Searching for self in a world of labels

Searching for Self is a performance poetry piece that demonstrates the difficulties of identity construction in contemporary life. The author challenges the ‘self’ and ‘other’ dichotomy, and in so doing she attempts to reduce the distance between the ‘client’ and ‘expert’; the researcher and researched; the service provider and service user; and theory and practice. The poems are linked to the authors’ experiences of being labeled with a disability.     

The bumpy road to ‘becoming’: capturing the stories that teenage mothers told about their journey into motherhood

Understanding the experience of women who become mothers during their teenage years is central to ensuring that the support that is offered is appropriate to meet their needs. This paper reports on a small part of a larger ethnographic study that captured the lived experience of young mothers who were between the ages of 16 and 19 years that potentially typifies and illuminates the experiences of young women who become mothers in their teenage years. By collecting data from narrative interviews as well as participant and non‐participant observations over an extended period of time it was possible to identify how the young women experienced a range of difficulties as they made their transition into motherhood. Drawing on the findings, this paper argues that this transition for teenage mothers can be significantly different from the experience of older mothers, and it identifies the importance of appropriate support to mediate the challenges that they face. Understanding the young women's journey to ‘becoming’ is critical when planning services because if their experience of support is negative, it can lead to increased levels of maternal stress and reluctance to engage with support services.     

The duty to care and the need to split

This paper arises out of psychoanalytically oriented consultancy to teams of staff in the helping professions where there is a statutory 'duty to care'. It takes as its premise the seemingly paradoxical hypothesis that workers may need to split off part of their emotional experience in order to preserve their own mental health and provide reliable services to their clients. I argue that while a professional 'duty to care' requires us to be emotionally 'in touch', the demands of our clients together with the demands of the institutional response to the 'duty to care' cause us to split off parts of our awareness. I also argue that provided the splitting does not become extreme we are doing no more or less than the rest of society. In other words, there is a degree of 'normal splitting' which numbs our awareness of danger and destructiveness and seeks to protect us from too much anxiety and pain. Yet if professional workers are charged with the responsibility of assessing risk and acting accordingly for the protection of all concerned they need ways of being 'in touch' (re-integrating the splits) for some or enough of the time. Finally, I will describe ways of being 'in touch', illustrating the difficulty and the pain of re-integrating the splits and some of the insights that can arise out of this work with examples from my consultancy work.     

Managing the process of change in residential child care: A consultancy approach

This article explores the impact of a consultancy undertaken with groups of residential child care staff within a large local authority who were experiencing considerable changes in their working environment as a result of a review of residential care structures. The authors were invited to engage directly with staff on an individual and group basis to help them work through the barriers they perceived to changing their approach to practice. The theoretical underpinning for the work was Charles Handy's [1993, Understanding Organisations (Harmondsworth, Penguin)] belief that change is more likely to have a positive outcome when staff have an investment in and contribution to the change processes. The model of change utilised within the sessions with staff was Kurt Lewin's three stages of 'unfreezing', 'change' and 'refreezing'. The consultancy raised a number of issues about the process of change and how this can be achieved within the residential child care context. In particular, it highlighted the problems of assuming that change is a linear process which can be directly controlled and managed in the flux and uncertainty which characterises this sector.     

Student and faculty perceptions about mandatory influenza vaccinations on a health sciences campus

Objective: To examine the perceptions among faculty and health professional students regarding mandatory vaccination policies on a health sciences campus. Participants: A total of 296 faculty and 244 students completed surveys during Fall 2015. Methods: The online survey administered to individuals who received the influenza vaccine during the fall 2015 influenza vaccination clinic season included five items evaluating perceptions of employer mandatory vaccination requirements. Results: Chi-square analysis indicated that although faculty and students agree mandatory vaccinations in a health care environment are appropriate, faculty are more likely than students to get vaccinated in the absence of a mandate. Additionally, a small fraction of faculty would consider employment elsewhere when facing this mandate. Conclusions: Overall, faculty and students had favorable perceptions about mandatory influenza vaccine policies. Since students were less likely to be vaccinated in the absence of a mandate, education of students should be improved to support the importance of vaccinations in a health care environment.     

Using In Vitro High‐Throughput Screening Data for Predicting Benzo[k]Fluoranthene Human Health Hazards

Today there are more than 80,000 chemicals in commerce and the environment. The potential human health risks are unknown for the vast majority of these chemicals as they lack human health risk assessments, toxicity reference values, and risk screening values. We aim to use computational toxicology and quantitative high‐throughput screening (qHTS) technologies to fill these data gaps, and begin to prioritize these chemicals for additional assessment. In this pilot, we demonstrate how we were able to identify that benzo[k]fluoranthene may induce DNA damage and steatosis using qHTS data and two separate adverse outcome pathways (AOPs). We also demonstrate how bootstrap natural spline‐based meta‐regression can be used to integrate data across multiple assay replicates to generate a concentration–response curve. We used this analysis to calculate an in vitro point of departure of 0.751 μM and risk‐specific in vitro concentrations of 0.29 μM and 0.28 μM for 1:1,000 and 1:10,000 risk, respectively, for DNA damage. Based on the available evidence, and considering that only a single HSD17B4 assay is available, we have low overall confidence in the steatosis hazard identification. This case study suggests that coupling qHTS assays with AOPs and ontologies will facilitate hazard identification. Combining this with quantitative evidence integration methods, such as bootstrap meta‐regression, may allow risk assessors to identify points of departure and risk‐specific internal/in vitro concentrations. These results are sufficient to prioritize the chemicals; however, in the longer term we will need to estimate external doses for risk screening purposes, such as through margin of exposure methods.     

Spanish migrants to European Union countries: predictors of psychological adjustment / Españoles que emigran a países de la Unión Europea: predictores de su ajuste psicológico

In recent years, the migration of Spanish people to other countries in Europe has increased; however, there are hardly any studies on this phenomenon. The aim of this study is to identify the predictive sociodemographic and psychosocial factors of psychological adjustment (life satisfaction and absence of internalizing symptoms) of emigrants and to determine the indirect effects of these factors through perceived stress. This study also seeks to examine whether the psychological adjustment of Spanish emigrants was similar to Spanish non-emigrants. The sample was made up of a group of Spanish emigrants to Germany and England (n = 858) and an equivalent control group of Spanish non-emigrants (n = 328). The results show that fulfilment of expectations, emotional support and job quality are the best predictors of perceived stress and psychological adjustment. These factors are confirmed to have indirect effects on psychological adjustment through perceived stress. Finally, the mental health of emigrants and non-emigrants was similar, and the implications of these findings are discussed.     

“She Finally Smiles … for Real”: Reducing Depressive Symptoms and Bolstering Resilience Through a Camp Intervention for LGBTQ Youth

ABSTRACT

While summer camps are a recognized evidence-based strategy for building social and emotional skills among youth (U.S. Centers for Disease Control and Prevention [CDC], 2009), no known studies have evaluated the effects of camp programming for LGBTQ youth in the United States. This pilot study evaluates a novel program (Brave Trails) for LGBTQ youth ages 12 to 20, using a pre-post camper survey (N = 56) and a post-camp parent survey (N = 54). Results show campers experienced increases in identity affirmation and hope and a reduction in depressive symptoms. Regression analyses found changes in identity affirmation predicted reductions in depressive symptoms and increases in resilience. Additionally, campers’ experience of key camp programming features predicted changes in depressive symptoms. Findings from the parent survey were consistent with camper survey results. Theoretical and practical implications are discussed.     

Assessing emotional and social health using photographs: An innovative research method for rural studies and its applicability in a care-farming program for youth

A framework for assessing photographs for the emotional and social health of young people (SHAPE) is described and tested, within the context of a rural program. Two independent raters assessed the photographs of participants. To assess inter-rater reliability, Cohen’ K and Kendall’s W were calculated. The two reviewers’ assessments of photographs were in agreement. The assessment of emotional/behavioural display showed 82% agreement. Agreement between reviewers’ judgements of proxemics (W = .866), interaction (W = .722), engagement (W = .932) and overall impression (W = .804) were all significant (p < .005). The method yielded results indicating that participants found gardening immediately engaging but their approach to equines exhibited a change from fascination to confidence during the program. The visual-diary method is a useful and sensitive method for research: where resources are limited; to complement traditional measures; for use with people who lack appropriate verbal communication or literacy skills to complete questionnaires; young children; other underrepresented groups.     

Dealing with context in logic model development: Reflections from a realist evaluation of a community health worker programme in Nigeria

Logic models (LMs) have been used in programme evaluation for over four decades. Current debate questions the ability of logic modelling techniques to incorporate contextual factors into logic models. We share experience of developing a logic model within an ongoing realist evaluation which assesses the extent to which, and under what circumstances a community health workers (CHW) programme promotes access to maternity services in Nigeria. The article contributes to logic modelling debate by: i) reflecting on how other scholars captured context during LM development in theory-driven evaluations; and ii) explaining how we explored context during logic model development for realist evaluation of the CHW programme in Nigeria. Data collection methods that informed our logic model development included documents review, email discussions and teleconferences with programme stakeholders and a technical workshop with researchers to clarify programme goals and untangle relationships among programme elements. One of the most important findings is that, rather than being an end in itself, logic model development is an essential step for identifying initial hypotheses for tentative relevant contexts, mechanisms and outcomes (CMOs) and CMO configurations of how programmes produce change. The logic model also informed development of a methodology handbook that is guiding verification and consolidation of underlying programme theories.