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.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.     

‘Before they kill my spirit entirely’: insights into the lived experiences of American Indian Alaska Native faculty at research universities

American Indian and Alaska Natives (AIAN) comprise about 2% of the US population and 0.5% of the faculty in higher education. While scholars have documented the experiences of underrepresented minority (URM) faculty, the perspectives of AIAN faculty at elite universities are largely absent. Although AIAN faculty share many of the same barriers to success as URM colleagues, their unique status as Tribal peoples and their relationship to settler colonialism pose particular challenges and resistance strategies. Findings from a mixed methods study of 25 AIAN faculty at research universities, employing a decolonizing, survivance-oriented framework, examines their lived institutional experiences. The data yielded five themes regarding (1) institutional climate, (2) mentorship, (3) family–work balance, (4) cultural taxation and role stress, and (5) discrimination. The authors conclude that decolonization involves the repatriation of Indigenous epistemologies and Indigenous ‘place’ in the growth of science, research, and knowledge production, creating liberatory spaces within the academy.     

Life Domain Satisfaction: A Portugal–France Comparison

The study was aimed at replicating on a Portuguese sample the seven-factor model of life appraisal (physical autonomy, love life, family life, social life, occupational life, finances, and leisure life) that was suggested by Salvatore and Munoz Sastre Social Indicators Research 53:229–255 (2001). A sample of 1,111 Portuguese participants, aged 17–85, was presented with the Appraisal of Life Questionnaire. The “domain” model of life appraisal satisfactorily accounted for the data gathered on the Portuguese sample. Regarding finances and occupational life, Portuguese scores were lower than French scores. Regarding the occupational score and the leisure score, a clear linear decrease as a function of age was evidenced in the Portuguese sample. Finally, regarding the family score and the financial score, a non-linear relationship with age was found. An increase was observed from young adult age to adult age, and a decrease was observed from adult age to older age. A strong decrease in the physical autonomy scores among Portuguese females was also observed.     

Parents at‐risk and their children: intersections of gender role attitudes and parenting practices

Existing research demonstrates that parent and child gender may influence important aspects of family relationships; however, most research in this area has been conducted with non‐clinical samples. As clinicians, it is important to consider how gender impacts family relationships, particularly among vulnerable families. This study examined the intersections of gender role attitudes and parenting practices among 34 parents involved with the child welfare system and referred for clinical intervention. Using a mixed methods design, themes regarding gender role beliefs and parenting practices were found through qualitative interviews with parents. Findings suggested that fathers felt responsible for financially providing for their families and expressed challenges in communicating with mothers, and mothers described challenges they face because of a lack of father involvement. Parents also discussed a perceived need to monitor daughters closely while fostering the independence of their sons. Results of the qualitative analyses were supported by quantitative findings indicating significant differences in harsh and inconsistent discipline practices and clear expectations for girls compared to boys. The discussion addresses implications for clinicians, including how a feminist family therapy perspective may help promote client influence over traditional gender norms by questioning gender role attitudes and exploring alternate narratives that may impact family dynamics.     

The role of eviction in veterans’ homelessness recidivism*

Eviction is one of the leading causes of homelessness in the U.S.A. Though permanent supportive housing (PSH) helps participants maintain housing, some still leave due to eviction. This study aimed to determine whether eviction is an important predictor of recidivism and time to return to homelessness for participants exiting PSH. The characteristics and post-exit service use of 2802 Veteran PSH participants were analyzed based on exit reason. A Cox proportional hazards survival analysis modeled risk factors for returning to homelessness within 360 days of exit. Compared with other exiters, evicted Veterans remained in the program for less time, were less likely to be receiving service-connected compensation, and used more services – particularly mental health and substance use services – following their exit, and those who returned to homelessness did so more quickly. Identifying participants who might benefit from more intensive services, project-based housing, or income supports may prevent evictions and subsequent returns to homelessness.     

Seed limitation and lack of downed wood,not invasive species,threaten conifer regeneration in an urban forest

Urban forests provide valuable ecosystem services, but their long-term viability is often threatened by low tree recruitment due to seed and/or microsite limitation. Distinguishing between these two causes of low recruitment has important management implications, but has been little studied in urban environments. We tested for seed and microsite limitation in an urban forested park in Seattle, Washington, USA by adding conifer tree seeds and seedlings to experimental plots in which we manipulated microsite conditions by removing invasive ivy (Hedera spp.) and adding deadwood. We found that natural seed production was low, and adding seeds increased the number of observed seedlings. Furthermore, adding deadwood increased seedling survival, whereas removing Hedera did not have strong effects. Seed limitation is frequently addressed through management actions such as sowing seeds and transplanting seedlings, and our results suggest that such actions address a critical barrier to tree recruitment in urban forests. However, we also observed strong microsite limitation. At our study site, microsite limitation can be addressed primarily by adding deadwood and retaining coarse woody debris on site. Addressing microsite limitation may be a critical component of successful management efforts to improve tree recruitment in urban forests, and should not be overlooked. Furthermore, our study highlights the need for active monitoring and data analysis alongside management, since the most apparent threat (widespread cover of an invasive plant in this case) may not be the primary limit on suitable microsite conditions.