Peer mentorship to promote effective pain management in adolescents: study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>This protocol is for a study of a new program to improve outcomes in children suffering from chronic pain disorders, such as fibromyalgia, recurrent headache, or recurrent abdominal pain. Although teaching active pain self-management skills through cognitive-behavioral therapy (CBT) or a complementary program such as hypnotherapy or yoga has been shown to improve pain and functioning, children with low expectations of skill-building programs may lack motivation to comply with therapists' recommendations. This study will develop and test a new manualized peer-mentorship program which will provide modeling and reinforcement by peers to other adolescents with chronic pain (the mentored participants). The mentorship program will encourage mentored participants to engage in therapies that promote the learning of pain self-management skills and to support the mentored participants' practice of these skills. The study will examine the feasibility of this intervention for both mentors and mentored participants, and will assess the preliminary effectiveness of this program on mentored participants' pain and functional disability.</p> <p>Methods</p> <p>This protocol will recruit adolescents ages 12-17 with chronic pain and randomly assign them to either peer mentorship or a treatment-as-usual control group. Mentored participants will be matched with peer mentors of similar age (ages 14-18) who have actively participated in various treatment modalities through the UCLA Pediatric Pain Program and have learned to function successfully with a chronic pain disorder. The mentors will present information to mentored participants in a supervised and monitored telephone interaction for 2 months to encourage participation in skill-building programs. The control group will receive usual care but without the mentorship intervention. Mentored and control subjects' pain and functioning will be assessed at 2 months (end of intervention for mentored participants) and at 4 month follow-up to see if improvements persist. Measures of treatment adherence, pain, disability, and anxiety and depression will be assessed throughout study participation. Qualitative interviews for mentors, mentored participants, and control subjects will also be administered.</p> <p>Trial registration</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01118988">NCT01118988</a>.</p

Being a graduate professional in the field of Early Childhood Education and Care: silence, submission and subversion

Recent workforce reform in England has sought to increase opportunities for practitioners who work outside the maintained (school) sector to gain graduate status. Whilst these opportunities have generally been welcomed within the sector, this has created dichotomous tensions for the ECEC workforce. The traditional construction of the ECEC practitioner assumes a lack of educational and social capital [Osgood, J. 2009. “Childcare Workforce Reform in England and ‘the Early Years Professional’: A Critical Discourse Analysis.” Journal of Education Policy 24 (6): 733–751. doi:10.1080/02680930903244557]. Its associated dispositions do not necessarily fit with the alternative construct of the Early Years Professional or Teacher who, through gaining educational capital in the form of a university degree, will be sufficiently equipped to enact the normative and performative discourses which dominate educational and social policy. These tensions serve as the focus for this study, which was concerned with examining how a group of graduate practitioners were endeavouring to broker their competing professional constructs within their own workplace. The research argues for the necessity to establish professional, relational spaces within and across the field of Early Years Education and Care in order to have a greater understanding of the value that all early years professionals can contribute to pedagogical practice

A longitudinal investigation of mothers' mind-related talk to their 12- to 24-month old infants

Children's exposure to mind-related talk has been shown to foster young children's metacognitive understanding and to orient them to the patterns of literate language long before they commence formal literacy instruction at school. In this paper, we report on a longitudinal study of the mind-related talk of 22 mothers when their infants were aged 12, 18 and 24 months. Results revealed broad and stable individual differences in mothers' propensity to use encouragement-of-autonomy, mental-state and modulation-of-certainty talk to their infants during a free play session. Mothers' talk about beliefs increased with infant age, and higher-educated mothers used significantly more mental-state and modulation-of-certainty talk than lower-educated mothers. These findings are discussed in terms of current understandings of the discourse contexts supporting children's developing understanding of the mind, and implications are derived for early childhood pedagogy in settings for children in the first two years of life.14 page(s

Conclusion

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