The Allocation of Merit Pay in Academia: A Case Study

This paper investigates whether the widespread awarding of faculty merit pay at a large public university accurately reflects productivity. We show that pairwise voting on a quality standard by a committee can in theory be consistent with observed allocation patterns. However, the data indicate only nominal adherence to a quality standard. Departments with more severe compression issues are more likely to award merit pay as a countermeasure and some departments appear to be motivated by nonpecuniary incentives. Much of the variance in merit pay allocation remains unexplained. These results suggest reform is needed to improve transparency in the merit system.merit, faculty compensation

Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial

BACKGROUND Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. AIM To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT) intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. METHOD 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. RESULTS Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. CONCLUSIONS A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. TRIAL REGISTRATION Controlled-Trials.comISRCTN93903959.Funding for the trial was provided by an Australian Research Council Linkage Project Grant (LP0667970) (http://www.arc.gov.au/). LF is supported by an Australian Postgraduate Award Industry scholarship. KG is supported by a National Health and Medical Research Council Fellowship (No. 525413) and HC is supported by a National Health and Medical Research Council Fellowship (No. 525411)

Are freestanding midwifery units a safe alternative to obstetric units for low-risk, primiparous childbirth?:An analysis of effect differences by parity in a matched cohort study

BACKGROUND: Intrapartum complications and the use of obstetric interventions are more common in primiparous childbirth than in multiparous childbirth, leading to concern about out of hospital birth for primiparous women. The purpose of this study was to determine whether the effect of birthplace on perinatal and maternal morbidity and the use of obstetric interventions differed by parity among low-risk women intending to give birth in a freestanding midwifery unit or in an obstetric unit in the North Denmark Region. METHODS: The study is a secondary analysis of data from a matched cohort study including 839 low-risk women intending birth in a freestanding midwifery unit (primary participants) and 839 low-risk women intending birth in an obstetric unit (individually matched control group). Analysis was by intention-to-treat. Conditional logistic regression analysis was applied to compute odds ratios and effect ratios with 95% confidence intervals for matched pairs stratified by parity. RESULTS: On no outcome did the effect of birthplace differ significantly between primiparous and multiparous women. Compared with their counterparts intending birth in an obstetric unit, both primiparous and multiparous women intending birth in a freestanding midwifery unit were significantly more likely to have an uncomplicated, spontaneous birth with good outcomes for mother and infant and less likely to require caesarean section, instrumental delivery, augmented labour or epidural analgesia (although for caesarean section this trend did not attain statistical significance for multiparous women). Perinatal outcomes were comparable between the two birth settings irrespective of parity. Compared to multiparas, transfer rates were substantially higher for primiparas, but fell over time while rates for multiparas remained stable. CONCLUSIONS: Freestanding midwifery units appear to confer significant advantages over obstetric units to both primiparous and multiparous mothers, while their infants are equally safe in both settings. Our findings thus support the provision of care in freestanding midwifery units as an alternative to care in obstetric units for all low-risk women regardless of parity. In view of the global rise in caesarean section rates, we consider it an important finding that freestanding midwifery units show potential for reducing first-birth caesarean. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-016-1208-1) contains supplementary material, which is available to authorized users

Age differences in mental health literacy

BACKGROUND: The community's knowledge and beliefs about mental health problems, their risk factors, treatments and sources of help may vary as a function of age. METHODS: Data were taken from an epidemiological survey conducted during 2003–2004 with a national clustered sample of Australian adults aged 18 years and over. Following the presentation of a vignette describing depression (n = 1001) or schizophrenia (n = 997), respondents were asked a series of questions relating to their knowledge and recognition of the disorder, beliefs about the helpfulness of treating professionals and medical, psychological and lifestyle treatments, and likely causes. RESULTS: Participant age was coded into five categories and cross-tabulated with mental health literacy variables. Comparisons between age groups revealed that although older adults (70+ years) were poorer than younger age groups at correctly recognising depression and schizophrenia, young adults (18–24 years) were more likely to misidentify schizophrenia as depression. Differences were also observed between younger and older age groups in terms of beliefs about the helpfulness of certain treating professionals and medical and lifestyle treatments for depression and schizophrenia, and older respondents were more likely to believe that schizophrenia could be caused by character weakness. CONCLUSION: Differences in mental health literacy across the adult lifespan suggest that more specific, age appropriate messages about mental health are required for younger and older age groups. The tendency for young adults to 'over-identify' depression signals the need for awareness campaigns to focus on differentiation between mental disorders

Clickety-Click: e-mental health train on track

Objective: Experts forecast that the Internet will bring about radical change in healthcare. This paper aims to summarise evidence concerning the efficacy of Internet-based programs in the delivery of mental health care and its implications for mental health professionals. It also describes those Internet programs which are both of demonstrated effectiveness in the treatment of anxiety or depression and available without restriction or cost to the public. Conclusions: There is evidence that Internet-based programs can improve a range of mental health conditions. Some of these programs could be used by psychiatrists and other mental health professionals as an adjunct to clinician-based treatment. However, clinicians need to know which programs work and how they can be accessed

Stemningsantropologi: At inddrage, fastholde og fremhæve det intime og stemningsmættede

Denne artikel illustrerer nogle af de følelsesmæssige reaktioner, der kan opstå under intime situationer i feltarbejdet med socialt udsatte voksne, og hvordan reaktionerne kan inddrages i det analytiske arbejde. Med udgangspunkt i feltarbejde med hjemløse argumenterer jeg for, at etnografens egne følelser med fordel kan benyttes i det analytiske arbejde og være med til at bidrage med indsigt i de samfundsfænomener eller praksisser, der studeres

Association between Practice Participation in a Pediatric-focused Medical Home Learning Collaborative and Reduction of Preventable Emergency Department Visits by Publicly-insured Children in Massachusetts

Introduction: This study evaluates the impact of practice participation in a pediatric patient-centered medical home learning collaborative on preventable emergency department (ED) visits among children in MassHealth (Massachusetts Medicaid/Children\u27s Health Insurance Program). Methods: Claims and enrollment data were extracted for child MassHealth members (aged 3–18) comprising 2 groups: members enrolled in a group of 13 child-serving practices that participated in an intensive, 29-month long patient-centered medical home learning collaborative (intervention group), and members enrolled in a group of 12 comparison practices with roughly similar panel size, type, and geographic location (comparison group). Preventable ED visits were identified using a modified version of the New York University ED algorithm. Two analyses were then conducted: (1) a repeat cross-sectional analysis among children enrolled in intervention or comparison group practices during baseline (first half of 2011) and follow-up (second half of 2013) periods; and (2) a longitudinal analysis among a subset of children enrolled for the full study period (2011–2013). Both analyses tested whether the effect of the intervention differed for children with versus without chronic conditions (effect modification). Results: Preventable ED visits declined from baseline to follow-up among children in both intervention and comparison practices. In the cross-sectional analysis, the decrease was the same in both practice groups, and for children with versus without chronic conditions. The longitudinal analysis shows a statistically significantly greater decrease among children with chronic conditions enrolled in the intervention practices (P = 0.02). Conclusion: Children with chronic conditions might receive the greatest benefit from receiving care in a medical home setting

Ideology and Deliberation : An Analysis of Public Support for Deliberative Practices in Finland

Peer reviewe