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Michigan State University (MSU) created a long-term, values-based strategic plan to increase help-seeking and reduce the incidence of relationship violence and sexual misconduct. Creating systemic change in institutions of higher education is challenging, particularly so in the wake of massive institutional crises and betrayal, as we had at MSU. In this paper, we address the challenges and critiques of our strategic planning efforts offered by esteemed scholar-activists: Jacobson López (2023), Hirsch and Khan (2023), McMahon (2023), and Boots et al. (2023).

This paper describes a multi-year initiative at Michigan State University (MSU) to change our institutional response to relationship violence and sexual misconduct (RVSM) in the aftermath of a large-scale institutional crisis. While the circumstances at MSU are unique, many universities have faced or will face moments that bring RVSM issues into the spotlight. To inform other colleges and universities, we describe how we developed a 5-year strategic plan to transform services for survivors and develop prevention programming for multiple audiences and at multiple levels of analysis. We titled this framework Know More. Do More. Support More, w hereby "know more" reflects our ongoing use of campus climate surveys and data sharing to educate our community about RVSM; "do more" includes our institutional-level strategic plan for culture change; and "support more" provides guidance to our community members on how to respond to disclosures in a trauma-informed way and connect survivors to support services. We discuss the challenges and opportunities that stemmed from our choice to work "within the system" to create this model, as well as the ethical dilemmas we faced in these partnerships.

Historians have examined the role of psychiatric institutions in the USA and addressed whether this form of care helped or harmed patients (depending on the perspective of the time period, historical actors, and historians). But the story for children's mental institutions was different. At the time when adult institutions were in decline, children's mental hospitals were expanding. Parents and advocates clamoured for more beds and more services. The decrease in facilities for children was more due to economic factors than ideological opposition. This paper explores a case study of a hospital in Michigan as a window into the different characteristics of the discussion of psychiatric care for children.

Different conventional and causal approaches have been proposed for mediation analysis to better understand the mechanism of a treatment. Count and zero-inflated count data occur in biomedicine, economics, and social sciences. This paper considers mediation analysis for count and zero-inflated count data under the potential outcome framework with nonlinear models. When there are post-treatment confounders which are independent of, or affected by, the treatment, we first define the direct, indirect, and total effects of our interest and then discuss various conditions under which the effects of interest can be identified. Proofs are provided for the sensitivity analysis proposed in the paper. Simulation studies show that the methods work well. We apply the methods to the Detroit Dental Health Project's Motivational Interviewing DVD trial for the direct and indirect effects of motivational interviewing on count and zero-inflated count dental caries outcomes.

The use of web-based surveys to gather information from teachers has become increasingly common primarily based on the premise that they can reduce costs. Yet, relatively, little is known about the quality or cost effectiveness of web-based versus mail surveys for teachers. To study the efficacy of web-based teacher surveys, the author randomly assigned a nationally representative sample of 877 elementary school teachers to a paper or web survey mode. The cost savings from the web administration were not enough to offset the loss of sample due to missing/inaccurate email addresses and the lower response rates that resulted from the web survey.

The specific risk factors for addiction within religious community members remain poorly understood and undefined. This paper presents data on the characteristics of chemically dependent women Religious (nuns) in order to understand the etiology and treatment needs of this special group. This study contrasts a group of Roman Catholic women Religious who are in treatment for chemical dependency with a volunteer, nonalcoholic, comparison group from similar religious communities. The treatment group had higher levels of mental health symptoms and past history of childhood trauma (parental separation or divorce, early loss of mother), compared to the volunteer sample. Family history of alcoholism did not differ, however, and prevalence of sexual abuse was more common for the volunteers than for those in treatment. Women Religious in this study resemble the classification of "negative affect" alcoholism (Cloninger Type I, Babor Type A), which is characterized by lower severity, prevalence of environmental over genetic risk factors, and less severe legal or social consequences. Implications for health screening and treatment of women Religious are addressed.

This paper contains a description of the use of the theory of dependent-care in the Nutrition Aimed at Toddlers project, a nursing intervention study with parents of toddlers, and discusses the research and practice utility of the theory of dependent-care, a corollary theory to Orem's self-care theory. In particular, the concepts of dependent-care, dependent-care agency, therapeutic self-care demand and an educative-supportive nursing system are discussed within the context of the Nutrition Aimed at Toddlers project.

Objective: To describe hygiene practices in licensed group day care and family day care homes and the association between these practices and the prevalence of respiratory illnesses in the children in attendance., Methods: Self-administered surveys were mailed to 137 group and 204 family day care providers., Results: Wearing diapers and being younger than age three were associated with a higher frequency of respiratory illness. Children attending family day care homes had more respiratory illness than children attending group day care homes. Infrequent washing of children's or providers' hands after nose wiping, after diapering, before meals, and before food preparation was significantly associated with a higher frequency of respiratory illness. Use of shared cloth towels instead of individual paper towels and washing of sleeping mats less than once a week were also associated with a higher frequency of respiratory illness., Conclusions: The findings underscore the importance of handwashing and other hygiene practices in reducing the spread of disease in day care settings.

Through efficient staff scheduling our 481-bed community teaching hospital has been able to expand its pharmacy services. This paper describes how a clinical pharmacy service program for cardiology and cardiac surgery patients was developed and defines the service components. After over two years of experience with the cardiology program, we have found this pharmacy service area to be very successful and well received. Various forms and proposals are provided to assist other pharmacists interested in expanding into this area of practice.

This paper uses 1985-1988 panel data from 745 married women in the Detroit, Michigan, US, Metropolitan Area to examine the mental health effects of employment and parenting status changes. Contrary to popular belief, the transition to parenting is not directly related to increases in psychological distress. Changes in employment status, however, are. Women who significantly increase their labor force participation report lower levels of psychological distress over the study period, while women who significantly decrease their labor force participation report higher psychological distress. The effects of labor force changes on mental health are not all modified by parenting status or changes in parenting status. The transition to parenting and increased parenting responsibilities, however, are indirectly related to increased psychological distress insofar as they result in decreased labor force participation. The implications of these results are used to evaluate 4 competing perspectives on the relationship between roles, stress, and psychological functioning.

Employee performance appraisals are an extremely important and integral part of a supervisor's duties. This paper describes how a job-specific, criteria-based performance appraisal tool was developed for the staff pharmacist position. Sample evaluation tools are provided. The performance appraisal process is outlined and discussed.

An existing multidisciplinary sequence in the preclinical curriculum of the College of Human Medicine at Michigan State University has been revised to include emphasis on psychological principles of clinical reasoning, decision analysis, ethical issues, and health economics. The course is a four-term sequence taught in the first and second years. In each term, the course consists of a one-hour lecture and two hours of group discussion weekly. The focus of the discussions is a series of carefully constructed paper-and-pencil cases that are graded in difficulty and coordinated with concurrent or previous biological science courses. Examinations have been developed based on written cases and using multiple choice, true-false, and short essay questions. The course is aimed at bringing about fundamental change in the new physicians' conceptions of value and benefit, the way uncertainty is managed, and the traditional belief that data and information are identical.

Within the field of gerontology investigators have been concerned with determining whether social behavior can be explained by a cohort effect or a generational maturation effect. This paper considers the question by examining suicidal behavior from a subjective perspective. A Suicide Potential Scale is constructed for a sample population in the city of Flint, Michigan, and it is shown that the scale fits the Guttman scale criteria. The mean suicide potential scores of various age groups in the sample are then examined and it can be seen that the data lend support to the cohort model with the exception of individuals seventy-five and older, where it appears that maturation factors play an important role in explaining suicidal behavior.