scholarly journals Early Childhood Education and Adult Depression: An Attrition Reanalysis With Inverse Propensity Score Weighting

2020 ◽  
pp. 0193841X2097652
Author(s):  
Christina F. Mondi ◽  
Arthur J. Reynolds ◽  
Brandt A. Richardson
Keyword(s):  
Early Childhood ◽  
Depressive Symptoms ◽  
Comparison Group ◽  
Practical Significance ◽  
Point Estimate ◽  
Marginal Effect ◽  
Alternative Analysis ◽  
Point Reduction ◽  
Program Selection ◽  
Matched Comparison

In a previous study of the Child-Parent Centers (CPC) education program, preschool participation was linked to a 4.6 percentage point reduction (26%) in depressive symptoms at ages 22–24 over the matched comparison group enrolling the usual programs. The present study reanalyzed these data in the Chicago Longitudinal Study to address potential attrition bias since more than a quarter of the sample was missing on the outcome. Using inverse probability weighting (IPW) involving 32 predictors of sample retention, findings for the 1,142 participants growing up in high-poverty neighborhoods indicated that CPC participation was associated with a 7.1 percentage point reduction (95% CI = [−9.7, −5.4]) in one or more depressive symptoms (39% reduction over the comparison group). Although this marginal effect was within the confidence interval of the original study (95% CI = [−9.5, 0.3]), the 54% increase in the point estimate is substantial and of practical significance, suggesting underestimation in the prior study. Alternative analysis of different predictors and IPW models, including adjustments for program selection and attrition together, yielded similar results. Findings indicate that high-quality early childhood programs continue to be an important strategy for the prevention of depression and its debilitating effects on individuals and families.

scholarly journals Cost-Effective Care Coordination for People With Dementia at Home

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Amber Willink ◽  
Karen Davis ◽  
Deirdre M Johnston ◽  
Betty Black ◽  
Melissa Reuland ◽  
...  
Keyword(s):  
Community Health ◽  
Care Coordination ◽  
Care Management ◽  
Comparison Group ◽  
Health Workers ◽  
Cost Effective ◽  
People With Dementia ◽  
Home Intervention ◽  
Matched Comparison ◽  
At Home

Abstract Background and Objectives People with dementia (PWD) represent some of the highest-need and highest-cost individuals living in the community. Maximizing Independence (MIND) at Home is a potentially cost-effective and scalable home-based dementia care coordination program that uses trained, nonclinical community workers as the primary contact between the PWD and their care partner, supported by a multidisciplinary clinical team with expertise in dementia care. Research Design and Methods Cost of care management services based on actual time spent by care management personnel over first 12 months of MIND at Home intervention was calculated for 342 MIND at Home recipients from Baltimore, Maryland and surrounding areas participating in a Centers for Medicare and Medicaid Services (CMS) funded Health Care Innovation Award demonstration project. Difference-in-differences analysis of claims-based Medicaid spending of 120 dually-eligible MIND at Home participants with their propensity score matched comparison group (n = 360). Results The average cost per enrollee per month was $110, or $1,320 per annum. Medicaid expenditures of dually-eligible participants grew 1.12 percentage points per quarter more slowly than that of the matched comparison group. Most savings came from slower growth in inpatient and long-term nursing home use. Net of the cost of the 5-year MIND at Home intervention, 5-year Medicaid savings are estimated at $7,052 per beneficiary, a 1.12-fold return on investment. Discussion and Implications Managed care plans with the flexibility to engage community health workers could benefit from a low-cost, high-touch intervention to meet the needs of enrollees with dementia. Limitations for using and reimbursing community health workers exist in Medicare fee-for-service, which CMS should address to maximize benefit for PWD.

The role of dissociation and abuse among adolescents who self-harm

2019 ◽  
Vol 53 (10) ◽  
pp. 989-999 ◽  
Author(s):  
Carlos Hoyos ◽  
Vincent Mancini ◽  
Yulia Furlong ◽  
Nick Medford ◽  
Hugo Critchley ◽  
...  
Keyword(s):  
Childhood Abuse ◽  
Comparison Group ◽  
Psychiatric Patients ◽  
Later Life ◽  
Structured Interviews ◽  
Emergency Presentation ◽  
Self Harm ◽  
And Gender ◽  
Matched Comparison

Objectives: Retrospective recall of dissociative symptoms has been found to mediate the association between childhood abuse and deliberate self-harm (DSH) in later life. To disentangle the effect of recall bias, we tested whether dissociation symptoms ascertained during an acute DSH presentation mediates this link. Method: All participants with DSH were recruited during emergency presentation. Seventy-one individuals aged 11–17 years with overdose (OD) and/or self-injury (SI) participated in semi-structured interviews and psychiatric assessment to measure abuse and dissociation. An age- and gender-matched comparison group of 42 non-psychiatric patients admitted to the same service were also assessed. Results: The DSH groups reported significantly higher levels of abuse and dissociation compared to comparison group. Dissociation significantly mediated the association between abuse and DSH. Of the four dissociation subtypes, ‘depersonalisation’ was the primary mediator. Adolescents with chronic patterns of DSH and the ‘OD + SI’ self-harm type reported more severe dissociation. Conclusion: Exposure to abuse significantly increased the risk of DSH in adolescence. This association was mediated by dissociation. Our findings suggest a possible dose–response relationship between dissociation with DSH chronicity and the ‘OD + SI’ self-harm type, implicating the importance of evaluating dissociation and depersonalisation symptoms as well as abuse exposure in DSH management.

Trajectories of maternal depressive symptoms in the early childhood period and family-wide clustering of risk

2017 ◽  
Vol 215 ◽  
pp. 49-55 ◽  
Author(s):  
Sheri Madigan ◽  
Mark Wade ◽  
André Plamondon ◽  
Jennifer M. Jenkins
Keyword(s):  
Early Childhood ◽  
Depressive Symptoms ◽  
Maternal Depressive Symptoms

Developmental trajectories of depressive symptoms from early childhood to late adolescence: gender differences and adult outcome

2007 ◽  
Vol 48 (7) ◽  
pp. 657-666 ◽  
Author(s):  
Marielle C. Dekker ◽  
Robert F. Ferdinand ◽  
Natasja D.J. van Lang ◽  
Ilja L. Bongers ◽  
Jan van der Ende ◽  
...  
Keyword(s):  
Gender Differences ◽  
Early Childhood ◽  
Depressive Symptoms ◽  
Developmental Trajectories ◽  
Late Adolescence ◽  
Adult Outcome

scholarly journals Passive Ankle Stiffness in Subjects With Diabetes and Peripheral Neuropathy Versus an Age-Matched Comparison Group

2000 ◽  
Vol 80 (4) ◽  
pp. 352-362 ◽  
Author(s):  
Gretchen B Salsich ◽  
Michael J Mueller ◽  
Shirley A Sahrmann
Keyword(s):  
Peripheral Neuropathy ◽  
Range Of Motion ◽  
Comparison Group ◽  
Plantar Flexor ◽  
Initial Angle ◽  
Flexor Muscle ◽  
Ankle Stiffness ◽  
Torque Curve ◽  
Muscle Excursion ◽  
Matched Comparison

Abstract Background and Purpose. Patients with diabetes mellitus and peripheral neuropathy (DM and PN) often complain of joint stiffness. Although stiffness may contribute to some of the impairments and functional limitations found in these patients, it has not been quantified in this population. The purpose of this study was to quantify and compare passive ankle stiffness and dorsiflexion (DF) range of motion in subjects with DM and PN versus an age-matched comparison group. Subjects. Thirty-four subjects were tested (17 subjects with DM and PN and 17 subjects in an age-matched comparison group). There were 10 male subjects and 7 female subjects in each group. Methods. A Kin-Com dynamometer was used to measure passive plantar flexor torque as each subject's ankle was moved from plantar flexion into dorsiflexion at 60°/s. The following variables were compared using a Student t test: initial angle (angle of onset of plantar flexor torque), maximal dorsiflexion angle, plantar flexor muscle excursion (difference between initial angle and maximal dorsiflexion angle), slope of the first half of the plantar flexor torque curve (stiffness 1 measurement), and slope of the second half of the plantar flexor torque curve (stiffness 2 measurement). Results. The subjects with DM and PN group had smaller maximal dorsiflexion angles and less plantar flexor muscle excursion than the comparison group. There was no difference in initial angle, stiffness 1 measurement, or stiffness 2 measurement. Conclusion and Discussion. Although the subjects with DM and PN had less dorsiflexion range of motion than did the comparison group, there was no difference in stiffness between the groups. This finding suggests that people with DM and PN have “short” versus “stiff” plantar flexor muscles.

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