Patient Perspectives on the Learning Health System: The Importance of Trust and Shared Decision Making

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership.     

Peer Leadership in Sport: Links with Friendship,Peer Acceptance,Psychological Characteristics,and Athletic Ability

The purpose of this study was to replicate and extend the work of Glenn and Horn (1993) Glenn, S. D. and Horn, T. S. 1993. Psychological and personal predictors of leadership behavior in female soccer athletes. Journal of Applied Sport Psychology, 5: 17–34. [CSA][Taylor & Francis Online] , [Google Scholar] by examining relationships between peer leadership in sport and social, psychological, and ability characteristics. The sample consisted of 71 female and 67 male high-school soccer players and their coaches. Players completed questionnaires measuring social (peer acceptance and friendship quality) and psychological (perceived competence, instrumentality, and expressiveness) variables, and leadership behavior for self and teammates. Coaches assessed each player on leadership behavior and soccer ability. For female athletes, all psychosocial variables were predictive of self-ratings of leadership, while coach and teammate ratings were related to ability only. For male athletes, all psychosocial variables and ability were related to self-ratings and teammate ratings of peer leadership, while coaches' ratings were related primarily to ability. These results are discussed with regard to social exchange theory and commonalities among peer relationship variables (acceptance, friendship, leadership).     

Workplace Mobbing: Family Dynamics and Therapeutic Considerations

Workplace mobbing is an underreported and understudied public health problem with significant health consequences on victims, intimate relationships, and families. Family and systemic dynamics influence the victim's response and recovery from in mobbing. Effective therapy with victims of mobbing, their significant others, and families requires familiarity with family and systemic dynamics. Various therapeutic considerations and interventions are described and illustrated in a case example.     

POWER AND INFLUENCE STRATEGIES IN VIOLENT AND NONVIOLENT MARRIAGES

How important is the use of physical violence in determining the balance of power within marriage? Do women in violent marriages make more use of indirect strategies in attempting to persuade their husbands than do women in nonviolent marriages? Is marital satisfaction related to influence styles? These questions are investigated by looking at decision making in couples and how this is related to the forms of influence strategies used by wives and husbands in violent and nonviolent marriages. Data from in-depth structured interviews with 137 self-identified battered wives and 137 comparison wives, some of whom were also found to have experienced violence from their husbands, are used to answer these questions. Results indicated that women with violent husbands used more influence strategies overall, although these women had less overall power in terms of decision making than did women with nonviolent husbands. The relationship of influence strategies to decision making was different for women with violent husbands than for those whose husbands were not violent. As expected, the use of coercive strategies related negatively to marital happiness, whereas positive strategies were positively predictive. Violence and other negative strategies should be included in future research on influence strategies in close relationships, and a positive-negative dimension should be included as a way of categorizing influence strategies.     

How job demands affect partners' experience of exhaustion: integrating work-family conflict and crossover theory

This study among 168 couples of dual-earner parents uses insights from previous work-family conflict and crossover research to propose an integrative model delineating how job demands experienced by men and women carry over to the home domain. The authors hypothesized that for both men and women, job demands foster their own work-family conflict (WFC), which in turn contributes to their partners' home demands, family-work conflict (FWC), and exhaustion. In addition, they hypothesized that social undermining mediates the relationship between individuals' WFC and their partners' home demands. The results of structural equation modeling analyses provided strong support for the proposed model. The hypothesis that gender would moderate the model relationships was rejected. These findings integrate previous findings on work-family conflict and crossover theories and suggest fluid boundaries between the work and home domains.     

Establishing schedule control over dropping to the floor

In contrast to inherently dangerous behaviors such as self‐injury and aggression, some behaviors are problematic because of the context in which they occur. In the current study, we report on a boy who engaged in dropping to the floor both excessively and at inappropriate times. During the functional analysis, dropping occurred across all conditions, suggesting that it was either multiply maintained or maintained by automatic reinforcement. Treatment involved the use of discriminative stimuli and differential reinforcement with response cost to teach the client when dropping to the floor was and was not appropriate. Copyright © 2003 John Wiley & Sons, Ltd.