Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

Reading the Feedback; An Interview with Doug Breunlin

Doug Breunlin is Vice President and Chief Operating Officer of The Family Institute, Chicago and an Associate Professor at Northwestern University. He was formerly the Director of the Family Systems Program at the Institute for Juvenile Research in Chicago, and he is Associate Editor of the Journal of Family Therapy (UK), and an editorial member of the Journal of Marital and Family Therapy. I first met him in 1975 when he joined the staff of The Family Institute, Cardiff, Wales for a period of three years. I remember those years as the most creative during my time at the Institute (and we also had a lot of fun). At one point, we were joined by a certain social work lecturer on sabbatical from the University of NSW by the name of Max Cornwell, who also contributed much to the creativity and the fun. Doug has published widely and, in 1992, was the joint author of a seminal work entitled Metaframeworks: Transcending the Models of Family Therapy. Doug recently visited New Zealand and also made his second trip to Australia to present workshops on dealing with complex cases using the metaframeworks. While in Melbourne, he gave the second biennial memorial lecture in honour of Geoff Goding. I interviewed Doug while he was in Sydney.     

Income Inequality across the Rural-Urban Continuum in the United States, 1970–2016*

The growth in macro-level income inequality in the United States is well established, but less is known about patterns of inequality at subnational scales and how they vary between and within rural and urban localities. Using data from the Decennial Census and American Community Survey, we produce estimates of within-county income inequality from 1970 to 2016 and analyze differences in inequality levels, the persistence of high (low) inequality, and populations' exposure to high (low) inequality across the rural-urban continuum. We find that income inequality has historically been higher in non-metropolitan than metropolitan counties, but inequality levels converged by 2016 due to growing inequality in metropolitan counties. Additionally, levels of inequality were generally persistent within counties over time, except that counties characterized by low inequality in 1970 were unlikely to remain as such in 2016. Third, non-trivial shares of the metropolitan population resided in low-inequality contexts in 1970, but virtually none of the U.S. population resided in such places by 2016. Residence in high-inequality counties is normative in rural and urban America. This statistical analysis provides an updated portrait of income inequality across the rural-urban continuum, and should spur additional research on stratification in rural America during an era of growing inequality.     

Pediatric Chronic Illness Management: A Qualitative Dyadic Analysis of Adolescent Patient and Parent Illness Narratives

In pediatric chronic illness, little is known about the relational interactions between adolescent patients, parents, and illnesses and how they influence self-management of illness. We conducted interviews with 32 individuals (16 dyads) representing adolescents diagnosed with a chronic illness and their primary parent who had been referred to a psychosocial treatment program for challenges with illness management. Interviews were conducted individually and analyzed dyadically using grounded theory to better understand the relational processes that may be contributing to illness management difficulties. Results include a theory of patient–parent illness responses and how parental illness meanings play a role in adolescent self-management. Results can be used to better understand and treat family relational patterns that may be influencing pediatric illness management challenges.     

Malaria in Pacific populations: seen but not heard?

Most Pacific Island countries are located in the tropics, where there is an abundance of mosquitoes with the potential to carry debilitating or life-threatening vector-borne diseases. This article examines three Melanesian countries in which malaria is endemic—Papua New Guinea, Solomon Islands and Vanuatu—but the threat posed by the spread of malaria gives the issues a broader significance to the Pacific region. After discussing the spatial distribution and prevalence of malaria in the Pacific, the article examines a number of health interventions through which people have sought to control malaria. Although the disease was nearly eradicated in the Pacific in the 1970s, it is no longer in retreat. The article concludes by examining why there are still grounds for cautious optimism, and the challenges that Pacific Island countries face in reducing the impact of malaria on their populations. There is a need for prompt and concerted action on malaria at the national, regional and international levels if the public health concerns arising from the disease are to be adequately addressed.     

Back to Hegel? On Gillian Rose's critique of sociological reason

Thirty‐five years ago, Gillian Rose articulated a significant critique of classical sociological reason, emphasizing its relationship to its philosophical forebears. In a series of works, but most significantly in her Hegel contra Sociology, Rose worked to specify the implications of sociology's failure, both in its critical Marxist and its ‘scientific’ forms, to move beyond Kant and to fully come to terms with the thought of Hegel. In this article, I unpack and explain the substance of her criticisms, developing the necessary Hegelian philosophical background on which she founded them. I argue that Rose's attempted recuperation of ‘speculative reason’ for social theory remains little understood, despite its continued relevance to contemporary debates concerning the nature and scope of sociological reason. As an illustration, I employ Rose to critique Chernilo's recent call for a more philosophically sophisticated sociology. From the vantage point of Rose, this particular account of a ‘philosophical sociology’ remains abstract and rooted in the neo‐Kantian contradictions that continue to characterize sociology.     

THE OPTIMAL DEFENSE OF NETWORKS OF TARGETS

This paper examines a game‐theoretic model of attack and defense of multiple networks of targets in which there exist intranetwork strategic complementarities among targets. The defender's objective is to successfully defend all the networks and the attacker's objective is to successfully attack at least one network of targets. Although there are multiple equilibria, we characterize correlation structures in the allocations of forces across targets that arise in all equilibria. For example, in all equilibria the attacker utilizes a stochastic “guerrilla warfare” strategy in which a single random network is attacked. (JEL C72, D74)     

Multidimensional Resilience: Predictive and Construct Validity of the Individual,Family, and Community Resilience Profile

Few measures parallel the robust depth offered in the existing multidimensional and ecologically informed theories of resilience. This study sought to evaluate the test–retest reliability, construct, and predictive validity of the individual, family, and community resilience resource profile (IFCR-R). The IFCR-R measures a family’s access to resilience resources and protective factors across multiple ecological levels. Confirmatory factor analysis was used with a sample of n?=?810 low-income families. And 159 families completed multiple time point measures for test–retest reliability and predictive validity evaluation. Results of this study support the proposed multidimensional ecological structure of the IFCR-R and found that the IFCR-R offers an acceptable test–retest reliability and predictive validity for outcomes of mental and physical health.     

Dyadic Supervision Evaluation: An Actor–Partner Relational Model

This article contributes to research practices in marital and family therapy, specifically the dyadic and development over time in clinical supervision, and describes and applies methodological strategies to develop measurements congruent with the systemic and developmental principles of the field. This project evaluates the psychometric properties of the dyadic supervision evaluation (DSE) in terms of measurement equivalence and causality. A structural equation analysis is conducted utilizing the actor–partner interdependent model resulting in a goodness of fit. This study presents a longitudinal model for evaluating the supervisory relationship and proposes a model of clinical supervision evaluation. The relationship among latent constructs in the DSE and its limitations related to inference and application are discussed.