A mixed-methods evaluation of the experience of emerging young adult care partners

There is limited literature on emerging young adult (EYA) care partners, despite a recent rise in interest in this group. The purpose of this study is to compare EYA care partners and their non-care partner peers in the domains of academic achievement and engagement, employment, health-related behaviors and self-care, and mental health and respite, as well as to assess EYA care partners’ burden and potential for positive psychosocial sequelae and life changes as a result of their role. Further, within EYA care partners, we examine the relationship between mental health variables and care partner-relevant variables. Two hundred undergraduates (100 care partners and 100 non-care partners) completed measures of academic achievement and engagement (grade point average and credit load), employment (number of paid positions held and number of hours worked per week), health-related behavior/self-care (visits to the dentist, primary care physician, optometrist, diet healthfulness, exercise, cigarette smoking, and drinks per week) and mental health/respite (depression, anxiety, loneliness, drinking, social support, peer pressure, vacation recency, and frequency). Care partners completed measures of spiritual well-being, burden, meaning, and benefit-finding, as well as provided qualitative feedback on how caregiving changed their lives. EYA care partners and non-care partners did not differ on any variables examined except for the number of jobs held, as EYA care partners held more paid jobs than EYA non-care partners. EYA care partners showed moderate burden and high levels of finding meaning/benefit, the latter of which was supported by the themes that emerged from their qualitative data. Within EYA care partners, we found that depression and anxiety (mental health variables) were significantly related to spiritual well-being, burden, benefit finding, and finding meaning through caregiving (care partner-relevant variables). It is encouraging that the care partner and non-care partner groups were similar in domains critical for this age group, such as academic achievement and engagement.     

How to conduct External Quality Assessment Schemes for the pre-analytical phase?

In laboratory medicine, several studies have described the most frequent errors in the different phases of the total testing process, and a large proportion of these errors occur in the pre-analytical phase. Schemes for registration of errors and subsequent feedback to the participants have been conducted for decades concerning the analytical phase by External Quality Assessment (EQA) organizations operating in most countries. The aim of the paper is to present an overview of different types of EQA schemes for the pre-analytical phase, and give examples of some existing schemes. So far, very few EQA organizations have focused on the pre-analytical phase, and most EQA organizations do not offer pre-analytical EQA schemes (EQAS). It is more difficult to perform and standardize pre-analytical EQAS and also, accreditation bodies do not ask the laboratories for results from such schemes. However, some ongoing EQA programs for the pre-analytical phase do exist, and some examples are given in this paper. The methods used can be divided into three different types; collecting information about pre-analytical laboratory procedures, circulating real samples to collect information about interferences that might affect the measurement procedure, or register actual laboratory errors and relate these to quality indicators. These three types have different focus and different challenges regarding implementation, and a combination of the three is probably necessary to be able to detect and monitor the wide range of errors occurring in the pre-analytical phase.     

Why would medical publishers not incorporate core bioethical values into their Ethics Guidelines?

It is quite universally acknowledged by bioethicists, at least in the western world, that respect for the patients’ autonomy, non-malevolence, beneficence, and justice (also called equity) are four core ethical values in medicine. The Ethics Guidelines of key journals in laboratory medicine are not explicit about the first three of these values, and even implicitly, they seem to miss values of justice. Health equity being one of the main objectives of public health policy across the world, we suggest that values of equity explicitly become part of the Ethics Guidelines of laboratory medicine journals. Biochemia Medica could show the way to other medical publishers by incorporating into its Ethics Guidelines these very important core bioethical values.     

以生为本是开启后进生心灵之门的金钥匙

由于学校比较重视学生的智力发展而忽略了素质教育,导致后进生逐年增多,严重制约着教育教学质量的提高。因此,是否能有效地转化后进生是保证和提高教育教学质量的关键,是学校德育工作的重中之重,这也已成为广大教育工作者的共识。     

人文关怀视野下大学语文课程改革与综合素养的提升

社会经济的高速发展与大学教育的普及化浪潮巩固了大学应用型、实用型学科课程教学的中心地位,而作为人文科学基础学科的大学语文课却没有得到应有的重视。语文课程是当代大学生内在精神发展的动力,也是提升大学生综合素养的基础所在。鉴于人文关怀的缺失是目前大学课程设置中普遍存在的问题,大学语文课程的改革应当立足于学科的人文性目标定位,通过“知、情、行”三者的有机结合,构建充满人文关怀的语文教学模式。     

Implementing the Generalist Model in Practice

Abstract

Through a study of field tasks performed by MSW foundation students, the authors show an empirical relationship to the Gener-alist model of practice. Secondarily, the paper explores whether practice under managed care should be used to inform curriculum or whether standards embedded in curriculum should be used to influence current practice. Implications for student learning in field and classroom are discussed.     

论青少年心理失衡

心理失衡是当代青少年中较普遍存在的心态形式，是影响青少年心理健康最本质的根源。重视心理失衡的研究，探索其预防和疏导的有效策略，使青少年在任何条件下都能保持心理的相对平衡，这是克服和消除一切心理问题的根本性措施，也是促进学校素质教育的务本之举。在类型考察与心理失衡分析的基础上，引导青少年战胜心理失衡的策略，一是增强内在心理保健素养，二是有针对性地开展心理疏导，并对相关具体措施进行提炼与概括。     

Coping styles in youth exposed to maltreatment: Longitudinal patterns reported by youth in foster care

Coping styles in youth living in foster care with a history of maltreatment were examined to determine the nature and stability of self-reported coping behavior over time. Participants included 542 (time 1), 377 (time 2), and 299 (time 3) youth ages 8–22 years (M = 13.28 years, SD = 3.04). Using the Behavioral Inventory of Strategic Control, a dimensional, continuous measure of coping, across four possible coping styles endorsed in reference to specific potentially stressful situations, the results indicated that direct action coping was the most frequently endorsed or preferred style for more than 50% of the sample at each time point. A number of youth endorsed using more than one coping style, indicating some flexibility in the approach to coping when problems occur. Although most youth endorsed a preferred style, coping style endorsed did vary somewhat over time. The coping style endorsed also varied depending on the type of problem referenced, but no statistically significant differences were noted across situations, including social, academic, general, and foster-specific situations. Effects for age were also examined and the results indicated no significant differences across the age range for type of coping most commonly endorsed. The present study is the first large-scale, longitudinal assessment of coping styles in youth in foster care and the results suggest that coping is not a simple, categorical-only construct and the implications for the endorsement of the direct approach for youth in foster care along with the other findings are discussed.     

Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration

Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs. Child welfare decision-makers must be informed of infant brain development and knowledgeable about the particular needs and circumstances of each child. This article describes a model with these features that has been developed and tested in the Bronx, New York, one of the nation's poorest urban counties with high rates of foster care. The Project utilizes evidence-based Child-Parent Psychotherapy (CPP) as its core intervention, and emphasizes collaboration and information sharing– driven by the CPP clinician– with judges, child welfare workers, attorneys and other social service and mental health providers, thereby encouraging developmentally and relationally informed case planning and permanency decisions. The model is evaluated using pre and post treatment psychosocial measures and program outcome data. Results indicate improvement in parenting interactions, positive child welfare outcomes (including increased rates of reunification, fewer returns to foster care), and improved safety and wellbeing. Results highlight the need for child welfare practices to be more closely aligned with the current science of infant brain development, and to incorporate a specialized approach to address the unique needs of infants.     

Clout or doubt? Perspectives on an infant mental health service for young children placed in foster care due to abuse and neglect

Despite knowledge about the profound effects of child abuse and neglect, we know little about how best to assess whether maltreated children should return home. The effectiveness of the New Orleans Intervention Model (NIM) is being tested in a randomized controlled trial where the comparison is social work ‘services as usual.’ The future trial results will tell us which approach produces the best outcomes for children; meanwhile qualitative process evaluation is generating intriguing findings about the perceived impact of NIM on decision-making about childrens’ futures. Interviews and focus groups were conducted with social workers, foster carers, legal decision-makers and the NIM team (n = 63). Data were analysed thematically. Findings suggest that NIM is seen as bringing greater influence (‘clout’) to decision-making due to its depth of focus, provision of treatment for the family, health professional input and perceived objectivity. Simultaneously, the NIM approach and the detailed information it produces potentially throws judgments into doubt in the legal system. Clout/doubt perceptions permeate opinions about NIM and are inter-related with a historical discourse about ‘health versus social’ models of information gathering, with implications for assessment of child abuse and neglect that extend beyond the study context. The juxtaposition of ‘clout versus doubt’ both highlights and is strengthened by an intense focus among social workers and legal professionals on how evidence will be regarded within legal fora when making decisions about children. There is continuing uncertainty in the child welfare system about the best ways of assessing maltreated children, underscoring a continued need for the trial.