Suchergebnisse

OBJECTIVE: To (1) map how different stakeholders understand telehealth and telecare technologies and (2) explore the implications for development and implementation of telehealth and telecare services. DESIGN: Discourse analysis. SAMPLE: 68 publications representing diverse perspectives (academic, policy, service, commercial and lay) on telehealth and telecare plus field notes from 10 knowledge-sharing events. METHOD: Following a familiarisation phase (browsing and informal interviews), we studied a systematic sample of texts in detail. Through repeated close reading, we identified assumptions, metaphors, storylines, scenarios, practices and rhetorical positions. We added successive findings to an emerging picture of the whole. MAIN FINDINGS: Telehealth and telecare technologies featured prominently in texts on chronic illness and ageing. There was no coherent organising vision. Rather, four conflicting discourses were evident and engaged only minimally with one another's arguments. Modernist discourse presented a futuristic utopian vision in which assistive technologies, implemented at scale, would enable society to meet its moral obligations to older people by creating a safe 'smart' home environment where help was always at hand, while generating efficiency savings. Humanist discourse emphasised the uniqueness and moral worth of the individual and tailoring to personal and family context; it considered that technologies were only sometimes fit for purpose and could create as well as solve problems. Political economy discourse envisaged a techno-economic complex of powerful vested interests driving commodification of healthcare and diversion of public funds into private business. Change management discourse recognised the complicatedness of large-scale technology programmes and emphasised good project management and organisational processes. CONCLUSION: Introduction of telehealth and telecare is hampered because different stakeholders hold different assumptions, values and world views, 'talk past' each other ...

AbstractThe goals of this study were to examine the additive and interactive effects of cumulative risk and child negative emotionality on children's social competence in the transition from preschool to school and to test whether these associations were mediated by child emotion regulation within a sample of 310 low‐income, ethnically diverse boys. Multiple informants and methods were used to measure contextual risk factors and negative emotionality at the ages of 1.5 and two, emotion dysregulation at the age of 3.5, and social competence in the home at the age of five and in school at the age of six. Results indicated that the relation between cumulative risk and emotion dysregulation was amplified for children with higher levels of negative emotionality. In turn, emotion dysregulation predicted lower social competence across both the home and the school contexts. This study represents an early effort to develop an integrative model of social competence by considering joint contributions of contextual risk, negative emotionality, and emotion regulation.

Objective: To (1) map how different stakeholders understand telehealth and telecare technologies and (2) explore the implications for development and implementation of telehealth and telecare services. Design: Discourse analysis. Sample: 68 publications representing diverse perspectives (academic, policy, service, commercial and lay) on telehealth and telecare plus field notes from 10 knowledge-sharing events. Method: Following a familiarisation phase (browsing and informal interviews), we studied a systematic sample of texts in detail. Through repeated close reading, we identified assumptions, metaphors, storylines, scenarios, practices and rhetorical positions. We added successive findings to an emerging picture of the whole. Main findings: Telehealth and telecare technologies featured prominently in texts on chronic illness and ageing. There was no coherent organising vision. Rather, four conflicting discourses were evident and engaged only minimally with one another's arguments. Modernist discourse presented a futuristic utopian vision in which assistive technologies, implemented at scale, would enable society to meet its moral obligations to older people by creating a safe 'smart'home environment where help was always at hand, while generating efficiency savings. Humanist discourse emphasised the uniqueness and moral worth of the individual and tailoring to personal and family context; it considered that technologies were only sometimes fit for purpose and could create as well as solve problems. Political economy discourse envisaged a techno-economic complex of powerful vested interests driving commodification of healthcare and diversion of public funds into private business. Change management discourse recognised the complicatedness of large-scale technology programmes and emphasised good project management and organisational processes. Conclusion: Introduction of telehealth and telecare is hampered because different stakeholders hold different assumptions, values and world views, 'talk past' each other and compete for recognition and resources. If investments in these technologies are to bear fruit, more effective inter-stakeholder dialogue must occur to establish an organising vision that better accommodates competing discourses.

AbstractThe present study tested whether attitudes toward violence mediate the association between intimate partner violence exposure and antisocial behavior across adolescence, and whether cortisol level moderates these pathways in an ethnically diverse sample of 190 boys from low‐income, urban families. Results suggest that a pathway from intimate partner violence exposure at age 12 to antisocial behavior at age 17 is explained by pro‐violence attitudes at age 15. Boys with greater exposure to intimate partner violence endorsed stronger pro‐violence attitudes, which predicted increases in antisocial behavior. Further, the pro‐violence attitudes to antisocial behavior pathway were stronger among boys with heightened versus dampened cortisol levels. Results suggest that violent attitudes are important for understanding the cognitive underpinnings of antisocial behavior following intimate partner violence exposure, particularly in youth with high cortisol levels. Implications for prevention and intervention are discussed with respect to targeting malleable child behavior linked to later antisocial behavior.

Abstract. Māori oral histories from the northern South Island of Aotearoa-New Zealand provide details of ancestral experience with tsunami(s) on, and surrounding, Rangitoto (D'Urville Island). Applying an inductive-based methodology informed by collaborative storytelling, exchanges with key informants from the Māori kin groups of Ngāti Koata and Ngāti Kuia reveal that a folk tale, published in 1907, could be compared to and combined with active oral histories to provide insights into past catastrophic saltwater inundations. Such histories reference multiple layers of experience and meaning, from memorials to ancestral figures and their accomplishments to claims about place, authority and knowledge. Members of Ngāti Koata and Ngāti Kuia, who permitted us to record some of their histories, share the view that there are multiple benefits to be gained by learning from differences in knowledge, practice and belief. This work adds to scientific as well as Maōri understandings about tsunami hazards (and histories). It also demonstrates that to engage with Māori oral histories (and the people who genealogically link to such stories) requires close attention to a politics of representation, in both past recordings and current ways of retelling, as well as sensitivities to the production of new and plural knowledges. This paper makes these narratives available to a new audience, including those families who no longer have access to them, and recites these in ways that might encourage plural knowledge development and co-existence.

AbstractWe examined associations of proactive parenting, child verbal ability, and child effortful control within the context of a randomized prevention trial focused on enhancing parenting practices in low‐income families. Participants (N = 731) were assessed annually from the age of two to five, with half randomly assigned to the Family Check‐Up (FCU). Results indicated that the child's verbal ability at the age of three partially mediated the influence of proactive parenting at the age of two on children's effortful control at the age of five. More importantly, the FCU indirectly facilitated children's effortful control by sequentially improving proactive parenting and children's verbal ability. The findings are discussed with respect to taking a more integrative approach to understanding early predictors and the promotion of self‐regulation in early childhood.

AbstractThe present study assessed longitudinal relations between paternal supportive parenting in infancy (12 months) and toddlerhood (36 months) and children's observed self‐regulation skills at preschool age (48 months) in a large sample of Norwegian families (N = 771; 48% girls, 52% boys, 28% experienced some socioeconomic risk). After accounting for child sex, socioeconomic risk (6 and 12 months), and observed maternal supportive parenting (24 moths), structural equation modeling revealed that observed paternal supportive parenting with children at 36, but not 12, months was independently associated with a latent factor representing children's observed self‐regulation skills at 48 months. Further, a significant indirect pathway emerged such that paternal supportive parenting at 12 months was associated with children's self‐regulation skills at 48 months, via paternal supportive parenting at 36 months. Results are discussed with implications for supporting paternal caregiving during infancy to promote children's emerging self‐regulation skills.

AbstractExtracurricular involvement in the school‐age years has widespread potential benefits for children's subsequent socioemotional development, especially for low‐income youth. However, there is a dearth of research on interventions aimed at increasing school‐age extracurricular involvement in low‐income youth. Thus, the present study aimed to test the collateral effect of a brief, family‐focused intervention for low‐income families, the Family Check‐Up, on children's school‐age extracurricular involvement via improvements in maternal positive behavior support (PBS) in early childhood. The sample (n = 630, 50% female, 50% White, 28% Black/African American) represented a subsample of families from the Early Steps Multisite Study. At the age of two, families were randomly assigned to the Family Check‐Up or Women, Infants, and Children Nutritional Supplement Services as usual. Mother‐child dyads participated in observed interaction tasks at child ages 2 and 3 that were subsequently coded to assess PBS. Primary caregivers reported on children's school‐age extracurricular involvement at ages 7.5, 8.5, and 9.5. Results indicated that although there was not a direct path between intervention status and children's school‐age extracurricular involvement, a significant indirect path emerged from intervention group to changes in PBS between ages 2 to 3 to children's school‐age extracurricular involvement. The results are discussed in terms of implications for designing preventive interventions in early childhood that promote extracurricular involvement at school‐age, particularly for children at risk for maladaptive outcomes.