Adolescent Self-Assessment of an Outdoor Behavioral Health Program: Longitudinal Outcomes and Trajectories of Change

Outdoor behavioral healthcare is an increasingly popular treatment modality for adolescents, and evidence suggests that it is effective for a wide range of complex issues. The outdoor behavioral healthcare literature still faces major limitations though, and one of these limitations is that outcomes are primarily measured at only admit and discharge. This study sought to explore the trajectory of change throughout treatment, and investigate outcomes up to 18?months post-discharge. Of the 659 adolescent participants from four outdoor behavioral healthcare programs, 29?% were female, 18?% were adopted, and the average age was 16?years old. Participants were invited to complete questionnaires four times during treatment, and at 6 and 18?months post-discharge. We used multilevel modeling to explore trajectories and predictors of change during treatment, and a regression and an ANOVA to examine outcomes post-discharge. Results of the multilevel modeling supported that adolescents make significant changes during outdoor behavioral healthcare, and also contributed new findings on demographic and diagnostic predictors. Gender and the presence of a mood or anxiety disorder predicted greater rates of change during treatment. Analysis of post-discharge data at six and 18?months post-discharge suggested that clients maintain treatment effects and that gender persists in influencing outcomes. This study is the first to examine trajectories of change in outdoor behavioral healthcare, to find diagnostic variables to be relevant, and to examine self-report outcomes past 12?months post-discharge.     

Using principles of cognitive science to improve science learning in middle school: What works when and for whom?

Four principles of cognitive science were used to make systematic revisions in middle school science instructional modules from two kinds of curriculum: one popular textbook series and one popular hands‐on series (two modules each). Schools were randomly assigned to 1 of the 3 arms (cognitive science modifications with professional development, active control with professional development, or business‐as‐usual). Two cohorts of students were followed in each arm for each setting. There were significant benefits of the cognitive science intervention, but the nature of effects varied for the two settings and curricula. For the text‐based curriculum, positive effects of cognitive science modifications were concentrated in classrooms with lower proportions of underrepresented minority students. For the hands‐on curriculum, there were positive effects that were not linked to school composition. Participation in the active control did not significantly improve student learning. Implications for policy and research are discussed.     

Symptom awareness and blood glucose estimation in diabetic adults

Self-regulation of diabetes depends in part on common-sense models of symptoms and blood glucose fluctuations. Symptom perception and subjective estimation of blood glucose were studied in 52 adult, difficult-to-control, non-insulin-dependent diabetics using a structured interview and laboratory blood-glucose measurement. Most patients believed they could detect hyperglycemia. Symptoms linked by patients to hyperglycemic and hypoglycemic episodes did overlap with symptoms traditionally associated with those states. Some patients may experience dysphoria during glycemic swings to which multiple symptom labels are applicable, although prominent exceptions and idiosyncratic symptoms were evident. Estimation of current blood glucose using an ordinal scale suggested some capacity for discriminating blood glucose levels. Numerical estimates of Chemstrip values were correlated with actual values, but far too inaccurately for purposes of self-regulation. Research is needed to clarify whether subjective symptom perception and blood glucose estimation helps or hinders self-regulation of diabetes.