Family coercion and valid consent

Coercion is commonly said to invalidate consent, and that is always true if the source of the coercion is the physician. However, if it is a family member who coerces the patient to consent, the resultant consent may be quite valid and treatment should proceed.     

THE CLASSWIDE PEER TUTORING PROGRAM: IMPLEMENTATION FACTORS MODERATING STUDENTS' ACHIEVEMENT

We conducted a study designed to assess implementation of the classwide peer tutoring program and the relationship between implementation variation and student outcome. A clinical replication design was used. Five volunteer elementary teachers were trained to implement the program; their implementation was monitored for 19 consecutive weeks during 1 school year. Overall, the results indicated that specific variations in program implementation were associated with students' responses to treatment. It was also demonstrated that different teachers' applications of the program produced differential levels of student outcome. Implementation factors related to lower spelling achievement were (a) reduced opportunities to receive program sessions, (b) reduced probabilities of students' participation in program opportunities, (c) too many students assigned unchallenging spelling words, and (d) reduced rates of daily point earning reflecting lower levels of spelling practice during tutoring sessions. The implications of these findings and methods of preventing these implementation problems are discussed in the context of quality assurance and social validity.     

COUNSELING AND PSYCHOTHERAPY AS MORAL AND SPIRITUAL PRACTICE: FACING A MAJOR PARADIGM SHIFT

Blakeney and Blakeney offer a metatheoretical perspective for counseling and therapy that gives primacy to developmental issues and to understanding the worldview of the client. Their thinking adds to the growing paradigm shift currently occurring in the counseling field. This article further demonstrates the holistic and integrative nature and potential of the Blakeney framework, using Developmental Counseling and Therapy (DCT) as a method of translation. The authors offer a framework that challenges the notion of “higher” forms of knowledge, emphasizing instead multiperspctive thought and life-span cognitive-developmental processes.     

Brand character as a function of brand loyalty

This study investigated the relationship between self-image, brand image, and brand loyalty by asking whether people use products to enhance self-image. Subjects described themselves on an adjective checklist, then listed product brands to which they consider themselves loyal or not loyal. One month later, using the same adjective checklist, subjects described the type of person who would buy a particular brand to which they are loyal and a brand to which they are not loyal for both gender and non-gender related products. Significant differences between the two groups and a high correlation between self and product user ratings, were found.     

Financial strain, economic values, and somatic symptoms in later life.

The purpose of this study was to evaluate whether the impact of financial strain on psychological distress depends on the value that older adults place on economic success. Feelings of personal control were specified as an intervening variable in this process. The data came from a nationwide survey of 819 people in Canada who were 55 years of age and older. The findings reveal that financial problems are associated with diminished feelings of control and that these effects are stronger when elderly people value economic achievement highly. In addition, financial strain and diminished feelings of control are related to increased distress regardless of how highly economic success is valued.     

Triage and equality: an historical reassessment of utilitarian analyses of triage

We distinguish and review aspects of the history of two models of triage: egalitarian and utilitarian. Egalitarian triage is widely and successfully practiced in battlefield medicine, as well as in the emergency room and the ICU. Utilitarian triage has been sporadically practiced and typically collapses under the pressure of public scrutiny. Unfortunately, the two models tend to be conflated, confusing our understanding of the past and confounding our ability to plan for the future.