Behavioral Health Risk Assessment and Estimation: Validating an Integrated, Multi-Risk Factor Approach aided by Technology

High rates of behavioral health problems in the U.S. require integrated, multi-dimensional approaches. The study of behavioral health risk assessment and estimation aided by technology has the potential to inform assessment and management of behavioral health problems toward the goal of reducing adverse outcomes. The objective of this study is to inform evidence-based behavioral health risk assessment and estimation. This research examines the U.S. Army Medical Command data within the Behavioral Health Risk Management module (BHRM) to explore behavioral health risk assessment and estimation aided by technology. Analyses are conducted on BHRM data from the records of 30,263 U.S. Army active duty, Guard and Reserve service members assigned to military medical units (U.S. Army Warrior Transition Units) between September 1, 2009 and November 12, 2013. To test risk assessment, responses on the BHRM intake tool (Behavioral Health Risk Assessment-Questionnaire / BHRA-Q) are used to test prevalence, associations, internal reliability and questionnaire’s factor group structure. To examine risk estimation, statistical tests are completed on the prevalence and correlations of risk estimates by the BHRM and clinical providers as well as the predictive properties of demographic variables toward risk estimation. Hypotheses are supported for significant relationships among behavioral health risk variables (r = .40); good fit of the data to the eight-factor group structure of the BHRA-Q (Comparative Fit Index = 0.969; Tucker-Lewis Fit Index = 0.967; Root Mean Square Error of Approximation = .029 [90% Confidence Interval 0.029 - 0.030]); significant correlations among BHRM and provider risk estimates (large or medium effect size of BHRM on provider estimates); and three significant demographic predictors of risk estimation (race, religion and military service component). Internal reliability of BHRA-Q is supported (Cronbach’s α = .897). This study tests data related to an integrated, multi-risk factor behavioral health risk assessment questionnaire (BHRA-Q) and risk estimation aided by technology (BHRM). Findings support behavioral health risk assessment and estimation using evidence-based / informed multi-risk factor assessment, aided by technology, to inform clinical decision making. Although demographic variables are not strong predictors of risk estimation, as grouped and tested, further study is recommended.Social Work, Graduate College o

International Coercion, Emulation and Policy Diffusion: Market-Oriented Infrastructure Reforms, 1977-1999

Why do some countries adopt market-oriented reforms such as deregulation, privatization and liberalization of competition in their infrastructure industries while others do not? Why did the pace of adoption accelerate in the 1990s? Building on neo-institutional theory in sociology, we argue that the domestic adoption of market-oriented reforms is strongly influenced by international pressures of coercion and emulation. We find robust support for these arguments with an event-history analysis of the determinants of reform in the telecommunications and electricity sectors of as many as 205 countries and territories between 1977 and 1999. Our results also suggest that the coercive effect of multilateral lending from the IMF, the World Bank or Regional Development Banks is increasing over time, a finding that is consistent with anecdotal evidence that multilateral organizations have broadened the scope of the “conditionality” terms specifying market-oriented reforms imposed on borrowing countries. We discuss the possibility that, by pressuring countries into policy reform, cross-national coercion and emulation may not produce ideal outcomes.http://deepblue.lib.umich.edu/bitstream/2027.42/40099/3/wp713.pd

Sanctions, Benefits, and Rights: Three Faces of Accountability

As countries throughout the world democratize and decentralize, citizen participation in public life should increase. In this paper, I suggest that democratic participation in local government is enhanced when citizens can reply affirmatively to at least three questions about their ability to hold local officials accountable for their actions: Can citizens use the vote effectively to reward and punish the general or specific performance of local public officials and/or the parties they represent? Can citizens generate response to their collective needs from local governments? Can citizens be ensured of fair and equitable treatment from public agencies at local levels? The findings of a study of 30 randomly selected municipalities in Mexico indicate that, over the course of a decade and a half, voters were able to enforce alternation in power and the circulation of elites, but not necessarily to transmit unambiguous messages to public officials or parties about performance concerns. More definitively, citizens were able to build successfully on prior political experiences to extract benefits from local governments. At the same time, the ability to demand good performance of local government as a right of citizenship lagged behind other forms of accountability

Cis and trans regulatory mechanisms control AP2-mediated B cell receptor endocytosis via select tyrosine-based motifs.

Following antigen recognition, B cell receptor (BCR)-mediated endocytosis is the first step of antigen processing and presentation to CD4+ T cells, a crucial component of the initiation and control of the humoral immune response. Despite this, the molecular mechanism of BCR internalization is poorly understood. Recently, studies of activated B cell-like diffuse large B cell lymphoma (ABC DLBCL) have shown that mutations within the BCR subunit CD79b leads to increased BCR surface expression, suggesting that CD79b may control BCR internalization. Adaptor protein 2 (AP2) is the major mediator of receptor endocytosis via clathrin-coated pits. The BCR contains five putative AP2-binding YxxØ motifs, including four that are present within two immunoreceptor tyrosine-based activation motifs (ITAMs). Using a combination of in vitro and in situ approaches, we establish that the sole mediator of AP2-dependent BCR internalization is the membrane proximal ITAM YxxØ motif in CD79b, which is a major target of mutation in ABC DLBCL. In addition, we establish that BCR internalization can be regulated at a minimum of two different levels: regulation of YxxØ AP2 binding in cis by downstream ITAM-embedded DCSM and QTAT regulatory elements and regulation in trans by the partner cytoplasmic domain of the CD79 heterodimer. Beyond establishing the basic rules governing BCR internalization, these results illustrate an underappreciated role for ITAM residues in controlling clathrin-dependent endocytosis and highlight the complex mechanisms that control the activity of AP2 binding motifs in this receptor system

Physiological Correlates of Volunteering

We review research on physiological correlates of volunteering, a neglected but promising research field. Some of these correlates seem to be causal factors influencing volunteering. Volunteers tend to have better physical health, both self-reported and expert-assessed, better mental health, and perform better on cognitive tasks. Research thus far has rarely examined neurological, neurochemical, hormonal, and genetic correlates of volunteering to any significant extent, especially controlling for other factors as potential confounds. Evolutionary theory and behavioral genetic research suggest the importance of such physiological factors in humans. Basically, many aspects of social relationships and social activities have effects on health (e.g., Newman and Roberts 2013; Uchino 2004), as the widely used biopsychosocial (BPS) model suggests (Institute of Medicine 2001). Studies of formal volunteering (FV), charitable giving, and altruistic behavior suggest that physiological characteristics are related to volunteering, including specific genes (such as oxytocin receptor [OXTR] genes, Arginine vasopressin receptor [AVPR] genes, dopamine D4 receptor [DRD4] genes, and 5-HTTLPR). We recommend that future research on physiological factors be extended to non-Western populations, focusing specifically on volunteering, and differentiating between different forms and types of volunteering and civic participation

Determinants of Collaborative Leadership: Civic Engagement, Gender or Organizational Norms?

This analysis attempts to unravel competing explanations of collaborative leadership styles of state legislative committee chairs. Specifically, the paper considers the influence of community or volunteer experience, gender, and institutional variables. The data show that women chairs are more likely than their male peers to cite as valuable the leadership skills and experiences that they gain through community and volunteer experience. Compared to their male colleagues, women committee chairs on average also report a greater reliance on collaborative strategies in the management of their committees. Prior community or volunteer experience has little or no direct effect on collaborative styles. In contrast, institutional factors have a much stronger and countervailing influence. Legislative professionalization produces a strong negative effect on collaborative style. Results suggest that conformity to institutional norms may be a more compelling influence than prior community experience. The analysis also points to the gendered nature of organizational leadership with men's and women's styles showing different associations to style depending on the number and power of women in a legislature.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead