Amanda N. Barczyk

Adolescent Cancer Survivors: Identity Paradox and the Need to Belong:

Adolescent cancer survivors face psychological effects that can include isolation, poor peer relations, anxiety, depression, and fear of recurrence, which can increase their risk for psychological late effects and poor health posttreatment. The purpose of this exploratory analysis was to understand the experiences of adolescent cancer survivors, with a particular focus on identity, health promotion, and meaning making. In-depth interviews were conducted with 12 adolescent cancer survivors. Constant comparative analysis was used to identify core themes from the data. Findings revealed that adolescent survivors might experience an identity paradox when making the transition to “survivor,” which can contribute to their sense of isolation and risk of health-detracting behaviors. Health promotion, prevention, and supportive programs need to be developed for health care professionals to address the isolation and identity transition needs of adolescent cancer survivors.

Factors Associated with Substance Use Among Homeless Young Adults

The purpose of this study was to investigate factors associated with substance use among homeless young adults. Multinomial logistic regression analyses examined the influence of social networks and economic factors among a group of homeless young adults with differing levels of alcohol and drug use. In addition, for those with an alcohol use disorder, the role of future time expectancies was examined. A sample (n = 185) of homeless young adults aged 18 to 23 were recruited from a community drop-in center and interviewed utilizing self-report instruments. Findings suggest that social networks, economic factors, and future expectancies are significant predictors of the level of substance use among homeless young adults. Being able to identify those areas that place homeless young adults at risk for substance abuse and dependence has implications for effective intervention.

Social Estrangement: Factors Associated with Alcohol or Drug Dependency among Homeless, Street-Involved Young Adults

Substance use is highly prevalent among homeless, street-involved young people. Societal estrangement is often associated with substance use, particularly among this population. The current study utilized a descriptive correlational design to identify four domains of social estrangement: disaffiliation, human capital, identification with homeless culture, and psychological dysfunction. These domains were tested to determine their association with alcohol or drug dependence. Interviews utilizing self-report instruments were conducted with 185 young adults aged 18–23 years of age who were receiving homeless services from a community drop-in center. In this sample, the vast majority reported high levels of alcohol and drug use with more than half being identified as dependent on alcohol and/or drugs. Polysubstance use was highly prevalent and most reported marijuana as their drug of choice. Findings indicate that identification with homeless culture was the most highly predictive domain of social estrangement for both alcohol and drug dependency. Implications for services to this population are discussed.

Cash and Counseling: A Model for Self-Directed Care Programs to Empower Individuals With Serious Mental Illnesses

Mental illness is the countrys leading cause of disability. However, approximately 60 percent of individuals with serious mental illness (SMI) are not receiving stable, ongoing treatment (Carper, 2005). One approach to combat this problem is to actively involve consumers in their treatment. Personal assistance services (PAS) assist individuals with disabilities with their daily living activities, and some, such as cash and counseling (C&C), empower individuals to make their own treatment decisions. Self-directed care programs have recently adapted from C&C programs targeting individuals with physical disabilities to models targeting individuals with SMI. The purpose of this article is to examine the effectiveness of these programs, explore their impact on individuals with SMI, and discuss the role of social workers in this new service delivery approach.

Homeless, Street-Involved Emerging Adults: Attitudes toward Substance Use.

Research has indicated that a high proportion of homeless emerging adults use substances. This article aims to understand the attitudes of these young adults concerning their substance use and its effect on their lives. A mixed methods study using semistructured interviews and self-report instruments was conducted with 87 emerging adults who received homeless services from a community drop-in center. Qualitative analyses found that participants reported positive attitudes of substance use; however, many recognized the benefits of a life without drugs or alcohol. Findings suggest attitudes toward substance use and the role of substance use in the lives of homeless emerging adults are viewed as a valuable means of coping with street life, connecting with peers, and managing physical and mental health symptoms.

Fathers of Children With Cancer: A Descriptive Synthesis of the Literature

This article reviews and synthesizes research studies on fathers of children diagnosed with cancer in order to identify the stressors resulting from their childs diagnosis. A systematic search of the literature between 1980 and 2007 generated 53 eligible studies that specifically identified issues relevant to fathers of children with cancer. Fathers experience unique stressors that may be related to gender-related roles. These stressors need specific focus and clinical attention from social workers. Review findings indicate the unique role gender plays in coping with childhood cancer, the importance of involving fathers in childhood cancer research, and in structuring psychosocial support addressing their specific concerns.

Family functioning and mental health in runaway youth: association with posttraumatic stress symptoms.

This study examined the direct effects of physical and sexual abuse, neglect, poor family communication and worries concerning family relationships, depression, anxiety, and dissociation on posttraumatic stress symptoms. Runaway youth were recruited from emergency youth shelters in New York and Texas. Interviews were completed with 350 youth who averaged 15 years of age. Structural equation modeling was used to examine family functioning, maltreatment, depression, dissociation, and anxiety in relation to posttraumatic stress symptoms. Results indicated that direct effects of family relationship worry to dissociation, β = .77, p < .001; depression, β = .85, p < .001; and anxiety, β = .90, p < .001 were significant, as were relationships between family communication and youth dissociation, β = .42, p < .001; depression, β = .46, p < .001; and anxiety, β = .32, p < .001. No significant effects of physical/sexual abuse or neglect were found. Higher levels of dissociation, β = .21, p < .001 and anxiety symptoms, β = .34, p = .01 were positively and significantly associated with posttraumatic stress symptoms, but depression was not. Findings underscore the critical role of family relationships in mental health symptoms experienced by runaway adolescents.

Threat of paediatric hyperthermia in an enclosed vehicle: a year-round study

Objective To describe temperature change throughout the workday in an enclosed vehicle in Austin, Texas across the calendar year while accounting for heat index. Methods In this observational study, vehicular temperature was measured 1 day per month during 2012 in Austin, Texas. Data were recorded at 5-min intervals via an EL-USB-1-PRO digital temperature sensor from 8:00 to 16:00. Selected days were primarily cloud-free (with ‘clear’ or ‘few clouds’) with a predicted ambient temperature high within ±20°F of the 30-year normal high. Referent temperature and 30-year normal data were collected via the nearest National Weather Service (NWS) weather station. The NWS heat index and corresponding hazard levels were used as a guideline for this study. Results Per NWS guidelines, the enclosed vehicle temperature rose to ‘danger’ levels of ≥105°F (41°C) in all months except January and December and to ‘extreme caution’ levels of ≥90°F (32°C) in every month of the year. In June, the vehicle rose to ≥105°F (41°C) by 9:25. The hottest vehicular temperature achieved was 137°F (58°C). In 9 months of the year, the vehicle reached ≥90°F (32°C) by noon. We also found that an ambient temperature as low as 68°F was associated with vehicular temperatures ≥105°F (41°C). Conclusions Infants and children in states that experience mild winter temperatures face the threat of vehicular hyperthermia disability and death across the calendar year. Prevention efforts that focus on awareness of a childhood heat vulnerability, parental perception of susceptibility to forgetting a child in a vehicle and universal availability of vehicular safety devices may reduce paediatric vehicular hyperthermia death.

Risky drinking among parents of pediatric trauma patients

BACKGROUND Unintentional injury is the leading cause of death for children in the United States. An association between parental alcohol use and the frequency and severity of childhood injuries has been found; however, research is limited. The purpose of this study was to (1) describe demographics, child safety behaviors, and parental risky behaviors for a pediatric trauma patient population and (2) assess the relationship between positive screen results for risky drinking in parents and demographic and child safety behaviors. METHODS Data were collected from a sample of parents of a child younger than 15 years who was admitted to an urban children’s hospital for treatment for an unintentional injury. Data were analyzed using descriptive statistics, bivariate analyses, and logistic regression. RESULTS A total of 926 parents of 693 patients were included in this study. Of the families who completed the survey, 37.1% (n = 257) had at least one parent screening positive for risky alcohol use. When looking at patients who ride bicycles, a little more than half (55.1%) were reported as consistently using a helmet. Results showed that inconsistent helmet use was associated with a higher likelihood of at least one parent screening positive for risky drinking (odds ratio, 1.58; 95% confidence interval, 1.06–2.36; p ⩽ 0.05). CONCLUSION Helmet use is a known prevention method of head injuries resulting from bicycle crashes. However, improvements need to be made on how to disseminate this information to parents and how to locate and intervene with the parents who have children that are at an increased risk of injury and injury recidivism. Using screening and brief intervention programs may assist in locating and reducing the potential of recurring visits by at-risk patients such as those in this sample who had at least one parent screening positive for risky drinking. LEVEL OF EVIDENCE Prognostic study, level III.

Perceptions of injury prevention and familial adjustment among mothers of teen parents

INTRODUCTION Injury is a leading cause of death for infants and children. Teen mothering has been shown to put children at increased risk of injury. The mothers of teen parents often play a predominant role in the lives and caregiving of the children born to their children. METHOD This article presents the findings of three focus groups conducted with 21 mothers of teen parents. Grounded theory methodology was used to explore family dynamics and how they relate to injury prevention beliefs and practices regarding infants and children. RESULTS Our findings revealed the difficulty mothers of teen parents and the teens themselves have in adjusting to the knowledge of the pregnancy. Unique barriers to injury prevention were also uncovered. CONCLUSIONS Our findings provide evidence for the need of a multigenerational approach to programs aimed at improving the safety and well-being of children in this context.