Reply to Comment on "Comparison of the Lateral Retention Forces on Sessile, Pendant, and Inverted Sessile Drops".

We address the issues raised in the Tadmor article (Tadmor, T., et al. Comment on "Comparison of the Lateral Retention Forces on Sessile, Pendant, and Inverted Sessile Drops". Langmuir 2019, 10.1021/acs.langmuir.9b02660). In particular, we explain why we did not use Tadmor's theory to explain our results.

Prevalence of environmental Aeromonas in South East Queensland, Australia: a study of their interactions with human monolayer Caco-2 cells.

AIMS: To investigate the prevalence of Aeromonas in a major waterway in South East Queensland, Australia, and their interactions with a gut epithelial model using Caco-2 cells. METHODS AND RESULTS: A total of 81 Aeromonas isolates, collected from a major waterway in South East Queensland, Australia, were typed using a metabolic fingerprinting method, and tested for their adhesion to HEp-2 and Caco-2 cells and for cytotoxin production on Vero cells and Caco-2 cells. Aeromonas hydrophila had the highest (43%) and Aeromonas veronii biovar sobria had the lowest (25%) prevalence. Four patterns of adhesion were observed on both HEp-2 and Caco-2 cell lines. Representative isolates having different phenopathotypes (nine strains) together with two clinical isolates were tested for their translocation ability and for the presence of virulence genes associated with pathogenic Escherichia coli. The rate and degree of translocation across Caco-2 monolayers varied among strains and was more pronounced with LogA pattern. Translocation was associated with the adherence of strains to Caco-2 cells microvilli, followed by internalization into Caco-2 cells. Two Aer. veronii biovar sobria strains were positive for the presence of heat-labile toxin genes, with one strain also positive for Shiga-like toxin gene. CONCLUSIONS: Pathogenic strains of Aeromonas carrying one or more virulence characteristics are highly prevalent in the waterways studied and are capable of translocating across a human enterocyte cell model. SIGNIFICANCE AND IMPACT OF THE STUDY: This study indicates that Aeromonas strains carrying one or more virulence properties are prevalent in local waterways and are capable of translocating in a human enterocyte cell culture model. However, their importance in human gastrointestinal disease has yet to be verified under competitive conditions of the gut.

A confirmatory factor analysis of the BASIS-32 in racial and ethnic samples.

The present study performed confirmatory factor analysis across major racial and ethnic groups of the BASIS-32, a measure of functional status of persons receiving mental health treatment and suitable for routine assessment mental health care. The purpose was to perform a preliminary investigation of cross-cultural equivalence in a county-level mental health program in a major metropolitan area. The results indicated a factor structure similar to that reported in the literature, and they suggested acceptable levels of agreement in structure between racial and ethnic minority groups and whites. The study revealed little reason to believe that the BASIS-32 varied in underlying structure across racial and ethnic boundaries, although further research is indicated.

Social embeddedness and psychological well-being among African Americans and whites.

Using data from the National Medical Expenditure Survey, a household survey of more than 18,000 respondents, this study examined racial and gender differences in social embeddedness, an indicator of community well-being and social support. The study hypothesized that higher levels of social embeddedness would be found among African Americans than among Whites and that the association between social embeddedness and psychological well-being would be stronger among African Americans than among Whites. African American men reported themselves more socially embedded overall than White men and, in one instance, their social involvement was especially important in predicting psychological well-being. African American women were more likely than White women to report attending meetings of churches and community groups, but otherwise were less socially involved than White women. There was no evidence of a difference between African American and White women in strength of the connection between social embeddedness and psychological well-being. African American social involvement is more selective than previously believed and generalizations must be qualified on the basis of gender.

Persons with depressive symptoms and the treatments they receive: a comparison of primary care physicians and psychiatrists.

OBJECTIVE: To determine if demographic differences exist in patients with depressive symptoms as the principal reason for visits to primary care physicians (PCP) versus psychiatrists. To estimate the likelihood of these patients receiving a range of mental health services from each provider group. METHODS: Review and analysis of all outpatient visits made by patients with depressive symptoms using the National Ambulatory Medical Care Surveys (NAMCS) conducted in 1995 and 1996. RESULTS: A significantly greater proportion of visits by persons with depressive symptoms as the principal reason for visit were made to psychiatrists than to primary care physicians (T = -3.56, p = .000). However, men, African-Americans, other Non-White persons, and persons aged 65 to 74 and 75 years and over were proportionately more likely to visit a PCP than a psychiatrist. Women, whites, and persons aged 45 to 64 were proportionately more likely to make a visit to a psychiatrist than to a PCP. The overall intensity of care delivered by PCPs for patients with depressive symptoms was significantly lower than that provided by psychiatrists (t = -2.03, p = .02). Analysis of individual services also revealed significant differences in service provision. CONCLUSIONS: Demographic differences among the patient caseloads of these physician groups have implications for mental health service delivery because of known distinctions in prevalence rates, symptom presentation, and functionality among depressed patient subgroups.

The impact of realignment on utilization and cost of community-based mental health services in California.

Decentralization of California's public mental health system under program realignment has changed the utilization and cost of community-based mental health services. This study examined a sample of 75,951 users, representing 1.5 million adults who visited California's public mental health services during a 6-year period (FY 1988-1990 and FY 1992-1994). Regression analysis was performed to examine cost and utilization reduction over time, across regions, and across psychiatric diagnoses. Overall utilization and cost of community-based mental health services dropped significantly after the implementation of realignment. They were significantly lower for (a) 24-hour services in the urban industrialized Southern Region and (b) outpatient services in the agricultural Central Region of the state. Users diagnosed with mood disorders took a greater portion, but were associated with significantly less treatment and cost than other users in the post-realignment period. When local communities bear the financial risks and rewards, they find more efficient methods of delivering community-based mental health services.

How capitated mental health care affects utilization by youth in the juvenile justice and child welfare systems.

Examine the impact of Colorado's Medicaid mental health carve-out program on children in child welfare and juvenile justice systems. Medicaid claims and encounter data for two experimental managed care sites and one comparison fee-for-service site are used to estimate a two-part model of inpatient, outpatient, and residential treatment center utilization, controlling for patient characteristics. The study finds that juvenile justice and child welfare populations were more strongly affected by managed care than the general youth population, regarding reduced utilization of inpatient and outpatient services. Increases in Residential Treatment Centers use were greater for juvenile justice than either the child welfare sample or the total sample. Youth in child welfare increase utilization of outpatient services. Most utilization effects are stronger for not-for-profit than for-profit managed care organizations. The experience of Colorado implies that a mental health carve-out affects patterns of care for youth and differentially so for youth in juvenile justice and child welfare systems. Controlling for population characteristics, the effects are stronger for not-for-profit than for-profit managed care organizations.

Barriers to effective mental health services for African Americans.

Many African Americans--especially the most marginal--suffer from mental health problems and would benefit from timely access to appropriate forms of care. However, few seek treatment from outpatient providers in the specialty mental health sector and those who do are at risk of dropping out. African Americans visit providers in the general medical sector, although they use another hypothesized alternative to specialty care, voluntary support networks, less than other groups. These help-seeking tendencies may reflect characteristic coping styles and stigma, as well as a lack of resources and opportunities for treatment. More should be learned about differences in need according to location, social standing, and cultural orientation so as to identify treatments and programs that are especially beneficial to African Americans.

The effect of capitated financing on mental health services for children and youth: the Colorado experience.

OBJECTIVES: This study tested 2 propositions concerning the effect of capitated financing on mental health services for Medicaid-eligible children and youth in Colorado. The first is that capitation reduces costs. The second is that shifting providers from fee-for-service to capitated financing will increase their efforts to prevent illness. METHODS: Interrupted time-series designs were applied to a naturally occurring quasi experiment occasioned by the state of Colorado's reorganization of mental health services financing. RESULTS: The cost of services was significantly lower in counties with capitated services compared with counties with fee-for-service financing. Findings also suggested that economic incentives may lead to greater efforts at secondary and tertiary prevention. CONCLUSIONS: Policymakers and the public can expect that capitation will reduce the costs of children's mental health services below those likely with fee-for-service financing. Capitation per se, however, may not increase prevention as surely or swiftly as it lowers costs.

Medicaid and African American outpatient mental health treatment.

The present study tested the hypothesis that Medicaid-financed African Americans would be more likely to receive outpatient mental health treatment than African Americans whose treatment was financed by private insurance. The hypothesis was confirmed: when compared with privately insured persons eligible for care under either fee-for-service or managed care, the Black-White gap in outpatient service use was significantly smaller under Medicaid. There was no racial difference in outpatient treatment rates among the uninsured. The often-noted difference between Blacks and Whites in the likelihood of receiving outpatient mental health treatment is confined largely to the privately insured.

Ethnic characteristics of mental disorders in five U.S. communities.

The study examined the ethnic ratio of 16 DSM-III mental disorders among White, Black, Hispanic, and Asian Americans. A total of 18,126 residents from 5 sites and 2,939 residents from the Epidemiological Catchment Area's Los Angeles site were studied separately. Logistic regression analysis was performed. Results showed that Blacks were significantly less likely than Whites to have major depressive episode, major depression, dysthymia, obsessive-compulsive disorder, drug and alcohol abuse or dependence, antisocial personality, and anorexia nervosa, but they were significantly more likely than Whites to have phobia and somatization. Lifetime prevalence rates of schizophrenia, obsessive-compulsive disorder, panic, and drug abuse or dependence were significantly lower among Hispanics than among Whites. Asians also had significantly lower rates than Whites of schizophreniform, manic episode, bipolar disorder, panic, somatization, drug and alcohol abuse or dependence, and antisocial personality. Compared with the overall findings, ethnic differences at the Los Angeles site were lessened between Blacks and Whites, enhanced between Hispanics and Whites, and basically unchanged between Asians and Whites.

Acculturation, alcohol consumption and AIDS-related risky sexual behavior among African American women.

The present study examined the relationship between acculturation, alcohol consumption and AIDS-related risky sexual behavior in a national probability sample of 533 African American women. Results indicated that women who were the heaviest drinkers were also the least acculturated. However, women most likely to engage in risky sexual behavior, including having multiple partners, being nonmonogamous or in a nonmonogamous relationship, and being nonmonogamous or in a nonmonogamous relationship and not using a condom consistently, were high in acculturation rather than low. Alcohol use proved related to risky sexual behavior when considered in conjunction with respondents' level of acculturation. Women at risk for contracting AIDS were not low acculturated African American women who drank heavily, but high acculturated African American women. Findings from this study extend our understanding of risk and contain implications for research and prevention efforts in the area of alcohol use and AIDS-related sexual behavior among African American women.

PIP: The relationship between acculturation, alcohol consumption, and AIDS-related risky sexual practices was investigated in a national probability sample of 533 African American women. Data were collected in 1991-92 as part of a follow-up survey to the 1984 US National Alcohol Survey. Acculturation--the extent of adaptation to US mainstream society--was measured through use of a 10-item questionnaire related to preference for African American mass media and reliance on an African American social network. Scores on this scale ranged from 1.00 (low acculturation) to 3.78 (high acculturation). Most respondents were 18-29 years of age and lived in urban areas. Among the 306 respondents (74%) who were sexually active in the preceding year, 60 (21%) had had multiple sex partners, 130 (43%) were in a nonmonogamous relationship, and 266 (91%) had not used condoms consistently. 109 women (41%) abstained from alcohol consumption, 107 (36%) were moderate drinkers, and 90 (22%) consumed 5 or more drinks per day. When sociodemographic factors, religiosity, and attitudes toward sex were controlled, it was found that high-risk sexual practices were most prevalent among respondents with high levels of both acculturation and alcohol consumption. Heavy drinking alone was not a risk factor. Multivariate analysis indicated that women in the high acculturation/heavy drinking group were 13 times more likely to have multiple sex partners than their low acculturation/alcohol abstinent counterparts. These findings suggest the need for AIDS prevention programs for African American women that address alcohol treatment and assertiveness training.

Expressions of anxiety in African Americans: ethnography and the epidemiological catchment area studies.

High levels of anxiety have long been reported for African Americans. Recent analyses of Epidemiological Catchment Area (ECA) data have failed to support this, although contemporary ethnographies have discussed important African American folk idioms of anxiety. This study compares ethnographically reported symptoms of anxiety in African Americans to those reported in the ECA data. A multivariate analysis of female African American and European American differences in comparable ECA and ethnographic symptoms was performed. Significant differences were found not in ethnicity but in education levels. Alternative interpretations are discussed. Methodological problems are discussed highlighting limitations of both household survey research, such as the ECA project, and ethnography.

Alcohol-related problems among black, Hispanic and white men: the contribution of neighborhood poverty.

OBJECTIVE: We examined the cross-sectional relationships between race/ethnicity, neighborhood poverty and alcohol-related problems among black, Hispanic and white male drinkers. Test hypotheses were that black and Hispanic men living in more impoverished neighborhoods would report increased numbers of alcohol-related problems than comparable white men. METHOD: Study hypotheses were tested in a sample of 744 black, Hispanic and white men participating in the 1992 National Alcohol Follow-up Survey. Study hypotheses were analyzed using generalized linear model regression analysis. RESULTS: Neighborhood poverty had a greater effect on alcohol-related problems in black than in white men, partially supporting our hypothesis. Black men living in more impoverished neighborhoods reported greater numbers of alcohol-related problems than comparable white men; there were no race differences among more affluent men. Neighborhood poverty had little effect on alcohol-related problems in Hispanic men. CONCLUSIONS: Findings suggest that, giving unfavorable economic conditions, black men will report greater numbers of alcohol-related problems than comparable white men.

An investigation into whether nursing student alter their attitudes and knowledge levels regarding HIV infection and AIDS following a 3-year programme leading to registration as a qualified nurse.

The purpose of this study was to examine whether a 3-year programme of nursing studies enabled nursing students to graduate from the course with greater knowledge and more positive attitudes towards HIV infection and AIDS than when they began the course. Students on a maths and information technology course were used as controls. The study involved the use of a questionnaire which gathered information about students' experience, knowledge, attitudes and moral judgement regarding HIV infection and AIDS. The experimental hypothesis stated that nursing students would show a greater increase in knowledge and positive attitude change towards HIV infection and AIDS than maths students. The results showed significant differences between third year nursing students' knowledge about HIV and AIDS when compared with other groups but it was noted that knowledge levels for all groups was quite low. There was no difference between first and third year nursing students' attitudes and moral judgement about HIV and AIDS but there was a significant difference between nursing students and maths students. It was suggested that there is a need to modify nurse education programmes in order to have greater impact on this topic area.

Problem type and referral to HMO mental health treatment.

The present study examined the cases of 353 patients seen in the outpatient department of psychiatry at a large west coast HMO. Comparisons were made between self-referred and physician-referred patients in the types of problems presented for treatment. Patients with relationship problems were self-referred more than those with adjustment, anxiety, and mood disorders who were more likely to be physician-referred. HMO patients with a self-referral option appear to enter mental health treatment because of relationship problems at a higher rate than their physician-referred counterparts.

Health-care-related attitudes and utilization among African American women.

This study examined attitudes of African American women toward medical care and health insurance. Data were analyzed from the National Medical Expenditure Survey, a large household survey conducted by the Agency for Health Care Policy and Research and focusing on insurance and health care utilization. The responses of African American women tended neither to downplay the importance of receiving health care as essential to health maintenance and recovery from illness, nor to minimize health insurance as a worthwhile investment. When African American women did give responses discounting the importance of health care, the attitude difference failed to account for race-related differences in utilization. There was no evidence in the data to indicate that attitudes lead African American women to neglect seeking medical care or acquiring health insurance, and solutions to the problem of medical care underutilization must be sought elsewhere.

Managed care in the public mental health system.

The movement towards managed care in the public mental health system has surpassed efforts to develop a systematic literature concerning its theory, practice, and outcome. In particular little has been written about potential challenges and difficulties in translating managed care systems from their origins in the private sector to the delivery of public sector mental health services. This paper provides an overview of managed care definitions, organizational arrangements, administrative techniques, and roles and responsibilities using a theoretical framework adopted from economics referred to as principal-agent theory. Consistent with this theory, we assert that the primary function of the managed care organization is to act as agent for the payor and to manage the relationships between payors, providers, and consumers. From this perspective, managed care organizations in the public mental health system will be forced to manage an extremely complex set of relationships between multiple government payors, communities, mental health providers, and consumers. In each relationship, we have identified many challenges for managed care including the complexity of public financing, the vulnerable nature of the population served, and the importance of synchronization between managed care performance and community expectations for the public mental health system. In our view, policy regarding the role of managed care in the public mental health system must evolve from an understanding of the dynamics of government-community-provider-consumer "agency relationships".

Ethnic minority populations and mental health outcomes.

This chapter presents a framework for evaluating outcomes from mental health intervention in ethnic minority populations, reviews existing outcomes research, and describes ways to increase the quantity and quality of minority outcomes research.