Survival models of community tenure and length of hospital stay for the seriously mentally ill : a 10-year perspective

Objective: To examine the effects of personal and community characteristics, specifically race and rurality, on lengths of state psychiatric hospital and community stays using maximum likelihood survival analysis with a special emphasis on change over a ten year period of time. Data Sources: We used the administrative data of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) from 1982-1991 and the Area Resources File (ARF). Given these two sources, we constructed a history file for each individual who entered the state psychiatric system over the ten year period. Histories included demographic, treatment, and community characteristics. Study Design: We used a longitudinal, population-based design with maximum likelihood estimation of survival models. We presented a random effects model with unobserved heterogeneity that was independent of observed covariates. The key dependent variables were lengths of inpatient stay and subsequent length of community stay. Explanatory variables measured personal, diagnostic, and community characteristics, as well as controls for calendar time. Data Collection: This study used secondary, administrative, and health planning data. Principal Findings: African-American clients leave the community more quickly than whites. After controlling for other characteristics, however, race does not affect hospital length of stay. Rurality does not affect length of community stays once other personal and community characteristics are controlled for. However, people from rural areas have longer hospital stays even after controlling for personal and community characteristics. The effects of time are significantly smaller than expected. Diagnostic composition effects and a decrease in the rate of first inpatient admissions explain part of this reduced impact of time. We also find strong evidence for the existence of unobserved heterogeneity in both types of stays and adjust for this in our final models. Conclusions: Our results show that information on client characteristics available from inpatient stay records is useful in predicting not only the length of inpatient stay but also the length of the subsequent community stay. This information can be used to target increased discharge planning for those at risk of more rapid readmission to inpatient care. Correlation across observed and unobserved factors affecting length of stay has significant effects on the measurement of relationships between individual factors and lengths of stay. Thus, it is important to control for both observed and unobserved factors in estimation.

The effects of rurality on mental and physical health

The effects of rurality on physical and mental health are examined in analyses of a national dataset, the Community Tracking Survey, 2000-2001, that includes individual level observations from household interviews. We merge it with county level data reflecting community resources and use econometric methods to analyze this multi-level data. The statistical analysis of the impact of the choice of definition on outcomes and on the estimates and significance of explanatory variables in the model is presented using modern econometric methods, and differences in results for mental health and physical health are evaluated. © 2010 Springer Science+Business Media, LLC.

Curriculum, Syllabus Design and Equity : A Primer and Model

Curriculum scholars and teachers working for social justice and equity have been caught up in acrimonious and polarizing debates over content, ideology and disciplinary knowledge. At the forefront in cutting through these debates and addressing the practical questions involved, this book is distinctive in looking to the technical form of the curriculum rather than its content for solutions. The editors and contributors, all leading international scholars, advance a unified, principled approach to the design of syllabus documents that aims for high quality/high equity educational outcomes and enhances teacher professionalism.

Activation of toxic chemicals by cytochrome P450 enzymes : regio- and stereoselective oxidation of aflatoxin B1

Cytochrome P450 (P450) enzymes are involved in the oxidations of numerous steroids, eicosanoids, alkaloids, and other endogenous substrates. These enzymes are also the major ones involved in the oxidation of potential toxicants and carcinogens such as those encountered among pollutants, solvents, and pesticides, as well as many natural products. A proper understanding of the basic mechanisms by which the P450 enzymes oxidize such compounds is important in developing rational strategies for the evaluation of the risks of these compounds.

Numerical simulation of anomalous infiltration in porous media

Nonlinear time-fractional diffusion equations have been used to describe the liquid infiltration for both subdiffusion and superdiffusion in porous media. In this paper, some problems of anomalous infiltration with a variable-order timefractional derivative in porous media are considered. The time-fractional Boussinesq equation is also considered. Two computationally efficient implicit numerical schemes for the diffusion and wave-diffusion equations are proposed. Numerical examples are provided to show that the numerical methods are computationally efficient.

Induction of a Th1 immune response and suppression of IgE via immunotherapy with a recombinant hybrid molecule encapsulated in liposome-protamine-DNA nanoparticles in a model of experimental allergy

Liposome-protamine-DNA nanoparticles (LPD) are safe, effective, and non-toxic adjuvants that induce Th1-like immune responses. We hypothesized that encapsulation of allergens into liposomes could be an appropriate option for immunotherapy. The present study evaluated the immunotherapeutic potential of a recombinant hybrid molecule (rHM) encapsulated in LPD nanoparticles in a murine model of Chenopodium album allergy. BALB/c mice were sensitized with the allergen in alum, and the immunotherapy procedure was performed by subcutaneous injections of LPD-rHM, rHM, or empty LPD at weekly intervals. Sensitized mice developed a Th2-biased immune response characterized by strong specific IgG1 and IgE production, IL-4, and the transcription factor GATA3 in spleen cell cultures. Treatment with the LPD-rHM resulted in a reduction in IgE and a marked increase in IgG2a. The LPD-rHM induced allergen-specific responses with relatively high interferon-gamma production, as well as expression of the transcription factor T-bet in stimulated splenocytes. In addition, lymphoproliferative responses were higher in the LPD-rHM-treated mice than in the other groups. Removal of the nanoparticles from the rHM resulted in a decrease in the allergen's immunogenicity. These results indicate that the rHM complexed with LPD nanoparticles has a marked suppressive effect on the allergic response and caused a shift toward a Th1 pathway.

The modern day bystander: Online and face-to-face bystander actions of adolescents in traditional bullying and cyberbullying

This study investigated whether bystanders of traditional bullying and cyberbullying used face-to-face methods, online methods or both methods when reporting, discouraging and providing support to the victims of traditional bullying and cyberbullying. A questionnaire was completed by 348 high school students (Years 7 – 12) from seven independent schools in Australia. Overall, students predominantly utilized face-to-face methods when reporting to others for both types of bullying. Older students were more likely to use online methods to discourage the traditional bully (i.e., asking the bully to stop). Males and older students were more likely to use online methods to support victims of traditional bullying. Females were more likely to use face-to-face methods to support victims of cyberbullying. Implications for practice and future research are discussed.

Leading Beautifully : Educational Leadership as Connoisseurship

Leading Beautifully provides a new dimension to understanding effective leadership. Drawing from lessons in the arts and the humanities, English and Ehrich explore how educational decision-making in schools can be informed by identity, personal competence, and an understanding of the field's intellectual foundations. Based on in-depth interviews of artists and educational leaders, this book provides insight into the inner world of successful leaders who have developed competencies and understandings that extend beyond the standard leadership tool box. This exciting new book explores the theory and practice of leadership connoisseurship as a human-centered endeavor and as an antidote to mechanistic, business-oriented practices. The authors' well-grounded reconsideration of educational leadership will enliven and enhance any educational leader's practice.

Literacy, Place and Pedagogies of Possibility

How can teachers ensure a pedagogy of possibility underpinned by social justice, and what has literacy got to do with this? This book explores the positive synergies between critical literacy and place-conscious pedagogy. Through rich classroom research it introduces and demonstrates how a synthesis of insights from theories of space and place and literacy studies can underpin the design and enactment of culturally inclusive curriculum for diverse student communities, and illustrates how making place and space the objects of study provide productive resources for teachers to design enabling pedagogical practices that extend students' literate repertoires. The argument is that systematic study of and engagement with specific elements of place can enable students' academic learning and literacy.

Experimental investigation on lateral impact response of concrete-filled double-skin tube columns using horizontal-impact-testing system

This paper presents an experimental investigation on the lateral impact performance of axially loaded concrete-filled double-skin tube (CFDST) columns. These columns have desirable structural and constructional properties and have been used as columns in building, legs of off shore platforms and as bridge piers. Since they could be vulnerable to impact from passing vessels or vehicles, it is necessary to understand their behaviour under lateral impact loads. With this in mind, an experimental method employing an innovative instrumented horizontal impact testing system (HITS) was developed to apply lateral impact loads whilst the column maintained a static axial pre-loading to examine the failure mechanism and key response parameters of the column. These included the time histories of impact force, reaction forces, global lateral deflection and permanent local buckling profile. Eight full scale columns were tested for key parameters including the axial load level and impact location. Based on the test data, the failure mode, peak impact force, impact duration, peak reaction forces, reaction force duration, column maximum and residual global deflections and column local buckling length, depth and width under varying conditions are analysed and discussed. It is evident that the innovative HITS can successfully test structural columns under the combination of axial pre-loading and impact loading. The findings on the lateral impact response of the CFDST columns can serve as a benchmark reference for their future analysis and design.

New York Railroads, 1857 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Map of the rail-roads of the state of New York, prepared under the direction of Silas Seymour, state engineer surveyor ; drawn by David Vaughn. It was published by C. Van Benthuysen in 1857. Scale [ca. 1:1,000,000]. Covers New York and portions of surrounding states and provinces. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Universal Transverse Mercator (UTM) Zone 18N NAD83 projection. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as roads, railroads (completed and proposed), canals, drainage, selected cities and towns, county and state boundaries, and more. Relief is shown by hachures. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

Manhattan, New York, N.Y., 1877 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Map of New York City, south of 46th St. : showing new arrangement of docks, piers, and water frontage, also soundings and former high water line .... It was published by Matthew Dripps in 1877. Scale [1:7,200]. Covers southern portion of Manhattan. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Universal Transverse Mercator (UTM) Zone 18N NAD83 projection. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as streets (with block numbers), railroads, drainage, selected public buildings (police stations, churches, theaters, schools, hotels, industries, etc.), wharves, parks, city wards, the former high water line, and more. Includes text: Key to r.r. routes, sub post offices, police stations, and street directory; and inset: New York in 1778. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

Adirondack Mountains Region, New York, 1883 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Map of the Adirondack wilderness, compiled by S.R. Stoddard. 4th rev. ed. It was published by S.R. Stoddard in 1883. Scale [ca. 1:255,000]. Covers the Adirondack Mountains Region, New York, including portions of St. Lawrence, Franklin, Clinton, Lewis, Herkimer, Hamilton, Essex, Warren, and Saratoga Counties. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Universal Transverse Mercator (UTM) Zone 18N NAD83 projection. All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as natural features, drainage, railroads, important roads, ordinary roads, carries and trails, and township and county boundaries, and more. "Distances are given in Figures on Roads and Trails. Air-Line Distances from Mount Marcy are indicated by Circles, 10 miles apart." Relief is shown by hachures and spot heights. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.