At the end of the journey Lyle Lewis Lloyd (August 10 1934–February 12 2020)
Lyle was a pioneer of the field of augmentative and alternative communication (AAC). He was one of the initiators of ISAAC and the journal Augmentative and Alternative Communication in the 1980s. His own engagement in nonspeech communication emerged in the 1970s. Lyle published articles, several together with Macalyn Fristoe, and organized courses about what later became known as AAC before ISAAC and the AAC journal were established. He remained strong within this field until the end of his career, and his work is frequently cited. He has guided, and supported several generations of researchers and practitioners working in the field of AAC.
The initial development and validation of the Racial Socialization Competency Scale: Quality and quantity
The present study investigated the reliability and validity of the Racial Socialization Competency Scale (RaSCS). As posited by the Racial Encounter Coping Appraisal and Socialization Theory (RECAST), the RaSCS consists of 3 factors representing 3 novel dimensions of racial socialization competency present in families (e.g., stress, skills, and confidence). Responses to the RaSCS were collected from 361 self-identified Black and African American parents and primary caretakers across the United States. After factor analysis, three scales and 27 items were maintained. Evidence was consistently found for 2 subscales within the stress dimension, namely “Call to Action” and “General” racial socialization stressors. Dimensions were also related to their respectively hypothesized constructs, including overall stress, racial socialization frequency, and self-efficacy. Future directions and recommendations on the measure’s use, particularly in the context of interventions, are also discussed.
Body Appreciation and Health Care Avoidance: A Brief Report
Research suggests that body image is related to health behaviors and health care use, but possible mechanisms for this relationship remain unclear. The current study examined the presence of a relationship between body appreciation and avoiding the doctor to avoid being weighed, using a diverse sample of women (N = 499). Controlling for body size and determinants of health care utilization, logistic regression results suggested that women with higher body appreciation were less likely to avoid health care to avoid being weighed (odds ratio = 0.38, p < .001). In addition, differences in avoiding the doctor to avoid being weighed were found for the covariates (that is, age, race, body mass index, and socioeconomic status). These results inform knowledge regarding barriers to health care use and the relationship between body image and health care use. The article concludes with a discussion of the implications for future research, social work interventions, and social work education to promote women's health and well-being.
Pathways From Intimate Partner Violence to Academic Disengagement Among Women University Students
More knowledge is needed related to collegiate intimate partner violence (IPV) and the pathways between experiencing physical and psychological IPV and academic disengagement. Students in a University System in the southwest completed an online survey including measures of physical and psychological IPV, academic disengagement, sense of community, and safety on campus. Conditional process analyses were used to understand key pathways for 6,818 woman identified students. All models found a significant indirect path between physical and psychological IPV and academic disengagement via depression symptoms. Students’ sense of community on campus was associated with less academic disengagement regardless of physical violence. The impact of psychological IPV on disengagement was stronger for those with lower senses of community. Enhancing screening and education, providing effective mental health counseling, and increasing advocacy will help institutions better address IPV.
Gender Differences in the Marital Plans and Union Transitions of First Cohabitations
In an era of changing relationship norms, plans for marriage are an increasingly complex yet important indicator of the link between cohabitation and marriage. Despite qualitative evidence on this complexity, little is known about the nuances of marital plans and gender differences at the population level. This study introduces the concept of “informal” marital plans—cohabitations beginning with some intentions to marry that had yet to be formalized. Drawing on data of heterosexual cohabitors in their first coresidential union from the National Survey of Family Growth (2011–2015, n = 5545), I examine the sociodemographic correlates of marital plans as well as their consequences for men’s and women’s union transitions. The results show significant gender differences in reports of marital plans at the time of moving in together, with women more likely to report engagement and men more likely to report informal marital plans. Although having any marital intentions is positively associated with transitioning to marriage for both genders, engagement is a significantly stronger predictor of marriage than informal marital plans. Pronounced gender differences are found with respect to the dissolution of first cohabitations, as both informal and formal marital plans are more protective against dissolution for men than for women. Distinguishing informal marital plans from engagement provides meaningful new insights into the role of cohabitation in modern American union formation.
Investigating the Factors That Influence Self-Efficacy Among Home Care Workers Providing Dementia Care
The self-efficacy beliefs of home care personal support workers (PSWs) play a crucial role in their professional competence and subsequent provision of quality care. Understanding the factors that influence self-efficacy of PSWs is critical to ensuring their job satisfaction and retention, and ultimately improving the quality of care provided to home care clients. Currently, there is a lack of literature exploring the factors influencing self-efficacy among home care PSWs who care for clients with dementia. Accordingly, the purpose of this study was to investigate the sources of self-efficacy for home care PSWs. Conventional content analysis of interviews with 15 home care PSWs yielded six categories of sources influencing self-efficacy: insufficient client information provided by employers, lack of supportive communication by employers, restriction of PSWs’ discretion and autonomy by employers, insufficient practical dementia-specific training, sufficient work experience with clients with dementia, and feedback from family caregivers. These findings call for a multi-pronged approach to enhance the self-efficacy of PSWs. In particular, these findings offer specific areas of improvement for employers on how to best support their PSWs. They also highlight the significant role of dementia-specific education and training for PSWs regardless of their experience in the field. Finally, the findings emphasize the importance of family caregivers in the home care context. Taken together, the study’s findings offer insights on how to best support PSWs and ensure stability in the dementia care workforce.
Improving parent-child relationships: Effects of the Your Family, Your Neighborhood intervention
Your Family, Your Neighborhood (YFYN) was developed to strengthen parent-child relationships among families living in low-income and subsidized housing communities, using a dual-generation approach. Few, if any, family-based interventions with a primary focus of enhancing parent-child relationships target parents and their children between the ages of seven to 12 years living in subsidized housing communities. This study aimed to fill this gap and examine the effects of the YFYN intervention on parent-child relationships. This mixed-methods study was conducted in three low-income neighborhoods, in a city in the western United States. Intention-to-treat (ITT) analysis was conducted on the entire quasi-experimental sample (N = 101) and a repeated measures ANOVA was conducted on the per protocol sample (N = 70). ITT analysis indicated no significant group by time differences. However, results of the two-way ANOVA on the per protocol sample revealed a significant group by time effect, with treatment families demonstrating improvements in the parent-child relationship from pre-assessment to post-assessment compared to the control group. Focus groups were conducted with parent participants in the treatment group, in which they indicated their parent-child relationships improved after participating in YFYN, including feeling closer to their children, improving communication, spending more time together, and eating dinner together as a family more often. This study offers preliminary findings regarding the effects of the YFYN intervention on the parent-child relationship for families living in low-income and subsidized housing communities. Future directions for family-based and neighborhood interventions are discussed.
Social support among people with mental illnesses on probation
Send Nudes? : Sexting Experiences and Victimization Relating to Attachment and Rejection Sensitivity – Incorporating Sexual Minority Perspectives
As texting continues to serve as an increasingly common method of communication among emerging adults, increases in rates of sexting, or sending sexually explicit messages, pictures, or videos, have also been observed. While consensual sexting can facilitate intimacy in relationships, when used as a tool to victimize others, it has been shown to yield a range of negative outcomes: from embarrassment to severe depression and suicide. This chapter aims to review the existing literature on emerging adults’ engagement in and evaluations of sexting, while also considering the risks associated with sexting victimization. The role that individual characteristics, such as attachment style and rejection sensitivity as well as demographic characteristics such as gender, sexual orientation, and relationship status, play in the relation between experiences with and evaluations of using sexting as a tool for victimization will also be explored.
Setting the Stage for Research Success: Creation of Standardized Physician-Scientist Training Program Guidelines to Facilitate Research During Clinical Training
OBJECTIVES/GOALS: To ameliorate the leaky pipeline of physician-scientists, we must address the factors that cause medical trainees to disengage from research. Here we describe the development of standardized Physician-Scientist Training Program guidelines that may be implemented across disciplines to address these challenges. METHODS/STUDY POPULATION: Maintenance of a robust pool of physician-scientists is critical to meet the rapidly growing need for novel therapeutics. A variety of factors contribute to the decline of this pool. Key among these are a lengthy training period that segregates research from clinical training, thus impeding research progress and milestones that allow for a successful research career. Through engagement of residency program directors and Vice Chairs of Research, we have created a series of guidelines that promote residency research tracks and enable better integration of research and clinical training time. Guidelines have been piloted in the Departments of Pediatrics, Medicine and Surgery in the context of 2 new R38-supported programs. RESULTS/ANTICIPATED RESULTS: Our physician-Scientist Training Program (PSTP) guidelines were developed by our central Office of Physician-Scientist Development (OPSD) after a successful pilot of an integrated research residency program in the Department of Pediatrics [Duke Pediatric Research Scholars (DPRS); Hurst, et al, 2019], which has included 36 resident and fellow scholars over 3 years. To date, eight clinical departments have adopted our PSTP guidelines as part of their R38-supported or pending programs. The OPSD has recently created a tracking database for scholar metrics, which will further promote PSTP development by enabling centralized reporting on scholar success to individual programs. DISCUSSION/SIGNIFICANCE OF IMPACT: PSTP guidelines enable effective implementation of new programs by sharing best practices and lessons learned, standardizing expectations, and defining metrics of success. By promoting proven strategies for integrated clinical and research training, PSTP guidelines may aid in retaining trainees pursuing research careers.
Prevalence of Intestinal Parasites in a Low-Income Texas Community
Strongyloidiasis affects an estimated hundreds of millions of people worldwide, with infection possibly persisting for life without appropriate therapy because of the helminth’s unique autoinfection cycle. Like other soil-transmitted helminths, because of the environmental conditions required for the life cycle of Strongyloides stercoralis, this parasite is endemic to tropical, subtropical, and temperate countries and areas with inadequate sanitation infrastructure. Given continued poverty and that nearly one in five American homes are lacking proper sanitation systems, many U.S. regions are at risk for intestinal parasites. A central Texas community was chosen as the study site, given previous reports of widespread sanitation failure, degree of poverty, and community willingness to participate. A total of 92 households were surveyed and residents tested for nine intestinal parasites using a multi-parallel quantitative real-time polymerase chain reaction and ELISA serology. From 43 stool samples, 27 (62.8%) tested positive for Blastocystis spp. and one (2.3%) for Giardia lamblia. From 97 serum samples, Strongyloides serology detected 16 (16.5%) positive individuals. These high rates of heterokont and helminthic laboratory findings in a peri-urban central Texas community suggest several key policy implications, including that strongyloidiasis should be added to the Texas notifiable conditions list, that clinical suspicion for this infection should be heightened in the region, and that residents without access to functioning and sustainable sanitation infrastructure should be provided that access as a basic human right and to promote public health.
Use of Enhanced Data Visualization to Improve Patient Judgments about Hypertension Control
Objective. Uncontrolled hypertension is driven by clinical uncertainty around blood pressure data. This research sought to determine whether decision support—in the form of enhanced data visualization—could improve judgments about hypertension control. Methods. Participants (Internet sample of patients with hypertension) in 3 studies (N = 209) viewed graphs depicting blood pressure data for fictitious patients. For each graph, participants rated hypertension control, need for medication change, and perceived risk of heart attack and stroke. In study 3, participants also recalled the percentage of blood pressure measurements outside of the goal range. The graphs varied by systolic blood pressure mean and standard deviation, change in blood pressure values over time, and data visualization type. Results. In all 3 studies, data visualization type significantly affected judgments of hypertension control. In studies 1 and 2, perceived hypertension control was lower while perceived need for medication change and subjective perceptions of stroke and heart attack risk were higher for raw data displays compared with enhanced visualization that employed a smoothing function generated by the locally weighted smoothing algorithm. In general, perceptions of hypertension control were more closely aligned with clinical guidelines when data visualization included a smoothing function. However, conclusions were mixed when comparing tabular presentations of data to graphical presentations of data in study 3. Hypertension was perceived to be less well controlled when data were presented in a graph rather than a table, but recall was more accurate. Conclusion. Enhancing data visualization with the use of a smoothing function to minimize the variability present in raw blood pressure data significantly improved judgments about hypertension control. More research is needed to determine the contexts in which graphs are superior to data tables.
Effects of Mindfulness Meditation on Self-Transcendent States: Perceived Body Boundaries and Spatial Frames of Reference
Objectives: Mindfulness training is believed to encourage self-transcendent states, but little research has examined this hypothesis. This study examined the effects of mindfulness training on two phenomenological features of self-transcendence: (1) perceived body boundary dissolution and (2) allocentric spatial frame of reference. Methods: A sample of healthy, young adults (n = 45) were randomized to five sessions of mindfulness training or an active listening control condition. Results: Results indicated that mindfulness training decreased perceived body boundaries (F4,172 = 6.010, p < .001, η2 = .12) and encouraged more allocentric frames of reference (F4,168 = 2.586, p = .039, η2 = .06). The expected inverse relationship was observed between perceived body boundaries and allocentric frames of reference ((β = − .58, p = .001)), and path analysis revealed that the effect of mindfulness training on allocentric frames of reference was mediated by decreased perceived body boundaries (β = .24, se = .17, CI: 0.11 to 0.78). Conclusions: Taken together, study results suggest that mindfulness training alters practitioners’ experience of self, relaxing the boundaries of the self and extending the spatial frame of reference further beyond the physical body. Future studies are needed to explore the psychophysiological changes that co-occur with phenomenological reports of self-transcendence and the behavioral consequences following self-transcendent experiences.
Advances in the evaluation and management of cortical/cerebral visual impairment in children
Cortical/cerebral visual impairment (CVI) is the most frequent cause of pediatric visual impairment in developed countries and is increasing in prevalence in developing nations. The most common underlying etiology is hypoxic-ischemic encephalopathy, particularly in premature children. Other causes include seizures, hydrocephalus, trauma, and infections. Because of neurologic comorbidities, children with CVI often present challenges in diagnosis and characterization of visual deficits. Caregiver questionnaires may aid in assessment of visual functioning, while newer types of neuroimaging, including functional neuroimaging and diffusion tensor magnetic resonance imaging, may provide further insights on structure-function relationships. Genetic testing may assist in identification of underlying genetic or metabolic syndromes. Although no standard therapy for pediatric CVI exists, advances in care of preterm children and those with hypoxic-ischemic encephalopathy may in future reduce the incidence of this disorder. In addition, various methods of visual stimulation and stem cells have been advocated as treatment for pediatric CVI. Future controlled trials using standardized methods of visual assessment are necessary to establish whether these interventions are superior to observation. Practitioners should work with families and teachers of children with CVI to optimize their environment for visual functioning. Comorbid ocular and systemic disorders, which are common, should be managed appropriately.
The Effects of Hopelessness on Chronic Disease Among African Americans and Caribbean Blacks: Findings from the National Survey of American Life (NSAL)
This paper examines the relationship between hopelessness on chronic disease in a national sample of African Americans (3570) and Caribbean Blacks (1438) Using the National Survey of American Life. A multivariate negative binomial regression examined whether chronic disease is associated with hopelessness, controlling for sociodemographic characteristics. Overall, 13.14% of the sample reported they were highly hopeless, and 31.5% indicated they were moderately hopeless. About 19% of respondents experienced chronic disease. Bivariate associations showed that those who have ever had chronic disease significantly differed from those who did not in regard to age, gender and spirituality. Multivariate results showed that respondents who ever have had chronic disease reported significantly higher hopelessness scores than those with no chronic disease. The study findings contribute to the current body of literature by supporting findings from smaller studies on the relationship between depression and hopelessness in African Americans and Caribbean Blacks.
Is your company actually fighting racism, or just talking about it?
Making the Connection Between Theories of Policy Change and Policy Practice: A New Conceptualization
Over the past few decades, powerful economic, political and cultural forces have restructured the welfare state and social work practice. In response, there have been calls in recent years for the re-politicisation of the social work profession. One of the main ways in which social work has been re-politicised is through the emphasis on social workers’ involvement in the policy arena, commonly referred to as ‘policy prac-tice’ in the literature. Although policy practice has recently received close attention in social work debates, it has remained relatively under-theorised. This article introduces social work scholars and practitioners to the theoretical work on policy change and elaborates its implications for how social workers can influence policy. Drawing on diverse literatures from the fields of political science and sociology, the article circum-scribes to four influential theories of policy change that provide support for informed action in the policy arena: neo-institutional theory, elite theory, resource mobilisation theory and interdependent power theory. Drawing on these theories, the article develops a conceptualisation of four different types of policy practice: institutional policy practice, elite policy practice, resource-based policy practice and radical policy practice.
Structural and operational factors as determinant of meaningful community participation in sustainable disaster recovery programs: The case of Bangladesh
The debate around community participation in post-disaster sustainable recovery is largely neglected in both development discourse and literature on developing countries. However, the philosophy of build back better (BBB) in sustainable disaster recovery (SDR), with roots in the early 90s, is seeing a resurgence, as tracked by the United Nations Office of the Disaster Risk Reduction Sendai Framework of Action (2015–2030). Among the most disaster vulnerable countries globally, Bangladesh has shown remarkable progress in disaster preparedness, response policy, and planning, but the disaster recovery phase remains neglected in national policy and planning. This study aims, using quantitative analyses, to identify the factors that regulate community participation in disaster recovery in governmental and nongovernmental organization programs. This study also provides recommendations to strengthen the local and national strategies for bottom-up participation in a disaster recovery program for sustainability. Findings reveal 11 dominant factors that regulate community participation in sustainable disaster recovery programming (SDRP), and five factors that control decision making participation: disaster management system, leadership decentralization, community capacity building, community resources, and disaster experiences and vulnerability. In addition, the factors associated with the type of community participation fall variably along structural, operational, community, and participant domains. The study findings argue that to promote bottom-up participation, collaboration and integration between recovery programs are needed to improve existing policies or to adopt a new policy.
Why Are So Many Indigenous Peoples Dying and No One Is Paying Attention? Depressive Symptoms and “Loss of Loved Ones” as a Result and Driver of Health Disparities
Indigenous peoples have not only experienced a devastating rate of historical loss of lives, they are more likely to experience mortality disparities. The purpose of this article is to examine Indigenous women’s lived experiences of grief and loss in two Southeastern tribes and the relationship between depressive symptoms and recent loss of a loved one. Our exploratory sequential mixed-methods research was informed by the Indigenous based Framework of Historical Oppression, Resilience, and Transcendence (FHORT). We summarized key qualitative themes from ethnographic data from 287 female participants across the two tribes, collected through focus groups, family interviews, and individual interviews. We then quantitatively examined how these themes predicted depressive outcomes among 127 respondents. Specifically, we examined associations between depressive symptoms and components of historical oppression—historical loss, loss of lives, and the presence of PTSD symptoms—along with resilience and transcendence.
Navigating a Minefield, Meta-Synthesis of Teen Mothers’ Breastfeeding Experience
Teen mothers have lower rates of breastfeeding duration and exclusivity than older mothers. A growing body of qualitative research on teen mothers’ experience helps to explain these disparities. Following a systematic search to identify relevant research, we synthesized the findings from 22 primary studies to conclude that teen mothers navigate a minefield that undermines their intention to breastfeed and their breastfeeding confidence and skill. This metaphorical minefield reflects competing norms for infant feeding and good mothering, as evident in mixed support from teens’ social networks; fragmented and stigmatizing healthcare; and spaces that are inhospitable to teen mothers and breastfeeding mothers in general. In recognition of this minefield, we urge clinicians to: respect teen mothers’ infant feeding decisions; develop collaborative relationships based on the principles of patient-centered and strength-based care; challenge stigmatizing healthcare practices; welcome teen mothers and their significant others to clinical settings; and press health systems to fully implement probreastfeeding policies. We also recommend further study to extend our knowledge about teen mothers’ breastfeeding experiences.