A Cost Analysis of a Validated Screening Tool for Pediatric Abusive Head Trauma

Doctors who treat young victims of trauma are required to make important decisions to launch or forgo child abuse evaluations in their acutely head-injured patients. To improve the accuracy of these decisions, Pediatric Brain Injury Research Network (PediBIRN) investigators derived and validated a 4-variable clinical prediction rule (CPR) that improves the detection of abusive head trauma (AHT) in pediatric intensive care units. Our objective was to estimate and compare medical costs from the health system perspective of AHT screening guided by the CPR vs. screening as usual (SAU). Cost estimates for child abuse evaluations, emergency department (ED)/pediatrician visits, and hospital admissions for AHT were combined with published data on service use and re-injury rates in children with missed or unrecognized AHT. Applying published estimates of the CPR’s potential screening performance, the cost per correctly identified child with AHT was calculated and compared for AHT screening guided by the CPR vs. SAU, and the potential medical cost savings associated with CPR application was estimated. Applied accurately and consistently, the CPR could reduce the cost per correctly identified child with AHT by 15.1%, and reduce health system costs resulting from missed AHT by 72.4%.     

Leader autonomy support in the workplace: A meta-analytic review

Leader autonomy support (LAS) refers to a cluster of supervisory behaviors that are theorized to facilitate self-determined motivation in employees, potentially enabling well-being and performance. We report the results of a meta-analysis of perceived LAS in work settings, drawing from a database of 754 correlations across 72 studies (83 unique samples, N?=?32,870). Results showed LAS correlated strongly and positively with autonomous work motivation, and was unrelated to controlled work motivation. Correlations became increasingly positive with the more internalized forms of work motivation described by self-determination theory. LAS was positively associated with basic needs, well-being, and positive work behaviors, and was negatively associated with distress. Correlations were not moderated by the source of LAS, country of the sample, publication status, or the operationalization of autonomy support. In addition, a meta-analytic path analysis supported motivational processes that underlie LAS and its consequences in workplaces. Overall, our findings lend support for autonomy support as a leadership approach that is consistent with self-determination and optimal functioning in work settings.     

A biopsychosocial model for depressive symptoms following acute coronary syndromes

A partial latent structural regression analysis was used to evaluate the influence of perceived stress and coping resources on depression following acute coronary syndromes (ACS) in a sample of 113 participants (25 females and 88 males with a mean age of 57.61 years (SD = 12.63). Out of them, 55 participants were Australian born and 48 were born elsewhere, with 53 of the patients scoring in the mild to high depression range on the Beck Depression Inventory and the Cardiac Depression Scale. Perceived stress and coping resources, after controlling for age and smoking explained 89% of the variance in the latent variable depression. Higher perceived stress levels and fewer coping resources predicted higher levels of depression. Higher levels of perceived stress predicted fewer coping resources and fewer coping resources predicted higher levels of depression. There was a significant direct and indirect effect of perceived stress through coping on depression. Cognitive and physical coping resources were the best predictors of the depression construct. These results have potential implications for the treatment of depression post-ACS. In particular, cognitive and physical coping mechanisms and perceived stress reduction need to be addressed when treating depression post-ACS.     

Assessment of Occupational Burnout in United States Air Force Predator/Reaper “Drone” Operators

This study investigates the self-reported levels of occupational burnout among 1,094 U.S. Air Force drone operators stationed within the borders of the United States who are supporting a wide range of around-the-clock military surveillance and weapons strike missions across the globe. Data were gathered from a Web-based survey of demographic items and the Maslach Burnout Inventory assessing the facets of occupational burnout (exhaustion, cynicism, and professional efficacy). The overall survey response rate was 49%. Approximately 20% reported high levels of exhaustion, and 11% reported high levels of cynicism, but only 3% reported low levels of professional efficacy. Predictors of exhaustion, as well as between group differences, were identified along with recommendations for performance improvement and mitigating risks to safety.     

Disparities in the moral intuitions of criminal offenders: The role of psychopathy

The present study examined whether and in what ways psychopathy is associated with abnormal moral intuitions among criminal offenders. Using Haidt et al.’s Moral Foundations Questionnaire, 222 adult male offenders assessed for clinical psychopathy reported their degree of support for five moral domains: Harm Prevention, Fairness, Respect for Authority, Ingroup Loyalty, and Purity/Sanctity. As predicted, psychopathy total score explained a substantial proportion of the variance in reduced support for Harm Prevention and Fairness, but not the other domains. These results confirm that psychopathy entails a discrete set of moral abnormalities and suggest that these abnormalities could potentially help to explain the characteristic antisocial behavior of individuals with psychopathy.     

The Academic Experience of Male High School Students with ADHD

This study compared the high school academic experience of adolescents with and without childhood ADHD using data from the Pittsburgh ADHD Longitudinal Study (PALS). Participants were 326 males with childhood ADHD and 213 demographically similar males without ADHD who were recruited at the start of the follow-up study. Data were collected yearly from parents, teachers and schools. The current study used assessment points at which the participants were currently in or had recently completed grades 9, 10, 11, and 12. Results indicated that adolescents with ADHD experienced significant academic impairment in high school relative to comparison adolescents, including lower overall and main academic subject grade point averages (GPA), lower levels of class placement (e.g. remedial vs. honors), and higher rates of course failure. In addition, teacher reports indicated that adolescents with ADHD completed and turned in a significantly lower percentage of assignments and were significantly less likely to be working up to their potential. Adolescents with ADHD were also significantly more likely to be absent or tardy during the academic year, and they were over eight times more likely than adolescents without ADHD to drop out of high school. These findings demonstrate that children with ADHD continue to experience severe academic impairment into high school.     

Intellectual, behavioral, and personality correlates of violent vs. non-violent juvenile offenders

The overall aim of this study was to examine the relationship between offender status (violent vs. nonviolent) and selected predictor variables from personality, behavioral, and intellectual domains. The two main sub goals were (a) to determine which variables from these domains were most closely associated with offender status, and (b) to construct a stepwise logistic regression model that could help identify which juveniles were more likely to be incarcerated for violent vs. nonviolent offenses. The participants for this investigation were juvenile offenders referred to the Juvenile Court Assessment Center by the Juvenile Justice Division of the Eleventh Judicial Circuit. The court-ordered assessment included the following measures: (a) The Millon Adolescent Clinical Inventory (MACI), (b) the Behavior Assessment System for Children (BASC), (c) the Peabody Picture Vocabulary Test-Third Edition (PPVT-III), (d) the Wide Range Achievement Test-Third Edition (WRAT-III), (e) the Kaufman Brief Intelligence Test (K-BIT), and (f) records of school achievement. The ten variables that had the strongest association with offender status were entered into the stepwise logistic regression analysis; five of these strategically chosen predictor variables accurately differentiated violent from nonviolent offenders 86.3% of the time. Reading Percentile (β=-.051), PPVT-III (β=-.059), MACI-Inhibition (β=-.033), MACI-Eating Dysfunction (β=.051), and BASC-Sense of Inadequacy (β=-.072). Gender differences were explored.     

Reactive aggression in psychopathy and the role of frustration: Susceptibility,experience, and control

This article is a commentary on ‘Psychopathy, frustration, and reactive aggression: The role of ventromedial prefrontal cortex’ ( Blair, 2010 ).