Psychosocial Issues That Face Patients With Charcot-Marie-Tooth Disease: The Role of Genetic Counseling

Charcot-Marie-Tooth (CMT) disease is a hereditary debilitating progressive muscular atrophy and sensory neuropathy of the distal extremities. CMT is usually nonlife threatening. Signs of the disease usually present in childhood or in young adulthood and the level of disability can be variable within and between families. Research addressing specific psychosocial and emotional issues faced by individuals with CMT is limited. Fourteen adults with a clinical and/or molecular diagnosis of CMT (ages 32–74 years) consented to an audio taped interview. The format of the interview was based around an informal questionnaire to prompt and guide the interviewee to describe their experiences of living with a disabling genetic disorder. The interviews focused on their experiences of first symptoms and diagnosis, their life experience with CMT, their limitations due to disability and the role of genetic counseling. This study identifies and explores life issues that individuals with CMT may face, specifically grief over the loss of independence, emotional pain and stress such as embarrassment and guilt of passing on a gene mutation, impact on quality of life, the impact of wearing orthopedic devices, and fear of progressive disability. Our findings suggest that that there are emotional and psychosocial issues specific to affected individuals at different life stages and genetic counselors need to be aware of these issues in order to provide age appropriate support and advice to individuals affected by CMT.     

Understanding the Academic–Practitioner Gap for Structured Interviews: ‘Behavioral’ interviews diffuse, ‘structured’ interviews do not

Recent studies about the academic–practitioner gap suggest that the nonadoption of evidenced‐based practices can be explained by their diffusion through practitioner‐oriented literature. This study extends these findings by investigating the case of the structured interview, which has not been widely adopted by practitioners despite its good psychometric properties. Using a social representations approach, we investigate how the academic concepts of ‘structured’ and ‘behavioral’ interviewing are diffused to practitioners in advice books. Results show that ‘behavioral’ interviews diffuse while ‘structured’ interviews do not, and that different arguments are used to describe these concepts. Facilitating the diffusion of structured interview practices requires academics to rethink their ways of communicating with practitioners through media.     

Student driver propensity to engage with distractions – a self-report survey

This paper reports a survey of engagement with, and ratings of, driver distraction, for undergraduate student drivers. Survey data was collected using an anonymous online questionnaire. 530 respondents contributed to the survey during a seven-year data collection period.Results indicate that the three internal-to-vehicle behaviours rated as most distracting when driving were ‘writing text messages’, ‘internet use’, and ‘reading text messages’. The three most frequently undertaken distractions were, ‘(interactions with) adults’, ‘daydreaming’, and ‘eating, drinking or smoking’. Considering external-to-vehicle distractions, the top three rated were ‘environmental conditions’, ‘unexpected objects or events’, and ‘animals behaving unexpectedly’; while the most frequently experienced external distractions were ‘people (behaving normally), ‘busy roads’ and ‘official signage’. Some evidence was found that internal-to-vehicle distractions were relatively more distracting than external-to-vehicle ones, along with limited findings showing significant variation in the amount of engagement with distractions over time. Significant predictive models for engagement with distraction were calculated (for both work-related and non-work-related driving) and found to be broadly in agreement with previous research, although accounting for less variance in the models. Significantly greater engagement with distractions was found during non-work-related driving, when compared to work-related.The data present a picture of ongoing and substantial engagement with distracting behaviours for this population over the data collection period. For example, on a daily or weekly basis, more than three-fifths of respondents reported willingness to read text messages with the vehicle in motion; while just under half indicated that they typically write text messages in the same circumstances. However, the findings do offer some promise that interventions targeted towards non-work-related driving behaviours may be effective to reduce volitional engagement with distractions.     

“What if It’s not Just an Item of Clothing?” – A Narrative Review and Synthesis of the White Coat in the Context of Aged Care

Although increasingly disputed, the white coat uniform is ubiquitous in geriatric care, which may reflect a phenomenon called medicalisation of ageing. This narrative review is the first attempt at integrating several theoretical approaches, such as the “white coat effect” and “enclothed cognition”, in order to gain a comprehensive understanding of the use of this clothing item. Based on extensive empirical evidence, we will examine the consequences of wearing a uniform, not only on patients (in this case, older patients) and healthcare professionals, but also on their relationship. The white coat has powerful symbolic functions for healthcare professionals and is still preferred by older adults. However, the negative repercussions of wearing a uniform require us to question its use, particularly in environments where older persons live, such as nursing homes.     

A comparison of computer and questionnaire methods of history-taking in a genito-urinary clinic

Abstract

Information on the medical history and symptomatology of 69 patients presenting at a genito-urinary (GU) clinic was obtained either by a computerized interview or a paper questionnaire and the results compared. A comparison was also made between these methods and notes taken during a standard physician interview. Significantly more symptoms were elicited by the computer than the paper questionnaire. Both methods also elicited significantly more symptoms than were recorded by the physician. The patients reported having previously attended a GU clinic more often to the computer than to the physician whereas the questionnaire was no different from the physician. The results indicate that computers can be used satisfactorily to facilitate medical history- taking in GU clinics and may result in a more complete profile of symptoms than either written questionnaire or physician interview.     

The predictive validity of individual psychological assessments in selecting UK public sector senior managers

Individual Psychological Assessment (IPA) is a very widely offered service in Organizational Psychology. It generally consists of a psychologist or HR practitioner using a combination of interview and psychometrics to arrive at a detailed assessment of an individual's capabilities in relation to a job they are being considered for. Although much used, this practice has limited supporting evidence of its validity—not least because of the methodological difficulties in conducting research on this subject—and has been criticized accordingly. The current study examines the use of IPAs with 115 middle and senior management level candidates in a civil service context. All candidates completed a set of psychometric measures and had an in‐depth interview with a psychologist as part of a standardized process. The ratings made by the assessors were correlated with a criterion measure of potential for promotion derived from multisource feedback ratings obtained on these candidates some months later. Analysis of the results indicated that three of the four attributes rated by assessors correlated significantly with the criterion measure. Further, assessors’ ratings were found to show incremental validity over that provided by psychometric test scores alone. These findings are discussed in terms of the use of IPAs in senior level assessment.     

The effect of the two feet-in-the-door technique on tobacco deprivation

The ‘Foot-in-the-door’ (FITD) is a well-known compliance technique that increases compliance with a request. Many investigations on this paradigm have generally used prosocial requests to test the effect of the technique. A new evaluation of the effect of the FITD technique was carried out on tobacco deprivation. A two feet-in-the-door technique in which the target request was preceded by two small target requests was used to encourage students to stop smoking for 24 h. The results were compared with two single foot-in-the- door procedures in which the final request was only preceded by one small request, as well as with a control condition using only a 24 h stop-smoking request. Results showed that the single FITD and the two feet-in-the-door procedures were effective to increase verbal compliance (accepting to stop smoking) but only the two feet-in-the-door technique significantly increased behavioural compliance (not smoking for 24 h) with the request.     

Enclothed cognition

We introduce the term “enclothed cognition” to describe the systematic influence that clothes have on the wearer's psychological processes. We offer a potentially unifying framework to integrate past findings and capture the diverse impact that clothes can have on the wearer by proposing that enclothed cognition involves the co-occurrence of two independent factors—the symbolic meaning of the clothes and the physical experience of wearing them. As a first test of our enclothed cognition perspective, the current research explored the effects of wearing a lab coat. A pretest found that a lab coat is generally associated with attentiveness and carefulness. We therefore predicted that wearing a lab coat would increase performance on attention-related tasks. In Experiment 1, physically wearing a lab coat increased selective attention compared to not wearing a lab coat. In Experiments 2 and 3, wearing a lab coat described as a doctor's coat increased sustained attention compared to wearing a lab coat described as a painter's coat, and compared to simply seeing or even identifying with a lab coat described as a doctor's coat. Thus, the current research suggests a basic principle of enclothed cognition—it depends on both the symbolic meaning and the physical experience of wearing the clothes.     

The motivating impact of informing women smokers of a link between smoking and cervical cancer: the role of coherence.

This research assessed the role of having a coherent explanation of the link between smoking and cervical cancer in motivating women to stop smoking. In the 1st study, women were given a leaflet with either a detailed or a minimal explanation of the link or no leaflet. The leaflets were similarly effective at providing a coherent explanation. In a cross-sectional analysis, having a coherent explanation moderated the relationship between perceived vulnerability and intention: Higher perceived vulnerability to cervical cancer was associated with greater intention to quit smoking only amongst women with a more coherent explanation of the link between smoking and cervical cancer. This finding was replicated in a 2nd study. These results are consistent with H. Leventhal et al.'s (1997) self-regulatory model, which suggests that motivation to change behavior depends not only on perceiving a threat but also on having a coherent model linking the behavior with the threat.     

Contextualising the Quebec Charter of Values: how the Muslim ‘Other’ is conceptualised in Quebec

At varying points in Quebec’s recent history, political parties have gained prominence through employing identity politics, framing Muslims as a threatening ‘Other’. This occurred during the Reasonable Accommodation debates from 2006 to 2008 and more recently in discussions over Bill 60, a proposed law that would have prohibited government employees or employees of state-funded institutions from wearing conspicuous forms of religious attire. This article attempts to contextualise the anti-Muslim fallout which resulted from Bill 60, arguing that it was symptomatic of pre-existing fears of a threatening ‘Other’. Through examining how Quebec identity was transformed in the 1960s, this article will demonstrate how the values proceeding from this era influenced state policies to preserve the white francophone majoritarian culture. In the post-9/11 context, this has resulted in Islamophobic rhetoric and anti-Muslim bias permeating political and media discourses in Quebec on the grounds of asserting gender equality and secularist ideals.     

Reason explanation and the second-person perspective

On a widely held view, the canonical way to make sense of intentional actions is to invoke the agent's ‘motivating reasons’, where the claim that X did A for some ‘motivating reason’ is taken to be neutral on whether X had a normative reason to do A. In this paper, I explore a challenge to this view, drawing on Anscombe's ‘second-personal’ approach to the nature of action explanation.     

Interviewing to detect omission lies

Interviewees sometimes deliberately omit reporting some information. Such omission lies differ from other lies because all the information interviewees present may be entirely truthful. Truth tellers and lie tellers carried out a mission. Truth tellers reported the entire mission truthfully. Lie tellers were also entirely truthful but left out one element of the mission. In truth tellers' statements, only the parts that lie tellers were also asked to recall were analysed. Interviews were carried out via the Cognitive Credibility Assessment, Reality Interview, or standard interview protocol. Dependent variables were the details, complications and verifiable sources interviewees reported. A questionnaire measured three deception strategies: ‘Tell it all’, ‘keep it simple’ or ‘paying attention to demeanour’. Lie tellers reported fewer details, complications and verifiable sources than truth tellers and reporting these variables was negatively correlated with the ‘keep it simple’ and ‘demeanour’ strategies. The type of interview protocol did not affect the results.     

Psychosocial Predictors of Change in Cigarette Smoking

Over a period of 6 months, factors related to change in cigarette smoking were investigated in a group of 250 adult outpatients, all of whom smoked at the time of enrollment in the study. Among the variables tested were demographic, social, and situational factors, beliefs about the health effects of smoking and difficulty of quitting, and intentions regarding future smoking. Information was gathered at baseline and the first and sixth months by means of telephone interviews. Relative to smoking at 6 months, intention, education, and professional advice made independent contributions to cessation. The processes of quitting were examined in more detail. Attempting to quit was related to intention, professional advice, level of smoking, and social cues to smoke. Among those who tried to stop, difficulty with urges to smoke, and education affected success versus failure. Earlier success related to less anxiety and tension, and to less difficulty in not smoking when in negative situations. The findings suggest that a complex set of social and cognitive factors affect change in smoking behavior, and that somewhat different factors are operative at different stages.     

A Comparison of Successful Smoking Cessation Interventions for Adults and Adolescent

This review of the counseling literature analyzes the motivating and impeding factors for adults and adolescents regarding smoking cessation. Adults and adolescents prefer to stop smoking on their own; however, even brief counseling will increase their chances of success. In addition to giving support, counselors can facilitate smoking cessation by increasing clients' motivation and teaching stress management. Counselors must be aware of how the social environment can influence a client's smoking status. With recent increases in adolescent smoking, particularly among African Americans, counselors should be prepared to help an increasing population of clients who will require smoking cessation assistance.     

RACIAL SOVEREIGNTY AND ‘SHOOTER’ VIOLENCE

The massacre at Oak Creek, Wisconsin, Gurdwara requires us to examine how and why so many white men are allowed to amass weapons that enable them to kill groups of people in incidents that are euphemistically called ‘mass shootings’. Neither ‘hate crime’ statutes nor surveillance over neo-Nazis can address why such violence is allowed to continue. This paper argues that ‘racial sovereignty’ is given to white, Christian males as the state disperses sovereignty on to the ‘private’ spheres of white men and corporate power. Such dispersal means that ‘ordinary’ white men are allowed to be perpetrators of violence while the state focuses its attention on surveillance and incarceration of non-whites and those who ‘look Muslim’.     

Perceived body size affected by garment and body mass index

This study investigated the effect of garment size on perceived body size. The perceived body sizes of nine Chinese men, with Body Mass Index between 17.0 and 37.1 kg/m(2), wearing five sizes of white T-shirts were assessed using Thompson and Gray's Nine-figural Scale. Garment sizes on perceived body sizes were different for those of different Body Mass Index. A backpropagation neural net model was used to model the nonlinear relationship between the perceived body size and the body's BMI, body chest girth, and garment ease (difference between garment and body chest girth). When the BMI was less than 20, wearing larger-sized T-shirts tended to increase perceived body size. For large chest sizes and for taller persons (BMI of 20 to 28) large garments made the wearer look thinner. However, for small persons (BMI of 20 to 28) effect of garment size was relatively small. Obese persons (BMI of > 28), wearing garments too tight or too loose were perceived as larger. Minimum perceived body size was found for garment ease of 2 to 3 cm.     

This White ‘I’: The Reciprocal Shame of Oppressor and Oppressed

Abstract

Vice’s answer to the question of this white ‘I’ who must try to live well in South Africa, configures shame, political silence and humble self-reconfiguration. I accept her insightful analysis of ‘whiteness’ in terms of the oppressor’s shame, but find that her specification of identity does not accommodate the multiplicity of privilege/oppression relations in which individuals participate. Since this implies that many South Africans, albeit unevenly, share the oppressor’s shame, her advice concerning ‘whites only’ political withdrawal seems inappropriate and curiously self-subversive. Focussing instead on her reflections concerning moral emotions in ethically-compromised selves, which should motivate self-reconfiguration, and drawing from Kristeva on ‘forgiveness’, I argue that compromised selves in privilege/oppression relations cannot reconfigure themselves independently, and should rather negotiate on-going forgiveness relationships. Further, since privileged and oppressed shoulder different but reciprocal ethical responsibilities, besides considering the privileged self who should appeal for forgiveness,¹ one must address a gap in Vice’s argument concerning the reciprocal shame of the oppressed.     

Patients and profits

The thesis of the paper is that For Profit Hospitals are morally inappropriate health care delivery institutions. The thesis is established first by elaborating on the beneficent nature of medicine, hospitals, and the physician/patient relationship. The primary obligation of the physician, who draws on the resources of medicine and the hospitals, is to restore personal autonomy that is diminished by illness and suffering within the constraints of the ‘canon of loyalty’ that frames the physician patient relationship. Hospitals have historically played the role of facilitator enhancing a physician's ability to administer treatment. Next it is argued that For Profit Hospitals may neglect the role of facilitator. This neglect may occur given the institutions' motivations to return a profit to investors by exploiting the patient/physician relationship. This exploitation is clearly shown to be contrary to the ‘canon of loyalty’ that ought to exist between the patient and physician.     

Les livres de conseils : un moyen de réduire l’incertitude des candidats liée à l’entretien de sélection

The selection interview is a situation full of uncertainty for applicants. Not knowing precisely how they will be evaluated, they will thus try to gather information about interviews, mainly through media such as advice books. These books can participate in reducing applicants’ uncertainty: (1) by materializing the abstract concept that is the interview using metaphors, (2) by providing information about interview formats, and (3) by providing advices to prepare for the interview. This study investigates the presence of these three means in both French and English advice literature. It highlights that all three are used in general, that the last two means are the most frequent ones, and that several differences between the two literatures emerge. Implications for research and organizations are discussed.