Specialized First Episode Psychosis (FEP) services have been conceptualized in part around the issue of engagement. Creating treatment that is easier to access, with more frequent contacts, assertive outreach to clients between appointments, and an explicit youth-oriented culture could make services more attractive to those most in need of care. However, engagement has remained a mostly fuzzy, peripheral construct rather than the object of study in itself. As we recognize the importance of treatment engagement, we must prepare to address it more rigorously within psychosis and schizophrenia research. At the same time, factors enhancing or obstructing treatment engagement are inevitably local, rather than universal. The availability of care, its associated costs and stigmas, individuals' motivations for seeking treatment, and their beliefs and expectations about providers' roles are determined by local and cultural features. There can be no singular “best practice” for engagement - but curiosity about how culture and locale influence clients' willingness to participate in care, and creativity in how we account for and incorporate these variables into study designs, will help to shed light on the critical issue of engagement in FEP treatment.
Experimental studies in guinea pigs demonstrated that influenza virus transmission is strongly modulated by temperature and humidity. A number of epidemiological studies have followed up on these findings and revealed robust associations between influenza incidence in temperate regions and local conditions of humidity and temperature, offering a long-awaited explanation for the wintertime seasonality of influenza in these locales. Despite recent progress, important questions remain as to the mechanism(s) by which humidity and/or temperature affect transmission.
We analyzed a sample of 12,065 hookup encounters among college students at 22 colleges and universities in the Online College Social Life Survey (OCSLS) to explore how partner meeting locales may influence college students' risky behavior when hookup partners are met in those contexts. For other-sex encounters, meeting in bars or at parties, through common interest groups or history, and (for women) at dormitories was associated with binge drinking during encounters, while meeting online and (for women) in public was associated with reduced binge drinking during encounters. Unprotected sex during other-sex encounters was more common when partners were met in public and less common with partners met in dormitories. Binge drinking and marijuana use during or just prior to encounters was associated with an increased risk of unprotected sex and other substance use. Marijuana use and unprotected sex during encounters was more common when students knew their hookup partner better or had hooked up with the partner before, while binge drinking was associated with hooking up with less familiar partners. Associations of meeting contexts with behavior were explained by the locale’s association with institutional and personal trust, social scripts, and selection into certain contexts by students with a risk-taking personality.
The growing global concern around antimicrobial mis-use and proliferating resistance has resulted in increasing interest in optimising antibiotics, particularly in hospitals. While the agenda to tighten antibiotic use has been critically explored in metropolitan settings, the dynamics of rural and remote settings have remained largely unexplored. Drawing on 30 interviews with doctors, nurses, and pharmacists in a remote Australian hospital, we focus on the pertinence of setting, and its importance for contextualising and potentially achieving antibiotic optimisation. Building on previous work on the dynamics of locale and core-periphery relations, here we consider how antimicrobial practice is deeply embedded in experiences of being on the geographical periphery, and crucially, at the periphery of (established) knowledge.
Urinary schistosomiasis has been a major public health problem in Zambia for many years. However, the disease profile may vary in different locale due to the changing ecosystem that contributes to the risk of acquiring the disease. The objective of this study was to quantify risk factors associated with the intensity of urinary schistosomiasis infection in school children in Lusaka Province, Zambia, in order to better understand local transmission.
Engaging Communities in Identifying Local Strategies for Expanding Integrated Employment During and After High School
- American journal on intellectual and developmental disabilities
- Published over 4 years ago
Amidst decades of attention directed toward improving employment outcomes for people with intellectual and developmental disabilities (IDD), few efforts have been made to engage communities in identifying local solutions for expanding integrated employment opportunities. We examined the implementation and outcomes of “community conversation” events held in 6 geographically and economically diverse locales. Each event used an asset-based dialogue approach called the World Café ( Brown & Isaacs, 2005 ) to solicit ideas from a broad cross-section of community members on improving integrated employment that reflect local priorities and possibilities. Six key themes encapsulated the 1,556 strategies generated by the almost 400 attendees. Although considerable consistency was found among the categories of strategies raised across events, the manner in which those individual strategies would be implemented locally reflected the unique accent of each community. Attendees also viewed these events as promising and productive pathways for identifying next steps for their community. We offer recommendations for community-level intervention efforts and suggest directions for future research.