School-Based Mental Health Services: Definitions and Models of Effective Practice

ABSTRACT

School-based mental health services are those delivered by school-employed and community-employed providers in school buildings. With the implementation of provisions of the Patient Protection and Affordable Care Act (2010) that funds school-based health centers, school-based mental health services could become more broadly available in communities throughout the United States. Playing a pivotal role in promoting models for school-based services that maximize benefits to children and adolescents while making efficient use of communities' mental health resources are school psychologists. School psychologists, who recognize and respect the separated development of school and community mental health professions, can foster school–agency partnerships to coordinate children's mental health services that are comprehensive, child centered, family focused, and culturally competent. In this article, we provide three case examples using the Participatory Culture-Specific Intervention Model (B. K. Nastasi, R. B. Moore, & K. M. Varjas, 2004 Nastasi, B. K., Moore, R. B., & Varjas, K. M. (2004). School-based mental health services: Creating comprehensive and culturally specific programs. Washington, DC: American Psychological Association. [Google Scholar]) as exemplars for the implementation of community partnerships providing comprehensive culturally and contextually relevant school-based mental health services.     

虚拟场景中不同客体朝向条件对内在参照系建立的影响

通过眼动记录和部分场景再认两种方法,探讨了虚拟建筑物对称场景中物体朝向统一、凸显两种条件对内在参照系建立的影响。结果发现:(1)场景中均为有朝向建筑物且朝向统一时,被试选择物体朝向与对称轴建立内在参照系的可能性没有差异;(2)场景中只有一个有朝向建筑物,其余均为无朝向物体时,即朝向凸显条件下,被试倾向于选择对称轴来建立内在参照系。物体朝向对内在参照系建立的影响作用具有局限性和不稳定性。     

Negotiating Ethical Paradoxes in Conducting a Randomized Controlled Trial: Aligning Intervention Science with Participatory Values

In this article, we describe ethical tensions we have faced in the context of our work as intervention scientists, where we aim to promote social justice and change systems that impact girls involved in the juvenile legal system. These ethical tensions are, at their core, about resisting collusion with systems of control while simultaneously collaborating with them. Over the course of designing and implementing a randomized controlled trial (RCT) of an ecological advocacy intervention for girls, called ROSES, ethical paradoxes crystalized and prompted us to engage in critical reflection and action toward the aim of moving away from conducting research on legal‐system‐involved girls and moving toward a more democratic, participatory process of inquiry with girls. Our experience revealed two intertwined paradoxes that ultimately served generative purposes. First, in collaborating with legal system stakeholders, we observed a single story of girls’ pathology narrated for girls, without girls, and ultimately internalized by girls. Second, in reflecting critically on the ethical implications of our study design, it became clear that the design was grounded in a medical model of inquiry although the intervention we sought to evaluate was based, in part, on resistance to the medical model. We describe emergent ethical tensions and the solutions we sought, which center on creating counternarratives and counterspaces that leverage, extend, and disrupt our existing RCT. We detail these solutions, focusing on how we restructured our research team to enhance structural competence, shifted the subject of inquiry to include the systems in which youth are embedded, and created new opportunities for former research participants to become co‐researchers through formal roles on an advisory board.     

Accountability,Collaboration, and Social Change: Ethical Tensions in an Action Research Project to Address Untested Sexual Assault Kits (SAKs)

We conducted a collaborative action research project with stakeholders in Detroit, Michigan, to develop long‐term policy strategies to resolve ~11,000 untested rape kits that were discovered in a police storage facility in August 2009. In our research, we uncovered overwhelming evidence of victim‐blaming behaviors and fundamental disrespect of rape survivors by the police, which directly contributed to their decisions not to submit kits for forensic testing. We had an ethical responsibility to report these negative findings accurately and completely, and in doing so, we were concerned that police stakeholders might disengage from the action research project and hamper our other ethical responsibilities to promote general and public welfare. In this article, we examine the ethical challenges of balancing accountability, collaboration, and social change.     

Comparison of the trunk-pelvis and lower extremities sagittal plane inter-segmental coordination and variability during walking in persons with and without chronic low back pain

Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral pelvis-thigh, thigh-shank and shank-foot coordination pattern and variability over the stance and swing phases of gait. Mann-Whitney U test was employed to compare the means of DP and MARP values between two groups (same side comparison). Statistical analysis revealed more in-phase/less variable trunk-pelvis coordination in the CLBP group (P < 0.05). CLBP group demonstrated less variable right or left pelvis-thigh coordination pattern (P < 0.05). Moreover, the left thigh-shank and left shank-foot MARP values in the CLBP group, were more in-phase than left MARP values in the non-CLBP control group during the swing phase (P < 0.05). In conclusion, the sagittal plane lower extremities, pelvis and trunk coordination pattern and variability could be generally affected by CLBP during walking. These changes can be possible compensatory strategies of the motor control system which can be considered in the CLBP subjects.     

运动技能水平与躯体感觉输入对运动表象的影响

运动表象质量与运动技能水平有关,运动表象质量随着运动技能水平的提高而上升。器械使用可使人脑产生可塑性改变,使用者会将器械纳入身体图式。然而,两者影响运动表象的神经心理机制还不清楚。本研究采用功能性磁共振成像探析篮球运动员与新手在不同持球条件下表象投篮时脑功能活动的差异。结果表明运动员表象质量较好,镜像神经系统激活高于新手;持球条件下运动员表象质量显著高于不持球条件下,镜像神经系统激活程度显著低于不持球条件下。研究说明持器械可以显著提高运动员的表象质量,器械使用带来镜像神经系统的可塑性变化。     

Scrutinizing the Emotional Nature of Intuitive Coherence Judgments

Dual‐system models propose that cognitive processing can occur either intuitively or deliberately. Unlike deliberate decision strategies, intuitive ones are assumed to have an emotional component attached to the decision process. We tested if intuitive decisions are indeed accompanied by an emotional response while deliberate decisions are not. Specifically, we conducted a psychophysiological study in which participants were instructed to decide either intuitively or deliberately if three simultaneously presented words were semantically coherent or incoherent (triad task). The degree of emotionality of these two decision strategies (intuitive vs. deliberate) was compared using changes in electrodermal activity (EDA) and the reaction time (RT) effect of an affective priming paradigm as primary measurements. Based on a valence‐arousal model, our results revealed that intuitive and deliberate judgments do not differ as to their emotional valence but that they do differ in emotional arousal. Most notably, sympathetic activation during intuitive judgments was significantly lower compared to sympathetic activation during deliberate judgments. Our results reflect that a relaxed state of mind—manifested in low sympathetic activity—could underlie the holistic processing that is assumed to facilitate the proliferation of semantic associations during coherence judgments. This suggests that coherence judgments made under an (instructed) intuitive decision mode have a specific psychophysiological signature and that arousal is the differentiating component between intuitive and deliberate decision strategies. © 2016 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd.     

干预胆碱M受体对药物成瘾的影响及其与多巴胺的关系

药物成瘾是一类精神及行为障碍, 涉及到中枢神经系统的病变。毒蕈碱受体(Muscarinic receptor, M受体)属于胆碱能受体, 分5种亚型。行为学研究表明, 干预M受体能有效影响药物成瘾行为, 但其神经机制还亟待探索。阿片类药物与精神活性药物均能激活中枢多巴胺系统, 而M受体与多巴胺系统在多个脑区产生了交互作用。其中激动M2及M4受体抑制了多巴胺系统功能, 而激动M5受体增强了多巴胺系统功能, 与干预M2、M4、M5受体对药物成瘾行为的影响相对应。以上证据提示, 干预M受体可能通过影响多巴胺系统对药物成瘾起作用。     

大连地区企业医院产权制度改革的实践与思考

企业医院社会化是区域卫生规划与卫生工作实行全行业管理的前提条件,也是国企改革和社会改革的需要,医企分离势在必行.在企业医院剥离过程中,医院产权制度改革已经成为医院改革的主要矛盾和深化医院改革的首要问题.通过大连地区企业医院产权制度改革的实践经验,对企业医院剥离模式进行探讨,阐述了对医院产权制度改革的认识,并提出合理化建议.     

胸腺功能的发现及其对免疫学发展的影响

19世纪60年代初,免疫系统的发现使免疫学的发展方向发生了革命性转变。在这场转变的过程中,胸腺功能的发现起到了重要的作用。详述了胸腺功能的发现过程,并进一步深入到免疫学思想史,讨论了这个发现如何影响了免疫学的历史进程。