STAFF AND ELDERLY KNOWLEDGE AND ATTITUDES TOWARD ELDERLY SEXUALITY

This study compared staff and elderly knowledge, attitudes, and practices related to sexual expression by elderly persons in a long‐term care setting. Volunteers (N = 194) responded agree or disagree to 159 items. Significant differences were observed between the staff and elderly responses on 36 items. Areas of greatest differences involved knowledge and attitudes about consensual sex and sexual abuse, issues related to family attitudes toward remarriage and sexual expression, and age‐related changes and health problems related to sexuality. Items related to masturbation received the greatest percentage of no response. The staff had significantly higher total scores as compared to the elderly reflecting more knowledge, positive attitudes, and support for more proactive responses toward elderly sexuality. Findings have major implications for staff training in long‐term care settings.     

END-OF-LIFE DECISION MAKING: PRACTICES,BELIEFS AND KNOWLEDGE OF SOCIAL WORKERS IN HEALTH CARE SETTINGS

The aim of the present study was to examine the involvement, beliefs, and knowledge of social workers in health care settings in the process of making decisions regarding life-sustaining treatments. A convenience sample of 68 social workers participated in the study (65 F and 3 M; mean age = 42.4 ; SD = 10.0 . Fifty-two participants worked at hospitals and 16 at nursing homes. The area in which social workers reported being more involved were activities related to family members. The extent of social workers' involvement was related to their beliefs regarding their role and their knowledge about life-sustaining treatments. Findings of this study emphasize the need for developing educational programs aimed at expanding social workers' knowledge in order to increase their autonomy and professional involvement in end-of-life decision making.     

School-linked and school-based health services: A renewed call for collaboration between school psychologists and medical professionals

Health care and education reform provide opportunities to build systems that promote rather than retard collaboration between school psychologists and medical professionals. School-linked and school-based health services (SLSBHS) are a family of approaches that provide medical, social, and mental health services to students through school settings. These services have potential to provide more than acute care or first-aid services. SLSBHS provide medical care to uninsured children, students with chronic medical needs, at-risk children, and the overall school population. However, there are usually not enough funds to hire new staff members in most school districts. Expanding the roles of current school staff, promoting interdisciplinary collaboration, and implementing creative fiscal strategies are necessary to develop SLSBHS. Interdisciplinary collaboration may be the largest hurdle to developing SLSBHS. As such, school psychologists and medical professionals may need to rethink their professional roles and develop new techniques of interdisciplinary consultation to fulfill the potential of SLSBHS.     

Perspectives of SENCos and support staff in England on their roles,relationships and capacity to support inclusive practice for students with behavioural emotional and social difficulties

With teachers under pressure to meet curriculum targets, responsibility for including students with behavioural emotional and social difficulties (BESD) in mainstream schools falls heavily on non‐teaching staff. In this article, semi‐structured interviews were conducted with special educational needs coordinators (SENCos) and support staff in a small sample of secondary education settings in England, to examine their perceptions of their role, their relationships with students with BESD and their parents and their ability to facilitate inclusive practice. Despite both SENCo and support staff roles having been regarded as low‐status roles in the past, findings reported here depict a set of highly skilled workers crucial to the inclusion of students with BESD. Through the creation of a nurturing environment combined with caring attitudes and accessibility, these staff were able to form positive relationships with these students and their parents. Implications regarding staffing, resources and inclusion are further discussed.     

School functioning of children in residential care: The contributions of multilevel correlates

ObjectiveThis study, using an ecological approach, examines the relationships between problems in school functioning (including academic and behavior problems) of children in residential care with a number of variables describing the child and the care setting.MethodsThe study reports on 4,061 children and youth (ages 6–20) in 54 Israeli residential care facilities supervised by the Ministry of Welfare. It is based on data derived from an ongoing system of monitoring care based on annual reports by social workers on children in care settings. Additionally, data on the characteristics of the settings were collected through a structured questionnaire completed by the supervisors at the Ministry of Welfare. Hierarchical Linear Modeling (HLM) was utilized to examine how characteristics of the individual children and the care settings were related to problems in school functioning among the children.ResultsMost of the children (about 62%) had at least one problem in school functioning. The most vulnerable children were boys, children who were taken from parental homes by court decree, children with problems in quality of contact with their biological parents, and children who stayed in the care setting for shorter periods. The settings’ characteristics most associated with poor performance at school are group structure (vs. mixed and family home structures), higher levels of peer violence, fewer after-school activities, and settings in which children tend to stay for shorter periods of times.ConclusionsThe findings demonstrate the need for an ecological perspective in addressing children's problems in school functioning within the care system. The results help to identify the types of placements that should benefit from additional resources in order to promote adaptive performance in school among the children.Practice implicationsSocial workers in residential care should give high priority to children's positive academic involvement. The study demonstrates the need for identifying the intersection of the individual, familial and institutional contexts in which problems in school functioning are more prevalent. Therefore, it is important to allocate sufficient resources to care settings which serve these children. The study suggests some priorities and directions for policy and practice with children in residential care.     

Mental health care for foster children in California

This paper reports on a study conducted to assess the health care needs of foster children in California. To evaluate foster children's mental health problems and the services provided to meet them, 154 program administrators, social workers, foster parents, and health care providers were interviewed in 14 counties. Foster parents and social workers were interviewed in groups, and foster parents and administrators also completed questionnaires. We found that although all counties care immediately for children who are injured, abused, or ill, only one county performs routine mental health evaluations of all children, and in most counties less than a third of children ever receive such evaluations. Informants identified mental health problems as more severe than medical problems in this population, and they identified four major barriers to access to appropriate therapy. Recommendations are that all children should receive comprehensive mental health evaluations, and procedures for immediate and ongoing care with consistent providers who are sensitive to foster children's needs should be included in case management plans, and covered by improved payment mechanisms. Additionally, communication, coordination and joint planning should be instituted among relevant agencies to address foster children's needs, and increased resources and training should be directed towards social service agencies and foster parents.     

Interagency collaboration: Strengthening substance abuse resources in child welfare

Supporting child welfare (CW) workers’ ability to accurately assess substance abuse needs and link families to appropriate services is critical given the high prevalence of parental substance use disorders (SUD) among CW-involved cases. Several barriers hinder this process, including CW workers’ lack of expertise for identifying SUD needs and scarcity of treatment resources. Drawing from theories and emergent literature on interagency collaboration, this study examined the role of collaboration in increasing the availability of resources for identifying and treating SUDs in CW agencies. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, study findings highlight a lack of SUD resources available to CW workers. On the other hand, the availability of SUD resources was increased when CW agencies had a memorandum of understanding, co-location of staff, and more intense collaboration with drug and alcohol service (DAS) providers. These results provide evidence to support efforts to improve collaboration between CW and DAS providers and showcase specific collaboration strategies to implement in order to improve service delivery.     

Diversity training for community aged care workers: An interdisciplinary meta-narrative review

Population ageing signals the need for a responsive community aged care workforce respectful of older people’s diverse healthcare needs. Person-centered care premises individual needs and preferences to enhance participation in health care. Training for diversity does not yet exist for this workforce, but is necessary to ensure appropriate care for diverse community-dwelling older people. This article aims to review the range of research traditions for conceptualizing diversity training, theoretical approaches, and empirical findings to understand the relevance for the community aged care sector. Using a meta-narrative approach, research from health, education, psychology, sociology, and business literature was reviewed for meaningful contribution to supporting training for community aged care workers. Meta-narrative review principles included: planning, searching, mapping, appraisal/synthesis, and recommendations. Six meta-narratives were identified, consolidated into three areas: person-centered and culturally competent health care; human rights approach; and psychological approaches to diversity training. The meta-narratives highlighted diversity within diversity and a move toward intersectionality. Meta-narratives were linked through concepts of inclusion, reduction in bias, and access and equity healthcare policy and practice. Training for community aged care workers is challenging, with this synthesis providing new understandings of diversity training, paramount for provision of responsive and equitable health care for older people.     

Foster care assessment: A study of the placement decision process in Flanders

Family foster care placement decision-making has a weak scientific underpinning. Mostly a ‘variable-oriented approach’ is taken, which requires a lot of information that is not always available. The identification of clusters of foster children with similar characteristics may be a more viable decision strategy. In this study we investigated if foster children could indeed be clustered, which problems were identified at the time of placement, and the influence of placement history. It proved possible to group foster children into two clusters: (1) young children with familial problems and few behavioral problems, and (2) older children with prominent child problems and behavioral problems. For foster children with and without placement history, problems associated with placement proved identical. Considering that a foster care placement did not result in fundamental change in the problems present at time of placement, the importance is stressed of approaching foster care assessment as part of a decision making process which looks back as well as forward. Placement decisions should be based on an appraisal of the appropriateness of foster placement as a solution for the child. In conjunction with this appraisal a decision is required on how parents can be supported toward reunification. Or – if this is not an option – whether long term foster care is the best option for the child and if so, what conditions need to be met.     

Mental health training and the hospice community: a national survey

This article summarizes a national survey of the hospice community. Respondents provided detailed information in the following areas: (a) What formal mental health training is provided for staff members? (b) Who conducts this training? (c) What areas are covered and where would more training be useful? (d) How is the training conducted--what formats and teaching materials are used? and (e) How much training do staff members receive? The results of the survey indicate that the hospice community is making a concerted effort to meet the mental health training needs of its paid staff members and volunteers. However, more than half of the hospices surveyed expressed a need for further training in 26 of the 33 issues and skills covered in the questionnaire, and many reported a need for a more systematic and comprehensive mental health curriculum. The findings point to several areas of particularly great need and provide a basis for the development of future mental health training in the hospice community.     

德州市农村预防保健机构人力资源现状分析

目的：了解德州市农村预防保健机构人力资源配置现状．方法：从农村乡镇防保机构数量、人员的年龄、学历、职称等方面进行了全面的调查,对人员的配置量和人员素质进行分析评价．结果：全市农村乡镇防保机构在编人数779人,人均服务人数6347人;平均年龄38岁;拥有中专以上学历者占90．12％,中级及以上职称占31．32％．结论：本市乡镇保防人员年龄偏大,整体素质偏低,应采取各项措施加强农村预防保健机构人力资源建设,保证农村疾病预防控制工作的可持续性发展．     

Improving science teaching practices

A review of research relating to the problem of using research findings to improve classroom practice is presented. There are two aspects to this problem: familiarizing teachers with relevant research and identifying an aspect of teaching that needs to be improved. Research conducted in local settings appears to have most relevance to teachers and is more likely to be accepted by them. Studies indicate that research can have an impact on practice as long as teachers are involved in identification of problems in their class and are provided with a context in which they can learn the strategies to be implemented and understand why they are likely to improve teaching. Teachers need opportunities to practice teaching in peer groups where errors can be made without jeopardizing student learning; receive performance feedback; practice the strategies in their own classes; observe others teach; and discuss teaching with others. Strategy analysis, coaching and peer coaching are techniques which enable most of these criteria to be met and to facilitate science teaching improvement.     

Evaluation of Mental Health Consultation in Child Care Centers

Mental health professionals have speculated that their consultation services should improve the overall quality of a child care center, but few research studies have shown this effect in child care settings. In the present study, mental health consultation services were provided by four agencies to 25 urban child care centers to enhance children's emotional lives and social abilities, and to strengthen child care center staff's capacity to work with children who have difficult behaviors. A one-year evaluation was conducted to assess the impact of the mental health services on the teachers and child care centers using observational measures, director- and teacher-completed questionnaires, and qualitative focus group data. Centers with more than one year of consultation showed increases in overall quality, teachers' self-efficacy, and teachers' competence. In addition, staff expressed satisfaction with the mental health consultation services provided. Implications of findings and suggestions for future interventions are discussed.     

DEVELOPING AND USING INTERDISCIPLINARY CASE STUDIES IN TEACHING GERIATRICS TO PRACTICING HEALTH CARE PROFESSIONALS

Continuing education programs for health care professionals who practice in geriatrics are an important part of improving the health care provided to older adults. Programs utilizing active forms of learning that mimic the clinical environment are more successful at changing the behavior of health care professionals than traditional didactic styles of teaching. Problem-based learning methods allow learners to identify their own areas of strength and weakness and to work toward improvement in a manner best suited to their needs. This article describes an interdisciplinary team of educator-clinicians in geriatrics who developed clinical case studies embodying these approaches as one method of improving the learning process for adult health care providers. An actual sample case study is presented as an illustration of the principles embodied in this process. Lessons learned from the development and use of these case studies are summarized in the context of improving the quality of continuing education programs for health care professionals in geriatric practice.     

Early Childhood Education and Care Content for the Social Work Curriculum

Social workers are poised to play an important role in early childhood education and care (ECEC) settings; however, they need the knowledge and skills necessary to make a meaningful contribution. This article presents learning activities that infuse ECEC content, centered on the following four areas for social work education: (1) history of the profession, (2) observation of current practice, (3) culturally competent service delivery, and (4) advocacy to enhance social justice. Through this infusion of content, social work educators can better prepare their students for the growing field of ECEC practice and for social work practice more broadly.     

Care or scare: the safety of youth in congregate care in New York City

OBJECTIVE: This qualitative study examined stakeholders' perceptions of the safety of youth ages 12 and older living in congregate care facilities within the New York City foster care system. The study explored the youth's physical safety, the safety of their personal belongings, the physical conditions of congregate care settings, and the relationship between staff quality and youth safety. METHOD: The study involved interviews with family court judges, representatives of private child welfare agencies, attorneys who represent children in foster care, social workers, representatives of advocacy and other relevant organizations in New York City, and former foster youth who had been placed in congregate care settings. RESULTS: Safety in congregate care environments was an issue of significant concern. Threats to the youth's safety were found to emanate from peer-on-peer violence, stealing of personal belongings, inappropriate staff conduct, and the poor physical conditions of facilities. Youth's sense of safety was strongly linked to staff quality, including staff ability to relate effectively to youth and to maintain control of congregate care environments. CONCLUSIONS: Existing regulations in New York State appear to have had little effect in ensuring the safety of youth in many group and residential care facilities. Steps to improve safety outcomes for youth in these settings are proposed.     

Sexuality in Older Adults: Effect of an Education Intervention on Attitudes and Beliefs of Residential Aged Care Staff

The sexual needs and wellbeing of older people living in residential aged care receives scant attention in practice, is easily dismissed by care staff, and remains a significant challenge for aged care service providers. This study reports on the evaluation of an education program delivered to residential aged care nurses to improve their knowledge about, and attitudes towards, older people's sexuality in this context. Participants' attitudes and beliefs towards older people expressing their sexuality in long-term care, including same sex couples and people with dementia, were more permissive following education. Findings further underscore the value of sexuality education as an important factor in dispelling the commonly held negative views of residential aged care staff about older people expressing their sexuality, thereby improving staff responses to this issue.     

关于我国数字信息资源长期保存问题研究

数字信息资源长期保存是近几年国内外关注的热点问题.本文结合国内外研究现状与进展,客观地分析了我国数字信息资源长期保存所存在的问题,提出了我国数字信息资源长期保存需要采取政策推进、完善管理体系、构建技术支撑体系等发展策略,对我国数字信息资源长期保存的实践具有重要的现实指导意义.     

Intensive oversight of youth residential treatment: Staff perspectives on the New York State Justice Center for the Protection of People with Special Needs

Youth care workers in U.S. residential treatment centers (RTCs) provide 24-h care to youth whose significant psychosocial needs cannot be managed in a less restrictive setting. They have sometimes abused or neglected youth in their care. This study investigates staff perspectives on a new form of intensive oversight developed in New York State to prevent maltreatment of youth in care facilities. It asks: How does intensive oversight and investigation mandated by a state-run agency for the protection of people in care affect residential youth care workers in RTCs? Derived from a 15-month ethnographic study of an RTC serving a child welfare population conducted in 2015 and 2016, these results suggest that intensive oversight may have unanticipated consequences for RTCs, the youth care workforce, and youth in care. Consistent with other studies of regulation and surveillance in risk societies, participants reported that fear of prolonged and intimidating investigations, false allegations, and unavoidable violations of policy negatively affected their practice and contributed to staff turnover. Organizational consequences included serious staffing challenges and increased costs of overtime and administrative management of compliance. Some participants suggested that the form of intensive oversight studied here may have reduced the quality of care received by youth by disrupting therapeutic relationships, causing youth to be cared for by unfamiliar workers, and compelling workers to act defensively to prevent allegations rather than in the best interest of youth. We suggest that, under conditions of intensive oversight, youth care workers, like their clients, should be considered an at risk population whose well being is essential for the provision of high quality care. We conclude with modest recommendations to organizations and jurisdictions using or considering intensive oversight practices to protect the rights and safety of youth in RTCs.     

Working towards better education for children in care: longitudinal analysis of the educational outcomes of a cohort of children in care in Australia

ABSTRACT

Internationally, reviews of educational outcomes of children in care reveal consistent findings highlighting the need for considerable policy attention to be paid to their education to ensure they achieve optimal economic and psychosocial life outcomes. Important to enhancing the educational achievement of children in care are support, stability of environment, teaching resources and the recognition by all stakeholders – birth parents, foster carers, social workers and statutory authorities — that education is paramount to a child’s future well-being. This paper highlights the perspectives of carers, teachers and children on the fostering experience with particular focus on educational outcomes drawing on a prospective longitudinal study of children in long-term care. Using a multimethod, repeated measures multi-informant design, children were assessed by carers and teachers using the Achenbach Child Behaviour Checklist and its companion, the Teacher Report. The findings indicate demonstrated gains in terms of improved scores and adaptive functioning at subsequent assessments following two years of stable care. Discussion of the findings and implications for practice will focus on the need for a coordinated strategy to improve placement continuity and focused professional and organisational support with respect to the emotional and educational needs of children in care.