Moving Beyond Lip Service: The Clinical Reasoning Behind Practicing Strengths

Social work has a long tradition of advocating for practice from the strengths perspective. However, it is unclear whether schools are truly preparing students for strengths based practice or whether they are simply teaching them to use the vocabulary of strengths without the clinical reasoning skills to switch paradigms from deficits to strengths, moving beyond lip service to real strengths-based practice. To explore this issue, data from an exercise in an MSW course was explored using qualitative methodology. The findings support that in addition to using a strengths vocabulary, other components are necessary for true implementation of a strengths approach. First, the data revealed a strengths-oriented structural model of an ideal process of clinical reasoning for approaching a client situation. Second, the process includes recognizing client strengths, reflecting on them with the client, and encouraging repetition and reinforcement of the client’s positive attitudes and actions. Finally, true strengths based understanding requires moving from social worker in the role of expert to social worker engaged in collaborative empowerment practice. These findings have implications for social work practice and education

Novel loci for childhood body mass index and shared heritability with adult cardiometabolic traits

The genetic background of childhood body mass index (BMI), and the extent to which the well-known associations of childhood BMI with adult diseases are explained by shared genetic factors, are largely unknown. We performed a genome-wide association study meta-analysis of BMI in 61,111 children aged between 2 and 10 years. Twenty-five independent loci reached genome-wide significance in the combined discovery and replication analyses. Two of these, located nearNEDD4LandSLC45A3, have not previously been reported in relation to either childhood or adult BMI. Positive genetic correlations of childhood BMI with birth weight and adult BMI, waist-to-hip ratio, diastolic blood pressure and type 2 diabetes were detected (R(g)ranging from 0.11 to 0.76, P-values Author summary Although twin studies have shown that body mass index (BMI) is highly heritable, many common genetic variants involved in the development of BMI have not yet been identified, especially in children. We studied associations of more than 40 million genetic variants with childhood BMI in 61,111 children aged between 2 and 10 years. We identified 25 genetic variants that were associated with childhood BMI. Two of these have not been implicated for BMI previously, located close to the genesNEDD4LandSLC45A3. We also show that the genetic background of childhood BMI overlaps with that of birth weight, adult BMI, waist-to-hip-ratio, diastolic blood pressure, type 2 diabetes, and age at menarche. Our results suggest that the biological processes underlying childhood BMI largely overlap with those underlying adult BMI. However, the overlap is not complete. Additionally, the genetic backgrounds of childhood BMI and other cardio-metabolic phenotypes are overlapping. This may mean that the associations of childhood BMI and later cardio-metabolic outcomes are partially explained by shared genetics, but it could also be explained by the strong association of childhood BMI with adult BMI.Peer reviewe

NeOProM: Neonatal Oxygenation Prospective Meta-analysis Collaboration study protocol

Background: The appropriate level of oxygenation for extremely preterm neonates ( 90%) have been reported to have greater rates of morbidity including retinopathy of prematurity and chronic lung disease. In order to answer this clinical dilemma reliably, large scale trial evidence is needed.Methods/Design: To detect a small but important 4% increase in death or severe disability in survivors, over 5000 neonates would need to be recruited. As extreme prematurity affects 1% of births, such a project undertaken by one trial group would be prohibitively lengthy and expensive. Hence, the Neonatal Oxygenation Prospective Meta-analysis (NeOProM) Collaboration has been formed. A prospective meta-analysis (PMA) is one where studies are identified, evaluated, and determined to be eligible before the results of any included studies are known or published, thereby avoiding some of the potential biases inherent in standard, retrospective meta-analyses. This methodology provides the same strengths as a single large-scale multicentre randomised study whilst allowing greater pragmatic flexibility. The NeOProM Collaboration protocol (NCT01124331) has been agreed prior to the results of individual trials being available. This includes pre-specifying the hypotheses, inclusion criteria and outcome measures to be used. Each trial will first publish their respective results as they become available and the combined meta-analytic results, using individual patient data, will be published when all trials are complete. The primary outcome to be assessed is a composite outcome of death or major disability at 18 months - 2 years corrected age. Secondary outcomes include several measures of neonatal morbidity. The size of the combined dataset will allow the effect of the interventions to be explored more reliably with respect to pre-specified patient- and intervention-level characteristics.Discussion: Results should be available by 2014

Toward Building a Culture of Strengths in U.S. MSW Programs

Social work has embraced the strengths perspective as a vital part of micro, mezzo, and macro practice. Yet the authors’ experience suggests that the medical model of deficits, disease, and disorder remains the dominant paradigm. This exploratory study sought to determine how and to what extent strengths-based practice is integrated into the MSW practice curriculum. Forty-four (44) of 181 programs responded to a 12-item web-based survey. Quantitative and qualitative responses indicate an almost universal awareness of and attention to integrating strengths-based content. However, a smaller number of programs appear to be looking beyond curriculum content towards the creation of a broader culture of strengths. Even so, challenges remain toward overcoming a pathological orientation in social work practice curricula