Team-focused implementation strategies to improve implementation of mental health screening and referral in rural Children\u27s Advocacy Centers: Study protocol for a pilot cluster randomized hybrid type 2 trial

BACKGROUND: Children\u27s Advocacy Centers (CACs) use multidisciplinary teams to investigate and respond to maltreatment allegations. CACs play a critical role in connecting children with mental health needs to evidence-based mental health treatment, especially in low-resourced rural areas. Standardized mental health screening and referral protocols can improve CACs\u27 capacity to identify children with mental health needs and encourage treatment engagement. In the team-based context of CACs, teamwork quality is likely to influence implementation processes and outcomes. Implementation strategies that target teams and apply the science of team effectiveness may enhance implementation outcomes in team-based settings. METHODS: We will use Implementation Mapping to develop team-focused implementation strategies to support the implementation of the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), a standardized screening and referral protocol. Team-focused strategies will integrate activities from effective team development interventions. We will pilot team-focused implementation in a cluster-randomized hybrid type 2 effectiveness-implementation trial. Four rural CACs will implement the CPM-PTS after being randomized to either team-focused implementation (n = 2 CACs) or standard implementation (n = 2 CACs). We will assess the feasibility of team-focused implementation and explore between-group differences in hypothesized team-level mechanisms of change and implementation outcomes (implementation aim). We will use a within-group pre-post design to test the effectiveness of the CPM-PTS in increasing caregivers\u27 understanding of their child\u27s mental health needs and caregivers\u27 intentions to initiate mental health services (effectiveness aim). CONCLUSIONS: Targeting multidisciplinary teams is an innovative approach to improving implementation outcomes. This study will be one of the first to test team-focused implementation strategies that integrate effective team development interventions. Results will inform efforts to implement evidence-based practices in team-based service settings. TRIAL REGISTRATION: Clinicaltrials.gov, NCT05679154 . Registered on January 10, 2023

Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability (FOREVER)—A cohort study in a Danish high street optician setting: Design and methodology

Purpose The purpose of the study was to describe the rationale and design of Project FOREVER (Finding Ophthalmic Risk and Evaluating the Value of Eye exams and their predictive Reliability). Design Project FOREVER will build a comprehensive database of clinical eye and vision data collected from ~280 000 adults at 100 optician stores across Denmark. The FOREVER database (FOREVERdb) includes detailed data from refraction, visual acuity, intraocular pressure, corneal thickness, visual field assessments and retinal fundus images. Linkage to the comprehensive Danish national registries with, that is diagnostic and prescribing data permits investigation of rare associations and risk factors. 30 000 individuals over 50 also provide a saliva sample for later genetic studies and blood pressure measurements. Of these 30 000, 10 000 will also get optical coherence tomography (OCT) nerve and retinal scans. This subpopulation data is reviewed by ophthalmologists for disease detection. All participants will be asked to complete a questionnaire assessing lifestyle, self‐perceived eye health and general health. Enrolment of participants began in April 2022. Perspective The FOREVERdb is a powerful tool to answer a wide range of research questions that can pave the way for better eye health. This database will provide valuable insights for future studies investigating the correlations between eye and general health in a Danish population cohort, enabling research to identify potential risk factors for a range of diseases

(Digital) tools as professional and generational identity badges in the Chinese creative industries

Animators, architects, designers, and others active in the Chinese creative industries are expert users of tools, both analog and digital. Performances of expert tool use (the wearing of professional identity badges) are strategic ways of signaling creativity understood as sets of skills and character traits essential for attracting work projects but also for professional identity formation. Analogue tools are generally associated with creative openness and fluidity whereas digital tools are discursively constructed as a technological other to the analogue. ‘Older’ creatives (born before 1980) tend to apply some of the media-inflected discourse around the balinghou generation (born 1980–1989) to their younger competitors, including an assumed affinity with digital media and technologies (the pinning on of a generational identity badge). Such generational assumptions can have the effect of reinforcing project hierarchies and denying expert users of digital tools their claims to creativity

Global Governance Behind Closed Doors : The IMF Boardroom, the Enhanced Structural Adjustment Facility, and the Intersection of Material Power and Norm Change in Global Politics

Up on the 12th floor of its 19th Street Headquarters, the IMF Board sits in active session for an average of 7 hours per week. Although key matters of policy are decided on in the venue, the rules governing Boardroom interactions remain opaque, resting on an uneasy combination of consensual decision-making and weighted voting. Through a detailed analysis of IMF Board discussions surrounding the Enhanced Structural Adjustment Facility (ESAF), this article sheds light on the mechanics of power in this often overlooked venue of global economic governance. By exploring the key issues of default liability and loan conditionality, I demonstrate that whilst the Boardroom is a more active site of contestation than has hitherto been recognized, material power is a prime determinant of both Executive Directors’ preferences and outcomes reached from discussions. And as the decisions reached form the backbone of the ‘instruction sheet’ used by Fund staff to guide their everyday operational decisions, these outcomes—and the processes through which they were reached—were factors of primary importance in stabilizing the operational norms at the heart of a controversial phase in the contemporary history of IMF concessional lending

Not what you expected: Implementing design thinking as a leadership practice

Changing user needs have created new opportunities for libraries, requiring evolving leadership practices that support innovation and rapid change. Design thinking can provide leaders with a concrete process to move toward action. The authors – one an executive administrator at a large, multi-branch public library, the other an academic librarian who leads a small team – share how design thinking has positively influenced their leadership practices. The benefits of implementing this flexible process have included improved user experience, more creative solutions, wise investments, staff empowerment, increased transparency and trust, and employee learning and development. Both leaders experienced these benefits even though they are in different positions on their hierarchical organization charts. The authors propose that implementing design thinking as a leadership practice has a place in the evolving role of libraries and can shift organizational cultures to become more user-centered and embrace innovation. In addition to these benefits, the chapter discusses specific project examples, challenges, and tips for library leaders to successfully implement the process. Design thinking is translatable across library types and throughout private industry. Discussing design thinking as a leadership practice can benefit the profession and communities by giving leaders a common language to use when learning from and sharing with each other in conversations about innovation

Prevalence of pre- and postpartum depression in Jamaican women

BACKGROUND: Maternal depression during pregnancy has been studied less than depression in postpartum period. The aims of this study were to find out the prevalence of prepartum and postpartum depression and the risk factors associated in a cohort of Afro-Jamaican pregnant women in Jamaica. METHODS: The Zung self-rating depression scale instrument was administered to 73 healthy pregnant women at 28 weeks gestation and at 6 weeks postpartum for quantitative measurement of depression. Blood samples were collected at 8, 28, 35 weeks gestation and at day 1 and 6 weeks postpartum to study the thyroid status. RESULTS: Study demonstrated depression prevalence rates of 56% and 34% during prepartum and postpartum period, respectively. 94% women suffering depression in both periods were single. There were significant variations in both FT(3 )and TT(4 )concentrations which increased from week 8 to week 28 prepartum (p < 0.05) and then declined at the 35(th )week (p < 0.05 compared with week 28) and 1 day post delivery study (p < 0.05 compared with week 35). The mean values for TSH increased significantly from week 8 through week 35. The mean values at 1 day postpartum and 6 week postpartum were not significantly different from the 35 week values. For FT(3), TT(4 )and TSH there were no significant between group differences in concentrations. The major determinants of postpartum depression were moderate and severe prepartum depression and change in TT(4 )hormone concentrations. CONCLUSION: High prevalence of depression was found during pre- and postpartum periods. Single mothers, prepartum depression and changes in TT(4 )were factors found to be significantly associated with postpartum depression

When ends Trump means: continuity versus change in US counterterrorism policy

This article utilizes a historical materialist informed framework to analyse change and continuity in US counterterrorism policy. Although Donald Trump’s “America First” discourse conveyed a “new” approach to counterterrorism, in practice his administration has largely reinforced pre-existing tendencies, expanding the military campaigns against ISIS and al-Qaeda. In accordance with America’s longstanding objectives in the global south, which centre on stabilizing existing patterns of capitalist political-economic relations, the US continues to police transnational security challenges “from below”. The article calls for increased sensitivity to the means-ends calculus in American statecraft. It argues that tactical shifts at the policy level (the means) should be situated in relation to historical considerations and the structural and material factors (the ends) that impact US foreign policymaking across presidential administrations

Behavioral Weight Loss Treatment for Youth Treated With Antipsychotic Medications

Background: Youth who are being treated with antipsychotic medications are at increased risk for the development of obesity and type 2 diabetes. Behavioral weight loss treatments show promise for reducing obesity and diabetes risk among adults treated with these drugs, but such treatments have not previously been studied in youth. Objective: We describe a rationale for behavioral weight loss intervention for high-weight youth being treated with antipsychotic medications. We report behavioral, anthropomorphic, and metabolic findings from a case series of obese adolescents taking antipsychotic medications who participated in a short-term, family-based behavioral weight loss intervention. Methods: We adapted the Traffic Light Plan, a 16-week family-based weight loss intervention that promotes healthy energy balance using the colors of the traffic light to categorize the nutritional value of foods and the intensity of physical activity. We then added a social and ecological framework to address health behavior change in multiple social contexts. The intervention was administered to three obese adolescents with long-term antipsychotic medication exposure. The efficacy of the intervention was evaluated with a battery of anthropomorphic and metabolic assessments, including weight, body mass index percentile, whole body adiposity, liver fat content, and fasting plasma glucose and lipid levels. Participants and their parents also filled out a treatment satisfaction questionnaire after study completion. Results: Two boys and one girl, all of whom were 14 years old, participated in this study. All three participants attended all 16 sessions of the intervention and experienced beneficial changes in adiposity, fasting lipid levels, and liver fat content associated with weight stabilization or weight loss. Adolescents and their parents all reported a high level of satisfaction with the treatment. Conclusions: Family-based behavioral weight loss treatment can be feasibly delivered and is acceptable to youth taking antipsychotic medications and their families. Randomized controlled trials are needed to fully evaluate the effectiveness and acceptability of these treatments for these individuals