Sociodemographic Factors Associated with Types of Projects Implemented by Volunteer Lay Health Educators in Their Congregations

This study focused on the association between type of community health interventions and lay health educator variables. Lay health educators are volunteers from local faith communities who complete a healthcare training program, taught by physicians in-training. Lay health educators are instructed to implement health-related initiatives in their respective communities after graduation. Of the 72 graduates since 2011, we surveyed 55 lay health educators to gain insight into their involvement with their congregation and the type of health projects they have implemented. We dichotomized the health projects into “raising awareness” and “teaching new health skills.” Using adjusted logistic regression models, variables associated with implementing health projects aimed at teaching health skills included length of time as a member of their congregation, current employment, and age. These results may help future programs prepare lay health community educators for the type of health interventions they intend to implement in their respective communities.     

Parental Monitoring and Adolescent Risk Behaviors: The Moderating Role of Adolescent Internalizing Symptoms and Gender

Parental monitoring can reduce adolescents’ engagement in risky behaviors; however, adolescents’ internalizing symptoms may alter the effectiveness of parental monitoring. The current study examines independent and interactive effects of maternal and paternal monitoring, adolescent’s internalizing symptoms, and adolescent gender on sexual behaviors and substance use with data from 659 of the 15-year-olds enrolled in the NICHD Study of Early Child Care and Youth Development. Results suggest girls who experienced less maternal monitoring and more internalizing symptoms—both independently and interactively—engaged in more risky sexual behaviors. Greater substance use was associated with less maternal and paternal monitoring for girls and boys, more internalizing symptoms for girls, and interactively with less maternal and paternal monitoring depending on girls’ levels of internalizing symptoms. The current study highlights the unique influences of mothers’ and fathers’ monitoring efforts on adolescent risky behavior based on the adolescent’s level of internalizing symptoms.     

Latina Mothers’ Involvement in an HIV/STI and Substance Use Prevention Program for Adolescents: A Parallel Intervention Curriculum

As part of a larger HIV/STI/Substance Abuse Prevention intervention targeted to middle school students, we offered students’ parents an opportunity to participate in an adult education class. The same curricular materials were used for students enrolled in the intervention and for their parents. In the current study, mothers who had completed the adult education class participated in a focus group. The focus group explored what components of the intervention were perceived by mothers as particularly useful to them or to their child. Three core themes emerged from interpretive analyses of the focus group: (1) positive relationships with intervention staff and school personnel enticed students to participate in the intervention and facilitated parents’ involvement; (2) both students and parents felt respected and empowered by the intervention’s cornerstone values and curricular philosophy of cultural richness and pride in Hispanic/Latino heritage; and (3) mothers perceived their mastery of the course content—materially wholly dedicated to the health and wellness of their children—benefitted them in terms of both understanding the material and potentially allowing mothers to discuss health-oriented behavior with their young adolescent child.     

Does message framing affect changes in behavioural intentions in people with psoriasis? A randomized exploratory study examining health risk communication

Message framing is important in health communication research to encourage behaviour change. Psoriasis, a long-term inflammatory skin condition, has additional comorbidities including high levels of anxiety and cardiovascular disease (CVD), making message framing particularly important. This experimental study aimed to: (1) identify whether health messages about psoriasis presented as either gain- or loss-framed were more effective for prompting changes in behavioural intentions (BI), (2) examine whether BI were driven by a desire to improve psoriasis or reduce CVD risk; (3) examine emotional reactions to message frame; and (4) examine predictors of BI. A two by two experiment examined the effects on BI of message frame (loss vs. gain) and message focus (psoriasis symptom reduction vs. CVD risk reduction). Participants with psoriasis (n = 217) were randomly allocated to one of four evidence-based health messages related to either smoking, alcohol, diet or physical activity, using an online questionnaire. BI was the primary outcome. Analysis of variance tests and hierarchical multiple regression analyses were conducted. A significant frame by focus interaction was found for BI to reduce alcohol intake (p = .023); loss-framed messages were more effective for CVD risk reduction information, whilst gain-framed messages were more effective for psoriasis symptom reduction information. Message framing effects were not found for BI for increased physical activity and improving diet. High CVD risk was a significant predictor of increased BI for both alcohol reduction (β = .290, p < .01) and increased physical activity (β = ?.231, p < .001). Message framing may be an important factor to consider depending on the health benefit emphasised (disease symptom reduction or CVD risk reduction) and patient-stated priorities. Condition-specific health messages in psoriasis populations may increase the likelihood of message effectiveness for alcohol reduction.     

Provider Conscientious Refusal of Abortion,Obstetrical Emergencies,and Criminal Homicide Law

Catholic doctrine’s strict prohibition on abortion can lead clinicians or institutions to conscientiously refuse to provide abortion, although a legal duty to provide abortion would apply to anyone who refused. Conscientious refusals by clinicians to end a pregnancy can constitute murder or reckless homicide under American law if a woman dies as a result of such a refusal. Such refusals are not immunized from criminal liability by the constitutional right to the free exercise of religion or by statutes that confer immunity from criminal homicide prosecution. Core principles of the rule of law require the state to protect the lives of all persons equally and to place the life and health of persons above any the interests of providers have in moral integrity or in respecting the moral status of prenatal humans. In some states criminal liability related to conscientious objection also applies to corporate hospital officials.     

Self–Compassion as Self-Care: A Simple and Effective Tool for Counselor Educators and Counseling Students

This article explores teaching self-compassion as a means of self-care for counseling graduate students. Self-care is vital to helping professionals, but few students learn specific self-care skills to integrate into their own self-care practice. Self-compassion is a simple practice used in the immediate moment or as an activity at home. The authors describe Kristen Neff’s model of self-compassion. The authors discuss the benefits of self-compassion as self-care and explain its practice as an effective avenue to increase compassion and relationship building with clients. In addition, they clarify how self-compassion practices strengthen relational connection. The writers describe three examples of self-care practices, and share suggestions for counselor educators to integrate self-care into graduate counselor training.     

Trusting families: Responding to Mary Ann Meeker, "Responsive care management: family decision makers in advanced cancer"

Mary Ann Meeker's article admirably reminds readers that family members are involved in--or "responsively manage"--the care of relatives with severe illness in ways that run considerably beyond the stereotypes at play in many bioethical discussions of advance directives. Her observations thus make thinking about the role of families in healthcare provision more adequate to the facts, and this is an important contribution. There's reason to be worried, however, that one explicit aim of the article--to ease the standing anxieties that many clinicians and ethicists have about the reliability of family members as proxy decision makers--will be frustrated by its very success. Those already inclined to suspicion may tend to think that the more intricate and pervasive the ways in which families influence the healthcare decision making of their sick, the more chances they have for altering the connection between patients' interests and the actions of professional providers. To determine whether and when such alterations are something to be concerned about, we'll need to supplement a better grasp of the pertinent facts with a deeper sense of how human agency works and why we value it. We may also need some reminders about the defensibility of diverse moral understandings. Although both professionals and family members may profess an ethic that sets patients' interests above those of non-patients--as Meeker's own results suggest--any strict allegiance to such a framework may be more notional than normative--as her findings also hint. The actual working norms (among professionals, as well as within families) will likely be more complex, but not necessarily any the less defensible for that.     

Personal and Professional Development for Judges: The Institute for Faculty Excellence

This interview study describes the role that participation in the Institute for Faculty Excellence in Judicial Education (IFEJE) played in the personal and professional development of four judges. Judicial education is a relatively new field of adult and continuing professional education. There is limited literature devoted to this area of study outside of the arena of substantive legal or judging topics. Interviews served as the primary data source for this study along with program evaluations, photographs, and e-mail correspondence from Institute participants. The findings revealed that the combined safe environment, challenges, and support participants experienced at the Institute and learning about adult learning helped them: feel less isolated in their work; stretch their normal work boundaries resulting in the completion of projects for which they had great passion; and benefited them as judges, supervisors, teachers, and in other social relationships.     

The concept of voluntary consent

Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals' perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research.