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Utilising telepractice videoconferencing technology to offer home visitation services has the potential to provide access and parenting support through a high‐tech and high‐touch service delivery option. Families can receive evidence‐based, family support intervention from their home via videoconferencing technology, removing the need for the provider to be physically in the home. While the expansion of telehealth and telepractice services for families is essential for meeting the needs of both parents and their children, well‐documented engagement barriers to digital health/computer‐mediated interventions exist across treatment modalities and technology platforms. Semi‐structured interviews with 15 providers were conducted and analysed to identify engagement strategies utilised to sustain families in a home visitation model offered through live videoconferencing technology on a telehealth platform. Analysis revealed four themes that were deemed essential for successfully attracting and maintaining families in a telepractice‐based home visitation programme: (a) engagement strategies to encourage families to participate; (b) clinical skills used within sessions; (c) articulation of benefits to the family; and (d) exploration of rationale for ending services. This study was able to identify strategies for engagement and sustained involvement of families in telehealth‐based home visitation. Findings include evidence that providers should be able to move between telehealth and on‐ground service provision with relative ease. [ABSTRACT FROM AUTHOR]

U.S. educational policymakers and equity advocates often frame the negative ramifications of racial inequality in schools in terms of worries about the nation's future global economic competitiveness. This article draws on frame theory (Snow & Benford, 1988) and education organizing theory (Warren & Mapp, 2011) to argue that educational policymakers and advocates must expand this national competitiveness frame to advance racial and educational justice. By outlining the emergence and reification of the national competitiveness frame in contemporary U.S. education policy, this article demonstrates how the national competitiveness frame can successfully build domestic alliances and create urgency for education reform. However, it can also risk co-opting racial justice goals. Further, this U.S.-centric frame ignores the global experience of racialization and educational injustice shared by marginalized groups around the world. The article closes by suggesting that educational equity advocates build on these transnational connections and use a collaborative frame to build collective power among historically marginalized groups worldwide to advance racial and educational justice in both the United States and abroad. [ABSTRACT FROM PUBLISHER]

In this article, Amanda J. Taylor uses portraiture methodology to explore one white teacher's efforts to understand whether and how race plays a role in her teaching practice. With no conscious experiences with race and racism, this teacher draws on her time as a cross-cultural traveler to construct and apply what Taylor calls a racial touchstone to best approximate the nature of racism. The teacher uses her touchstone to frame her interpretations and guide her pedagogical choices in the context of her classroom. Ultimately, this touchstone allows her to center culture and avoid racial analyses, resulting in her justification of surface-level approaches to engaging difference that are not likely to dismantle racial inequality. [ABSTRACT FROM AUTHOR]

This paper describes the psychometric properties of two fidelity scales created as part of the Substance Abuse and Mental Health Services Administration (SAMHSA) sponsored medication management toolkit and their metric properties when used in 26 public mental health clinics with 50 prescribers. A 23-item scale, based on chart reviews, was developed to assess whether prescribers are following good medication practices, in conjunction with a 17-item scale to assess organizational support for and evaluation of prescriber adherence to recommended medication-related practices. Fundamental gaps in routine practice, including poor documentation of medication history and infrequent monitoring of symptoms and side effects were found. [ABSTRACT FROM AUTHOR]

The article discusses the role of photographic images taken as part of the U.S. National Aeronautics and Space Administration's (NASA's) Apollo programme in the environmental movement. Particular focus is given to the photographs "Earthrise from the Moon" and "Whole Earth" and related works by artists Chesley Bonestell, David Hardy, and Chris Butler. According to the authors, the images expressed the importance and agency of the Earth and played a significant part in calling public attention to ecocritical concerns. It is suggested that future exploration of the solar system should be informed by the environmental awareness engendered by these images. Other topics include depictions of outer space in art, space tourism, and proposals for the protection of planetary environments.

Factor H (FH), a member of the regulators-of-complement-activation (RCA) family of proteins, circulates in human plasma at concentrations of 180-420 mg/L where it controls the alternative pathway (AP) of complement in the fluid phase and on cell surfaces. When the regulatory function of FH is impaired, complement-mediated tissue injury and inflammation occur, leading to diseases such as atypical hemolytic uremic syndrome (a thrombotic microangiopathy or TMA), C3 glomerulopathy (C3G) and monoclonal gammopathy of renal significance (MGRS). A pathophysiological cause of compromised FH function is the development of autoantibodies to various domains of the FH protein. FH autoantibodies (FHAAs) are identified in 10.9% of patients with aHUS, 3.2% of patients with C3G, and rarely in patients with MGRS. The phenotypic variability of FHAA-mediated disease reflects both the complexity of FH and the epitope specificity of FHAA for select regions of the native protein. In this paper, we have characterized FHAA epitopes in a large cohort of patients diagnosed with TMA, C3G or MGRS. We explore the epitopes recognized by FHAAs in these diseases and the association of FHAAs with the genetic deletion of both copies of the CFHR1 gene to show how these disease phenotypes are associated with this diverse spectrum of autoantibodies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Zhang, Ghiringhelli Borsa, Shao, Dopler, Jones, Meyer, Pitcher, Taylor, Nester, Schmidt and Smith.)

Background: To address concerns about access to care, the Veterans Access, Choice, and Accountability Act of 2014 was enacted to make care available in the community when Veterans Health Administration (VA) care was unavailable or not timely. This paper examined VA referrals for diagnostic sleep studies from federal fiscal year (FY) 2015-2018., Design: Sleep studies completed between FY2015 and 2018 for Veterans tested within VA facilities (VAF) or referred to VA community care (VACC) providers were identified using VA administrative data files. Sleep studies were divided into laboratory and home studies., Key Results: The number of sleep studies conducted increased over time; the proportion of home studies increased in VAF (32 to 47%). Veterans were more likely to be referred for a sleep study to VACC if they lived in a rural or highly rural area (ORs = 1.47 and 1.55, respectively), and had public or public and private insurance (ORs = 2.01 and 1.35), and were less likely to be referred to VACC if they were age 65+ (OR = 0.72) and were in the highest utilization risk based on Nosos score (OR = 0.78). Regression analysis of sleep study type revealed that lab studies were much more likely for VACC referrals (OR = 3.16), for persons living in rural areas (OR = 1.21), with higher comorbidity scores (OR = 1.28) and for ages 44-54, 55 to 64, and 65+ (ORs = 1.12, 1.28, 1.45, respectively) compared to younger Veterans. Veterans with some or full VA copayments (ORs = 0.91 and 0.86, respectively), and overweight Veterans (OR = 0.94) were less likely to have lab studies., Conclusions: The number of sleep studies performed on Veterans increased from 2015 to 2018. Access to sleep studies improved through a combination of providing care through the Veteran Choice Program, predominantly used by rural Veterans, and increased use of home sleep studies by VA.

Employment specialist competencies were examined as predictors of employment outcomes for consumers with serious mental illness participating in supported employment. Self-report and supervisor-rated performance measures from 57 employment specialists were correlated with three consumer employment outcomes (i.e., competitive employment rate, 90-day employment rate, and dropout rate). Employment specialists varied from 0 to 80 % in the competitive employment rates for their caseloads. Supervisor ratings of job performance and employment specialist efficacy, percentage of time in the community, and frequency of contacts with consumers were associated with employment outcomes. Employment specialist self-report measures were unrelated to employment outcomes. Surprisingly, employment specialists with larger caseload sizes had higher employment rates. Employment specialists vary widely in their effectiveness. Behavioral measures and supervisory ratings of employment specialists were most predictive of employment outcomes. Direct observation of employment specialist job performance appears to be the most promising method for identifying competencies predictive of employment outcome.

Context: In the 1990s, US welfare reform legislation imposed a 5-year lifetime limit on financial support for low-income families with young children (younger than 18 years). With increasing numbers of single mothers and their children reaching the end of their welfare eligibility, there is concern about potentially high rates of untreated psychiatric and substance use disorders in this population., Objective: To determine the prevalence, correlates, and likelihood of treatment for mental and substance use disorders in a population of urban single mothers receiving Temporary Assistance for Needy Families (TANF)., Design: In-person diagnostic assessments were conducted from November 1, 2003, to October 31, 2004., Setting: Cook County, Illinois., Participants: Female TANF recipients and residents of Cook County (N = 333) who were randomly sampled during the final 24 months of their eligibility for TANF., Main Outcome Measure: Prevalence rates of DSM-IV mental and substance use disorders using the World Health Organization's Composite International Diagnostic Interview., Results: Lifetime prevalence of Composite International Diagnostic Interview disorders was 61.0% (95% confidence interval [CI], 55.7%-66.3%); 12-month prevalence was 46.8% (41.5%-52.2%). Lifetime prevalence of mental disorders was 53.2% (95% CI, 47.8%-58.5%); 12-month prevalence was 44.1% (38.8%-49.5%). Lifetime prevalence of substance use disorders was 29.1% (95% CI, 23.9%-33.8%); 12-month prevalence was 9.0% (6.8%-12.0%). Lifetime prevalence of comorbid mental/substance use disorders was 21.3% (95% CI, 16.9%-25.7%); 12-month prevalence was 6.3% (3.7%-8.9%). Only 21.7% (95% CI, 14.8%-28.5%) of participants with 12-month mental disorders received treatment for mental disorders; 41.4% (22.3%-60.4%) of participants with 12-month substance abuse disorders received treatment for substance use disorders., Conclusions: Despite the high prevalence of psychiatric and substance use disorders in this population, many remain untreated. The consequences of terminating welfare assistance are worthy of further investigation, given the potential for adverse effects on both mothers and their young children.

People with psychiatric disabilities experience disproportionately high rates of unemployment. As research evidence is mounting regarding effective vocational programs, interest is growing in identifying subgroup variations. Data from a multisite research and demonstration program were analyzed to identify demographic characteristics associated with employment outcomes, after adjusting for the effects of program, services, and study site. Longitudinal analyses found that people with more recent work history, younger age, and higher education were more likely to achieve competitive employment and to work more hours per month, while race and gender effects varied by employment outcome. Results provide strong evidence of demographic subgroup variation and need.