Caring and being cared -for: Perceptions of adolescent males at -risk for school failure

This qualitative study used grounded theory methods and purposeful sampling to explore perceptions on caring and being cared-for. Twenty-four adolescent male participants, identified as at-risk for school failure, completed a two phase interview process exploring these phenomena within three relationships; the relationship with the friend, with the most caring person they knew and with the teacher they felt cared for them. ^ Each participant was asked a predetermined set of open questions in an initial semi-structured interview. In addition each participant was encouraged to explore his own reflections on caring. A second interview allowed for member checking and for the participant to continue sharing his meaning of caring and being cared-for. ^ Line by line analysis with open, axial and selective coding was applied to interview transcripts along with a constant comparative method. Results indicated that the core category integrating all other categories was attachment bonding. Participants' stories manifested characteristics of proximity seeking, secure base, safe haven and distress upon involuntary separation from an attachment figure. ^ Strategies facilitating attachment bonding were influenced by the power positions of the relational players. Participants responded positively to the one-caring when they felt cared-for. Results further indicated that participants did not need to feel a sense of belonging in order to feel cared-for. Teacher behaviors indicating openness for authentic connections with students were specific to teacher's friendliness and professional competence. Teachers who nurtured feelings of being cared-for were uncommon in the participants' educational experience. ^ The number of adolescent males leaving high school prematurely is both a personal problem and a social problem. Despite a “mask” of indifference often exhibited by adolescent males at-risk for school failure, teachers might consider the social/emotional needs of these students when implementing the curriculum. In addition, policy makers might consider the social/emotional needs of this vulnerable population when developing programs meant to foster psychological well-being and connectedness for adolescent males at-risk for school failure. ^

Glycemic Control: Risk Factors, Quality of Life, Workforce Participation, and Mortality Among US Adults with Type 2 Diabetes

Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, 1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) ≥7%), borderline (HbA1c 7-8.9%), and poor (HbA1c ≥9%) glycemic control and potentially new risk factors (e.g. work characteristics), and 2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with glycemic control; and 3) using prospective data, assess the relationship between mortality risk and glycemic control in US adults with type 2 diabetes. Data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys were used. HbA1c values were used to create dichotomous glycemic control indicators. Binary logistic regression models were used to assess relationships between risk factors, employment status and glycemic control. Multinomial logistic regression analyses were conducted to assess relationships between glycemic control and HRQOL variables. Zero-inflated Poisson regression models were used to assess relationships between missed work days and glycemic control. Cox-proportional hazard models were used to assess effects of glycemic control on mortality risk. Using STATA software, analyses were weighted to account for complex survey design and non-response. Multivariable models adjusted for socio-demographics, body mass index, among other variables. Results revealed that being a farm worker and working over 40 hours/week were risk factors for suboptimal glycemic control. Having greater days of poor mental was associated with suboptimal, borderline, and poor glycemic control. Having greater days of inactivity was associated with poor glycemic control while having greater days of poor physical health was associated with borderline glycemic control. There were no statistically significant relationships between glycemic control, self-reported general health, employment, and missed work. Finally, having an HbA1c value less than 6.5% was protective against mortality. The findings suggest that work-related factors are important in a person’s ability to reach optimal diabetes management levels. Poor glycemic control appears to have significant detrimental effects on HRQOL.