Clinical Use of the Surgeon General’s “My Family Health Portrait” (MFHP) Tool: Opinions of Future Health Care Providers

This study examined medical students’ and house officers’ opinions about the Surgeon General’s “My Family Health Portrait” (MFHP) tool. Participants used the tool and were surveyed about tool mechanics, potential clinical uses, and barriers. None of the 97 participants had previously used this tool. The average time to enter a family history was 15 min (range 3 to 45 min). Participants agreed or strongly agreed that the MFHP tool is understandable (98%), easy to use (93%), and suitable for general public use (84%). Sixty-seven percent would encourage their patients to use the tool; 39% would ensure staff assistance. Participants would use the tool to identify patients at increased risk for disease (86%), record family history in the medical chart (84%), recommend preventive health behaviors (80%), and refer to genetics services (72%). Concerns about use of the tool included patient access, information accuracy, technical challenges, and the need for physician education on interpreting family history information.     

Fixed-time schedule effects in combination with response-dependent schedules

We evaluated the effects of fixed-interval (FI), fixed-time (FT), and conjoint (combined) FI FT reinforcement schedules on the responding of 3 adults who had been diagnosed with schizophrenia. Responding on vocational tasks decreased for 2 of 3 participants under FT alone relative to FI alone. Responding under FI FT resulted in response persistence for 2 of 3 participants. Results have implications for the maintenance of desirable behavior, as well as for situations in which FT treatment has been implemented for problem behavior and problem behavior is nevertheless reinforced by caregivers.     

Executive dysfunction affects word list recall performance: Evidence from amyotrophic lateral sclerosis and other neurodegenerative diseases

The Rey Auditory Verbal Learning Test (RAVLT) is widely used in clinical practice to evaluate verbal episodic memory. While there is evidence that RAVLT performance can be influenced by executive dysfunction, the way executive disorders affect the serial position curve (SPC) has not been yet explored. To this aim, we analysed immediate and delayed recall performances of 13 non‐demented amyotrophic lateral sclerosis (ALS) patients with a specific mild executive dysfunction (ALSci) and compared their performances to those of 48 healthy controls (HC) and 13 cognitively normal patients with ALS. Moreover, to control for the impact of a severe dysexecutive syndrome and a genuine episodic memory deficit on the SPC, we enrolled 15 patients with a diagnosis of behavioural variant of frontotemporal dementia (bvFTD) and 18 patients with probable Alzheimer's disease (AD). Results documented that, compared to cognitively normal subjects, ALSci patients had a selective mid‐list impairment for immediate recall scores. The bvFTD group obtained low performances with a selectively increased forgetting rate for terminal items, whereas the AD group showed a disproportionately large memory loss on the primary and middle part of the SPC for immediate recall scores and were severely impaired in the delayed recall trial. These results suggested that subtle executive dysfunctions might influence the recall of mid‐list items, possibly reflecting deficiency in control strategies at retrieval of word lists, whereas severer dysexecutive syndrome might also affect the recall of terminal items possibly due to attention deficit or retroactive interference.     

Authoritative Parenting of Chinese Mothers of Children with and without Intellectual Disability

The present study examined authoritative parenting and associations with parenting sense of competence and social support in Chinese mothers of children with intellectual disability and mothers of typically developing children. One hundred and sixty-seven mothers of children with intellectual disability with a mean age of 10.89 years (SD?=?1.74) and 119 mothers of typically developing children with a mean age of 10.55 years (SD?=?1.10) participated in a survey. Mothers of children with intellectual disability reported similar levels of parental warmth, and less use of reasoning and autonomy support compared with mothers of typically developing children. Parenting efficacy contributed uniquely to three dimensions of authoritative parenting for mothers of children with intellectual disability. By comparison, parenting efficacy did not contribute to use of reasoning and autonomy support for mothers of typically developing children. Social support made a unique but small contribution to parental warmth but not to parental reasoning and autonomy support for mothers of children with intellectual disability. For mothers of typically developing children, social support was associated with both parental warmth and autonomy support. This study suggests that child disability status is related to maternal authoritative parenting, and additionally, parenting efficacy plays a more critical role in predicting authoritative parenting of Chinese mothers of children with intellectual disability than mothers of typically developing children.     

Personality Traits Elucidate Sex Differences in Attention-Deficit/Hyperactivity Disorder Comorbidity During Early Childhood

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly comorbid with other childhood disorders, and there are striking sex differences in this comorbidity, particularly during early childhood. For example, boys with ADHD are more likely to exhibit comorbid disruptive behavior and neurodevelopmental disorders, compared to girls, during early childhood. Yet, explanations for these well-established sex differences remain in short supply. The current study evaluated the novel hypothesis that personality traits may serve as intermediate phenotypes that help explain sex differences in common ADHD comorbidity profiles during early childhood. Study participants were 109 children between the ages of 3 and 6 and their primary caregivers and teachers/daycare providers, recruited from the community and over-recruited for ADHD-related problems. Primary caregivers completed the Child Behavior Checklist, and teachers/daycare providers completed the Teacher Report Form as a measure of child behavior problems. Examiners completed the California Q-Sort as a measure of child personality traits. Moderated mediation analyses suggested that personality traits explain associations between ADHD and oppositional-defiance, aggression, and language problems in a sex-specific manner. While high neuroticism mediated associations between ADHD and oppositional-defiance in girls, disagreeableness mediated associations between ADHD and aggression and low conscientiousness mediated associations between ADHD and neurodevelopmental language problems in boys. Sex differences in trait-psychopathology associations may help explain sex differences in comorbidity profiles with possible implications for child assessment and personalized early intervention.     

Connecting to belonging: a cross-disciplinary inquiry into rural Australian Anglican Church engagements with people from culturally and linguistically diverse backgrounds

People from diverse backgrounds enrich the rural, regional, and remote communities where they relocate and settle. Research about rural diversity tends to focus on demographics (age, gender, country of origin) while ignoring personal narratives of integration, for example, engagements with religious institutions (such as the local Christian church). This article presents the research themes from an investigation using co-operative inquiry into rural diversity and the Anglican Church, with specific reference to the Australian experience. It is a cross-disciplinary dialogic exchange between social workers and theologians. Positive narratives about connection, welcome, participation, and belonging are shared.     

“I Just Miss Her. I Just Need Her Here.” Life After a Mother’s Cancer

The purpose of this research was to examine the lived experience of a family unit that lost their spouse/mother/sister-in-law to cancer. A phenomenological case study was used to guide this research. Four participants, or one family unit consisting of one spouse, one daughter, one son, and one sister-in-law to the deceased, were recruited from Southern Ontario. Background questionnaires and one-on-one semi-structured interviews were conducted with each family member. The following themes emerged: (1) Negatives and (2) Silver Linings. This paper only addresses the theme “Silver Linings”; the first theme was addressed in Part I of this research. Within the theme “Silver Linings,” there were two sub-themes: (1) “…She was remarkable” and (2) Hope for the future. Each will be discussed in turn. Overall, the research study revealed some silver linings that may come from a diagnosis of cancer in a family unit. The family found it difficult to find positives in the loss of their loved one; however, they were able to acknowledge that they have a heightened appreciation for others. This research study provides insight regarding the lived experiences of families coping with the cancer journey of a loved one. It may allow readers to develop a greater sense of appreciation for their health and family members.     

Secondary traumatic stress in emergency medicine clinicians

Previously called Secondary Traumatic Stress (STS), secondary exposure to trauma is now considered a valid DSM-5 Criterion A stressor for posttraumatic stress disorder (PTSD). Previous studies have found high rates of STS in clinicians who treat traumatically injured patients. However, little research has examined STS among Emergency Medicine (EM) physicians and advanced practice providers (APPs). The current study enrolled EM providers (N = 118) working in one of 10 hospitals to examine risk factors, protective factors, and the prevalence of STS in this understudied population. Most of the participants were physicians (72.9%), Caucasian (85.6%), and male (70.3%) with mean age of 39.7 (SD = 8.9). Overall, 12.7% of the sample screened positive for STS with clinical levels of intrusion, arousal, and avoidance symptom clusters, and 33.9% had at least one symptom cluster at clinical levels. Low resilience and a history of personal trauma were positively associated with positive STS screens and STS severity scores. Borderline significance suggested that female gender and spending ≥10% of one’s time with trauma patients could be additional risk factors. Findings suggest that resilience-building interventions may be beneficial.     

Adolescent adaptation before,during and in the aftermath of the Great Recession in the USA

This study examines the impact of the “Great Recession” (from December 2007 to June 2009) on 8th and 10th graders in the USA, using annual nationally representative data from the Monitoring the Future study. Historical changes in youth adjustment (self‐esteem, depressed mood, risk taking, aggression and property crime), school achievement (grade point average [GPA], time spent on homework and educational expectations) and structured and unstructured activities (volunteering, employment, sports and evenings out for fun) were examined between 1991 and 2014. Overall, there were only slight changes in mean levels of adjustment, achievement and most youth activities. However, the percentage of youth working during the school year did decline during the Great Recession. Several longer‐term trends were also evident, though not directly tied to the Great Recession. These include an increase in GPA, a decrease in time spent on homework, rising educational expectations and more time spent volunteering. Future work should assess how the shift to unpaid work activities (e.g. volunteering and internships) among youth is impacting the transition from school to work in the contemporary economy, and whether the Great Recession had deleterious impacts for younger children or among youth whose parents lost work or had their homes foreclosed.