Foster Care and Disconnected Youth: A Way Forward for New York

On December 1, 2011, the Community Service Society of New York and The Children's Aid Society convened over 200 local and national experts, policymakers, service providers, and advocates to discuss the issues faced by older youth in foster care and strategies to prevent and address their disconnection from anchor social institutions like school, work, and family. This report highlights and further develops the issues raised at the forum, recommends policy directions, and discusses successful program models that address the many challenges facing aging-out youth who become disconnected. Evidence suggests that after aging out of foster care, these young adults have particularly poor chances of becoming successful adults . Between the ages of 16 and 24, many have been homeless more than once . Many have experienced trauma and show signs of depression, behavior problems, and/or emotional difficulties. They are more likely than their peers to get pregnant or become parents. Those who are LGBTQ are often targets of discrimination . All are less likely to reach educational milestones, less likely to be employed, and more likely to rely on public benefit programs. Much can be done to prevent the hardships that aging out of foster care often brings, so that all are "connected by 25"—meaning they have achieved their educational objectives, established connections to employment, and have strong family relationships and stable housing, with the goal that every young person in foster care will develop and reach his or her full potential. These youth can be helped with effective programs that take a comprehensiveapproach, using a strategic combination of services, job training, and employment, along with alternative education options and skills training. Such programs exist, but there are not enough of them, and they lack funding, even though they demonstrate success and represent significant savings over the long-term

Preliminary Assessment of Potential Habitat Composites' Durability when Exposed to a Long-Term Radiation Environment and Micrometeoroid Impacts

NASA's exploration goals include extending human presence beyond low earth orbit (LEO). As a result, habitation for crew is a critical requirement for meeting this goal. However, habitats are very large structures that contain a multitude of subsystems to sustain human life over long-durations in space, and one of the key challenges has been keeping weight to a minimum in order to reduce costs. Thus, light-weight and multifunctional structural materials are of great interest for habitation. NASA has started studying polymeric composite materials as potential lightweight and multifunctional structural materials for use in long-duration spaceflight. However, little is known about the survivability of these materials when exposed to the space environment outside of LEO for long durations. Thus, a study has been undertaken to investigate the durability of composite materials when exposed to long-duration radiation. Furthermore, as an addition to the primary study, a secondary preliminary investigation has been started on the micrometeoroid and orbital debris (MMOD) susceptibility of these materials after radiation exposure. The combined effects of radiation and MMOD impacts are the focus of this paper

Analysis of International Space Station Vehicle Materials on MISSE 6

The International Space Station Materials and Processes team has multiple material samples on MISSE 6, 7 and 8 to observe Low Earth Orbit (LEO) environmental effects on Space Station materials. Optical properties, thickness/mass loss, surface elemental analysis, visual and microscopic analysis for surface change are some of the techniques employed in this investigation. Results for the following MISSE 6 samples materials will be presented: deionized water sealed anodized aluminum; Hyzod(tm) polycarbonate used to temporarily protect ISS windows; Russian quartz window material; Beta Cloth with Teflon(tm) reformulated without perfluorooctanoic acid (PFOA), and electroless nickel. Discussion for current and future MISSE materials experiments will be presented. MISSE 7 samples are: more deionized water sealed anodized aluminum, including Photofoil(tm); indium tin oxide (ITO) over-coated Kapton(tm) used as thermo-optical surfaces; mechanically scribed tin-plated beryllium-copper samples for "tin pest" growth (alpha/beta transformation); and beta cloth backed with a black coating rather than aluminization. MISSE 8 samples are: exposed "scrim cloth" (fiberglass weave) from the ISS solar array wing material, protective fiberglass tapes and sleeve materials, and optical witness samples to monitor contamination

Results of International Space Station Vehicle Materials Exposed on MISSE-7B

Materials samples were exposed to the low Earth orbit (LEO) environment as part of the MISSE-7B flight experiment for 18 months. Optical properties, thickness/mass loss, surface elemental analysis, visual and microscopic analysis for surface change are some of the techniques employed in this investigation. Where possible, the MISSE-7B results are compared to analyses from other LEO experiments. ISS materials currently flying on MISSE-8 are also discussed

SUPPORT-AF: Piloting a Multi-Faceted, Electronic Medical Record-Based Intervention to Improve Prescription of Anticoagulation

Background: Only 50% of eligible atrial fibrillation ( AF ) patients receive anticoagulation ( AC ). Feasibility and effectiveness of electronic medical record (EMR)-based interventions to profile and raise provider AC percentage is poorly understood. The SUPPORT-AF (Supporting Use of AC Through Provider Profiling of Oral AC Therapy for AF) study aims to improve rates of adherence to AC guidelines by developing and delivering supportive tools based on the EMR to providers treating patients with AF. Methods and Results: We emailed cardiologists and community-based primary care providers affiliated with our institution reports of their AC percentage relative to peers. We also sent an electronic medical record-based message to these providers the day before an appointment with an atrial fibrillation patient who was eligible but not receiving AC . The electronic medical record message asked the provider to discuss AC with the patient if he or she deemed it appropriate. To assess feasibility, we tracked provider review of our correspondence. We also tracked the change in AC for intervention providers relative to alternate primary care providers not receiving our intervention. We identified 3786, 1054, and 566 patients cared for by 49 cardiology providers, 90 community-based primary care providers, and 88 control providers, respectively. At baseline, the percentage of AC was 71.3%, 63.5%, and 58.3% for these 3 respective groups. Intervention providers reviewed our e-mails and electronic medical record messages 45% and 96% of the time, respectively. For providers responding, patient refusal was the most common reason for patients not being on AC (21%) followed by high bleeding risk (19%). At follow-up 10 weeks later, change in AC was no different for either cardiology or community-based primary care providers relative to controls (0.2% lower and 0.01% higher, respectively). Conclusions: Our intervention profiling AC was feasible, but not sufficient to increase AC in our population

How should we deliver sexual health services in the 2020s?

This Special Issue aims to collate the latest evidence-base focused on optimising sexual health services in the 2020s. We discuss why we need specialist sexual health services, how to get the right people to attend, how to strengthen current services, and smarter use of technologies to enhance sexual health services

Progression to AIDS: The effects of stress, depressive symptoms, and social support

Objective: We examined the effects of stress, depressive symptoms, and social support on the progression of HIV infection. Methods: Eighty-two HIV- infected gay men without symptoms or AIDS at baseline were followed up every 6 months for up to 5.5 years. Men were recruited from rural and urban areas in North Carolina as part of the Coping in Health and Illness Project. Disease progression was defined using criteria for AIDS (CD4+ lymphocyte count of less than 200/μl and/or an AIDS-indicator condition). Results: We used Cox regression models with time-dependent covariates, adjusting for age, education, race, baseline CD4+ count, tobacco use, and number of antiretroviral medications. Faster progression to AIDS was associated with more cumulative stressful life events (p = .002), more cumulative depressive symptoms (p = .008), and less cumulative social support (p = .0002). When all three variables were analyzed together, stress and social support remained significant in the model. At 5.5 years, the probability of getting AIDS was about two to three times as high among those above the median on stress or below the median on social support compared with those below the median on stress or above the median on support, respectively. Conclusions: These data are among the first to demonstrate that more stress and less social support may accelerate the course of HIV disease progression. Additional study will be necessary to elucidate the mechanisms that underlie these relationships and to determine whether interventions that address stress and social support can alter the course of HIV infection

Variability in the use of mobile ICTs by homeworkers and its consequences for boundary management and social isolation

We examine how the use of mobile information and communication technologies (ICTs) among self-employed homeworkers affects their experience of work, focusing particularly on where work is carried out, how the work/non-work boundary is managed, and people's experiences of social and professional isolation. Positively, their use enhanced people's sense of spatio-temporal freedom by allowing them to leave the home without compromising their work availability. This also helped reduce people's feelings of social isolation. More negatively, their use enhanced people's sense of 'perpetual contact', creating a sense that work was difficult to escape from. However, the extent to which mobile ICTs were used, and the extent to which their impact on people's experiences of work were understood, were found to vary significantly, highlighting the agency that users have with regard to technology use. The findings are framed by combining Nippert-Eng's boundary work theory, with an 'emergent process' perspective on socio-technical relations

Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

<p>Abstract</p> <p>Background</p> <p>Genital chlamydia is the most commonly notified sexually transmissible infection (STI) in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT) has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs) are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs) in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis.</p> <p>Methods</p> <p>In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs) from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT.</p> <p>Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed.</p> <p>Results</p> <p>Perceived barriers to patients telling partners (patient referral) included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral) included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT - many felt concerned that it is not best clinical practice but many also felt that it is better than nothing.</p> <p>GPs identified the following factors which they considered would facilitate partner notification: clear clinical guidelines; a legal framework around partner notification; a formal chlamydia screening program; financial incentives; education and practical support for health professionals, and raising awareness of chlamydia in the community, in particular amongst young people.</p> <p>Conclusions</p> <p>GPs reported some partners do not seek medical treatment even after they are notified of being a sexual contact of a patient with chlamydia. More routine use of PDPT may help address this issue however GPs in this study had negative attitudes to the use of PDPT. Appropriate guidelines and legislation may make the use of PDPT more acceptable to Australian GPs.</p