Achieving Nationhood Through Health Care Delivery: A History of the Relationship between the Indian Health Service and Indian Tribes

By the measure of its mission, the Indian Health Service is one of the most successful and productive government agencies. At the same time, it is an agency often criticized for not achieving enough. Part of this criticism undoubtedly results from the negative effects caused by a chronic lack of funding. Another part of the criticism, however, comes from a deep-seated belief that they agency’s priorities are too deeply intertwined with the federal government’s national policy agenda and are not sufficiently responsive to the needs of those who receive its services. This paper examines both of these criticisms in light of the transformation of the Indian Health Service from a dominating, centralized federal agency to an agency redefining both its cause and its structure in a time of expanding Indian sovereignty. The paper concludes with an analysis of how the Indian Health Service can support the expansion of sovereignty by pursuing policies that do not just mimic national trends, but that instead develop from cooperation and negotiation with tribal “almost-equals.â&euro

Multiple Family Groups to reduce child disruptive behavior difficulties: Moderating effects of child welfare status on child outcomes

Children who remain at home with their permanent caregivers following a child welfare (CW) involvement (e.g., investigation, out-of-home placement) manifest high rates of behavioral difficulties, which is a risk factor for further maltreatment and out-of-home placement if not treated effectively. A recently tested Multiple Family Group (MFG) service delivery model to treat youth Disruptive Behavior Disorders (DBDs) has demonstrated effectiveness in improving child behavior difficulties among hard-to-engage, socioeconomically disadvantaged families by addressing parenting skills, parent-child relationships, family communication and organization, social support, and stress. This exploratory study examines whether child behavioral outcomes for MFG differ for families with self-reported lifetime involvement in CW services compared to other families, as families with CW involvement struggle with additional stressors that can diminish treatment success. Youth (aged 7–11) and their families were assigned to MFG or services as usual (SAU) using a block comparison design. Caregivers reported on child behavior, social skills, and functional impairment. Mixed effects regression modeled multilevel outcomes across 4 assessment points (i.e., baseline, mid-test, post-test, 6 month follow-up). Among CW-involved families, MFG participants reported significantly reduced child oppositional defiant disorder symptoms at 6-month follow-up compared with SAU participants. No other differences were found in the effect of MFG treatment between CW and non-CW involved families. Findings suggest that MFG may be as effective in reducing child behavior difficulties for both CW and non-CW involved families. As a short-term, engaging, and efficient intervention, MFG may be a particularly salient service offering for families involved in the CW system

Sleep health of young adults in Western Australia and associations with physical and mental health: A population-level cross-sectional study

OBJECTIVES: This article aims to report on the sleep health characteristics of a population-level sample of young Australian adults and examine associations with measures of physical and mental health. METHODS: A cross-sectional study using data from the Raine Study. Data from participants (n = 1234) born into the study (Generation 2) at the 22-year follow-up were used, including data from a self-report questionnaire and polysomnography. RESULTS: The highest prevalence of suboptimal sleep health was seen on measures of sleep duration (30%), onset latency (18%), satisfaction (25%) and regularity (60%). Dissatisfaction with sleep (physical health: =0.08; mental health: =0.34) and impaired daytime alertness (physical health: =0.09; mental health: =0.08) were significantly associated with poorer physical and mental health and inadequate polysomnography-measured sleep duration was associated poorer mental health ( =0.07) (all ps \u3c 0.05). CONCLUSIONS: Satisfaction with sleep and daytime alertness, both of which are assessed via self-report, are essential aspects of sleep health for young adults. IMPLICATIONS FOR PUBLIC HEALTH: Findings could inform public health interventions, including screening guidelines, to improve the sleep health and, in turn, the physical and mental health of young adults in Australia

A Grounded Analysis of Player-Described Board Game Immersion

Substantial research has explored the experience of immersion in digital games, but it is unclear whether this phenomenon extends to other game genres such as board games. Immersion is a concept widely discussed in the board game community by both developers and players and yet there is relatively little research in the area. This paper presents a grounded theory analysis of board game players’ online discussions of immersion. This data is augmented by interviews with five board game players describing their experiences of immersion. The resultant analysis highlights that board game players discuss immersion in terms of both engrossment in the challenge of the game, and submergence within the game world the board game creates. We also focus on elements of game play which players reported in helping and hindering their immersion; importantly these elements do not always come from the game itself. We conclude that board game immersion shares similarities with the literature on immersion in digital games, despite the lack of multimedia interactio

Conceptual Model of Autonomous Seed Germination Habitat for Mars Mission

As human space exploration extends to Mars, the ability to germinate seeds in extraterrestrial environments is becoming a necessity. Recent technological feats such as the development of the European Modular Cultivation System (EMCS) have made botany experiments possible on the International Space Station (ISS). Despite preliminary designs, a biocompatible plant life support system capable of traveling to Mars has yet to be developed. This study focuses on two preparatory measures regarding seed germination in spaceflight: analysis of seed dormancy protocols and compact autonomous habitat development.The objective of this project is to conceptualize a habitat capable of preserving arabidopsis plant seeds on a long duration spaceflight for the purpose of germinating the first plants on Mars. The proposed container will require a compact, low wattage system to provide gas ventilation, artificial light, and water. A visualization system will also need to be developed in order to monitor seed germination remotely. In order to test the effects of dormancy durations on plant viability, we will conduct a ground study to monitor seed germination in seeds which have been dormant for three, six, nine, and twelve months. We will also compare the effects of different sterilization procedures. The results of this study will be instrumental in developing a viable procedure for transferring the first living plants to Mars