Exploring Suicide Risk History Among Youth in Residential Care

Adolescents in residential care settings have double the national average of suicide risk histories (attempts, threats, and ideation). However, little is known about youth with specific suicide-risk histories. This study explored differences in demographic characteristics and mental health variables for 509 youth in residential care with high and low suicide-risk histories. Overall, nearly 40% of participants had a high suicide-risk history, and significant differences between low and high suicide-risk history groups were found for multiple variables (e.g., gender, ethnicity, number of diagnoses). This study highlights a need for research into areas associated with suicide-risk history in residential care.     

The Family Characteristics of Youth Entering a Residential Care Program

Although much is known about the mental health and behavioral functioning of youth who enter residential care programs, very little research has focused on examining the family characteristics of this population. Knowledge about family characteristics is important, however, as it can aid in tailoring programs to meet the needs of families who are involved in treatment and help them address concerns in order to facilitate the transition home. Therefore, the purpose of the present study was to examine the characteristics of youth's families at the time of entry into a residential care program. Using data from archived youth files, family characteristics were examined across several areas, including: (a) youth variables related to family (e.g., out-of-home placements, legal guardian), (b) family risk (e.g., substance abuse, domestic violence, financial problems), and (c) parenting (e.g., adequate supervision, discipline, communication). Findings suggested that youth entering residential care programs have families with high levels of risk and low levels of parenting skills. Implications and considerations for future research are discussed     

Resilient Youth in Residential Care

Youth typically enter residential treatment once other less-intensive interventions have been ineffective. Youth in residential care often have trauma histories, resulting in significant behavioral and emotional impairments. Given the adversity residential youth have faced, how can resiliency and protective factors be fostered? The purpose of the present study is to examine the relationship between adverse childhood experiences (ACEs), resiliency, and positive youth development in a sample of adolescent youth placed in residential care. The sample included 42 youth between the ages of 13–18 in five different residential treatment centers. Results showed that higher levels of resiliency indicated higher levels of positive youth development. A strong, positive correlation was found between resiliency and positive youth development. Results suggest that higher levels of trauma are related to lower levels of resiliency. A moderate, negative correlation was found between trauma and resiliency. Understanding and accessing youth's sources of strength is an important tool to build upon in therapy. These findings may lead to more effective treatment interventions that are tailored to residential youth's specific needs, ultimately fostering resilient outcomes.     

Community Adaptation of Youth Accessing Residential Programs or a Home-Based Alternative: Contact With the Law and Delinquent Activities

This article presents the findings from a longitudinal investigation of the prevalence of negative contact with the law for a sample of youth 12–18 months after graduating from residential and intensive children's mental health programming. Results of this study suggest serious community adaptation difficulties face many youth graduating from these children's mental health programs. This study suggests that delinquency outcomes may be particularly problematic for older males who are transitioning out of treatment programs, as well as for youth with prior contact with the law, and greater challenges adapting to school at program admission.     

Prevalence of Overweight and Obesity in Children With Intellectual Disabilities in Korea

Background Overweight and obesity in children with intellectual disabilities may be a major health threat. The purpose of this study was to examine the prevalence of overweight and obesity in Korean children with intellectual disabilities aged 7–18 years who did not have specific genetic syndromes or physical disabilities. Materials and methods Participants were 2,404 children with intellectual disabilities aged 7–18 years attending thirteen special schools in Korea. Data from school health records were analysed using SAS (version 9.2). The differences between boys and girls were assessed for children’s height and weight using t‐tests and for children’s age and weight status, such as using Chi‐Square (χ²) test. The relationships between children’s weight status, age and gender were reassessed using Chi‐Square (χ²) test, and strengths of the relationships were measured using Gamma coefficient. Results Approximately one‐quarter of children with intellectual disabilities were either overweight or obese. Children’s gender was significantly associated with their weight status, such that overweight and obesity were more prevalent in girls than in boys, specifically girls aged 15–18 years. There was a positive relationship between age and the prevalence of overweight and obesity in children for both boys and girls. Conclusions The high rates of overweight and obesity in children with intellectual disabilities highlight the need for interventions to help children achieve healthy weight. Before conducting weight management interventions, identifying risk factors that influence weight status in children with intellectual disabilities is an important step.     

辽宁省农村老年女性超重与肥胖患病率及其危险因素调查

  目的  分析辽宁省农村地区老年女性超重和肥胖的患病率及其相关危险因素。  方法  2004年6月至2005年6月, 采用分层整群随机抽样方法, 对辽宁省农村地区3232名年龄在60岁以上的老年女性人群进行横断面研究。全部研究对象进行体格检查及生活方式等其他相关因素调查。超重及肥胖分别按WHO及中国标准定义。  结果  按WHO标准, 超重及肥胖的患病率分别为17.7%和2.2%;而按中国标准, 分别为23.7%和5.8%。通过多元Logistic回归分析:蒙古族、饮酒是超重与肥胖的危险因素; 而年龄及吸烟则为保护性因素。  结论  辽宁省农村老年女性肥胖的患病率尽管较低, 但其超重患病率仍处于较高水平。不健康的生活方式、年龄、民族与超重和肥胖相关。     

Predicting Residential Treatment Outcomes for Emotionally and Behaviorally Disordered Youth: The Role of Pretreatment Factors

This study examined outcomes with 170 children and youth admitted to residential treatment with complex mental health problems. Overall, outcomes at 2 years post-treatment was predicted by children and youth's behavioral pretreatment status reflected in lower internalizing and externalizing behavior at admission. These findings recognize a cluster of variables upon admission that are differentially predictive of specific outcomes. Higher school participation/achievement and an absence of witnessing interparental abuse predicted educational status. Family status was predicted at admission by higher family functioning, being younger in the family, and children and youth who had poor community behavior. The results are discussed as they relate to pretreatment screening and the need to evaluate service outcomes.     

Considering Residential Treatment for Youth in the Continuum of Care: A Systems Perspective

This article examines the residential treatment alternative in social and historical contexts. It provides recommendations for clearly defining residential treatment services and measuring the effectiveness of residential treatment programs. The study suggests models for family involvement, after care, and follow-up that may enhance the long term success of residential treatment. The research has been designed to assist Orion House, Inc., a residential treatment center for male youth in Newport, New Hampshire, and therefore the study includes information about the macro-environment in which Orion House operates. However, suggested methods may be generalized and applied to other residential treatment facilities.     

Youth and Family Participation in the Governance of Residential Treatment Facilities

This study used data from a national survey of residential treatment facilities and conducted interviews with stakeholders in systems of care that serve children and youth with serious emotional disturbances to examine the extent to which youth and families participate in the governance activities of residential treatment facilities. Twenty percent of residential treatment facilities included youth and families in some type of governance activity, such as serving on the board of directors or participating in quality assurance. Thirty-eight percent of residential treatment providers agreed that licensing or accreditation standards should require the participation of youth and families in facility governance, and these facilities were more likely to have adopted treatment practices consistent with a commitment to partnering with youth and families in the delivery of services. These practices include unrestricted visitation and allowing youth and families to select their treatment team. Residential treatment providers and other stakeholders in systems of care identified several challenges to engaging youth and families in facility governance and proposed solutions for overcoming them. Further work is needed to encourage and monitor the participation of youth and families in the governance of residential treatment.     

Developing a Clinical Framework for Children/Youth Residential Treatment

The idea of implementing consistent overall clinical approaches in residential treatment facilities may improve care by influencing family engagement, interactional styles of residential staff and clinicians with children and youth, specific therapeutic interventions including the management of problematic behaviors, milieu approaches, and group interventions, as well as inform programmatic structure, rules, and expectations of residential living. A clinical framework should demonstrate contemporary and evidence supported practices in order to achieve meaningful success. This article summarizes a literature search and discussion points regarding family/community engagement, individualized assessment/treatment, interprofessional teams, and organizational factors in developing a clinical framework for children/youth residential treatment.     

Beyond Control: Staff Perceptions of Accountability for Children and Youth in Residential Group Care

This article explores the perceptions of residential staff teams regarding the concept of accountability for children and youth living in group care situations. Using a qualitative research approach, the authors held focus groups with residential staff teams in children's mental health and private group care facilities and then interviewed the supervisors separately in an effort to explore how these teams conceive of their responsibility to teach children and youth about accountability, as well as in order to determine the specific tools used and approaches taken for this purpose. The authors found that a strong reliance on control-based approaches persists and that, furthermore, very little conceptual or theoretical thinking informs team discussions or approaches to holding children and youth accountable for their actions. It is argued here that there is an urgent need to seriously engage with residential care providers about the lived experiences of children and youth under conditions. The use of control and vigilance around the enforcement of program expectations are rarely focused on the individual needs of the clients and typically reflect the intuition or “common sense” of residential staff teams instead.     

Social Implications of Overweight and Obesity in Children

PURPOSE.  To elucidate some of the social impacts that overweight and obesity in children has on families. Healthcare practitioners may be unaware of these impacts if not similarly affected.
DESIGN.  Qualitative semistructured, interview-based study.
METHODS.  A purposive sample of parents ( n  = 58) with overweight and obese children ( n  = 48) from three areas in the United Kingdom was used. Analysis was thematic and iterative , underpinned by Grounded Theory.
RESULTS.  There are many social situations that have an impact on the child directly (stigmatization), on parents (blame), and on the family in general (being ostracized).
PRACTICE IMPLICATIONS.  Seeing the child and his/her family in a broader context with improved understanding of the complexity of raising an overweight child.     

对1513名离退休干部超重和肥胖情况的调查与分析

目的 分析离退休干部人群超重和肥胖的发生率，为干部门诊就诊的该类患者制定针对性健康教育方案与护理干预提供依据。方法 对干部门诊接受年度体检的60岁以上人群共计l513名，进行体重测定，并从查体资料中获取慢性病的发病情况。结果 1513人中48．9％的人超重，12．8％的人肥胖，仅有36．5％的人体重正常；整个老年人群的体重处于超重状态。结论 离退休干部人群中超重和肥胖情况严重。     

Correlates of Substance Use Severity Among Homeless Youth

PROBLEM: This cross-sectional study identified a number of factors that were correlated with drug-use severity among homeless youth. METHODS: To examine a commonly used measure of substance-use severity, the TCU Drug Screen II, in a convenience sample of 156 homeless youth, ages 15–25 from a drop-in site in Santa Monica, California. FINDINGS: Higher drug-use severity scores were independently related to low levels of perceived health and maladaptive coping strategies. CONCLUSIONS: The findings from this study are particularly relevant in that they support previous results showing that psychosocial variables are related to substance use behavior among young populations.     

Staff Support and Supervision in Residential Youth Justice: An Australian Model

The role for staff within the residential youth justice facility is an intense one, offering both reward and challenge. Post-traumatic stress related to serious episodes of violence and vicarious trauma relating to the abuse and neglect derived from the residents' personal narratives are common. In recent years a residential center in Melbourne, Victoria, Australia has experimented with provision of a Staff Support and Supervision Program (SSSP). This article describes the context which gave rise to the program, its multi-theoretical underpinning, and its modus operandi. A qualitative evaluation highlights practice challenges and leadership techniques. The model is now being applied in two other Victorian youth justice centers.     

1260例公务员超重肥胖及其与高血脂的相关性分析

目的：了解四川省直机关省厅级公务员超重、肥胖的现状,探讨体重指数、腰围与血脂的关系。方法：2008年对四川省直机关省厅级公务员取样调查1260人测身高,体重,腰围（WC）,血脂,计算体重指数（BMI）,并对男女各组间胆固醇、甘油三酯进行统计学分析。结果：四川省直机关省厅级公务员的男女肥胖率分别为9.1%、7.7%,超重率分别为45.3%、27.8%,肥胖组及超重组甘油三酯明显高于正常组,多元回归分析结果显示男女性甘油三酯与BMI、WC均有明显相关性（P〈0.01）。结论：防治高血脂,控制肥胖及腹型肥胖甚为重要,体重指数、腰围的控制也为防治高血脂的基本措施之一。     

Clinical Gains for Youth in Psychiatric Residential Treatment Facilities: Results from a State-Wide Performance Information System

This article presents findings on clinical gains for youth in psychiatric residential treatment facilities (PRTF) through the use of state-wide performance management information. Data was collected on 1,258 youth admitted to one of seventeen PRTF facilities in a single, mid-western state. Results suggest that youth made positive clinical changes during treatment. Furthermore, results indicate that parent and youth hopefulness and satisfaction were significant predictors of positive clinical changes in problem severity and youth functioning. These findings contribute to current literature on PRTF effectiveness in achieving positive youth outcomes and the role of consumer attitudinal factors in treatment.