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1.
J Career Dev ; 50(4): 947-964, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37463233

RESUMO

Veterans living with mental health conditions have ambitious career goals and want support to find employment that meets their interests and preferences. Despite calls from researchers to "invest" and "commit" to career development research and practice for individuals living with psychiatric conditions, we still do not have empirically tested models for facilitating career development among individuals with mental health conditions, especially veterans. This qualitative study investigates the career development needs and recommended intervention strategies of veterans living with mental health conditions. Vocational counselors from the Veterans Health Administration (VHA) and veterans receiving vocational rehabilitation services (N = 13) participated in semi-structured focus groups. Findings illuminate the tasks, barriers, interventions, implementation strategies, and transitional work context that hinder and support career development of veterans with mental health conditions. Findings offer theoretical and applied guidance to researchers and counselors regarding career development of veterans living with mental health conditions.

3.
J Couns Psychol ; 69(5): 565-577, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35420838

RESUMO

This study explores the nature of precarity via the lens of the coronavirus disease (COVID-19) pandemic. Precarity refers to uncertainty, loss, disruption, and anxiety, which differentially impact people across contexts. We sought to (a) identify how people understand and resist precarity during the pandemic; (b) explore the potential of precarity to serve as an organizing concept for psychological praxis and research; and (c) explore ways in which psychology of working theory (PWT) may be enriched by an infusion of precarity into its theoretical tenets. Twenty-seven participants who experienced work-related disruptions completed an open-ended survey during the summer of 2020 about the multifaceted challenges they faced. We used conventional content analysis to analyze the responses and derived the following three themes: (a) disruptions at work elevate precarity; (b) relationships as a source of both stress and resilience/resistance; and (c) expanding critical consciousness and resistance. Using a critical qualitative research lens, we identified ways in which people were protected from, or vulnerable to, the threats to their security. We also explored the complex intersection of structural barriers and social identities in relation to precarity. We presented propositions to guide future scholarship on precarity and PWT. Implications for practice and advocacy conclude the article. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
COVID-19 , Pandemias , Ansiedade , Humanos , Pandemias/prevenção & controle , Pesquisa Qualitativa
4.
Matern Child Health J ; 25(1): 27-37, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33219911

RESUMO

OBJECTIVE: The aim of the present study was to describe self-regulation (the ability to influence or control one's thoughts or behavior in response to situational demands and social norms) in children ages 3-5 years using a nationally representative sample and examine risk and protective factors to identify opportunities to support children and families. METHODS: Using a cross-sectional design, we examined data from a parent-reported pilot measure of self-regulation from the 2016 National Survey of Children's Health (NSCH). We compared U.S. children aged 3-5 years who were described by parents as "on track" with self-regulation development with children who were not. In addition, we described how health care and developmental services, community, family, and child health and development factors are associated with children's self-regulation. RESULTS: The majority of children (4 of 5) were described by their parents to be developmentally on track with self-regulation. Compared to children described as not on track, children described as on track more often lived in financially and socially advantaged environments and less often experienced family adversity. They also had other positive health and development indicators, whether or not they were receiving developmental services. However, only half of children not on track received developmental surveillance, and only 1 in 4 children described as not on track received educational, mental health, or developmental services. CONCLUSION: The findings are a step towards using self-regulation as an indicator of healthy child development and as a potential strategy to identify groups of children who may need additional support.


Assuntos
Desenvolvimento Infantil , Nível de Saúde , Autocontrole , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Estados Unidos
5.
Infants Young Child ; 33(2): 95-107, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33132516

RESUMO

This article describes novel methods of applying the Ages and Stages Questionnaire-3rd edition (ASQ-3) to assess and quantify developmental delay among children following the 2015-2016 Zika virus outbreak in Brazil. Many of the children with Zika virus infection were expected to have severe developmental delay. However, administering the ASQ-3 to caregivers of these children according to standard protocol would have screened for the overall presence of delay but not the severity of delay. We adopted an amended protocol for administration of the ASQ-3 to quantify the developmental functioning of children severely affected by Zika virus infection in this investigation. Protocols for administering the ASQ-3 among this population were drafted in consultation with developmental measurement experts and are presented here. Specific developmental estimates are discussed, including developmental age equivalents, developmental quotients, and developmental quotient z scores. The calculations of these estimates are presented with examples in the context of the 2015-2016 Zika virus outbreak and associated microcephaly among prenatally infected children from 2 states in northeastern Brazil. Potential applications of these methods for estimating developmental ability among similar pediatric populations are discussed.

6.
J Dev Behav Pediatr ; 40(5): 344-353, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30921104

RESUMO

OBJECTIVE: Evidence suggests that caring for a child with special health care needs can affect many domains of family life, including caregiver mental health. However, few studies have examined these outcomes among families impacted by the Zika virus (ZIKV). This study examines depressive symptom severity and care demands among primary caregivers of children, aged 15 to 26 months, with evidence of congenital Zika virus infection (ZVI). METHODS: A sample of primary caregivers of children with evidence of congenital ZVI in northeastern Brazil (n = 150) reported on depressive symptoms, care demands, and their children's development. Children were categorized into groups according to their developmental delay status. Bivariate analyses were run to test for differences between groups. A path analysis model was used to examine the indirect effects of developmental delay on depressive symptoms through economic challenges and time spent providing health care at home and whether these associations varied by child care support. RESULTS: Compared to primary caregivers of children without developmental delay, primary caregivers of children with developmental delay had higher depression scores (p = 0.002), reported more economic (p < 0.001) and child care (p < 0.001) challenges, and spent more time providing health care at home (p < 0.001). Among primary caregivers who did not have child care support, developmental delay had a significant indirect effect on depressive symptoms through economic challenges but not through time spent providing health care at home. CONCLUSION: For families impacted by the ZIKV outbreak in Brazil, economic and child care challenges may be associated with primary caregiver mental health.


Assuntos
Cuidadores , Cuidado da Criança , Depressão , Deficiências do Desenvolvimento , Microcefalia , Mães , Assistência Pública , Fatores Socioeconômicos , Infecção por Zika virus , Brasil/epidemiologia , Cuidadores/economia , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Cuidado da Criança/economia , Cuidado da Criança/estatística & dados numéricos , Pré-Escolar , Depressão/epidemiologia , Deficiências do Desenvolvimento/economia , Deficiências do Desenvolvimento/epidemiologia , Deficiências do Desenvolvimento/enfermagem , Feminino , Humanos , Lactente , Masculino , Microcefalia/economia , Microcefalia/epidemiologia , Microcefalia/enfermagem , Mães/psicologia , Mães/estatística & dados numéricos , Infecção por Zika virus/congênito , Infecção por Zika virus/economia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/enfermagem
7.
MMWR Morb Mortal Wkly Rep ; 67(50): 1377-1383, 2018 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-30571671

RESUMO

Childhood mental, behavioral, and developmental disorders (MBDDs) are associated with adverse outcomes that can persist into adulthood (1,2). Pediatric clinical settings are important for identifying and treating MBDDs (3). Early identification and treatment of MBDDs can promote healthy development for all children (4), especially those living in poverty who are at increased risk for MBDDs (3,5) but might have reduced access to care (6). CDC analyzed data from the 2016 National Survey of Children's Health (NSCH) on MBDDs, risk factors, and use of federal assistance programs (e.g., Supplemental Nutrition Assistance Program [SNAP]) to identify points to reach children in poverty. In line with previous research (3,6), compared with children in higher-income households, those in lower-income households more often had ever received a diagnosis of an MBDD (22.1% versus 13.9%), and less often had seen a health care provider in the previous year (80.4% versus 93.8%). Among children living below 200% of the federal poverty level (FPL) who did not see a health care provider in the previous year, seven of 10 were in families receiving at least one public assistance benefit. Public assistance programs might offer collaboration opportunities to provide families living in poverty with information, co-located screening programs or services, or connection to care.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Atenção à Saúde/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Família , Transtornos Mentais/epidemiologia , Pobreza/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Estados Unidos/epidemiologia
8.
MMWR Morb Mortal Wkly Rep ; 67(38): 1045-1049, 2018 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-30260943

RESUMO

Children with heart conditions often use more health care services and specialized care than children without a heart condition (1); however, little is known about the number of U.S. children with heart conditions and their special health care needs. CDC used data from the 2016 National Survey of Children's Health (NSCH) to estimate the prevalence of heart conditions among U.S. children aged 0-17 years, which indicated that 1.3% had a current heart condition and 1.1% had a past heart condition (representing approximately 900,000 and 755,000 children, respectively). Sixty percent and 40% of children with current and past heart conditions, respectively, had one or more special health care needs, compared with 18.7% of children without a heart condition (adjusted prevalence ratios [aPRs] = 3.1 and 2.1, respectively). Functional limitations were 6.3 times more common in children with current heart conditions (30.7%) than in those without heart conditions (4.6%). Among children with current heart conditions, males, children with lower family income, and children living in other than a two-parent household had an increased prevalence of special health care needs. These findings highlight the importance of developmental surveillance and screening for children with heart conditions and might inform public health resource planning.


Assuntos
Serviços de Saúde da Criança , Necessidades e Demandas de Serviços de Saúde , Cardiopatias/terapia , Especialização , Adolescente , Criança , Pré-Escolar , Feminino , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Estados Unidos/epidemiologia
9.
J Electromyogr Kinesiol ; 28: 99-103, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27093137

RESUMO

It has been shown that under isometric conditions, as the activity of the abdominal muscles increases, the thicknesses of the muscles also increase. The purpose of this experiment was to determine whether change in muscle thickness could be used as a measure of muscle activity during a deadlift as well as determining the effect of a weightlifting belt and/or the Valsalva maneuver on the muscle thicknesses. The Transversus Abdominis (TrA) and Internal Obliques (IO) muscles were analyzed at rest and during a deadlift. Muscle thickness was measured using ultrasound imaging and muscle activity was simultaneously recorded using electromyography. Each subject performed deadlift under normal conditions, while performing the Valsalva maneuver, while wearing a weightlifting belt and while both utilizing the belt and the Valsalva maneuver. There was no relationship between change in muscle thickness and muscle activity for both the TrA and IO (R(2)<0.13 for all conditions). However it was found that the Valsalva maneuver increased abdominal muscle thickness whereas the belt limited muscle expansion; each with an increase in activity. These results indicate that ultrasound cannot be used to measure muscle activity for a deadlift and that the belt affects how the IO and TrA function together.


Assuntos
Músculos Abdominais/fisiologia , Aparelhos Ortopédicos , Manobra de Valsalva , Levantamento de Peso/fisiologia , Adulto , Feminino , Humanos , Masculino , Contração Muscular
10.
MMWR Morb Mortal Wkly Rep ; 65(9): 221-6, 2016 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-26963052

RESUMO

Sociodemographic, health care, family, and community attributes have been associated with increased risk for mental, behavioral, and developmental disorders (MBDDs) in children (1,2). For example, poverty has been shown to have adverse effects on cognitive, socio-emotional, and physical development (1). A safe place to play is needed for gross motor development, and accessible health care is needed for preventive and illness health care (3). Positive parenting and quality preschool interventions have been shown to be associated with prosocial skills, better educational outcomes, and fewer health risk behaviors over time (2). Protective factors for MBDDs are often shared (4) and conditions often co-occur; therefore, CDC considered MBDDs together to facilitate the identification of factors that could inform collaborative, multidisciplinary prevention strategies. To identify specific factors associated with MBDDs among U.S. children aged 2-8 years, parent-reported data from the most recent (2011-2012) National Survey of Children's Health (NSCH) were analyzed. Factors associated with having any MBDD included inadequate insurance, lacking a medical home, fair or poor parental mental health, difficulties getting by on the family's income, employment difficulties because of child care issues, living in a neighborhood lacking support, living in a neighborhood lacking amenities (e.g., sidewalks, park, recreation center, and library), and living in a neighborhood in poor condition. In a multivariate analysis, fair or poor parental mental health and lacking a medical home were significantly associated with having an MBDD. There was significant variation in the prevalence of these and the other factors by state, suggesting that programs and policies might use collaborative efforts to focus on specific factors. Addressing identified factors might prevent the onset of MBDDs and improve outcomes among children who have one or more of these disorders.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Atenção à Saúde/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Família , Transtornos Mentais/epidemiologia , Características de Residência/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Assistência Centrada no Paciente/estatística & dados numéricos , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
12.
J Perinatol ; 24(11): 730-2, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15510103

RESUMO

When sedation, prematurity or other disease processes mask symptoms in the clinically ill newborn, serum bilirubin concentration is monitored as the sole indicator of kernicterus risk. This case emphasizes the value of auditory brainstem responses for the management of indirect hyperbilirubinemia complicated by prematurity, hemolytic anemia, asphyxia, and direct hyperbilirubinemia.


Assuntos
Potenciais Evocados Auditivos do Tronco Encefálico , Hiperbilirrubinemia/complicações , Kernicterus/diagnóstico , Bilirrubina/sangue , Humanos , Recém-Nascido , Masculino
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