Attachment Matters for All - An Attachment Mapping Exercise for Children's Services in Scotland

As part of the first phase of the Looked After Strategic Implementation Group (LACSIG), the Scottish Children’s Reporter Administration (SCRA) undertook research into care and permanence planning for younger children in care.1 They focused on 100 children all aged under four years old when they first came to the attention of services and examined how long it took from that point to achieve permanence. For over 90% of children this process took longer than two years and more than half had still not achieved a permanent placement four years after first contact with services. Several children had also experienced multiple placements, with transitions between carers often occurring at critical developmental points. The research highlighted the negative impact on long-term outcomes of such continued disruption of children’s attachments

Running a successful network to support methodologists and guideline developers: sharing experiences from UK evidence synthesis networks

Running a successful network to support methodologists and guideline developers: sharing experiences from UK evidence synthesis networks Facilitators: Judith Thornton (NICE); Ruaraidh Hill (University of Liverpool), Emma McFarlane (NICE), Li Chia Chen (University of Manchester) BACKGROUND AND INTRODUCTION We established the ‘North West Evidence Synthesis Network’ (NWESN) to bring together guideline developers, health researchers and policy makers from across our region in order to share knowledge and expertise and raise awareness of methodological developments. Several other UK networks have been initiated including the ‘Liverpool Evidence Synthesis Network’ (LivEN). Feedback from members has been positive with both personal and institutional benefits. Other networks include: • Health Research Methodology and Implementation (HeRMI) • Bangor Evidence Synthesis Hub (BESH) • Peninsula Systematic Review discussion group (PenSR) OBJECTIVES • To advocate the role of networks • To discuss the practicalities to establishing/running networks • To explore what guideline developers needs from networks DESCRIPTION OF THE WORKSHOP Short presentations to compare and contrast the remit, structure and function of different networks. Group discussions to explore: • What guideline developers want from networks • Challenges to establishing/running networks and strategies to overcome these. • Future directions for networking • How networks can be better connected Group feedback and conclusions TARGET GROUPS All staff involved in evidence synthesis and guideline development. IMPLICATIONS FOR GUIDELINE DEVELOPERS Our presentation at the Global Evidence Summit 2017 demonstrated the benefits of membership of the NWESN. Implications for guideline developers included general education and updating on new methods; a key benefit is the opportunity to share skills, information and support across researchers and institutions. CONCLUSIONS The workshop intends to raise awareness of the benefits of networks and what they can offer methodologists and guideline developers. We hope to encourage more people to connect with and establish methodological networks

Applying community participatory methods to meet women\u27s mental health needs in Karachi, Pakistan

Poor mental health is a global epidemic with women affected more often compared to men. Compromised mental health jeopardizes women\u27s health and functioning and also the health and wellbeing of their children. To promote women\u27s mental health, principles of community participatory methods were used to design and implement a mental health program, which was predicated on empirical research, sensitive to community culture and needs, and delivered by Lady Health Workers in an urban slum area of Karachi, Pakistan. The sequential steps of community participation, program development, implementation and strategies for sustainability are described

Using a Model of Economic Solvency to Understand the Connection between Economic Factors and Intimate Partner Violence

Poverty is a risk factor for intimate partner violence (IPV); however, little is known about the economic state at which women are no longer at risk for IPV due to their economic status, which is economic solvency. A Model of Economic Solvency in women has been developed from the literature that includes four factors: human capital, social capital, sustainable employment, and independence. The purpose of this research is to validate the model in a sample of women reporting IPV. A confirmatory factor analysis was performed to test the model using data from 280 abused women. Examination of the model yielded adequate fit with the data, indicating that the model is valid for use with women reporting IPV. The validation of the model offers strength of association between constructs and can be used to plan interventions to improve economic solvency in abused women to potentially reduce violence and facilitate recovery

Patient and public attitudes to and awareness of clinical practice guidelines : a systematic review with thematic and narrative syntheses

Article Accepted Date: 15 July 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Acknowledgements The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 258583 (DECIDE project). The Health Services Research Unit, Aberdeen University, is funded by the Chief Scientist Office of the Scottish Government Health Directorates. The authors accept full responsibility for this paper and the views expressed in it are those of the authors and do not necessarily reflect those of the Chief Scientist Office. NS receives funding through a Knowledge Translation Fellowship from the Canadian Institutes of Health Research. No funding bodies had a role in the manuscript. We would like to thank Healthcare Improvement Scotland and the University of Dundee for support, including access to literature. We would also like to thank Lorna Thompson (Healthcare Improvement Scotland), for her help with the protocol for this review.Peer reviewedPublisher PD

A pilot study of a 6-week parenting program for mothers of pre-school children attending family health centers in Karachi, Pakistan.

BACKGROUND: Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-schoolchildren attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan. METHODS: A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 intervention; n = 27 control) participated in this study. Mothers in the intervention group received SOS Help for parents module, while mothers in the control group received information about routine childcare. A parenting scale (PS) was administered before the program was implemented and repeated 2 weeks after the program was completed in both groups. Statistical analysis was performed to compare participants\u27 attributes. Descriptive analysis was conducted to compare pre- and post-test mean scores along with standard deviation for parenting subscales in the intervention and control groups. RESULTS: A total of 50 mothers (n = 25 intervention; n = 25 control) completed the 6-week program. Attrition was observed as 5/30 (17%) in the intervention arm and 2/27 (2%) in the control arm. Mothers commonly reported the burden of daily domestic and social responsibilities as the main reason for dropping out. Furthermore, the majority of participants in the control group recommended increasing the duration of weekly sessions from 1 to 1.5 hours, thereby decreasing the program period from 6 to 4 weeks. Mothers in intervention group reported substantial improvement in parenting skills as indicated by mean difference in their pre- and post-test scores for laxness and over-reactivity. CONCLUSION: Parenting programs can be implemented for mothers attending FHCs in Pakistan. Mothers require positive reinforcement and constant encouragement at the participant level. Integrating such programs into primary healthcare at the population level has the potential to maximize child health benefits and to improve parenting skills at the country level

Predicting Behavioral Dysfunctions of Youth Living in Violent Homes: A Rapid Assessment Triage Tool

Objective: To design and test a rapid assessment tool for predicting dysfunctional behavior of children who live in homes where their mother reports recent physical or sexual partner abuse. Methods: A cohort analysis was completed. 300 abused mothers accessing services for partner abuse were interviewed to determine risk factors for dysfunctional behavior of their children. Mothers were asked if they had taken their child to a health care provider within the last four months as well as questions about their functioning and the behaviors of the child during the same four months. Results: Among the 300 children living in a violent home, 81% had seen a health care provider within the preceding four months. Model testing revealed among the children classified as having the highest risk for dysfunctional behavior (predicted probability of clinical behaviors \u3e 75%), between 82-100% of these children presented with clinical level behaviors when their mother sought services for the abuse. Conclusions: The Rapid Assessment Triage tools offer an evidence-based, high predictability method for rapid assessment and triage of children who are most likely to have dysfunctional behaviors when their abused mothers seek services. Since 81% of the children had seen a healthcare provider within the preceding 4 months of their mother seeking services, the triage tools offer healthcare providers an opportunity to assess the risk of dysfunctional behavior of children with a mother who screens positive for abuse. To maximize child health, mothers require assessment for partner violence and assessment for dysfunctional behavior of their children

Attachment Matters for All : Executive Summary

In 2011 the Scottish Children’s Reporter Administration (SCRA) published research into care and permanence planning for looked after children. This identified long delays in achieving permanence, multiple placements and the adverse effects of these on children’s attachments. Potential long-term effects on individuals of poor attachment experiences in infancy and childhood include an increased risk of violent and anti-social behaviour, mental and physical health difficulties and a reduced capacity to parent their own children. Attachment-informed practice can ameliorate the long-term effects of early adversity. The Scottish Government responded to the SCRA research by commissioning the Centre for Excellence for Looked After Children in Scotland (CELCIS) and Scottish Attachment in Action (SAIA) to map attachment training and attachment-focused practice in Scotland

Abuse Assessment Screen–Disability (AAS-D): Measuring Frequency, Type, and Perpetrator of Abuse toward Women with Physical Disabilities

An interview questionnaire was presented to a multiethnic sample of 511 women, age 18–64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen–Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., Asian, mixed ethnic background) were more likely to report physical or sexual abuse or both, whereas disability-related abuse was reported almost exclusively by white women. The perpetrator of physical or sexual abuse was most likely to be an intimate partner. Disability-related abuse was attributed equally to an intimate partner, a care provider, or a health professional. This study concludes that both traditional abuse-focused questions and disability-specific questions are required to detect abuse toward women with physical disabilities

Attitude towards gender roles and violence against women and girls (VAWG): Baseline findings from an RCT of 1752 youths in Pakistan

Background: Violence against women is driven by gender norms that normalize and justify gender inequality and violence. Gender norms are substantially shaped during adolescence. Programs offered through schools offer an opportunity to influence gender attitudes toward gender equity if we understand these to be partly shaped by peers and the school environment.Objective: We present an analysis of the baseline research conducted for a randomized controlled trial with 1752 grade 6 boys and girls and their attitudes toward gender roles, VAWG, and associated factors.Methods: We used baseline data from a cluster randomised control study. Interviews were conducted in 40 public schools in Hyderabad, with 25–65 children per school. Questions were asked about attitudes toward gender roles, peer-to-peer perpetration, and victimization experiences, and family life, including father- or in-law-to- mother violence and food security. Multiple regression models were built of factors associated with gender attitudes for boys and girls.Results: Our result have shown youth attitudes endorsing patriarchal gender beliefs were higher for boys, compared to girls. The multiple regression model showed that for boys, patriarchal gender attitudes were positively associated with hunger, depression, being promised already in marriage, and being a victim and/or perpetrator of peer violence. For girls gender attitudes were associated with hunger, experiencing corporal punishment at home, and being a perpetrator (for some, and victim) of peer violence.Conclusion: Youth patriarchal attitudes are closely related to their experience of violence at school and for girl’s physical punishment, at home and for boys being promised in early marriage. We suggest that these variables are indicators of gender norms among peers and in the family. The significance of peer norms is that it provides the possibility that school-based interventions which work with school peers have the potential to positively impact youth patriarchal gender attitudes and foster attitudes of gender equality and respect, and potentially to decrease youth victimization and perpetration