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Do (Even) Depressed Individuals Believe That Life Gets Better and Better? The Link Between Depression and Subjective Trajectories for Life Satisfaction

October 24, 2014 Comments off

Do (Even) Depressed Individuals Believe That Life Gets Better and Better? The Link Between Depression and Subjective Trajectories for Life Satisfaction
Source: Clinical Psychological Science

We investigated the widespread belief that life gets better and better over time—as revealed in individuals’ “subjective trajectories” for life satisfaction (LS) derived from their ratings of recollected past, current, and anticipated future LS—among depressed (i.e., current major depressive disorder, fully remitted, partially remitted) and nondepressed groups using a two-wave longitudinal sample of American adults. Linear and inclining subjective trajectories (past LS < current LS < future LS) were normative among nondepressed individuals, as were nonlinear but inclining subjective trajectories (past LS ~ current LS < future LS) among depressed individuals. Furthermore, Wave 1 temporal-perspective LS ratings uniquely predicted risk of depression 10 years later (Wave 2), even after we controlled for baseline depression status. Thus, the use of a novel temporally expanded perspective revealed that even depressed individuals view their lives as improving over time and that such beliefs predict heightened (rather than less) risk of future depression.

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Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections

October 24, 2014 Comments off

Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections
Source: New England Journal of Medicine

As of September 14, 2014, a total of 4507 confirmed and probable cases of Ebola virus disease (EVD), as well as 2296 deaths from the virus, had been reported from five countries in West Africa — Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. In terms of reported morbidity and mortality, the current epidemic of EVD is far larger than all previous epidemics combined. The true numbers of cases and deaths are certainly higher. There are numerous reports of symptomatic persons evading diagnosis and treatment, of laboratory diagnoses that have not been included in national databases, and of persons with suspected EVD who were buried without a diagnosis having been made

Maternal Clinical Diagnoses and Hospital Variation in the Risk of Cesarean Delivery: Analyses of a National US Hospital Discharge Database

October 23, 2014 Comments off

Maternal Clinical Diagnoses and Hospital Variation in the Risk of Cesarean Delivery: Analyses of a National US Hospital Discharge Database
Source: PLoS Medicine

Background
Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women’s clinical diagnoses.

Methods and Findings
Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project—a 20% sample of US hospitals—we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status.

The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age.

Conclusions
Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight the need for more comprehensive or linked data including parity and gestational age as well as examination of other factors—such as hospital policies, practices, and culture—in determining cesarean section use.

See also: Variation in Caesarean Section Rates in the US: Outliers, Damned Outliers, and Statistics

Posthumously Conceived Children: An International and Human Rights Perspective

October 22, 2014 Comments off

Posthumously Conceived Children: An International and Human Rights Perspective
Source: Journal of Law & Health

This essay considers posthumous conception from an international and child-centered approach. After a sketch in Part I of the phenomenon of posthumous conception and the complexities it evokes, Part II examines the types of issues arising in court cases concerning posthumous conception. Part III considers how courts in their rulings have addressed the welfare and best interests of posthumously conceived children and analyzes the scope and meaning of relevant decisions. Part IV looks into children’s rights or interests raised in those judicial decisions: parental acknowledgement, family structures, identity harm, and inheritance and social benefits. This part draws on the Convention on the Rights of the Child (CRC), a prime instrument to advance children’s rights on the international level, incorporating as much as possible the perspectives of children. I argue that the discourse must include concern for the rights and interests of posthumously conceived children and that a new special category of children who are “outcast” cannot stand the test of equality and non-discrimination, nor of the entrenched principles of child welfare and best interests. Moreover, I suggest that attending to children’s perspectives may illuminate the gaps in the current discourse and what needs to be addressed. Finally, Part V draws some conclusions and calls for a more relational approach to ensure that posthumously conceived children do not pay the price of their parents’ decisions and that their welfare and best interests are upheld.

Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation

October 22, 2014 Comments off

Web-Based Intervention Programs for Depression: A Scoping Review and Evaluation
Source: Journal of Medical Internet Research

Background:
Although depression is known to affect millions of people worldwide, individuals seeking aid from qualified health care professionals are faced with a number of barriers to treatment including a lack of treatment resources, limited number of qualified service providers, stigma associated with diagnosis and treatment, prolonged wait times, cost, and barriers to accessibility such as transportation and clinic locations. The delivery of depression interventions through the Internet may provide a practical solution to addressing some of these barriers.

Objective:
The purpose of this scoping review was to answer the following questions: (1) What Web-delivered programs are currently available that offer an interactive treatment component for depression?, (2) What are the contents, accessibility, and usability of each identified program?, and (3) What tools, supports, and research evidence are available for each identified program?

Methods:
Using the popular search engines Google, Yahoo, and Bing (Canadian platforms), two reviewers independently searched for interactive Web-based interventions targeting the treatment of depression. The Beacon website, an information portal for online health applications, was also consulted. For each identified program, accessibility, usability, tools, support, and research evidence were evaluated and programs were categorized as evidence-based versus non-evidence-based if they had been the subject of at least one randomized controlled trial. Programs were scored using a 28-point rating system, and evidence- versus non-evidence-based programs were compared and contrasted. Although this review included all programs meeting exclusion and inclusion criteria found using the described search method, only English language Web-delivered depression programs were awarded an evaluation score.

Results:
The review identified 32 programs meeting inclusion criteria. There was a great deal of variability among the programs captured in this evaluation. Many of the programs were developed for general adolescent or adult audiences, with few (n=2) focusing on special populations (eg, military personnel, older adults). Cognitive behavioral therapy was the most common therapeutic approach used in the programs described. Program interactive components included mood assessments and supplementary homework sheets such as activity planning and goal setting. Only 12 of the programs had published evidence in support of their efficacy and treatment of depressive symptoms.

Conclusions:
There are a number of interactive depression interventions available through the Internet. Recommendations for future programs, or the adaptation of existing programs include offering a greater selection of alternative languages, removing registration restrictions, free trial periods for programs requiring user fees, and amending programs to meet the needs of special populations (eg, those with cognitive and/or visual impairments). Furthermore, discussion of specific and relevant topics to the target audience while also enhancing overall user control would contribute to a more accessible intervention tool.

How Much (More) Should CEOs Make? A Universal Desire for More Equal Pay

October 22, 2014 Comments off

How Much (More) Should CEOs Make? A Universal Desire for More Equal Pay (PDF)
Source: Perspectives on Psychological Science (forthcoming)

Do people from different countries and different backgrounds have similar preferences for how much more the rich should earn than the poor? Using survey data from 40 countries (N = 55,238), we compare respondents’ estimates of the wages of people in different occupations – chief executive officers, cabinet ministers, and unskilled workers – to their ideals for what those wages should be. We show that ideal pay gaps between skilled and unskilled workers are significantly smaller than estimated pay gaps, and that there is consensus across countries, socioeconomic status, and political beliefs for ideal pay ratios. Moreover, data from 16 countries reveals that people dramatically underestimate actual pay inequality. In the United States – where underestimation was particularly pronounced – the actual pay ratio of CEOs to unskilled workers (354:1) far exceeded the estimated ratio (30:1) which in turn far exceeded the ideal ratio (7:1). In sum, respondents underestimate actual pay gaps, and their ideal pay gaps are even further from reality than those underestimates.

Explaining Extreme Events of 2013 From a Climate Perspective

October 22, 2014 Comments off

Explaining Extreme Events of 2013 From a Climate Perspective (PDF)
Source: Bulletin of the American Meteorological Society

Attribution of extreme events is a challenging science and one that is currently undergoing considerable evolution. In this paper, 20 different research groups explored the causes of 16 different events that occurred in 2013. The findings indicate that human-caused climate change greatly increased the risk for the extreme heat waves assessed in this report. How human influence affected other types of events such as droughts, heavy rain events, and storms was less clear, indicating that natural variability likely played a much larger role in these extremes. Multiple groups chose to look at both the Australian heat waves and the California drought, providing an opportunity to compare and contrast the strengths and weaknesses of various methodologies. There was considerable agreement about the role anthropogenic climate change played in the events between the different assessments. This year three analyses were of severe storms and none found an anthropogenic signal. However, attribution assessments of these types of events pose unique challenges due to the often limited observational record. When human-influence for an event is not identified with the scientific tools available to us today, this means that if there is a human contribution, it cannot be distinguished from natural climate variability.

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