Beyond the RCT: Integrating Rigor and Relevance to Evaluate the Outcomes of Domestic Violence Programs

Programs for domestic violence (DV) victims and their families have grown exponentially over the last four decades. The evidence demonstrating the extent of their effectiveness, however, often has been criticized as stemming from studies lacking scientific rigor. A core reason for this critique is the widespread belief that credible evidence can derive only from research grounded in randomized control trials (RCTs). Although the RCT method has its strengths, we argue that it is rarely an optimal—or even a possible—approach for evaluating multifaceted DV programs. This article reviews the reasons that RCT is a poor fit for such programs and argues that a more inclusive conceptualization of credible evidence is critical to expanding our knowledge base about how DV programs affect survivors’ safety and well-being

Chronic Disease Data And Analysis: Current State Of the Field

Chronic disease usually spans years of a person’s lifetime and includes a disease free period, a preclinical, or latent period, where there are few overt signs of disease, a clinical period where the disease manifests and is eventually diagnosed, and a follow-up period where the disease might progress steadily or remain stable. It is often of interest to investigate the relationship between risk factors measured at a point in time (usually during the disease free or preclinical period), and the development of disease at some future point (e.g., 10 years later). We outline some popular designs for the identification of subjects and discuss issues in measurement of risk factors for analysis of chronic disease. We discuss some of the complexities in these analyses, including the time dependent nature of the risk factors and missing data issues. We then describe some popular statistical modeling techniques and outline the situations in which each is appropriate. We conclude with some speculation toward future development in the area of chronic disease data and analysis

Using Animal Models to Disentangle the Role of Genetic, Epigenetic, and Environmental Influences on Behavioral Outcomes Associated with Maternal Anxiety and Depression

The etiology of complex psychiatric disorders results from both genetics and the environment. No definitive environmental factor has been implicated, but studies suggest that deficits in maternal care and bonding may be an important contributing factor in the development of anxiety and depression. Perinatal mood disorders such as postpartum depression occur in approximately 10% of pregnant women and can result in detriments in infant care and bonding. The consequences of impaired maternal–infant attachment during critical early brain development may lead to adverse effects on socioemotional and neurocognitive development in infants resulting in long-term behavioral and emotional problems, including increased vulnerability for mental illness. The exact mechanisms by which environmental stressors such as poor maternal care increase the risk for psychiatric disorders are not known and studies in humans have proven challenging. Two inbred mouse strains may prove useful for studying the interaction between maternal care and mood disorders. BALB/c (BALB) mice are considered an anxious strain in comparison to C57BL/6 (B6) mice in behavioral models of anxiety. These strain differences are most often attributed to genetics but may also be due to environment and gene by environment interactions. For example, BALB mice are described as poor mothers and B6 mice as good mothers and mothering behavior in rodents has been reported to affect both anxiety and stress behaviors in offspring. Changes in gene methylation patterns in response to maternal care have also been reported, providing evidence for epigenetic mechanisms. Characterization of these two mouse inbred strains over the course of pregnancy and in the postpartum period for behavioral and neuroendocrine changes may provide useful information by which to inform human studies, leading to advances in our understanding of the etiology of anxiety and depression and the role of genetics and the environment

Joint Attention in Preschool Children: Is it a Meaningful Measure?

Abstract The goal of this study was to evaluate the degree to which measuring joint attention an aspect of social attention, is meaningful for the learning and development of preschool children. Joint attention refers to the executive capacity to coordinate visual attention with another person. This pivotal skill begins to develop from 6 to 18 months of age and continues to be refined and coordinated throughout individual developmental trajectories. In this study joint attention was measured in forty-three 4 to 5-year-olds asked to coordinate their attention with that of an unfamiliar adult during a social attention word learning task. The results revealed that there were individual differences in joint attention for children in this age group which suggests that this may be a meaningful construct to measure. These data contribute to a small but growing literature on the potential utility of joint attention theory and measurement in preschool aged children to further our understanding of social attention coordination in classroom contexts

Using the Kaleidoscope Career Model to Examine Generational Differences in Work Attitudes

The purpose of this paper is to examine, utilising the Kaleidoscope Career Model, whether members of the Baby Boom generation and Generation X differ in their needs for authenticity, balance, and challenge. This paper won the 2009 McGraw Hill Irwin Distinguished Paper Award at the Southwestern Academy of Management

Plasma Leptin Levels and Incidence of Heart Failure, Cardiovascular Disease, and Total Mortality in Elderly Individuals

OBJECTIVE: Obesity predisposes individuals to congestive heart failure (CHF) and cardiovascular disease (CVD). Leptin regulates energy homeostasis, is elevated in obesity, and influences ventricular and vascular remodeling. We tested the hypothesis that leptin levels are associated with greater risk of CHF, CVD, and mortality in elderly individuals. RESEARCH DESIGN AND METHODS: We evaluated 818 elderly (mean age 79 years, 62% women) Framingham Study participants attending a routine examination at which plasma leptin was assayed. RESULTS: Leptin levels were higher in women and strongly correlated with BMI (P < 0.0001). On follow-up (mean 8.0 years), 129 (of 775 free of CHF) participants developed CHF, 187 (of 532 free of CVD) experienced a first CVD event, and 391 individuals died. In multivariable Cox regression models adjusting for established risk factors, log-leptin was positively associated with incidence of CHF and CVD (hazard ratio [HR] per SD increment 1.26 [95% CI 1.03–1.55] and 1.28 [1.09–1.50], respectively). Additional adjustment for BMI nullified the association with CHF (0.97 [0.75–1.24]) but only modestly attenuated the relation to CVD incidence (1.23 [1.00–1.51], P = 0.052). We observed a nonlinear, U-shaped relation between log-leptin and mortality (P = 0.005 for quadratic term) with greater risk of death evident at both low and high leptin levels. CONCLUSIONS: In our moderate-sized community-based elderly sample, higher circulating leptin levels were associated with a greater risk of CHF and CVD, but leptin did not provide incremental prognostic information beyond BMI. Additional investigations are warranted to elucidate the U-shaped relation of leptin to mortality.National Institutes of Health's National Heart, Lung, and Blood Institute (N01-HC25195, N01-HV28178, K24-HL04334, R01-DK080739

Serum Cholesterol and Cognitive Performance in the Framingham Heart Study

Objective: The objective of this study was to examine the relationship between total cholesterol (TC) and cognitive performance within the context of the Framingham Heart Study, a large, community-based, prospective investigation of cardiovascular risk factors. Methods: Participants were 789 men and 1105 women from the Framingham Heart Study original cohort who were free of dementia and stroke and who received biennial TC determinations over a 16- to 18-year surveillance period. Cognitive tests were administered 4 to 6 years subsequent to the surveillance period and consisted of measures of learning, memory, attention/ concentration, abstract reasoning, concept formation, and organizational abilities. Statistical models were adjusted for multiple demographic and biological covariates. Results: There was a significant positive linear association between TC and measures of verbal fluency, attention/concentration, abstract reasoning, and a composite score measuring multiple cognitive domains. Performance levels for three clinically defined groups were examined. Participants with “desirable” TC levels (/dL) performed less well than participants with borderline-high TC levels (200–239 mg/dL) and participants with high TC levels (∃240 mg/dL). Conclusions: Lower naturally occurring TC levels are associated with poorer performance on cognitive measures, which place high demands on abstract reasoning, attention/concentration, word fluency, and executive functioning

Imaging Sources with Fast and Slow Emission Components

We investigate two-proton correlation functions for reactions in which fast dynamical and slow evaporative proton emission are both present. In such cases, the width of the correlation peak provides the most reliable information about the source size of the fast dynamical component. The maximum of the correlation function is sensitive to the relative yields from the slow and fast emission components. Numerically inverting the correlation function allows one to accurately disentangle fast dynamical from slow evaporative emission and extract details of the shape of the two-proton source.Comment: 13 pages, 4 figure