In Their Own Words: Perceived Experiences and Family Functioning of Suicide Survivors before and after Suicide Loss

This research explored the unique experiences of relatives of individuals who have died by suicide, termed suicide survivors, in an in-depth fashion using qualitative methods. Through a semi-structured interview, the present study explored how families dealt with general stress prior to the experience of suicide loss, how they handled the loss of a family member to suicide, and what has been used to cope in the aftermath. A major focus was to explore whether or not the event of suicide dramatically altered family dynamics or if families continued a pre-existing interaction pattern established prior to the loss. The results revealed that there was overall consistency in their patterns of interaction both prior to and following the experience of suicide loss. The support of friends was regarded as integral to the participants’ subjective well-being. Themes extracted from the interviews were compared with The Interpersonal Theory of Suicide (Van Orden et al., 2010) and the resulting theory (“the perfect storm model”) integrates the elements that unified the experiences of the group of suicide survivors as a whole. In terms of intervention, results revealed that seeking out the support of others who have a shared experience of suicide loss was helpful in regard to mutual support and to instilling hope for the future. Additional processes of healing are explored and promoted as authentic options for mental health providers to use in their work with the particularly vulnerable population of suicide survivors

An Empirical Examination of the Impact of Item Parameters on IRT Information Functions in Mixed Format Tests

IRT, also referred as modern test theory , offers many advantages over CTT-based methods in test development. Specifically, an IRT information function has the capability to build a test that has the desired precision of measurement for any defined proficiency scale when a sufficient number of test items are available. This feature is extremely useful when the information is used for decision making, for instance, whether an examinee attain certain mastery level. Computerized adaptive testing (CAT) is one of the many examples using IRT information functions in test construction. The purposes of this study were as follows: (1) to examine the consequences of improving the test quality through the addition of more discriminating items with different item formats; (2) to examine the effect of having a test where its difficulty does not align with the ability level of the intended population; (3) to investigate the change in decision consistency and decision accuracy; and (4) to understand changes in expected information when test quality is either improved or degraded, using both empirical and simulated data. Main findings from the study were as follows: (1) increasing the discriminating power of any types of items generally increased the level of information; however, sometimes it could bring adverse effect to the extreme ends of the ability continuum; (2) it was important to have more items that were targeted at the population of interest, otherwise, no matter how good the quality of the items may be, they were of less value in test development when they were not targeted to the distribution of candidate ability or at the cutscores; (3) decision consistency (DC), Kappa statistic, and decision accuracy (DA) increased with better quality items; (4) DC and Kappa were negatively affected when difficulty of the test did not match with the ability of the intended population; however, the effect was less severe if the test was easier than needed; (5) tests with more better quality items lowered false positive (FP) and false negative (FN) rate at the cutscores; (6) when test difficulty did not match with the ability of the target examinees, in general, both FP and FN rates increased; (7) polytomous items tended to yield more information than dichotomously scored items, regardless of the discriminating parameter and difficulty of the item; and (8) the more score categories an item had, the more information it could provide. Findings from this thesis should help testing agencies and practitioners to have better understanding of the item parameters on item and test information functions. This understanding is crucial for the improvement of the item bank quality and ultimately on how to build better tests that could provide more accurate proficiency classifications. However, at the same time, item writers should be conscientious about the fact that the item information function is merely a statistical tool for building a good test, other criteria should also be considered, for example, content balancing and content validity

Behavioral Couple Therapy: Partner-Involved Treatment for Substance-Abusing Women

Among the various psychosocial interventions presently available to treat alcohol and drug abuse, it could be argued that partner-involved treatments are the most broadly efficacious. There is not only substantial empirical support for the use of couple-based treatments in terms of improvements in primary targeted outcomes, such as substance use and relationship adjustment, but also in other areas that are of clear public health significance, including intimate partner violence (IPV), children\u27s adjustment, and cost-benefit ratio and cost-effectiveness. During the last few decades, programmatic research on the application of partner-involved therapies for substance abuse has been among the most active and fruitful. Although marital and family therapies for substance abuse have been used with a wide variety of patient populations, the purpose of this chapter is to focus on the application of partner-involved interventions with women who abuse substances and are in intimate relationships. More specifically, we (1) provide a conceptual rationale as to why couple therapy for female patients with substance abuse problems may be particularly appealing, compared to more traditional individual-based approaches; (2) describe theoretical and practical considerations involved when implementing couple therapy with these patients; (3) examine available evidence for the efficacy of couple therapy with female patients who abuse alcohol and drug; and (4) discuss future directions with respect to partner-involved therapies with these patients

Willingness, preferred ways and potential barriers to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in China

Objective To explore willingness and preferred ways to use HIV pre-exposure prophylaxis (PrEP), factors associated with willingness, and potential barriers to PrEP use among men who have sex with men (MSM) in Changsha, China. Design A cross-sectional survey was conducted from 25 June to 31 August 2019. Two hundred and fifty-five MSM were recruited from three community-based organisations (CBOs) in Changsha City. Willingness and potential barriers to use PrEP were examined using researcher-created scales. Univariate and multivariate logistic regression was used to analyse the factors associated with willingness to use PrEP. P values <0.05 were considered significant. Setting Three MSM inclusive CBOs in Changsha, Hunan Province, China. Participants 255 HIV-negative MSM were recruited through their CBOs with snowball sampling. Results Less than half of the participants (43.1%) had heard of PrEP and 15.3% were willing to use PrEP. The participants reported higher willingness to use event-driven PrEP (3.70±0.07) than daily PrEP (2.65±0.07). Higher self-rated risk and fear of contracting HIV (OR: 14.47, 95% CI 2.19 to 95.53), awareness of PrEP (OR: 4.20, 95% CI 1.64 to 10.73), sharing one's own sexual orientation with parents or siblings (OR: 2.52, 95% CI 1.54 to 7.20) and having a university education or above (OR:0.29, 95% CI 0.12 to 0.72) were associated with willingness to use PrEP. Only 12.2% of the sample was concerned about potential barriers to PrEP use. Conclusion Efforts to improve awareness and knowledge of PrEP, teach self-evaluation of HIV infection risk and provide social and emotional support for MSM are needed to scale up PrEP implementation in China. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Wendy Cross, Louisa Lam and Bixwajit Banik” is provided in this record*

Condom use consistency and associated factors among college student men who have sex with men from seven colleges in Changsha city : a cross-sectional survey

Background: College student men who have sex with men (MSM) are at high risk for HIV infection due to multiple social and behavioral factors. Consistent condom use is nationally advocated for HIV prevention. This study explored the sexual behaviors and factors associated with condom use consistency in the past six months among college student MSM from seven colleges in Hunan Province, China. Methods: A cross-sectional survey was conducted from September 2017 to March 2018. Condom use consistency, sexual behaviors, HIV testing performance, substance use, and alcohol consumption were examined using researcher-created questionnaires. Condom use self-efficacy and HIV-related knowledge were assessed using the Condom Use Self-Efficacy Scale and the unified National AIDS Sentinel Surveillance Questionnaire. Univariate and multivariate logistic regressions were used. P <0.05 was considered significant. Results: In the 214 respondents, the rate of consistent condom use was 56% (n = 119) during the past six months. Participants who were studying at first-tier universities (odds ratio [OR]: 2.522, 95% confidence interval [CI]: 1.255–5.067) and had higher scores for condom use self-efficacy (OR: 2.617, 95% CI: 1.462–4.685) were more likely to report consistent condom use than the others. The risk factor was having suspicious symptoms of sexually transmitted diseases (OR: 0.357, 95% CI: 0.163–0.780). Conclusion: Numerous students were at high risk of HIV infection with inconsistent condom use. Comprehensive and specific topics about safe sex education from parents and peers should be offered on campuses in China. © 2021 Wang et al

Influence of core competence on voice behavior of clinical nurses : a multicenter cross-sectional study

Background: Voice behavior, referred to as a positive guarantee for organizational development, is influenced by several kinds of individual, collective and organizational features. However, the impact of individual competence on voice behavior is unclear. The aim of the present study was to investigate the status quo of core competence and voice behavior of clinical nurses and explore the impact of core competence on nurses’ voice behavior. Methods: A multicenter cross-sectional survey. A total of 1717 nurses were recruited from nine tertiary and secondary hospitals between March and June 2019. An online questionnaire, including socio-demographic variables, employee voice behavior scale and competence inventory for registered nurses, was used to investigate prohibitive and promotive voice behavior and core competence of clinical nurses. Pearson correlation and hierarchical multiple regression were performed in the data analysis. Results: The mean score for prohibitive and promotive voice behavior of nurses were 3.46 (SD 0.77) and 3.46 (SD 0.88), respectively. The mean score for core competence was 2.46 (SD 0.77). Critical thinking/research aptitude was the most important predictor for both prohibitive and promotive voice behavior (each p < 0.05), but its influence on promotive voice behavior was greater (p < 0.05). Leadership was another significant predictor for prohibitive voice behavior (p < 0.05). Legal/ethical practice, teaching-coaching, professional development and shift work were other predictors for promotive voice behavior (each p < 0.05). Conclusion: Clinical nurses experience modest levels of prohibitive and promotive voice behavior and their core competence is moderate. Core competence, especially critical thinking/research aptitude, impacts significantly on voice behavior of clinical nurses. Cultivating nurses’ core competence could positively increase their voice behavior for organizational development. © 2021 Guo et al

Comparison of behaviors regarding live poultry exposure among rural residents in Vietnam and Thailand

Introduction: Live poultry exposure and risk behaviors are more prevalent in rural communities, increasing the risk of influenza A/H5N1 infection. We examined the economic and socio-cultural influences on poultry-related practices by comparing the poultry-related practices among Vietnamese and Thai rural residents by family income and consumption preference. Methods: Stratified cluster sampling was performed to select households. Within each household, one adult was randomly selected for a face-to-face interview in five Vietnamese and five Thai rural districts. Using a standardized questionnaire to assess domestic poultry husbandry, live poultry purchase, and demographics, logistic regression enabled comparisons of behaviors related to live poultry exposure and examination of associated factors. Results: Among 994 Vietnamese and 907 Thai rural residents, live poultry exposure (prevalence of raising poultry, improper handling of sick or dead poultry, touching live poultry before buying, and slaughtering poultry at home) was more prevalent among Vietnamese than Thai respondents. After adjusting for other demographics, respondents with higher family incomes were less likely to rear backyard poultry in both Vietnam and Thailand, and with more likely to buy live poultry in Vietnam, but not in Thailand. Consumption preference for live poultry was associated with being more likely to rear backyard poultry in Vietnam and Thailand, and with being more likely to buy live poultry in Thailand, but not in Vietnam. Conclusion: The findings suggest important roles of economic imperatives and cultural preference for live poultry for consumption in supporting poultry rearing and live poultry purchase among rural residents. © 2014 Liao et al.published_or_final_versio

Chinese immigrant parents' vaccination decision making for children: A qualitative analysis

Background: While immunization coverage rates for childhood routine vaccines in Hong Kong are almost 100%, the uptake rates of optional vaccines remain suboptimal. Understanding parental decision-making for children's vaccination is important, particularly among minority groups who are most vulnerable and underserved. This study explored how a subsample of new immigrant mothers from mainland China, a rapidly-growing subpopulation in Hong Kong, made decisions on various childhood and adolescent vaccines for their offspring, and identified key influences affecting their decision making. Methods. Semi-structured in-depth interviews were conducted with 23 Chinese new immigrant mothers recruited by purposive sampling. All interviews were audio-taped, transcribed and analyzed using a Grounded Theory approach. Results: Participants' conversation revealed five underlying themes which influenced parents' vaccination decision-making: (1) Institutional factors, (2) Insufficient vaccination knowledge and advice, (3) Affective impacts on motivation, (4) Vaccination barriers, and (5) Social influences. The role of social norms appeared overwhelmingly salient influencing parents' vaccination decision making. Institutional factors shaped parent's perceptions of vaccination necessity. Fear of vaccine-targeted diseases was a key motivating factor for parents adopting vaccination. Insufficient knowledge about vaccines and targeted diseases, lack of advice from health professionals and, if provided, suspicions regarding the motivations for such advice were common issues. Vaccination cost was a major barrier for many new immigrant parents. Conclusions: Social norms play a key role influencing parental vaccination decision-making. Insight gained from this study will help inform healthcare providers in vaccination communication and policymakers in future vaccination programme. © 2014 Wang et al.; licensee BioMed Central Ltd.Link_to_subscribed_fulltex

Resilience-based multifactorial model of depression among people who lost an only-child in China

Objective: There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psychointervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression. Methods: A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory. Results: The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was −0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was −0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables. Conclusion: Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person