Understanding engagement in the Program of Assertive Community Treatment (PACT) from the perspectives of individuals receiving treatment

ABSTRACT

Engagement of individuals with serious mental illnesses in community mental health services is a significant challenge. The Program of Assertive Community Treatment (PACT) is an individual-centered and self-contained mental health program that provides psychiatric treatment, rehabilitation, and support services to persons with serious mental illness who have a history of or likelihood of disengagement with services. Understanding what helps and hinders consumers’ involvement in PACT services may provide information on how to tailor engagement strategies to individuals based on their treatment needs and preferences. The current study builds on existing studies by exploring factors that help and hinder engagement in PACT services from the perspectives of individuals receiving treatment. We conducted open-ended, semi-structured interviews with 17 individuals receiving PACT services. Nine themes were identified through thematic analysis: Desirable qualities of PACT, Focusing on positive outcomes, PACT as a safety net, Recovery orientation, Practical barriers, Conflictual relationships, and Medication side-effects. We conclude that the development of a trusting, therapeutic relationship that is collaborative and person-centered and that is facilitated by both practical and emotional support is critical to engaging individuals in treatment and maximizing positive outcomes.     

<Emphasis Type="BoldItalic">MAD-STEC</Emphasis>: a method for multiple automatic detection of space-time emerging clusters

Crime or disease surveillance commonly rely in space-time clustering methods to identify emerging patterns. The goal is to detect spatial-temporal clusters as soon as possible after its occurrence and to control the rate of false alarms. With this in mind, a spatio-temporal multiple cluster detection method was developed as an extension of a previous proposal based on a spatial version of the Shiryaev–Roberts statistic. Besides the capability of multiple cluster detection, the method have less input parameter than the previous proposal making its use more intuitive to practitioners. To evaluate the new methodology a simulation study is performed in several scenarios and enlighten many advantages of the proposed method. Finally, we present a case study to a crime data-set in Belo Horizonte, Brazil.     

Testing for bioequivalence of highly variable drugs from TR‐RT crossover designs with heterogeneous residual variances

Traditional bioavailability studies assess average bioequivalence (ABE) between the test (T) and reference (R) products under the crossover design with TR and RT sequences. With highly variable (HV) drugs whose intrasubject coefficient of variation in pharmacokinetic measures is 30% or greater, assertion of ABE becomes difficult due to the large sample sizes needed to achieve adequate power. In 2011, the FDA adopted a more relaxed, yet complex, ABE criterion and supplied a procedure to assess this criterion exclusively under TRR‐RTR‐RRT and TRTR‐RTRT designs. However, designs with more than 2 periods are not always feasible. This present work investigates how to evaluate HV drugs under TR‐RT designs. A mixed model with heterogeneous residual variances is used to fit data from TR‐RT designs. Under the assumption of zero subject‐by‐formulation interaction, this basic model is comparable to the FDA‐recommended model for TRR‐RTR‐RRT and TRTR‐RTRT designs, suggesting the conceptual plausibility of our approach. To overcome the distributional dependency among summary statistics of model parameters, we develop statistical tests via the generalized pivotal quantity (GPQ). A real‐world data example is given to illustrate the utility of the resulting procedures. Our simulation study identifies a GPQ‐based testing procedure that evaluates HV drugs under practical TR‐RT designs with desirable type I error rate and reasonable power. In comparison to the FDA's approach, this GPQ‐based procedure gives similar performance when the product's intersubject standard deviation is low (≤0.4) and is most useful when practical considerations restrict the crossover design to 2 periods.     

Doin’ Meth or Doin’ Math: What Client Constructions of Social Class Mean for Social Work Practice

The voices of people experiencing poverty are underrepresented in social work research, public policy development, and practice interventions. This study explored the social class attributions of clients receiving poverty-related services through qualitative interviews. Findings reveal dynamic contributions of individual, environmental, and structural factors of social class positioning and significant stress and stigmatization associated with experiencing economic hardship. Participants indicate a sense of lived contradiction, viewing social class to be the result of fate while simultaneously endorsing individualistic attributions of poverty. Results have implications for social work research and practice, as well as poverty-related policy and program development.     

Youth studies,citizenship and transitions: towards a new research agenda

A key goal in youth studies is to gain holistic understandings of what it means to be young. However, a significant impediment to achieving this has been the tendency of youth studies to develop along siloed and stratified subfields. In keeping with the goal of creating more productive dialogue between subfields in youth studies, this paper examines the intersections between research in youth citizenship and youth transitions to consider the fresh insights and cross fertilisations that such an analysis may yield. This examination reveals a sense of dissatisfaction in both subfields with traditional normative and linear models of citizenship and transitions which rely on step-wise and sequential notions of time. In response, the paper advances a new research agenda which posits more temporally, spatially and relationally-sensitive understandings of youth citizenship and transition. Drawing on Ingold (2007. Lines: A brief history. London: Routledge), this agenda proposes the use of three alternative metaphors – genealogical, wayfaring and threads – which could hold the potential to unsettle the normativity and linearity of previous youth transitions and citizenship frameworks, and thus provide deeper insights into what it means to live and to be young citizens in times of transition.     

Staff Development as a School Climate Intervention to Support Transgender and Gender Nonconforming Students: An Integrated Research Partnership Model for School Counselors and Counselor Educators

ABSTRACT

This article posits that an integrative research partnership model can assist school counselors in addressing the marginalization of transgender students in schools through staff development. A methodological integration of action research and program evaluation through quantitative and qualitative data collection is explained, and a collaborative process is highlighted. A case example is provided to demonstrate the use of the design.     

Sex/love skirmishes: “swinging,” “polyamory,” and the politics of naming

The contested definitions of “swinging” and “polyamory” reveal profound inconsistencies in the logics of sex, love, commitment, and coupledom. In this article, I use a number of non-monogamy blogs and online glossaries as examples of the way these two words are often deployed against each other in an effort to position the speaker in relation to mononormative practices of sex and love. Leaving aside questions of the accuracy of particular definitions, I map a range of definitions against two existing scholarly/activist tools for describing relationship styles, specifically Gayle Rubin’s “Charmed Circle” and Meg-John Barker’s sex/love continuums. This exercise is doubly fruitful: first, the tools reveal the political stakes of the definitional debates; second, the definitions demonstrate that the distinctions we commonly use to distinguish between types of relationships—including types of non-monogamous relationships—in fact rely on mononormative assumptions about sex, love, and friendship. If “mononormativity” is defined as the system of ideas, institutions, and practical orientations that provide the backdrop against which the idea of monogamy as coherent, common, natural, and right congeals, the sex/love skirmishes of “swinging” and “polyamory” remind us that its logics are both pervasive and deeply fractured.     

Infant–Mother and Infant–Caregiver Emotional Relationships: Process Analyses of Interactions in Three Contemporary Childcare Arrangements

Emotional relationships in infant–mother dyads in families where mothers provided full‐time childcare were compared with those of families where mothers used in‐home childcare providers and family childcare providers (N = 245). Infant relationships with childcare providers were also studied. Emotional relationships were adequate in all three childcare arrangements, but infant–mother dyads in in‐home childcare arrangements displayed healthier emotional relationships than infant–mother dyads in mother care arrangements; no differences in the health of emotional relationships with infants emerged among the three types of childcare providers (mother care, in‐home childcare, family childcare). Infant–mother dyads in in‐home childcare arrangements also displayed healthier emotional relationships than infant–in‐home childcare caregiver dyads, but infant–mother and infant–caregiver dyads were comparable in family childcare families. Emotional relationships in infant–mother and infant–caregiver dyads were not correlated, regardless of the type of childcare.