Children\u27s Justice: How to Improve Legal Representation of Children in the Child Welfare System

From 2009 to 2016 the University of Michigan Law School served as the National Quality Improvement Center on the Representation of Children in the Child Welfare System (QIC-ChildRep). This seven-year, multimillion dollar project, directed by Clinical Professor Don Duquette, conducted a national needs assessment that identified a substantial consensus on the role and duties of the child’s lawyer. The needs assessment led to the QIC-ChildRep Best Practice Model, an update and expansion of the 1996 ABA Standards for Lawyers Representing Children in Child Abuse and Neglect Cases. Released in 2016 as a300-page softcover book, CHILDREN\u27S JUSTICE is the final report of the QIC-ChildRep project, guiding the reader through 13 chapters and 3 appendices: Chapter 1: Challenge: Improve Child Representation in America Chapter 2: Evolution of Child Representation Chapter 3: National Needs Assessment Chapter 4: Emerging Consensus and the QIC Best Practice Model Chapter 5: Six Core Skills and the QIC Best Practice Training Chapter 6: What the Lawyers Say About Implementing the Six Core Skills Chapter 7: Sample Selection and Research Methods Chapter 8: Profile of Lawyers Representing Children Chapter 9: Lawyer Activities and Their Impact Chapter 10: Findings of the Evaluation of the QIC-ChildRep Best Practices Model Training for Attorneys Chapter 11: Reflections on QIC Empirical Findings Chapter 12: The Flint MDT Study: A Description and Evaluation of a Multidisciplinary Team Representing Children in Child Welfare Cases Chapter 13: How to Improve Legal Representation of Children in America’s Child Welfare System Appendix A: QIC Best Practice Model of Child Representation in the Child Welfare System Appendix B: 1996 American Bar Association Standards of Practice for Lawyers Who Represent Children in Abuse and Neglect Cases Appendix C: 2011 ABA Model Act Governing Representation of Children in Abuse, Neglect and Dependency Proceedings This product was created by the National Quality Improvement Center on the Representation of Children in the Child Welfare System at the University of Michigan Law School, Cooperative Agreement No. 90CO1047, funded by the Children’s Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.https://repository.law.umich.edu/books/1109/thumbnail.jp

Children\u27s Justice: How to Improve Legal Representation of Children in the Child Welfare System

From 2009 to 2016 the University of Michigan Law School served as the National Quality Improvement Center on the Representation of Children in the Child Welfare System (QIC-ChildRep). This seven-year, multimillion dollar project, directed by Clinical Professor Don Duquette, conducted a national needs assessment that identified a substantial consensus on the role and duties of the child’s lawyer. The needs assessment led to the QIC-ChildRep Best Practice Model, an update and expansion of the 1996 ABA Standards for Lawyers Representing Children in Child Abuse and Neglect Cases. Released in 2016 as a300-page softcover book, CHILDREN\u27S JUSTICE is the final report of the QIC-ChildRep project, guiding the reader through 13 chapters and 3 appendices: Chapter 1: Challenge: Improve Child Representation in America Chapter 2: Evolution of Child Representation Chapter 3: National Needs Assessment Chapter 4: Emerging Consensus and the QIC Best Practice Model Chapter 5: Six Core Skills and the QIC Best Practice Training Chapter 6: What the Lawyers Say About Implementing the Six Core Skills Chapter 7: Sample Selection and Research Methods Chapter 8: Profile of Lawyers Representing Children Chapter 9: Lawyer Activities and Their Impact Chapter 10: Findings of the Evaluation of the QIC-ChildRep Best Practices Model Training for Attorneys Chapter 11: Reflections on QIC Empirical Findings Chapter 12: The Flint MDT Study: A Description and Evaluation of a Multidisciplinary Team Representing Children in Child Welfare Cases Chapter 13: How to Improve Legal Representation of Children in America’s Child Welfare System Appendix A: QIC Best Practice Model of Child Representation in the Child Welfare System Appendix B: 1996 American Bar Association Standards of Practice for Lawyers Who Represent Children in Abuse and Neglect Cases Appendix C: 2011 ABA Model Act Governing Representation of Children in Abuse, Neglect and Dependency Proceedings This product was created by the National Quality Improvement Center on the Representation of Children in the Child Welfare System at the University of Michigan Law School, Cooperative Agreement No. 90CO1047, funded by the Children’s Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.https://repository.law.umich.edu/books/1109/thumbnail.jp

Impaired Sleep Quality in COPD Is Associated With Exacerbations The CanCOLD Cohort Study

BackgroundCOPD increases susceptibility to sleep disturbances, which may in turn predispose to increased respiratory symptoms. The objective of this study was to evaluate, in a population-based sample, the relationship between subjective sleep quality and risk of COPD exacerbations.MethodsData were obtained from the Canadian Cohort Obstructive Lung Disease (CanCOLD) study. Participants with COPD who had completed 18 months of follow-up were included. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and a three-factor analysis. Symptom-based (dyspnea or sputum change ≥ 48 h) and event-based (symptoms plus medication or unscheduled health services use) exacerbations were assessed. Association of PSQI with exacerbation rate was assessed by using negative binomial regression. Exacerbation-free survival was also assessed.ResultsA total of 480 participants with COPD were studied, including 185 with one or more exacerbations during follow-up and 203 with poor baseline sleep quality (PSQI score > 5). Participants with subsequent symptom-based exacerbations had higher median baseline PSQI scores than those without (6.0 [interquartile range, 3.0-8.0] vs 5.0 [interquartile range, 2.0-7.0]; P = .01), and they were more likely to have baseline PSQI scores > 5 (50.3% vs 37.3%; P = .01). Higher PSQI scores were associated with increased symptom-based exacerbation risk (adjusted rate ratio, 1.09; 95% CI, 1.01-1.18; P = .02) and event-based exacerbation risk (adjusted rate ratio, 1.10; 95% CI, 1.00-1.21; P = .048). The association occurred mainly in those with undiagnosed COPD. Strongest associations were with Factor 3 (sleep disturbances and daytime dysfunction). Time to symptom-based exacerbation was shorter in participants with poor sleep quality (adjusted hazard ratio, 1.49; 95% CI, 1.09-2.03).ConclusionsHigher baseline PSQI scores were associated with increased risk of COPD exacerbation over 18 months' prospective follow-up