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Foster care has been associated with increased HIV risk behaviors among youth, yet long-term association with HIV infection
has not been examined. This study explored the associations between foster placement, victimization, mental health, onset
of sex work and HIV infection among highly vulnerable female sex workers. 562 drug-involved African American women were enrolled
into an intervention study to increase health services utilization and reduce HIV risk. Seventeen percent reported a history
of foster placement. Foster history was associated with significantly lower educational attainment, higher victimization,
and more severe mental health problems. Women with foster histories reported significantly earlier entry into paid sex work,
with some 62% active in the sex trade before age 18. Multivariate analyses found that foster care was independently associated
with HIV seropositivity, and that early sex work partially mediated this association. The potential long-term health vulnerabilities
associated with foster placement are understudied and warrant additional research. 相似文献
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Victor M. Neira MD M. Dylan Bould MBChB Amy Nakajima MD Sylvain Boet MD Nicholas Barrowman PhD Philipp Mossdorf MD PhD Devin Sydor MD Amy Roeske MD Stephen Noseworthy MD Viren Naik MD Dermot Doherty MD Hilary Writer MD Stanley J. Hamstra PhD 《Journal canadien d'anesthésie》2013,60(3):280-289
Purpose
Our objective was to develop and evaluate a Generic Integrated Objective Structured Assessment Tool (GIOSAT) to integrate Medical Expert and intrinsic (non-medical expert) CanMEDS competencies with non-technical skills for crisis simulation.Methods
An assessment tool was designed and piloted using two pediatric anesthesia scenarios (laryngospasm and hyperkalemia). Following revision of the tool, we used previously recorded videos of anesthesia residents (n = 50) who managed one of two intraoperative advanced cardiac life support (ACLS) scenarios (ventricular tachycardia or ventricular fibrillation). Four independent trained raters, blinded to the residents’ level of training, analyzed the video recordings using the GIOSAT scale. Inter-rater reliability was calculated using intraclass correlations (ICCs) for single raters (single measure) and the average of the four raters (average measure), and construct validity was investigated by correlating GIOSAT scores with postgraduate year of residency (PGY).Results
Total GIOSAT scores for the ACLS scenarios had single measure ICCs of 0.62 and average measure ICCs of 0.85. Inter-rater reliability was substantial for both Medical Expert and intrinsic competencies (single measure ICCs 0.69 and 0.62, respectively; average measure ICCs 0.90 and 0.82, respectively). We found significant correlations between PGY level and total GIOSAT score (r = 0.36; P = 0.011) and between PGY level and Medical Expert competencies (r = 0.42; P = 0.003); however, correlations were not found between PGY level and intrinsic CanMEDS competencies (r = 0.24; P = 0.09).Conclusion
Inter-rater reliability of the total GIOSAT scores using four trained raters was substantial. Significant correlation between PGY and (i) total GIOSAT score and (ii) Medical Expert competencies supports construct validity. Evidence of validity was not obtained for intrinsic CanMEDS competencies. 相似文献88.
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Jennifer S. Beighley Johnny L. Matson Robert D. Rieske Hilary L. Adams 《Research in developmental disabilities》2013,34(10):3497-3503
Feeding problems are common in children with autism spectrum disorders (ASDs), with food selectivity being the most frequently reported. Selectivity based on type and/or texture of food is of concern in those with ASD. Variations in symptom presentation of food selectivity in children with different autism spectrum diagnoses across childhood have not often been investigated. Parent-report of food selectivity was examined in 525 children age 2–18 years diagnosed with autistic disorder, PDD-NOS, Asperger's disorder, atypical development, and typical development using information garnered from the Autism Spectrum Disorder-Comorbidity for Children (ASD-CC), a tool to assess emotional issues and comorbid psychopathology. Individuals with an ASD were reported to have significantly more food selectivity than both the atypically developing group and the typically developing group. In addition, the ASD groups, when looked at together, showed a decrease in food selectivity across childhood with significant decrease in the Asperger's disorder group. 相似文献