Complexities in attracting and retaining direct support professionals

Recruiting and retaining direct support professionals (DSPs) remains essential to the full inclusion for persons with disabilities. Using a mixed-evaluation model, we measured DSPs' views versus those of their supervisors. DSPs expressed lower perceptions concerning their supervisors, satisfaction with their work situation, and environmental and safety factors. Focus groups provided insights into resolving issues related to compensation, work environment, and recruiting and retaining future DSPs. Motivating factors included wanting to be part of a helping community where all are valued. To improve their performance, DSPs stated their desire to understand the roles of managers and of the consumer. DSPs indicated that having career paths that provided advancement opportunities and direct contact with persons with disabilities were primary motivators.     

The unique effects of environmental strategies in health promotion campaigns: a review

Various strategies are used as tools in health promotion campaigns to increase health-related outcomes among target populations. Evaluations of these campaigns examine effects on changing people's knowledge, attitudes, and/or behaviors. Most evaluations examine the combined impact of multiple strategies. Less is known about the unique effects of particular strategies. To address this gap, we used highly systematic methods to identify and review scientifically rigorous evaluations of 18 campaigns that examined the unique effects of three sets of intervention strategies (entertainment education, law enforcement, and mass media) on changes in knowledge, attitudes, and practice with regard to various health behaviors. Results showed differences in evaluation processes based on the type of strategy used to promote campaign messages. For instance, evaluations of mass-media based campaigns were more likely to examine changes in knowledge, relative to evaluations of campaigns that used law enforcement strategies. In addition, campaign effects varied by particular strategies. Mass media-based campaigns were more likely to affect knowledge, relative to behaviors. Law enforcement and entertainment education-based campaigns showed positive effects on behaviors. The implications for planning and evaluating health promotion campaigns are described.     

What about Rural Blight? Housing and Neighborhood Conditions in Southeastern Small Towns

Though the concept of blight clarifies housing and neighborhood changes in rural and small towns experiencing disinvestment and decline, the term is rarely examined outside of urban discourse. This study explores the extent of rural blight and its relationship to community characteristics using survey results from elected officials and staff members of small towns in one southeastern state. We examine the historical background of blight, including its connections to urban renewal, racial bias and stereotyping, and the broken windows theory. Among the small towns in the study, economic blight, particularly dilapidated housing, was prevalent. Social blight, which includes behaviors that are thought to be threatening or criminal in nature, was less common but correlated moderately with economic forms of blight. While social disorganization and collective efficacy theories link a range of demographic characteristics to physical and social disorder, our findings pointed only to a significant relationship between communities with a higher portion of the population who are black and multiple forms of extensive blight. More research is needed to understand the relationship, both observed and perceived, between economic and social blight in rural small towns and how these issues may be remediated through local collective action.     

Staff & client perceptions of unit quality: a pilot study

This pilot study compared psychiatric health care team members' perceptions of unit quality with discharged clients' perceptions of quality of care received on the unit. The staff members were from four different service units in one acute care psychiatric facility. The study used the Perceptions of Unit Quality (PUQ) scale, a valid and reliable outcome measurement instrument, developed by Cronenwett. Most quality assurance instruments that exist have focused on individual caregivers' or service-specific views of quality, but the PUQ scale allows quality assurance data that represent team performance to be described through team perceptions of quality. Results of this pilot study suggest that use of the PUQ scale, in conjunction with clients' perceptions of unit quality, may be a legitimate approach in continuous quality improvement efforts in psychiatric-mental health care centers.     

Blurring the lines for learning: the role of out-of-school programs as complements to formal learning

As debates continue over the effectiveness of after-school programs, we need to create stronger links between schools and out-of-school activities. Where do such connections begin? How can we integrate skill-building and academic competence into the out-of-school-time context?     

Therapeutic change in Colombian families dealing with violence: therapists, clients, and referring systems in conversation

There is a gap in the Marriage and Family Therapy literature regarding clients', therapists', and family judges' theories of change in relational therapy for family violence. We conducted in-depth interviews with eleven court-referred families, their therapists, and two family judges in Bogota, Colombia. Interviews focused on their expectations of therapy outcomes, their understanding of change, and their evaluation of individual and relational therapy outcomes. We followed a grounded theory approach to data analysis. Analyses showed that therapists, family judges, and clients hold different expectations and theories regarding therapeutic change. Findings are discussed based on existing research on clients' and therapists' ideas about change. Implications for future research and practice are presented.     

The Effect of Mixing Events on the Dynamics of pH1N1 Outbreaks at Small Residential Colleges

Abstract Objective: The authors examine the dynamics and the impact of all-campus events on pH1N1 spread at Bates College in fall 2009, with comparisons to 3 other campuses. Participants: Students (N = 285) presented or called in to the Bates Health Center with symptoms consistent with influenza-like illness. Methods: Health Center staff at Bates collected data on the outbreak; data from other colleges are from Web sites and journal articles. Data were analyzed using a mathematical model for influenza. Results: Bates held 2 vaccine clinics mid-outbreak. The data are consistent with the hypothesis that the vaccine clinics may have altered routine student interactions, facilitating transmission of pH1N1 among students who otherwise might not have encountered each other. Conclusion: The vaccine clinics, held when vaccine became available, were too late to halt transmission. The disruptions to campus rhythms due to the vaccine clinics may instead have contributed to pH1N1 spread.     

Family structure and child outcomes: a high definition, wide angle “snapshot”

Using data from the National Survey of America??s Families (NSAF), this research investigates the relationships between a highly defined set of family structures and a broad set of child outcomes at a particular point in time in a child??s life. A detailed classification of family structures is constructed that clarifies key differences among various types of diverse families, and facilitates equivalencies testing and pairwise comparisons across nontraditional family structures. The NSAF contains a large number of observations for less common, but growing, family structures such as single-father families, grandparent-headed households and cohabiters, which makes such detailed analyses feasible and allows further stratification by child age, gender and race. The data also contains information on child behavioral, educational and physical health outcomes, as well as extensive household characteristics, economic resources and parental behaviors and inputs. Results suggest that differences across nontraditional family structures are particularly prominent for child health outcomes and that the gender of the resident parent is empirically important, more so than the presence of a cohabiting or married step-parent. Children in single father families have lesser access to health care yet enjoy better health outcomes than those in other families, even after controlling for economic resources (and inputs). In contrast, few differences are found between grandparent-headed families and other non-parent families. While we explore alternative explanations for these results, our cross-sectional data and complex set of family structure variables preclude isolating causal relationships; instead, our analyses yield empirically important distinctions that point to promising avenues for future research.     

Impact of lightweight and conventional jackhammers on the operator

Jackhammer manufacturers have recently developed lightweight (45-60 lbs) jackhammers intended to reduce the required lifting and pushing forces during operation. However, the vibration characteristics of the lightweight jackhammers and their effect on muscle activity are currently unknown. The objective of this study was to compare the measured vibration and muscle activity between: (i) conventional (90 lb) and light weight (60 lb) jackhammers, (ii) different pavement type/thickness combinations, and (iii) pneumatic and hydraulic jackhammers. Five jackhammers were tested on 4 and 6 inch thick asphalt and concrete pavements by four experienced operators. Analysis of the results revealed that both weight classes averaged 9.7 m/s(2) at the 20 Hz weighted 1/3 octave band frequency, and the TLV of daily exposure for either weight class of jackhammer was less than 1.5 hours/per day. There was an approximately 33% difference in vibration measured on the hand of the operators due to pavement thickness, 30% due pavement type, and no difference due to power source. Conventional jackhammers overall produced higher muscle activity than lightweight jackhammers. Although selection of the correct jackhammer for the job involves many factors including pavement type and thickness, the results of this research can be used to assist in selecting the appropriate jackhammer.