The utilization of antidepressants and benzodiazepines among people with major depression in Canada

Objective: Although clinical guidelines recommend monotherapy with antidepressants (ADs) for major depression, polypharmacy with benzodiazepines (BDZs) remains an issue. Risks associated with such treatments include tolerance and dependence, among others. We assessed the prevalence and determinants of AD and BDZ utilization among Canadians who experienced a major depressive episode (MDE) in the previous 12 months, and determined the association of seeing a psychiatrist on the utilization of ADs and BDZs. Method: Data were drawn from the 2002 Canadian Community Health Survey: Health and Well-Being, a nationally representative sample of Canadians aged 15 years and older. Descriptive statistics quantified utilization, while logistic regression identified factors associated with utilization, such as sociodemographic characteristics or type of physician seen. Sampling weights and bootstrap variance estimations were used for all analysis. Results: The overall prevalence of AD and BDZ utilization was 49.3% of respondents who experienced an MDE in the past 12 months and reported AD use. Key determinants of utilization were younger age and unemployment in the past week (OR 2.6; P < 0.001). Being seen by a psychiatrist increased utilization (OR 2.5; P < 0.001), possibly because psychiatrists were seeing patients with severe depression. Conclusion: A large proportion of people with past-year MDEs utilized ADs and BDZs. It is unclear how much of this is appropriate given that evidence-based clinical guidelines recommend monotherapy with ADs in the treatment of major depression

Evaluation of Dosing and Clinical Outcomes in Patients Undergoing Conversion of Insulin Glargine to Insulin Detemir

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96348/1/phar1168.pd

America's Rural Hospitals: A Selective Review of 1980s Research

We review 1980s research on American rural hospitals within the context of a decade of increasing restrictiveness in the reimbursement and operating environments. Areas addressed include rural hospital definitions, organizational and financial performance, and strategic management activities. The latter category consists of hospital closure, diversification and vertical integration, swing-bed conversion, sole community provider designation, horizontal integration and multihospital system affiliation, marketing, and patient retention. The review suggests several research needs, including: developing more meaningful definitions of rural hospitals, engaging in methodologically sound work on the effects of innovative programs and strategic management activities—including conversion of the facility itself—on rural hospital performance, and completing studies of the effects of rural hospital closure or conversion on the health of the communities served.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74857/1/j.1748-0361.1990.tb00682.x.pd

What Students Say Versus What They Do Regarding Scientific Inquiry

Science Education, Vol. 98, No. 1, pp. 1–35We teach a course for elementary education undergraduates that gives students an opportunity to conduct open-ended scientific inquiry and pursue their own scientific questions in much the sameway that practicing research scientists do. In this study,we compared what our students say declaratively about the nature of science (NOS) in surveys and interviews with what they do procedurally when engaged in authentic scientific practice. Initially, we were surprised when our students showed very little change on two different validated NOS questionnaires, adhering to seemingly memorized definitions of key NOS vocabulary such as “science” and “experiment.” In contrast, on procedural measures of NOS understanding, students developed a decidedly sophisticated approach to answering scientific questions. Our data suggest that students’ declarative understandings about the NOS are not a reliable measure of students’ ability to engage productively in scientific practices and vice versa. We discuss why this might be and consider the implications of this disconnect on identifying the best approach to NOS instruction and on future science education research

Investigating teacher learning supports in high school biology curricular programs to inform the design of educative curriculum materials

Reform efforts have emphasized the need to support teachers' learning about reform-oriented practices. Educative curriculum materials are one potential vehicle for promoting teacher learning about these practices. Educative curriculum materials include supports that are intended to promote both student and teacher learning. However, little is known about the extent to which existing curriculum materials provide support for teachers and the ways they can be improved. In this study, eight sets of high school biology curriculum materials were reviewed to determine their potential for promoting teacher learning. Design heuristics for educative curriculum materials were adapted for use as evaluation criteria. From this analysis, several themes emerged. First, the materials tended to provide support for teachers' subject matter knowledge and pedagogical content knowledge for students' ideas (e.g., misconceptions) but rarely for their pedagogical content knowledge of scientific inquiry. Second, the materials contained several implementation guidance supports but far fewer rationales for instructional decisions, which are an important feature of educative curriculum materials. Finally, the quality of support varied widely, differing in its degree of relevance, pedagogical helpfulness, and depth. The article concludes with recommendations for the redesign of existing curriculum materials. © 2009 Wiley Periodicals, Inc. J Res Sci Teach 46: 977–998, 2009Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64326/1/20293_ftp.pd

A VALUE PLATFORM ANALYSIS PERSPECTIVE ON CUSTOMER ACCESS INFORMATION TECHNOLOGY

Customer access information technologies (CAITs) provide a link between a firm and its customers. Firms invest in CAITs to reduce costs, increase revenues and market share, lock in existing customers and capture new ones. These benefits, however, are notoriously difficult to measure. This paper proposes an evaluative method for CAlT deployment called value platform analysis, that is based on a conceptual model drawn from the theory of retail outlet deployment in marketing science. The model focuses on the impact of CAIT features and environmental features on transactions generated by the CAIT. Specific econometric models are developed for deployment. Hypotheses regarding the likely impact of automated teller machine (ATM) location design choices and environmental features on ATM transactions are evaluated. The results indicate that there are a number of key features influencing ATM performance. Two distinct ATM deployment scenarios emerge: one for servicing a bank's own customers, and another for providing transaction services for customers for a fee.Information Systems Working Papers Serie

Correlates of psychological distress and major depressive disorder among African American men

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88155/1/lincoln_taylor_watkins_chatters2011.pd

Self-archiving and the Copyright Transfer Agreements of ISI-ranked library and information science journals

A study of Thomson-Scientific ISI ranked Library and Information Science (LIS) journals (n = 52) is reported. The study examined the stances of publishers as expressed in the Copyright Transfer Agreements (CTAs) of the journals toward self-archiving, the practice of depositing digital copies of one\u27s works in an Open Archives Initiative (OAI)-compliant open access repository. Sixty-two percent (32) do not make their CTAs available on the open Web; 38% (20) do. Of the 38% that do make CTAs available, two are open access journals. Of the 62% that do not have a publicly available CTA, 40% are silent about self-archiving. Even among the 20 journal CTAs publicly available there is a high level of ambiguity. Closer examination augmented by publisher policy documents on copyright, self-archiving, and instructions to authors reveals that only five, 10% of the ISI-ranked LIS journals in the study, actually prohibit self-archiving by publisher rule. Copyright is a moving target, but publishers appear to be acknowledging that copyright and open access can co-exist in scholarly journal publishing. The ambivalence of LIS journal publishers provides unique opportunities to members of the community. Authors can self-archive in open access archives. A society-led, global scholarly communication consortium can engage in the strategic building of the LIS information commons. Aggregating OAI-compliant archives and developing disciplinary-specific library services for an LIS commons has the potential to increase the field\u27s research impact and visibility. It may also ameliorate its own scholarly communication and publishing systems and serve as a model for others

Testing posttraumatic stress as a mediator of physical, sexual, and psychological intimate partner violence and substance problems among women

This study examined whether posttraumatic stress specifically resulting from intimate partner violence (IPV-related posttraumatic stress) mediated relationships between types of IPV and drug and alcohol problems among 212 women currently experiencing IPV. Six-month prevalence was high for drug use (48%) and alcohol use (59%). Structural equation modeling revealed that the frequency of physical, sexual, and psychological IPV were significantly and positively related to greater IPV-related posttraumatic stress, and IPV-related posttraumatic stress was significantly and positively related to drug problems. Further, IPV-related posttraumatic stress mediated the relationships between physical IPV and drug problems and psychological IPV and drug problems. Findings suggest that prevention and intervention efforts targeting posttraumatic stress among IPV-exposed women may reduce drug problems in this population