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1.
The wraparound process aims to provide an effective practice-level approach to coordinating care for youths with complex behavioral health needs, and reformed system structures to support such integration of care. The current study provides an update to two prior surveys of state children’s mental health directors, completed in 1998 and 2007, on the extent of wraparound implementation in the United States and implementation supports that have been employed. Results from 2013 found that 100 % of states reported having some type of wraparound program that conformed to the definition and yielded an estimate of 75,000 children and families served via wraparound in that year. States reported a continued increase in use of wraparound standards; however, fewer states reported collection of fidelity data, and availability of internal resources for training and coaching. Over three-quarters of states reported availability of parent to parent peer support, and 46 % of states are supporting wraparound implementation by blending or braiding funding across child-serving systems. Results also revealed that 61 % of states had a centralized oversight entity for wraparound, an important finding given that such “statewideness” was also associated with more youth served, greater accountability, use of standards, and other implementation supports.  相似文献   

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OBJECTIVE: Health communication can help reduce the cancer burden by increasing processing of information about health interventions. Negative affect is associated with information processing and may be a barrier to successful health communication. DESIGN AND MAIN OUTCOME MEASURES: We examined associations between negative affect and information processing at the population level. Symptoms of depression (6 items) and cancer worry (1 item) operationalized negative affect; attention to health information (5 items) and cancer information-seeking experiences (6 items) operationalized information processing. RESULTS: Higher cancer worry was associated with more attention to health information (p<.01) and worse cancer information-seeking experiences (p<.05). More symptoms of depression were associated with worse information-seeking experiences (p<.01), but not with attention. CONCLUSIONS: We found population-level evidence that increased cancer worry is associated with more attention to health information, and increased cancer worry and symptoms of depression are associated with worse cancer information-seeking experiences. Results suggest that affect plays a role in health information processing, and decreasing negative affect associated with cancer communication may improve experiences seeking cancer information.  相似文献   

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Seventy‐one leaders in state, regional, and national professional and credentialing associations in counseling responded to a survey concerning professional advocacy efforts, resources, obstacles, and needs. The results indicate a variety of ongoing advocacy initiatives, specific needs for resources and interprofessional collaboration, and agreement on the importance of advocacy for the future of the profession.  相似文献   

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Within the past decade, the wraparound approach has gained significant popularity in providing services to children with challenging social and family needs. While a plethora of wraparound programs have been developed and studies have been conducted to assess their effectiveness, the need to develop instruments that measure the implementation of wraparound services is clear. The purpose of the present study was to evaluate the reliability of a scale that measures wraparound services. In this study, the Wraparound Observation Form (WOF), was developed to evaluate the implementation of the wraparound process in treatment planning meetings. The WOF includes 34 closed-ended items that requires the respondent to note the occurrence or non-occurrence of specific events or behaviors at treatment planning meetings. In the present study, two data collectors attended planning meetings and independently completed the WOF. The inter-rater reliability was 95%. The WOF appears to be a reliable instrument and be appropriate in evaluating wraparound services.  相似文献   

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In this article the author reports results from a national survey of recovering alcoholic Catholic Sisters, describing their addiction history, treatment, and the role of the community.  相似文献   

6.
Few studies have examined associations of inhalant use and inhalant use disorders (IUDs) to suicide ideation and attempts. We investigated these relationships in the largest comorbidity survey conducted in the United States. Suicidal ideation was significantly more prevalent among inhalant users than nonusers and severity of inhalant use problems was positively related to suicidal ideation. Among persons with IUDs, 67.4% had thought about committing suicide and 20.2% had attempted suicide. Multivariate logistic regression analyses indicated that respondents with IUDs reported significantly higher levels of suicide ideation than inhalant nonusers. Inhalant use is associated with significantly increased risk for suicide ideation, especially among women and persons with DSM‐IV IUDs.  相似文献   

7.
The aim of this study was to examine socio-demographic and psychosocial correlates of concurrent tobacco use and risky drinking. We analysed data from the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) 2011–2012. The sample included 14 764 adolescents and adults aged 15 years and older. They responded to questions on tobacco and alcohol use, psychosocial, and socio-demographic indicators. Results indicate that 9.6% (16.8% among men and 3.5% among women) of South Africans were involved in concurrent tobacco use and risky drinking, 18.2% in current tobacco use only, and 20.3% in risky drinking only. In covariate adjusted analysis, being 25 to 64 years, being male, belonging to the coloured population group, residing in urban areas, having experienced three or more traumatic events, and poor self-rated health were associated with concurrent tobacco use and risky drinking. Findings suggest socio-demographic and health factors are important for public health interventions in addressing concurrent tobacco and alcohol use in South Africa.  相似文献   

8.
Analyses from the National Comorbidity Study Replication provide the first nationally representative estimates of the co-occurrence of impulsive angry behavior and possessing or carrying a gun among adults with and without certain mental disorders and demographic characteristics. The study found that a large number of individuals in the United States self-report patterns of impulsive angry behavior and also possess firearms at home (8.9%) or carry guns outside the home (1.5%). These data document associations of numerous common mental disorders and combinations of angry behavior with gun access. Because only a small proportion of persons with this risky combination have ever been involuntarily hospitalized for a mental health problem, most will not be subject to existing mental health-related legal restrictions on firearms resulting from a history of involuntary commitment. Excluding a large proportion of the general population from gun possession is also not likely to be feasible. Behavioral risk-based approaches to firearms restriction, such as expanding the definition of gun-prohibited persons to include those with violent misdemeanor convictions and multiple DUI convictions, could be a more effective public health policy to prevent gun violence in the population. Copyright © 2015 John Wiley & Sons, Ltd.  相似文献   

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The association between marital dissatisfaction and 12-month prevalence rates of Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev., 1987) Axis I psychiatric disorders was examined in married respondents from the National Comorbidity Survey (N = 2,538). Results indicate that marital dissatisfaction was associated with the presence of any disorder, any mood disorder, any anxiety disorder, and any substance-use disorder; dissatisfaction was also associated with 7 of 12 specific disorders for women and 3 of 13 specific disorders for men. To evaluate the unique association between marital dissatisfaction and psychiatric disorders, analyses were conducted controlling for comorbid disorders. Covariance analyses generally attenuated the bivariate associations between marital dissatisfaction and specific disorders and groupings of disorders. Results indicate that marital dissatisfaction was uniquely related to major depression and posttraumatic stress disorder for women and dysthymia for men.  相似文献   

12.
Hearing loss is a common sensory deficit and more than 50% of affected individuals have a genetic etiology. The discovery of 40 genes and more than 100 loci involved in hearing loss has made genetic testing for some of these genes widely available. Genetic services for deafness are also being sought more often due to the early identification of hearing loss through newborn screening services. The motivations for pursuing genetic testing, and how genetic services are provided to the client may differ among individuals. Additionally, information obtained through genetic testing can be perceived and used in different ways by parents of deaf children and deaf adults. This study aimed to follow up on focus group studies published earlier with a quantitative survey instrument and assess the preference of consumers for provision of genetic services. We conducted a national survey of hearing and deaf parents of children with hearing loss and of deaf adults. Data was compared and analyzed by hearing status of the participant, their community affiliation and the genetic testing status using nominal logistic regression. Consistent with our focus group results, the survey participants thought that a genetic counselor/geneticist would be the most appropriate professional to provide genetics services. Statistically significant differences were noted in the preferred choice of provider based on the genetic testing status. Parents preferred that genetic evaluation, including testing, occur either immediately at or a few months after the audiologic diagnosis of hearing loss. This data should help providers in clinical genetics keep patient preferences at the helm and provide culturally competent services.  相似文献   

13.
Drug courts and mental health courts have expanded rapidly in the past several decades to provide more efficient coordination of treatment and supervision of offenders with behavioral health problems. A significant number of offenders in these court‐based programs have co‐occurring mental and substance use disorders, which predict early termination, relapse, rearrest, and other negative outcomes. A web‐based national survey examined programmatic adaptations for co‐occurring disorders (CODs) among 54 drug courts, mental health courts, and freestanding COD dockets. COD dockets were smaller and of longer duration, and provided more intensive services than programs situated in drug courts or in mental health courts. However, more similarities than differences were noted across the different types of court‐based program. Key adaptations for CODs included extended program duration, highly intensive and integrated treatment, smaller, less formal, and more frequent hearings, and use of specialized supervision teams and dually credentialed staff. Copyright © 2012 John Wiley & Sons, Ltd.  相似文献   

14.
A previous study evaluating receptive language after unilateral brain damage in childhood hypothesized lateralized attention and memory deficits without direct measurement. Our study directly measured attention, memory, and language in order to evaluate empirically the severity and laterality of sequelae. The performances of 11 individuals with a unilateral ischemic-lesion (7 right and 4 left hemisphere) were compared to controls matched on age, sex, and socioeconomic status. Results suggest subtle but persistent deficits in verbal memory, functional memory, and speed of processing after a lesion to either hemisphere. Lesions sustained before two years of age were associated with the lowest IQ scores. Our findings provide support for a configural representation of language that can to some extent compensate for inefficient or damaged components (Bates, 1994), and the middle-ground lateralization position (Thal et al., 1991) that asserts initial hemispheric specialization with the potential for reorganization.  相似文献   

15.
Vignettes were used to assess gender differences in likelihood of hearing others engage in and perceived pressure to join in positive, negative (fat talk), and self-accepting body talk. An age-representative sample of 4,014 adult women and men voluntarily responded to an emailed “Health and Wellness” survey from an internet polling company with whom they had pre-registered. Women reported more likelihood of hearing fat-talk scenarios and greater pressure to participate in them compared to men. Only a subset of participants reported frequent exposure to and pressure to join in fat talk. Demographic predictors of pressure to engage in fat talk were also examined. This was the first survey to examine body talk among older adults.  相似文献   

16.
Using the data from the South African World Health Survey (WHS), the current study aims to assess the self-reported prevalence of diabetes and associated risk factors by socio-economic characteristics in South Africa. A population-based survey of 2314 participants (1116 men and 1236 women) was conducted in South Africa in 2003. Results indicate an overall self-reported diabetes prevalence of 9.1%, 7.1% for men and 10.8% for women. In terms of diabetes risk factors, high rates of overweight or obesity (58.4%), physical inactivity (55.2%), less than 5 servings of fruits and vegetables in a day (69.3%), and medium or high stress levels (63.3%) were found; 18.4% were smoking daily and 7.3% were risky drinkers. Univariate regression analyses found that from the six different risk factors none apart from having high stress were associated with the occurrence of diabetes. Greater age was associated with obesity and inversely associated with insufficient consumption of fruits and vegetables. Daily smoking and being physically inactive were inversely associated with risky drinking. Low socioeconomic background was associated with unhealthy diet, physical inactivity and stress.  相似文献   

17.
A national sample (n = 479) of counselors representative of the 1993 American Counseling Association membership was surveyed regarding their value orientations in four domains: universal values, mental health values, individualistic-collectivistic values, and religious-spiritual values. Results yielded a multifaceted, generally concordant (although by no means unanimous) value profile for professional counselors across these value domains, presenting an overall content pattern that might be globally summarized as a strong core valuing of holistic-humanistic empowerment related to personal development and interpersonal and social concern. Implications for counseling practice, limitations, and suggestions for future research are discussed.  相似文献   

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In Atkins v. Virginia 2002, the U.S. Supreme Court held that the Eighth Amendment prohibits executing offenders who are mentally retarded. Rather than adopting a uniform definition of mental retardation, the court charged each state with defining mental retardation in a manner that enforces the constitutional restriction. An unanswered question is how states define mental retardation after Atkins, which has implications for capital defendants and forensic evaluators who conduct capital mitigation evaluations. This project identified the statutory definitions of mental retardation in each state, and grouped the definitions based on consistency with accepted clinical criteria for mental retardation. Results show that definitions of mental retardation vary considerably by state. The large majority of states, both overall and specifically among death penalty states, use criteria for mental retardation that are not entirely consistent with accepted clinical standards. As such, it is not clear whether the majority of states are effectuating the intent of Atkins. The implications of these findings for both policy and practice are discussed.  相似文献   

20.
The 1979 National Longitudinal Survey of Youth (NLSY) provided data for the analysis of the impact of self-esteem, locus of control, attitudes towards women's family roles, work, and school on the probability of a nonmarital birth. The study avoided methodological problems of prior studies by using a national data base with attitude measured before nonmarital childbearing occurs. No prior studies included these 5 factors. Previous research on attitudes and nonmarital childbearing is summarized. Theoretical models imply that self-esteem, high educational goals, and an internal locus of control are associated with a lower likelihood of a nonmarital birth. The conceptual model for this study is described. It does not include how attitudes develop or estimate the linkage between family background variables and attitudes. A reduced from approach was used and controls were included for 6 family background and personal variables. The sample of 1184 girls was restricted to those aged 14 or 15 years in 1979 who were never married or had a child. 16.9% of the sample had a nonmarital child by 19 years. Measurement of explanatory variables is indicated as the Rosenberg Self Esteem Scale and the Rotter scale for internal-external locus of control. A 7-item scale measured women's roles, an 8-item scale measured attitudes toward school, and 3 items assessed views on the importance of improving one's employment prospects. Background control variables were race/ethnicity, mother's education, presence of welfare income, family income, family structure, and religiosity. The standard logistics technique was used to estimate the logarithm of the odds of having a nonmarital birth as a linear function of both attitude and family background variables. Models were estimated both with and without the educational expectation variable. The results appear to indicate that self-esteem and attitudes toward school are associated with nonmarital childbearing, as predicted by theory. Locus of control does not systematically affect the likelihood of nonmarital childbearing, nor do family and gender roles and attitudes toward work. Educational expectations are not associated, but may act as an intervening variable.  相似文献   

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