Predictors of Therapists Use of Homework in Community Mental Health: Session and Therapist Characteristics

Assigning and reviewing homework as a strategy to help clients gain therapeutic skills is a common technique used across a variety of evidence-based practices (EBPs) and has been shown to improve therapy outcomes for children and youth. However, in studies characterizing routine psychotherapy delivered in community mental health settings, homework is rarely used in sessions. While some therapist and client level predictors of EBP strategy use have been identified in routine psychotherapy (e.g. client stressors, therapists’ attitudes towards EBPs) it is unknown what is associated with community mental health therapists using homework in the increasingly common context of system-driven implementation of multiple EBPs. To identify predictors of therapists’ use of homework, 680 videos of sessions with 274 clients were collected from 103 therapists (of which 55% were Hispanic) providing children’s mental health services through the Los Angeles County Department of Mental Health (LACDMH). The current study uses a multilevel logistic regression analysis model to identify which factors are associated with therapist use of homework in therapy sessions when there is system-driven implementation support for the use of multiple EBPs in community mental health settings. After controlling for the EBP delivered in session and the number of EBPs therapists were trained in, having a caregiver present in the therapy session, older child age, and being an unlicensed therapist were associated with a higher likelihood of therapists assigning and reviewing homework during a specific session. Therapist race/ethnicity, perceptions of the EBP being delivered, their report of emotional exhaustion, and direct hours with clients, as well as emergent unexpected stressful client life events within a session were not significantly associated with therapists’ delivery of homework. These findings underscore the need to provide explicit attention during therapist training on the use of homework with younger clients when caregivers are absent from sessions and the need to facilitate the use of homework among licensed therapists

Securing Financial Resources For Small And Medium Contracting Firms In Malaysia [HD2346.M2 L366 2008 f rb].

Penyelidik dalam bidang perusahaan kecil dan sederhana (PKS) sering mendalilkan bahawa PKS mempunyai criteria seperti kekurangan modal dan tidak mendapat pembiayaan perkembangan yang setaraf. Small and medium enterprises (SMEs) researchers often argue that SME are characterised by lack of capital and are unable to access the same kinds of growth funding

Socioeconomic Status and Parenting Priorities: Child Independence and Obedience Around the World

This study investigated the extent to which national and personal socioeconomic status shapes national norms and parenting priorities concerning child socialization. Data came from European Values Survey, World Values Survey, and World Bank Data Catalog, resulting in 227,431 parents from 90 nations across fives study waves (1981-2008). At nation-level, child independence was more popular in nations with greater wealth and higher percentage of educated populations; obedience was more popular in nations with less wealth and lower percentages of educated and urban populations. At person-level, personal socioeconomic status rather than national socioeconomic characteristics predicted individual parents’ prioritization of child independence and obedience; higher social class predicted greater likelihood of endorsing independence and not endorsing obedience. Time slope estimation across study waves revealed that parental prioritization of both independence and obedience expected to rise over time in developing nations. Results provide implications for education, practice, and policy concerning cultural variation in parenting

Socioeconomic Status and Parenting Priorities: Child Independence and Obedience Around the World

This study investigated the extent to which national and personal socioeconomic status shapes national norms and parenting priorities concerning child socialization. Data came from European Values Survey, World Values Survey, and World Bank Data Catalog, resulting in 227,431 parents from 90 nations across fives study waves (1981-2008). At nation-level, child independence was more popular in nations with greater wealth and higher percentage of educated populations; obedience was more popular in nations with less wealth and lower percentages of educated and urban populations. At person-level, personal socioeconomic status rather than national socioeconomic characteristics predicted individual parents’ prioritization of child independence and obedience; higher social class predicted greater likelihood of endorsing independence and not endorsing obedience. Time slope estimation across study waves revealed that parental prioritization of both independence and obedience expected to rise over time in developing nations. Results provide implications for education, practice, and policy concerning cultural variation in parenting

Developing and evaluating a lay health worker delivered implementation intervention to decrease engagement disparities in behavioural parent training: a mixed methods study protocol.

IntroductionBehavioural parent training (BPT) programmes are effective in preventing and treating early-onset conduct problems and child maltreatment. Unfortunately, pervasive mental health service disparities continue to limit access to and engagement in these interventions. Furthermore, challenges with parental engagement can impede the successful implementation of evidence-based practices (EBPs) in community settings that serve low-income, ethnic minority families. Lay health workers (LHWs)-individuals without formal mental health training-represent an important workforce to increase engagement, as they are members of the communities they serve. However, the mobilisation of LHWs has not been well studied as an implementation strategy to extend the reach or effectiveness of EBPs in the USA. LHW-delivered implementation interventions that specifically support the engagement of Latinx parents in evidence-based BPT programmes have the potential to improve clinical and implementation outcomes.Methods and analysisA community-partnered approach will use the Quality Implementation Framework (QIF) to tailor and implement an LHW-delivered implementation intervention that aims to promote Latinx parent engagement in BPT programmes. Steps from the QIF will guide study activities to (1) conduct a mixed methods needs assessment to fit the implementation intervention to the local context, (2) adapt LHW-delivered implementation strategies to promote parent access to and engagement in Parent-Child Interaction Therapy and (3) conduct a hybrid effectiveness-implementation pilot trial to examine the feasibility, acceptability and preliminary effectiveness of the LHW implementation intervention at increasing engagement.Ethics and disseminationStudy procedures have been approved by the Institutional Review Board at the University of California, Santa Barbara. Results will be shared with the community-advisory group, at community-based meetings for other stakeholders involved in the pilot project, and submitted for publication in peer-reviewed journals

Anti-tumor necrosis factor-alpha therapy during murine Klebsiella pneumoniae bacteremia: increased mortality in the absence of liver injury.

Klebsiella pneumoniae is a leading cause of gram-negative bacterial pneumonia, often resulting in bacteremia concurrent with the localized pulmonary infection. The beneficial role of tumor necrosis factor (TNF)-alpha during pulmonary infection has been well documented; however, consequences of TNF-alpha production during systemic bacterial infection are controversial. A murine model of K. pneumoniae was developed to address this important issue. Liver-associated TNF-alpha mRNA was induced within 30 min after intravenous bacterial inoculation and remained elevated through 6 h before returning to near-baseline at 24 h postinfection. Intravenous K. pneumoniae infection induced liver cellular injury that was completely ablated when mice were pretreated with a neutralizing anti-TNF-alpha antibody. Interestingly, this reduction in liver injury failed to translate into improved survival. Mice receiving anti-TNF-alpha continued to succumb to the infection even out to day 10 postinfection. Bacterial clearance after TNF-alpha neutralization was significantly impaired at later time points during infection. Correlating with impaired bacterial clearance was diminished production of liver-associated MIP-2, MIP-1alpha, MCP-1, and interferon-gamma. Further evidence of diminished antibacterial immune responses was noted when the activational status of splenic natural killer cells in anti-TNF-alpha-treated mice was examined 24 h postinfection. Natural killer cells displayed decreased CD69 expression. Combined, these data indicate that the beneficial effects of TNF-alpha during systemic K. pneumoniae infection outweigh the detrimental effects of TNF-alpha-mediated hepatocyte cellular injury. Anti-TNF-alpha therapy, although preventing liver injury during blood-borne bacterial infection, results in a dampened anti-bacterial host response, resulting in decreased bacterial clearance and overall survival