Concerns about opioid-related adverse events, including overdose, prompted the Veterans Health Administration (VHA) to launch an Opioid Safety Initiative and Overdose Education and Naloxone Distribution program. To mitigate risks associated with opioid prescribing, a holistic approach that takes into consideration both risk factors (e.g., dose, substance use disorders) and risk mitigation interventions (e.g., urine drug screening, psychosocial treatment) is needed. This article describes the Stratification Tool for Opioid Risk Mitigation (STORM), a tool developed in VHA that reflects this holistic approach and facilitates patient identification and monitoring. STORM prioritizes patients for review and intervention according to their modeled risk for overdose/suicide-related events and displays risk factors and risk mitigation interventions obtained from VHA electronic medical record (EMR)-data extracts. Patients' estimated risk is based on a predictive risk model developed using fiscal year 2010 (FY2010: 10/1/2009-9/30/2010) EMR-data extracts and mortality data among 1,135,601 VHA patients prescribed opioid analgesics to predict risk for an overdose/suicide-related event in FY2011 (2.1% experienced an event). Cross-validation was used to validate the model, with receiver operating characteristic curves for the training and test data sets performing well (>.80 area under the curve). The predictive risk model distinguished patients based on risk for overdose/suicide-related adverse events, allowing for identification of high-risk patients and enrichment of target populations of patients with greater safety concerns for proactive monitoring and application of risk mitigation interventions. Results suggest that clinical informatics can leverage EMR-extracted data to identify patients at-risk for overdose/suicide-related events and provide clinicians with actionable information to mitigate risk. (PsycINFO Database Record

Shelter-based studies have documented risks to homeless children's development, but scant information is available about children residing in family supportive housing, a key strategy for preventing long-term homelessness. This study assessed the psychosocial and health status of 454 formerly homeless children living with their families in 17 supportive housing communities. Findings indicated that children had good access to physical health care. However, children faced significant psychosocial risks and manifested behavioral, emotional, and school challenges. Housing agencies lacked infrastructure or expertise in children's mental health. The authors propose that supportive housing provides a valuable but hitherto underused opportunity to support children's psychosocial functioning.

Studies of children's functioning following exposure to a traumatic event rarely have investigated change over the weeks following the event, but examining recovery in the short aftermath of a traumatic event is important for understanding vulnerability to subsequent disorder, as well as the potential utility of preventive interventions. Data are reported from a short-term longitudinal study of 35 mother-child dyads over 14 weeks following exposure to an incident of severe intimate partner violence. Using a developmental-ecological framework, we proposed that maternal parenting practices would be associated with children's recovery, and that maternal distress would be associated with her parenting practices. Consistent with hypotheses, observed parenting practices at baseline predicted the trajectory of children's self-reported internalizing problems over the study period. Maternal mental health problems were associated with child depression symptoms, but not with overall child internalizing symptoms. Parenting was not associated with maternal mental health symptoms. Further studies should pay closer attention to the role of parenting in children's adjustment in the aftermath of a traumatic event.

This analysis explores student outcomes related to taking developmental English (i.e., reading and/or writing) and math classes in three community colleges in three different states, using institutional data from 7,898 students who began college in the fall of 2009 (Cohort 1) or fall 2010 (Cohort 2). We examine the outcome trajectories of students at each college, considering their enrollment in developmental courses in their first term at college as well as other variables. Several factors helped students persist into the second term of college, and a subset of these was also significantly related to continued persistence, graduation, and higher overall grade point average (GPA). Older students, White/non-Hispanic students, and occupational students were more likely to graduate. These groups, and women, also had higher cumulative GPAs. Math ability at the time of college entrance was a powerful predictor of student success. The utility of reading placement as a predictor, and the utility of developmental English, reading, and writing (DERW) classes as an intervention, were both limited to retention into the second term and/or second year. Financial aid and tutoring were much more clearly related to student success than was developmental coursework.

The purpose of this study was to examine growth in early writing skills as assessed by curriculum-based measurements. The writing performance of 85 first-grade students was monitored across 12 weekly administrations of picture-word and sentence-copy measures using multiple scoring procedures. Data analysis was conducted using a model-building procedure in which random effect and quadratic effect parameters were systematically added to unconditional models to create best-fitting models for each scoring procedure and measure. Results suggested that random effect quadratic models fit picture-word tasks best, but that random effect linear models fit the data best for sentence-copy tasks. Additional analyses showed that a student's initial performance was moderately related to linear growth for a scoring metric that accounted for grammar, and that gender was related to initial performance but not growth. Limitations and implications for further use and research of curriculum-based measures for early writing are discussed.