The wellbeing of foster children and their relationship with foster parents and biological parents: a child’s perspective

Most Dutch foster children live permanently in foster families. It is often assumed that foster children have ambivalent loyalties and attachments to their birth parents and foster parents and are torn between the two. In this study 59 children between 10 and 18 years placed in long term foster care completed standardised questionnaires on the relationship with their parents respectively foster parents and their wellbeing. Results show that, on average, foster children have positive feelings of loyalty and attachment towards both their foster parents and biological parents. However, their wellbeing appeared mainly related with stronger attachment representations towards their foster parents. This study found no indications for a competing position of biological parents and foster parents from the perspective of the child. Nevertheless, foster children who see their foster and biological parents as more vulnerable or experience stronger normative boundaries, feel worse compared to children who experience this feelings less.     

Derived Equivalence Relations of Geometry Skills in Students with Autism: an Application of the PEAK-E Curriculum

The present study evaluated the efficacy of equivalence-based instruction (EBI) as described in the PEAK-E curriculum (Dixon, 2015) for promoting the emergence of derived geometry skills in two children with high-functioning autism. The results suggested that direct training of shape name (A) to shape property (B) (i.e., A-B relations) was effective for both participants. Following A-B training, both participants demonstrated emergent relations that are consistent with symmetry (B-A), as well as emergent shape name (A) to shape picture (C) relations that are consistent with transitivity (A-C). The results expand on existing literature by demonstrating the emergence of an A-C relation when neither A nor B stimuli were ever trained to C stimuli and illustrate the efficacy of EBI for training geometry skills.

     

Predicting Well‐Being and Internalizing Symptoms in Late Adolescence From Trajectories of Externalizing Behavior Starting in Infancy

This study aimed to examine the long‐term prediction of well‐being and internalizing symptoms from trajectories of externalizing behavior problems in 921 children from a population‐based sample. We found that a high stable trajectory of externalizing behavior from infancy (age 1.5) to mid‐adolescence (age 14.5) predicted lower scores on life satisfaction and flourishing for both girls and boys (age 18.5). The high stable trajectory also predicted higher levels of depressive symptoms in boys and anxiety symptoms in girls (age 18.5). The findings are noteworthy as they document how a person‐oriented study of externalizing behavior problems starting in infancy can predict well‐being and internalizing in late adolescence. The findings underline the importance of early health promotion and problem intervention efforts.     

Contemporary Epidemiology: A Review of Critical Discussions Within the Discipline and A Call for Further Dialogue with Social Theory

The discipline of epidemiology, which holds major influence on public health policy as well as on clinical medical practice, has in recent decades to a large extent been concerned with the identification of factors and markers of risk for disease. Much health information and intervention is thus informed by a wealth of studies on a variety of risk factors, of which the individual is encouraged to keep informed and to be responsible about. Meanwhile, risk factor epidemiology has been subject to intense debate, both within and outside the discipline. The following review offers an overview of critical intradisciplinary debates. It then opens discussion on three partially overlapping areas where social theory has been called upon to contribute to epidemiological inquiry, namely analysis of macro‐social determinants of health and disease, of categories of human difference and of embodiment. The review ends with, and is motivated by, a plea for further integration of and dialogue between epidemiology and social theory.     

Extremity injuries and dementia disproportionately increase the risk for long-term care at older age in an analysis of German Health Insurance routine data for the years 2006 to 2010

Background

Extremity injuries (EI) and dementia are important causes of long-term care (LTC), but they can also cause each other and are often present concurrently. Mobility-limiting EI can increase the risk of dementia, and dementia increases the risk for falls, which are often the cause of EI. When EI and dementia are present together, they can increase their negative effect on long-term care risk. This study aims to assess the strength of this interaction and the role of different body regions and severities of EI regarding LTC risk.

Methods

We use Cox proportional-hazard models on LTC as dependent variable. EI (primarily fractures) and dementia (all types) are the central independent variables. We control for age, sex, rehabilitation and 18 relevant comorbidities. Analyses are based on health claims records for 2004–2010 for a random sample of about 122.000 insurants of Germany's largest public health insurance "AOK" aged 65+, about 25.000 of whom entered LTC.

Results

Without concurrent dementia, non-severe EI (NSEI) of the lower and both extremities and all kinds of severe EI (SEI) increase LTC risk (HR: hazard ratio with 95% confidence interval. Lower NSEI: HR?=?1.09 [1.05–1.14]; both NSEI: HR?=?1.36 [1.29–1.44]. Lower SEI: HR?=?1.67 [1.57–1.79]; upper SEI: HR?=?1.27 [1.19–1.37]; both SEI: HR?=?1.94 [1.81–2.07]). Dementia alone increases LTC risk more than fourfold (HR?=?4.23 [4.11–4.35]).Taking the interaction of EI and dementia into account, the concurrent presence of EI and dementia tends to increase the LTC risk more than expected for lower as well as upper NSEI and SEI. Summarily, when lower or upper EI and dementia are both present, the LTC risk tends to be higher than expected, suggesting synergistic effects.

Conclusions

EI and dementia are important independent risk factors for long-term care. When lower or upper EI and dementia are present together, the resulting long-term care risk is increased disproportionately. Since the concurrent presence of both conditions increases the risk for care need, and a working treatment for dementia is not in sight, preventing EI, lessening the impact of EI and improving the outlook after an EI could help to reduce LTC need in the coming decades.

     

Collaborative Partnership in Age-Friendly Cities: Two Case Studies From Quebec,Canada

This article aims to explain the collaborative partnership conditions and factors that foster implementation effectiveness within the age-friendly cities (AFC) in Quebec (AFC-QC), Canada. Based on a community-building approach that emphasizes collaborative partnership, the AFC-QC implementation process is divided into three steps: (1) social diagnostic of older adults' needs; (2) an action plan based on a logic model; and (3) implementation through collaborations. AFC-QC promotes direct involvement of older adults and seniors' associations at each of the three steps of the implementation process, as well as other stakeholders in the community. Based on two contrasting case studies, this article illustrates the importance of collaborative partnership for the success of AFC implementation. Results show that stakeholders, agencies, and organizations are exposed to a new form of governance where coordination and collaborative partnership among members of the steering committee are essential. Furthermore, despite the importance of the senior associations' participation in the process, they encountered significant limits in the capacity of implementing age-friendly environments solely by themselves. In conclusion, we identify the main collaborative partnership conditions and factors in AFC-QC.     

Is “Sexual Competence” at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status?

The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on “early” first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010–2012, this study examined whether a context-based measure of first intercourse—termed sexual competence—was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as “sexually competent” at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were “equally willing,” and that it happened at the “right time.” A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.     

Independent Advocacy for Children and Young People: Developing an Outcomes Framework

This article draws on a study of the outcomes and impact of independent advocacy for children and young people to explore how the value of advocacy is understood by them and by professionals, and what differences advocacy can make to the lives of children and young people. Findings indicate that outcomes of advocacy can be significant and wide‐ranging, including both direct effects on the child or young person and wider impact on services. This has implications for how to capture and report the outcomes of advocacy, for which this article offers a new conceptual framework.     

Local Digital Algorithms Applied to Boolean Models

We investigate the estimation of specific intrinsic volumes of stationary Boolean models by local digital algorithms; that is, by weighted sums of local configuration counts. We show that asymptotically unbiased estimators for the specific surface area or integrated mean curvature do not exist if the dimension is at least two or three, respectively. For three‐dimensional stationary isotropic Boolean models, we derive asymptotically unbiased estimators for the specific surface area and integrated mean curvature. For a Boolean model with balls as grains, we even obtain an asymptotically unbiased estimator for the specific Euler characteristic.