Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

Mental illness etiology beliefs among African American men with serious mental illness and their social support networks

Semi-structured qualitative interviews were conducted with 26 African American men with serious mental illness who were consumers of community mental health services and 26 members of their social support networks. All participants were asked what they believed had caused the consumers’ mental illness. Consumer participants most commonly identified chronic life stressors as a causal factor, while social supports most often identified intrinsic factors such as genetics or biology as causes of mental illness. Some support participants believed that unintentional drug use had precipitated the onset of mental illness or had no causal theories. The fact that some support participants could not identify a causal explanation may indicate failure on the part of mental health care systems to engage with consumers’ social support networks and provide education about mental illness and its causes. The implications of etiology beliefs on mental health service utilization are discussed.     

The Effect of Social Responsiveness on Infants' Object‐Directed Imitation

Previous research has demonstrated that social interactions underlie the development of object‐directed imitation. For example, infants differentially learn object action sequences from a live social partner compared to a social partner over a video monitor; however, what is not well understood is what aspects of social interactions influence social learning. Previous studies have found variable influences of different types of caregiver responsiveness on attention, language, and cognitive development. Therefore, the purpose of this study was to examine how the responsive style of a social partner influenced the learning of object‐directed action sequences. Infants interacted with either a sensitive or redirective experimenter before the learning trial. Results revealed infants changed their patterns of engagement; infants interacting with a sensitive experimenter had longer periods of attentional engagement than infants interacting with a redirective experimenter. Furthermore, during the learning trial, the amount of sensitivity during interaction with the social partner predicted learning scores. These findings suggest that infants' attention is influenced by social partners' interactive style during ongoing interaction, which subsequently affects how infants learn from these social partners.     

Critical Discourse,Applied Inquiry and Public Health Action with Urban Middle School Students: Lessons Learned Engaging Youth in Critical Service-Learning

The Nuestro Futuro Saludable partnership designed a critical service-learning intervention focused on health equity and action. The 10-week afterschool intervention was implemented in a Boston middle school. Youths who took part in the intervention were knowledgeable about the social determinants of health in their communities, as well as to the barriers to health. Our findings indicate that engaging young people in a meaningful way will be critical if health improvement efforts are to be realized. We found that a critical service-learning framework that incorporates elements of applied inquiry and critical pedagogy was effective as a health intervention and provided opportunities for action.     

Inappropriate Comparisons: The LGB Population's Missing Reference Group

ABSTRACT

Given that many professional organizations emphasize the need for comparing assessment results to appropriate reference groups in their codes of ethics, we consider this practice through an ecological perspective as it applies to the lesbian, gay, and bisexual (LGB) population. The purpose of norming and types of assessment bias is discussed with respect to LGB population, which frequently lack specific norming data. The authors discuss whether the LGB population has characteristics similar to other commonly normed for groups and explore how group-shared constructs such as minority stress and internalized homophobia may introduce bias and affect the validity of assessments. A social anxiety assessment as well as a personality disorder inventory are examined for bias as case examples explaining how these assessments may exhibit bias when used with the LGB population. Increases in validity and effects on treatment planning are discussed as benefits of providing LGB-specific norms. Risks of providing these norms, such as minimizing subgroup differences and possibly increasing the risk of discrimination are also addressed before providing clinicians with recommendations as to how they may minimize the risk of bias in their assessment process.     

“Friendly” Initiatives: An Emerging Approach to Improve Communities for Vulnerable Populations

A growing number of cities and towns are implementing “friendly” initiatives to change the community’s social and physical infrastructure to address the needs of a particular vulnerable segment of their population. Three prominent examples are aging-friendly, child-friendly, and immigrant-friendly initiatives. Although the limited but growing literature describes these initiatives as promising strategies to improve the quality of life of the targeted population, to date there has been little written about the underlying goals, values, and assumptions of these efforts. Using the value-critical approach, this article aims to better understand these aspects of population-friendly initiatives by examining the scholarly and grey literature. Social workers engaged in community and policy practice can play a key role in these efforts and call attention to the ways they may alleviate or exacerbate inequities. Future research is needed to assess the effects of these initiatives on their targeted population as well as other community residents.     

Gender and Performance Capital among Local Musicians

This article extends Bourdieu’s field theory to explain how learning spaces in the Toronto folk and metal scenes create gendered access to a field-specific form of cultural capital: performance capital, or the instrumental and interpersonal skills required to perform music. Folk musicians develop performance capital in open-access spaces, such as workshops and open stages at local folk clubs, while metal musicians learn in private spaces such as garages, basements, and rented rehearsal rooms. Folk’s learning spaces are open to all aspiring musicians, while access to heavy metal’s learning spaces relies on social networks from which women are often excluded. These different processes of capital development can lead to greater or lesser opportunities for women to become cultural producers: In Toronto, women make up approximately five percent of heavy metal musicians, but almost half of practicing folk musicians.     

The intersection of nonsuicidal self-injury and suicide-related behavior: Patterns of elevated risk and implications for college mental health

Objective: To analyze the overlap of nonsuicidal self-injury (NSSI) and suicide-related behaviors (SRB) among college students with regard to demographics, mental health, and coping styles. Participants: Respondents were 572 undergraduate students at a southwestern public university. Methods: Data were collected in 2015. Respondents completed a demographic survey and assessments of NSSI, SRB, internalizing symptoms (ie, anxiety, stress, and depression), aggression, and negative coping strategies. The survey was administered via a Web-based procedure. Results: Women reported more frequent cutting behaviors than men. Endorsement of NSSI was also associated with an increased likelihood of lifetime SRB. A subgroup of students endorsing both NSSI and SRB demonstrated poorer mental health, more negative coping, and self-reported female sex. Conclusions: College healthcare providers may benefit from competency-based training in techniques for the combination treatment of NSSI and SRB, as well as culturally based models of suicide.