Does More Intensive Neonatal Intensive Care Unit Follow-Up Service Result in Better Outcomes? A Cost-Effective Analysis

Little is known about the relative cost-effectiveness of the many different types of early intervention services provided to medically fragile infants and their families. This study compared two intensities of services for such infants and their families: (a) a coordinated and comprehensive system of early intervention services initiated prior to discharge from the NICU and designed to transition infants to community-based services were compared with the effects of services (high intensity); and (b) a more traditional hospital follow-up consisting of medical checkups and referrals following discharge (low intensity). High-intensity services resulted in five times more community-based early intervention hours for families and infants when compared with low-intensity services. Annual costs of the high-intensity group were approximately triple the costs of the low-intensity group ($10,814 versus $3,032 per child per year), but there were only a few statistically significant differences on measures of child and family functioning between the groups at 6-, 12-, 18-, and 24months' corrected age. Implications of these findings for research and practice are given.     

Introduction to the special issue ‘How adolescents read and learn on the Web: internal and external factors (Introducción al número especial ‘Cómo leen y aprenden los adolescentes en la red: factores internos y externos’)

ABSTRACT

The World Wide Web has become a major information resource for adolescents (i.e., 10–19 years of age), offering an unprecedented amount of information on virtually any topic. While the Web can potentially offer new learning opportunities, it also presents several challenges. Reading and learning on the Web requires a set of advanced literacy skills that adolescents do not necessarily possess and need to develop in order to effectively deal with the complexity of information encountered online. This special issue brings together five empirical articles and a discussion paper that examine internal and external factors that are beneficial (or detrimental) to adolescents’ reading and learning on the Web, and contribute to explaining how young learners develop complex literacy skills. Theoretically, the special issue contributes to the conceptualization of what researchers refer to as ‘multiple documents literacy’. In practice, it informs researchers and educators of emerging empirical results regarding adolescents’ information behaviour, as well as on instructional strategies that can be effective for developing adolescents’ literacy skills.     

Teacher ratings of social skill by direct observation and through interactive video

The purpose of this study was to investigate the relationship between interactive video based teacher ratings and direct classroom observation of social skills. The behaviour of 25 randomly selected grade seven children aged between 11 and 12 years was rated by nine teachers using items from an interactive video social skills rating scale (Bain 1989). A video camera was then placed in each of the teacher's classrooms for one week to sample the actual behaviour of the target children. Measures obtained showed correlations ranging from — 0.39 to 0.77, whilst percentage agreement between rated and actual behaviour varied from 28% to 74% over the course of the study.     

Interagency collaboration between child protection and mental health services: practices, attitudes and barriers

OBJECTIVE: The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and experiences, and barriers to effective collaboration. METHOD: A self-administered, cross-sectional survey was developed and distributed via direct mail or via line supervisors to workers in statutory child protection services, adult mental health services, child and youth mental health services, and Suspected Child Abuse and Neglect (SCAN) Teams. There were 232 completed questionnaires returned, with an overall response rate of 21%. Thirty-eight percent of respondents were statutory child protection workers, 39% were adult mental health workers, 16% were child and youth mental health workers, and 4% were SCAN Team medical officers (with 3% missing data). RESULTS: Analysis revealed that workers were engaging in a moderate amount of interagency contact, but that they were unhappy with the support provided by their agency. Principle components analysis and multivariate analysis of variance (MANOVA) on items assessing attitudes toward other workers identified four factors, which differed in rates of endorsement: inadequate training, positive regard for child protection workers, positive regard for mental health workers, and mutual mistrust (from highest to lowest level of endorsement). The same procedure identified the relative endorsement of five factors extracted from items about potential barriers: inadequate resources, confidentiality, gaps in interagency processes, unrealistic expectations, and professional knowledge domains and boundaries. CONCLUSIONS: Mental health and child protection professionals believe that collaborative practice is necessary; however, their efforts are hindered by a lack of supportive structures and practices at the organizational level.     

Socioeconomic status and health in adolescents: the role of stress interpretations

The role of psychological interpretations in the relationship between low socioeconomic status (SES) and physiological responses was tested. One hundred high school students (ages 15–19) watched videos of ambiguous and negative life situations, and were interviewed about their interpretations. Lower SES was associated with greater threat interpretations during ambiguous (but not negative) situations and with greater diastolic blood pressure and heart rate reactivity. Threat interpretations partially mediated relationships between SES and reactivity. General life events (e.g., lack of positive life events), rather than specific life events (e.g., exposure to violence), partially explained the relationship between low SES and threat interpretations. Results suggest that the larger social environment helps explain how adolescents approach new social situations, which in turn has implications for adolescent physical health.     

A study of clerics who commit sexual offenses: are they different from other sex offenders?

OBJECTIVE: The goal of this study was to determine if cleric-sex offenders differed significantly from other sex offenders when compared to a control group and assessed with standard instruments that examine the major factors important in sexual offenses. METHOD: Twenty-four male clerics accused of sexual offenses were compared to 24 male sex offender controls, matched on offense type, age, education, and marital status. Both groups were compared to a general sample of sex offenders (n = 2125) matched only for offense type. The three groups were compared on sexual history and preference, substance abuse, mental illness and personality, history of crime and violence, neuropsychological impairment, and endocrine abnormalities, using reliable and valid measures. RESULTS: The clerics in this study formed a statistically significant highly educated, older, and predominantly single subgroup of sex offenders. The majority of cleric-sex offenders suffered from a sexual disorder (70.8%), predominantly homosexual pedophilia, as measured by phallometric testing, but did not differ from the control groups in this respect. The clerics were comparable to the other two groups in most respects, but tended to show less antisocial personality disorders and somewhat more endocrine disorders. The most noteworthy features differentiating the clerics from highly educated matched controls were that clerics had a longer delay before criminal charges were laid, or lacked criminal charges altogether, and they tended to use force more often in their offenses. CONCLUSIONS: In spite of differences in age, education, and occupation between cleric-sex offenders and sex offenders in general, the same procedures should be used in the assessment of this group as for the sex offender population in general. Hypotheses about reduced sexual outlet and increased sexual abuse of clerics in childhood were not supported. Assessment and treatment of cleric-sex offenders should focus especially on sexual deviance, substance abuse, and endocrine disorders.