Involvement In Such Programs Research Articles

Technology-Assisted Parenting Intervention Plus Therapist Coaching: A Pilot Randomized Trial in a Community Practice Setting

ABSTRACT Disruptive behaviors are the most common clinical presentation in children and adolescents, particularly among disadvantaged youth referred to community mental health clinics (CMHCs). When left unaddressed, disruptive behaviors can increase the risk of adverse mental health outcomes. While parenting interventions are known to be efficacious and efficient treatment approaches, there are many barriers to involvement in such programs, particularly for disadvantaged populations. This pilot randomized controlled trial evaluated a technology-assisted parenting intervention (Parenting Wisely, PW) with therapist coaching compared to treatment as usual (TAU) at a CMHC. Participants included 53 caregiver-adolescent dyads and 13 clinicians recruited from a CMHC. Dyads randomized to PW + therapist coaching received a multi-component intervention that utilized a technology-assisted parenting program alongside therapist coaching sessions. Feasibility/acceptability assessments were conducted and preliminary findings on parenting outcomes and adolescent behavior outcomes were collected at 3- and 6-months post-baseline. Qualitative and quantitative results supported the feasibility and acceptability of the parenting PW + therapist coaching intervention as evidenced by caregiver engagement, therapist adherence, lack of treatment withdrawals, and satisfaction ratings. Exploratory analyses did not show differences between treatment conditions for parenting and adolescent behavioral outcomes. PW + therapist coaching may be better suited for early adolescents, who are at a critical period when disruptive behavior patterns are not yet ingrained, and parents have more authority and opportunity to address family interactions. Next steps for further evaluation include testing the effectiveness, predictors, moderators, and mechanisms of treatment outcomes of PW + therapist coaching as an adjunct to usual care.

Provision of infertility care for the underserved in reproductive endocrinology and infertility practices associated with obstetrics and gynecology residency training programs in the United States

ObjectiveTo survey practice patterns designed to increase access to infertility care and evaluate the exposure of obstetrics and gynecology residents to infertility care for the underserved.DesignCross-sectional.SettingReproductive endocrinology and infertility (REI) practices associated with Accreditation Council for Graduate Medical Education-accredited obstetrics and gynecology residency training programs.Patient(s)None.Intervention(s)Questionnaire survey.Main Outcome Measure(s)Presence of clinical programs designed to improve access to REI care, resident involvement in such programs, and perceived barriers to expanding access to care.Result(s)Clinical initiatives to expand access included discounted infertility services (38%, n = 30), utilization of a low-cost in vitro fertilization (IVF) program (28%, n = 22), and utilization of a resident- and/or fellow-staffed clinic to provide infertility care (39%, n = 31). The most commonly discounted infertility services were IVF (73%, n = 22), clinical consultation (70%, n = 21), and intrauterine insemination (53%, n = 16). The provision of discounted prices was correlated with the increasing practice size (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.23–4.24) and number of assisted reproductive technology cycles performed annually (OR, 3.65; 95% CI, 1.48–9.02). Academic REI practices (OR, 3.6; 95% CI, 0.98–13.25) were more likely to have a low-cost IVF program. Less than half of obstetrics and gynecology residency programs (39%, n = 31) had an associated REI clinic in which obstetrics and gynecology residents provide direct infertility care to the medically underserved. Frequency and services offered in trainee clinics varied. Multiple barriers to expanding access to care were reported.Conclusion(s)Reproductive endocrinology and infertility practices associated with obstetrics and gynecology residency programs utilize a diverse range of approaches to provide infertility care to the underserved in the backdrop of considerable challenges and barriers, but significant gaps persist.

Creation of a Pharmacy Student Longitudinal Rotation to Expand the Scope of an Antimicrobial Stewardship Program.

Allergy assessments and penicillin skin testing have emerged as a vital intervention for Antimicrobial Stewardship Programs (ASPs). Investment and involvement in such programs by ASPs, however, are often limited due to resources, time, and personnel constraints. Harnessing an underutilized resource, 4th-year advanced pharmacy practice experience (APPE) students, allows for expanded ASP involvement and scope of practice. We aim to outline and provide insight on how 4th-year APPE students serve as an asset to an ASP. Through our novel longitudinal rotation experience, APPE students complete penicillin allergy assessments, patient education, and work alongside a clinical pharmacist to refer patients for penicillin skin testing if appropriate. Students also achieve many of the education standards required by the Accreditation Counsel for Pharmacy Education (ACPE) for graduation within the Doctor of Pharmacy degree while developing a strong foundation in antimicrobial stewardship and gaining invaluable knowledge for their future. The addition of APPE pharmacy students to our ASP has also enabled our program to achieve its goals and expand involvement and reach within our facility.

265 Impact of Firefighter Participation in Burn Survivor Community Reintegration: A Qualitative Analysis

Community reintegration programs are vital in rehabilitation of burn survivors. Social interaction in the community can be a challenge for survivors as there is limited professional support after discharge. Early research validates a program’s ability to build resolve and foster coping skills in real life settings. Our program sees firefighters volunteer in community recreational outings with pediatric burn survivors. Very few outcomes exist identifying firefighter response to involvement in such programs; we created a quality improvement survey to gain firefighter perspective on the impact. Following volunteer participation, firefighters completed a short, comprehensive questionnaire (13 yes/no, 7 open answer questions) designed to gauge overall experience of the program. Questions included assessing comfort level of engagement, impact on their job, and effect on their view of their role in burn survivor recovery and reintegration. Final questions addressed recommending participation to others and gave an opportunity to add comments. Surveys anonymously distributed via an electronic system with data blinded and compiled by a research assistant. Thirty surveys were completed, majority of volunteers having participated in outings either 1–3 times or more than 7 times. Firefighters reported overall positive experiences, involvement improved comfort level with strangers and enhanced communication skills, with 80% reporting positive impact on their view of themselves as first responders and role in recovery of burn survivors. Comments reflected feelings of pride, admiration, and greater perspective for what patients and families endure. Additionally, requests for input on quality improvement were constructive. Responses wholly expressed success in realizing the mission; 100% of respondents stated they are very likely to recommend the program to others. Development of a reintegration program is important in enriching the rehabilitation of survivors and first responders in the burn community. Pilot data reveals the positive impact volunteering with a reintegration program can have on firefighters. Involvement is obviously rewarding, resulting in pride in their role within the community, and awareness of outcomes for burn survivors. Responses included several reports of increased empathy and resilience, validating the mission of the program for firefighters and patients. Our program embodies a successful model for achieving collaboration and fostering awareness within the community. Growth of our program is driven by feedback provided in the survey. Despite positive outcomes, in-depth analysis of effects of involvement in community reintegration in firefighters is needed.

The Risks Of Using Workplace Wellness Programs To Foster A Culture Of Health.

In many respects, employers are well positioned to take a leading role in helping create a culture of health. Employers have access to many programs that could be beneficial to their employees' health. The potential for financial gains related to health improvement may motivate employers to offer these programs, and if the gains are realized, they may help finance the programs. At the same time, employers' involvement in such programs may create substantial risks. Enthusiasm about the financial and health gains that wellness programs might yield coexists with concerns about health costs shouldered by employees, the possibility of employment discrimination, and the potential for employers' invasion of employees' privacy. A fragmented regulatory regime, including a recently issued final rule under the Americans with Disabilities Act, has been created to address these concerns. Whether the regime strikes the right balance between wellness program benefits and risks remains to be determined.

Digi Days: Using the Rey Papers to Teach Digitization to Library Science and Archival Students

Digi Days: Using the Rey Papers to Teach Digitization to Library Science and Archival Students

Facilitating innovation in European research area through pre-competitive EU-funded COST Actions

Abstract The European Union (EU) Heads of States regularly confirm that knowledge and innovation are critical to Europe's growth and agreed to make the EU the most competitive knowledge-driven economy. The EU's ability to facilitate innovation by strengthening its research capacities is central to achieving this goal. Some EU initiatives under this innovation policy integrate research capacities already existing in individual states through pan-European participation in collaborative projects in science and technology. The EU is financing a number of formal pre-competitive networking programs aiming at a better deployment of existing national research capacities via their inclusion in joint research initiatives. Although there is a general consensus that increasing levels of collaboration amongst researchers produce better results, the issue of research networking and of related research outcomes continues to generate debate with a wide variety of views on what roles such programs play and their general implications for research and scientific performance. As the EU Framework Programme 7 is coming to its end, this paper explores whether such formal networking programs contribute to facilitating innovation in the European Research Area by enabling Science and Technology participants to achieve anticipated research outcomes from their involvement in such programs.

Peer workers’ role in smoking-cessation groups for people with mental illness

The objective of this article is to evaluate the impact of peer workers' involvement as co-leaders in smoking-cessation programmes provided within mental health services. Group smoking-cessation programmes were provided for people living with mental illness. Peer workers were involved in the development and delivery of these programmes. Group participants and mental health workers were asked to respond to a questionnaire about their experience of the peer workers. The questionnaire included both Likert scales and qualitative responses. Thirty-three mental health workers and 108 group participants completed the questionnaire. The majority of participants believed that the peer workers increased their confidence, helped them to learn about smoking cessation and promoted well-being. Mental health workers were also positive about the role of peer workers in the groups. This study supports the role of peer workers providing support and guidance within smoking-cessation programmes for people with mental illness. The results suggest that peer workers make a substantial contribution and that greater peer worker involvement in such programmes is likely to improve their acceptability and efficacy.

Experiences of individuals with chronic low back pain during and after their participation in a spinal stabilisation exercise programme – A pilot qualitative study

Spinal stabilisation exercises are commonly used in the management of low back pain (LBP). There is limited evidence relating to patients' experiences of their involvement in such programmes. The aim of this study was to explore the experiences of a sample of individuals with chronic LBP who participated in a randomised controlled trial (RCT) investigating the most efficacious dosage and frequency of spinal stabilisation exercises. The qualitative study involved nine participants who took part in focus group discussions. The data were analysed using thematic content analysis and provided insights into the experiences of the participants. Four themes emerged: Physical dimensions of the LBP experience, emotional and psychological dimensions of the LBP experience and perceived effects of the programme and lastly, the impact of the treatment programme on participants' knowledge, understanding and adherence. In conclusion participants' experiences were not limited to the positive effects of stabilisation exercises on pain, functional disability and quality of life, but also reflected increases in confidence, the formulation of self help strategies and the ability to exert better control over their LBP. The findings highlight the importance of well planned associated educational support packages in the treatment of LBP paving the way for future qualitative research.

Good students, bad pupils: constructions of “aspiration”, “disadvantage” and social class in undergraduate‐led widening participation work

This C‐SAP funded research explores undergraduate student involvement in widening participation initiatives at a traditional university and the ways that students promote and market their university and higher education more generally. It seeks to explore the widening participation messages disseminated by students in their work with pupils and teachers, the ways that these are taken up and/or resisted, and the interactions between university students and “local” school pupils. The idea of peer led discussion, whereby “sameness” is encouraged and endorsed, is positively promoted within student tutoring programmes. However, this study found a sharpening of notions of “us” and “them” amongst many student participants and a vocalization of educational success stories versus educational “failures”. While involvement in such programmes may be a way that students can contribute to their locality and foster career skills, this study interrogates the scope of “all round benefits” in widening participation and suggests that social class is mobilized in constructions of the “good student” as against the “bad pupil”. Widening participation initiatives need to engage with – and beyond – such interpersonal positioning in order to erode continued structured inequalities.

The Family Forum: Directions for the Implementation of Family Psychoeducation for Severe Mental Illness

The Family Forum: Directions for the Implementation of Family Psychoeducation for Severe Mental Illness

Sustainable development of a suggestion system: Factors influencing improvement activities in a confectionary company

AbstractAlthough the use of continuous improvement (CI) is widespread today, many organizations face problems maintaining high and sustained employee involvement in such programs. The purpose of this study was to identify factors influencing employee involvement in submitting suggestions within a suggestion system in a Swedish production company. The company had maintained a successful suggestion system for about 10 years. The study builds on a database containing all the suggestions submitted (2343 in number) within the suggestion system. The following factors were identified to influence employee involvement in submitting suggestions and hence the sustainability of the suggestion system as well: (a) Situations when the employees had a personal benefit from submitting suggestions, e.g., concerning their own work environment, contributed to long‐term sustainability of the system; (b) campaigns emphasizing different themes encouraged employees to become more active within the suggestion system; (c) employees having some of their suggestions rejected were more active in submitting suggestions than employees having most suggestions rejected or accepted; (d) a high monetary reward (80 euros and above) was not found favorable for submitting new suggestions, compared to lower rewards; (e) increased support of group suggestions contributed to a sustained and high level of activity of the suggestion system. © 2007 Wiley Periodicals, Inc. Hum Factors Man 17: 79–94, 2007.

Assessing knowledge, exploring needs: A reproductive health survey of adolescents and young adults in Pakistan

Rationale & objective The sexual and reproductive health (SRH) needs of adolescents have increased over the last few years, but are largely unmet. Lack of involvement of youth in the programs and limitations of the mass media in a conservative milieu are some of the issues. Our objectives were to assess the baseline SRH knowledge and to suggest interventions based on needs with regard to SRH promotion, so that the level of existing services could be upgraded.Methods A cross-sectional survey was conducted in 20 villages of Lahore, in which 400 adolescents and young adults were interviewed using a semi-structured questionnaire. Respondents were equally divided in gender in all villages, using stratified random sampling.Results Adolescents and young adults do have some knowledge of SRH issues. Males are relatively more knowledgeable than females about puberty (M = 68%; F = 58%), pregnancy (M = 55%; F = 43%), family planning (M = 62%; F = 50%) and sexually transmitted infections (M = 56%; F = 44%). Yet, a large majority needs clarification on their concepts and perceptions. They believe that having sound SRH knowledge will promote mother & child health and family health.Conclusion Peers, media and a family doctor could be the acceptable source of information on SRH. Life skills programs to increase unmarried girls' cognitive skills and young men's involvement in such programs is a must. Involving families and communities will enhance the effectiveness of youth programs.

Conceptions of Work Among Adolescents and Young Adults With Mental Retardation

Semistructured interviews were conducted with 16 Israeli adolescents and young adults with mild mental retardation to examine their perceptions of the world of work. A consensual qualitative strategy of analysis (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997) yielded 4 domains (Definitions of Work, Reasons for Working, Self‐Awareness, Knowledge About the World of Work) and 12 categories. Although respondents showed strong willingness to participate in the world of work, they had little information regarding this realm. Implications are discussed for career development programs targeting young persons with mental retardation and community and family involvement in such programs.

Nature-based Excursions: School Students' Perceptions of Learning in Natural Environments

Increasingly, environmental educators are incorporating visits to natural areas into their environmental learning programmes for school students. This paper investigates school students' expectations regarding environmental education experiences in natural areas and the attitudinal and behaviour changes they report as a result of their involvement in such programmes. Questionnaire responses from 580 students aged 8-17 years confirmed that learning in natural environments is attractive to students and has an important impact on their attitudes towards the environment, their desire to look after the environment, their behaviour in natural areas and their household environmental practices. It is concluded that combining observation with instruction is a powerful teaching strategy, especially when this allows students to understand the impact of human action on wildlife and natural habitats.

"To Take the Information Down to the People": Life Skills and HIV/AIDS Peer Educators in the Durban Area

Education in “life skills” has been a central pillar of state and NGO strategy in combating the threat of HIV/AIDS in South Africa. Based on research conducted in Durban in 1999, this paper examines how life skills education – thought of by some as a euphemism for “teaching about safe sex” but by others as an essential way of contextualising sex education in its broader context of empowerment and striving for equitable gender relations – is understood in contrasting ways by senior personnel and the largely unpaid volunteers who form the ranks of peer educators. Outlining the complicated institutional context of funding and educational practice in which this teaching has been taking place, the paper shows how conceptualisations of the role played by life skills peer educators, and their motivation for involvement in such programmes, diverge considerably. Senior personnel see educators as conveyors of accurate biological knowledge about reproduction and disease transmission to their peers and, subscribing to development discourse about “sustainability”, perceive them as driven primarily by an altruistic spirit of voluntarism. What is equally important for some peer educators, however, is the sense of identity provided by involvement in such programmes, and the prospects for future employment, and escape from the beleaguered world of township poverty, which they offer.

Vertical coordination in the US pork industry: Status, motivations, and expectations

In addition to horizontal consolidation at the input, production, and processing subsectors, the US pork industry is becoming more vertically aligned. The largest hog producers and pork processors were surveyed regarding their involvement in vertical coordination arrangements and their plans for future involvement in such programs. Motivation for entering these vertical agreements was examined as was the rate of adoption. Structural and regional implications of these results for the pork industry are discussed. © 1997 John Wiley & Sons, Inc.

Medical participation in and leadership of quality programmes.

Notes that medical participation in organization-wide quality programmes and leadership of quality is commonly viewed as the key to a successful programme. Reviews and reports research into doctors' involvement in such programmes as distinct from doctors' involvement in medical quality activities. Reveals the lack of systematic evidence on the subject, suggests areas for future research, and summarizes what is known. Gives recommendations based on reported research and experience for quality training for doctors and how medical managers might engage their colleagues and other professions in quality programmes.

Kids and Condoms: Parental Involvement in School Condom-Distribution Programs

To counter the growing number of teenagers infected with the HIV virus, almost four hundred public junior high and high schools nationwide, including those in New York, Washington, D.C., and Philadelphia, have begun distributing condoms to students.' When the New York City public school system began its program in 1991, it neither required prior parental consent nor gave concerned parents a chance to out.2 In Alfonso v Fernandez, a New York state appellate court ruled that such a program, by entirely bypassing parents, violated the parents' right to control the upbringing of their children.3 The court remarked that it would allow distribution if New York permitted parents to opt out of the program,4 but the court's opinion did not address the more stringent alternative of requiring prior parental consent. Since then, in Curtis v School Committee of Falmouth, the Massachusetts Supreme Judicial Court held that parental involvement in such programs is not constitutionally required.5 Hence, it is unclear whether parental involvement in public-school condom-distribution programs is necessary, and if so, what form such involvement should take. This Comment argues that parental involvement is constitutionally mandated, and, further, that condom-distribution programs requiring prior parental consent are the only such programs adequately protective of parental rights to withstand constitutional scrutiny. The Supreme Court has long recognized that, under the Due Process Clause of the Fourteenth Amendment,6 parents have a

Autologous Transfusion in Pregnant Women with Significant Risk for Hemorrhage

Autologous transfusion, storage of one's own blood for subsequent infusion if needed, is safe and effective in a variety of scheduled operative procedures. Obstetric involvement in such programs is very limited, however, because of concern over the possibility of inducing premature labor or causing fetal distress by blood volume change or vasovagal reactions. We describe our experience with pregnant women in this program. The incidence of vagovagal reactions of autologous donation was 9.5% (2/21). After entry into this program, 17pastients received a total 37pints, which consist of 19 Autologous and 18 Homologous. Homologous transfusion was avoided in 30% of patients receiving blood. The values of the mean haematocrits before and after hpebotomy were 34.1 % and 31.8 % respectively. It was statically significant(p