Gender differences in the family-relatedness of relocation decisions

Using a dyadic study design, the present study draws on research into the family-relatedness of work decisions to examine the impact of the spouse's characteristics on an employee's willingness to engage in job-related relocation. With a sample of 1234 employees, the results show that spousal willingness to relocate mediates (a) the negative effect of the spouse's community ties and (b) the positive effect of the spouse's job alternatives on an employee's willingness to relocate. The indirect effect of the spouse's job alternatives was stronger among female than among male employees. To validate employees' perceptions, this study uses matched data from a subsample of 207 employees and their spouses to test a multi-source model, which revealed several notable inconsistencies. Our exploration of discrepancies between employee and spousal ratings helps explain these differences between single-source and multi-source models. Overall, findings suggest that employees consider various spousal factors in their career decision-making, and the family-relatedness of relocation decisions is particularly strong among female employees.     

Experiences of Women Who Underwent Predictive BRCA 1/2 Mutation Testing Before the Age of 30

This qualitative interview study focuses on the experiences of a sample of British female BRCA 1/2 carriers who had predictive testing before the age of 30, which is the minimum age for breast screening in the UK. Following appropriate informed consent procedures participants were recruited through the Cancer Genetics Service for Wales. Semi-structured interviews were conducted face-to-face with seven participants, transcribed in full and analyzed using thematic analysis. The motives for testing and perceived advantages described by participants were similar to those identified in previous studies with older participants, such as increased awareness and knowledge and feeling more in control. However some of the perceived disadvantages were specific to younger women, including feeling pressured to make important life decisions earlier than they would have liked, such as about family planning and risk reducing surgery. Participants also reported feeling abandoned or forgotten because of lack of ongoing clinical contact, or feeling “stuck waiting” for screening to begin. However, none felt that these disadvantages were a reason to regret having testing. Findings in this small study suggest that having BRCA 1/2 predictive testing can have positive outcomes for young women even though they may be unable to access interventions such as breast screening. However it may be helpful to encourage young women during pre-test counseling to explore the decisions and choices they may face. These young women could benefit from ongoing support and follow up and increased interaction with healthcare professionals.     

A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.     

Elementary schoolchildren know a logical argument when they see one

Both empirical data and theoretical approaches suggest that argumentation is an important component of development of reasoning skills. We argue that if argumentation does have a primary role, then children should be able to distinguish more from less logical justifications even when they are incapable of determining the correct conclusion by themselves. We asked 8- and 11-year-old children to choose one of two conclusions for abstract reasoning problems, based on justifications from authority (friends and teacher) or logical ones (probability and counterexamples). Although there was a clear age-related increase, even the younger children considered logical justifications to be better than authority, irrespective of the specific conclusion endorsed. Thus, children can distinguish logical and non-logical justifications even when they cannot easily arrive at the correct conclusion by themselves.     

Cost Analysis of Integrated Behavioral Health in a Large Primary Care Practice

A residency-based Family Medicine outpatient clinic chose to implement an integrated behavioral health care program in a large primary care clinic in the Southeast to improve patient access to behavioral health care. We hypothesized that embedding a BHP in a primary care setting would be a cost neutral intervention. We implemented a prospective cohort design and included expenses from both inpatient and outpatient visits. We implemented a mixed effects linear regression model to evaluate pre- and post-BHP exposure costs. A total of 1256 patients were identified in the post-BHP exposure period that had more than one-year post-exposure. After applying exclusion criteria, there were 926 patients included in analysis. These patient had an average total cost during the one-year pre-BHP exposure period of $5113 (SD = 7712) and one-year post-BHP exposure period of $5462 (SD = 7813). Our analysis shows a relatively cost neutral impact following the introduction of BHPs in a primary care setting. The results of this study provide a gauge for future planning of services.

     

The BlackBerry project: capturing the content of adolescents' text messaging

This article presents an innovative method for capturing the content of adolescents' electronic communication on handheld devices: text messaging, e-mail, and instant messaging. In an ongoing longitudinal study, adolescents were provided with BlackBerry devices with service plans paid for by the investigators, and use of text messaging was examined when participants were 15 years old and in the 10th grade (N = 175; 81 girls). BlackBerries were configured so that the content of all text messages, e-mail messages, and instant messages was saved to a secure server and organized in a highly secure, searchable, online archive. This article describes the technology used to devise this method and ethical considerations. Evidence for validity is presented, including both information on use of text messaging to show that participants used these devices heavily and frequencies of profane and sexual language in a 2-day sample of text messaging to demonstrate that they were communicating openly.     

Condition-dependent adaptive phenotypic plasticity and interspecific gene-culture coevolution

Evolutionary socioecological theory and research proposing linking parasites with human social organization is uncommon and therefore welcome. However, more generally, condition-dependent adaptive phenotypic plasticity requires environmental uncertainty on a small scale, accompanied by reliable cues. In addition, genes in parasites may select among biologically adaptive cultural alternatives directly without necessarily going through human genetic predispositions, resulting in inter-specific gene-culture coevolution.     

‘The third person in the room’: Recording the counselling interview for the purpose of counsellor training – barrier to relationship building or effective tool for professional development?

Objective: Audio and videotape interview recording for training and supervision in counsellor education is commonplace within New Zealand, yet researchers have paid little attention to its value perceived by students. This study explores counselling students’ perceptions of the effects of recording counselling interviews on themselves, their clients and on the counselling process. Design: Counselling students from five tertiary educational settings in New Zealand participated in individual or focus group interviews to discuss their experiences of recording counselling interviews. Findings: All interviewees indicated that recording initially curtailed their ability to be completely present in the counselling interview. Some thought this may have negatively influenced their clients’ ability to use the counselling session effectively. Most noted their own increased confidence over time. Almost all considered recording to be extremely beneficial to the development of effective counselling skills. Conclusion: Most students considered the benefits of recording to outweigh the drawbacks. Implications for continuing the practice of recording and playing back interviews in counsellor‐education programmes are considered.     

Links between Family Social Status and Preschoolers' Persistence: The Role of Maternal Values and Quality of Parenting

Children who develop persistence in the preschool years are likely to function more effectively during the transition into school. In this study of 231 3‐year‐old children and their mothers, we examined the relations among family social status, maternal values of self‐direction, quality of parenting, and children's persistence in challenging tasks. Results of structural equation modelling path analysis indicated that family social status was related to maternal values of self‐direction, which in turn were associated with the quality of maternal cognitive stimulation and emotional support and child persistence at preschool age. Family social status and maternal values were indirectly related to child persistence through emotional support. Focusing on parental values of self‐direction and provision of support during challenging tasks may help to reduce the gap in school success between children from lower and higher social status families. Copyright © 2012 John Wiley & Sons, Ltd.     

The Application of Attachment Theory and Mentalization in Complex Tertiary Structural Dissociation: A Case Study

The concept of structural dissociation can provide useful information for increasingly complex applications of mentalizing in therapeutic settings; however, little integration of the two approaches has emerged. Grounded in the intricate case of a woman diagnosed with dissociative identity disorder, this case study integrates and applies the concepts of structural dissociation and mentalizing from an attachment perspective. Client history includes pervasive spiritual and sexual abuse, as well as extreme neglect throughout her development. The presenting problems, relevant history (including the profound impact of neglect), and the therapeutic models that guided treatment are described. Also presented are the specific therapeutic interventions that have facilitated and strengthened therapeutic alliances, levels of integration, and mentalizing capacity in this challenging but rewarding study of human resiliency.