Culture-based versus risk-based screening for the prevention of group B streptococcal disease in newborns: A review of national guidelines

BackgroundMaternal colonisation with group B streptococcus (GBS) is recognised as the most frequent cause of severe early onset infection in newborns. National and international guidelines outline two approaches to the prevention of early onset disease in the neonate: risk based management and antenatal culture-based screening. We undertook an analysis of existing national and international guidelines in relation to GBS in pregnancy using a standardised and validated instrument to highlight the different recommended approaches to care.MethodsEnglish language guidelines on the screening and management of GBS colonisation in pregnant women and the prevention of early-onset group B streptococcal disease in newborns were sought.ResultsFour guidelines met the inclusion criteria, one from the United States of America (USA), the United Kingdom (UK), Canada and New Zealand. All four were appraised as at a high standard in terms of development using the AGREE II tool. Both approaches were recommended in the guidelines with different regions of the world advocating different approaches often based on the same evidence. Guidelines from the USA recommend an antenatal culture-based approach while the UK guidelines recommend risk-based management.ConclusionBased on an AGREE II analysis, the standard of the guidelines was high despite having disparate recommendations. Both approaches to the prevention of early onset GBS infection in neonates are recommended with the split being geographically-based.     

‘Wishing to go it alone’: the complicated interplay of independence,interdependence and agency

Some individuals with disabilities for whom verbal speech is not reliable use facilitated communication to express thoughts and ideas. While they may require intensive physical support initially, the goal is independent typing. However, this emphasis on fading support and independence bears consideration. We utilize a Disability Studies lens to frame practices around independence and the complicated interplay between interdependence, agency and voice. Based on qualitative analysis of communication training sessions, we present four findings: the complexity of the message versus fading of physical support, the emotional dimensions of independence, the facilitator’s navigation of multiple roles, and the importance of facilitating agency. We also share implications of reframing independence and facilitating agency for the communication training process.     

Does Health Insurance Premium Exemption Policy for Older People Increase Access to Health Care? Evidence from Ghana

Aging in Sub-Saharan Africa causes major challenges for policy makers in social protection. Our study focuses on Ghana, one of the few Sub-Saharan African countries that passed a National Policy on Aging in 2010. Ghana is also one of the first Sub-Saharan African countries that launched a National Health Insurance Scheme (NHIS; NHIS Act 650, 2003) with the aim to improve access to quality health care for all citizens, and as such can be considered as a means of poverty reduction. Our study assesses whether premium exemption policy under the NHIS that grants non-payments of annual health insurance premiums for older people increases access to health care. We assessed differences in enrollment coverage among four different age groups (18–49, 50–59, 60–69, and 70+). We found higher enrollment for the 70+ and 60–69 age groups. The likelihood of enrollment was 2.7 and 1.7 times higher for the 70+ and 60–69 age groups, respectively. Our results suggest the NHIS exemption policy increases insurance coverage of the aged and their utilization of health care services.     

Mistrusting companies, mistrusting the tobacco industry: clarifying the context of tobacco prevention efforts that focus on the tobacco industry

Campaigns to prevent adolescent smoking increasingly depict the tobacco industry as deceitful and exploitative. This study was undertaken to determine how adolescents' expectations about the trustworthiness of companies, in general, influence the pathway through which anti-tobacco industry campaigns prevent smoking. Structural equation modeling was used with survey data from 6,670 adolescents, ages 12 to 17. In the first model, statistically significant coefficients were associated with paths from mistrust of companies to mistrust of the tobacco industry, from mistrust of the tobacco industry to anti-tobacco industry attitudes, and from anti-tobacco industry attitudes to smoking. In models stratified by mistrust of companies, paths from mistrust of the tobacco industry to anti-tobacco industry attitudes and from anti-tobacco industry attitudes to smoking appeared comparable among youth with both high and low mistrust of companies. These results suggest that anti-tobacco industry campaigns resonate with youth because of youths' trust-related values and expectations.     

Factors Influencing the Career Decision Status of Chinese American Youths

The purpose of this study was to understand how intergenerational family conflict and relational‐interdependent self‐construal influence the career decision status of Chinese American youths. Participants were 129 Chinese American youths, with ages ranging from 14 to 21 years. Results from regression analysis indicated that high intergenerational family conflict was predictive of career indecision. High relational‐interdependent self‐construal, on the other hand, was predictive of career certainty. Implications for counseling and future research are also discussed.     

The Comparative Contributions of Congruence and Social Support in Career Outcomes

The authors assessed the relative contributions of social support and interest‐occupation congruence in job satisfaction and tenure. Congruence predicted 13% of the variance in job satisfaction for men, but it was not a significant predictor of job satisfaction for women. Social support accounted for 10% of the variance in job satisfaction for women but was not a significant predictor for men. Neither congruence nor social support predicted tenure. Implications for vocational counseling are discussed.     

Expanding Vocal Requesting Repertoires via Relational Responding in Adults with Severe Developmental Disabilities

The purpose of this project was to demonstrate untrained vocal requests in three adults with severe developmental disabilities. Specifically, we evaluated whether a history of reinforced relational responding would give rise to untrained vocal requests for novel items. Participants were first taught to request preferred items using their category names. They were then taught conditional discriminations between pictures of preferred items that were categorically related. Finally, participants were tested for their abilities to request items that had not been originally presented during request training, using their category names. All participants demonstrated untrained requests, and for some participants, changes in the mand repertoire were accompanied by changes in the tact repertoire. Some participants also showed generalization of skills across settings.