Relearning to Live Life Without Substances: A Grounded Theory of the Impact of Group Physical Exercise on Sobriety

Research has found significant benefits in using exercise as an adjunct treatment for substance use. This study used a qualitative grounded theory approach to explore the role of group exercise on maintaining sobriety. Sixteen persons (13 White men and 3 White women, age M = 31.81, SD = 8.23), recruited from a substance use recovery group that meets at a gym in an urban area in the Southeast part of the United States, were individually interviewed. Data were analyzed using Charmaz’s (2006) constructivist grounded theory strategies. Central themes revealed a parallel process between the steps taken to seek sobriety and those taken to maintain sobriety. The driving forces of sobriety success in both was 12 steps and group exercise programming that included elements of mentorship, structure, accountability, and fellowship or community. This study supported the use of physical group exercise as an adjunct treatment option for substance use treatment.     

Variations in the Life Histories of Incarcerated Parents by Race and Ethnicity: Implications for Service Provision

ABSTRACT

Incarcerated parents have complex life histories that often remain unresolved during incarceration, can continue to create barriers to prosocial success on release, and present similar intergenerational challenges for their children. This study examines the life histories of incarcerated fathers and mothers from the Pacific Northwest and how their experiences vary based on race and ethnicity. Five areas examined were exposure to trauma, child welfare involvement, mental health and substance abuse problems, juvenile justice and adult criminal justice involvement, and intergenerational criminal justice involvement. The sample comprised 359 incarcerated parents, and their racial/ethnic composition was 59% White, 14% African American, 11% multiracial, 8% Native American, and 7% Latino. Few differences were found across racial and ethnic groups. Mothers appeared more similar to each other across groups than fathers. Results illustrated similarities yet some surprising differences with national trends on key study variables. Implications for future research and intervention and prevention are discussed.     

Adaptive phase I/II clinical trials for drug combination assessment in oncology using the outcomes of each cycle

Many new anticancer agents can be combined with existing drugs, as combining a number of drugs may be expected to have a better therapeutic effect than monotherapy owing to synergistic effects. Furthermore, to drive drug development and to reduce the associated cost, there has been a growing tendency to combine these as phase I/II trials. With respect to phase I/II oncology trials for the assessment of dose combinations, in the existing methodologies in which efficacy based on tumor response and safety based on toxicity are modeled as binary outcomes, it is not possible to enroll and treat the next cohort of patients unless the best overall response has been determined in the current cohort. Thus, the trial duration might be potentially extended to an unacceptable degree. In this study, we proposed a method that randomizes the next cohort of patients in the phase II part to the dose combination based on the estimated response rate using all the available observed data upon determination of the overall response in the current cohort. We compared the proposed method to the existing method using simulation studies. These demonstrated that the percentage of optimal dose combinations selected in the proposed method is not less than that in the existing method and that the trial duration in the proposed method is shortened compared to that in the existing method. The proposed method meets both ethical and financial requirements, and we believe it has the potential to contribute to expedite drug development.     

‘Do you want to do some arm wrestling?’: children's strategies when experiencing domestic violence and the meaning of age

The aim of this study is, by analysing children's and young people's discourses, to investigate their strategies in response to domestic violence episodes, in relation to their age. The empirical data come from individual interviews with children and young people (ages 8–20 years) who had experienced domestic violence and lived at refuges for abused women. The thematic analysis shows that the children describe a wide range of strategies before, during and after a violent episode, that all children act regardless of age and that strategies vary according not only to age but also to situation and context. The theoretical framework used is the sociology of childhood, and the analysis engages with theoretical concepts of age, agency and positioning.     

Peer violence in foster care: a review of the research evidence

Whilst a small amount of research has been undertaken on peer violence in residential settings, very little is known about peer violence in foster care. This paper reviews the published research since 1995 about the nature and extent of peer violence in foster care and interventions for preventing and managing these negative peer interactions. The evidence indicates that young people in foster care can be the instigators and recipients of peer violence, but the limited number of studies found means that conclusions cannot be drawn about the extent of the problem. There is some evidence about the impact of this type of violence on young people and fostering households. However, there remain gaps in the evidence about the full extent of all forms of exploitation and violence that are experienced and instigated by young people in foster care, the circumstances in which it takes place, the young people affected and its co‐occurrence with other difficulties. Critically, young people's views were largely absent from included studies, an important area that requires further research.     

Mortality among elder abuse victims in rural Malaysia: A two-year population-based descriptive study

Our study aims at describing mortality among reported elder abuse experiences in rural Malaysia. This is a population-based cohort study with a multistage cluster sampling method. Older adults in Kuala Pilah (n = 1,927) were interviewed from November 2013 to May 2014. Mortality was traced after 2 years using the National Registration Department database. Overall, 139 (7.2%) respondents died. Fifteen (9.6%) abuse victims died compared to 124 (7.0%) not abused. Mortality was highest with financial abuse (13%), followed by psychological abuse (10.8%). There was a dose-response relationship between mortality and clustering of abuse: 7%, 7.7%, and 14.0% for no abuse, one type, and two types or more, respectively. Among abuse victims, 40% of deaths had ill-defined causes, 33% were respiratory-related, and 27% had cardiovascular and metabolic origin. Results suggest a link between abuse and mortality. Death proportions varied according to abuse subtypes and gender.     

Developing an undue influence screening tool for Adult Protective Services

The study purpose was to develop and pilot an undue influence screening tool for California’s Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature—including existing undue influence models—was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.     

On the Road to Resilience: The Help‐Seeking Experiences of Irish Emigrant Survivors of Institutional Abuse

Understanding how survivors of complex trauma navigate towards resources can inform the design of interventions and health promotion strategies. However, there are little data on the resilience and help‐seeking experiences of this group or others who have experienced institutional abuse in childhood. This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse (ICA). Twenty‐two survivors of ICA were purposefully recruited from community organisations in the UK and data were collected via semi‐structured interviews. As a result of negative initial help‐seeking experiences in Ireland, most participants engaged in long periods of self‐management and disclosed information about their childhood as part of a redress scheme in later life. Outside of this scheme, turning points, such as illness or family problems, and the needs of children were influential in seeking help. Peer support networks played an important role as a trusted signposting pathway towards formal interventions. Participants identified interpersonal barriers to formal help‐seeking as helping professionals' failure to share control, insensitivity to identity loss and literacy issues, and the lack of explicit boundaries. The paper concludes with a discussion about the implications for research and future practice.

‘This empirical study sets out to illustrate the help‐seeking experiences of Irish emigrant survivors of institutional childhood abuse’

Key Practitioner Messages:

• Turning points, such as illness and bereavement, and the desire to provide for children, influence the help‐seeking of survivors of ICA.
• Irish emigrant survivors of ICA cite failure to share control, insensitivity to identity loss, literacy issues and the lack of explicit boundaries as barriers to help‐seeking.
• General awareness of ICA can help practitioners in low‐threshold services prevent against culturally insensitive practice.
• Peer support networks can provide uniquely trusted signposting towards formal interventions.

     

Irish Women’s Ongoing Experiences of Domestic Abuse in Cases of Separation and Divorce

The issue of postseparation abuse is a significant problem for women. This qualitative research examines Irish women’s experiences of domestic abuse in cases of separation and divorce. Findings show that methods of abuse change after separation and perpetrators can use institutions of the state to continue their abusive behavior in a new forum and can continue long after marital dissolution is finalized. Such behavior is legitimized by the state’s nonaction and enabled through women’s previous experiences of institutional processes associated with separation and divorce, which resulted in feelings fear and distress.