Inpatient tube weaning in children with long‐term feeding tube dependency: A retrospective analysis

This study investigates the outcome of an intervention program to establish oral feeding after prolonged tube feeding in children. The intervention is based on supervised reduction of enteral formula within a few days supported by a 3‐week program of speech therapy, occupational therapy, psychoanalytically based eating therapy, physical therapy, psychodynamic coaching, and nutritional counseling of the infant and his or her parents. Two hundred twenty‐one cases were included in this study. All patients had been severely ill or were handicapped and had been exclusively fed by tube for most of their lives. The major outcome variable was complete discontinuation of tube feeding with sufficient oral feeding after treatment, defined as the child's ability to sustain stable body weight by self‐motivated oral feeding. Two hundred three patients (92%) were completely fed orally after treatment. Tube feeding was discontinued completely within 8 days in mean, and mean in‐patient treatment time was 21.6 days. The current method can be used by a trained and experienced team to wean tube‐dependent children from prolonged tube feeding. Tube weaning should be addressed from the beginning of tube feeding in all children who are expected to restore oral feeding after the phase of nutritional stabilization. Since successful programs are rare, we were motivated to present our results of this elaborate program in this article.     

A Narrative Approach to Child and Family Therapy in Africa*

Professional family therapy in Africa is heavily influenced by theories and principles of Western family practice. Its practice structure and philosophies are however grounded on African family values and the principles and orientations of traditional African psychology. This paper presents a clinical report that illustrates adaptations we make to incorporate compatible aspects of narrative family practice in African and Western cultures. A summary of African family values and child psychology intended as a background perspective is provided. The paper is significant against the background of the current need for forging multiculturally relevant healing methods that fit well with the globalized nature of the contemporary world. Augustine Nwoye, PhD, is Associate Professor and Chairman, Department of Psychology, Kenyatta University, Nairobi, Kenya (amnwoye@avu.org). Professor. Nwoye has developed an African paradigm for mental health and, in particular, for family and couple therapy. He also has experience in dealing with stress and multiple losses, especially surrounding HIV/AIDS within an African context. *An earlier version of the paper was presented to the members of staff and students of the Faculty of Education, University of Cambridge, England, UK, and the initial version was presented to the members of the Family Therapy Program of the Faculty of Medicine of the University of Calgary, Calgary, Canada. I wish to thank Dr. Colleen McLaughlin (University of Cambridge) and Professor Karl Tomm (University of Calgary) for their invitation, assistance, time, attention, and suggestions.     

DEGRÉ DE CONTACT ET STRESS ACCULTURATIF DANS LE PROCESSUS D'ADAPTATION DES RÉFUGIÉS AFRICAINS

This study examines some aspects of the adaptive process of African refugees taking up residence in Quebec city, a rather culturally homogenous area. Considering that acculturative stress and degree of contact and participation with the host society are strong indicators of one's adjustment to a new culture, the main hypothesis is that the more contact and participation one establishes with the host society, the less acculturative stress he will report. Out of 62 subjects who voluntarily accepted to participate in the study, 57 were retained for analysis. Results reveal no significant relationship between stress and contact. Multiple regression analyses used to determine the significant predictor variables indicate that age and length of stay explain 19.5% of the total variance for stress while length of stay, sex and adaptive options explain 44% of the total variance for contact. These results tend to demonstrate that, for African refugees, degree of contact is a better indicator of adaptation than stress.     

Affect regulation and temporal discounting: interactions between primed, state, and trait affect

Previous research has largely focused on the influence of experienced affect on decision making; however, other sources of affective information may also shape decisions. In two studies, we examine the interacting influences of affective information, state affect, and personality on temporal discounting rates (i.e., the tendency to choose small rewards today rather than larger rewards in the future). In Study 1, participants were primed with either positive or negative affect adjectives before making reward choices. In Study 2, participants underwent either a positive or negative affect induction before making reward choices. Results in both studies indicate that neuroticism interacts with state unpleasant affect and condition (i.e., positive or negative primes or induction) to predict discounting rates. Moreover, the nature of the interactions depends on the regulatory cues of the affective information available. These results suggest that irrelevant (i.e., primes) and stable (i.e., personality traits) sources of affective information also shape judgments and decision making. Thus, current affect levels are not the only source of affective information that guides individuals when making decisions.     

Functional analysis of aberrant behavior through measurement of separate response topographies

Functional analysis results for multiple topographies of aberrant behavior were graphed in an aggregate fashion and then separately for 48 clients. The results indicated that multiple topographies of behavior may be maintained by different contingencies. These results indicate that graphing functional analysis data in an aggregate fashion and then separately may improve the accuracy of their interpretation.     

Timing conditions and the magnitude of gender differences on the Mental Rotations Test

In two experiments, we examined the effect of timing conditions on the magnitude of gender differences in performance on the Mental Rotations Test (MRT). In Experiment 1, each of 196 females and 119 males was administered the MRT via a Microsoft PowerPoint presentation in one of five timing conditions (15, 20, 25, 30, and 40 sec). The participants were exposed to each MRT item for the period specified in the assigned timing condition. Experiment 2 was conducted to address flaws found in Experiment 1. Accordingly, each of 105 females and 105 males was individually administered the task in one of three timing conditions (15 sec, 25 sec, or unlimited duration). The results of both experiments showed that the magnitude of gender differences was similar across timing conditions when a conventional scoring method was used. An analysis of guessing behavior generally indicated that men tend to show little effect of timing conditions, whereas women's propensity to guess increases when they are given more time to respond. In general, the results supported an interpretation of gender differences on the MRT that relies on the joint operation of performance factors and level of spatial ability.     

Reliability and validity of the Beck depression inventory--II with adolescent psychiatric inpatients

This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess content validity. In Study 2, confirmatory factor analyses of several first-order solutions failed to provide adequate fit estimates to data for 205 boys, 203 girls, and the combined sample. Exploratory factor analyses identified new item-factor solutions. Reliability estimates were good (range =.72 to.91) for the BDI-II total and scale scores. In Study 3 (N=161 boys and 158 girls from Study 2), preliminary evidence for estimates of concurrent, convergent, and discriminant validity were established for the BDI-II.     

Psychotherapists' efforts to increase awareness of social privilege

Understanding the role of privilege in systemic oppression positions psychotherapists to engage in culturally oriented practice. Twenty-five practising psychotherapists were asked: ‘How can psychotherapists increase their awareness of social privilege?’ Participants sorted 68 unique responses into six concepts. The concepts included: make yourself uncomfortable; embrace humility; learn from the community; involvement in social action; seek critical knowledge; and find like-minded others in the profession. Recommendations for student training are offered.