Many children struggle to successfully acquire early mathematics skills. Theoretical and empirical evidence has pointed to deficits in domain-specific skills (e.g., non-symbolic mathematics skills) or domain-general skills (e.g., executive functioning and language) as underlying low mathematical performance. In the current study, we assessed a sample of 113 three- to five-year old preschool children on a battery of domain-specific and domain-general factors in the fall and spring of their preschool year to identify Time 1 (fall) factors associated with low performance in mathematics knowledge at Time 2 (spring). We used the exploratory approach of classification and regression tree analyses, a strategy that uses step-wise partitioning to create subgroups from a larger sample using multiple predictors, to identify the factors that were the strongest classifiers of low performance for younger and older preschool children. Results indicated that the most consistent classifier of low mathematics performance at Time 2 was children’s Time 1 mathematical language skills. Further, other distinct classifiers of low performance emerged for younger and older children. These findings suggest that risk classification for low mathematics performance may differ depending on children’s age.

Gaps in educational outcomes between racial/ethnic and socioeconomic groups persist in the United States, and parental involvement is often cited as an important avenue for improving outcomes among racially/ethnically diverse adolescents. This study utilized data from the Education Longitudinal Study 2002-2013 (56% female, N = 4429), which followed 10th-graders through high school and ten years post-high school, to examine the links between parental involvement strategies and academic outcomes (grade point average and educational attainment). Participants included white, African American, and Hispanic/Latino adolescents from low-SES families. This study used recursive partitioning, a novel analytic strategy used for exploring higher-order interactions and non-linear associations among factors (e.g., parental educational involvement strategies) to predict an outcome (e.g., grade point average or educational attainment) through step-wise partitioning. The results showed that the combination of greater academic socialization and school-based involvement was beneficial for all adolescents' grade point average, whereas the combination of home-based involvement with academic socialization and school-based involvement yielded mixed results. Greater academic socialization and home-based involvement appeared beneficial for educational attainment among African American and Hispanic/Latino adolescents, but not white adolescents. More home-based involvement and less academic socialization were associated with less educational attainment for white adolescents. Overall, the findings showed different combinations of parental educational involvement strategies were beneficial for adolescents across racial/ethnic groups, which may have implications for practice and policy.

BackgroundHealthcare organisations have legal and ethical duties to reduce inequalities in access to healthcare services and related outcomes. However, lesbian, gay, bisexual and/or transgender (LGBT+) people continue to experience and anticipate discrimination in health and social care. Skilled communication is vital for quality person-centred care, but there is inconsistent provision of evidence-based clinician education on health needs and experiences of LGBT+ people to support this. This study aimed to identify key stakeholders’ experiences, preferences and best practices for communication regarding sexual orientation, gender identity and gender history in order to reduce inequalities in healthcare.MethodsSemistructured qualitative interviews with LGBT+ patients with serious illness, significant others and clinicians, recruited via UK-wide LGBT+ groups, two hospitals and one hospice in England. We analysed the interview data using reflexive thematic analysis.Results74 stakeholders participated: 34 LGBT+ patients with serious illness, 13 significant others and 27 multiprofessional clinicians. Participants described key communication strategies to promote inclusive practice across three domains: (1) ‘Creating positive first impressions and building rapport’ were central to relationship building and enacted through routine use of inclusive language, avoiding potentially negative non-verbal signals and echoing terminology used by patients and caregivers; (2) ‘Enhancing care by actively exploring and explaining the relevance of sexual orientation and gender identity’, participants described the benefits of clinicians initiating these discussions, pursuing topics guided by the patient’s response or expressed preferences for disclosure. Active involvement of significant others was encouraged to demonstrate recognition of the relationship; these individual level actions are underpinned by a foundation of (3) ‘visible and consistent LGBT+ inclusiveness in care systems’. Although participants expressed hesitance talking about LGBT+ identities with individuals from some sociocultural and religious backgrounds, there was widespread support for institutions to adopt a standardised, LGBT+ inclusive, visibly supportive approach.ConclusionsPerson-centred care can be enhanced by incorporating discussions about sexual orientation and gender identity into routine clinical practice. Inclusive language and sensitive exploration of relationships and identities are core activities. Institutions need to support clinicians through provision of adequate training, resources, inclusive monitoring systems, policies and structures. Ten inclusive communication recommendations are made based on the data.

Background: Support from social networks is vital after the death of a partner. Lesbian, gay, bisexual and/or transgender (LGBT+) people can face disenfranchisement and isolation in bereavement. The Acceptance-Disclosure Model (of LGBT+ bereavement) posits that experiences are shaped by the extent to which individuals feel able to disclose their bereavement to others, and whether that loss is acknowledged appropriately. Aim: To explore LGBT+ specific experiences of partner bereavement; determine decision-making processes regarding disclosure of relationships/identities; and appraise the Acceptance-Disclosure Model using primary qualitative data. Design: Exploratory in-depth qualitative interview study positioned within a social constructivist paradigm. Data were analysed using inductive and deductive reflexive thematic analysis. Setting/participants: 21 LGBT+ people from across England bereaved of their civil partner/spouse. Results: Participants described LGBT+ specific stressors in bereavement: lack of recognition of their loss; inappropriate questioning; unwanted disclosure of gender history; and fears of discrimination when accessing support. Disclosure of LGBT+ identities varied across social networks. Some participants described hiding their identities and bereavement to preserve relationships, and challenging intersections between LGBT+ identities and other aspects of culture or self. These findings provide primary evidence to support the Acceptance-Disclosure Model. Conclusions: LGBT+ people face additional stressors in bereavement. Not all LGBT+ people want to talk directly about their relationships/identities. Sensitive exploration of support needs, aligned with preferences around disclosure of identities, can help foster trust. Five recommendations for inclusive practice are presented. Further research should consider whether the Acceptance-Disclosure Model has utility to explain bereavement experiences for other isolated or disenfranchised groups.

Discrepancies between parents' and adolescents' reports in parental knowledge of adolescents' daily activities and whereabouts are common and have implications for adolescents' well-being and school success. Grounded in a family systems perspective utilizing reports from parents and adolescents, the goal of this study was to explore the extent to which parent-adolescent warmth and adolescent self-disclosure could account for discrepancies in parental knowledge by testing the indirect effects linking warmth to discrepancies in parental knowledge via adolescent self-disclosure. Participants were early adolescents (N = 172; 53% female) and their parents (90% mothers). Adolescents (57% African American/Black, 18% multiracial, 17% White/Caucasian, 7% Hispanic/Latino and 1% Asian American) attended a Midwestern, Title 1, urban, public middle school. Using structural equation modeling, findings showed that parent-adolescent warmth significantly predicted adolescent self-disclosure, which in turn predicted fewer discrepancies in parental knowledge. The findings from this study help in understanding the factors that contribute to parental knowledge discrepancies and highlight potential targets for family interventions.

Background Data suggest poorer bereavement outcomes for lesbian, gay and bisexual people, but this has not been estimated in population-based research. This study compared bereavement outcomes for partners of same-gender and different-gender decedents. Methods In this population-based, cross-sectional survey of people bereaved of a civil partner or spouse 6–10 months previously, we used adjusted logistic and linear regression to investigate outcomes of interest: (1) positive screen on Inventory of Complicated Grief (ICG), (2) positive screen on General Health Questionnaire (GHQ), (3) grief intensity (ICG) and (4) psychiatric symptoms (GHQ-12). Results Among 233 same-gender partners and 329 of different-gender partners, 66.1% [95% confidence interval (CI) 60.0–72.2] and 59.2% [95% CI (53.9–64.6)] respectively screened positive for complicated grief on the ICG, whilst 76.0% [95% CI (70.5–81.5)] and 69.3% [95% CI (64.3–74.3)] respectively screened positive on the GHQ-12. Same-gender bereaved partners were not significantly more likely to screen positive for complicated grief than different-gender partners [adjusted odds ratio (aOR) 1.56, 95% CI (0.98–2.47)], p = 0.059, but same-gender bereaved partners were significantly more likely to screen for psychiatric caseness [aOR 1.67 (1.02, 2.71) p = 0.043]. We similarly found no significant association of partner gender with grief intensity [B = 1.86, 95% CI (−0.91to 4.63), p = 0.188], but significantly greater psychological distress for same-gender partners [B = 1.54, 95% CI (−0.69–2.40), p < 0.001]. Conclusions Same-gender bereaved partners report significantly more psychological distress. In view of their poorer sub-clinical mental health, clinical and bereavement services should refine screening processes to identify those at risk of poor mental health outcomes.

An integrative literature review was undertaken as a means of drawing together contemporary perspectives on the outcomes and affordances of videoconference-based therapy. This review was conducted in a way which placed emphasis on the need for mental healthcare strategies which are mindful of the cultural and social needs of indigenous and ethnic minority populations, particularly those situated in the Global South. The review was undertaken using an inverse funnelling approach which sought to prioritise literature on videoconference-based therapy literature which specifically focused on indigenous and ethnic minority populations. A series of general and population specific searches across relevant health databases were supplemented by a simultaneous search of Google Scholar. The PICOS search tool was used in developing the search terms, and data was processed using an inductive approach to thematic analysis. A final dataset of 43 articles were included in the review. This body of literature encompassed an international range of studies and included perspectives informed by quantitative, qualitative and mixed methods research. Four key themes were identified across the reviewed literature: indigenous and ethnic minority populations, therapeutic relationships, clinical outcomes and technical and logistical considerations. Based on our findings, there is reason to believe that videoconference-based therapy can be made to be just as effective as offline, face-to-face modes of delivery. However, research into the efficacy, impact and cultural implications of this technology in relation to indigenous and ethnic minority populations represents a significant gap within contemporary literature.

During lockdown in response to COVID-19, students in the Master of Psychotherapy at Auckland University of Technology were required to rapidly move their clinical work online. We surveyed these students about their experience of working clinically online. We used a mixed-methods approach and analysed qualitative data using grounded theory methods. Students found the move online challenging in terms of the technological challenges, lack of professional clinical space, and establishing and maintaining the therapeutic alliance. Students showed a strong preference for in-person (or, face-to-face) clinical work, along with scepticism about the efficacy of online therapy, though some acknowledged its convenience and others its currency and relevance. Most expressed a need for more specific training in online therapy. The literature finds equivalence between the effectiveness of in-person and online therapy. However, it acknowledges that online therapy can impose increased strain on clinicians and finds that clinician expectations directly impact their capacity to manage online clinical work.