Great minds don't always think alike: the challenges of conducting substance abuse prevention research in public schools

Prevention researchers and school personnel lack a common understanding concerning the opportunities and burdens of school-based drug prevention research. In this article, we review issues related to researching substance abuse prevention programs in school settings, and assess challenges related to recruitment, communication, research design, surveying, and ensuring program fidelity. We conclude that before any school is enrolled, there must be a mutual understanding as to the nature and extent of the study's requirements and what adjustments a school will have to make to support a successful collaboration. Further, researchers must understand that schools' responsibilities for preparing students to perform well on academic and standardized tests will always overshadow the value they place on participating in studies to evaluate the effectiveness of prevention curricula.     

The development of core competencies for the practice of marriage and family therapy

In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The task force also was responding to a call for outcome-based education and for the need to answer questions about what marriage and family therapists do. Development of the CC moves the field of MFT into a leading-edge position in mental health. This article describes the development of the CC, outcomes of the development process for the competencies, and recommendations for their continued development and implementation.     

Neurobiological effects of childhood abuse

Child abuse and violence are significant public health problems. Research indicates a strong correlation between early childhood abuse and enduring neurobiological changes in specific regions of the brain. These neurobiological changes are often reflected in psychopathology and lifelong maladaptive behaviors. However, emerging research suggests that these neurobiological changes may be modified through specific evidence-based interventions. Nurses must be able to evaluate the current research and translate the findings into their practice, remembering that prevention is the most effective remedy for abuse and violence.     

Virgin College Students' Reasons for and Reactions to Their Abstinence From Sex: Results From a 23-Year Study at a Midwestern U.S. University

Sexual activity is normative in college. Thus, college students who are virgins are a minority; they are also an understudied group. This study extended a prior investigation (Sprecher &; Regan, 1996 Sprecher, S., &; Regan, P. C. (1996). College virgins: How men and women perceive their sexual status. Journal of Sex Research, 33, 3–15.[Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) that focused on U.S. college virgins' reported reasons for and reactions to virginity. Data were collected from the same university over an additional 18 years and from more than 700 additional virgin students. We found differences between male and female virgins that showed that men are more reluctant virgins. For example, the only reason for being a virgin that male virgins endorsed to a greater degree than did female virgins was “my partner was not willing.” Men also had more negative affective reactions to being a virgin than did women. We also found some variation in reasons for and reactions to virginity based on sociodemographic variables such as religiosity and ethnicity. A temporal analysis revealed that reasons for being a virgin that referred to a fear (e.g., fear of AIDS and other sexually transmitted infections) became less important over the 23-year period. We discuss our findings in the frameworks of evolutionary and social exchange theories.     

A novel test to compare two treatments based on endpoints involving both nonfatal and fatal events

In a clinical trial comparing two treatment groups, one commonly‐used endpoint is time to death. Another is time until the first nonfatal event (if there is one) or until death (if not). Both endpoints have drawbacks. The wrong choice may adversely affect the value of the study by impairing power if deaths are too few (with the first endpoint) or by lessening the role of mortality if not (with the second endpoint). We propose a compromise that provides a simple test based on the time to death if the patient has died or time since randomization augmented by an increment otherwise. The test applies the ordinary two‐sample Wilcoxon statistic to these values. The formula for the increment (the same for experimental and control patients) must be specified before the trial starts. In the simplest (and perhaps most useful) case, the increment assumes only two values, according to whether or not the (surviving) patient had a nonfatal event. More generally, the increment depends on the time of the first nonfatal event, if any, and the time since randomization. The test has correct Type I error even though it does not handle censoring in a customary way. For conditions where investigators would face no easy (advance) choice between the two older tests, simulation results favor the new test. An example using a renal‐cancer trial is presented. Copyright © 2015 John Wiley & Sons, Ltd.     

Embarking on self-directed support in Scotland: a focused scoping review of the literature

This article presents findings from a focused scoping review of the published literature on self-directed support (SDS), the term adopted by the Scottish Government to refer to its policy to improve social care outcomes and choices for people using publicly funded services and to distinguish it from personalisation, the term more commonly used in England, and from consumer-directed-care and cash for counselling. The review was undertaken to inform an evaluation of the early adopters of SDS, funded by the Scottish Government 2009–2011, and was updated with later literature. It focused on the evidence base available to inform the Test Sites' (pilot local authorities) efforts to reduce bureaucracy or ‘red tape’ for people choosing their own social care and support; the available evidence about leadership and training to support these changes and about the use of specific transitional funding to ease the process of implementation. The findings of the literature review around these three themes are presented and discussed. The article concludes with a discussion of the potential for such focused literature reviews to inform policy-makers, researchers, and social work practitioners across Europe of the options available when seeking to combine rapid yet rigorous approaches to evidence.     

The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys

We document the impact of the AIDS crisis on non-AIDS-related health services in 14 sub-Saharan African countries. Using multiple waves of Demographic and Health Surveys (DHS) for each country, we examine antenatal care, birth deliveries, and rates of immunization for children born between 1988 and 2005. We find deterioration in nearly all these dimensions of health care over this period. The most recent DHS survey for each country collected data on HIV prevalence, which allows us to examine the association between HIV burden and health care. We find that erosion of health services is the largest in regions that have developed the highest rates of HIV. Regions of countries that have light AIDS burdens have witnessed small or no declines in health care, using the measures noted above, while those regions shouldering the heaviest burdens have seen the largest erosion in non-HIV-related health services for pregnant women and children. Using semiparametric techniques, we can date the beginning of the divergence in the use of antenatal care and in children’s immunizations between high- and low-HIV regions to the mid-1990s.     

Parental mental health as a child protection issue: data from the NSPCC national child protection helpline

Analysis of a sample of 2084 child abuse referrals to the NSPCC Child Protection Helpline showed that in 10% a parent or carer was reported as having a mental health problem. Mothers were the parent affected in the majority of these cases. The mental health sample differed from the other referrals in an increased concern about emotional abuse and less about sexual abuse; greater levels of violence and discord between parents; and more agency involvement. Issues of potential labelling and therapeutic needs are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

Group Support Systems,Power, and Influence in an Organization: A Field Study

Emerging group technologies are attracting attention from researchers and practitioners for the benefits they potentially offer in terms of communications, productivity, and decision-making capabilities within an organization. To date, research in this area has focused on process or outcome variables, substantively ignoring organizational context issues. This paper reports on a field study that investigated users' perceptions of the impact of group support systems on power and influence within the organization. The study was conducted within a division of a major U.S. software company specializing in the development of business software tools for desktop PCs. Fifteen purposively selected managers and nonmanagers, spanning diverse functional areas, were extensively interviewed for this study. Evidence gathered suggested that group support systems are perceived to exert an equalizing force on power and influence by (1) increasing participation in the decision-making process, (2) improving access to information, (3) improving access to persons, (4) reducing the “power distance” to key individuals, and (5) providing increased opportunities to influence the opinions of others. These results provide a basis for future studies that will attempt to clarify the relationships between organizational context and group technology usage.