The assessment of the readiness of five countries to implement child maltreatment prevention programs on a large scale

This study aimed to systematically assess the readiness of five countries – Brazil, the Former Yugoslav Republic of Macedonia, Malaysia, Saudi Arabia, and South Africa – to implement evidence-based child maltreatment prevention programs on a large scale. To this end, it applied a recently developed method called Readiness Assessment for the Prevention of Child Maltreatment based on two parallel 100-item instruments. The first measures the knowledge, attitudes, and beliefs concerning child maltreatment prevention of key informants; the second, completed by child maltreatment prevention experts using all available data in the country, produces a more objective assessment readiness. The instruments cover all of the main aspects of readiness including, for instance, availability of scientific data on the problem, legislation and policies, will to address the problem, and material resources. Key informant scores ranged from 31.2 (Brazil) to 45.8/100 (the Former Yugoslav Republic of Macedonia) and expert scores, from 35.2 (Brazil) to 56/100 (Malaysia). Major gaps identified in almost all countries included a lack of professionals with the skills, knowledge, and expertise to implement evidence-based child maltreatment programs and of institutions to train them; inadequate funding, infrastructure, and equipment; extreme rarity of outcome evaluations of prevention programs; and lack of national prevalence surveys of child maltreatment. In sum, the five countries are in a low to moderate state of readiness to implement evidence-based child maltreatment prevention programs on a large scale. Such an assessment of readiness – the first of its kind – allows gaps to be identified and then addressed to increase the likelihood of program success.     

Childhood maltreatment and post-traumatic stress disorder among incarcerated young offenders

Young offenders have a high prevalence of mental illness and a large proportion report experiencing a number of traumatic events during childhood, but there is little research exploring this association. This study describes the prevalence of, and association between, child maltreatment and post-traumatic stress disorder (PTSD) among young offenders. The study uses data collected as part of the 2009 NSW Young People in Custody Health Survey which was conducted in nine juvenile detention centers. This paper reports on findings from the baseline questionnaires and 18-months of re-offending data. The analysis included 291 participants who were assessed for PTSD and child maltreatment. The sample was 88% male, 48% Aboriginal, with an average age of 17 years (range 13–21 years). One in five (20%) participants were diagnosed with PTSD, with females significantly more likely to have PTSD than males (40% vs. 17%, p < 0.05). Over half (60%) of young offenders reported any child abuse or neglect, with females nearly 10 times more likely to report three or more kinds of severe child maltreatment than males. The main correlate for a diagnosis of PTSD was having three or more kinds of severe child maltreatment (OR = 6.73, 95% CI: 1.06–42.92). This study provides evidence for the need to comprehensively assess child abuse and neglect among young offenders in order to provide appropriate treatment in custody and post-release.     

Beyond the Tipping Point: Issues of Racial Diversity in Magnet Schools Following Unitary Status

This article uses qualitative case study methodology to examine why the racial composition of magnet schools in Nashville, Tennessee, has shifted to predominantly African American in the aftermath of unitary status. The article compares the policy contexts and parents' reasons for choosing magnet schools at two points in time—under court order and under unitary status. Social networks, choice sets, and “closer to home” student assignment policies are identified as key influences on the changing demographics of magnet schools in a postunitary status environment.     

A psycho‐educational approach to helping adolescents cope

Understanding Children, Vol. I, State, Education And Economy; Vol. II, Changing Experiences And Family Forms Anne Cleary, Maire Nic Ghiolla Phadraig and Suzanne Quin (eds) Oaktree Press, 2001. No price.     

UpToDate versus DynaMed: a cross-sectional study comparing the speed and accuracy of two point-of-care information tools

Objective:To compare the accuracy, time to answer, user confidence, and user satisfaction between UpToDate and DynaMed (formerly DynaMed Plus), which are two popular point-of-care information tools.Methods:A crossover study was conducted with medical residents in obstetrics and gynecology and family medicine at the University of Toronto in order to compare the speed and accuracy with which they retrieved answers to clinical questions using UpToDate and DynaMed. Experiments took place between February 2017 and December 2019. Following a short tutorial on how to use each tool and completion of a background survey, participants attempted to find answers to two clinical questions in each tool. Time to answer each question, the chosen answer, confidence score, and satisfaction score were recorded for each clinical question.Results:A total of 57 residents took part in the experiment, including 32 from family medicine and 25 from obstetrics and gynecology. Accuracy in clinical answers was equal between UpToDate (average 1.35 out of 2) and DynaMed (average 1.36 out of 2). However, time to answer was 2.5 minutes faster in UpToDate compared to DynaMed. Participants were also more confident and satisfied with their answers in UpToDate compared to DynaMed.Conclusions:Despite a preference for UpToDate and a higher confidence in responses, the accuracy of clinical answers in UpToDate was equal to those in DynaMed. Previous exposure to UpToDate likely played a major role in participants'' preferences. More research in this area is recommended.     

Round-robin presentations: Increasing opportunities for public speaking in large lectures and beyond

Courses: Large-lecture; public speaking, business, professional, and technical communication; sales and marketing courses; courses with team-based projects

Objectives: To provide opportunities to develop public speaking skills, especially in large-lecture courses; to improve public speaking endurance; to improve students’ abilities to give concise and focused presentations; to reduce public speaking anxiety.     

Bringing evidence to practice: a team approach to teaching skills required for an informationist role in evidence-based clinical and public health practice

Objective: The objectives were (1) to develop an academic, graduate-level course designed for information professionals seeking to bring evidence to clinical medicine and public health practice and to address, in the course approach, the “real-world” time constraints of these domains and (2) to further specify and realize identified elements of the “informationist” concept.Setting: The course took place at the Division of Health Sciences Informatics, School of Medicine, Johns Hopkins University.Participants: A multidisciplinary faculty, selected for their expertise in the course core competencies, and three students, two post-graduate National Library of Medicine (NLM) informationist fellows and one NLM second-year associate, participated in the research.Intervention: A 1.5-credit, graduate-level course, “Informationist Seminar: Bringing the Evidence to Practice,” was offered in October to December 2006. In this team-taught course, a series of lectures by course faculty and panel discussions involving outside experts were combined with in-class discussion, homework exercises, and a major project that involved choosing and answering, in both oral and written form, a real-world question based on a case scenario in clinical or public health practice.Conclusion: This course represents an approach that could be replicated in other academic health centers with similar pools of expertise. Ongoing journal clubs that reiterate the question-and-answer process with new questions derived from clinical and public health practice and incorporate peer review and faculty mentoring would reinforce the skills acquired in the seminar.

Highlights

• Interdisciplinary faculty designed and offered a graduate-level course to teach the skills required by an informationist in clinical and public health practice, further elaborating a model for preparing informationists.

Implications

• This scalable approach to teaching skills for the transfer of evidence into practice could be replicated in academic health centers with similar pools of expertise; such replication could contribute data toward validating this training approach.
• Greater clarity on an appropriate, or “good enough,” standard of evidence for supporting point-of-action decision making is needed.
• Based on the assumption that practicing skills increases confidence and the likelihood that skills will be applied, this course included mentored practice of oral and written evidence presentation skills. Further research could determine whether a course that includes such mentored practice increases the likelihood that students will apply their newly acquired skills.

     

Walk-In Triage Systems in University Counseling Centers

To meet the complex mental health needs of students, some university counseling centers (UCCs) have implemented walk-in triage intake systems, which have not yet been empirically investigated. This study compared client and clinician differences (N = 5564) between a traditional scheduled intake system (Year 1) and a walk-in triage system (Year 2) at a large, southeastern UCC. Results showed a significant increase in clients’ attendance rates and clinicians’ caseloads, a significant decrease in no-show rates, and no change in students’ symptom severity at intake between Years 1 and 2. Clinicians’ number of scheduled appointments were unchanged, indicating that clinicians were already at maximum capacity for appointments in Year 1. Results are discussed in terms of the benefits and challenges that walk-in triage systems present to students, universities, and UCCs.