Validity of the SF-12 in a Canadian Old Order Mennonite Community

To assess the validity of the Physical and Mental Component Summary scores (PCS-12 and MCS-12) of the SF-12 Health Survey (SF-12) in an Old Order Mennonite (OOM) community in Ontario, Canada. Most SF-12 validation studies have focused on general populations or clinical groups. This paper adds to the SF-12 literature by validating the instrument in a minority population. Sixty percent of the adult OOM population (n?=?1,171) completed a survey which had the SF-12 embedded within it. The survey also included questions on health determinants and the prevalence of chronic conditions. Factor analysis was used to confirm the two-factor structure of the SF-12. Item-scale correlations were calculated to assess convergent and discriminant validity. PCS-12 and MCS-12 variability by known subgroups were also explored. Factor analysis confirmed the two-factor structure and hypothesized loadings on the latent physical and mental health factors. Item-scale correlations demonstrated satisfactory convergent and discriminant validity. SF-12 summary scores distinguished well, and in the expected manner, between groups of respondents for gender, age, income adequacy, marital status, self-reported health measures, and other health determinants such as coping, trust, social interaction, and spirituality. PCS-12 and MCS-12 scores were lower in those with various chronic conditions compared to those without.The SF-12 appears to be a valid instrument for measuring health status in this minority population. Future SF-12 studies in OOMs and other populations may benefit from using Version 2 of the SF-12, where the dichotomous questions have been replaced by questions offering respondents more choice.     

Learning to listen to trans and gender diverse children: A Response to Zucker (2018) and Steensma and Cohen-Kettenis (2018)

ABSTRACT

The authors answer recent responses by Steensma & Cohen-Kettenis (2018 Steensma, T. D., & Cohen-Kettenis, P. T. (2018). A critical commentary on “A critical commentary on follow-up studies and “desistence” theories about transgender and gender non-conforming children”. International Journal of Transgenderism. Advance online publication. doi:10.1080/15532739.2018.1468292[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) and Zucker (2018 Zucker, K. (2018). The myth of persistence: Response to AA critical commentary on follow-up studies and “Desistance” theories about transgender and gender non-conforming children. International Journal of Transgenderism. Advance online publication. doi:10.1080/15532739.2018.1468293[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) to our critical commentary on “desistance” stereotypes and their underlying research on trans and gender diverse children (Temple Newhook et al., 2018 Temple Newhook, J., Pyne, J., Winters, K., Feder, S., Holmes, C., Tosh, J., … Pickett, S. (2018). A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children. International Journal of Transgenderism. Advance online publication. doi:10.1080/15532739.2018.1456390[Taylor & Francis Online], [Web of Science ®] , [Google Scholar]). We provide clarification in the following areas: (1) the scope of our paper; (2) our support of longitudinal studies; (3) consequences of harm to trans and gender diverse children; (4) clinical practice implications; (5) concerns about validity of research methodology; and (6) the importance of learning to listen to trans and gender diverse children.     

Intersectional experiences of discrimination in a low‐resource urban community: An exploratory latent class analysis

There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical applications to reduce health inequities. Data were drawn from a community health survey in New Haven, CT (N = 1,293 adults) and analysed using latent class analysis. Results yielded 4 classes. Members of the 4 classes were similar sociodemographically. Three classes of participants reported experiencing discrimination, and members of these classes had greater stress, higher rates of smoking and sleep disruption, and worse overall health than members of the class reporting no discrimination. Members of 2 classes made multiple, or intersectional, attributions for discrimination, and members of these classes reported the most frequent discrimination. Findings suggest that community members who are sociodemographically similar may have diverse discrimination experiences. Multilevel interventions that address multiple forms of discrimination (e.g., racism and sexism) may hold promise for reducing discrimination and, ultimately, health inequities within low‐resource urban community settings.     

Beyond Pathologizing Harm: Understanding PTSD in the Context of War Experience

An alternative to objectifying approaches to understanding Post-traumatic Stress Disorder (PTSD) grounded in hermeneutic phenomenology is presented. Nurses who provided care for soldiers injured in the Iraq and Afghanistan wars, and sixty-seven wounded male servicemen in the rehabilitation phase of their recovery were interviewed. PTSD is the one major psychiatric diagnosis where social causation is established, yet PTSD is predominantly viewed in terms of the usual neuro-physiological causal models with traumatic social events viewed as pathogens with dose related effects. Biologic models of causation are applied reductively to both predisposing personal vulnerabilities and strengths that prevent PTSD, such as resiliency. However, framing PTSD as an objective disease state separates it from narrative historical details of the trauma. Personal stories and cultural meanings of the traumatic events are seen as epiphenomenal, unrelated to the understanding of, and ultimately, the therapeutic treatment of PTSD. Most wounded service members described classic symptoms of PTSD: flashbacks, insomnia, anxiety etc. All experienced disturbance in their sense of time and place. Rather than see the occurrence of these symptoms as decontextualized mechanistic reverberations of war, we consider how these symptoms meaningfully reflect actual war experiences and sense of displacement experienced by service members.     

Predictive Relationship Between Parental Beliefs and Accommodation of Pediatric Anxiety

Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortunately, little is known about the beliefs parents hold regarding accommodation, as there exists no validated measure of this construct. First, the psychometric properties were examined for the Parental Accommodation Scale (PAS), a novel measure of parental accommodating behavior frequency (PAS-Behavior scale) and parental beliefs about accommodation (PAS-Belief scale). Second, the relationship between parental beliefs about accommodation and accommodation frequency was examined. Results provide preliminary evidence of the internal consistency and convergent validity of the PAS. Stronger positive beliefs about accommodation significantly predicted accommodation frequency, even after controlling for youth anxiety severity. Specifically, beliefs that accommodation prevents youth from losing behavioral and emotional control significantly predicted accommodation frequency. Therefore, efforts to decrease accommodation in clinical settings should involve correcting maladaptive parental beliefs about accommodation, with a particular emphasis on beliefs regarding the necessity of accommodation in preventing a youth from losing behavioral and emotional control.     

Good government and the vocation of citizenship: A Lutheran perspective

Martin Luther considered governmental authority to be one of the structures through which God exercises providential care of the created world. Consequently, government and civil society are dimensions of life in which one lives out the divine calling to serve one's neighbors. This theological perspective offers a distinct contribution to discussions of the appropriate role of religion in the public square. God's desire for justice for all is the criterion by which to evaluate specific governments, policies, and officials. The goal of justice provides a common framework within which Christians can work for the common good with those of other faiths and no faith.     

A comparison of procedures for unpairing conditioned reflexive motivating operations

This study compared the effectiveness of two procedures to reduce behavior evoked by a reflexive conditioned motivating operation (CMO‐R). Task demands were shown to evoke escape‐maintained problem behavior for 4 students with disabilities. Alternative communication responses were taught as an appropriate method to request escape and this treatment combined with extinction for problem behavior led to decreases in problem behavior for all students. A beeping timer was then arranged to temporally precede the task demand to create a CMO‐R that evoked communication responses. When data showed that the sound of the timer was functioning as a CMO‐R, two methods to reduce behavior evoked by a CMO‐R—extinction unpairing and noncontingent unpairing—were evaluated. Results indicated that noncontingent unpairing was an effective method to reduce the evocative effects of the CMO‐R. Extinction produced unsystematic effects across participants. Results are discussed in terms of abolishing CMOs and the implications of CMOs.     

CROSSING THE DIVIDE: LESSONS FROM DEVELOPING WIND ENERGY IN POST‐FACT AMERICA

The income and careers that come with building wind turbines have become a lifeline for many factory towns and farming communities. Generating electricity from the wind puts increasingly cheap power on the grid, saving consumers billions a year. And it is one of the biggest, fastest, cheapest ways to reduce carbon pollution, reducing the threat of climate change. Yet as wind farms have rapidly spread to forty‐one states, their developers must make their case anew with each community that hosts them. Facts matter, but so do empathy, honoring deep connections to neighbors and landscape, and developing mutual respect. Successful wind farm developers listen first for shared values and speak with inclusive language, to communicate with potential opponents across divides of misunderstanding and motivate local residents to adapt to and benefit from change.