Attending to social vulnerability when rationing pandemic resources

Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources.     

How clinical trials really work rethinking research ethics

Despite prevalent concerns about the ethical conduct of clinical trials, little is known about the day-to-day work of trials and the ethical challenges arising in them. This paper reports on a study designed to fill this gap and demonstrates a need to refine the oversight system for trials to reflect an understanding of this day-to-day work. It also illuminates ethical challenges that cannot be addressed by the oversight system and so necessitate a rethinking of the ethics of clinical trials.     

An introduction to the 2011 National Multicultural Conference & Summit keynote addresses

This article provides and introduction to the 2011 National Multicultural Conference & Summit Keynote Addresses. The authors explain that they chose to focus on the tension and possibilities within multicultural psychology at the seventh biennial National Multicultural Conference & Summit (NMCS), which was held on January 27-28, 2011, at The Westin-Seattle Hotel. During the 2-day conference, nearly 900 attendees engaged with one another and heard from experts in the field as we focused on the theme, "Unification through Diversity: Bridging Psychological Science & Practice in the Public Interest. Two key sets of presentations are highlighted.     

Using Personality Testing for Personnel Selection: Faking and Test-Taking Inductions

This research assessed whether warning subjects that faked responses could be detected would reduce the amount of faking that might occur when using a personality test for selection of police officers. Also, personality test subscales which best differentiated honest from dissimulated responses were determined. Subjects (N=120) were randomly assigned to a straight-take (that is, respond honestly), fake good, or modified fake good group. Both fake good groups were instructed to respond to the test so as to appear favourably for the job; additionally, the modified fake good group was warned that faking could be detected and could reduce hiring chances. Multivariate analyses revealed significant differences on the Denial and Deviation subscales between the three conditions (p <0.01). The pattern of differences suggested that the threat of faking detection reduced faking. Potential application of these findings in personnel selection was discussed.     

Social isolation and gender

This study investigated the relationship between gender and social support. It was found that men were more isolated than women although there were no gender differences in perceived adequacy (i.e., satisfaction with one's social support network) or network size. Given that both the adequacy and network size variables were associated with socially desirable responding but the isolation variable was not, the results suggest that the behaviorally oriented indicator of isolation was a better measure of the degree of social isolation than traditional subjective scales currently used by many researchers. This suggests that traditional measures of social support that incorporate the dimensions of network size and perceived adequacy of one's social support system need to control for socially desirable responding and that measures can and need to be developed that are not significantly influenced by this response set bias. Hence, the assessment of social support may need to be more multifaceted than is currently undertaken in many studies. Our finding that men reported being more isolated than women may be a function, in part, of the fact that the majority of the sample (76.7%) was single/did not live with a partner. Previous research has found that men generally get their emotional needs met by their spouses/partners while women often get their emotional needs met by their female friends. Consistent with the literature, and given that most of our respondents were single, this study supports the contention that men are generally more socially isolated than women because they do not create adequate emotional intimacy when they are not in partnership with a significant other.     

Using Experiential Learning Theory to Train Career Practitioners

Effective instructional strategies are needed for career practitioner training. Experiential learning theory (ELT; A. Y. Kolb & Kolb, 2009) provides an instructional foundation from which awareness of the various components of career development can be enhanced. Support for ELT as an effective method of instruction exists in various fields (Hoover, Giambatista, Sorenson, & Bommer, 2010; Ti et al., 2009). ELT integrates 6 shared propositions derived from John Dewey, Jean Piaget, William James, Carl Jung, and Carl Rogers (A. Y. Kolb & Kolb, 2009). This article outlines components of ELT and their application in training career service practitioners.     

Postdeployment Suicide Risk Increases Over a 6‐month Period: Predictors of Increased Risk among Midwestern Army National Guard Soldiers

National Guard (NG) soldiers returning from deployments in Iraq and Afghanistan were surveyed at 6 and 12 months following their return (N = 970). The overall prevalence of suicide risk at 6 and 12 months following their return was assessed, as were changes in suicide risk among soldiers initially at high or low risk. Factors associated with changes in risk were assessed. The percentage of NG soldiers with high suicide risk increased from 6.8% at 6 months to 9.2% at 12 months (odds ratio = 1.7, p = .02). In the 882 soldiers initially at low risk, 5.9% (52/882) became high risk at 12 months; in the 64 soldiers initially at high risk, 46.9% (30/64) became low risk at 12 months. Initial levels of depressive symptoms were predictive of changing to high risk; this association appeared to be partially explained by soldier reports of increased search in the meaning in life and higher levels of perceived stress. Because suicide risk increases over the first 12 months, continued risk assessments during this time period should be considered. Supporting soldiers to find meaning in their life after deployment and enhancing their capacity to cope with perceived stress may help prevent increases in suicide risk over time.     

The Relation Between Co-rumination, Maternal Depressive Symptoms and Child Psychopathology

Little is known about which processes explain the well-established link between maternal and child symptomatology. Interpersonal coping processes may be worth exploring, as depressed mothers have characteristic coping styles that may influence interactions with their children. We examined two interpersonal coping processes as potential factors explaining how depressive symptomatology in mothers impacts child psychopathology: parent-child co-rumination (dwelling on negative affect, over-analyzing problems) and impaired problem-solving. We analyzed 198 aggressive children (most of whom also had elevated internalizing symptoms) who engaged in structured discussions with their mothers. Coders rated the extent to which dyads problem-solved and co-ruminated during discussions, and mothers filled out questionnaires assessing maternal and child symptoms. Path analysis tested whether higher levels of co-rumination and poor problem-solving statistically mediated the relation between depressive symptoms in mothers and child internalizing and externalizing behaviour. Maternal depressive symptomatology was correlated with greater child symptoms, higher rates of co-rumination and poorer problem-solving. Statistical mediation was non-significant. Results support the established link between maternal depression and child psychopathology, and suggest that dysphoric mothers and their children engage in maladaptive coping interactions.