Substance Abuse Policies in Long-Term Care Facilities: A Survey with Implications for Education of Long-Term Care Providers

The aging of the Baby Boom presents long-term care with many new challenges. Among these are the historically high levels of drug use by this cohort. This study surveyed administrators of licensed skilled nursing facilities in the Commonwealth of Kentucky regarding their perception of current drug use by residents, facility policies and procedures currently in place regarding illicit drug use, and their attitudes toward use of illicit drugs by residents. The results of interviews with 40 administrators or their designees revealed that they have experienced little problem with use or abuse of illegal drugs by residents. Fewer than one-third of the facilities had formal policies in place regarding illegal drug use. Only 10% had any experience with requests for medical marijuana, but almost one in five had a policy on the matter and nearly one-third stated they would support medical marijuana use by some of their residents if the matter arose. These authors recommend the following: (a) that the issue of illicit drug use needs to be addressed now before the situation becomes critical, (b) that administrators and staff need to be educated about recreational drug use and appropriate responses to drug abuse, (c) that screening instruments for drug abuse in this population should be developed and implemented, and (d) that policies regarding medical marijuana need to be adopted by all such facilities.     

“Why Give Up Something That Works So Well?”: Retirement Expectations Among Academic Physicians

For individuals with strong work identities, the decision to retire can be particularly challenging. For academic physicians, retirement is an important personal decision that also has far-reaching implications for the healthcare system. This is because academic physicians are responsible for producing the research from which key medical decisions are made, for training future healthcare providers, and for providing specialized care for patients. For this study, we conducted focus groups with academic physicians from a large research university in Canada and then performed inductive thematic analyses to examine perceptions and concerns about later life career transitions. This study highlights tensions between professional experiences for the next generation of physicians and individual struggles with personal identity. Findings suggest improvements to institutional programs that support flexible, agentive, and respectful retirement transitions will not only be beneficial but necessary as medical and university systems continue to grapple with issues of balanced recruitment and succession.     

Fostering Instructor Knowledge of Student Thinking Using The Flipped Classroom

Abstract

In this article, we share a model of flipped instruction that allowed us to gain a window into our students’ mathematical thinking. We depict how that increased awareness of student thinking shaped our mathematics instruction in productive ways. Drawing on our experiences with students in our own classrooms, we show how flipped instruction can be used to design experiences that help students make sense of mathematics during class sessions.     

Understanding participant and practitioner outcomes of environmental education

Environmental education can deliver benefits to individuals, society and the environment, but few studies have asked practitioners or participants what they feel these benefits are. This research compares the perspectives of practitioners and participants in environmental education projects, using questionnaires, focus groups and participant observation. Practitioners and participants listed a large number of outcomes, with increasing knowledge about the environment mentioned most frequently. For participants, this was often in relation to gaining new skills. Social outcomes, such as making new friends, were more prominent in participant than practitioner responses. Practitioners did not spontaneously mention any negative outcomes of environmental education, and few were suggested with prompting. Participants suggested more negative outcomes than practitioners, notably damage to the environment. The differing views suggest a need for greater discussion between practitioners and their participants.     

Infant vocalizing and phenotypic outcomes in autism: Evidence from the first 2 years

Infant vocalizations are early-emerging communicative markers shown to be atypical in autism spectrum disorder (ASD), but few longitudinal, prospective studies exist. In this study, 23,850 infant vocalizations from infants at low (LR)- and high (HR)-risk for ASD (HR-ASD = 23, female = 3; HR-Neg = 35, female = 13; LR = 32, female = 10; 80% White; collected from 2007 to 2017 near Philadelphia) were analyzed at 6, 12, and 24 months. At 12 months, HR-ASD infants produced fewer vocalizations than HR-Neg infants. From 6 to 24 months, HR-Neg infants demonstrated steeper vocalization growth compared to HR-ASD and LR infants. Finally, among HR infants, vocalizing at 12 months was associated with language, social phenotype, and diagnosis at age 2. Infant vocalizing is an objective behavioral marker that could facilitate earlier detection of ASD.     

Autistic young people’s experiences of transitioning to adulthood following the Children and Families Act 2014

Changes to special educational needs and disability (SEND) legislation in England were implemented in 2014. Here, we evaluate the impact of these changes from the perspective of 80 autistic young people aged 16–25 years. Using an online survey and/or interviews, we examined young people’s views on three key principles of the SEND reforms: the help and support provided to them; whether they were given a say in the choices and support that they were offered; and their satisfaction with their educational journeys and outcomes. The results paint a mixed picture. Our sample of young people reported varied experiences regarding the help and support they received, and how much of a say they had regarding the choices and support available to them. The types of schooling they accessed played a role here: young people in mainstream schools highlighted particular challenges in accessing appropriate support, while many young people in special schools said they felt well supported. Parental advocacy was crucial for all young people, as was having key ‘champions’ in the form of teachers who really knew them well. The need for the development of general life and self-advocacy skills was apparent, however, especially in preparing the young people for life after school. Encouragingly, most of our participants were generally happy with their current situation, despite identifying several areas for further improvement. Overall, the results highlight the importance of listening to—and learning from—autistic young people, throughout their educational journeys and especially as they transition to adulthood.     

Conditions for mental health in education: Towards relational practice

There are concerns globally about the emotional wellbeing and mental health of young people and in this paper a critical orientation comprises both theoretical and empirical data sources. The case is made that (1) the medical model of mental health – that of problem identification, diagnosis and medical treatment at the level of the individual – is not appropriate for the vast majority of children and young people in schools and (2) relational approaches would be more sensitive in responding to the complexity of the ‘conditions’ in the schools, homes and communities in which young people live. Articulations of these conditions in the literature are explored while we also draw on empirical data from part of an evaluation of a school-based teacher-training programme in which interviewees and respondents mapped out their own conditions for emotional wellbeing and mental health. We conclude with proposals for relational approaches which (1) acknowledge the links between affect, cognition and school climate and culture, (2) foreground mental health and poverty as impacting on young people’s emotional wellbeing in their communities, families and schools and (3) attend to voice – providing spaces in which young people can develop their own ‘preferred narratives’ concerning emotional wellbeing and mental health.