13 research outputs found
Developmental Trajectories of Marriage, Coparenting, and Parenting Stress for Parents of Adolescents and Young Adults with Intellectual Disability
This study assessed marital quality, coparenting, and parenting stress over time for parents of children with intellectual disability by creating developmental trajectories from longitudinal data. Both mothers and fathers (N = 152 couples), with children ages 6-18 at the first wave, evaluated their relationship and parenting stress on up to 4 occasions over a 14-year period. The study provided separate models of change over time for mothers and fathers which showed that marital quality, coparenting, and parenting stress are dynamic relationship constructs that changed during the child’s development. Overall, marital quality was found to follow a curvilinear pattern, with declines when children were adolescents and increases as children entered young adulthood. Positive coparenting increased linearly over time for mothers and fathers, and negative coparenting declined linearly for mothers. With an emphasis on transition periods in the family life cycle, trajectories included indicators of the child’s development to allow for periods of discrete change in the trajectories based on the child’s entrance into adolescence and young adulthood. The child’s entrances into these developmental periods were associated with changes in levels of marital quality and coparenting for mothers only. Patterns for stress over time depended on the parent reporting, with mothers reporting decreases in parent and family problems over time and a quadratic trend for pessimism, with initial growth in reported pessimism followed by declines as the children exited adolescence. Fathers, however, did not report significant changes for parent and family problems and perceived increases in pessimism with time. The study also assessed how support in the marital and coparenting roles with time is associated with levels of parenting stress. Marital quality consistently predicted lower levels of parent and family problems for both parents, but findings for associations between marital quality and pessimism, and coparenting with both types of stress, varied depending on the parent reporting
Implementation strategies in the Exploration and Preparation phases of a colorectal cancer screening intervention in community health centers
Abstract Background Adoption of colorectal cancer (CRC) screening has lagged in community health center (CHC) populations in the USA. To address this implementation gap, we developed a multilevel intervention to improve screening in CHCs in our region. We used the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to guide this effort. Here, we describe the use of implementation strategies outlined in the Expert Recommendations for Implementing Change (ERIC) compilation in both the Exploration and Preparation phases of this project. During these two EPIS phases, we aimed to answer three primary questions: (1) What factors in the inner and outer contexts may support or hinder colorectal cancer screening in North Carolina CHCs?; (2) What evidence-based practices (EBPs) best fit the needs of North Carolina CHCs?; and (3) How can we best integrate the selected EBPs into North Carolina CHC systems? Methods During the Exploration phase, we conducted local needs assessments, built a coalition, and conducted local consensus discussions. In the Preparation phase, we formed workgroups corresponding to the intervention’s core functional components. Workgroups used cyclical small tests of change and process mapping to identify implementation barriers and facilitators and to adapt intervention components to fit inner and outer contexts. Results Exploration activities yielded a coalition of stakeholders, including two rural CHCs, who identified barriers and facilitators and reached consensus on two EBPs: mailed FIT and navigation to colonoscopy. Stakeholders further agreed that the delivery of those two EBPs should be centralized to an outreach center. During Preparation, workgroups developed and refined protocols for the following centrally-delivered intervention components: a registry to identify and track eligible patients, a centralized system for mailing at-home stool tests, and a process to navigate patients to colonoscopy after an abnormal stool test. Conclusions This description may be useful both to implementation scientists, who can draw lessons from applied implementation studies such as this to refine their implementation strategy typologies and frameworks, as well as to implementation practitioners seeking exemplars for operationalizing strategies in early phases of implementation in healthcare
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Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection - United Kingdom and United States, March-August 2020
During the course of the coronavirus disease 2019 (COVID-19) pandemic, reports of a new multisystem inflammatory syndrome in children (MIS-C) have been increasing in Europe and the United States (1-3). Clinical features in children have varied but predominantly include shock, cardiac dysfunction, abdominal pain, and elevated inflammatory markers, including C-reactive protein (CRP), ferritin, D-dimer, and interleukin-6 (1). Since June 2020, several case reports have described a similar syndrome in adults; this review describes in detail nine patients reported to CDC, seven from published case reports, and summarizes the findings in 11 patients described in three case series in peer-reviewed journals (4-6). These 27 patients had cardiovascular, gastrointestinal, dermatologic, and neurologic symptoms without severe respiratory illness and concurrently received positive test results for SARS-CoV-2, the virus that causes COVID-19, by polymerase chain reaction (PCR) or antibody assays indicating recent infection. Reports of these patients highlight the recognition of an illness referred to here as multisystem inflammatory syndrome in adults (MIS-A), the heterogeneity of clinical signs and symptoms, and the role for antibody testing in identifying similar cases among adults. Clinicians and health departments should consider MIS-A in adults with compatible signs and symptoms. These patients might not have positive SARS-CoV-2 PCR or antigen test results, and antibody testing might be needed to confirm previous SARS-CoV-2 infection. Because of the temporal association between MIS-A and SARS-CoV-2 infections, interventions that prevent COVID-19 might prevent MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this newly described condition
Additional file 1 of Implementation strategies in the Exploration and Preparation phases of a colorectal cancer screening intervention in community health centers
Additional file 1. Adherence to reporting guidelines. Description of project adherence to reporting guidelines as outlined in Proctor, E.K., Powell, B.J. & McMillen, J.C. Implementation strategies: recommendations for specifying and reporting. Implementation Sci 8, 139 (2013)
Curbing the major and growing threats from invasive alien species is urgent and achievable.
Although invasive alien species have long been recognized as a major threat to nature and people, until now there has been no comprehensive global review of the status, trends, drivers, impacts, management and governance challenges of biological invasions. The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) Thematic Assessment Report on Invasive Alien Species and Their Control (hereafter 'IPBES invasive alien species assessment') drew on more than 13,000 scientific publications and reports in 15 languages as well as Indigenous and local knowledge on all taxa, ecosystems and regions across the globe. Therefore, it provides unequivocal evidence of the major and growing threat of invasive alien species alongside ambitious but realistic approaches to manage biological invasions. The extent of the threat and impacts has been recognized by the 143 member states of IPBES who approved the summary for policymakers of this assessment. Here, the authors of the IPBES assessment outline the main findings of the IPBES invasive alien species assessment and highlight the urgency to act now