More Than What Meets the Eye: An Examination of Characteristics That Impact Juvenile Justice Detention Decisions

Research shows that disparities still exist in the juvenile justice decision-making process, but there is a gap in our understanding of neighborhood characteristics that may affect those detention decisions. Therefore, this research examines structural factors influenced by social disorganization theory to explore the impact they have on juvenile detention decisions. Neighborhood parks and recreation centers are examined as important local institutions that provide informal social control to the neighborhood. The Virginia Department of Juvenile Justice (DJJ) for the city of Norfolk compiled juvenile justice data, and 2016 Census data were also used to obtain neighborhood structural information. Non-White juveniles were more likely to be detained than White juveniles. Males were more likely to receive detention. The older the juvenile, the more likely they were to be detained at intake. The more available recreation centers in a neighborhood, the less likely a juvenile will be detained at intake from the same neighborhood. Poverty and heterogeneity also showed significance in the decision to detain a juvenile at intake. The policy implications are discusses as well as limitations and directions for future research

The benefit mindset: The psychology of contribution and everyday leadership

This paper explores the significance of mindset in shaping a future of greater possibility. One’s mindset reflects personally distinguishable attitudes, beliefs and values, which influence one’s ability to learn and lead, and to achieve and contribute. Bringing together two areas of research – a “being well” perspective from positive psychology and a socially and ecologically orientated “doing good” perspective – the Benefit Mindset is presented as a mutually supportive model for promoting wellbeing on both an individual and a collective level. It builds upon Dweck’s Fixed and Growth Mindset theory, by including the collective context in which an individual resides. The Benefit Mindset describes everyday leaders who discover their strengths to make valuable contributions to causes that are greater than the self, leaders who believe in making a meaningful difference, positioning their actions within a purposeful context. We argue that creating cultures of contribution and everyday leadership could be one of the best points of leverage we have for simultaneously bringing out the best in people, organizations and the planet

Causal Inference in HIV/AIDS Research: Generalizability and Applications

In this research, we develop and apply causal inference methods for the field of infectious diseases. In the first part of this research, we consider an inverse probability (IP) weighted Cox model to estimate the effect of a baseline exposure on a time-to-event outcome. IP weighting can be used to adjust for multiple measured confounders of a baseline exposure in order to estimate marginal effects, which compare the distribution of outcomes when the entire population is exposed versus the entire population is unexposed. IP weights can also be employed to adjust for selection bias due to loss to follow-up. This approach is illustrated using an example that estimates the effect of injection drug use on time until AIDS or death among HIV-infected women. In the second part of this research, we develop and apply methods for generalizing trial results for continuous data. In a randomized trial, assuming participants are a random sample from the target population may be dubious. Lack of generalizability can arise when the distribution of treatment effect modifiers in trial participants is different from the distribution in the target. We consider an inverse probability of sampling weighted (IPSW) estimator for generalizing trial results to a user-specified target population. The IPSW estimator is shown to be consistent and asymptotically normal. Expressions for the asymptotic variance and a consistent sandwich-type estimator of the variance are derived. Simulation results comparing the IPSW estimator to a previously proposed stratified estimator are provided. The IPSW estimator is employed to generalize results from the AIDS Clinical Trials Group (ACTG) to all people currently living with HIV in the U.S. In the third part of this research, we develop and apply methods for generalizing trial results for right-censored data. The IPSW estimator is considered for right-censored data and is defined as an inverse weighted Kaplan-Meier (KM) estimator. Simulation results are provided to compare this estimator to an unweighted KM estimator and a stratified estimator. The average standard error is computed using a nonparametric bootstrap. The IPSW estimator is employed to generalize survival results from the ACTG to all people currently living with HIV in the U.S.Doctor of Public Healt

Impact of a Yoga and Meditation Intervention on Students\u27 Stress and Anxiety Levels

Objective: To evaluate the impact of a 6-week yoga and meditation intervention on college students’ stress perception, anxiety levels and mindfulness skills. Methods. College students participated in a 6-week pilot program consisting of a 60-minute vinyasa yoga class followed by guided meditation once weekly, delivered by trained faculty at the University of Rhode Island College of Pharmacy. Students completed pre- and post-questionnaires to evaluate changes in the following outcomes: stress levels, anxiety levels, and mindfulness skills. The questionnaire was comprised of three self reporting tools: Beck Anxiety Inventory (BAI), Perceived Stress Scale (PSS), and Five Facet Mindfulness Questionnaire (FFMQ). Changes from baseline were assessed using numerical and categorical scales (low, medium, and high). Results. Seventeen participants (ages 19-23) completed the study. Thirteen participants were female, and four were male. Nine of the students were enrolled in the PharmD program and eight from other majors. Anxiety and stress scores decreased while total mindfulness increased, with all changes statistically significant. Categorical pre-post data from BAI and PSS were statistically significant with no students reported being in the “high” category of both stress and anxiety post intervention. Conclusion. Students demonstrated a reduction in stress and anxiety levels after completing a 6-week yoga and meditation program preceding final exams. Results suggest adopting a mindfulness practice for as little as once per week may reduce stress and anxiety in college students. Higher education may consider the inclusion of nonpharmacologic methods, such as yoga and meditation, to support student self-care

Design of egocentric network-based studies to estimate causal effects under interference

Many public health interventions are conducted in settings where individuals are connected to one another and the intervention assigned to randomly selected individuals may spill over to other individuals they are connected to. In these spillover settings, the effects of such interventions can be quantified in several ways. The average individual effect measures the intervention effect among those directly treated, while the spillover effect measures the effect among those connected to those directly treated. In addition, the overall effect measures the average intervention effect across the study population, over those directly treated along with those to whom the intervention spills over but who are not directly treated. Here, we develop methods for study design with the aim of estimating individual, spillover, and overall effects. In particular, we consider an egocentric network-based randomized design in which a set of index participants is recruited from the population and randomly assigned to treatment, while data are also collected from their untreated network members. We use the potential outcomes framework to define two clustered regression modeling approaches and clarify the underlying assumptions required to identify and estimate causal effects. We then develop sample size formulas for detecting individual, spillover, and overall effects. We investigate the roles of the intra-class correlation coefficient and the probability of treatment allocation on the required number of egocentric networks with a fixed number of network members for each egocentric network and vice-versa.Comment: 30 pages for main text including figures and tables, 5 figures and 3 table

Interpretation of the Individual Effect Under Treatment Spillover

Some interventions are intended to benefit both individuals and the groups to which they belong. When a treatment given to one person exerts a causal effect on others, the treatment is said to exhibit spillover, dissemination, or interference. However, defining meaningful causal effects under spillover can be challenging. In this commentary, we discuss the meaning of the “individual effect,” a quantity proposed to summarize the effect of treatment on the person who receives it, when spillover may be present

Prevalence of Psychotropic Polypharmacy and Associated Healthcare Resource Utilization during Initial Phase of Care among Adults with Cancer in USA

Background: The use of psychotropic medications is not uncommon among patients with newly diagnosed cancer. However, the impact of psychotropic polypharmacy on healthcare utilization during the initial phase of cancer care is largely unknown. Methods: We used a claims database to identify adults with incident breast, prostate, lung, and colorectal cancers diagnosed during 2011–12. Psychotropic polypharmacy was defined as concurrent use of two or more psychotropic medication classes for at least 90 days. A multivariable logistic regression was performed to identify significant predictors of psychotropic polypharmacy. Multivariable Poisson and negative binomial regressions were used to assess the associations between psychotropic polypharmacy and healthcare utilization. Results: Among 5604 patients included in the study, 52.6% had breast cancer, 30.6% had prostate cancer, 11.4% had colorectal cancer, and 5.5% had lung cancer. During the year following incident cancer diagnosis, psychotropic polypharmacy was reported in 7.4% of patients, with the highest prevalence among patients with lung cancer (14.4%). Compared with patients without psychotropic polypharmacy during the initial phase of care, patients with newly diagnosed cancer with psychotropic polypharmacy had a 30% higher rate of physician office visits, an 18% higher rate of hospitalization, and a 30% higher rate of outpatient visits. The rate of emergency room visits was similar between the two groups. Conclusion: Psychotropic polypharmacy during the initial phase of cancer care was associated with significantly increased healthcare resource utilization, and the proportion of patients receiving psychotropic polypharmacy differed by type of cancer. Impact: Findings emphasize the importance of evidence-based psychotropic prescribing and close surveillance of events causing increased healthcare utilization among patients with cancer receiving psychotropic polypharmacy

Assessing Individual and Disseminated Effects in Network-Randomized Studies

Implementation trials often involve clustering via risk networks, where only some participants directly received the intervention. The individual effect is that among directly treated persons beyond being in an intervention network; the disseminated effect is that among persons engaged with those directly treated. We employ a causal inference framework and discuss assumptions and estimators for individual and disseminated effects and apply them to HIV Prevention Trials Network 037. HIV Prevention Trials Network 037 was a Phase III, network-level, randomized controlled HIV prevention trial conducted in the US and Thailand from 2002 to 2006 that recruited persons who injected drugs, who received either intervention or control, and their risk network members, who received no direct intervention. Combining individual and disseminated, a 35% composite rate reduction was observed in the adjusted model (95% confidence interval = 0.47, 0.90). Methodology is now available to estimate the full set of these effects enhancing knowledge gained from network-randomized trials. Although the overall effect gains validity from network randomization, we show that it will, in general, be less than the composite effect. Additionally, if only index participants benefit from the intervention, as the network size increases, the overall effect tends to the null, an unfortunate and misleading conclusion