Risk and protective factors for suicide among Guyanese youth: Youth and stakeholder perspectives

Guyana, a low-to-middle-income country (LMIC) in South America, leads the world in youth suicide. As an understanding of risk and protective factors is critical to the development of culturally informed suicide prevention efforts, research exploring these factors among youth in Guyana is needed. The current study expands on current research on adolescent suicide in Guyana and LMICs broadly by using qualitative focus groups and interviews to explore adult stakeholders' and youth's perspectives. Participants included 17 adult stakeholders and 40 adolescents in Guyana. Data were analysed using a grounded theory approach. Themes related to participants' perceptions of risk factors for suicide included demographic characteristics, pressure and expectations, adults' responses to youth, limited coping with stressful life events and exposure to suicide. Themes related to protective factors for suicide included positive social support and involvement in community activities. Findings have implications for the development and tailoring of suicide prevention efforts for Guyanese youth.     

“We” are Different: Exploring the Diverse Effects of Friend and Family Accessibility on Consumers' Product Preferences

Prior research suggests that close friends and family members exert similar effects on consumer behavior because both represent strong social ties and are subject to communal norms. However, drawing on regulatory focus theory, we postulate that accessibility of friend and family can have divergent impacts on consumers' subsequent purchase decisions. Across four experiments, as well as a pilot study, we demonstrate that accessibility of friend (vs. family) is more likely to activate a promotion focus, which results in more favorable consumer responses toward products with promotion‐focused appeals, whereas accessibility of family (vs. friend) is more likely to activate a prevention focus, which leads to more positive consumer responses toward products with prevention‐focused appeals.     

Mobiliser les arbitrages organisationnels pour prévenir les risques professionnels dans les espaces confinés : le cas des chantiers de réfection de canalisation en égouts

This contribution participates to the development of ergonomic contributions to the prevention of occupational risks in confined spaces, specifically in sewer pipe rehabilitation projects. The intervention deployed was structured around a participatory and collaborative approach involving all stakeholders in the project to sustainably improve the prevention of work-related accidents and musculoskeletal disorders among workers. Detailed analyses of workers’ activities coupled with a systemic analysis of the design and collective monitoring of the worksites were carried out. This made it possible to characterize the health and safety risks of site teams as products that compromise between several organizational requirements and situational constraints. Extended to the site manager, the analysis of his activity, although strategic, of anticipation and continuous design of intervention situations, proved to be limited by a vertical organization of the sites, which does not integrate his expertise. Based on the diagnosis, validated and shared by all, the prevention challenges were articulated with the performance objectives of the worksites in a perspective of co-design with and by the different hierarchical levels of the department. The intervention made it possible to collaboratively build new organizational rules that consider the concrete realities of the work of workers and site managers.     

Implications of evidence-based practice for community health

Evidence-based practice, developed in clinical medicine, is being applied to community health programs. Barriers to implementation of evidence-based practice noted in clinical medicine are likely to exist in community health settings and may be complicated by the nature of community health programs. These barriers include accessibility and availability of relevant data, social and political considerations of program decision-making, and conflicting expectations for evaluation research. This paper discusses barriers to both amassing evidence for practice and using evidence for decision-making in community health. The potential for conflict between practice goals set by evidence-based thinking and those set by community health organizations is also discussed. Implications for evaluations of community health programs are raised and recommendations for improving access to and use of evaluation information are made.     

A systems framework for understanding social settings

In this paper, we argue that attempts to change social settings have been hindered by lack of theoretical advances in understanding key aspects of social settings and how they work in a dynamic system. We present a systems framework for understanding youths' social settings. We focus on three aspects of settings that represent intervention targets: social processes (i.e., patterns of transactions between two or more people or groups of people), resources (i.e., human, economic, physical, temporal resources), and organization of resources (i.e., how resources are arranged and allocated). We postulate that these setting aspects are in dynamic transaction with each other, resulting in setting outcomes. Discussion focuses on the implications of our theoretical framework for setting intervention.     

Determinants of Employee Participation in Organizations’ Family-friendly Programs: A Multi-level Approach

Many organizations have become more “family-friendly” by initiating programs to help employees meet their family needs. In return, family-friendly organizations are said to benefit from the positive attitudes and behavior of appreciative employees. However, long-term positive outcomes may not emerge if employees are reluctant to participate in work–family programs because they are concerned that their organization or manager does not support their participation. We propose two parallel conceptual models of the complex, multi-level mechanisms behind employees’ decisions to participate in their organization’s family-friendly programs.     

Career Research Interests and Training of Genetic Counseling Students

Research is important to validate clinical services, provide information on the effectiveness of practice techniques, and develop the knowledge base of a clinical profession. Genetic counseling students from American Board of Genetic Counseling (ABGC) accredited training programs were surveyed to determine their career research interests and interest in pursuing a hypothetical doctoral degree in genetic counseling. Genetic counseling program directors were surveyed to assess the emphasis on research training within their programs. A substantial number (46%, n = 92) of genetic counseling students are interested in performing research in their careers and many (40%, n = 80) would pursue a doctoral degree in genetic counseling if it was available. Students and directors from programs with a thesis requirement reported a significantly higher emphasis on career research preparation than those from programs without a thesis requirement. The results of this study indicate that future genetic counselors are interested in contributing to the research base that will advance the field. This study suggests a need to strengthen research training within ABGC accredited graduate programs and explore the development of a doctoral degree option in genetic counseling.     

Drop Out from Behavioral Management Training Programs for ADHD: A Prospective Study

To investigate dropout from parenting programs for disruptive behavior disorders, we followed 18 clients prospectively from the beginning of a manualized treatment program to three month follow-up. Using qualitative and quantitative methods, we then compared those who dropped out of the program with those who completed it. We found that in general, those participants who dropped out of the program were parents of children with more disturbed behavior, who perceived their children to be more difficult than others, and who experienced more subjective parenting stress. Those who dropped out were also not convinced that the strategies proposed in the program to help manage their children were useful. On the other hand, those who completed the program reported a determination to persevere with the strategies which they saw as assisting them to re-establish positive relationships with their adolescent children. The findings are discussed in the context of how manualized programs might be modified to increase retention.     

A randomised controlled trial to assess the effectiveness of providing self-help information to people with symptoms of acute stress disorder following a traumatic injury

BACKGROUND: Patients attending accident and emergency (A&E) may develop long-term psychological difficulties. Psycho-education has been suggested to reduce the risk of post-injury disorders. AIMS: We tested the efficacy of providing self-help information to a high-risk sample. METHODS: A&E attenders were screened for acute stress disorder and randomised to two groups: patients (n=116) receiving a self-help booklet and those who did not (n=111). A sample of 'low' scorers was also included (n=120); they did not receive a booklet. Psychological assessments were completed at baseline (within 1 month post-injury) and 3 and 6 months post-injury. RESULTS: Post-traumatic stress disorder (PTSD), anxiety and depression decreased (p<0.001) across time but there were no group differences in these measures or quality of life. However, subjective ratings of the usefulness of the self-help booklet were very high. CONCLUSIONS: This trial failed to support the efficacy of providing self-help information, as a preventative strategy to ameliorate PTSD.     

The prevention of depressive symptoms in low-income, minority children: two-year follow-up

We present 2-year follow-up data on the efficacy of the Penn Resiliency Program (PRP), a school-based depression prevention program, with low-income, racial/ethnic minority children. This program taught cognitive and social problem-solving skills to 168 Latino and African American middle school children who were at-risk for developing depressive symptoms by virtue of their low-income status. We had previously reported beneficial effects of the PRP up to 6 months after the conclusion of the program for the Latino children, but no clear effect for the African American children. In this paper, we extend the analyses to 24 months after the conclusion of the PRP. We continue to find some beneficial effects for the Latino children and no differentially beneficial effect for the African American children. Implications of findings and future research directions are discussed.