information for practice
news & new scholarship from around the world 11.23.09information for practice April 2008 archives
April 30, 2008
This set of studies is part of the ROI Evidence Base, which was developed by the Center for Health Care Strategies and Mathematica Policy Research, Inc. to help policymakers identify intervention strategies with the potential to both improve quality and reduce health care costs.
Over the last 20 years the UK has experienced rapid house price inflation. The Barker Review reported that an additional 120,000 private sector homes per annum would need to be built in England to reduce the trend in real house prices to the European average, and recent Government announcements have increased this target. Some key professionals, such as teachers and nurses, cannot afford to live and work in most cities. Increased rates of household formation, as more people live alone, is one factor that has increased the demand for housing. At the same time, cities are becoming socio-economically polarised, with extremes of wealth existing alongside economically poor populations living in social housing and a relative absence of middle class households. There is a widely presumed need for greater social diversity and cohesion through 'mixed' communities. As John Hills (2007) notes, there has been a 'residualisation' of social rented housing over the last 20 years; the poorest groups have been concentrated in this tenure, and it has been seen as an unattractive housing option. Thus there exists a central policy concern to break up this concentration of poverty and exclusion in the tenure, largely through the promotion of mixed neighbourhoods. New types of affordable high-density mixed tenure housing could be one way of addressing some of these issues, by increasing housing options, making affordable properties available via low cost home ownership, and increasing socio-economic diversity. However, high-density housing and inner city living are potentially unattractive to some sections of society. This study focused specifically on resident perceptions of these new forms of high-density affordable housing in eight new housing scheme in England and Scotland.
- Alcohol and illicit drug dependence were defined in SAMHSA's National Survey on Drug Use and Health using the DSM-IV diagnostic criteria which includes such symptoms as withdrawal, tolerance, unsuccessful attempts to cut down on use, and continued use despite health and emotional problems caused by the substance.
- Based on SAMHSA's National Survey on Drug Use and Health, 3.2% of the persons aged 12 or older who first used alcohol 13 to 24 months prior to the survey interview were dependent on alcohol in the past 12 months.
- Of the persons aged 12 or older who first used marijuana 13 to 24 months prior to the survey interview, 5.8% were dependent on marijuana in the past year.
- Among new users of crack cocaine in the 13 to 24 months prior to the survey interview, 9.2% were dependent on any type of cocaine in the past year.
- Of the new users of heroin in the 13 to 24 months prior to the survey interview, 13.4% were dependent on heroin in the past year.
In 2004, the National Wraparound Initiative (NWI) focused its attention on building agreement about essential elements of wraparound practice. To begin this work, a small core group came together to review existing wraparound manuals and training materials. This core group, which included researchers, trainer/consultants, family members and administrators, used these materials as the basis for an initial version of a practice model. This initial version saw the wraparound process as consisting of a series of activities grouped into four phases: engagement, initial plan development, plan implementation, and transition. . . . . The practice model that emerged from this process did not include any activities that were completely new (i.e., all the activities had appeared in one or more of the exiting manuals or materials). However, the overall model was still quite different from any single model that had been described previously.
This knowledge review sets out to identify what is known about the social care needs of children with complex health care needs (CHCN) and their families, and about the services designed to meet those needs. The review is made up of three distinct parts:
- consultation with children with CHCN and their families
- review of relevant research
- survey to identify examples of good practice in service provision.
This new CHCS issue brief examines the CMS targeted case management rule, issued December 4, 2007, in the context of people with complex health needs who receive community-based care management services. Following a brief overview of the case management amendments contained in the Deficit Reduction Act, this analysis summarizes the key elements of the CMS regulation and considers its implications for specialized services, providers, and programs. The House recently approved legislation to delay the implementation of the TCM rule, as well as six other Medicaid regulations, until April 2009. Similar legislation is pending in the Senate.
No matter how old your child is, you can be sure that adoption is something he thinks about. And what about his classmates and friends? We’ve compiled a list of our best resources that will help you talk to your child and other people about adoption—Clip-and-Save guides, advice on discussing sensitive details, answering your child's first questions, helping your adolescent open up, and more.
April 29, 2008
The Implementation Guide is organized by domain (general category), focus area (sub- ategory), and standards (taken from the three documents referenced above and the work of the Cultural Competence Action Team which is referenced below in the Implementation Guide as “CCAT”). Implementation strategies, community examples/best practices, resources/tools and performance indicators/measures are provided for each domain. The Implementation Guide, as a living document, will be updated at regular intervals. It is in a pdf file and can be downloaded and printed.
The goal of this roundtable was to bring together leaders in child welfare training in ACF Region V states and provide opportunities for them to confer about quality training with peers from other states. The roundtable was designed to be an interactive, peer to peer, working event that responded to the needs and interests of the states. In fact, the topics discussed during the roundtable were identified by the states in a pre-roundtable survey that asked them to suggest ideas for the agenda and highlight unique or innovative training activities that they would be willing to share with the other participants. Throughout this roundtable, participants shared strategies, tools, practical examples and approaches that they use to strengthen the training they offer within their state. Topics discussed included:
- Overview of each state’s training system
- Opportunities for collaboration around distance learning
- The level of training system involvement in foster parent training
- The relationship between quality assurance, training and policy development
- Training Evaluation
In April 2005, the CQ Researcher singled out Illinois as setting the “gold standard” for child welfare reform (Price, 2005). The size of the Illinois foster care program dropped from a peak of 52,000 children in 1997 to less than 17,000 in 2005, and child removal rates were cut in half. More than 45,000 foster children in the state were moved from long-term foster care into permanent homes with relatives, adoptive parents, or legal guardians. Median length of stay in foster care decreased from 45 to less than 24 months (Children and Family Research Center, 2006; Illinois Department of Children and Family Services, 2003). Despite this solid record of accomplishment, Illinois was put on the watch list of 16 states that flunked all seven national standards, based on the results of the CFSR. This inconsistency illustrates that the federal evaluation of state child welfare services is seriously flawed. It is mainly due to the problem that the CFSR relies on state data submitted to the federal Adoption and Foster Care Analysis and Reporting System (AFCARS), which is limited to cross-sectional snapshots of child welfare data at sixmonth intervals (Bishop, Grazian, McDonald, Testa, & Gatowski, 2002; Courtney,
Needell, & Wulczyn, 2004). While this point-in-time method provides statistical descriptions that are far superior to the aggregate counts previously reported by the states, AFCARS inability to track children prospectively from foster care entry to exit seriously limits measurement and can severely distort the assessment of performance trends.
Since 2003, the Agency for Healthcare Research and Quality (AHRQ), together with its partners in the Department of Health and Human Services (HHS), has reported on progress and opportunities for improving health care quality. With this fifth annual National Healthcare Quality Report (NHQR), these reports will have provided more than 50,000 data points about health care quality in the United States. Has it made a difference? Have Federal and State governmental agencies, provider organizations, insurers, and employers made progress in improving health care quality and safety? While every previous release of the NHQR has attempted to summarize the direction in which health care quality is going, this fifth report tries to summarize the progress that has been made and the remaining challenges to improve health care quality in this Nation. The NHQR is built on 218 measures categorized across four dimensions of quality—effectiveness, patient safety, timeliness, and patient centeredness. This year’s report focuses on the state of health care quality for a group of 41 core report measures that represent the most important and scientifically credible measures of quality for the Nation, as selected by the HHS Interagency Work Group.
This is the story of how I learned to conduct the type of research that is respected by my academic peers, yet also informs local community action and promotes social change.
There is a growing interest in many communities in developing more comprehensive approaches and enhanced services for transition-age young people with mental health difficulties. Based on literature, research with young people aged 16-24 and families, and evaluations completed with several transition programs for young people with mental health difficulties, we have learned that there are many challenges in developing effective transition services. Here we present a synthesis of lessons learned and advice gained from young people, families, and transition service providers.
Since the 1970s, there has been an alarming increase in the rate of obesity among children of all ages in the United States. The epidemic of childhood obesity is widely recognized as an immediate and long-term threat not only to children’s health and quality of life, but also to the nation’s health care system and economy. Changing the environments—homes, schools and neighborhoods—in which children live, learn and play is now seen as an essential strategy for reversing the obesity epidemic. This summary provides a synopsis of the current state of research into the environmental factors and policies related to young people’s physical activity and sedentary behavior patterns, and how these in turn may be linked to obesity. This research identifies potential strategies for addressing physical inactivity among youth and the childhood obesity epidemic
Each year, the Government decides how much to raise benefits and tax allowances. The basis for these upratings is rarely debated, yet has major long-term consequences for the relative living standards of different groups and for public finances. This research considers the implications of present uprating policies, and aims to stimulate debate on this hidden area of policy-making.
The National Service Framework for Older People (Department of Health, 2001) formed the basis of successive policy for the reconfiguration of services in the care sector as a whole. Policy has indicated particular interest in the provision of intermediate care and the promotion of partnership working, including multi-agency assessment. Within the care home sector in particular, it is recognised that there are differences in the management of homes and access to NHS nursing and other expertise. The involvement of care homes in rehabilitation is also acknowledged to be variable. The training and education of care home staff is seen as crucial in addressing the complexity and dependency of older residents’ needs and ensuring a good quality of care. This study reports on an evaluation of an initiative in Bath and North East Somerset (B&NES) involving the Local Authority and the Primary Care Trust. In this area, a dedicated team provided nursing and physiotherapy to support up to 131 residents in three local authority residential care homes. The team members also supported enhanced health and nursing training for designated care staff within the homes.
This guide has been designed for people who want to make a difference and improve standards of dignity in care. It provides information for service users on what they can expect from health and social care services, and a wealth of resources and practical guidance to help service providers and practitioners in developing their practice, with the aim of ensuring that all people who receive health and social care services are treated with dignity and respect. Whether you only have five minutes to get some quick ideas, or five hours to gain an in-depth understanding, this guide should meet your needs. You may like to go straight to our Quick Links section. Here you can find ideas about small changes you can implement that make a big difference. You can also download ready-made training packages and dignity audit tools or see the dignity challenge. If you have more time to spare, you will find this guide very informative and easy to use. It begins with an overview of what is known from UK and international research and policy about dignity in health and social care for older people. Further sections, based on subject areas identified by older people and their carers, translate these findings into recommendations for practice (practice points) and give examples (ideas from practice) from people and organisations that have already tackled these issues. There are also links to other useful websites and sources of information.
The guide draws heavily on SCIE Knowledge Review 15. This features a literature review and practice survey, including interviews and focus groups with African and Caribbean men, in order to identify the basis for the organisational models and principles discussed in this guide. However, this guide does not suggest a single solution and describes a range of ways that mental health advocacy can be organised to meet a diverse range of individual needs. The focus on men reflects the concern about their over-representation and negative experiences of mental health services. There are clearly equivalent and specific issues for African and Caribbean women requiring consideration, albeit out of the scope of this guide.
April 24, 2008
This participant's guide presents information and materials designed to prepare professionals for providing foster care services in Georgia. Seven modules are included.
This fact sheet provides basic information on bipolar disorder in children and describes an approach to getting services and supports, called “systems of care,” that helps children, youth, and families thrive at home, in school, in the community, and throughout life.
After a short-lived recovery in 2006–07, faculty salaries are lagging behind inflation again this year. Yet the salaries paid to head football coaches, presidents, and other top administrators do not seem to reflect an economic downturn. Over the past three decades, the ranks of contingent faculty, nonfaculty professionals, and administrators have swelled while the number of tenured and tenure-track faculty stagnated. These are the central findings of Where Are the Priorities? The Annual Report on the Economic Status of the Profession, 2007–08, released by the American Association of University Professors (AAUP) today. The AAUP’s annual report has been an authoritative source of data on faculty salaries and compensation for decades. Here are some of the highlights:
- Overall average salaries for full-time faculty rose 3.8 percent this year, the same as the increase reported last year. But with inflation at 4.1 percent for the year, the purchasing power of faculty salaries has declined for the third time in four years.
- Long-term salary trends also indicate a widening differential between the average salaries of faculty members at private colleges and universities and the average salaries of their colleagues at public institutions. When public institutions struggle to attract (and keep) the best faculty, our nation faces the risk of creating separate but unequal systems of higher education.
- The salaries paid to head football coaches at Division I-A universities are ten times as high as the salaries of senior professors. What does this say about the priorities of these universities?
- The gap between faculty salaries and salaries paid to administrators continues to grow. What does that tell us about institutional priorities? This year’s report builds on previous discussions of presidents’ salaries by including data for other top administrators.
- Over three decades, employment patterns in colleges and universities have been radically transformed. While the number of tenured and tenure-track faculty has grown 17 percent, the ranks of contingent faculty (both part and full time) and full-time nonfaculty professionals have each tripled, and the count of administrators has doubled.
Natural and manmade disasters have heightened awareness of the critical need to support effective mental health responses. Disasters disrupt stability and structure by altering normal economic and social activities both of individuals and of whole communities. They have had, and will continue to have, serious mental health consequences: bringing a sense of loss, grief, depression, and change to those impacted. The focus of the mental health response is generally twofold. First, mental health assessment and crisis counseling need to be readily available to all residents and evacuees impacted by disasters. Second, those individuals with serious mental illnesses need appropriate services and supports for their ongoing recovery.
In recent years, self-help and peer support, through Federal and State government funding, have become part of the array of services in response to disasters. Such services may include outreach, individual and family crisis counseling, group counseling, public education, community support groups, referral, home visits, transportation services, and warm lines. In concert with the growing self-help and mutual aid models nationally within the arena of mental health services, mental health consumers have initiated peer support services in response to the Northridge earthquake, the Oklahoma City bombing, the 9-11 tragedy, and recent hurricane disasters.
The Child Welfare Trauma Training Toolkit is designed to teach basic knowledge, skills, and values about working with children who are in the child welfare system and who have experienced traumatic stress. It also teaches how to use this knowledge to support children's safety, permanency, and well-being through case analysis and corresponding interventions tailored for them and their biological and resource families.
anges in the institution of adoption over the past few decades have resulted in many questions about the best way to prepare and support adoptive parents for the task of raising their children. Historically, many parents who adopted children were given little, if any, information about their children’s origins or about adoption in general. Yet, without adequate information, the chances for developing appropriate expectations about adoption, or for understanding the best ways of managing the challenges that can be associated with adoptive family life, are lessened. This is especially true for adoptions from the child welfare system and from other countries, where there is significant risk of medical and/or psychological issues. It is widely accepted among adoption professionals today that parental preparation, education and support is crucial for the stability of an adoption and for the long-term emotional well-being of all family members. Nevertheless, there is a high degree of variability in the types and extent of preparation and education offered by agencies, attorneys, and others who facilitate adoption placements. Some of these organizations and individuals offer extensive services, both during the pre-adoption and post-adoption periods; however, others offer little to adoptive parents in these areas. This paper, which represents the first phase of the Evan B. Donaldson Adoption Institute’s Adoptive Parent Preparation Project, outlines the basic principles, key issues, methods, and content areas forming best-practice standards regarding the preparation and education of adoptive parents. This phase focuses on preparing adoptive parents to better understand and manage the mental health, developmental, and parenting issues about which all adoptive parents should be educated, as well as those issues more relevant to specific types of adoptions. The information in this paper should be viewed as a roadmap for the development of specific curricula for professionals to use in preparing and educating adoptive parents in a wide range of content areas.
The second AHAR makes use of two primary data sources. The first source is HMIS data on the number, characteristics, and patterns of shelter use among sheltered homeless persons— or persons who used emergency and transitional housing—during a six-month period from January 1 through June 30, 2006. The data were obtained from a nationally representative sample of communities. A total of 58 sample sites participated in the second AHAR, including 49 communities that participated in the first AHAR and 9 new sample communities that were not able to provide data for the first report. Because some sample communities are still working to secure the participation of homeless assistance providers in HMIS, not all could provide data for this analysis (or could provide only partial data). As a result, the estimates provided in this report have large confidence intervals (i.e., sampling error). In addition to the sample communities, 16 communities, or “contributing communities,” that were not part of the original sample met the minimum requirements for participation and volunteered to provide their data for this second report.
The National Children’s Study will examine the effects of environmental influences on the health and development of more than 100,000 children across the United States, following them from before birth until age 21. The goal of the study is to improve the health and well-being of children.
April 23, 2008
This paper will examine the reasons behind the CAP shortage, discuss how New York is currently tackling the problem, and make recommendations for how the state can increase the supply of CAPs, as well as offer other alternatives for care to families in need. The reasons for the shortage are many and varied. Barriers exist for those considering CAP training, and disincentives exist for those entering the fi eld. The New York State Offi ce of Mental Health (OMH) currently contracts with 25 programs to fund 135 residencies, some of them CAP positions. OMH will fund more positions in July 2008. In addition, Governor Spitzer’s new Docs Across New York proposal may make more positions possible in high-need areas.
This fact sheet provides basic information on attention-deficit/hyperactivity disorder (ADHD) in children and describes an approach to getting services and supports, called “systems of care,” that helps children, youth, and families thrive at home, in school, in the community, and throughout life. In a classroom of 30 children or youth, it is likely that at least two students are affected by ADHD. This surprisingly common condition makes it hard for children and youth to control their behavior (sit still, think before speaking or acting, etc.) and/or to pay attention. If left untreated, it can lead to school or job difficulties, depression, relationship problems, and substance abuse.
For our purposes, we will examine the needs of children in the child welfare and children’s mental health systems—those children who will transition or “age-out” of those systems at some point, and who require supports to do so successfully. We will attempt to answer two questions. First, how do we work within these systems to keep children and youth engaged, address their needs, and tailor services to fit those needs? Second, how do we coordinate care across systems and state agencies?
The purpose of this Statistics Release is to present the fifth set of national figures for services provided by local authorities in Scotland for adults with learning disabilities. All figures for 2007 relate to the week ending 16 September 2007 and are provisional. As such, they may be subject to change. The final figures will be published in future publications. This publication is a result of The same as you? review of services for people with learning disabilities, published in May 2000. Its 29 recommendations for developing learning disability services set out a programme for change over 10 years.
This paper draws on peer-reviewed papers and chapters from data gathered during the National Survey of Child and Adolescent Well-Being (NSCAW) to examine correlates and contributors to racial disproportionality. NSCAW was commissioned in 1997 by the Administration on Children, Youth and Families, U.S. Department of Health and Human Services, to learn about the experiences of children and families who come in contact with child welfare agency–supervised services. The first national longitudinal study of its kind, NSCAW is examining the characteristics, needs, experiences, and outcomes for these children and families. This report summarizes published and in-press articles and chapters based on the NSCAW study in order to examine the evidence on the relationship between race/ethnicity and several important areas related to child welfare and well-being.
To further protect children from exposure to lead-based paint, EPA is issuing new rules for contractors who renovate or repair housing, child-care facilities or schools built before 1978. Under the new rules, workers must follow lead-safe work practice standards to reduce potential exposure to dangerous levels of lead during renovation and repair activities.
April 22, 2008
Statistics on Students in Higher Education (HE) at Scottish Institutions 2006-07 are
published today by Scotland’s Chief Statistician. This publication contains updates of the
figures in the Students in Higher Education in Scotland, 2005-06 publication, published
on 16th May 2007. Some of the tables in this publication have been improved to reflect
feedback from users of the statistics (see note 5 of notes to news editors). The release
contains information on HE provision in higher education institutions (HEIs) as well as
Scotland’s colleges. The figures include distance learning students enrolled at Scottish
institutions, which may involve the provision of education through one or more of the
following: teaching staff from Scottish institutions delivering programmes abroad; Scottish
HEIs teaching at campuses abroad as well as the use of electronic learning programmes
provided by Scottish HEIs. Figures on students of the Open University in Scotland are
excluded from the tables and text except where stated.
A knowledge revolution is transforming our understanding of how young children grow and learn, what they need to succeed in school, and how they can reach adulthood as healthy, productive, and participating members of society. This remarkable advance is critical for policymakers – it directs us to the nature of the environments, supports and relationships that are fundamental for all children. We now have the basis to make informed decisions that will significantly affect the future of our children, our families, our economy, and our society. The combination of recent findings from neuroscience, early intervention studies, and program evaluation provides excellent guidance for designing policy and directing resources to ensure children’s healthy development. That’s the big message from the National Summit on Children. Panels of distinguished experts – scientists and medical professionals, business leaders and law enforcement, academics and experienced evaluators – presented the latest science about how the brain develops, what interventions make a difference and why, and how family stability is central to a child growing up ready to achieve.
Through dialogue people can come together for a mutual exchange of ideas, observations and experiences. Dialogues go beyond the usual interactions between practitioners and recipients of mental health services. They provide a safe environment in which participants may speak freely to create better understanding and mutual trust and respect. For the first time ever, this participatory dialogue manual, developed by mental health consumers, offers a blueprint for action. It describes the benefits of dialogue meetings and provides easy-to-follow detailed specific action steps on how states, local communities, providers, managed care organizations, advocates, family members and consumers can organize meetings to develop working partnerships to improve mental health service delivery. The goal is to bring all stakeholders together on a level playing field and to develop the kinds of partnerships that are needed to improve mental health services.
The report begins by describing the public health context for the promotion of mental health and the prevention of mental disorders in children. It then describes opportunities for implementing evidence-based programs to reach families in need and summarizes the evidence base that shows that the programs do indeed strengthen the caretaking skills of parents and other caregivers and enhance child resilience. Next, it presents current knowledge about the economics of these programs, suggests how to reach families with interventions, and concludes with recommendations for further dissemination of these programs.
RESULTS. A total of 310 youth met the inclusion criteria; 160 youth were mentored, and 150 youth were nonmentored. Demographic characteristics were similar for mentored and nonmentored youth. Mentored youth were more likely to report favorable overall health and were less likely to report suicidal ideation, having received a diagnosis of a sexually transmitted infection, and having hurt someone in a fight in the past year. There was also a borderline significant trend toward more participation in higher education among mentored youth. On the summary measure, mentored youth had, on average, a significantly greater number of positive outcomes than nonmentored youth.
CONCLUSIONS. Mentoring relationships are associated with positive adjustment during the transition to adulthood for youth in foster care. Strategies to support natural mentoring relationships for this population should be developed and evaluated.
SAMHSA recognizes the critical role of child care providers in facilitating a young child’s social, emotional, and cognitive development in collaboration with the child’s parent and significant caretakers. Increasingly, child care providers report difficulty working with children who are experiencing multiple challenges. Mental health consultants, trained to work with young children and their families, can serve as important resources to help the child care provider find effective ways to work with these children. A Training Guide for the Early Childhood Services Community offers a guide for trainers to use when teaching the early childhood community how to use the blueprint.
April 21, 2008
Older adults and family caregivers are willing to use new technologies (such as telemedicine and telepharmacy) that can allow people to remain independent—and in their own homes—as they age. These December 2007 national surveys of 907 adults age 65+ and 1,023 caregivers age 45-75 conclude that both groups could benefit by knowing more about the range of technological innovations that are available today (and those that are on the horizon)
Senate Judiciary Committee
Subcommittee on Human Rights and the Law
A new analysis by the Kaiser Family Foundation and the Asian & Pacific Islander American Health Forum examines the health coverage, access to health care, and health status of Asian American, Native Hawaiian and Pacific Islander ethnic groups in the United States, and finds that certain subgroups are doing much worse than others in terms of health insurance coverage and access to health care. For example, Korean Americans, Native Hawaiians and Pacific Islanders are about twice as likely to be uninsured as whites. The analysis reveals substantial differences in the health care experiences of about a dozen subgroups of the nation’s estimated 13 million Asian Americans and more than half million Native Hawaiians and Pacific Islanders. The analysis uses data from the 2004, 2005 and 2006 National Health Interview Survey and Current Population Survey.
The ability to predict future health care costs reasonably accurately is critical to planning for the Centers for Medicare and Medicaid Services (CMS). The models used for such projections to date, however, are limited in terms of their capacity to take into account the complex array of factors likely to affect future spending. To improve CMS’s ability to map the effects on spending of such factors as medical breakthroughs and demographic trends, RAND Health developed the Future Elderly Model (FEM), a demographic-economic model framework of health spending projections that enables the user to answer “what-if” questions about the effects of changes in health status and disease treatment on future health care costs. What distinguishes the FEM from other models is its inclusion of a multidimensional characterization of health status, which allows the user to include a richer set of demographic controls as well as comorbid conditions and functional status. This report describes the development of the FEM and its application in four clinical areas: cardiovascular disease, the biology of aging and cancer, neurological disease, and changes in health care services.
This monograph presents the findings of the RAND Corporation’s Women and Nation Building Project, which is designed to assess the multilayered development of women’s diverse roles in the post-conflict context. The principal task of this study was an overarching consideration of women and nation-building, an exceedingly complex task which was simplified by our ability to use examples from the recent nation-building activities in Afghanistan. Those examples provided several pragmatic points for consideration. Our findings should prove useful and interesting to policymakers, practitioners, and scholars concerned with both the academic and the pragmatic implementation of a more-engendered approach to nation-building.
Children's hospitals are in a prime position to provide parent education that can help prevent child abuse. A report by the National Association of Children's Hospitals and Related Institutions (NACHRI) highlights the efforts being implemented by 12 children's hospitals across the country working closely with families and communities to prevent child maltreatment.
April 18, 2008
This publication presents a range of statistics for the Aboriginal and Torres Strait Islander (Indigenous) population of Australia using results of the 2006 Census of Population and Housing. It covers Indigenous population structure and distribution; mobility; household composition; language and religious affiliation; education; work; income; and housing and transport. It also includes the new topics of need for assistance, unpaid work and dwelling Internet connection. Estimates of the resident Indigenous population of Australia, and a discussion of issues affecting Indigenous population data are also included. This information provides insights into the contemporary social and economic situation of Indigenous Australians.
This guidance is for teachers, school governors and professionals with public health as part of their remit working in education, local authorities, the NHS and the wider public, independent, voluntary and community sectors. Children's social and emotional wellbeing is important in its own right but also because it affects their physical health (both as a child and as an adult) and can determine how well they do at school. Good social, emotional and psychological health helps protect children against emotional and behavioural problems, violence and crime, teenage pregnancy and the misuse of drugs and alcohol.
The federal Moving to Opportunity program (MTO) was designed to help poor minority families move from distressed, high poverty neighborhoods to better locations, thereby improving their quality of life and long term chances for well-being. Low income families living in concentrated poverty face a variety of challenges to their safety, health, and economic health, including poor schools, high crime and unemployment. This brief examines areas where the MTO program helped movers with those challenges, areas still problematic even after moving, and factors affecting those outcomes and considers policy implications for the next generation of assisted housing mobility initiatives.
In an effort to better understand the maternal, infant and child health (MICH) services available to urban American Indians and Alaska Natives; we conducted a MICH Capacity Needs Assessment. We surveyed the 34 urban Indian health organizations (UIHO) nationwide. The survey included questions about the populations served and the services provided to women, infant, child and youth groups. Descriptive analyses were used to summarize information about site accessibility, quality and affordability of services in aggregate. Potential barriers to care for women, infant, child and youth clients were also assessed. The findings of the assessment may be used to identify specific areas where greater attention is needed to enhance services for women, infants, children and youth.
People think of retirement security as balancing on a three-legged stool, with income from assets, private pensions, and Social Security as the legs. However, despite growing awareness about the importance of saving for retirement, many elderly people cannot rely on their financial assets. According to data from the 2004 Health and Retirement Study, lower-income adults age 65 and older rely less on income from assets and traditional defined-benefit pensions than their higher-income counterparts. Instead, older adults with lower income rely primarily on Social Security and public transfers for their retirement security.
Government policies for neighbourhood and civil renewal, community cohesion and devolution emphasise participative governance. Local government and other public bodies are increasingly required to develop local partnerships and other structures that enable communities to participate in and influence local decision-making. Increasing participation at community level improves local service delivery, raises local accountability, empowers communities and develops cohesive communities. It is also vital for reconnecting citizens with the process of government and improving satisfaction with electoral democracy. This study examined the realities of citizen governance from the perspective of participants living and working within six Birmingham wards, and 50 women from black and minority ethnic (BME) communities in Birmingham and Wolverhampton. BME women refers to Asian women from Indian, Pakistani and Bangladeshi backgrounds and black women, including black Caribbean and black African.
April 17, 2008
The New Deal for Young People (NDYP) was introduced in 12 Pathfinder areas during early 1998 and rolled out nationally from April 1998. The programme is mandatory and provides support for 18 to 24 year olds who have been unemployed and claiming Jobseeker’s Allowance (JSA) for six months. The NDYP is the largest government labour market programme with nearly 960,000 clients having started the programme by March 2005. There has been extensive evaluation of the immediate impact of the NDYP on individuals and the level of unemployment but relatively little research into its longer-term effect and the longer-term outcomes of participants. This paper seeks to fill this gap by addressing the following questions:
• What is the impact of the NDYP?
• Which of the NDYP’s options is the best?
• Who performs best on the NDYP?
Families in HUD's Moving to Opportunity program had the chance to move to neighborhoods with lower poverty, lower crime rates and, presumably, more opportunities for employment, good schools and better quality of life. Did they benefit from the moves and did they remain there to continue those benefits? This brief identifies patterns of moving for MTO families and the characteristics of the neighborhoods both from and to which they moved.
This guidance aims to address disparities in the nutrition of low-income and other disadvantaged groups compared with the general population. It is relevant for all women who are pregnant (or planning to become pregnant), mothers of children aged under 5 and others who care for children aged under 5. The guidance complements and supports, but does not replace, NICE clinical guidelines on: antenatal care, diabetes in pregnancy, intrapartum and postnatal care.
Is there a correlation between exposure to racially integrated, low poverty areas and employment outcomes? Does moving from a poor, inner city neighborhood to a less poor area bring greater proximity to job opportunities, or contacts with new networks of neighbors who might steer movers to jobs? Does living in a community where more people work increase motivation to work or to increase income? In examining these questions for the MTO experimental movers, this brief finds that factors in addition to where people live affect their employment and earnings.
This policy brief focuses on CMS’ regulatory changes in the context of health care and patient and family supports for children with special health care needs. For purposes of longstanding Medicaid policy, special needs children are defined not by their nominal family income, but by their diminished health status and a level of health care need that is substantial enough to threaten the economic stability of all but the wealthiest families. The brief then describes and examines the implications of recent CMS regulations and directives.
Five studies were identified that met the inclusion criteria. All were conducted in the USA. Four focussed on young delinquents or children with a range of behaviour problems. The fifth examined the effectiveness of TFC for young people in a state mental hospital. Findings indicate that TFC care may be a useful intervention to help place these usually hard to place children and young people in family settings. Results indicate some clinically meaningful decreases in: antisocial behaviour, the number of days children and young people abscond from placement; the number of criminal referrals and the time spent in locked settings. There is some evidence that young people in Treatment Foster Care spent more time in treatment over the long-term and more time at home. Examination of educational andemployment outcomes showed improvements in school attendance, homework completion and engagement with employment. However, the generalisability of findings is limited. The total number of included studies was small and the profile of participants quite mixed. The evidence may be subject to bias given the involvement of programme developers in the research teams responsible for all included studies. On the basis of this review, nothing can be said about the costs and benefits of what is a relatively costly service. Furthermore, it is not possible to make statements about TFC effectiveness vis-a-vis other composite interventions.
April 16, 2008
Primary speech and language delay/disorder is a common developmental difficulty which, if unresolved, can cause difficulties of both learning and socialisation lasting into adolescence and beyond. This review examines the effectiveness of speech and language therapy interventions for children with primary speech and language delay/disorder. The review concludes that whilst there may be some support for the effectiveness of speech and language therapy for children with expressive phonological and expressive vocabulary difficulties, the evidence concerning the effectiveness of interventions for expressive syntax is mixed, and no evidence is available concerning interventions for children with receptive language difficulties.
MTO offered families living in concentrated poverty the chance to move to lower poverty areas, away from the high unemployment and high crime rates areas with the challenges and risks they present. This brief looks at whether the program was successful in helping families move away from those neighborhoods and stay away from them, noting both the reasons for subsequent moves and the characteristics of the neighborhoods to which they made those moves.
Data from the National Health and Nutrition Examination Surveys (NHANES). The prevalence of HIV infection among adults aged 18–49 years residing in households in the United States was 0.47% for the period 1999–2006. Men were more likely to be HIV positive than women. Race/ethnic disparities in HIV infection were also seen. Non-Hispanic blacks were more likely to be HIV positive than all other race/ethnic groups. Infection with HSV-2 was significantly associated with HIV infection among the total population aged 18–49 years and especially so among the non-Hispanic black population. In 1999–2006, nearly one-quarter of HIV-positive individuals but only 1% of the HIV-negative individuals aged 18–49 years had low CD4 counts (a marker of decreased immune function). Approximately one-third of HIV-positive persons had healthy immune systems as compared with 90% among those HIV negative.
This project followed up a cohort of 113 children, removed from their parents’ care by the courts because of child protection concerns, who were then placed with members of their extended families or social networks. This form of care is known as family and friends or kinship care. The placements were all those known to be made in the course of care proceedings, brought by two local authorities, which completed between 1995 and 2001. The cases were followed up during 2004/5. The study was part of a research programme linked to the government’s Quality Protects initiative and the outcomes assessed were derived from Objective 1 of that programme: ‘secure attachment to safe and effective carers for the duration of childhood’. We also examined the factors associated with better or poorer outcomes, the decision-making processes, the perspective of carers and children, placement support and contact issues.
Results of eight randomised controlled trials of Multisystemic Therapy (MST) conducted in the USA, Canada, and Norway indicate that it is premature to draw conclusions about the effectiveness of MST compared with other services. Results are inconsistent across studies that vary in quality and context. There is no information about the effects of MST compared with no treatment. There is no evidence that MST has harmful effects.
This report used 2000 Census and American Housing Survey data to clarify the housing issues faced by grandparents and other relatives who accept the responsibility of providing care for minor children. The research is in response to a Congressional mandate to determine an estimate of the number of such families in the United States who are covered by the LEGACY Act of 2003, and to identify their affordable housing needs. The study further explores how the major assisted housing programs of the Department of Housing and Urban Development, including the supportive housing for the elderly program under Section 202 of the Housing Act of 1959, can be used, amended, or altered to meet the affordable housing needs of eligible intergenerational families.
While this review found improvements in knowledge and protective behaviours among children
who had received school-based programs, these results should be interpreted with caution. The
reasons for a need for caution is that there were problems with the way that many of the original
studies were analysed, children's knowledge was tested only a short time period after the program, the studies were conducted in North America and therefore may not apply to other countries and cultures, and several studies reported harms, such as increased anxiety in children. Potential harms need to be closely monitored in future studies and existing school based programs. It is difficult to know if the changes in children's knowledge and protective behaviours seen in the studies will result in prevention of child sexual abuse. As such, school-based programs should, at best, be seen as part of a community approach to the prevention of child sexual abuse.
April 15, 2008
Personal assistance is paid support of at least 20 hours per week for people with impairments. This review investigated the effectiveness of personal assistance versus any other form of care for older adults (65+). An exhaustive literature search identified 4 studies that met the inclusion criteria, which included 1642 participants. They suggested that personal assistance may be preferred over other services; however, some people prefer other models of care. This review indicates that personal assistance probably has some benefits for some recipients and their informal caregivers. Paid assistance might substitute for informal care and cost government more than alternative arrangements; however, the relative total costs to recipients and society are unknown.
- What is the Nature of Poverty and Economic Hardship in the United States?
- What does it mean to experience poverty?
- How is poverty measured in the United States?
- Are Americans who experience poverty now better off than a generation ago?
- How accurate are commonly held stereotypes about poverty and economic hardship?
- Of the substance abuse treatment admissions aged 18 to 64 reported to SAMHSA's Treatment Episode Data Set (TEDS), 31% in 2006 were employed full- or part-time at the time of admission, 33% were unemployed, and 36% were not in the labor force (i.e., not employed and not looking for work).
- Full time employed substance abuse treatment admissions were more likely to report alcohol as their primary substance of abuse (58%) than substance abuse treatment admissions who were homemakers (35%), unemployed (39%), labor force dropouts (39%), or disabled (46%).
- Substance abuse treatment admissions who were labor force dropouts were more than twice as likely as admissions who were employed full time to report daily use of their primary substance in the past month (56% vs. 26%).
- Substance abuse treatment admissions who were homemakers (59%) or who were employed full time (57%) were more likely to report entering treatment for the first time than admissions who were unemployed (40%), labor force dropouts (47%), or disabled (41%).
Policymakers nationwide must decide how to best invest in education and related opportunities, such as out-of-school-time programs targeting youth and early-childhood education programs. In this paper, we review the costs, benefits, and costs and benefits relative to one another for one alternative type of investment: youth programs that are offered during the time that students are not in school. Such programs are often viewed as a mechanism for addressing working parents’ needs for care of their school-age children, for improving the developmental outcomes of youth, and for reducing the gap in academic achievement between advantaged youth and disadvantaged youth. At this time, the evidence of evaluations of such programs, all of which were geared to at-risk youths, is strongest for programs that are costlier and provide more-intense resources to youth.
This review synthesizes the evidence on the effectiveness of programs aimed at reducing sexual risk-taking among teens. By including only rigorous randomized controlled trials that meet additional methodological criteria, it uses meta-analytic techniques to estimates the average effects that interventions have on reducing sexual experience, unprotected sexual activity, and pregnancy rates. It focuses on four main types of interventions: (1) one-time consultations; (2) sex education programs with an abstinence focus (and no contraceptive focus); (3) sex education programs with a contraception component; and (4) multi-component youth development programs. In total, this review presents findings based on over 37,000 youth who were the subjects of 31 studies that reported on a total of 38 randomized trials of interventions aimed at reducing teen sexual activity and pregnancy. This review finds no consistent evidence that the types of pregnancy prevention programs evaluated rigorously to date will alter in intended ways the sexual activity or pregnancy risks of youth. However, this overall pooling of studies mixes results of different program types serving different populations of adolescents.
Early malnutrition and/or micronutrient deficiencies can negatively affect many aspects of child health and development. School feeding programs are designed to provide food to hungry children and to improve their physical, mental and psychosocial health. This is the first systematic review on the topic of school feeding. Eighteen studies were included in this review; nine were performed in higher income countries and nine in lower income countries. In the highest quality studies (randomized controlled trials (RCTs) from low income countries, children who were fed at school gained an average of 0.39 kg more than controls over 19 months; in lower quality studies (controlled before and after trials (CBAs)), the difference in gain was 0.71 kg over 11.3 months. Children who were fed at school attended school more frequently than those in control groups; this finding translated to an average increase of 4 to 6 days a year per child. For educational and cognitive outcomes, children who were fed at school gained more than controls on math achievement, and on some short-term cognitive tasks.
April 14, 2008
There is evidence from a range of studies to suggest that adverse maternal psychosocial health can have an impact on the parent-infant relationship and potentially lead to adverse child outcomes in the longer term. Parenting programmes are increasingly being used to promote the well-being of parents and children, and this review aims to establish whether they can improve maternal psychosocial health in particular. The findings of the review are based on a total of 26 studies and these have been classified into five groups according to the theoretical approach underpinning the programme - behavioural, cognitive-behavioural, multi-modal, behavioural-humanistic and rational-emotive therapy. The 23 studies produced a total of 64 assessments of maternal health, including measures of maternal depression, anxiety, and self-esteem. The combined data show that parenting programmes can be effective in improving a range of aspects of maternal psychosocial functioning. While it was not possible to compare the effectiveness of the programmes in the five different categories, all of the programmes reviewed were successful in producing positive change in maternal psychosocial health.Further research is needed to clarify some of the questions arising from this review.
Authors conclusions: Welfare-to-work programmes in the USA have shown small, but consistent effects in moving welfare recipients into work, increasing earnings, and lowering
welfare payments. The results are not clear for reducing the proportion of recipients receiving
welfare. Little is known about the impacts of welfare-to-work programmes outside of the
USA.
The National Healthcare Disparities Report (NHDR) describes the quality of and access to care for multiple subgroups across the United States, and also represents a source of information for tracking the Nation’s progress over time. The observed disparities va ry by condition and population. Overall, disparities in quality and access for minority groups and poor populations have not been reduced since the first NHDR. Based on 2000 and 2001 data compared with this year’s 2004 and 2005 data (depending on the data source), the number of measures on which disparities have gotten significantly worse or have remained unchanged since the first NHDR is higher than the number of measures on which they have gotten significantly better for Blacks, Hispanics, American Indians and Alaska Natives, Asians, and poor populations. While some of the biggest disparities in quality remain, progress has been made in reducing disparities.
The summary presents the key findings of a major survey of homeless families and 16-17 year olds. The survey investigated the characteristics of homeless households and the causes of their homelessness. It also investigated their experience of living in temporary accommodation, and the impacts of statutory homelessness and living in temporary accommodation on their health, welfare and well-being.
There is evidence from a range of studies which suggests adverse child outcomes for the children of teenage parents. Parenting programmes are increasingly being used to promote the well-being of parents and children, and this review aims to establish whether they can improve outcomes for teenage parents and their children. The findings of the review are based on a small number of studies, and are therefore limited. The results suggest, however, that parenting programmes may be effective in improving a range of psychosocial and developmental outcomes for teenage mothers and their children. Further research is needed, particularly that which includes long-term follow-up of the children of teen parents and the role of young fathers as well as young mothers.
As discussions on national health care reform move to the forefront, some have focused on the
role of immigrants in the health care system. To address questions about how immigrants use and affect the health care system, key facts about immigrants and health care are summarized.
Sex offending is of increasing public concern with calls for longer terms of imprisonment and closer supervision of such offenders in the community. Currently a variety of treatment approaches are used including medication and talking therapies, though little is known about their success rates. The small group of sex offenders with learning disabilities pose a particular challenge as talking therapies need to be modified to account for the offender's limited understanding. We could find no randomised controlled trial evidence to guide us in the treatment of learning disabled sex offenders.
April 11, 2008
During Federal fiscal year (FFY) 2005, an estimated 3.3 million referrals, involving the alleged maltreatment of approximately 6.0 million children, were made to CPS agencies. The increase of approximately 73,000 children who received an investigation during FFY 2005, compared to FFY 2004, is largely due to the inclusion of data from Alaska and Puerto Rico for FFY 2005. An estimated 3.6 million children in the 50 States, the District of Columbia, and Puerto Rico received investigations by CPS agencies.
- A majority (62.1%) of referrals were screened in for investigation or assessment by CPS agencies.
- Approximately 30 percent (28.5%) of the reports included at least one child who was found to be a victim of abuse or neglect.
- About 60 percent (60.3%) of the reports were found to be unsubstantiated; about 25 percent (25.2%) of the reports were substantiated.
The Government is committed to halving child poverty by 2010, on the way to eradicating it by 2020. A cross-Government Child Poverty Unit to drive forward progress towards these targets was recently established. Evidence of public attitudes to child poverty and its perceived causes is required to build consensus around the targets and, more generally, the need to address child poverty in the UK. With HM Treasury, the Child Poverty Unit recently published the document Ending Child Poverty: Everybody’s Business, which outlines the case for eradicating child poverty and the challenges that lie ahead. This public attitudes research suggests that a significant step-change is required if the majority of the public is to be aware of the Government’s goals. The Department for Work and Pensions (DWP) placed a module of questions related to these topics on a wave of the National Centre for Social Research’s face-to-face omnibus survey in 2007, with fieldwork taking place between July and September.
This paper describes the rationale that a full protection theory of free speech, a theory based on respect for individual autonomy, would give for protecting hate speech. The paper then notes that such a rationale will be unpersuasive to many (including this author) if the harms associated with a failure to outlaw hate speech are as great as often suggested – most dramatically, if the failure to prohibit makes a substantial contribution to the occurrence of serious racial/ethnic violence or genocide. The article then attempts to outline what empirical evidence would be needed to support this conclusion and gives reasons to doubt that this evidence has been or will be forthcoming. Still, given the horrendous nature of the harm, caution suggests not taking the risk. That is, the risk may justify prohibiting hate speech given its possible role in causing these consequences. In response to this last point, however, the paper gives reasons to believe that the attempt to prohibit hate speech is more likely to exacerbate the risk of unacceptable outcomes than to generate the benign opposite. Thus, the argument ends in accepting the theoretical reasons for giving First Amendment protection to hate speech.
This guide can help you work with your doctor or nurse to choose medicines for depression. It covers:
- Common medicines for adults with depression.
- Side effects.
- Price.
This guide is based on a government-funded review of research about the medicines often used to treat adults with depression. The antidepressants are listed in section 9.
This guide summarizes the clinical research comparing the effectiveness and safety of commonly used antidepressants for adults with major depression. The medications included in this guide are the selective serotonin reuptake inhibitors (SSRIs) and other agents approved for depression in the United States over the past 20 years. The reviewed drugs are listed in section 9. This guide does not cover depression in children or adolescents, postpartum depression, or depression in people with coexisting psychiatric disorders. It also does not include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), St. John's Wort, psychotherapy, light therapy, or exercise. It does not cover any combination of therapies.
Contemporary anti-Semitism manifests itself in overt and subtle ways, both in places where sizeable Jewish communities are located and where few Jews live. Anti-Semitic crimes range from acts of violence, including terrorist attacks against Jews, to the desecration and destruction of Jewish property such as synagogues and cemeteries. Anti-Semitic rhetoric, conspiracy theories, and other propaganda circulate widely and rapidly by satellite television, radio, and the Internet. Traditional forms of anti-Semitism persist and can be found across the globe. Classic anti-Semitic screeds, such as The Protocols of the Learned Elders of Zion and Mein Kampf, remain commonplace. Jews continue to be accused of blood libel, dual loyalty,and undue influence on government policy and the media, and the symbols and images associated with age-old forms of anti-Semitism endure. These blatant forms of anti-Semitism, often linked with Nazism and fascism, are considered unacceptable by the mainstream in the democratic nations of Western Europe, North America, and beyond, but they are embraced and employed by the extreme fringe. Anti-Semitism has proven to be an adaptive phenomenon. New forms of anti-Semitism have evolved. They often incorporate elements of traditional anti-Semitism. However, the distinguishing feature of the new anti-Semitism is criticism of Zionism or Israeli policy that—whether intentionally or unintentionally—has the effect of promoting prejudice against all Jews by demonizing Israel and Israelis and attributing Israel’s perceived faults to its Jewish character.
April 10, 2008
This report presents information from the Winter 2006-07 Integrated Postsecondary Education Data System (IPEDS) web-based data collection. Tabulations represent data requested from all postsecondary institutions participating in Title IV federal student financial aid programs. The tables in this publication include data on the number of staff employed in Title IV postsecondary institutions in fall 2006 by primary occupational activity, length of contract/teaching period, employment status, salary class interval, faculty and tenure status, academic rank, race/ethnicity, and gender. Also included are tables on the number of full-time instructional faculty employed in Title IV postsecondary institutions in 2006-07 by length of contract/teaching period, academic rank, gender, and average salaries.
This technical report explores recent trends in the unemployment of recent veterans as estimated from two nationally representative surveys, the Current Population Survey (CPS) and the American Community Survey (ACS). Analyses of CPS data indicates that veteran youth unemployment increased relative to nonveteran youth unemployment between 2003 and 2005 (and that this relative increase is statistically significant) and that veteran youth unemployment decreased between 2005 and 2006. However, analysis of ACS unemployment data also draws into question whether veteran youth unemployment in fact increased relative to nonveteran youth unemployment between 2003 and 2005. While veteran youth unemployment did increase in the ACS data between 2003 and 2004, it fell between 2004 and 2005, and none of those changes in unemployment rates relative to changes in nonveteran youth unemployment rates is statistically significant.
Child welfare professionals require ready access to State laws and regulations regarding child protection, foster care, and adoption. This publication provides web addresses for State statutes websites and lists the parts of the code for each State and territory that contain the laws addressing child protection, adoption, and child welfare. It also provides web addresses for State regulation and policy websites and lists other resources that explain States’ policies and procedures.
Approximately 48 States, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands designate professions whose members are mandated by law to report child maltreatment. Individuals designated as mandatory reporters typically have frequent contact with children. Such individuals may include:
- Social workers
- Teachers and other school personnel
- Physicians and other health-care workers
- Mental health professionals
- Childcare providers
- Medical examiners or coroners
- Law enforcement officers
DISPARITIES
Behind the national averages lie large and growing disparities, making it ever more obvious that the chances for a child to benefit from state pre-K are largely determined by the state where he or she lives. The top 10 states in access now serve more than one-third of all their 4-year-olds. (See Box.) Longtime leader Oklahoma serves more than two-thirds of its 4-year-olds with high-quality state pre-K, and nearly three-quarters when special education is considered. In marked contrast, a dozen states still provide no state-funded preschool education to even their most disadvantaged families other than special education services for young children with disabilities.
This dissertation consists of four stand-alone essays that focus on alcohol and food environments. They examine the following: (1) Disparities in alcohol environments and their relationship to adolescent drinking. Nineteen percent of all expenditure on alcohol in 1999 was attributed to underage drinking. Alcohol outlets located in close proximity to homes are significantly associated with adolescents’ binge drinking and driving after drinking. (2) The spatial location of alcohol outlets and problem drinking among the adult population. There is consistent evidence of a concentration of alcohol retailers in minority and low-income neighborhoods in California. Some types of alcohol outlets are found to be associated with excess alcohol consumption and heavy episodic drinking among the adult population with indirect effects such as drunk driving and violent crime. (3) Weight gain trends across sociodemographic groups in the United States. Although sociodemographic disparities in obesity are well-documented, weight gain trend is quite similar across sociodemographic groups — probably due in part to broadly environmental factors such as transportation and community design. (4) Retail food environments. Retail food outlets are associated with individual obesity status. Improving the supply of and access to healthy food choices can play a role in the prevention of obesity.
- Inhalants were the most frequently reported class of illicit drugs used in the past year among adolescents aged 12 or 13 (3.4 and 4.8 percent, respectively)
- Combined data for 2002 to 2006 indicated that an annual average of 593,000 adolescents aged 12 to 17 had used inhalants for the first time in the year before their survey interview
- Among past year inhalant initiates aged 12 to 15, the three most commonly used types of inhalants were glue, shoe polish, or toluene; spray paints; and gasoline or lighter fluid; in comparison, nitrous oxide or whippets were the most common type of inhalant used among past year inhalant initiates aged 16 or 17
April 9, 2008
Results from reviewed studies indicate that for most participants in the Food Stamp Program—children, nonelderly men, and the elderly—use of food stamp benefits does not result in an increase in either Body Mass Index (BMI) or the likelihood of being overweight or obese. However, for nonelderly women, who account for 28 percent of the food stamp caseload, some evidence suggests that participation in the Food Stamp Program may increase BMI and the probability of obesity. Different results for age and sex subgroups remain unexplained. Further, because food stamp benefits are issued to households, not individuals, mixed results across age and sex subgroups make it difficult to target policy alternatives to address potential weight gain among some participants while not affecting others in the household.
Presents findings from a BJS survey of campus law enforcement agencies serving 4-year colleges and universities with 2,500 or more students. The survey covered the 2004-05 academic year and collected data from agencies using sworn police officers and those using only nonsworn security officers. The report compares law enforcement agencies serving public and private campuses by number and type of employees, screening methods used for hiring officers, training and education requirements for officers, agency functions, types of equipment, computers and information systems, special programs, and written policy directives. General campus characteristics, including crime statistics, are also summarized.
Every State, the District of Columbia, and the U.S. territories have statutes that identify persons who are required to report child maltreatment under specific circumstances. Approximately 26 States currently include members of the clergy among those professionals specifically mandated by law to report known or suspected instances of child abuse or neglect. In approximately 18 States and Puerto Rico, any person who suspects child abuse or neglect is required to report. This inclusive language appears to include clergy but may be interpreted otherwise.
Caring Choices, a coalition of 15 organisations from across the long-term care system, sought to gather the views of older people, carers and others with direct experience of the system on how care should best be funded in the future. It was born out of widespread and growing concern that the current long-term care funding system is not fit for purpose. Throughout 2007, it has engaged with more than 700 individuals at events across England and Scotland and through an interactive website. The initiative – and this final report in particular – provides insights into potential areas of consensus as well as some of the difficult choices and trade-offs that will need to be made in order to create a funding system that is fair, effective and sustainable. The findings reported below came from the discussions at the Caring Choices events and from a survey of those attending the events, web visitors and a number of partner organisation contacts.
Recent neurobiological research has produced a solid basis for introducing an early childhood mental health perspective into programs and systems that serve young children and their families. Neurobiologists have dramatically increased our understanding of how the brain develops during the first 3 years of life by describing the impact of environmental and biological factors on a child’s cognitive, physical, behavioral, and social development. Concurrently, research on child development and clinical practice has shown that nurturing relationships play a crucial role in facilitating young children’s social and emotional development. These bodies of knowledge provide a solid basis for introducing the mental health perspective into early childhood programs and systems. The ultimate goals of this early childhood mental health perspective are to enhance the well-being of all children in child care settings and to minimize or avoid behavioral problems in children with special needs (Donohue, Falk, & Provet, 2000). Designing and implementing child care and other programs that emphasize the mental health of the participating children reflect the essence of the mental health perspective.
This NACo issue brief examines the general outcomes affecting youth aging out of foster care, and identifies model county programs and best practices that are addressing the needs of this population in an innovative way.
Tertiary intervention programs are more likely to report effectiveness than primary and secondary programs for reducing youth violent behaviors, concludes a systematic review of studies on the topic. Primary prevention programs aim to reduce risk behaviors associated with subsequent violence, such as substance abuse. Secondary programs focus on youth at increased risk for violence, such as those in impoverished neighborhoods. Tertiary programs focus on youth who have already engaged in violent behavior, explain researchers at the Southern California Evidence-based Practice Center. Researchers included 41 studies for review, 15 of which were randomized control trials (RCTs). Overall, nearly half (49 percent) of interventions were effective. Of the RCTs, two of six (33 percent) primary interventions, three of seven (43 percent) secondary interventions, and two of two (100 percent) tertiary interventions were effective.
This study follows up on a prior study of child welfare agencies' efforts to identify, locate, and involve nonresident fathers of children in foster care. These analyses use information from the original survey and administrative data on case outcomes to explore three research questions: (1) Is nonresident father involvement associated with case length? (2) Is nonresident father involvement associated with foster care discharge outcomes? and (3) Is nonresident father involvement associated with subsequent child maltreatment allegations? The study finds that having an involved father is associated with shorter case length and a greater likelihood of reunification, though it is only modestly related to subsequent allegations of maltreatment. Future research is needed to better understand the nature of nonresident fathers' involvement.
Policymakers nationwide must decide how to best invest in education and related opportunities, such as out-of-school-time programs targeting youth and early-childhood education programs. In this paper, we review the costs, benefits, and costs and benefits relative to one another for one alternative type of investment: youth programs that are offered during the time that students are not in school. Such programs are often viewed as a mechanism for addressing working parents’ needs for care of their school-age children, for improving the developmental outcomes of youth, and for reducing the gap in academic achievement between advantaged youth and disadvantaged youth. At this time, the evidence of evaluations of such programs, all of which were geared to at-risk youths, is strongest for programs that are costlier and provide more-intense resources to youth.
April 8, 2008
This Postsecondary Education Descriptive Analysis Report uses data from the National Postsecondary Student Aid Studies (NPSAS:96, NPSAS:2000 and NPSAS:04) to examine trends in Stafford loan borrowing among undergraduates. Since 1995-96, borrowing of subsidized Stafford loans increased among low-income dependent undergraduates and among independent students at all income levels. The rate of borrowing any Stafford loan (subsidized or unsubsidized) increased among all but those in the lowest income category, for both dependent and independent undergraduates alike. While the average amount of subsidized loans has leveled off over time, unsubsidized loans have continued to grow both in the amount of the average loan as well as in the percentage of borrowers. Unlike subsidized loans, interest on an unsubsidized loan accrues and is usually added to the principal of the loan while the student is enrolled in school and not yet in repayment. This study found that between 1995-96 and 2003-04, an increasing proportion of both dependent and independent student borrowers at all income levels took out unsubsidized loans either alone or in addition to their subsidized loans. This was true particularly among independent students whose higher loan limits allow more of them to take out both types of loans. The Stafford loan program permits dependent students to take out both subsidized and unsubsidized loans, but the combined amount cannot exceed the maximum amount of a single loan. In 2003-04, about three-fourths (73 percent) of all dependent student borrowers took out the annual maximum amount allowed in subsidized and unsubsidized Stafford loans combined. This was an increase from 57 percent in 1995-96.
Aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone are atypical antipsychotics approved by the U.S. Food and Drug Administration (FDA) for treatment of schizophrenia and bipolar disorder. These drugs have been studied for off-label use in the following conditions: dementia and severe geriatric agitation, depression, obsessive-compulsive disorder, posttraumatic stress disorder, and personality disorders. The atypicals have also been studied for the management of Tourette's syndrome and autism in children. The purpose of this report is to review the scientific evidence on the safety and effectiveness of such off-label uses.
For FY07, there were 2,688 total reports of sexual assault involving Military Service Members
Overall, this survey found that Head Start programs lack the funding to serve young children and families as Head Start’s founders had intended. Head Start programs throughout the country are hampered. Reduced funding is preventing Head Start programs from reaching their full potential and limiting their impacts on children and families. According to many Head Start directors, they are “hanging on by a thread.” To just survive, programs are being forced to eliminate their planning time and limit their scope of services, including a reduction in individualized services. This survey revealed many negative impacts on service delivery, training and professional development, staffing. These impacts on Head Start programs are exacerbated by many of requirements imposed by the federal government under the Improving Head Start for School Readiness Act of 2007 and other federal, state, and local unfunded mandates. This survey also found budget cuts to state and local social welfare and/or human service programs are affecting Head Start programs.
According to a new study, regulatory warnings which cautioned that initiating antidepressants could potentially increase suicidal thoughts and behavior in children and adolescents led to fewer new pediatric prescriptions of antidepressants in 2004 and 2005. Two regulatory agencies, the United Kingdom (UK) Committee on Safety of Medicines (CSM) and the U.S. Food and Drug Administration issued the warnings in late 2003 and 2004.
One expected benefit of moving poor families from the concentrated poverty of some inner city neighborhoods to better, less poor neighborhoods, was that the children would attend better schools, with more resources and more advantaged peers who might be models for hard work and higher achievement. This brief looks at the schools MTO children attended after their move, how they did or did not differ from the schools in their pre-move neighborhoods, and what factors mattered to families choosing schools for their children.
Depressive disorders such as major depressive disorder (MDD), dysthymia, and subsyndromal depression (including minor depression) may be serious disabling illnesses. MDD is the most prevalent, affecting more than 16 percent (lifetime) of U.S. adults. In 2000, the U.S. economic burden of depressive disorders was estimated to be $83.1 billion. More than 30 percent of these costs are attributable to direct medical expenses.
April 7, 2008
The Medicare Part D drug plans (PDPs) provide nursing home residents with reasonably broad coverage across different drug classes, with minimal prior authorization requirements. However, a minority of PDPs are less generous, and some drug formulations important to nursing home residents are covered less well, note the Harvard Medical School researchers. Using national data that reflect initial coverage in Part D, they analyzed PDP formularies and utilization management practices across several categories of drugs commonly used by nursing home residents and older people. They focused on PDPs to which individuals dually eligible for both Medicaid and Medicare could be auto-assigned (those with premiums at or below regional benchmarks). PDPs are required to cover at least two drugs in each therapeutic class. However, they must cover all drugs in six "protected" classes, such as antidepressants, antipsychotics, and HIV-related drugs.
Results: 12,882 seniors initiated conventional APM therapy and 24,359 atypical APMs. Within the first 180 days of use, 1,822 patients (14.1%) who initiated treatment with conventional APMs died, compared with 2,337 patients (9.6%) who initiated treatment with atypical APMs (unadjusted mortality ratio = 1.47; 95% confidence interval: 1.39 – 1.56). Multivariable adjustment resulted in a 180-day mortality ratio (MR) of 1.32 (1.23-1.42). The increase in mortality was highest in users of haloperidol (MR = 2.14; 95% CI: 1.86 to 2.45) but lower for loxapine (MR = 1.29; 95% CI: 1.19 to 1.40).The greatest mortality increase occurred with use of higher (> median) conventional APM dosages (MR=1.67; 1.50-1.86) and during the first 40 days after initiation (MR=1.60; 1.42-1.80). Results were confirmed in propensity score analyses and instrumental variables estimation adjusting for unmeasured confounders.
Conclusions. Elderly patients using conventional APMs are at no lower risk of mortality than those using atypical APMs. The observed 32% increased mortality risk of conventional APMs is unlikely to be explained by confounding.
Energy-related expenditures include spending for utilities and fuel to operate, heat, and cool homes and spending for gasoline and motor oil for private transportation. Energy prices to consumers have increased 70% between 2000 and 2007, driven largely by growth in prices for energy commodities such as petroleum. Petroleum-based products such as fuel oil, propane and gasoline comprise about 50% of household energy expenditures. Older Americans are disproportionately affected by higher energy costs. As a share of income, households headed by a person age 65 or older spend more on energy-related expenditures than their younger counterparts. In addition, low-income households (those with less than $15,000 in household income) spent nearly 20% of their household income on energy-related expenditures in 2006 (the latest year for which data are available). This compares to 7.3% spent by older households with incomes above $15,000. These estimates are for 2006 and do not reflect the additional 17% increase in energy prices that occurred in 2007. The key public program that provides energy assistance to low-income households is the Low-Income Home Energy Assistance Program (LIHEAP). Approximately 40% of low-income households that were eligible for LIHEAP have a household member aged 60 or older. Funding for the LIHEAP Program has not kept pace with recent increases in energy costs of older Americans. This report will explore the burden of rising energy costs on older Americans and discuss implications for public policies. This report will be updated when new data is released.
Since the 1960s there has been a mass exodus of patients from public psychiatric
hospitals. Data are available on the number of patients in such hospitals in 1955 and in 2004–
2005. The data show that:
• In 2005 there were 17 public psychiatric beds available per 100,000 population compared
to 340 per 100,000 in 1955. Thus, 95 percent of the beds available in 1955 were no
longer available in 2005.
• The states with the fewest beds were Nevada (5.1 per 100,000), Arizona (5.9), Arkansas
(6.7), Iowa (8.1), Vermont (8.9), and Michigan (9.9). The states with the most beds were
South Dakota (40.3) and Mississippi (49.7).
• A consensus of experts polled for this report suggests that 50 public psychiatric beds per
100,000 population is a minimum number. Thus, 42 of the 50 states had less than half the
minimum number needed, and Mississippi was the only state to achieve this goal.
We all know the life chances of children are vastly improved when they are the top priority of supportive families and communities. Most American children live in such secure environments and sail into young adulthood physically and emotionally healthy, becoming productive members of society. But while all states provide a basic network of social programs to assist vulnerable children and families, children do much better in some states than in others. As the sorry numbers in this report show, a huge gap exists among states on a wide variety of child well-being indicators. The state they live in should not adversely influence the life and death of children—but it does. Such inequalities affect all Americans, rich and poor alike, and weaken both our economy and our democracy.
About 20,000 youth "age out" of the foster care system each year, without being reunited with families. Many of these youth become homeless for a time. For example, 40 percent of homeless young adults (18 to 20 years old) were in the foster care system as youth. Being homeless for an average of a month after leaving the foster care system is associated with worse care access, but not worse health, according to a new study.
The Moving to Opportunity program targeted families living in some of the nation's poorest, highest-crime neighborhoods and offered them a chance to move to lower poverty areas. One hope was that, away from concentrated poverty and the risks associated with it–including poor physical and mental health, risky sexual behavior and delinquency–families would fare better. This brief examines how adolescent girls benefited from moving out of high poverty and discusses why girls might have fared so much better than boys.
Aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone are atypical antipsychotics approved by the U.S. Food and Drug Administration (FDA) for treatment of schizophrenia and bipolar disorder. These drugs have been studied for off-label use in the following conditions: dementia and severe geriatric agitation, depression, obsessive-compulsive disorder, posttraumatic stress disorder, and personality disorders. The atypicals have also been studied for the management of Tourette's syndrome and autism in children. The purpose of this report is to review the scientific evidence on the safety and effectiveness of such off-label uses.
April 4, 2008
This document outlines the values and ethics underpinning the social work task. It offers to social workers a definition of their task and a set of principles to provide a reference point in guiding day-to-day decision making. The definition of social work is centred on the social context of people's lives and the right of individuals to make decisions for themselves. Because social work often operates on the edge of the individual's normal social functioning, or the limits that social systems can tolerate, there can be a tension between the social control, social care, social justice and social change functions of social work. This tension may be resolved by consideration of what is right or wrong; what is good or bad; or the impact on the individual's happiness - all as determined by the service user, or by reference to a professional standard. Difficulties in resolving this tension may arise where a social worker has to balance the rights and needs of the service user, the sometimes contradictory rights and needs of others, the rights and duties owed to colleagues and other professionals and the limited resources available. However, any decision made must be respectful of a service user's overriding right to know and challenge the basis on which the decision was made. It is expected, therefore, that social workers will use this Code of Ethics as a foundation on which to frame procedures guiding day-to-day practice. It is designed to be applied in working with individuals, in groups, or within communities. Similarly, in emphasising the professional nature of social work, it respects and encourages the worker's own judgements which are a fundamental part of the social work task.
The study provides important insights into policing practices and draws out implications for policy development, ahead of the Government’s new drugs strategy which will be launched in 2008. The report:
- describes the organisation of street policing of problem drug users;
- examines the nature and purpose of street encounters between the police and drug users;
analyses drug users’ experiences of policing; and
- considers the implications of street policing for drug users and local communities.
The researchers worked with three police forces in England and Wales, interviewing police officers and problem drug users, professionals at drug agencies and local councils.
• Treatments demonstrated effective in laboratory settings are not routinely adopted in practice
• Models are critical to guide dissemination science
• Stage model has guided dissemination in drug abuse, but has shown limitations for behavioral treatments
• A model drawn from outside biomedical science offers a promising alternative
• Methodological innovations are needed that balance scientific rigor and policy relevance
This Report Card provides a comprehensive assessment of the lives and well-being of children and young people in 21 nations of the industrialized world. Its purpose is to encourage monitoring, to permit comparison, and to stimulate the discussion and development of policies to improve children's lives. The report represents a significant advance on previous titles in this series which have used income poverty as a proxy measure for overall child well-being in the OECD countries. Specifically, it attempts to measure and compare child well-being under six different headings or dimensions: material well-being, health and safety, education, peer and family relationships, behaviours and risks, and young people's own subjective sense of well-being. The United Kingdom and the United States find themselves in the bottom third of the rankings for five of the six dimensions reviewed. In all, the report draws upon 40 separate indicators relevant to children's lives and children's rights.
The Children’s Court Initiative (CCI) is a comprehensive, ongoing collaborative project created by the Director of State Courts Office, Children’s Court Improvement Program designed to strengthen court processing in Chapter 48 cases. The mission of CCI is to assist the court system and those providing services to it in achieving safety, permanency, due process, and timeliness outcomes for children and families in child welfare proceedings. CCI works in partnership with the Division of Children and Family Services and its Continuous Quality Improvement (CQI) program. The goal of CQI is to improve child welfare practice. CQI staff review agency child welfare case files and conduct in-depth interviews about the specific cases they are reviewing. When schedules permit, CCI and CQI staffs travel in unison to conduct simultaneous reviews of the same counties to minimize disruption and duplication.
This paper, which represents the first phase of the Evan B. Donaldson Adoption Institute’s Adoptive Parent Preparation Project, outlines the basic principles, key issues, methods, and content areas forming best-practice standards regarding the preparation and education of adoptive parents. This phase focuses on preparing adoptive parents to better understand and manage the mental health, developmental, and parenting issues about which all adoptive parents should be educated, as well as those issues more relevant to specific types of adoptions. The information in this paper should be viewed as a roadmap for the development of specific curricula for professionals to use in preparing and educating adoptive parents in a wide range of content areas.
This review was commissioned to better understand the effectiveness of floating support services, and the balance needed between floating support and accommodation-based services in order to improve service delivery and choice and control for service users.
This report recommends some immediate easy wins, such as ensuring that NHS Direct provides links to volunteering opportunities to boost recruitment. But if the Government is really serious about wanting to improve health and social care services through the involvement of volunteers, a much longer term cultural change will be needed. The message needs to be communicated both to statutory providers and to commissioners that volunteers do not present an unnecessary risk and that they can really add value. But that is only true if they are invested in seriously and managed properly. This report lists many ways in which the culture could be changed. I have included recommendations around the implementation of employee volunteering schemes, training and information being available to commissioners and the encouragement of in-house ‘volunteer hubs’. But if all these recommendations are to be taken seriously and driven through, a programme board needs to be established, probably in the Department of Health, to oversee the implementation of the recommendations and to examine further ways of expanding volunteering in health and social care. The increased role of volunteers in the public services has been controversial among some groups. There is a suspicion among trade unions for example, that the only motivation for the increased role of volunteers is cost-cutting and job substitution. This should never be the case. The Government must be clear about that. Instead it is about helping to create services that are people centred. Besides, good management that brings about the best outcomes for volunteers, staff and service-users does not come cheaply – this is not a cost cutting measure.
April 3, 2008
One in three teens will experience some form of abuse in a dating relationship. Teens who suffer from abusive relationships exhibit increased rates of substance abuse, high-risk sexual behaviors, eating disorders and suicidality. Teen victims are substantially more likely than classmates to bring weapons to school and three times as likely to be involved in a physical fight. Sadly, teens face overwhelming obstacles to getting help such as limited access to basic securities like money, shelter and transportation. Exacerbating the barriers for teens are the widespread statutory restrictions that exist because so few states recognize teens as victims of domestic abuse. In fact, teens experience abuse at extremely high rates and young women between the ages of 16 and 24 exhibit the highest rates of abuse—above any other age group. To call attention to this critical situation, Break the Cycle set out to assess the climate of each state’s civil domestic violence restraining order laws and their impact on teens seeking protection from abusive relationships. Initially, the aim of the research was to compile an up to date single location of this state-by-state information for teens and those who care about them.
The RE-AIM Model for Planning, Evaluation and Reporting on Implementation and Dissemination Research
- Challllenges to Success in Implementatiion and Dissemination
- Basics of RE-AIM and Key Issues Addressed by RE-AIM Model
- Current and Future Applicatiions of RE-AIM
Strategies to connect policy, practice and research
Challenge of change
CTN and Blending Products
Advancing Recovery
Goal is persistent improvement
The study was conducted in four states, Arizona, Massachusetts, Minnesota, and Tennessee, using three methods of data collection—interviews with child welfare administrators, case-level data collection through interviews with caseworkers, and data linkage between child welfare and child support systems. Of the three components, only the case-level data collected through interviews with caseworkers was contributed to the Archive. Investigators interviewed local agency caseworkers about particular cases between October 2004 and February 2005 to examine front-line practices related to nonresident fathers. Cases were selected from among children who had been in foster care for at least 3 months but no more than 36 months. Children in the sample were all in foster care for the first time (first placement episode), and the child welfare agency’s records indicated that each of the children’s biological fathers were alive but not living in the home from which the child was removed. Additionally, only one child per mother was eligible for the study. Data on 1,958 eligible cases (83% response rate) were collected through telephone interviews with 1,222 caseworkers. The nonresident fathers of the children sampled represent a varied group. While most caseworkers, at the time of the interview, knew the identity of the fathers of children in the study’s sample (88%), paternity had not yet been established for over one-third of the total sample’s children (37%).
Social work is an established professional discipline with a distinctive part to play in promoting and securing the wellbeing of children, adults, families and communities. It operates within a framework of legislation and government policy, set out in Putting People First and the Children’s Plan, and contributes to the development of social policy, practice and service provision. It collaborates with other social care, health, education and related services to ensure people receive integrated support. It is a profession regulated by law. Social work is committed to enabling every child and adult to fulfil their potential, achieve and maintain independence and self-direction, make choices, take control of their own lives and support arrangements, and exercise their civil and human rights. It looks at people’s lives and circumstances in the round, and works with them to personalise social care responses to fit their own individual situations. Its approaches and working methods aim to promote empowerment and creativity.
This report identifies good practice in personal finance education. It also examines the case for personal finance education being part of the curriculum for all 11-18-year-olds and considers current weaknesses in provision and barriers to future development.
April 2, 2008
Population estimates are one of the major outputs of any National Statistical Office. They are key statistics for a wide range of planning and policy decisions and while population can be simply defined e.g. 'the total number of persons inhabiting a country, town or any district or area' (Macquarie Dictionary, 2005) the concepts associated with its measurement are increasingly complex. In the Australian context the key population measure is the estimated resident population (ERP) which is based on the concept of usual residence. However there are a range of other population concepts that are relevant to different analytical situations. These can include the population in a particular area at a particular time, or, while not entirely consistent with above definition, it can extend to the concept of the population serviced by a particular area. The objectives of this paper are to discuss the range of population concepts, highlight the differences between the various concepts and identify some of the measurement issues associated with the different concepts
A practical guide to commissioning migrant and refugee community organisations (MRCOs) to deliver public services.
This guide reviews the commissioning process, why it should include bodies like MRCOs, what MRCOs are and what they can offer to commissioners of public services. It demonstrates how MRCOs can engage with the commissioning process, asks whether it is the right step for them to take, and suggests what changes in their organisations and capacities might be required. It explores potential commissioning opportunities for MRCOs in eight service areas, including accommodation, Supporting People services, health care and legal advice, and includes over 30 practical examples of service provision.
The goal of this workshop was to explore novel treatment approaches to neurodevelopmental disorders and strategies for promoting the development of innovative therapeutic approaches. As defined in this workshop, neurodevelopmental disorders include attention-deficit hyperactivity disorder (ADHD), autism spectrum disorders, early-onset schizophrenia, childhood-onset obsessive-compulsive disorder (OCD), Tourette syndrome, and single gene developmental disorders, such as Fragile X and velocardiofacial syndrome. Workshop participants included experts in pediatric drug development, psychosocial/ behavioral treatment development for minors and families, cognitive training, interventional neurophysiology, and the use of novel technologies, such as virtual reality and robotics. The following is a summary of major themes discussed.
The purpose of the Fact Book is to provide data annually about the well-being of children in the District of Columbia and to place these statistics within a meaningful context. Ten of the indicators presented were selected by the Annie E. Casey Foundation and the Center for the Study of Social Policy to mirror those reported in the National KIDS COUNT Data Book that the Casey Foundation produces annually. The D.C. KIDS COUNT Collaborative has continued to expand the original list to include additional indicators that are relevant to the District. We encourage suggestions for additions from our readers, which we will try to fill if the needed data are available.
This paper was prepared to provide ideas for a child welfare system faced with a massive, statewide litigation driven reform that encompassed changes in policy, workload, information systems, provider performance, staff training, resource development, front-line practice and child and family outcomes. Attempting to support such massive organizational change across an entire system was proving to be challenging and where change in the quality of practice was concerned, disappointing. The Child Welfare Group, which was in an advisory role, was asked to prepare a background paper on Alabama’s experience in approaching change on a similar scale, in which it approached reform incrementally in groups of counties each year. The following narrative reflects the experience of Paul Vincent, Director of The Child Welfare Policy and Practice Group who was the Alabama child welfare system’s director during its reform implementation and that of several of his colleagues.
A case worker will review all of these rights and expectations with you in person and will be happy to go back over it with you if you wish. Still, many families find it useful to have it all in writing so they can review it later. If you need help understanding anything here, ask. Feel free to go through it with your lawyer or someone you trust.
April 1, 2008
This study explores the ways in which neighbourhood identity is formed and considers the implications for policies that seek to improve and enhance neighbourhoods and communities. Part of the motivation for the study was to explore why regeneration policies often fail in their objectives and how far the reputations of housing estates – 'good' and 'bad' – persist or change over time. The study focused on how such reputations are established and understood by those from within and outside particular places and what implications this has for the identities of neighbourhoods and the individuals who live in them. To explore these issues, the study concentrated on three neighbourhoods in the city of Stirling in central Scotland – Raploch, Riverside and Randolph Road – which were chosen for their distinct socio-economic profiles and differing relative identities. Each was constructed in the 1920s and 1930s as a 'planned community'. Raploch was selected as being the 'poorer' working class neighbourhood, Riverside the 'wealthier' working class one, and Randolph Road middle class and 'aspiring'. The study also explored what it meant to 'come fae' (come from) each of these neighbourhoods as a way of understanding issues of belonging and attachment to particular places.
Collaborations and partnerships between researchers and community health care providers, including clinical practice, school, and public health delivery systems, are important for studying the effectiveness of mental health interventions. Traditional clinical trials conducted in academic settings, although highly successful in answering critical efficacy questions, use selected samples of patients and have limited generalizability. Moreover, their sample size is too small for allowing adequate testing of possible predictors and moderators of treatment effects, take a long time to complete, and are expensive. Hence, it is appropriate to consider practical clinical trials to test treatment effectiveness. Over recent years, NIMH has launched initiatives to stimulate effectiveness research, such as funding dedicated community research networks as part of the NIMH Advanced Centers for Innovation in Services and Intervention Research. This area of investigation, however, remains in an early phase of development.
This study assesses the death penalty's costs to Maryland taxpayers by examining a sample of the 1,136 death-eligible murder cases occurring between 1978 and 1999. We find that an average capital-eligible case in which prosecutors did not seek the death penalty will cost approximately $1.1 million over the lifetime of the case. A capital-eligible case in which prosecutors unsuccessfully sought the death penalty will cost $1.8 million and a capital-eligible case resulting in a death sentence will cost approximately $3 million. In total, we forecast that the lifetime costs to Maryland taxpayers of these capitally-prosecuted cases will be $186 million.
The Commonwealth Fund is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable.
The recruitment, preparation, support, and retention of child welfare staff working with abused and neglected children and their families across the nation are important and ongoing concerns. New federal policy approaches and resources are needed to support a child welfare workforce that is able to deliver high quality services and ensure that children are safe and have the opportunity to grow up in permanent families.
Overall, positive trends were seen for lead agencies over time (2004-2007). Although initially climbing, both number of children served by lead agencies and children placed in out-of home care have decreased from 2006 to 2007. Two indicators were examined specific to child safety: abuse during services and recurrence of maltreatment. During the time period of 2004 to 2007 fewer children were abused during services. Recurrence rates showed fluctuations per quarter, but there was a small decrease over time. Overall, lead agencies achieved targets set by the Department on these two indicators. Six permanency indicators were examined: length of stay (length of time children remaining in care have been in care), children in out- of- home care longer than 12 months, children exiting out-of-home care within 12 months, children reunified within 12 months, adoptions finalized within 24 months, and children in care less than 12 months with three or more placements. Length of stay fluctuated between 11 and 12 months over time, but showed no marked increase or decrease. While the percent of children staying in out-of-home care longer than 12 months decreased during 2006, it has returned to the same level seen in earlier years (48%). One of the most positive trends seen across 2004 to 2006 was that the proportion of children exiting out-of-home care increased by 7% statewide. Reunifications within 12 months slightly fluctuated over time, but remained at 66%, which is below the target set by the Department. However, a positive trend was seen with adoptions increasing from 2004 to 2007 by 14% statewide.