Using stepped-care approaches within internet-based interventions for youth anxiety: Three case studies.

Background There are a lack of clear guidelines for the dissemination of Internet-based cognitive behaviour therapy (ICBT) for childhood and adolescent anxiety in routine care. While self-guided ICBT has greater reach than therapist-guided ICBT, it is plagued by problems of low program adherence and many young people are not successfully treated. It is important that we identify models of ICBT that are accessible, but provide the right support, at the right time to those who need it. Stepped-care models of ICBT offer one potential solution. Objective This case study examined the application of stepped-care within an ICBT intervention for childhood and adolescent anxiety, in which young people were stepped up from self-guided to therapist-guided ICBT. Methods Three case studies are presented and include young males (aged 11–12 years) who participated in BRAVE Stepped-Care, a new ICBT program incorporating two treatment steps: Step 1 – five sessions of self-guided ICBT and Step 2 – five sessions of therapist-guided ICBT. Participants completed diagnostic assessments at pre- and post-treatment, along with a battery of self-report questionnaires. Step-up requirements were determined at a mid-treatment assessment. Treatment response was determined by change on diagnostic severity and presence of diagnosis and changes in self-reported anxiety symptoms (through T-scores and Reliable Change Indices). Results In-depth examination of the three case studies showed that decisions to step-up from Step 1 to Step 2 were complex and required consideration of program engagement and adherence, as well as changes on self-reported anxiety, behavioural indicators of anxiety and parent perspectives. Results showed that non-responders at mid-treatment who were stepped-up to therapist-guided ICBT after Step 1 were able to increase engagement and response to treatment in Step 2, such that they were free of their primary anxiety diagnosis at post-treatment. Conclusions The findings highlight the importance of early assessment of engagement and non-response within self-guided ICBT programs for youth anxiety and the positive changes that can subsequently occur when therapist-guidance is introduced mid-treatment for non-responders. The efficacy of stepped-care ICBT models needs to be confirmed in larger randomised controlled trials

Demographic Data for Development: Uganda

A recent increase in decentralization and democratization in developing countries has expanded the role that data plays in informing policies and measuring program results. Increasingly, programs and policies are being assessed by their ability to reach goals that have evidence-based indicators. This growing focus on evidence places greater and greater demand on those who generate clear, timely, reliable, and relevant data. In an effort to strengthen data, initiatives around the globe, such as PARIS21 and Health Metrics Network, have been designed to increase access to and use of data by harmonizing measures, providing technical support in data collection, and increasing the dialogue between data producers and users. This report presents the Uganda findings of a qualitative study simultaneously conducted in Ethiopia, Ghana, and Senegal. The case studies aimed to develop a picture of the demand for data, access to data, quality of available data, and perceived supply and demand for demographic data in the four countries. These countries were chosen based on their upcoming censuses, identified statistical capacity, active engagement in the production of important data, and participation in international data initiatives

Demographic Data for Development: Senegal

Current global developmental frameworks, including the Millennium Development Goals and Poverty Reduction Strategy Papers, require recent and reliable data to measure the achievement of targets. At the same time, increased decentralization and democratization have expanded the role that data play in informing development policies and evaluating development interventions at the national level. Increasingly, programs and policies are assessed by their ability to reach goals that have evidence-based indicators, placing a greater demand on countries to produce clear, timely, reliable, and relevant data. The Senegal case study that forms the basis of this report aimed to develop a general picture of the demand for data by policymakers and other data users. It also aimed to elicit views on barriers to data access, quality of available data, and potential interventions to improve the demand and supply of data. Similar case studies were conducted in three other countries: Ethiopia, Ghana, and Uganda. These countries were chosen based on their upcoming censuses, identified statistical capacity, active engagement in the production of important data, and participation in international data initiatives

Koinonia

A Mandate for Action in Residential Living and Learning President\u27s Corner 1996 ACSD Annual Conference Photo Highlights CoCCA: Christian College Dating & Hot Ideas Book Review: The Abandoned Generation Regional Directorshttps://pillars.taylor.edu/acsd_koinonia/1036/thumbnail.jp

Demographic Data for Development: Ethiopia

This case study from Ethiopia is one of four looking at data for social and economic development in sub-Saharan Africa. The case studies identified activities to enhance data demand, utilization, and quality in each of the focus countries. They involved interviews with key stakeholders to solicit their views on country-level data needs, utilization, access, and demand. Recent emphasis on programs for poverty reduction and improved development have highlighted the need for data to identify the specific problem areas and assess the progress of new initiatives. The main sources of data are the census; Demographic and Health Surveys; Welfare Monitoring Surveys; and Household Income, Consumption, and Expenditure Surveys. The Ethiopian case study sought a broad range of views from individuals working for the government, nongovernmental organizations, development partners, civil society organizations, and academia/researchers. The entities represented data users and producers. The discussion in this final report synthesizes the multifaceted views of those interviewed, and highlights lessons that can be learned from the opinions shared

Demographic Data for Development: Ghana

The attempts of African countries to develop their economies and to democratize their political systems have led to a renewed interest in the use of demographic and socioeconomic data for decision-making and planning. This new direction calls for clear, timely, reliable, and relevant data. At the international level, initiatives such as the African Charter on Statistics, PARIS 21, and the Health Metrics Network have emerged to provide direction and technical support for strengthening initiatives and activities that harmonize measures and improve data collection processes. This report on Ghana is part of a four-country study involving Ethiopia, Ghana, Senegal, and Uganda. The countries were chosen based on their upcoming censuses, identified statistical capacities, active engagement in the production of data, and participation in many of the international data initiatives. The main aim of the case studies is to provide a broad picture of the demand for and access to data, quality of available data, and the perceived supply of demographic data among policymakers and other stakeholders

Engaging Older Youth: Program and City-Level Strategies to Support Sustained Participation in Out-of-School Time

With support from The Wallace Foundation, the Harvard Family Research Project and P/PV conducted a study of almost 200 out-of-school-time (OST) programs in six cities to better understand how they promote sustained participation among older youth.The resulting data indicated that two of the most important practices distinguishing high-retention programs were: ample leadership opportunities for youth and high levels of staff efforts to keep informed about participants' lives outside the programs. The study also compares and contrasts effective practices for middle school- versus high school-aged youth, noting the shortcomings of "one-size-fits-all" strategies. Finally, Engaging Older Youth details the influence of city-level OST initiatives on programs and identifies the types of city-level services that likely support participation

The Jamming Donut: A Free-Space Gripper based on Granular Jamming

Fruit harvesting has recently experienced a shift towards soft grippers that possess compliance, adaptability, and delicacy. In this context, pneumatic grippers are popular, due to provision of high deformability and compliance, however they typically possess limited grip strength. Jamming possesses strong grip capability, however has limited deformability and often requires the object to be pushed onto a surface to attain a grip. This paper describes a hybrid gripper combining pneumatics (for deformation) and jamming (for grip strength). Our gripper utilises a torus (donut) structure with two chambers controlled by pneumatic and vacuum pressure respectively, to conform around a target object. The gripper displays good adaptability, exploiting pneumatics to mould to the shape of the target object where jamming can be successfully harnessed to grip. The main contribution of the paper is design, fabrication, and characterisation of the first hybrid gripper that can use granular jamming in free space, achieving significantly larger retention forces compared to pure pneumatics. We test our gripper on a range of different sizes and shapes, as well as picking a broad range of real fruit