Caregivers' perspectives on the SafeCare® programme: Implementing an evidence‐based intervention for child neglect

This qualitative study examined caregivers' experiences with SafeCare®, an evidence‐based programme that focuses on child neglect through modules on health, safety, and parenting. Shortly after completing SafeCare, 30 caregivers participated in a semi‐structured interview about their experiences with the programme. Overall, caregivers indicated that the programme helped with improvements in their parenting skills. Among the factors that contributed to a positive experience were the simplicity of language, the skills‐based approach, and the quality of the relationship with the SafeCare provider. Caregivers also noted several factors that made it difficult to fully benefit from the programme, including financial constraints, removal of their child from the home, and general distrust towards the child welfare system. Findings provide relevant information for SafeCare providers in terms of identifying areas that work well for caregivers completing the programme, as well as areas that might serve as impediments. Implications for contemporary child welfare practice are also considered.     

Modification of Tukey's additivity test

In this paper we discuss testing for an interaction in the two-way ANOVA with just one observation per cell. The known results are reviewed and a simulation study is performed to evaluate type I and type II risks of the tests. It is shown that the Tukey and Mandel additivity tests have very low power in case of more general interaction scheme. A modification of Tukey's test is developed to resolve this issue. All tests mentioned in the paper have been implemented in R package Additivity Tests.     

Distributed leadership patterns and service improvement: Evidence and argument from English healthcare

This article focuses on the pattern and impact of change leadership in complex, pluralistic, public sector settings, and specifically in English healthcare. The argument draws on evidence from ten comparative cases, exploring links between leadership patterns and organizational outcomes. Our analysis builds three themes. First, a pattern of widely distributed change leadership is linked to delivering improvements in service outcomes. Second, professional/managerial hybrids are shown to perform crucial lateral facilitation activities, adapting and extending their roles to suit their organizational context. Third, a foundation of good pre-existing relationships underpins the capacity of distributed leadership to implement service improvements. Conversely, poor relationships and conflicts erode the concerted capacity of distributed change leadership. The key contribution of this article thus concerns the establishment of links between situated patterns of distributed leadership, and service improvement outcomes, based on the cumulative effects of actors – managers and clinical hybrids – at different organizational levels.     

Validation of the 12 Item Short form Health Survey in a Sample from Region Central Jutland

In 2010 the Danish regions started a new program of public health surveillance in collaboration with the national and local health authorities using the short form health survey (SF-12) for measuring and reporting on health related quality of life among the Danish adult population. The instrument has not, however, been validated in a Danish setting. The aim of this study was to assess the reliability and validity of the physical component summary (PCS) and the mental component summary (MCS) score of the 12-item short form health survey (SF-12) in a sample from Central Denmark Region. A total of 26,397 persons above the age of 25 were included in the analyses. Reliability was assessed by Cronbach’s α. The validity was assessed using known-groups comparisons and convergent validity. The factor structure was investigated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Cronbach’s α showed high reliability with a score of 0.90 and 0.85 for PCS and MCS respectively. The SF-12 discriminated well with respect to gender, age, educational status and long term illness. Individual items correlated higher with own hypothesized scales than with other scales and summary measures corroborating the convergent validity. The EFA gave a two-factor structure. Irrespective of the chosen rotation method (varimax and oblimin) the items related to PCS loaded on one factor and the items related to MCS loaded on another factor. The factor structure was validated with acceptable model-fit values in CFA. The SF-12 instrument is a reliable and valid measure of health related quality of life among the population of Central Denmark Region.     

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Patterns of Autonomic Arousal in Imaginal Situations of Winning and Losing in Problem Gambling

AIMS: To examine changes in skin conductance level (SCL), for problem gamblers in response to personally relevant imaginal tasks, representing winning or losing. SETTING, DESIGN, PARTICIPANTS AND MEASUREMENTS: SCL and subjective arousal were compared for problem poker machine gamblers (n = 13) and a control group (n = 20). Participants were asked to describe a situation in which they had (a) won and (b) lost during a period of gambling. Before and during the task, recordings of SCL were taken. FINDINGS: There were significant differences between responses of problem and social gamblers. A significant interaction indicated that social gamblers became more aroused in reaction to winning than losing, whereas problem gamblers became equally aroused in response to both tasks. CONCLUSIONS: The results suggest that it may be responses to losing, rather than winning that are paramount to the development and maintenance of problem gambling.