Public Health Ethics Education in a Competency-Based Curriculum: A Method of Programmatic Assessment

Public health ethics began to emerge in the 1990s as a development within bioethics. Public health ethics education has been implemented in schools of public health in recent years, and specific professionalism and ethics competencies were included in the Master of Public Health (MPH) competency set developed nationally and adapted by individual schools of public health around the country. The University of Texas School of Public Health approved the present set of MPH competencies in 2005. After 4 years of experience, we now report information measuring the extent to which “Professionalism and Ethics” competencies and subcompetencies are being met in the MPH degree program. To this end we have audited the MPH “Professionalism and Ethics” competency forms for FY2009 MPH graduates (n = 61). Eight courses, including required MPH core courses plus the practicum and culminating experience, were found to have substantial professionalism and ethics content. Further, 67.2% of graduates met eight or more of the 13 competencies and subcompetencies, but only 36.1% met all thirteen, indicating a need to identify topic areas to be added to, or enhanced in, the MPH curriculum. In addition, these findings will inform ongoing efforts to enhance ethics education in our health science center. Assessment of these competencies and subcompetencies is an essential step in strengthening ethics education at our institutions and in better preparing our graduates for a challenging future. We report our efforts here to demonstrate one way of carrying out programmatic assessment of ethics education in a school of public health.     

Bilingual Therapeutics: Integrating the Complementary Perspectives and Practices of Motivational Interviewing and Dialectical Behavior Therapy

Informed by the practice of code-switching or style-switching in linguistics, “bilingual therapeutics” is proposed as the complementary integration of two evidence-based practices in psychotherapy: motivational interviewing (MI) and dialectical behavior therapy (DBT). Unique features of MI and DBT are presented, current research of each practice is reviewed, and their similarities and distinctions are discussed. It is proposed that fluency in both “languages” of MI and DBT may usher in a new therapeutic perspective to enhance client case conceptualization, illuminate subtleties of the therapeutic process, and foster more intentional and deliberate practitioners. Specifically, MI and DBT code-switching may help recruit and retain clients in formal treatment (e.g.,”speaking” MI more prominently to prepare clients for 12-month standard DBT) and promote consultation among therapists. The complementary integration of MI and DBT also suggests the emergence of a linguistic “third space,” including “spirit as synthesis” and “improvisational dance.”     

International stem cell tourism and the need for effective regulation. Part II: Developing sound oversight measures and effective patient support

Part I of this article, published in the March 2010 issue of the Kennedy Institute of Ethics Journal, traces and addresses the provision of unproven stem cell treatments in Russia and India, examines the concept of innovative treatment, and concludes that stronger regulations are needed to protect the health and informed choices of patients. The current paper, Part II, proposes that the regulatory frameworks for the development of safe and efficacious treatments in effect in the United States and the United Kingdom provide examples of strong oversight measures from which countries seeking to obtain international credibility for their biotechnological competence could draw when developing regulations for stem cell treatments. Major sources of information available to persons who consider receiving such unproven treatments are explored in order to understand and address their concerns. The paper concludes with proposed measures to inform those considering the pursuit of unproven stem cell treatments abroad more accurately about their efficacy and safety and provide them with improved medical and social support in their home countries.     

Parental Interpersonal Sensitivity and Youth Social Problems: A Mediational Role for Child Emotion Dysregulation

We examined the relations between parental interpersonal sensitivity and youth social problems and explored the mediational role of child emotion dysregulation. Mothers (N = 42; M age = 39.38) and fathers (N = 41; M age = 39.38) of youth aged 7–12 (N = 42; M age = 9.12) completed measures of their own interpersonal sensitivity and reported on their child’s emotion regulation skills and social functioning. Maternal interpersonal sensitivity was positively associated with child social problems, and this relationship was fully mediated by child emotion dysregulation. A bootstrapping technique provided evidence for the significance of the mediation. For fathers, only the association between child emotion dysregulation and child social problems was significant. Our findings suggest one potential mechanism through which maternal behaviors relate to youth psychosocial functioning. Identification of such mechanisms contributes to the development of conceptual models of youth functioning and suggests specific targets for prevention and intervention efforts.     

Development of a Cognitive-Behavioral Intervention Program to Treat Anxiety and Social Deficits in Teens with High-Functioning Autism

Anxiety is a common co-occurring problem among young people with autism spectrum disorders (ASD). Characterized by deficits in social interaction, communication problems, and stereotyped behavior and restricted interests, this group of disorders is more prevalent than previously realized. When present, anxiety may compound the social deficits of young people with ASD. Given the additional disability and common co-occurrence of anxiety in ASD, we developed a manual-based cognitive-behavioral treatment program to target anxiety symptoms as well as social skill deficits in adolescents with ASD [Multimodal Anxiety and Social Skills Intervention: MASSI]. In this paper, we describe the foundation, content, and development of MASSI. We also summarize data on treatment feasibility based on a pilot study that implemented the intervention.     

More on Enrolling Female Students in Science and Engineering

This paper investigates reasons for practices and policies that are designed to promote higher levels of enrolment by women in scientific disciplines. It challenges the assumptions and problematic arguments of a recent article questioning their legitimacy. Considering the motivations for and merits of such programs suggests a practical response to the question of whether there should be programs to attract female science and engineering students.     

Ethnic and racial differences in body size perception and satisfaction

Body dissatisfaction in women in the United States is common. We explored how women from various racial and ethnic groups used figural stimuli by exploring differences in current and preferred silhouette, and their discrepancy. We surveyed 4023 women aged 25–45 in an online investigation. Participants were identified using a national quota-sampling procedure. Asian women chose a smaller silhouette to represent their current body size, which did not remain significant after adjusting for self-reported BMI. After controlling for BMI, African American women selected a smaller silhouette than White women to represent their current size. Both African American and women reporting “Other” race preferred larger silhouettes than White women even after controlling for BMI. The discrepancy score revealed lower body dissatisfaction among African American than White women. Understanding factors that promote body satisfaction differentially across racial and ethnic groups could become a tool in appropriately tailored interventions designed to prevent eating disorders.     

Women's sexual and reproductive health in post-socialist Georgia: does internal displacement matter?

CONTEXT: Persons displaced by armed conflicts, natural disasters or other events are at increased risk for health problems. The Republic of Georgia has a substantial population of internally displaced women who may face elevated risks of STIs and pelvic inflammatory disease (PID). METHODS: The 1999 Georgia Reproductive Health Survey was used to examine the prevalence of self-reported STI and PID diagnoses among displaced and nondisplaced sexually experienced women. Multivariate analyses were conducted to determine whether displacement is associated with STI and PID risk, and whether the behavioral and socioeconomic factors associated with these diagnoses differ between internally displaced women and the general population. RESULTS: In models that controlled for behavioral factors only, displacement was associated with elevated odds of PID diagnosis (odds ratio, 1.3), but the relationship was only marginally significant when socioeconomic factors were added (1.3). Displacement was not associated with STI diagnosis. The factors associated with STI and PID diagnoses among displaced women generally differed from those in the general population, but access to medical care and previous STI diagnosis were associated with PID diagnosis in both groups. Among nondisplaced women, residing in the capital city was associated with increased odds of STI diagnosis (2.2) but reduced odds of PID diagnosis (0.8). CONCLUSIONS: These findings highlight the importance of displacement status in determining a woman's reproductive health risks, and underscore the complex relationships between behavioral and socioeconomic variables and the elevation of STI and PID risk.     

Is counter-terrorism policy evidence-based? What works, what harms, and what is unknown

Is counter-terrorism policy evidence-based? What works, what harms, and what is unknown. One of the central concerns surrounding counter-terrorism interventions today, given the attention and money spent on them, is whether such interventions are effective. To explore this issue, we conducted a general review of terrorism literature as well as a Campbell systematic review on counter-terrorism strategies. In this article, we summarize some of our findings from these works. Overall, we found an almost complete absence of evaluation research on counter-terrorism strategies and conclude that counter-terrorism policy is not evidence-based. The findings of this review emphasise the need for government leaders, policy makers, researchers, and funding agencies to include and insist on evaluations of the effectiveness of these programs in their agendas.