Perinatal suicidal ideation and behaviour: psychiatry and adversity

Pregnant women are at increased risk for suicidal ideation and behaviours (SIB) compared to the general population. To date, studies have focused on the psychiatric correlates of SIB with lesser attention given to the associated contextual risk factors, particularly in low- and middle-income countries. We investigated the prevalence and associated psychiatric and socio-economic contextual factors for SIB among pregnant women living in low resource communities in South Africa. Three hundred seventy-six pregnant women were evaluated using a range of tools to collect data on socio-economic and demographic factors, social support, life events, interpersonal violence and mental health diagnoses. We examined the significant risk factors for SIB using univariate, bivariate and logistic regression analyses (p ≤ 0.05). The 1-month prevalence of SIB was 18%. SIB was associated with psychiatric illness, notably major depressive episode (MDE) and any anxiety disorder. However, 67% of pregnant women with SIB had no MDE diagnosis, and 65% had no anxiety disorder, while 54% had neither MDE nor anxiety disorder diagnoses. Factors associated with SIB included lower socio-economic status, food insecurity, interpersonal violence, multiparousity, and lifetime suicide attempt. These findings focus attention on the importance of socio-economic and contextual factors in the aetiology of SIB and lend support to the idea that suicide risk should be assessed independently of depression and anxiety among pregnant women

An Exploratory Analysis: A Mixed-Methods Investigation Of The Construct Validity Of The 2016 Mississippi Statewide Accountability System

Abstract: the purpose of this research project was to conduct an exploratory analysis of the 2016 Mississippi Statewide Accountability System (MSAS), which is the model by which all public school in Mississippi are assessed, rated, and ranked, in an attempt to assess whether or not the system is an effective policy tool, especially in relation to the goals associated with its development and implementation. The study was conducted in three distinct sections: phase one analyzed the model itself and all associated documents, while the researcher also conducted interviews with several individuals with knowledge of the development of the system to establish the goals for implementation. Phase two was a quantitative analysis of the 2015-2016 MSAS to identify if there were any issues of construct validity revealed in the results, primarily looking at the top-15 and bottom-15 districts in the state. Phase three consisted of one-on-one interviews with community members in six school districts across Mississippi, three from the top-15 group and three from the bottom-15 group, in hopes of identifying the perception surrounding the accountability model and whether or not it had any impact on the local communities being served. While phase one revealed implementation goals centered on themes of simplification and improvement, phase two highlighted several issues of construct validity across the various components being measured, and phase three revealed stakeholder perceptions centered on themes of knowledge of the accountability system, which was extremely limited, and impact of the accountability grades on the local community, which was unanimously perceived to be a direct link. Overall, as the MSAS was developed to provide parents and community members with relatable information about the performance of their local schools and guide improvement, the results of this study appear to prove the model is an ineffective policy tool, as a lack of knowledge of the system and its intricacies is widespread and the components being measured raise several validity issues, which leave room for potential inequities in the education system, especially for areas stricken by widespread poverty. In spite of these issues with the model, community members across the state see the potential impact a school or district\u27s accountability grade has on the local community and it is therefore necessary for the Mississippi legislature, the Mississippi department of education, educators, and community stakeholders to re-convene and further discuss the issue of accountability and how best to move the state\u27s public education system forward to promote student achievement and community development

Building Quality Improvement Systems: Lessons from Three Emerging Efforts in the Youth-Serving Sector

Quality is fast becoming a policy priority in states and localities around the country. As a result, formal and informal networks of youth organizations are seeking and developing strategies to help them assess and improve performance. This report takes a close look at efforts underway in three networks and provides a preliminary framework for thinking about key questions when planning any kind of program quality improvement work in the youth-serving sector

Student Perceptions Of Digital Resources And Digital Technology In A Flipped Classroom

ABSTRACT The purpose of this study was to analyze student perceptions of flipped classroom instruction strategies, and student perceptions of their learning experience using digital resources and digital technology in a flipped classroom. Although perceptions are important, student achievement is a common tool used by policy-makers and judged by the general public as a means to evaluate and achieve continuous improvement in K-12 public education. This case study may be a beneficial illustration for school administrator practitioners to consider prior to implementation or utilization of flipped classroom instructional strategies. The study provides a review of a high school that first implemented a flipped classroom in 2010-2011. The study may create a general framework and provide insight to guide practitioners of the benefits, short-comings, and types of technology challenges encountered when considering implementing a flipped classroom instructional strategy in their school(s). The variables within this study were student perceptions of their learning experiences in a flipped classroom, student performance based on pre-existing survey results from students, state assessment results from Minnesota Comprehensive Assessments (MCAs), and assessment results from ACT® tests. This mixed method case study focused on one rural Minnesota school and was designed to seek answers to the following research questions: 1. What are high school student perceptions of the flipped classroom as a classroom instructional strategy? 2. What are high school student perceptions of their learning experiences using digital resources and digital technology in a flipped classroom? 3. What effect does the use of digital resources and digital technology within a flipped classroom environment have on student achievement based on common assessments such as the Minnesota Comprehensive Assessments (MCAs) and college entrance exams such as ACT® tests? The researcher approached this problem as an administrator looking for new teaching strategies to help schools in his own district improve student outcomes. The results of the data collected and analyzed indicated students had a favorable perception of the flipped classroom instructional strategy used by classroom teachers. Evidence within the study also indicated students had a favorable perception of the type of digital technologies used and available in a flipped classroom instructional strategy. Evidence of student achievement data based on Minnesota Comprehensive Assessments (MCAs) and the ACT® college entrance exam indicated the grade levels of students in the case study was above state of Minnesota average grade levels prior to implementation of a flipped classroom instruction strategy and continued at a higher level of achievement in the transition from a traditional lecture classroom instructional strategy to a flipped classroom instructional strategy. There was no evidence of regression of achievement with implementation of the flipped classroom instructional strategy

Gamification Kit: Käytännöllinen työkalu käyttäjälähtöisen pelillistämisen suunnitteluun

The use of game elements in non-game contexts can increase user engagement, which makes applying gamification principles to all kinds of services attractive. However, designing user-centered gamification is easier said than done. It is not enough to apply points and leaderboards to a service for it to become successfully gamified. Gamification design needs to be user-centered to create meaningful gamified experiences for the users. This thesis conducts a design science research that studies what kind of a tool can aid user-centered gamification design process. The outcome of this study is Gamification Kit – a practical toolkit that brings user-centeredness to gamification design. The toolkit is evaluated in a case study, where it is used to gamify an existing service. Based on this study, the Gamification Kit simplifies the complex process of gamification design and ensures that user-centeredness is considered in gamification. The toolkit is especially focusing on increasing the intrinsic motivation of the users towards the service. The Gamification Kit divides the design process of gamification into three phases – gamification applicability, ideation and validation. The applicability phase discusses if gamification should be applied to a specific service. It evaluates if the service contains aspects that are required for user-centered gamification, and identifies the main user emotions related to the use of the service. In the ideation phase, gamification activity loops, which consist of challenge, feedback and reward, are created. These activity loops can be used to create initial gamification concepts. In the validation phase, the intrinsic motivation of the gamification concept is validated by evaluating the presence of the intrinsic motivation drivers in the concept – meaning, mastery, autonomy and relatedness. The Gamification Kit is still in its early stage of development. The results of this study however indicate that the Gamification Kit can be used to aid the design of user-centered gamification in the study context. However, future research is needed for more generalizable results.Pelielementtien käyttö palveluissa voi sitouttaa asiakkaita, mikä tekee pelillisten ominaisuuksien käytön niissä houkuttelevaksi. Käyttäjälähtöisen pelillistämisen suunnittelu ei kuitenkaan ole yksinkertaista. Pisteiden ja tulostaulujen lisääminen palveluun ei tee siitä onnistuneesti pelillistettyä. Pelillistämisen suunnittelun täytyy olla käyttäjälähtöistä, jotta pelilliset kokemukset voidaan tehdä merkityksellisiksi käyttäjille. Tämä diplomityö käyttää design science research –menetelmää ja tutkii, minkälainen työkalu voi auttaa käyttäjälähtöistä pelillistämisprosessia. Tutkimuksen tulos on Gamification Kit – käytännöllinen työkalu, joka tuo käyttäjälähtöisyyden pelillistämisen suunnitteluun. Tämä tutkimus arvioi työkalua case study –menetelmällä, käyttäen sitä projektissa, jossa pelillistetään olemassa oleva palvelu. Tutkimuksen perusteella Gamification Kit yksinkertaistaa kompleksista pelillistämisen suunnitteluprosessia ja varmistaa, että käyttäjälähtöisyys otetaan huomioon pelillistämisessä. Työkalu keskittyy erityisesti kasvattamaan käyttäjän sisäistä motivaatiota palvelun käyttöä kohtaan. Gamification Kit jakaa pelillistämisen suunnitteluprosessin kolmeen vaiheeseen – pelillistämisen soveltuvuus, ideointi ja validointi. Soveltuvuusvaihe tarkastelee tulisiko pelillistämistä liittää tutkittavaan palveluun arvioimalla sisältääkö palvelu ominaisuuksia, joita käyttäjälähtöiseen pelillistämiseen tarvitaan. Lisäksi se tunnistaa tärkeimmät tunnetilat, jotka liittyvät palvelun käyttöön. Ideointivaiheessa luodaan pelillistämisen aktiivisuusluuppeja, jotka koostuvat haasteesta, palautteesta ja palkinnosta. Näiden avulla voidaan luoda alustavia pelillistämiskonsepteja. Validointivaiheessa pelillistämiskonseptin sisäisen motivaation lähteitä validoidaan. Tämä tehdään arvioimalla, kuinka hyvin sisäisen motivaation tekijät - merkitys, taituruus, autonomia ja suhde – ovat läsnä pelillistämiskonseptissa. Gamification Kit on vielä kehitystyönsä alussa. Tämän tutkimuksen tulokset kuitenkin osoittavat, että sitä voidaan käyttää apuna käyttäjälähtöisen pelillistämisen suunnittelussa tutkimuksen kontekstissa. Jatkotutkimusta kuitenkin tarvitaan, jotta tulokset olisivat yleistettävissä muihin käyttötilanteisiin

Assessing the Risk of 100-year Freshwater Floods in the Lamprey River Watershed of New Hampshire Resulting from Changes in Climate and Land Use

What is the coastal resource issue the project sought to address? Both the magnitude and frequency of freshwater flooding is on the rise in seacoast NH and around much of New England. In the Great Bay watershed, this is the result of two primary causes: 1) increases in impervious surface stemming from a three-to-four fold increase in developed land since 1962; and 2) changing rainfall patterns in part exemplified by a doubling in the frequency of extreme weather events that drop more than 4 inches of precipitation in less than 48 hours (Wake et al., 2011) over the same time period. Moreover, the size of the 100-year precipitation event in this region has increased 26% from 6.3 inches to 8.5 inches from the mid 1950’s to 2010 (NRCC and NRCS, 2012). One consequence is the occurrence of three 100-year floods measured on the Lamprey River at Packers Falls since 1987, and a fourth if the three days of flooding in March of 2010 had occurred instead in two days (Figure 1). Flooding events are expected to continue to increase in magnitude and frequency as land in the watershed is further developed and climate continues to change in response to anthropogenic forcing (e.g., Hayhoe et el., 2007; IPCC, 2007; Karl et al., 2009). Land use management strategies, in particular low impact development (LID) zoning requirements, are one strategy that communities can employ for increased resiliency to flooding with the greatest influence in urban environments

Assessing the Risk of 100-year Freshwater Floods in the Lamprey River Watershed of New Hampshire Resulting from Changes in Climate and Land Use

What is the coastal resource issue the project sought to address? Both the magnitude and frequency of freshwater flooding is on the rise in seacoast NH and around much of New England. In the Great Bay watershed, this is the result of two primary causes: 1) increases in impervious surface stemming from a three-to-four fold increase in developed land since 1962; and 2) changing rainfall patterns in part exemplified by a doubling in the frequency of extreme weather events that drop more than 4 inches of precipitation in less than 48 hours (Wake et al., 2011) over the same time period. Moreover, the size of the 100-year precipitation event in this region has increased 26% from 6.3 inches to 8.5 inches from the mid 1950’s to 2010 (NRCC and NRCS, 2012). One consequence is the occurrence of three 100-year floods measured on the Lamprey River at Packers Falls since 1987, and a fourth if the three days of flooding in March of 2010 had occurred instead in two days (Figure 1). Flooding events are expected to continue to increase in magnitude and frequency as land in the watershed is further developed and climate continues to change in response to anthropogenic forcing (e.g., Hayhoe et el., 2007; IPCC, 2007; Karl et al., 2009). Land use management strategies, in particular low impact development (LID) zoning requirements, are one strategy that communities can employ for increased resiliency to flooding with the greatest influence in urban environments

Conducting high-quality, culturally-appropriate primary healthcare research with Aboriginal and Torres Strait Islander peoples

Health research should inform culturally-appropriate, evidence-based primary healthcare (PHC), potentially enhancing social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) Peoples. When conducting such research, scientific and ethical quality should be forefront. Aim To identify approaches and enablers to conducting high-quality, culturally-appropriate Indigenous-focused SEWB PHC research. Methods This thesis comprises three sections: firstly, two systematic reviews of the Indigenous-focused SEWB PHC research literature; secondly, an in-depth critical and reflective case study of an Indigenous-focused SEWB PHC research project entitled Getting it Right: the validation study (hereafter referred to as Getting it Right); finally, a process evaluation of Getting it Right using a grounded theory approach. Results Twenty-five research projects were included in the systematic reviews. Two were judged as high quality using scientific and ethical criteria. Research projects that were judged as ethical used culturally-sensitive approaches, focused on developing relationships and involved community members. These approaches also appeared to enable this research. Getting it Right had an adaptive protocol (where localised approaches were developed within certain requirements) and PHC services were reimbursed on a per participant basis. The research was evaluated as meeting scientific and ethical quality criteria. The process evaluation showed that the research was acceptable to most participating staff (n=36), community members (n=4) and participants (n=500). Many were willing to participate in research and speak about SEWB. Staff reported that the reimbursement provided to the service sufficiently resourced the research. Conclusion High-quality, culturally-appropriate Indigenous-focused SEWB PHC research can be facilitated by culturally-sensitive, flexible, collaborative and sufficiently-funded approaches

The psychological impact of trauma on preschool children and their parents

Aims: The aim of this thesis portfolio was to examine the psychological impact of experiencing a traumatic event in young children and parents. Factors that may predict an individual’s psychological response following a traumatic event were also explored. Design: This portfolio contains two main papers and supporting chapters. The first paper, a meta-analysis, reviewed the prevalence of post-traumatic stress disorder (PTSD) in preschool-aged children. The second paper, an empirical study, examined the impact of a child’s admission to a Paediatric Intensive Care Unit (PICU) on parents. In both papers, factors contributing to higher emotional distress were explored. The additional chapters include further information and an overall discussion and critical review. Results: The meta-analysis revealed that a significant minority of preschool-aged children met the diagnostic threshold for PTSD following direct exposure to trauma. The empirical paper indicated a high prevalence of parents who were vulnerable to future psychological distress (PTSD and depression) following their child’s PICU admission. Pre-trauma factors, including pre-existing mental health difficulties, and peri-trauma appraisals strongly predicted parent vulnerability to psychological distress. These factors predicted parental vulnerability over and above medical severity markers. Conclusions: Children under six years old can develop PTSD, with similar prevalence trends to older children following different trauma types. It is therefore important for clinicians to be aware of symptoms in young children, and for appropriate interventions to be developed. A high proportion of parents of are at risk of developing longer-term psychological distress following their child’s PICU admission. Importantly, pre-trauma psychological factors, and peri-trauma appraisals, predict parental psychological vulnerability. The importance of applying appropriate diagnostic criteria, and using screening measures to identify individuals are discussed. Early identification can trigger support that will likely benefit both the individual and their family