Most multi‑problem young adults (18–27 years old) have been exposed to childhood maltreatment and/or have been involved in juvenile delinquency and, therefore, could have had Child Protection Service (CPS) interference during childhood. The extent to which their childhood problems persist and evolve into young adult‑ hood may differ substantially among cases. This might indicate heterogeneous profiles of CPS risk factors. These pro‑ files may identify combinations of closely interrelated childhood problems which may warrant specific approaches for problem recognition and intervention in clinical practice. The aim of this study was to retrospectively identify distinct statistical classes based on CPS data of multi‑problem young adults in The Netherlands and to explore whether these classes were related to current psychological dysfunctioning and delinquent behaviour. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
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Objectives: Current study explores the potential of the safety rating scale in order to determine the surplus value for evidence based practise. This study wants to contribute to this knowledge gape by exploring the safety scale by analysing the change between two safety ratings. First, the absolute change in safety is investigated. Secondly the study explores to what extent family background characteristics and case management characteristics determine the extent of change in perceived safety. Materials and Methods: The study analysed 105 Dutch child protection cases who had registration files with filled out LIRIK checklist, Action Plan and additional baseline safety and end safety measure as perceived by case managers. Results: On average perceived safety increased from an insufficient level to sufficient level. Significant regression coefficients with larger changes for primary school children (6 - 12 years) and lower changes for children within the ‘socio economic problems cluster’. The results reveal significant vulnerability for preschool children and families attending the socio-economic cluster due to limited improvement. Conclusion: According to this study the safety measure can be of value to outcome monitoring. The safety measure is a practical measure that reflects on the current state of safety within a family according to professionals and can be used on several occasions during case management. In addition, on aggregated level pre and post measures can be analysed for quality management purpose. Further exploration of this measure is needed. Publishers article: https://www.ecronicon.com/ecpe/ECPE-10-00873.php
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Chronic sorrow involves parents’ enduring grief due to their child’s disability. This stems not only from the recurring painful reality parents face, which differs from the life they had hoped for their children, families, and themselves but from also being confronted with societal and personal norms and expectations they cannot meet. There is a lack of research on the lived experiences of parents’ chronic sorrow. An Interpretative Phenomenological Analysis (IPA) study involving six parents with severely disabled children explored what it is like for parents to confront being ‘‘different.’’ Besides sorrow, the parents experienced intense ambiguity,guilt, and uncertainty while navigating societal expectations and their own perceptions of their children. Their ideas of parenthood and their self-identity as parents proved central to their strategies. This study provides insight into the intricacies of this particular aspect of chronic sorrow in parents, with relevance for research and practice.
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Risk assessment instruments are widely used to predict risk of adverse outcomes, such as violence or victimization, and to allocate resources for managing these risks among individuals involved in criminal justice and forensic mental health services. For risk assessment instruments to reach their full potential, they must be implemented with fidelity. A lack of information on administration fidelity hinders transparency about the implementation quality, as well as the interpretation of negative or inconclusive findings from predictive validity studies. The present study focuses on adherence, a dimension of fidelity. Adherence denotes the extent to which the risk assessment is completed according to the instrument’s guidelines. We developed an adherence measure, tailored to the ShortTerm Assessment of Risk and Treatability: Adolescent Version (START:AV), an evidence-based risk assessment instrument for adolescents. With the START:AV Adherence Rating Scale, we explored the degree to which 11 key features of the instrument were adhered to in 306 START:AVs forms, completed by 17 different evaluators in a Dutch residential youth care facility over a two-year period. Good to excellent interrater reliability was found for all adherence items. We identified differences in adherence scores on the various START:AV features, as well as significant improvement in adherence for those who attended a START:AV refresher workshop. Outcomes of risk assessment instruments potentially impact decision-making, for example, whether a youth’s secure placement should be extended. Therefore, we recommend fidelity monitoring to ensure the risk assessment practice was delivered as intended.
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Background: Persons with an intellectual disability are at increased risk of experiencing adversities. The current study aims at providing an overview of the research on how resilience in adults with intellectual disabilities, in the face of adversity, is supported by sources in their social network. Method: A literature review was conducted in the databases Psycinfo and Web of Science. To evaluate the quality of the included studies, the Mixed Method Appraisal Tool (MMAT) was used. Results: The themes: “positive emotions,” “network acceptance,” “sense of coherence” and “network support,” were identified as sources of resilience in the social network of the adults with intellectual disabilities. Conclusion: The current review showed that research addressing sources of resilience among persons with intellectual disabilities is scarce. In this first overview, four sources of resilience in the social network of people with intellectual disabilities were identified that interact and possibly strengthen each other.
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Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization’s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy. Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations’ inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects.
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Objective: Despite the common occurrence of lower levels of physical activity and physical fitness in youth with spina bifida (SB) who use a wheelchair, there are very few tests available to measure and assess these levels. The purpose of this study was to determine reliability and the physiologic response of the 6-minute push test (6MPT) in youth with SB who self-propel a wheelchair. Methods: In this reliability and observational study, a sample of 53 youth with SB (5-19 years old; mean age = 13 years 7 months; 32 boys and 21 girls) who used a wheelchair performed 2 exercise tests: the 6MPT and shuttle ride test. Heart rate, minute ventilation, respiratory exchange ratio, and oxygen consumption were measured using a calibrated mobile gas analysis system and a heart rate monitor. For reliability, intraclass correlation coefficients (ICCs), SE of measurement, smallest detectable change for total covered distance, minute work, and heart rate were calculated. Physiologic response during the 6MPT was expressed as percentage of maximal values achieved during the shuttle ride test. Results: The ICCs for total distance and minute work were excellent (0.95 and 0.97, respectively), and the ICC for heart rate was good (0.81). The physiologic response during the 6MPT was 85% to 89% of maximal values, except for minute ventilation (70.6%). Conclusions: For most youth with SB who use a wheelchair for mobility or sports participation, the 6MPT is a reliable, functional performance test on a vigorous level of exercise. Impact: This is the first study to investigate physiologic response during the 6MPT in youth (with SB) who are wheelchair using. Clinicians can use the 6MPT to evaluate functional performance and help design effective exercise programs for youth with SB who are wheelchair using. Keywords: 6-minute push test; adolescent; disabled children; spinal diseases; wheelchairs.
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Worldwide, pupils with migrant backgrounds do not participate in school STEM subjects as successfully as their peers. Migrant pupils’ subject-specific language proficiency lags behind, which hinders participation and learning. Primary teachers experience difficulty in teaching STEM as well as promoting required language development. This study investigates how a professional development program (PDP) focusing on inclusive STEM teaching can promote teacher learning of language-promoting strategies (promoting interaction, scaffolding language and using multilingual resources). Participants were five case study teachers in multilingual schools in the Netherlands (N = 2), Sweden (N = 1) and Norway (N = 2), who taught in primary classrooms with migrant pupils. The PDP focused on three STEM units (sound, maintenance, plant growth) and language-promoting strategies. To trace teachers’ learning, three interviews were conducted with each of the five teachers (one after each unit). The teachers also filled in digital logs (one after each unit). The interviews showed positive changes in teachers’ awareness, beliefs and attitudes towards language-supporting strategies. However, changes in practice and intentions for practice were reported to a lesser extent. This study shows that a PDP can be an effective starting point for teacher learning regarding inclusive STEM teaching. It also illuminates possible enablers (e.g., fostering language awareness) or hinderers (e.g., teachers’ limited STEM knowledge) to be considered in future PDP design.
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This dissertation presents the results of a research project on unraveling the dynamics of facilitating workplace learning through pedagogic practices in healthcare placements. Supervisors are challenged to foster safe learning opportunities and fully utilize the learning potential of placement through stimulating active participation for students while ensuring quality patient care. In healthcare placements, staff shortages and work pressure may lead to stress when facilitating workplace learning. Enhancing pedagogic practices in healthcare placements seems essential to support students in challenging experiences, such as emotional challenges. This dissertation proposes approaches for optimizing learning experiences for students by highlighting the value of day-to-day work activities and interactions in healthcare placements, and shedding light on agency in workplace learning through supervisor- and student-strategies.
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