How do you feel? Using natural language processing to automatically rate emotion in psychotherapy.

Emotional distress is a common reason for seeking psychotherapy, and sharing emotional material is central to the process of psychotherapy. However, systematic research examining patterns of emotional exchange that occur during psychotherapy sessions is often limited in scale. Traditional methods for identifying emotion in psychotherapy rely on labor-intensive observer ratings, client or therapist ratings obtained before or after sessions, or involve manually extracting ratings of emotion from session transcripts using dictionaries of positive and negative words that do not take the context of a sentence into account.

"It's hard to argue with a computer:" Investigating Psychotherapists' Attitudes towards Automated Evaluation.

We present CORE-MI, an automated evaluation and assessment system that provides feedback to mental health counselors on the quality of their care. CORE-MI is the first system of its kind for psychotherapy, and an early example of applied machine-learning in a human service context. In this paper, we describe the CORE-MI system and report on a qualitative evaluation with 21 counselors and trainees.

Variability in motivational interviewing adherence across sessions, providers, sites, and research contexts.

Providers' adherence in the delivery of behavioral interventions for substance use disorders is not fixed, but instead can vary across sessions, providers, and intervention sites. This variability can substantially impact the quality of intervention that clients receive. However, there has been limited work to systematically evaluate the extent to which substance use intervention adherence varies from session-to-session, provider-to-provider, and site-to-site.

A multivariate meta-analysis of motivational interviewing process and outcome.

Motivational interviewing (MI) theory proposes a process whereby a set of therapist behaviors has direct effects on client outcomes and indirect effects through in-session processes (e.g., client change talk).

Chronic Disease Risks From Exposure to Long-Hour Work Schedules Over a 32-Year Period.

Objectives: This study aims at evaluating the chronic disease risk related to prolonged work in long-hour schedules for eight major chronic diseases: heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, chronic depression, and hypertension.

Methods: The study used data from the National Longitudinal Survey of Youth, 1979 covering 32 years of job history (1978 to 2009) for 7492 respondents. Logistic regression analyses were performed to test the relationship between average weekly work hours, and the reported prevalence of those conditions for each individual.

How Long Do Adolescents Wait for Psychiatry Appointments?

Appointment wait times are a neglected dimension of children's access to psychiatry. We systematically examined how long an adolescent waits for a new patient appointment with a psychiatrist for routine medication management. From state directories, we identified 578 providers of adolescent psychiatric care in Ohio.

Does time pressure create barriers for people to receive preventive health services?

Objective: Regular use of recommended preventive health services can promote good health and prevent disease. However, individuals may forgo obtaining preventive care when they are busy with competing activities and commitments. This study examined whether time pressure related to work obligations creates barriers to obtaining needed preventive health services.

A 3-year assessment of the effects of a self-administered health risk assessment on health care utilization, costs, and health risks.

Objective: This study examines the effect of taking a health risk assessment (HRA) on health care costs, utilization, and member health risks over a 3-year period.

Methods: This retrospective cohort study examined changes utilization, costs, and health risks among a random sample of 500 employees completing an HRA compared with a matched group of 500 employees who did not complete an HRA.

Results: The HRA group accessed services more frequently and at a lower overall cost, was more likely to utilize primary care and preventive services after the HRA, and improved on seven out of eight health risk measures.

Incidence of adverse events in an integrated US healthcare system: a retrospective observational study of 82,784 surgical hospitalizations.

Background: Many health care facilities have developed electronic reporting systems for identifying and reporting adverse events (AEs), so that measures can be taken to improve patient safety. Although several studies have examined AEs in surgical settings, there has not previously been a systematic assessment of the variations in adverse event rates among different types of surgery, nor an identification of the particular types of AEs that are most common within each surgical category. Additionally, this study will identify the AE severity level associated with each of the AE category types.

Using O*NET to estimate the association between work exposures and chronic diseases.

Background: A standardized process using data from the Occupational Information Network (O*NET) is applied to estimate the association between long-term aggregated occupational exposure and the risk of contracting chronic diseases later in life. We demonstrate this process by analyzing relationships between O*NET physical work demand ratings and arthritis onset over a 32-year period.

Methods: The National Longitudinal Survey of Youth provided job histories and chronic disease data.

A novel method for estimating the effects of job conditions on asthma and chronic lung disease.

Objective: This study uses 32 years of longitudinal job history to analyze the long-term effect of exposure to specific workplace conditions on the risk of contracting asthma or chronic lung disease later in life. Our approach allows for the estimation of occupational respiratory risks even in the absence of direct environmental monitoring.

Methods: We employ a novel methodology utilizing data from the National Longitudinal Survey of Youth 1979 (NLSY79), and ratings of job exposures from the Occupational Information Network (O*NET), which are based on 70 years of empirical data compiled by the U.

The translational research impact scale: development, construct validity, and reliability testing.

Increasing emphasis is being placed on measuring return on research investment and determining the true impacts of biomedical research for medical practice and population health. This article describes initial progress on development of a new standardized tool for identifying and measuring impacts across research sites. The Translational Research Impact Scale (TRIS) is intended to provide a systematic approach to assessing impact levels using a set of 72 impact indicators organized into three broad research impact domains and nine subdomains.

Employers' role in helping Latino workers obtain access to health care services: results of a community-based pilot demonstration project.

A coalition of employers in the hotel and restaurant industries collaborated with community-based organizations to undertake a unique demonstration project, called the Employed Latino Health Initiative, aimed at improving access to basic health care services for low-wage Latino workers in Columbus, Ohio. With grant funding from the Robert Wood Johnson Foundation, the project developed and tested protocols allowing Latino workers from participating companies to obtain basic health care screenings, referrals to medical providers, health education training, and the services of a qualified community health navigator. Data from the pilot project indicated high screening participation rates, extensive referrals to providers for follow-up care, and a substantial need for facilitation services by community health navigators.

Opioid use and dosing in the workers' compensation setting. A comparative review and new data from Ohio.

Background: Many authorities are concerned about the rising use and the potential overuse of opioid pain medications. A study of opioid prevalence and dosage in Ohio's workers' compensation (WC) system was conducted, with comparisons made to opioid use in other WC and non-WC settings.

Methods: Systematic literature reviews of WC and non-WC opioid use and dosage nationally were conducted.

Statistical software applications used in health services research: analysis of published studies in the U.S.

Background: This study aims to identify the statistical software applications most commonly employed for data analysis in health services research (HSR) studies in the U.S. The study also examines the extent to which information describing the specific analytical software utilized is provided in published articles reporting on HSR studies.

Mental health community based funding: Ohio's experience in revising its funding allocation methodology.

Over the past 20 years, states have increasingly moved away from centrally financed, state-operated facilities to financing models built around community-based service delivery mechanisms. This paper identifies four important broad factors to consider when developing a funding formula to allocate state funding for community mental health services to local boards in an equitable manner, based on local community need: (1) funding factors used by other states; (2) state specific legislative requirements; (3) data availability; and (4) local variation of factors in the funding formula. These considerations are illustrated with the recent experience of Ohio using available evidence and data sources to develop a new community-based allocation formula.

Results of a pilot study of pre-release STD testing and inmates' risk behaviors in an Ohio prison.

This study presents the results of a pilot study of mandatory pre-release testing for sexually transmitted disease (STD) and a behavioral risk survey for male inmates at an Ohio prison. Approximately 4-6 weeks prior to scheduled release, inmates took part in a mandatory blood test and optional genital swab and physical examination to test for STDs. At the time of testing, a voluntary behavioral and knowledge survey was administered to inmates.

Screening and identification of depression among patients with coronary heart disease and congestive heart failure.

Depression occurring concurrently with cardiovascular diseases is associated with poor outcomes. Several review articles have examined the link between established indices of depression and prognosis in individuals with known coronary heart disease (CHD). These studies have demonstrated relatively consistent results and suggest an important connection between cardiovascular morbidity and mortality in patients with depressive symptoms or major depression.

How historical factors have affected the application of workers' compensation data to public health.

A recent meeting of leading workers' compensation (WC) researchers was held in Washington, DC to consider ways of improving the use of WC data for injury and illness prevention. Participants identified specific deficiencies that limit the application of WC data for research purposes. For example, commercial insurers are often reluctant to provide claims records to research organizations.

Estimating provider and service costs at a community-based medical home project in central Ohio.

This article describes a preliminary economic feasibility study estimating the costs involved in ensuring basic services and adequate provider capacity as a first step in creating a patient-centered medical home model in Franklin County, Ohio. The initial feasibility study estimated the costs involved in: 1) increasing the number of primary care providers in the county, 2) increasing care capacity at existing federally qualified health centers, and 3) increasing capacity to provide a set of comprehensive care services involving care coordination and availability of specialists and prescription drugs. Cost estimates based on providing services to children and adults below 400% of the federal poverty level in the county ranged from $2.

Predictors of health plan satisfaction among employees in an academic setting.

This study's goal was to identify the strongest predictors of satisfaction with a health plan offered to employees at a large university in the Midwestern United States. Survey responses from 1533 employees were analyzed (response rate of 51.2%).

Management of acute appendicitis: the impact of CT scanning on the bottom line.

Background: Acute appendicitis continues to be a common general surgical problem. Little is known about whether the contribution to margin has been affected by changes in technology.

Study Design: Patients undergoing appendectomy for acute appendicitis from June 2005 to May 2007 were evaluated for demographics, diagnostic and treatment alternatives, and outcomes.

Estimates of injury risks for healthcare personnel working night shifts and long hours.

Background: Evidence suggests that working long hours or unconventional shifts (night, evening and rotating shifts) can induce fatigue and stress in healthcare employees that might jeopardise quality of care and patient safety.

Methods: This study is based on a retrospective analysis of 13 years of occupational data from the National Longitudinal Survey of Youth, covering nearly 11,000 American workers. During the study period, 545 injuries were reported by employees in healthcare professions.

The applicability of Lean and Six Sigma techniques to clinical and translational research.

Background: Lean and Six Sigma are business management strategies commonly used in production industries to improve process efficiency and quality. During the past decade, these process improvement techniques increasingly have been applied outside the manufacturing sector, for example, in health care and in software development. This article concerns the potential use of Lean and Six Sigma in improving the processes involved in clinical and translational research.