Supported Employment: A Best Practice for People with Psychiatric Disabilities

Over the past several decades, research from a variety of fields has presented powerful evidence of the importance of employment to people with psychiatric disabilities. Many of these people want to work and can successfully participate in the labor market in a variety of competitive jobs. Researchers have also shown how employment can alleviate poverty, reduce hospitalization, and improve quality of life. Society also benefits through taxes paid by workers, goods and services they purchase, and reductions in entitlements and the overall cost of care. However, the 1997 National Health Interview Survey (NHIS) reports employment rates for people with a wide range of mental disorders to be 37.1 percent (Harris et al., 2005; New Freedom Commission on Mental Health, 2003). Employment rates for people with schizophrenia and related disorders are 22 percent (Jans, et al., 2004). Recently, funding agencies and practitioners have begun to move towards evidence-based practice in serving people with psychiatric disabilities. A number of reviews and meta-analyses of single-site, randomized controlled trials of supported employment for this group have found it to be more effective at establishing competitive employment outcomes than prevocational training or non-vocational community care (Crowther et al., 2001; Twamley et al., 2003; Wewiorski & Fabian, 2004). Still in question at the time of this study\u27s funding, however, was the effectiveness of different models of supported employment, operating in a variety of organizational settings, for consumers with diverse demographic characteristics, in different regions of the country. Therefore, the Employment Intervention Demonstration Program (EIDP) was designed as a multi-site randomized controlled trial of the effectiveness of supported employment (SE) for people with psychiatric disabilities in eight locations across the U.S. SE programs use a rapid job search approach to help clients obtain jobs directly (rather than providing lengthy assessment, training, and counseling), and provide them with ongoing support to maintain and improve their earnings after they start work. This policy brief describes the EIDP, presents study findings, and suggests some policy and research implications

Is birthweight associated with total and aggressive/lethal prostate cancer risks? A systematic review and meta-analysis

BACKGROUND: It has been hypothesised that intrauterine exposures are important for subsequent prostate cancer risk. Prior epidemiological studies have used birthweight as a proxy of cumulative intrauterine exposures to test this hypothesis, but results have been inconsistent partly because of limited statistical power. METHODS: We investigated birthweight in relation to prostate cancer in the Medical Research Council (MRC) National Survey of Health and Development (NSHD) using Cox proportional hazards models. We then conducted a meta-analysis of birthweight in relation to total and aggressive/lethal prostate cancer risks, combining results from the NSHD analysis with 13 additional studies on this relationship identified from a systematic search in four major scientific literature databases through January 2015. RESULTS: Random-effects models found that per kg increase in birthweight was positively associated with total (OR=1.02, 95% confidence interval (95% CI)=1.00, 1.05; I(2)=13%) and aggressive/lethal prostate cancer (OR=1.08, 95% CI=0.99, 1.19; I(2)=40%). Sensitivity analyses restricted to studies with birthweight extracted from medical records demonstrated stronger positive associations with total (OR=1.11, 95% CI=1.03, 1.19; I(2)=0%) and aggressive/lethal (OR=1.37, 95% CI=1.09, 1.74; I(2)=0%) prostate cancer. These studies heavily overlapped with those based in Nordic countries. CONCLUSIONS: This study provides evidence that heavier birthweight may be associated with modest increased risks of total and aggressive/lethal prostate cancer, which supports the hypothesis that intrauterine exposures may be related to subsequent prostate cancer risks

"Any lady can do this without much trouble ...": class and gender in The dining room (1878)

Macmillan's "Art at Home" series (1876–83) was a collection of domestic advice manuals. Mentioned in every study of the late-nineteenth-century domestic interior, they have often been interpreted, alongside contemporary publications such as Charles Eastlake's Hints on Household Taste (1868), as indicators of late 1870s home furnishing styles. Mrs Loftie's The Dining Room (1878) was the series' fifth book and it considers one of the home's principal (and traditionally masculine) domestic spaces. Recent research on middle-class cultural practices surrounding food has placed The Dining Room within the tradition of Mrs Beeton's Household Management (1861); however, it is not a cookery book and hardly mentions dinners. Drawing upon unpublished archival sources, this paper charts the production and reception of The Dining Room, aiming to unravel its relationships with other contemporary texts and to highlight the difficulties of using it as historical evidence. While it offers fascinating insights into contemporary taste, class and gender, this paper suggests that, as an example of domestic design advice literature, it reveals far more about the often expedient world of nineteenth-century publishing practices

An Instrumental Variable Evaluation of Antidepressant Use on Employment Among HIV-Infected Women Using Highly-Active Antiretroviral Therapy in the United States: 1996-2004

This paper examines the effect of antidepressant use on the likelihood of being employed among HIV-positive women receiving highly active antiretroviral therapy (HAART) in the United States from 1994 to 2004. We use instrumental variables to predict antidepressant use independently of outcomes; thus, addressing potential sources of bias -- more depressed women are more likely to receive antidepressant treatment, but they are also more likely to be unemployed. The results show that antidepressant use has a positive effect on the employment probability of women living with HIV. The proposed instrumental variables can be used to identify antidepressant use in the WIHS population. Among women receiving HAART, and controlling for individual and local area labor market characteristics, the use of antidepressants is associated with a higher probability of being employed.

Safety Evaluation of Two Commercial Lithium-ion Batteries for Space Applications

Lithium-ion batteries have been used for applications on the Shuttle and Station for the past six years. A majority of the li-ion batteries flown are Commercial-off-the-shelf (COTS) varieties. The COTS batteries and cells were tested under nominal and abusive conditions for performance and safety characterization. Within the past six months two batteries have been certified for flight and use on the Space Station. The first one is a Hand Spring PDA battery that had a single prismatic li-ion cell and the second is an Iridium satellite phone that had a two-cell pack with prismatic li-ion cells

Towards a Critical Understanding of Music, Emotion and Self-Identity

The article begins by outlining a dominant conception of these relations in sociologically informed analysis of music, which sees music primarily as a positive resource for active self-making. My argument is that this conception rests on a problematic notion of the self and also on an overly optimistic understanding of music, which implicitly sees music as highly independent of negative social and historical processes. I then attempt to construct a) a more adequately critical conception of personal identity in modern societies; and b) a more balanced appraisal of music-society relations. I suggest two ways in which relations between self, music and society may not always be quite so positive or as healthy as the dominant conception suggests: 1) Music is now bound up with the incorporation of authenticity and creativity into capitalism, and with intensified consumption habits. 2) Emotional self-realisation through music is now linked to status competition. Interviews are analysed

Characteristics of outdoor falls among older people: A qualitative study

Background Falls are a major threat to older people’s health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people’s experiences of outdoor falls to develop understanding of how they may be prevented. Methods We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses. Results Forty-four adults aged 65 – 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week. Conclusions This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people

HIV Services for Mental Health Consumers with Hearing Impairment: Risk Assessment and Prevention Strategies

This paper describes an HIV risk assessment screening for deaf clients with severe mental ilnes at a large psychosocial rehabilitation agency in Chicago, IL. The agency has developed education, prevention, and ongoing support services to respond to the needs of this at-risk population. The results of an HIV risk assessment screening of 39 clients with this dual diagnosis are presented, detailing the numbers and characteristics of clients who report engaging in high risk sexual and drug use behaviors. Reported rates of sexual activity, number of partners, sexually transmitted disease history, intravenous and recreational drug use behaviors, and alcohol use are reported along with knowledge levels about HIV and modes of transmission. Also discussed are issues and concerns relevant to people with mental illness who are deaf, including a summary of an agency HIV education group conducted in sign language