Patients’ intention to speak up for health care providers’ hand hygiene in inpatient diabetic foot wound treatment: a cross-sectional survey in diabetes outpatient centres in Lower Saxony,Germany*

Hand hygiene in wound care by health care providers (HCPs) is a key principle in treating hospitalized patients with diabetic foot infections. This study aimed to estimate the extent to which patients with type-2-diabetes (T2D) intend to speak up for HCPs’ hand hygiene during inpatient foot treatment, test whether this motivation increases given the hospital would invite patients to speak up, and identify associations with socio-demographics, knowledge of hand hygiene requirements, and diabetes-related factors. A questionnaire-survey was conducted in eight diabetes outpatient centres in Lower Saxony/Germany. Intentions to speak up (without and with institutional encouragement) and knowledge about hand hygiene during foot-care were assessed. Analyses of variance were conducted, partly as repeated measures-models with intention-items as within-subject factor. N = 473 patients participated (response = 77.4%). N = 177 (41%) strongly intended to speak up. Institutional encouragement was associated with an increased rate of strong (54% vs. 41%; p < .001) and higher mean intention (M = 3.9 vs. 3.4 with vs. without encouragement [5-point-scales]; F(1, 434)?=?41.5, p < .001). In patients without diabetic foot syndrome, this effect was limited to those with at least medium school education (F(2, 292)?=?4.4, p = .013) and knowledge on HCPs’ hand hygiene (F(2, 294)?=?3.1, p = .047). In conclusion, a majority of T2D-patients in diabetes outpatient centres intend to speak for HCPs’ hand hygiene in inpatient foot treatment, and are receptive to institutional encouragement. However, this presupposes at least medium education and knowledge about hand hygiene, emphasizing that patient empowerment begins with knowledge.     

A Pilot Study of Fragile X Syndrome Screening in Pregnant Women and Women Planning Pregnancy: Implementation,Acceptance, Awareness,and Geographic Factors

We report herein results of a study performed in the Balearic Islands which had the following goals: 1) Determine the proportion of pregnant or non-pregnant women planning pregnancy, who would choose to undergo a screening test for Fragile X Syndrome (FXS), if it is accompanied by the appropriate information; 2) Assess satisfaction and any increase in stress among women who participate in screening; 3) Collect epidemiological information about the incidence of the disease in our population; and 4) Collect demographic and health history data and assess participants’ awareness of the disease. Screening was performed on 3,731 pregnant and non-pregnant women of childbearing age and the results indicate: a very high voluntary rate of participation; a high level of self-reported satisfaction and low levels of stress because of the test; a very high incidence of premutation (1/106) in our population; and a low level of awareness about the existence of FXS (25 %). Additional findings indicate no significant correlation between self-reported health history and premutation detection, and the high premutation incidence does not seem to be specific to the indigenous Balearic population. Based on these results, we discuss the pros and cons of an implementation of preconception and pregnant women screening for FXS within a public health screening program.     

Ensuring Community Participation During Program Planning: Lessons Learned During the Development of a HIV/STI Program for Young Sexual and Gender Minorities

HIV/STI incidence has shifted to a younger demographic, comprised disproportionately of gay and bisexual men, transgender women, and people of color. Recognizing the importance of community organizing and participatory engagement during the intervention planning process, we describe the steps taken to engage diverse constituents (e.g., youth and practitioners) during the development of a structural‐level HIV/STI prevention and care initiative for young sexual and gender minorities in Southeast Michigan. Our multi‐sector coalition (MFierce; Michigan Forward in Enhancing Research and Community Equity) utilized a series of community dialogues to identify, refine, and select programmatic strategies with the greatest potential. Evaluation data (N = 173) from the community dialogues highlighted constituents’ overall satisfaction with our elicitation process. Using a case study format, we describe our community dialogue approach, illustrate how these dialogues strengthened our program development, and provide recommendations that may be used in future community‐based program planning efforts.     

The Ecology of Teachers’ Experiences with Violence and Lack of Administrative Support

Teacher‐directed violence is a common, yet understudied, phenomenon. Perpetrators of violence against teachers include not just students, but also administrators, parents, and colleagues. Administrators are key stakeholders when it comes to shaping school climate and safety that can reduce or increase the negative impact of violence against teachers. In this study, 237 teachers’ qualitative responses from a larger sample of 2,431 anonymous, online survey responses were examined to better understand their experiences with incidents of violence and how administrators played a role in these experiences. Results reveal that lack of administrator support negatively impacts teachers at multiple levels, including teachers’ feelings (individual); challenges associated with addressing issues related to students, parents, and other perpetrators (interpersonal); and school systems and policies (organizational). This study highlights the importance of administrative support and illustrates how administrators’ actions and inactions can have ripple effects at each level of the school microcosm. Implications for research, practice, and policy are discussed.     

What mothers don't know and doctors don't say: Detecting early developmental delays

The present study examined the detection of early developmental delays of high‐risk infants by first‐time mothers in a community sample of families (N = 451). About half of the mothers were adolescents at time of childbirth, and two thirds reported household incomes below $20,000 annually. Children were assessed at 12 and 24 months of age on standardized measures of cognitive, language, adaptive, and socioemotional development. According to the Individuals with Disabilities Education Act (PL101‐476) guidelines, about 1 in 4 children was eligible for intervention services at 12 months, and about 1 in 3 children was eligible at 24 months. Despite receiving regular medical services, mothers reported that very few eligible children (2% at 12 months and 9% at 24 months) were identified by medical professionals as having any problems that could interfere with development. Much like medical professionals, few mothers were appropriately worried about development, and the likelihood of expressing concerns was related to mothers' knowledge about infant development. These findings highlight the need for medical providers to frequently screen high‐risk children and for parents to become more knowledgeable about infant development.     

Two sides of the same coin: The differentiating role of need satisfaction and frustration in passion for screen-based activities

Rooted in Self-Determination Theory, the present research sought to investigate whether the “bright” and “dark” side of human functioning (need satisfaction and need frustration, respectively) would, as determinants, differentially predict harmonious passion (HP) and obsessive passion (OP) for screen-based activities such as Facebook use, TV series watching, online gaming, and smartphone gaming. For this purpose, four cross-sectional studies were carried out (N_total = 1,065). Results showed that, across all activities, need satisfaction was negatively related to OP, but not HP. A similar pattern emerged with need frustration: It was positively related to OP, but not HP. Moreover, even after controlling for the self-reported amount of time spent on the activities, HP predicted adaptive, activity-specific outcomes, whereas OP predicted maladaptive ones. These findings suggest that general need satisfaction may be a protective factor against the compensatory function of OP, but need frustration may be a potential risk factor of OP and both should be taken into account in the case of passion for screen-based activities.     

Preventing Serious Conduct Problems in School-Age Youth: The Fast Track Program

Children with early-starting conduct problems have a very poor prognosis and exact a high cost to society. The Fast Track project is a multisite, collaborative research project investigating the efficacy of a comprehensive, long-term, multicomponent intervention designed to prevent the development of serious conduct problems in high-risk children. In this article, we (a) provide an overview of the developmental model that serves as the conceptual foundation for the Fast Track intervention and describe its integration into the intervention model; (b) outline the research design and intervention model, with an emphasis on the elementary school phase of the intervention; and (c) summarize findings to date concerning intervention outcomes. We then provide a case illustration, and conclude with a discussion of guidelines for practitioners who work with children with conduct problems.