Improving Health Education for Women Who Carry an <Emphasis Type="Italic">FMR1</Emphasis> Premutation

Women who carry an FMR1 (i.e., fragile X) premutation have specific health risks over their lifetime. However, little is known about their experience understanding these risks and navigating their health needs. The aim of this study was to use qualitative analysis to uncover both barriers and facilitators to personal healthcare using a framework of the Health Belief Model. Five focus groups were conducted with a total of 20 women who carry the FMR1 premutation using a semi-structured discussion guide. All sessions were transcribed verbatim and independently coded by two researchers. The coders used a deductive – inductive approach to determine the prominent themes related to the participants’ experiences seeking healthcare for premutation-related conditions. Salient barriers to personal healthcare included difficult clinical translation of research findings, lack of knowledge among healthcare providers and among the women themselves, different priorities, and shortage of premutation-specific support and targeted educational materials. Facilitators included family members, national and community support organizations, research studies, compassionate physicians, and other premutation carriers. Addressing barriers to personal healthcare through up-to-date educational materials can help diminish misperceptions regarding health risks. Targeted educational materials will aid in information sharing and awareness for women who carry the FMR1 premutation and their physicians.     

Acceptability and Feasibility of Peer Assisted Supervision and Support for Intervention Practitioners: A Q-methodology Evaluation

Evidence-based interventions often include quality improvement methods to support fidelity and improve client outcomes. Clinical supervision is promoted as an effective way of developing practitioner confidence and competence in delivery; however, supervision is often inconsistent and embedded in hierarchical line management structures that may limit the opportunity for reflective learning. The Peer Assisted Supervision and Support (PASS) supervision model uses peer relationships to promote the self-regulatory capacity of practitioners to improve intervention delivery. The aim of the present study was to assess the acceptability and feasibility of PASS amongst parenting intervention practitioners. A Q-methodology approach was used to generate data and 30 practitioners volunteered to participate in the study. Data were analyzed and interpreted using standard Q-methodology procedures and by-person factor analysis yielded three factors. There was consensus that PASS was acceptable. Participants shared the view that PASS facilitated an environment of support where negative aspects of interpersonal relationships that might develop in supervision were not evident. Two factors represented the viewpoint that PASS was also a feasible model of supervision. However, the third factor was comprised of practitioners who reported that PASS could be time consuming and difficult to fit into existing work demands. There were differences across the three factors in the extent to which practitioners considered PASS impacted on their intervention delivery. The findings highlight the importance of organizational mechanisms that support practitioner engagement in supervision.     

Differential Effects of Racial Socialization Messages for African American Adolescents: Personal Versus Institutional Racial Discrimination

Racial socialization is one factor known to attenuate the negative consequences of racial discrimination on adolescents’ anger and depressive symptoms. However, little is known about whether racial socialization messages addressing cultural and racial pride and messages preparing youth for racial discrimination and racial barriers function differently depending upon whether adolescents perceive personal versus institutional racial discrimination. Thus, the present study examined whether racial socialization messages emphasizing racial pride and racial barriers protected against anger and depressive symptoms for African American adolescents’ experience of personal and institutional racial discrimination. Participants were a community sample of 106 urban African American adolescents (57 % girls; mean age = 15.41) residing in a large metropolitan area. Regression analyses revealed that personal racial discrimination was positively associated with anger for youth reporting low cultural pride reinforcement, and positively associated with depressive symptoms for youth reporting low cultural alertness to discrimination; there were no associations between personal racial discrimination and anger or depressive symptoms for youth reporting high racial socialization messages. Neither cultural pride nor racial barrier racial socialization message protected against institutional racial discrimination. Findings suggest that the protective effects of racial socialization messages vary based on the type of racial discrimination adolescents experience.     

The Indirect Effect of Early Experiences on Deliberate Self-Harm in Adolescence: Mediation by Negative Emotional States and Moderation by Daily Peer Hassles

The present study examines whether early experiences of threat, subordination and devaluation with family influence adolescents’ negative emotional states and subsequently deliberate self-harm; and if this effect is conditioned by daily peer hassles. The sample consisted of 441 adolescents (57.6 % female) with ages between 13 and 18 years old from middle and high schools. Participants completed self-report instruments measuring early memories of threat, subordination and devaluation, daily peer hassles, negative affect and deliberate self-harm behaviors. Results from conditional process analysis showed that adolescents who feel devalued and experience threat and submission within family tend to endorse high levels of negative affect, which in turn accounts for increased endorsements on deliberate self-harm. Moreover, the impact of negative affect on deliberate self-harm is amplified by the presence of moderate and high levels of daily peer hassles. This study suggests the relevance of assessing and intervening on type of emotional memories (i.e., threat, subordination and devaluation), daily disruptions with peers and negative emotional states with adolescents who self-injure. These findings may be useful in the development of preventive and intervention programs for reducing deliberate self-harm in adolescence.     

Made in America: Perspectives on Friendship in West African Immigrant Families

This qualitative study compared West African immigrant parents’ and adolescents’ perspectives on parental monitoring of adolescents’ peer groups. Parents (n = 31) and adolescent children (n = 25) were interviewed using focus groups and individual interviews, and data were analyzed using a grounded theory approach. Parents expressed a general concern about external influences on their children, particularly their mistrust of their children’s friends. Adolescents reported that they were aware of their parents’ fears and described their attempts to manage their parents’ concerns while simultaneously maintaining friendships with same-ethnic and other-ethnic peers. This study offers both parent and adolescent perspectives in an effort to better understand adolescents’ peer socialization and parental monitoring among West African immigrant families, one of the fastest growing demographic groups in the United States. Recommendations for mental health professions are discussed.     

Preparing Interventionists via Telepractice in Incidental Teaching for Children with Autism

Telepractice has emerged as a potentially effective means of preparing parents and educators as interventionists for children with autism spectrum disorder (ASD). The purpose of this study was to evaluate the use of telepractice to train interventionists to implement incidental teaching with preschool children with ASD. Three interventionists were taught to implement incidental teaching using a telepractice training package consisting of an online module, self-evaluation, and delayed performance feedback delivered via videoconferencing. A single-case multiple-baseline across-participant design was employed to evaluate the effects of the telepractice training package on interventionist acquisition and maintenance of incidental teaching. The distal effects of interventionist implementation of incidental teaching on child mands were also evaluated. Results showed that following the telepractice training program, interventionist implementation fidelity improved and child mands increased. Within six telepractice sessions, all interventionists reached the preset performance criteria of four consecutive sessions above 90 % fidelity. Changes in interventionist and child behaviors maintained at 2- and 4-week follow-up sessions. Taken together, these results suggest that telepractice is a promising method of providing instruction in incidental teaching to interventionists of young children with ASD.     

Integration of anatomical and external response mappings explains crossing effects in tactile localization: A probabilistic modeling approach

To act upon a tactile stimulus its original skin-based, anatomical spatial code has to be transformed into an external, posture-dependent reference frame, a process known as tactile remapping. When the limbs are crossed, anatomical and external location codes are in conflict, leading to a decline in tactile localization accuracy. It is unknown whether this impairment originates from the integration of the resulting external localization response with the original, anatomical one or from a failure of tactile remapping in crossed postures. We fitted probabilistic models based on these diverging accounts to the data from three tactile localization experiments. Hand crossing disturbed tactile left–right location choices in all experiments. Furthermore, the size of these crossing effects was modulated by stimulus configuration and task instructions. The best model accounted for these results by integration of the external response mapping with the original, anatomical one, while applying identical integration weights for uncrossed and crossed postures. Thus, the model explained the data without assuming failures of remapping. Moreover, performance differences across tasks were accounted for by non-individual parameter adjustments, indicating that individual participants’ task adaptation results from one common functional mechanism. These results suggest that remapping is an automatic and accurate process, and that the observed localization impairments in touch result from a cognitively controlled integration process that combines anatomically and externally coded responses.     

Reducing Ethical Hazards in Knowledge Production

This article discusses the ethics of knowledge production (KP) from a cultural point of view, in contrast with the more usual emphasis on the ethical issues facing individuals involved in KP. Here, the emphasis is on the cultural environment within which individuals, groups and institutions perform KP. A principal purpose is to suggest ways in which reliable scientific knowledge could be produced more efficiently. The distinction between ethical hazard and (un)ethical behaviour is noted. Ethical hazards cannot be eliminated but they can be reduced if the cultural ambience is suitable. The main suggestions for reducing ethical hazards in KP relate to the review process. It is argued that some defects of the current, largely anonymous, review process could be ameliorated by a process of comprehensive, open and ongoing review (COOR). This includes partial professionalisation of the work of reviewing. Review at several stages is a vital part of the long filtering that incorporates some claims into the canon of reliable knowledge. The review process would be an acknowledged and explicit part of KP—a respected, public and rewarded activity. COOR would be expensive but cost-effective. The costs should be built explicitly into research culture. Finally, the considerations about a more ‘KP friendly’ culture lead to advocacy of a ‘long-term, short-term’ synthesis; that is, of the synthesis of long-term vision, such as a more cooperative and less competitive culture, with incremental changes which may be implemented in the short term.