Impediments to Health Care for the Foreign Student

Abstract

Today's college students occupy a “window” between older adults, whose need for hepatitis B vaccination is minimal, and younger people who receive the vaccine as part of their childhood immunization series. However, because of the high-risk activities that are often part of student behavior, college students are among the individuals who are at the highest risk for this disease; 75% of all reported hepatitis B cases occur in persons between the ages of 15 and 39 years. It is therefore imperative that college health professionals take seriously their responsibility to educate students about issues related to hepatitis B and make available programs that enable the students to receive immunizations. This article briefly describes a successful hepatitis B education and immunization program at an institution that has no mandatory prematriculation immunization requirements.     

Projecting Australia's Fertility

A method has been evolved for projecting Australia's fertility which takes into account changes in family size. Total fertility is expected to fall by about 2 per cent a year. The total number of births is likely to increase to about 285,000 in 1981 and remain at that level to the end of the century.     

Inequalities in English child protection practice under austerity: A universal challenge?

The role that area deprivation, family poverty, and austerity policies play in the demand for and supply of children's services has been a contested issue in England in recent years. These relationships have begun to be explored through the concept of inequalities in child welfare, in parallel to the established fields of inequalities in education and health. This article focuses on the relationship between economic inequality and out‐of‐home care and child protection interventions. The work scales up a pilot study in the West Midlands to an all‐England sample, representative of English regions and different levels of deprivation at a local authority (LA) level. The analysis evidences a strong relationship between deprivation and intervention rates and large inequalities between ethnic categories. There is further evidence of the inverse intervention law (Bywaters et al., 2015): For any given level of neighbourhood deprivation, higher rates of child welfare interventions are found in LAs that are less deprived overall. These patterns are taking place in the context of cuts in spending on English children's services between 2010–2011 and 2014–2015 that have been greatest in more deprived LAs. Implications for policy and practice to reduce such inequalities are suggested.     

Integrating Solution-Focused Brief Therapy for Systemic Posttraumatic Stress Prevention in Paediatrics

Paediatric trauma can leave devastating effects on patients and their families if unattended. Medical family therapy (MedFT) is one approach to address the emotional and relational impact of paediatric trauma and prevent possible posttraumatic stress. The biopsychosocial model is widely practiced in MedFT, yet we argue that adding solution-focused conversations can further enhance practitioner effectiveness and increase client outcome. This article discusses and provides rationale for the use of solution-focused brief therapy (SFBT) through a biopsychosocial lens when treating paediatric intensive care unit (PICU) patients and their families. A fictionalised illustration is provided to guide family therapists in applying SFBT to the PICU population.     

The Quagmire of Return and Reintegration: Challenges to Multi-Stakeholder Co-ordination of Involuntary Returns

The institutional aspect of return migration has received little attention in the theoretical and empirical literature on return migration. This research fills the apparent lacuna by unearthing institutional challenges to multi-stakeholder coordination, at different spatial levels in crisis situations and negative effects on reintegration of forcibly returned migrants. We use the evacuation of Ghanaian migrants from Libya who occupied very low socio-economic positions, experienced racism and discrimination, including physical attacks and arbitrary arrests in 2011, as a case study to understand institutional challenges to forced return when migrants’ carefully tailored plans are thrown into disarray and they are forced to return unprepared. This study employed mainly qualitative research methods among six different categories of actors and engaged an adaptation of Cassarino's “returnee's preparedness framework” to expand theoretical understandings of return migration from the institutional perspective and to highlight what can go wrong when institutions are unprepared for involuntary returnees.     

Improving sample size recalculation in adaptive clinical trials by resampling

Sample size calculations in clinical trials need to be based on profound parameter assumptions. Wrong parameter choices may lead to too small or too high sample sizes and can have severe ethical and economical consequences. Adaptive group sequential study designs are one solution to deal with planning uncertainties. Here, the sample size can be updated during an ongoing trial based on the observed interim effect. However, the observed interim effect is a random variable and thus does not necessarily correspond to the true effect. One way of dealing with the uncertainty related to this random variable is to include resampling elements in the recalculation strategy. In this paper, we focus on clinical trials with a normally distributed endpoint. We consider resampling of the observed interim test statistic and apply this principle to several established sample size recalculation approaches. The resulting recalculation rules are smoother than the original ones and thus the variability in sample size is lower. In particular, we found that some resampling approaches mimic a group sequential design. In general, incorporating resampling of the interim test statistic in existing sample size recalculation rules results in a substantial performance improvement with respect to a recently published conditional performance score.     

Treatment for Juveniles Who Sexually Offend in a Southwestern State

A 25-item questionnaire was mailed to sex offender treatment providers from counties with 60 or more reported juvenile sex offenders in a Southwestern state to determine the most effective treatment for juvenile sex offenders. Results indicated that cognitive behavioral therapy was the most successful reported approach to treatment with an average success rate of 87%. The most commonly used approach was cognitive behavioral therapy with relapse prevention. The most common sexual offense was indecency with a child involving sexual contact, contrary to studies that found that in the Probation Commission data, aggravated sexual offense was the most common. These results have ramifications for state policies on treatment for juvenile sex offenders.