Stress in telephone helpline nurses is associated with failures of concentration,attention and memory,and with more conservative referral decisions

Nurses working for telephone‐based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information‐processing errors. Nurses who experienced more frequent cognitive failures at work made more conservative decisions, tending to refer patients on to other health professionals more often than other nurses. As stress is associated with cognitive performance decrements in telephone nursing, stress‐reduction interventions could improve the quality and safety of care that callers to medical helplines receive.     

Latent Profile Analysis of Observed Parenting Behaviors in a Clinic Sample

We examined typologies of parenting practices using latent profile analysis (LPA) in a sample of families with young children who had externalizing behavior disorders. We also examined mother and child characteristics associated with class membership using ratings from multiple informants. The sample included pooled data from five parenting treatment outcome research studies on oppositional defiant disorder (ODD) and/or conduct disorder (CD) conducted throughout the past 20 years. These studies included 21 separate cohorts of children resulting in a total of 514 families. All children met diagnostic criteria for ODD or CD and 78 % were male. Parenting practices were observed by independent raters using the Dyadic Parent–child Interactive Coding System-Revised (DPICS-R). Four summary scores (i.e., total critical statements, total commands, total positive, total supportive) from the DPICS-R were used as class indictors in the LPA. Four classes best characterized the parenting practices of this clinic sample, roughly comprising a quarter of the sample each: Positive Only, Negative Only, Positive/Negative, and Neither Positive/Negative. High observed child negative behaviors, low observed child warmth, high socioeconomic status, and low academic performance distinguished the two classes with high negative behaviors (Negative Only, Positive/Negative) from the other classes. These results provide markers of the most common parenting profiles at entry into treatment programs for behavior disorders in young children. Findings have significant implications for the tailoring parenting interventions and supports to specific family needs.     

Ethnically based rejection sensitivity and academic achievement: The danger of retracting into one's heritage culture

This study examined the relation between ethnically based rejection sensitivity and academic achievement in a sample of 936 immigrant students in Germany and Switzerland. The theory of race‐based rejection sensitivity that originated in North America was extended to immigrant students in Europe. The rough political climate against immigrants in Europe makes it probable that immigrant youth face particular difficulties and are affected by ethnically based rejection sensitivity, at least as much as—or even more than—minority youth in the United States. Using a standardized literacy performance test and multilevel analyses, we found that ethnically based rejection sensitivity was negatively related to academic achievement for immigrant students. This relation was partially mediated by a strong contingency of the students' self‐worth on the heritage culture, as well as by a low number of native German or Swiss majority‐group friends. We interpret these processes as immigrant students' efforts to cope with ethnically based rejection sensitivity by retracting into their heritage culture and avoiding majority‐group contact, which unfortunately, however, at the same time also results in lower academic achievement. Copyright © 2014 John Wiley & Sons, Ltd.     

Threats to the Internal Validity of Spinal Surgery Outcome Assessment: Recalibration Response Shift or Implicit Theories of Change?

A recalibration response shift will cause the patient to think about a self-report measure’s response options differently after a health state change. Commonly assessed using the retrospective-pretest design (“then-test”), recent guidelines suggest adjusting then-test estimates for competing explanations. This prospective longitudinal study investigated recalibration response shift after adjusting for implicit theories of change in patients undergoing spinal surgery. The Oswestry Disability Index (ODI) and Short Form-36 (SF-36) were collected before surgery and at 6 weeks and 3 months after spinal decompression surgery. Then-tests of the measures were also collected at all post-tests. Recalibration response shift was operationalized as the then-minus-pre difference score on the evaluative SF-36. Implicit theories of change were operationalized as the then-minus-pre difference score on the perception-based ODI. Improved vs. No-Effect patient groups were compared using the Minimally Important Difference (±15 points) as a cut-off on the Visual Analogue Scale (VAS) items for back and leg pain. Logistic regression analyses investigated whether recalibration response shift had an independent effect distinguishing patient groups, after adjusting for implicit theories of change. The sample (baseline n?=?169, mean age 52, 39 % female) was well-educated, and 1/3 were working. All then-minus-pre difference scores were non-zero at each time point and were stable over time. In the adjusted models distinguishing Improved versus No Effect groups, then-minus-pre ODI difference scores were significant in the majority of the adjusted models at all timepoints, but only one then-minus-pre SF-36 difference score—for physical functioning recalibration—was significant and only at 6-weeks post-surgery. This suggests that implicit theories of change bias the estimation of post-surgical outcomes, but that recalibration response shift biased only the estimation of physical functioning and only at 6 weeks post-surgery. Recalibration response shift and implicit theories of change can both be sources of bias in patient-reported outcome assessment. Our findings suggest that implicit theories of change are a greater threat to validity in this patient sample. Future research using the then-test should control for implicit theories of change to minimize misspecification of effects.     

The structure of analog representation

This paper develops a theory of analog representation. We first argue that the mark of the analog is to be found in the nature of a representational system's interpretation function, rather than in its vehicles or contents alone. We then develop the rulebound structure theory of analog representation, according to which analog systems use interpretive rules that map syntactic structural features onto semantic structural features. The theory involves three degree-theoretic measures that capture three independent ways in which a system can be more or less analog. We explain how our theory improves upon prior accounts of analog representation, provides plausible diagnoses for novel challenge cases, extends to hybrid systems that are partially analog and partially symbolic, and accounts for some of the advantages and disadvantages of representing analogically versus symbolically.     

ENGINEERING CAREERS: WOMEN IN A MALE-DOMINATED FIELD

A national survey was conducted to compare the background and career characteristics of men and women engineers differing in the number of years since they completed their BS degrees (0–5, 6–10, 11–15, and 16–20 years). The parents of women engineers were more likely to have college degrees and to be employed in professional positions than were the parents of men engineers. Women engineers were less likely to be married and were more likely to be childless than were the men. Both men and women were influenced by courses and work–related factors in their decisions to pursue engineering, but men made their career decisions sooner than women. Although men and women reported comparable levels of technical responsibility in their present jobs, gender differences favoring men were found for supervisory responsibility and salary among those with more than five years of experience, with the gap between men and women increasing with experience. Men with 16–20 years of experience and all four degree cohorts of women endorsed the opinion that there are better opportunities for men than women in engineering.     

A Longitudinal Study of Racial Discrimination and Risk for Death Ideation in African American Youth

Although multiple studies have found that African Americans commonly experience racial discrimination, available studies have yet to examine how perceived racism might be related to suicide vulnerability in African American youth. The purpose of this study was to examine a framework for how perceived racial discrimination contributes to symptoms of depression and anxiety as well as subsequent suicide ideation and morbid ideation. Data were obtained from 722 African American youth at mean age 10.56 years (SD = 0.64); a second wave of data was obtained 2 years later. Results revealed both a direct effect and mediated effects of perceived racism on later suicide and morbid ideation. For boys and girls, the effect of perceived racism was mediated by symptoms of depression. However, the association was mediated by anxiety for girls, but not for boys in the current sample. Implications for future research and interventions are discussed.