Fetal Risks,Relative Risks,and Relatives' Risks

Several factors related to fetal risk render it more or less acceptable in justifying constraints on the behavior of pregnant women. Risk is an unavoidable part of pregnancy and childbirth, one that women must balance against other vital personal and family interests. Two particular issues relate to the fairness of claims that pregnant women are never entitled to put their fetuses at risk: relative risks and relatives' risks. The former have been used—often spuriously—to advance arguments against activities, such as home birth, that may incur risk; the latter implicate the nature of relationships in determining the acceptability of coercing or precluding activities. Motivated reasoning by clinicians and judges leads to inaccurate risk assessments, and judgments based on false claims to objectivity. Such judgments undermine the moral and legal standing of pregnant women and do not advance the interests of fetuses, pregnant women, families, or states.     

Contracting, prompting, and reinforcing substance use disorder continuing care: a randomized clinical trial.

Although continuing care is strongly related to positive treatment outcomes for substance use disorder (SUD), participation rates are low and few effective interventions are available. In a randomized clinical trial with 150 participants (97% men), 75 graduates of a residential Veterans Affairs Medical Center SUD program who received an aftercare contract, attendance prompts, and reinforcers (CPR) were compared to 75 graduates who received standard treatment (STX). Among CPR participants, 55% completed at least 3 months of aftercare, compared to 36% in STX. Similarly, CPR participants remained in treatment longer than those in STX (5.5 vs. 4.4 months). Additionally, CPR participants were more likely to be abstinent compared to STX (57% vs. 37%) after 1 year. The CPR intervention offers a practical means to improve adherence among individuals in SUD treatment.     

Mule cognition: a case of hybrid vigour?

This study compares the behaviour of the mule (Equus asinus × Equus caballus) with that of its parent species to assess the effects of hybridization on cognition. Six mules, six ponies (E. caballus) and six donkeys (E. asinus) were given a two choice visual discrimination learning task. Each session consisted of 12 trials and pass level was reached when subjects chose the correct stimulus for at least 9 out of the 12 trials in three consecutive sessions. A record was made of how many pairs each subject learnt over 25 sessions. The mules’ performance was significantly better than that of either of the parent species (Kruskal-Wallis: H_x = 8.11, P = 0.017). They were also the only group to learn enough pairs to be able to show a successive reduction in the number of sessions required to reach criterion level. This study provides the first empirical evidence that the improved characteristics of mules may be extended from physical attributes to cognitive function.     

Understanding Strengths in Relation to Complex Trauma and Mental Health Symptoms within Child Welfare

Strengths can have a potent effect in mitigating the impact of trauma on mental health needs and functioning. Yet, evidence is limited on the role that strengths may have in ameliorating trauma-related or mental health symptoms over time. Providing a comprehensive assessment that includes strengths, as well as needs, is an important step in making appropriate service recommendations for youth in child welfare. This study assessed 7,483 children and adolescents entering an intensive stabilization program through the Illinois child welfare system. The interaction of individual, child strengths in relation to complex trauma exposure, traumatic stress symptoms, risk behaviors, and other mental health needs were examined. Results indicated strengths are relatively stable over time and inversely associated with several negative outcomes, including risk behaviors (?.32, p?<?.001), emotional/ behavioral needs (?.33, p?<?.001) and overall functioning (?.47, p?<?.001). Traumatic stress symptoms were also related to increases in these negative outcomes. Overall, strengths had a buffering effect on traumatic stress symptoms and outcomes over time. The role of strengths in relation to traumatic stress symptoms, however, was less consistent. Youth with histories of complex trauma exposure had significantly fewer useable strengths than youth without this exposure. However, strengths improved for both youth with and without complex trauma exposure over the course of stabilization services. These findings suggest that early identification and development of child strengths can mitigate risk-taking behaviors, mental health, and functional difficulties among youth in the child welfare system. Implications for more targeted trauma-informed and strengths-based assessment, and treatment/service planning are discussed.     

Do Functional Behavioral Assessments Improve Intervention Effectiveness for Students Diagnosed with ADHD? A Single-Subject Meta-Analysis

The primary purpose of this quantitative synthesis of single-subject research was to investigate the relative effectiveness of function-based and non-function-based behavioral interventions for students diagnosed with attention-deficit/hyperactivity disorder. In addition, associations between various participant, assessment, and intervention characteristics were investigated. Eighty-two studies incorporating a total of 168 participants were included. Because no single effect size metric has garnered absolute support to date, three different effect size metrics were calculated: the standard mean difference, percent exceeding the median baseline phase, and improvement rate difference. Overall, function-based interventions were associated with significantly larger effects than non-function-based interventions. Interventions based on the functional analysis manipulations were also associated with larger effects. Limitations, directions for future research, and implications for practice are discussed.     

Training the supervisor: Integrating a family of origin approach

The replication of intergenerational patterns is considered here within the supervisor-family therapist-and family system, and the proposal of integrating a family of origin approach into the training of supervisors is presented. To become aware of the relation of one's own family of origin issues and their potential impact within the supervision and treatment can effectively improve intervention approaches, benefitting the supervisor, the therapist and the family in treatment. Being considerate of the training needs and levels of supervisors is an important component when integrating family of origin work into the training.     

Toward the reduction of population obesity: macrolevel environmental approaches to the problems of food, eating, and obesity

The authors reviewed the evidential basis of three environmental approaches to reducing population obesity: What are the effects of (a) taxing or subsidizing foods, (b) manipulating the ease of food access, and (c) restricting access to certain foods? A narrative review evaluated evidence using National Heart, Lung, and Blood Institute criteria. There was strong evidence that subsidization influences food purchases, but not necessarily food consumption or body weight. Ease of food access may influence food purchases, and possibly food intake and body weight. Data on restriction were lacking. More studies are needed to justify that altering these macro-environmental variables will necessarily reduce population obesity. A proposed conceptual model posits that the steps through environmental interventions may exert intended and unintended influences on body weight and obesity prevalence. Contemplated policy changes should weigh scientific evidence with social judgments and values concerning changes to the environment.