expected based on program and developmental theory, there were impacts of the intervention for those children identified by teachers at baseline with the highest levels of aggression ( d = 0.32–0.59) on 4 other outcomes: children's self-reports of aggressive fantasies, teacher reports of academic skills, reading achievement scaled scores, and children's attendance. Conclusions: This report of effects of the 4Rs intervention on individual children across domains of functioning after 1 school year represents an important first step in establishing a better understanding of what is achievable by a schoolwide intervention such as the 4Rs in its earliest stages of unfolding. The first-year impacts, combined with our knowledge of sustained and expanded effects after a second year, provide evidence that this intervention may be initiating positive developmental cascades both in the general population of students and among those at highest behavioral risk.
The American Single Mother
Women of Color Policy Network
Across race and age groups, education is the single greatest predictor of single-motherhood in America. This policy brief offers a profile of the American single woman mother, contemporary population trends, and the economic security of this growing demographic. See also our full report "At Ropes End: Single Women Mothers, Wealth and Asset Accumulation in the United States.