A novel Family of Origin as Supervisory Resource Model that harnesses the family of origin of the therapist-in-training as a cultural supervisory resource in the training paradigm is presented. The format of the model comprises three phases: supervisor’s exploration of the trainee’s professional dilemmas, supervisor’s exploration of the same dilemma through stories narrated by the supervisee’s family of origin members, and supervisee’s presentation of a case that is an example of the dilemma. The application of this training model during supervision strengthens the trainee’s flexibility in divergent family systems and enhances the ability to handle dilemmas and to form a healthy therapeutic alliance.
It has been well established that strong therapeutic alliances correlate with positive outcomes in the course of any therapy. For therapists who seek to enhance their professional development, the contribution of familial alliances to therapy necessitates information about their proclivities with different types of family systems. Since the early days of family therapy, the genogram has served as a tool for identifying family patterns, resources, and potential hindrances. More recently, genograms have aided trainees to better understand how cultural, gender and other biases and assumptions affect administration of therapy. In this manuscript, we introduce the theoretical framework of a new model where the family-of-origin forms an important resource for the professional development of the therapist in training.
Objectives Malnutrition increases the risk for adverse outcomes after musculoskeletal trauma. Food insecurity is an increasingly recognized risk factor for malnutrition. The purpose of this investigation is to evaluate the prevalence and risk factors for food insecurity in a diverse population treated for operative fracture fixation. Methods A two-center study (Midwest and Pacific Northwest) enrolled participants of any age within 6 months of operative fixation of pelvis or extremity fractures. Food insecurity was assessed using the USDA Household Food Insecurity questionnaire. A score ≥3 indicated food insecurity, 1 or 2 indicated marginal food security, and 0 indicated high food security. Subgroup analysis was performed for participants with available demographic, income, and food access data. Differences between food insecure and food secure participants in continuous and categorical variables were evaluated using the Wilcoxon sum rank test and Fisher's exact test, respectively. Spearman's correlation was used to describe associations between food security scores and participant characteristics. Logistic regression was used to relate patient demographics and odds of food insecurity. Results Of the 476 participants enrolled, 53 (11%) were food insecure, 48 (10%) had marginal food security, and 375 (79%) were food secure. Those with food insecurity were more commonly female (p < 0.0001). Participants with a household income ≤$15,000 were 5.7 times more likely to be food insecure (95% CI 1.8–18.1). Widowed/single/divorced participants were 10.2 times more likely to experience food insecurity than married/partnered participants (95% CI 2.3–45.6). Median time to the nearest full-service grocery store was significantly longer for food insecure (t = 10 minutes) than for food secure participants (t = 7 minutes, p = 0.0202). Time to store demonstrated a weak correlation with food security score (r = 0.23, p = 0.0041). Age (r = −0.08, p = 0.327) and hours working (r = −0.10, p = 0.429) demonstrated no correlation with food security score. Conclusions Food insecurity is common in the musculoskeletal trauma population. Those with lower household incomes and living alone are more likely to experience food insecurity. Food insecurity is a potentially modifiable risk factor for malnutrition-related complications after operative fracture fixation. Funding Sources None.
The Iron Range will never be the same. A powerful and influential group from communities surrounding Hibbing Minnesota has aligned to ensure area students have every opportunity to discover engineering as their lifelong passion. Powerful is not based on any organizational chart but rather an attitude of we-will-make-it-happen. The group started as the Hibbing High School Engineering Advisory Committee. Creating an ad-hoc partnership with local businesses, industry, higher education and regional development, this committee has sponsored activities such as: Curriculum development in the High School, Mentoring with young practicing engineers (representing multiple organizations from diverse backgrounds
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