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The present study uses data from the National Longitudinal Study of Adolescent Health (Ad Health) to evaluate the effects of exposure to violent victimization in childhood on adolescent delinquency and subsequent adult criminality.

Using Longitudinal Latent Class Analysis (LLCA), the present study investigates whether there are distinct and diverse longitudinal delinquency trajectories among those exposed to violence in childhood.

Findings from the current study indicate that there are three distinct trajectories of delinquency and offending from age 14 to 27 for both males and females exposed to violence in childhood. Further, it appears that violent victimization in childhood bridges the gender gap in delinquency between males and females. Thus, childhood violent victimization, and the fact that females are victimized by parents/caregivers and romantic partners at higher rates than males, might be partially responsible in explaining the narrowing of the gender gap between male and female offending in the recent decades. At the same time, childhood violent victimization also seems to impact males and females in somewhat different ways. Practically, all female victims stop offending by their late 20s, whereas a fairly large proportion of males exposed to violent victimization in childhood steadily continue offending.

Although this study was able to identify the diverse impacts of violence exposure on engagement in subsequent delinquency, it did not examine the unique contributions of each type of violence on adolescent outcomes or the chronicity of exposure to each of these types of violent victimization. We were also not able to measure all types of violence experiences in childhood, such as exposure to parents’ or caregivers’ intimate partner violence.

While early prevention would be the most desirable option for both genders for the most optimal outcome, the retrospective intervention and treatment programs should be gender-specific. For males, they should heavily focus on providing alternative ways to cope with anger, impulse control and frustration, as well as teach empathy, cognitive problem solving skills, verbal communication skills, and tangible life and job skills. For females, most successful intervention and treatment programs may focus on helping the girls through a transition from adolescence to adulthood while providing mental health, medical, and family support services.

The paper uses a unique methodological approach to identify distinct and diverse longitudinal delinquency trajectories. The findings demonstrate how more resilient individuals (in terms of externalizing behaviors) can bring down the mean scores of delinquency even though many other individuals can be severely affected by violence exposure in childhood.

This article presents a typology of the medicated self, as developed through in-depth interviews with twenty-two social work students and practitioners. Utilizing an interactionist perspective, the experience of taking psychiatric medication is examined in both samples, using a comparative analysis. Emphasis is placed on the impact of taking psychiatric medication on the sense of self. The data suggest that the development of a medicated self is complex and varied, and includes a small number of those who feel that medication led to an improved self, and the majority who felt damaged by their experience with medication, and expressed varying degrees of ambivalence about its use. Despite this ambivalence, most of our respondents seemed to develop an altruistic, empathetic self geared toward helping others. This self emerged in spite of respondents saying that their self was damaged. Implications are presented, and conclusions and suggestions for further work on the impact of psychiatric medication use on the self are presented.

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in receiving quality healthcare services. Individuals with developmental disabilities often experience health issues associated with aging at earlier ages and at higher rates than the general population. This population has a higher incidence of chronic health conditions that require regular medical attention.

The intent of this project was to learn directly from adults and their caregivers how well healthcare providers understand autism, explore their experience with how well their care is coordinated between primary healthcare and other specialty services, and identify factors which could impact access to care and to discover what other barriers which may potentially influence health outcomes for ASD adult.

A qualitative study conducted with semi-structured interviews with 12 adults diagnosed with ASD and/or their guardians/caregivers.

Some of the adults interviewed experienced negative health outcomes and suboptimal relationships with healthcare providers; others seemed to have positive relationships. Clinical and communications accommodations were necessary to make healthcare provision more comfortable. Barriers to accessing healthcare services existed in many forms.

The healthcare needs of the growing population adults diagnosed with ASD/ID are anticipated to be significant. This challenge is further exacerbated given there are few trained healthcare providers who are prepared or dedicated to serve this population. Continuing to build awareness of the health needs of the ASD/ID adult population is critical.

This project is highly innovative as it is the first attempt to understand how the adult autism population accesses care and perceives their healthcare interactions. This study serves as a starting point to suggest new opportunities for further research for this growing population.

Native American (NA) women's health needs in general are underresearched, and use of holistic, community-informed, and resilience-based approaches are rare. Despite extensive documentation of the continuing health inequalities between NA women and the general US population, little research examines what healthcare infrastructure and healthcare provider factors most impact, and exacerbate, these health disparities. The purpose of the study was to provide insight into the healthcare experiences of NA women. A qualitative descriptive research methodology with “hues” of an ethnographic life-history approach was used. Data were collected through qualitative semi-structured life-history interviews with 31 NA women from the Gulf Coast region of the United States. All women identified healthcare obstacles and barriers. These barriers were predominately comprised of Healthcare Infrastructure Barriers, which entailed: (1) Cost and Insurance Barriers; (2) Concerns about Western Medication; (3) Language Barriers; (4) Distance to Medical Facilities or Specialists; and (5) Long-wait Times, and Negative Provider Relationships, which included: (1) Rushed or Rude Provider Interactions; (2) Providers not Listening, or Ignoring Patient Concerns; (3) Poor, Inaccurate, or Inadequate Care or Diagnosis; (4) Discrimination in Healthcare; and (5) The need for Personal Relationships with Providers. These findings suggest that healthcare infrastructure issues and poor healthcare provider relationships are important structural issues that contribute to health disparities. The findings from this study have important implications for the type of training those working in healthcare services receive to be more sensitive to the needs of NA women and suggest that NA women may need unique support when accessing healthcare.

Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs).

To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case.

Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions.

By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.

In addressing positive general education teaching practices for use with students with or at risk for emotional and behavioral disorders (EBD), the chapter emphasizes teacher behavior change research that has been informed by applied behavior analytic (ABA) principles. Its central theme is that general education teachers can access research informed by ABA in developing prosocial instructional and management practices. Highlighted teaching practices include fostering correct academic responses from students, increasing active student response, and using contingent praise with regularity. The chapter also discusses functional behavioral assessment, positive behavioral interventions and supports, and controversial behavior change issues surrounding seclusion and restraints and medication, topics related to teaching students with or at risk for EBD in general education settings.

Purpose – The authors focus on understanding the relationship between costs and cost sharing on medication adherence for individuals who initiated a disease-modifying therapy (DMT) for the treatment of multiple sclerosis (MS). DMTs reduce the risk of relapse and are an essential component of MS treatment. Furthermore, the authors compare monthly payment levels for copayments versus coinsurance and estimate the effects on adherence.

Methods – Using the MarketScan Commercial Claims and Encounters database evidence from July 1 2005 to March 31 2008, the authors employ a multivariate two-stage least-squares model (2SLS) to examine the impact of copayments or coinsurance on the medication possession ratio (MPR).

Findings – Descriptive results show that the mean out-of-pocket (OOP) costs of DMT per month were higher for patients with coinsurance than for patients with copayments. For the cohort of patients with copayment there was little difference in monthly copayments across adherence thresholds. Regression analysis shows that an increase in cost sharing reduces adherence overall, but this effect was small and insignificant in the copayment cohort. In contrast, in the coinsurance cohort increased cost sharing was significantly associated with decreased adherence to DMT medication; with a 10% increase in cost sharing leading to an 8.6% decline in adherence.

Implications – Employers increasingly rely on coinsurance, despite evidence that reliance on coinsurance results in lower adherence. Our research findings suggest that coinsurance appears to be a greater obstacle to compliance, confirming predictions found in the theoretical literature.

Originality – This research converted counts of injectable treatments into a continuous adherence measure. Previous literature on cost sharing did not examine MS.