Physician Migration: Experience of International Medical Graduates in the USA

The purpose of this study was to explore the experience of foreign-born international medical graduates (IMGs) in the USA. Few studies describe IMG experiences in attaining medical licensure in the USA at each step of the process. Furthermore, little is known about IMGs who choose not to become a licensed physician or were unsuccessful in doing so. In this study, 20 foreign-born IMGs, 16 practicing IMGs and 4 non-licensed physician IMGs, participated in a 1-h semi-structured face-to-face interview between September 2013 and April 2014. Participants were from North America (Canada), Latin America, South Asia, East Asia, Europe, the Middle East, or Sub-Saharan Africa. Interviews were transcribed. Two of the authors conducted initial analysis of each interview separately. Four primary themes emerged based on the data analysis: (1) barriers to physician careers include the immigration process, years since graduating from medical school, language and culture, and cost and time; (2) positive factors to support physician careers include networking and research experience; (3) factors that positively or negatively affect IMGs seeking physician careers such as the education system in a home country and family; and (4) non-physician careers. In order to develop multiple pathways to utilize IMGs in the US healthcare system, future research examining the following areas is necessary: (1) support systems for IMGs who are taking the US Medical Licensing Exam (USMLE) or applying for a residency position and (2) the experience of IMGs who are not certified physicians in the USA.     

The temporal weighting of loudness: effects of the level profile

In four experiments, we studied the influence of the level profile of time-varying sounds on temporal perceptual weights for loudness. The sounds consisted of contiguous wideband noise segments on which independent random-level perturbations were imposed. Experiment 1 showed that in sounds with a flat level profile, the first segment receives the highest weight (primacy effect). If, however, a gradual increase in level (fade-in) was imposed on the first few segments, the temporal weights showed a delayed primacy effect: The first unattenuated segment received the highest weight, while the fade-in segments were virtually ignored. This pattern argues against a capture of attention to the onset as the origin of the primacy effect. Experiment 2 demonstrated that listeners adjust their temporal weights to the level profile on a trial-by-trial basis. Experiment 3 ruled out potentially inferior intensity resolution at lower levels as the cause of the delayed primacy effect. Experiment 4 showed that the weighting patterns cannot be explained by perceptual segmentation of the sounds into a variable and a stable part. The results are interpreted in terms of memory and attention processes. We demonstrate that the prediction of loudness can be improved significantly by allowing for nonuniform temporal weights.     

Positive Approaches to Coping with the Challenges of Ageing: Research Priorities

This article identifies research priorities in respect of the social dimension of ageing. Three areas are explored; ageing in one's own community; ageing in another community as a consequence of migration and ageing in a residential community. Exemplar research studies, conducted by the authors (singly) are presented briefly and contextualised in the literature to reveal key research priorities. The determination of research priorities should take account of those aspects of social functioning that are associated with factors amenable to change. Key research priorities identified include the development of a better understanding of the importance of social networks; how these are created, maintained to promote the successful social ageing of individuals.     

The influence of background music on learners with varying extraversion: Seductive detail or beneficial effect?

Seductive details in general affect learning and cognitive load negatively. However, especially background music as a seductive detail may also influence the learner's arousal, whose optimal level depends on the learner's extraversion. Therefore, the effects of extraversion and background music on learning outcomes, cognitive load, and arousal were investigated. We tested 167 high school students and found better transfer outcomes for the group with background music. They also reported higher germane load, but no impact of background music on extraneous cognitive load or arousal was found. In the group without background music, learners with higher extraversion reached better recall scores, which was not found in the group with background music. Results may cautiously be interpreted that there is a beneficial impact of background music that compensates for the disadvantages of low extraverted learners and which cannot be explained through arousal.     

The Minnesota Multiphasic Personality Inventory-2 across the human immunodeficiency virus spectrum

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) was used to assess individuals' patterns of psychological symptoms across the spectrum of HIV illness. Two hundred and twenty-five participants in the present sample were administered the MMPI-2, 61 were HIV-seronegative controls, 61 were asymptomatic, 36 were symptomatic, and 67 met criteria for AIDS. Symptomatic HIV-seropositive patients scored higher on the Hypochondriasis, Conversion-Hysteria, and Depression Scales. These differences appeared to be largely due to an increase in somatic complaints rather than an increase in other depressive symptoms. Group differences did not appear to be due to HIV-associated neuropsychological dysfunction. Interpretive strategies for the MMPI-2 and treatment considerations are discussed.     

Impulsive decision making and working memory

Decision making that favors short-term over long-term consequences of action, defined as impulsive or temporally myopic, may be related to individual differences in the executive functions of working memory (WM). In the first 2 experiments, participants made delay discounting (DD) judgments under different WM load conditions. In a 3rd experiment, participants high or low on standardized measures of imupulsiveness and dysexecutive function were asked to make DD judgments. A final experiment examined WM load effects on DD when monetary rewards were real rather than hypothetical. The results showed that higher WM load led to greater discounting of delayed monetary rewards. Further, a strong direct relation was found between measures of impulsiveness, dysexecutive function,and discounting of delayed rewards. Thus, limits on WM function, either intrinsic or extrinsic, are predictive of a more impulsive decision-making style.     

Provider contact with families of adults with severe mental illness: taking a closer look

This exploratory study examined the frequency and nature of providers' contact with families of persons with severe mental illness. Fifty-nine providers in six community mental health programs completed a self-administered survey. A subsample of 8 providers also completed two in-depth interviews. Although most providers had some family contact, the contact was restricted to a small percent of their caseloads. The nature of contact that providers have with families is generally limited by their professional role. Best practice guidelines for the treatment of mental illness and agency administrators responsible for instituting these guidelines will need to clarify the types of providers who are expected to implement various aspects of family involvement.     

Use of Photovoice in Processing Race-Based Topics in a Multicultural Counseling Course

This phenomenological study assessed master-level students’ experiences of using photovoice, a creative learning activity, in a race-based multicultural counseling course. Students were asked to engage in weekly written reflections regarding a course-related photographic image, with the goal of more deeply processing cognitive and affective reactions to the course. Data analyzed included focus groups, student written responses, and photos. Findings indicated use of photovoice as a means for processing cognitions, which allowed students to deepen learning by extending a racialized lens outside of the classroom. Students also indicated use of the tool to process emotional reactions at various stages of the course, allowing learners to creatively and visually express feelings as they surfaced.     

How Competent are Adolescent Bullying Perpetrators and Victims in Mastering Normative Developmental Tasks in Early Adulthood?

A substantive body of literature suggests that those involved in bullying as perpetrators but particularly victims are at greater risk for psychological maladjustment. In comparison, relatively little is known about associations between bullying-victimization and perpetration and mastery of early adult tasks in domains including romantic relationships, education, work, financial competence, and conduct. These links were tested using data from two Dutch cohorts (RADAR-young, n = 497, 43% girls; TRAILS, n = 2230, 51% girls) who reported on victimization and perpetration at age 11 (TRAILS) and 13 (RADAR-young) and mastery of developmental tasks in early adulthood. Unadjusted regression analyses suggested for both cohorts that perpetrators were less likely to abide the law and more likely to smoke. Victims in TRAILS were less competent in the domains of education, work, and finances, and more likely to smoke in RADAR-young. Adjusting for childhood demographics and child intelligence and including psychopathology in the prediction models substantially reduced the strength of associations between bullying involvement and later outcomes in both cohorts; although association were retained between victimization and welfare dependence and perpetration and crime involvement in TRAILS. Parental support did not buffer associations in either sample and neither were gender differences detected. Overall, findings underline that negative outcomes of bullying are not only a concern for victims but also for their perpetrators although involvement in bullying is not a stable predictor of mastery of developmental tasks when childhood demographics, child intelligence, and psychopathology are taken into account.     

Loneliness and Negative Affective Conditions in Adults: Is There Any Room for Hope in Predicting Anxiety and Depressive Symptoms?

This study examined the role of hope in understanding the link between loneliness and negative affective conditions (viz., anxiety and depressive symptoms) in a sample of 318 adults. As expected, loneliness was found to be a significant predictor of both anxiety and depressive symptoms. Noteworthy, hope was found to significantly augment the prediction of depressive symptoms, even after accounting for loneliness. Furthermore, we found evidence for a significant Loneliness × Hope interaction effect in predicting anxiety. A plot of the interaction confirmed that the association between loneliness and anxiety was weaker among high, compared to low, hope adults. Some implications of the present findings are discussed.