Professional Efforts Research Articles

HomeBase: Participation, Engagement, Alliance, and Social Validity of a Motivational Parenting Intervention

Abstract This article examines the participation, engagement, alliance, and social validity of homeBase—a parent management intervention developed specifically to address parent engagement of elementary-level students. The intervention infuses motivational interviewing (MI) into its implementation procedures and trains behavioral coaches to use this approach as their primary interactive vehicle with parents. Process data from participants (N = 120) assigned to one of the two homeBase intervention conditions were examined to better understand the following dimensions: parental participation and engagement, coach–parent alliance, and the satisfaction of the homeBase intervention. Results indicate that parental participation was challenging in that 21 percent of the parents seemed unable to engage at all in the intervention. However, those who did participate were highly engaged and developed effective relationships with their coach. Parents perceived the homeBase intervention to be socially valid. There were also several interesting correlations among these measures that might potentially guide further research and practice. The authors recommend that school social work preparation programs and school districts consider including MI in curriculum and professional development efforts as a strategy for parental engagement.

Physician Well-being.

1. Paria M. Wilson, MD, MEd* 2. Maneesh Batra, MD, MPH† 3. Kathi J. Kemper, MD, MPH‡ 4. John D. Mahan, MD‡,§ 5. Betty B. Staples, MD¶ 6. Janet R. Serwint, MD** 1. *Division of Emergency Medicine, Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA 2. †Department of Pediatrics, Division of Neonatology, Seattle Children’s Hospital and the University of Washington, Seattle, WA 3. ‡The Ohio State University, Columbus, OH 4. §Department of Pediatrics, Division of Nephrology, Nationwide Children’s Hospital and The Ohio State University, Columbus, OH 5. ¶Department of Pediatrics, Duke University Medical Center, Durham, NC 6. **Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD * Abbreviations: EHR: : electronic health record OR: : odds ratio SMART: : Stress Management and Resiliency Training > Every once in a while in Pediatrics in Review , Editors-in-Chief Bob Haggerty and Larry Nazarian would advise readers to care for themselves. They offered commentaries on such subjects as how to transition to retirement or part-time practice, taking time to reflect on the joy of pediatrics, and stepping out of the office to partake in community events. In the spirit of Dr Haggerty’s and Dr Nazarian’s hope that readers take care of themselves, Pediatrics in Review offers the following review. > > —JZ Clinicians and trainee physicians should be aware of the components of wellness and how to foster them in their daily practice. Interventions have been aimed at the individual and organizational levels. After …

Experience With Store-and-Forward Consultations in Providing Access to Pediatric Endocrine Consultations in Low- and Middle-Income Countries.

Pediatric specialists are often unavailable in low- and middle-income countries. As part of multiple professional associations' efforts to improve access to endocrine expertise globally, a pediatric endocrine teleconsultation network was established on a store-and-forward teleconsultation platform to facilitate focused, language-appropriate advice that can be kept for future reference while bypassing real-time video-conferencing, and obviating the need for a scheduled appointment. User information was recorded, and quality statistics on network performance and qualitative evaluation by referring physicians were analyzed. Over a 3-year period, 81 referrers (88% from Haiti) and 13 pediatric endocrinologists registered onto the network and discussed 47 pediatric endocrine cases, exchanging a total of 412 messages for a median of 7 messages (IQR 5, 11) per case. Diagnoses spanned the spectrum of pediatric endocrine disorders. According to referrers, an appropriate expert was consulted and an answer provided sufficiently quickly in 100% of cases. The answer was well-adapted to their environment in 86%, and referrers were able to follow the advice given in 72%. All but one referrer found the advice helpful, it clarified the diagnosis in 88%, assisted with management in 93%, improved patient's symptoms in 77%, improved function in 77%, and was considered cost-saving in 50%. Perceived benefits of the consultations were academic instruction, setting-adapted advice beyond the scope of guidelines or textbooks, and advancement in the diagnostic process. Pediatric endocrine remote store-and-forward consultations in low- and middle-income countries may provide a reasonable alternative to face-to-face visits, providing clinical and educational benefit, and a potential for cost-saving.

Workloads in Clinical Psychiatry: Another Way.

Caseload and daily volume requirements present clinical and administrative challenges in organized settings primarily serving the public sector. These challenges are examined through lenses of systems-level fiscal viability, population health, and patient experience. Framed by previous efforts in caseload methodology, illustrative data collected from members of the American Association of Community Psychiatrists are discussed, with consideration of issues of professional effort and burnout. A systematic effort is needed to develop guidelines for caseload and volume expectations that support recovery outcomes, account for practitioner skills, and promote high-quality clinical encounters.

C-66 Limited Access to Pediatric Neuropsychological Evaluations for Non-English Speakers

Abstract Objective The aim of this empirical study was to examine the accessibility of pediatric neuropsychological evaluations in the state of Arizona for non-English speaking children. To date, there is very limited research that analyzes the accessibility of neuropsychological evaluations. Diversity variables, such as primary language, can negatively impact assessment scores (Norbury & Sparks, 2013), leaving diverse individuals at risk of misdiagnosis when an assessment is not conducted in one’s primary language, nor normed on similar individuals (Mindt et al., 2008). The Center for Immigration Studies (2017) found 28% of school-age children in Arizona speak a foreign language, warranting a need for culturally-appropriate evaluations. Method Arizona pediatric neuropsychologists in non-hospital settings were identified via electronic resources: AzNS, AAPdN, AzPA, CSN, and AACN provider lists; LinkedIn; Google search. Participants met criteria for inclusion if “pediatric neuropsychological” evaluations were provided by a neuropsychologist on staff. “Pediatrics” is defined as 0-17. Neuropsychologists were contacted directly via phone for survey participation; verbal informed consent was obtained. Results Seventeen pediatric neuropsychologists were found in the state of Arizona, and 52.9% consented to participate in the survey (n = 9). All participants (100%, n = 9) stated they provide evaluations in English only, and refer-out for non-English evaluations. Conclusions There is a severe disparity in the access to care with respect to availability of culturally-appropriate evaluations in Arizona: a state with a large population of non-English speakers. The current study adds to the limited literature in this area, and sets the stage for continued professional advocacy efforts. Goals for future national research is critically discussed.

Impact of professional development programme on teachers’ competencies in assessment

ABSTRACTIn the past few decades, increasing demands have been placed on developing students’ autonomy and critical thinking skills. To enhance students’ agency in learning, teachers have been encouraged to adopt alternative pedagogical practices. The revamp of pedagogy needs to be reflected in assessment as it is an integral part of instruction. Practising teachers, however, lack assessment knowledge due to inadequate training during the pre-service preparation programmes. The enhancement of assessment knowledge is being urgently called for, which demands the professional development of teachers. This study seeks to investigate the impact of a professional development programme organized by a university in Hong Kong on the development of assessment knowledge of four teachers in two elementary schools. Findings indicate that the acquisition of assessment knowledge is a long-term achievement, which requires ongoing professional development efforts.

Investigating the role of contextual factors in effectively executing communication evaluation and measurement

PurposeEvaluation and measurement (E&M) remains a critical and debated topic among communication scholars and practice. Substantial research and professional efforts have been devoted to discussing what should be measured and which methods should be applied. Most of the E&M models seem to carry a positivist imprint. But, in real-life, organizations could not have clear aims, enough resources, or adequate informative systems to support E&M. Moreover, several contextual factors could affect the implementation of E&M management processes. The communication literature rarely highlights these factors. To fulfill this gap, the purpose of this paper is to theorize the contextual factors relevant to the management of the evaluation process.Design/methodology/approachA scoping literature review was carried out exploring the role of contextual factors and impact of contextual factors on E&M management processes. More specifically, the review examines the contribution provided by program evaluation and performance measurement (PM) fields of research.FindingsThe paper provides a scoping review of program evaluation and PM approaches. Additionally, it explains how both streams of thought argued the importance of contextual factors, such as organizational, relational, cultural and communicative factors, for the success of any evaluation processes. The study underlined that the main evaluation models used in the field of communication have overlooked these studies and put on evidence the role of contextual factors in effectively executing communication E&M.Originality/valueThe paper enriches the dominant rationale concerning the E&M management processes by incorporating literature on: program evaluation; and PM. The analysis could provide useful insights also from a professional perspective, by helping practitioners for a contextual assessment of strategic communication programs and activities.

Scaling Up and Integrating Effective Behavioral and Instructional Support Systems (EBISS): A Study of One State’s Professional Development Efforts

Oregon’s Effective Behavioral and Instructional Support Systems (EBISS) initiative was implemented in 25 school districts. The initiative trained and coached district leaders and teachers in the use of the EBISS model through the lens of implementation science. The EBISS model integrates school-wide positive behavior intervention and supports (SWPBIS) and the school-wide reading model (SWRM) to improve schools for all students and to reduce the number of students at risk of learning difficulties. Proximal outcomes included gains in the number of building-level SWPBIS and SWRM implementation teams and the activities of those teams. Distal outcomes included statistically significant gains in oral reading fluency (ORF) in first and third grades and marginally significant decreases in the percentage of students in the intensive category for reading in second and fourth grades. These findings suggest that to optimize improvements in teacher and student outcomes, a rigorous system of professional development and coaching appears necessary.

179-LB: Confidence of Healthcare Providers to Prescribe Antihyperglycemic Agents with Cardiovascular Benefit

Several antihyperglycemic agents have recently been demonstrated to provide additional glucose lowering and CVD risk reduction benefits in people living with type 2 diabetes (T2D). However, little is known about confidence of healthcare providers (HCPs) to utilize these agents in clinical practice. A national sample of 905 physicians and nurse practitioners (NPs) from primary care, cardiology, and endocrinology completed an online survey and were asked: “How confident are you that you can effectively prescribe and manage type 2 diabetes with the following medications?” Answer options included a 5-point Likert-type scale ranging from “Not at All Confident” to “Extremely Confident.” Results were weighted for representation by U.S. specialty-specific distributions of gender, race/ethnicity, years in practice, region, and employment. When compared to other HCPs, endocrinologists reported higher confidence in prescribing antihyperglycemic agents for people living with T2D (Table 1). Large proportions of HCPs in cardiology and primary care expressed low confidence prescribing many antihyperglycemic agents, particularly novel agents with CVD risk reduction benefit. Guideline-based professional education efforts may improve confidence of HCPs to utilize antihyperglycemic agents to optimize glycemic control and cardiovascular risk reduction when treating people living with T2D. Disclosure C.M. Shay: None. K.J. Robb: None. M.T. Martin: None. M.P. Petersen: None. E. Sanchez: None.

Effective Professional Development and Change in Practice: The Case of Queen Rania Teacher Academy Science Network

This study aimed at evaluating the impact of Queen Rania Teacher Academy science teachers professional development program’s activities on teachers’ instructional practices by identifying the successes, challenge and ways to sustain the exemplary reformed instructional practices in the science classroom. The idea is to analyze participating science teachers’ reflections on a three-year journey of continuous professional development. Qualitative data collected in the form of participants’ self-reflection and field notes from 18 male and female participating science teachers. Findings indicate that even with effective professional development, science teachers encounter diverse challenges to implement the reformed instructional practices in the classroom. Teachers need support, time and resources to succeed in implementing what they learned in their classrooms. Findings also revealed that professional development efforts need to reveal and address existing teachers’ beliefs in order to be successful. Implications for future science continuous professional development efforts are discussed.

Implementing volunteer peer mentoring as a supplement to professional efforts in primary rehabilitation of persons with spinal cord injury

Study designA feasibility study, supplemented by a noncontrolled pretest/posttest.ObjectivesTo examine if a nationwide volunteer peer-mentoring program for in-patients with acute/subacute spinal cord injury is feasible and achievable.SettingThe Spinal Cord Injury Center of Western Denmark and Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark.MethodsVolunteer mentor groups were formed similarly in two highly specialized SCI centers covering Denmark. Hospital staff was responsible for referral to the mentoring project and for the interdisciplinary evaluation of patient eligibility. At each of the two centers, a person living with the consequences of SCI coordinated the intervention in collaboration with healthcare personnel. Designated project personnel introduced eligible participants to the project. Staff at the SCI centers arranged to fit in the supplementary mentoring with ongoing treatment. A self-report questionnaire was completed prior to and after peer intervention. Outcome: patient reports regarding mentoring sessions, change in quality of life (QoL), depression items from the Short Form Health Survey (SF-36), pain frequency and intensity (11-point Numerical Rating Scale).ResultsA nationwide mentor corps was established. Fifty-two eligible in-patients completed the study. Significant improvement in QoL was found after mentoring. Frequency and intensity of pain did not change, although five out of nine depression items improved significantly. A majority (94%) of the participants recommended others to meet with a peer mentor.ConclusionsEstablishing a nationwide volunteer mentor system at a highly specialized neuro-rehabilitation units for SCI in-patients is both feasible and acceptable.

Peer support for mood disorder: Characteristics and benefits from attending the Depression and Bipolar Support Alliance mutual-help organization

BackgroundMood disorders (MDs) are pervasive and debilitating psychiatric conditions. Many helpful psychological and psychopharmacological treatments exist, but MD's prevalence and chronicity often means relying purely on professional care can create financial strain on individuals and healthcare systems. Also, many individuals respond only partially to professionally-delivered medical/pharmacological interventions or are unable to tolerate or adhere to them. Peer-led mutual-help organizations (MHOs) have emerged and grown in the U.S. to extend and potentiate professional efforts or otherwise address needs unmet by professional care. The Depression and Bipolar Support Alliance (DBSA) is the largest of these, but beyond observational evidence, little is known about participation or benefits. Greater knowledge could inform the field regarding clinical and public health utility of peer-driven efforts. MethodCommunity-based cross-sectional comparative investigation of MD individuals attending (N = 202) or not attending (N = 105) DBSA. Measures included demographics, clinical characteristics and clinical service use, and indices of symptomatology, functioning, quality of life (QOL), and psychological well-being. ResultsCompared to non-DBSA participants, DBSA participants were more likely to be male and white and trended toward greater religious affiliation (p = 0.05). DBSA participants attended meetings about twice per month with two-thirds attending for more than one year. The DBSA cohort had a much higher proportion with bipolar I disorder and reported more lifetime and past 90-day use of acute, intensive, medical services and medications. There were no between-group differences on indices of QOL or psychological well-being, but within the DBSA group, greater DBSA attendance and involvement was associated with greater QOL and well-being, and less functional impairment. LimitationsCross-sectional design and regional sampling frame with unknown generalizability to national DBSA membership. ConclusionGiven the grave impact of MDs and that DBSA is freely available it may fill an important clinical and public health need by attracting and engaging MD individuals with greater functional instability and impairment. The positive association found between greater active DBSA participation and improvements in functioning and well-being, while promising, requires longitudinal investigation to formally establish the causal direction of effects.

Psychiatry in the sorting of schoolchildren in Scandinavia 1920–1950: IQ testing, child guidance clinics, and hospitalisation

ABSTRACTThis article explores the role of psychiatry in the sorting of schoolchildren in Denmark, Norway, and Sweden from 1920 to 1950. Whereas the role and rise of educational psychology and IQ-testing in the differentiation processes in schooling have been examined through earlier research, the role of psychiatry in the interprofessional collaboration has so far been largely unexplored when it comes to the Scandinavian case. In line with Michel Foucault, the article regards these professional efforts as part of the biopolitics, where psychiatry amongst other disciplines engaged in the development of means to involve strategically in the life of schoolchildren and their families, as part of shaping the future of the population. We argue that psychiatric sorting activities related to schoolchildren did not solely take place through IQ-testing in schools, but involved classification of children through a range of measures in various settings. We further argue that these processes took place due to local agents and initiatives in a broader context of interprofessional collaborations between psychiatrists, psychologists, and teachers, rather than top–down processes initiated by the state. The analysis in the article draws on different sources of the period: journals, articles, and monographs from the key-agents of the period.

Teacher outcomes from a statewide initiative to build assessment literacy

Contemporary professional development programs for teachers often aim to build assessment literacy. This study advances empirical examination in this important area. We examined the outcomes of a state education agency-sponsored teacher professional development initiative in the northwestern United States. Over five academic-year months, participants completed assignments, attended webinars, viewed videos, and developed assessment materials. Results showed no changes in teacher knowledge of assessment concepts across the training. Teacher self-efficacy for assessment tasks, however, increased significantly. Teachers reported self-efficacy levels that were modestly correlated with their demonstrated knowledge. These results highlight an opportunity to investigate affective and contextual variables as outcomes or mediators of assessment literacy initiatives and examine existing assessment literacy measures for sensitivity to change. Future studies and professional development efforts should consider how to engage teachers in authentic training opportunities that stimulate transferable growth while remaining feasible within constraints of time and geography.

The medicolegal, psycho-criminological, and epidemiological reality of intimate partner and non-intimate partner femicide in North-West Italy: looking backwards to see forwards

This paper addresses femicide in Italy. The assumption is that femicide is not a discrete act of killing a woman. It is assumed that depending on the types of relationship between the victim and the perpetrator (e.g., known versus unknown, intimate versus acquaintance), the risk processes may differ. When femicide involves the killing of an intimate partner, it is likely to be characterized by sustained and escalating intimate partner violence (IPV) that can reach its climax with extreme acts of violence that lead to intimate partner femicide (IPF). Eighty-six cases of femicide that occurred in North-West Italy between 1993 and 2013 were examined in this study. Findings suggest that femicide was disproportionately perpetrated by intimate partners (current or past), rather than strangers. IPF was likely to be the epilogue of an abusive relationship, with high levels of contentiousness and conflicts being the frequent significant precursors. Non-intimate partner femicide (NPF) was more likely to be characterized by antisocial or predatory motives, highly frequent when the victims were prostitutes.These preliminary findings suggest that joint scientific, professional, and political efforts are paramount in order to address strategies aimed at assessing the differential risk of IPV early in time so as to prevent it from escalating into IPF or NPF and to provide the appropriate support for victims and their families.

Exploring the Lexicon or Lack Thereof in Clinical Teacher Preparation

ABSTRACTRecent policy and scholarly reports, accreditation agencies’ guidelines, and professional association efforts have called for teacher preparation programs to incorporate more frequent and rigorous clinical experiences. Directing three elementary and secondary education programs in two states, we recognized that one reason they—and perhaps other teacher educators around the United States—have been challenged to develop robust and consistent experiences was because of the lack of a common language by which clinical program efforts, roles, and structures are described. Curious about whether variation in terminology was a widespread phenomenon, yet committed to practitioners’ rights to determine the language that names the structures of their profession, we conducted two studies of the lexicon used by the constituents of teacher preparation programs, focusing on language used to name clinical features. Here we share the results of these studies, revealing the range of terms employed in clinical preparation in the absence of a common lexicon. They ultimately propose consideration of a common framework of such language, suggesting caution about adopting a standardized lexicon that disregards localized conditions or impedes collegial discussions across contexts.

A multilevel neo-institutional analysis of infection prevention and control in English hospitals: coerced safety culture change?

Despite committed policy, regulative and professional efforts on healthcare safety, little is known about how such macro-interventions permeate organisations and shape culture over time. Informed by neo-institutional theory, we examined how inter-organisational influences shaped safety practices and inter-subjective meanings following efforts for coerced culture change. We traced macro-influences from 2000 to 2015 in infection prevention and control (IPC). Safety perceptions and meanings were inductively analysed from 130 in-depth qualitative interviews with senior- and middle-level managers from 30 English hospitals. A total of 869 institutional interventions were identified; 69% had a regulative component. In this context of forced implementation of safety practices, staff experienced inherent tensions concerning the scope of safety, their ability to be open and prioritisation of external mandates over local need. These tensions stemmed from conflicts among three co-existing institutional logics prevalent in the NHS. In response to requests for change, staff flexibly drew from a repertoire of cognitive, material and symbolic resources within and outside their organisations. They crafted 'strategies of action', guided by a situated assessment of first-hand practice experiences complementing collective evaluations of interventions such as 'pragmatic', 'sensible' and also 'legitimate'. Macro-institutional forces exerted influence either directly on individuals or indirectly by enriching the organisational cultural repertoire.

Going Big!: The Case of a Large District’s Effort to Maximize the Benefits of Dual Language Programming for their Children

Dual language (DL) programs have been held up as a promising means by which to reach student achievement goals across demographics (Collier & Thomas, 2004). Yet, the social and political risks associated with implementing DL programs are significant. This paper analyzes one large metropolitan school district’s rationale and preparedness for initiating its DL program, as well as the outcomes of its efforts to scale up the DL program to reach thousands of students, most of whom are children of color. The findings suggest that the district personnel used three pillars to rationalize their decision to implement their DL program: legal, research, and student demographics. In addition, the school district administrators, teachers, and parents showed varying levels of preparedness for the mass implementation of the DL program. While a young program with few quantitative data points to showcase its success, the qualitative data revealed that the program’s structure and professional development efforts for the teachers and principals benefited from a clear and ambitious vision and the unwavering support of the district’s executive leadership. In addition to the extensive data compiled from interviews with key stakeholders, case studies of two schools from the district are provided in order to highlight emergent tensions and showcase how the district’s efforts have materialized into intentional and dynamic DL learning environments.

Citizens as Active Participants in Integrated Care: Challenging the Field's Dominant Paradigms.

Policy makers, practitioners and academics often claim that care users and other citizens should be ‘at the center’ of care integration pursuits. Nonetheless, the field of integrated care tends to approach these constituents as passive recipients of professional and managerial efforts. This paper critically reflects on this discrepancy, which, we contend, indicates both a key objective and an ongoing challenge of care integration; i.e., the need to reconcile (1) the professional, organizational and institutional frameworks by which care work is structured with (2) the diversity and diffuseness that is inherent to pursuits of active user and citizen participation. By identifying four organizational tensions that result from this challenge, we raise questions about whose knowledge counts (lay/professional), who is in control (local/central), who participates (inclusion/exclusion) and whose interests matter (civic/organizational). By making explicit what so often remains obscured in the literature, we enable actors to more effectively address these tensions in their pursuits of care integration. In turn, we are able to generate a more realistic outlook on the opportunities, limitations and pitfalls of citizen participation.

Grand challenges for ambient intelligence and implications for design contexts and smart societies

This paper highlights selected grand challenges that concern especially the social and the design dimensions of research and development in Ambient Intelligence (AmI) and Smart Environments (SmE). Due to the increasing deployment and usage of ‘smart’ technologies determining a wide range of everyday life activities, there is an urgent need to reconsider their societal implications and how to address these implications with appropriate design methods. The paper presents four perspectives on the subject grounded in different approaches. First, introducing and reflecting on the implications of the ‘smart-everything’ paradigm, the resulting design trade-offs and their application to smart cities. Second, discussing the potential of non-verbal communication for informing the design of spatial interfaces for AmI design practices. Third, reflecting on the role of new data categories such as ‘future data’ and the role of uncertainty and their implications for the next generation of AmI environments. Finally, debating the merits and shortfalls of the world’s largest professional engineering community effort to craft a global standards body on ethically aligned design for autonomous and intelligent systems. The paper benefits from taking different perspectives on common issues, provides commonalities and relationships between them and provides anchor points for important challenges in the field of ambient intelligence.