Mental health assessment of infants in foster care

Infants placed in foster care are at high risk for emotional and behavioral problems. Assessment of their mental health must account for their often-adverse life experiences prior to placement and the involvement of multiple systems that shape their lives in lieu of parents' authority. This article presents practice guidelines for infant mental health evaluations with consideration of legal requirements and the unique issues conferred by foster care.     

Analysis of strategic plans to assess planning for sustainability of comprehensive community initiatives

In order to achieve the intended impact on a community, comprehensive community initiatives must sustain programs once they have been implemented. However, planning for sustainability is challenging and is rarely incorporated in the planning process of an initiative. The current study examined 19 5-year plans developed during the planning phase of the Comprehensive Strategy for Serious, Violent and Chronic Juvenile Offenders. Quantitative and qualitative methods were employed to assess the extent to which the construct of sustainability was incorporated. The plan analysis was supplemented with results from other components of the complex evaluation design implemented as part of the process evaluation of Comprehensive Strategy. Results suggested that sustainability was not accounted for during the planning phase of this initiative. The implications of these findings, including the importance of planning for sustainability in order to achieve sustainability, are discussed.     

Fatigue management by truck drivers in real life situations: some suggestions to improve training

Truck driver fatigue is a major safety issue for truck drivers and the public in general. Although training prepares drivers to effectively operate a truck, it tends to minimize the importance of working constraints faced daily on-the-job and thus reduces its impact on safety and effectiveness. With experience, drivers develop skills to combat fatigue. Documenting these skills can contribute to improved training of apprentices. An ethnographic approach was used to better understand the real-life fatigue management skills of truck drivers. Participant observation was used to analyze the activity of apprentices in training and the activity of truck drivers at work. Observations indicated that training focused on time management and regulations, but did not prepare trainees to manage real-life constraints. Experienced drivers were not merely managing time; rather they were managing working constraints (including time) as a whole. To do so, they used two strategies: managing psycho-physical transformations and dynamic work planning. By integrating psycho-physical preoccupations into all aspects of work and by preparing future drivers to face real-life constraints, we could better train and prepare apprentices. Drivers do develop effective skills to combat fatigue which can improve training and better prepare future drivers to face daily constraints. These improvements can have a significant impact on fatigue and safety in the transportation industry.     

The Transitional Discharge Model: comparing implementation in Canada and Scotland

Effective discharge planning is needed to facilitate clients' transition from psychiatric hospital wards to community care. Previous studies have shown that client outcomes can be improved by using a Transitional Discharge Model (TDM) that includes peer support and an extension of inpatient-practitioner relationships that are introduced prior to discharge. However, countries vary in many ways that may affect implementation of the model. This article describes some of the similarities and differences related to introducing transitional discharge in two countries: Canada and Scotland. It is important to elucidate facilitators and challenges in implementing the TDM to identify and disseminate strategies to aid implementation. Implications for future implementation of the model are also discussed.     

Point subtraction aggression paradigm: validity of a brief schedule of use

The Point Subtraction Aggression Paradigm (PSAP) is a validated behavioral measure of aggression in response to provocation. Canonically, multiple sessions continue until performance asymptotes, requiring significant time. We sought to examine whether use of the PSAP-first-session ("PSAP-FS") had acceptable construct validity for group data, potentially expanding the settings in which the PSAP may be useful. One hundred male and female young adult subjects completed the PSAP-FS and additional behavioral measures of aggression, and provided information related to risk factors. The PSAP-FS correlated significantly with known risk factors of aggression. The PSAP-FS, which measures aggression in the present, correlated well with measures of recent aggression and less strongly with life history of aggression. The PSAP-FS had satisfactory validity properties for use where group-level data are of interest.     

A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff

There is a need to investigate novel interventions that promote worksite physical activity and wellness. OBJECTIVE: The authors' purpose in this study was to evaluate the effectiveness of a 12-week walking program supplemented with a pedometer, computer educational program, and weekly e-mails. METHODS: College faculty and staff participated in a one-group pre-posttest study to determine whether the 12-week walking intervention had an effect on body mass index (BMI), blood pressure, blood glucose, and cholesterol. The authors also determined participant-perceived wellness effects. RESULTS: The authors observed differences between baseline and follow-up in BMI (p = .024), blood glucose (p = .06), and total cholesterol (p = .09). The program had a moderate effect on fitness, mood, health awareness, nutrition, and health. CONCLUSIONS: It is incumbent that experts develop innovative worksite physical activity and wellness programs. A pedometer-monitored walking program is one way that a worksite health initiative can improve the health and wellness of its employees and simultaneously reduce health-care costs.     

Social inequalities in intimate partner violence: a study of women in Kenya

This study examines social inequalities in intimate partner violence (IPV) among women of reproductive age in Kenya. A sample comprising 3,696 women was retrieved from the Kenyan Demographic and Health Survey of 2003. The study design was cross-sectional. Chi-square tests and logistic regression were used to analyze the data. Results indicated that while high education among women reduced the risk of IPV exposure, both being employed and having a higher education/occupational status than her partner increased a woman's vulnerability to IPV. Age differences between the partners, illiteracy, and lack of autonomy and access to information increased the likelihood of IPV. Finally, being in polygamous relationships was associated with IPV exposure. The findings indicate demographic, social, and structural differences in exposure to IPV with important implications for interventions.     

Gender differences in the relationship between intimate partner violence victimization and the perception of dating situations among college students

Although the prevalence and severity of dating violence among college students is well known, the relationship between past victimization and perceptions of future dating situations has not been examined. Using both qualitative and quantitative research methods, this study investigated gender differences in the relationship between intimate partner violence victimization and the perceptions of dating situations. The study found that the more psychological, physical, or sexual violence that was experienced by females, the more likely they perceived dating situations as inappropriate. Males, on the other hand, were more likely to report aggressive behaviors in dating situations only if victimized by sexual violence. Implications for professionals working with college students or community prevention programs are discussed.     

The life-course origins of mastery among older people

In this article, we aim to identify the sources of mastery--the understanding that individuals hold about their ability to control the circumstances of their lives. The sample for our inquiry was drawn from the Medicare beneficiary files of people 65 and older living in Washington, DC, and two adjoining Maryland counties. We find that past circumstances, particularly those reflecting status attainment and early exposure to intractable hardships, converge with stressors experienced in late life to influence elders' level of mastery. The impact of past conditions, however, does not necessarily directly affect the current mastery of older people. Instead, the effect of prior experiences on current mastery is mediated by what we refer to as life-course mastery: one's belief that one has directed and managed the trajectories that connect one's past to the present. Our analyses show that life-course mastery largely serves as the mediating channel through which individuals connect their past to their present.     

Operationalizing environmental indicators for physical activity in older adults

This qualitative study describes environmental supports and barriers to physical activity in an older adult sample drawn from low- and high-walkable neighborhoods. Thirty-seven individuals age 55 and over were recruited and answered open-ended survey questions, with a subsample invited back to partake in a semistructured interview. Content analysis identified categories and themes linking perceptions of neighborhood-environment characteristics to activity. Emerging categories and themes did not differ across neighborhood walkability, so results are presented for both groups combined. Infrastructure was the most common category identified to encourage activity, specifically, well-maintained sidewalks, bike paths or lanes, and traffic control. Other categories of land use, landscape, and aesthetics were reported. Poorly maintained or missing sidewalks, crosswalks, bike paths or lanes, and traffic safety were categories that discouraged activity. In conclusion, the information obtained is helpful in solidifying which environmental characteristics are important to measure as they relate to activity behavior in an older adult population.