Promoting Sustainable Responses to the US Opioid Epidemic with Community-Academic Partnerships: Qualitative Outcomes from a Statewide Program.

Background: Drug overdose deaths in the United States have continued to increase at an alarming rateThe United States is facing two devastating public health crises– the opioid epidemic and the COVID-19 pandemic. Within this context, one of the most ambitious implementation studies in addiction research is moving forward. Launched in May 2019, the HEALing Communities Study (HCS) was developed by the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) as part of the Helping to End Addiction Long-termSM Initiative (National Institutes of Health, 2020). The goal for this research was to reduce opioid overdose deaths by 40 % in three years by enhancing and integrating the delivery of multiple evidence-based practices (EBPs) with proven effectiveness in reducing opioid overdose deaths across health care, justice, and community settings. This paper describes the initial vision, goals, and objectives of this initiative; the impact of COVID-19; and the potential for knowledge to be generated from HCS at the intersection of an unrelenting epidemic of opioid misuse and overdoses and the ravishing COVID-19 pandemic.. The Substance Abuse and Mental Health Services Administration distributed more than $7 billion between January 2016 and June 2020 to address the drug overdose crisis. The funds were intended to support evidence-based responses, including medications for opioid use disorder, and other prevention, treatment and recovery activities. Although the SOR grants support much-needed community level interventions, many of the services they support may not be sustainable. Methods: This paper describes a statewide effort to support local entities through SAMHSA’s State Opioid Response (SOR) grants in Virginia. Our investigators conducted detailed needs assessment exercises with community agencies across the state, and collaboratively developed requests for proposals (RFPs) to sustain their SOR programs. We distributed the RFPs to prospective partners at universities across the state, and provided all responsive proposals to local agencies who selected the proposal most likely to meet their needs. Our investigators also conducted an inductive, three-phase content analysis approach to examine the RFPs submitted to the VHEOC to identify nominal categories of support requested of the academic partners. Results: Our investigators received and coded 27 RFPs from ten community agencies representing four of five regions of the state. We identified six nominal categories of academic support with high inter-coder agreement. The six categories of support requested of the academic partners were program development and support, literature review and best practices, outreach and education, data analysis and interpretation, program evaluation, and grant writing assistance. Several RFPs requested up to three categories of support in a single project. Conclusions: Our analysis of the requests received by the consortium identified several categories of academic support for SOR-grantees addressing the drug overdose crisis. The most common requests related to development and maintenance of supportive collaborations, which existing research has demonstrated is necessary for the long-term sustainability of SOR-funded services. In this way, the academic partners served as a source of support for sustainable SOR-funded programs. As the state opioid response program is implemented nationally, we hope that other states will consider similar models in response to the opioid crisis.

Two-Dimensional Index of Departure from the Symmetry Model for Square Contingency Tables with Nominal Categories

In the analysis of two-way contingency tables, the degree of departure from independence is measured using measures of association between row and column variables (e.g., Yule’s coefficients of association and of colligation, Cramér’s coefficient, and Goodman and Kruskal’s coefficient). On the other hand, in the analysis of square contingency tables with the same row and column classifications, we are interested in measuring the degree of departure from symmetry rather than independence. Over past years, many studies have proposed various types of indexes based on their power divergence (or diversity index) to represent the degree of departure from symmetry. This study proposes a two-dimensional index to measure the degree of departure from symmetry in terms of the log odds of each symmetric cell with respect to the main diagonal of the table. By measuring the degree of departure from symmetry in terms of the log odds of each symmetric cell, the analysis results are easier to interpret than existing indexes. Numerical experiments show the utility of the proposed two-dimensional index. We show the usefulness of the proposed two-dimensional index by using real data.

Weighting Schemes and Incomplete Data: A Generalized Bayesian Framework for Chance-Corrected Interrater Agreement

Van Oest (2019) developed a framework to assess interrater agreement for nominal categories and complete data. We generalize this framework to all four situations of nominal or ordinal categories and complete or incomplete data. The mathematical solution yields a chance-corrected agreement coefficient that accommodates any weighting scheme for penalizing rater disagreements and any number of raters and categories. By incorporating Bayesian estimates of the category proportions, the generalized coefficient also captures situations in which raters classify only subsets of items; that is, incomplete data. Furthermore, this coefficient encompasses existing chance-corrected agreement coefficients: the S-coefficient, Scott’s pi, Fleiss’ kappa, and Van Oest’s uniform prior coefficient, all augmented with a weighting scheme and the option of incomplete data. We use simulation to compare these nested coefficients. The uniform prior coefficient tends to perform best, in particular, if one category has a much larger proportion than others. The gap with Scott’s pi and Fleiss’ kappa widens if the weighting scheme becomes more lenient to small disagreements and often if more item classifications are missing; missingness biases play a moderating role. The uniform prior coefficient usually performs much better than the S-coefficient, but the S-coefficient sometimes performs best for small samples, missing data, and lenient weighting schemes. The generalized framework implies a new interpretation of chance-corrected weighted agreement coefficients: These coefficients estimate the probability that both raters in a pair assign an item to its correct category without guessing. Whereas Van Oest showed this interpretation for unweighted agreement, we generalize to weighted agreement.

SUBJECTIVE SOCIAL STATUSES OF THE UKRAINIANS: CHANGES OVER TIME (2009–2019)

The article examines the dynamics of social status self-evaluations of the Ukrainians based on two waves (2009 and 2019) of the Social Inequality module of International Social Survey Programme. Three types of social status self-evaluation in different biographical situations were noted: the current one (at the time of the survey), the retrospective one (of the parents’ family status) and the perspective one (status of oneself in 10 years’ time). They were measured through the respondents’ self-determination of their appropriate status on an imaginary 10-step social ladder. The noticeable changes for the better in the current social status self-evaluations of the Ukrainians are stated, which is visualized in changing the diagram of their distribution from pyramidal shape (where the lower-middle and the lowest positions are the basic ones) to the close to rhombus shape (where the majority is concentrated on the middle levels). The retrospective self-evaluations still demonstrate negative situation: the respondents mostly perceive the social status of parents’ families as higher than their current status. At the same time, the perspective self-evaluations of the Ukrainians are rather optimistic: majority of them hope to significantly increase their own status in the social hierarchy in the next decade. A connection between the class positions (both objectively and subjectively determined) and the status self-evaluations of three kinds was also studied. It is recorded that in both years of the survey this connection remains quite significant and expected in nature. Regarding EGP-classes: representatives of service classes and small owners had significantly higher current, retrospective and prospective self-evaluations than working-class people, primarily unskilled workers and farm labours. Regarding the subjective classes defined by nominal categories (upper middle, middle, lower middle, working, lower class): the higher the subjective class position a person has, the higher he/she evaluates his/her social status.

Measure of departure from cumulative local symmetry for square contingency tables having ordered categories

SummaryFor square contingency tables with nominal categories, a local symmetry model which indicates the symmetric structure of probabilities for only one pair of symmetric cells is proposed. For ordinal square tables, the present paper proposes (1) another local symmetry model for cumulative probabilities from the upper-right and lower-left corners of the table, and (2) a measure to represent the degree of departure from the proposed model. The measure has the form of a weighted harmonic mean of the diversity index, which includes the Shannon entropy as a special case. Examples are given in which the proposed method is applied to square table data on decayed teeth in Japanese women patients.

Revealing Criterial Vagueness in Inconsistencies

Sixty undergraduate students made category membership decisions for each of 132 candidate exemplar-category name pairs (e.g., chess – Sports) in each of two separate sessions. They were frequently inconsistent from one session to the next, both for nominal categories such as Sports and Fish, and ad hoc categories such as Things You Rescue from a Burning House. A mixture model analysis revealed that several of these inconsistencies could be attributed to criterial vagueness: participants adopting different criteria for membership in the two sessions. This finding indicates that categorization is a probabilistic process, whereby the conditions for applying a category label are not invariant. Individuals have various functional meanings of nominal categories at their disposal and entertain competing goals for ad hoc categories.

Separating kindhood from naturalness: Kinds are diverse in causal structure

[UPDATED 3/11/2020] This paper proposes that the richness of a category (i.e., high inductive potential, non-accidental properties, and generalizable causal structure) is conceptually distinct from its being natural or socially constructed. To test this account, we explore beliefs related to the classic distinction between natural kinds and nominal categories. Specifically, we subjected these beliefs, across diverse categories, to exploratory factor analysis (Studies 1 and 2), examined the inferential connections between these beliefs using experimental manipulations of novel categories (Study 3), and tested the discriminant and predictive validity of these beliefs in the context of real-world social categories (Studies 4 and 5). We find consistent support that rich structure (kindhood) is conceptually distinct from that structure being natural or social (naturalness). We argue that ‘psychological essentialism’ is best understood as a circumscribed set of beliefs related to naturalness, and that referring to kindhood as a type of essentialist belief is inaccurate.

The Grammar of Copulas Across Languages

Copular verbs and copular sentences have been for many years a central issue in the theoretical discussions about the nature of (light) verbs and other grammatical categories, the ingredients of predication structures, the properties of nominal categories, agreement, and the interaction between syntax and semantics at the level of clause structure. The current research on copulas has gone beyond the investigation of what kind of objects they are, and has implications for the nature of agreement and other formal processes in syntax and morphology, as well as proposals about the types of structure building operations available in natural languages, the types of features that lexical selection is sensitive to, and the possibility that languages have access to semantically-empty elements required for the satisfaction of purely formal properties. The twelve works included in this volume illustrate the state of the art of these discussions through the analysis of detailed patterns of data from a variety of languages.