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Objective: The co-occurrence of anxiety disorders, depressive disorders, and substance use problems was examined. Methods: The Mental Health Client-Level Data dataset was used to conduct logistic regression models and an artificial neural network analysis. Logistic regression analyses were conducted among adults with anxiety (n = 547,473) or depressive disorders (n = 1,610,601) as their primary diagnosis who received treatment in a community mental health center. The artificial neural network analysis was conducted with the entire sample (N = 2,158,074). Results: Approximately 30% of the sample had co-occurring high-risk substance use or substance use disorder. Characteristics including region of treatment receipt, age, education, gender, race and ethnicity, and the presence of co-occurring anxiety and depressive disorders were associated with the co-occurring high-risk substance use or a substance use disorder. Conclusions: Findings from this study highlight the importance of mental health facilities to screen for and provide integrated treatment for co-occurring disorders.
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In modern science, interdisciplinary and collaborative research is encouraged among scientists to solve complex problems. However, when the time comes to measure an individual's academic productivity, collaborative efforts are hard to conceptualize and quantify. In this study, we hypothesized that a social behavior coined "scientific civility", which encompasses civility, collaboration, cooperation, or a combination of these, enhances an individual's productivity influencing their academic performance. To facilitate recognition of this unique attribute within the scientific environment, we developed a new indicator: the C score. We examined publicly available data from 1000 academic scientists at the individual-level, focusing on their scholarly output and collaborative networks as a function of geographic distribution and time. Our findings strongly suggest that the C score gauges academic performance from an integral perspective based on a synergistic interaction between productivity and collaborative networks, prevailing over institutionally limited economic resources and minimizing inequalities related to the length of individual's academic career, field of investigation, and gender.
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OBJECTIVES: Since incivility is linked to adverse effects in patient care and health care worker well-being, evaluation of the prevalence of incivility during the formative years of residency training is warranted. The aim of this study was to determine the perceived presence and degree of incivility between emergency medicine (EM) and ophthalmology residents during emergency department (ED) consultations. METHODS: We conducted a single-site, survey-based study, targeted to ophthalmology and EM residents. The survey we distributed included questions adapted from validated and widely used surveys measuring incivility in the workplace (Workplace Incivility Scale) and incivility within the ED. RESULTS: Ophthalmology (13/15, 86.7%) and EM (42/48, 87.5%) residents participated, with an overall response rate of 55 of 63 (87.3%). Most residents (47/55, 85.5%) reported some degree of incivility during consultations, with a greater proportion of females reporting incivility (100%) than males (77.4%, p = 0.033). A total of 52.7% of respondents reported occurrence of incivility on a quarterly basis; 21.8% reported monthly, 10.9% weekly, and none daily. Incivilities were reported most commonly during nonurgent consults (85.5%). The two most common incivilities reported by trainees were when the other party paid little attention to their statements or opinions (80% of residents) or doubted their professional judgment (74.5% of residents). More female trainees reported jokes being told at their expense compared to males (15.8% vs. 0%, p = 0.049). Residents most often attributed incivility to stress (78.2%), loss of empathy/burnout (63.6%), or attempts to shift responsibility to another party (60.0%). Among EM residents surveyed, incivility was identified as occurring most often during consultations with surgical specialties. CONCLUSIONS: Incivility during interdepartmental consultations between EM and ophthalmology is commonly reported by physicians-in-training. It occurs more often during consultations deemed as nonurgent and is more commonly reported by females. Given its associations with adverse outcomes, interventions to decrease incivility early in training may be warranted.
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Three brief psychotherapy outcome measures were assessed for equivalence. The Rating of Outcome Scale (ROS), a 3-item patient-reported outcome measure, was evaluated for interitem consistency, test-retest reliability, discriminant validity, repeatability, sensitivity to change, and agreement with the Outcome Rating Scale (ORS) and Outcome Questionnaire (OQ) in 1 clinical sample and 3 community samples. Clinical cutoffs, reliable change indices, and Bland-Altman repeatability coefficients were calculated. Week-to-week change on each instrument was compared via repeated-measures-corrected effect size. Community-normed T scores and Bland-Altman plots were generated to aid comparisons between instruments. The ROS showed good psychometric properties, sensitivity to change in treatment, and discrimination between outpatients and nonpatients. Agreement between the ROS and ORS was good, but neither the agreement between these nor that between ultrabrief instruments and the OQ were as good as correlations might suggest. The ROS showed incremental advantages over the ORS: improvements in concordance with the OQ, better absolute reliability, and less oversensitivity to change. The ROS had high patient acceptance and usability, and scores showed good reliability, cross-instrument validity, and responsiveness to change for the routine monitoring of clinical outcomes. (PsycINFO Database Record
