A Two-Phase Approach to Developing SNAP: an iPhone Application to Support Appointment Scheduling and Management for Women with a <Emphasis Type="Italic">BRCA</Emphasis> Mutation

Professional organizations provide surveillance guidelines for BRCA1 and BRCA2 (BRCA) carriers with intact breasts and/or ovaries to facilitate early cancer detection. However, literature indicates adherence to surveillance guidelines is inconsistent at best. Using the Messaging Model for Health Communication Campaigns framework, we undertook a two-phase formative research approach to develop an intervention to promote adherence to surveillance guidelines. Discussion groups identified preferred intervention format and function in phase I. Findings indicated carriers desired a phone application (app) to assist with surveillance management and appointment tracking. Thus, an iPhone app for carriers to track appointments based on published surveillance guidelines was developed. In phase II, we obtained feedback from BRCA carriers via a survey during a prototype demonstration at a regional conference. Participants in phase II wanted reminder capabilities and the ability to add and modify information fields. This feedback informed intervention modifications, resulting in the Scheduling Necessary Advised Procedures (SNAP) iPhone app currently being pilot tested by BRCA carriers throughout the USA.     

Collaboration facilitates abstract category learning

We examined the effects of collaboration (dyads vs. individuals) and category structure (coherent vs. incoherent) on learning and transfer. Working in dyads or individually, participants classified examples from either an abstract coherent category, the features of which are not fixed but relate in a meaningful way, or an incoherent category, the features of which do not relate meaningfully. All participants were then tested individually. We hypothesized that dyads would benefit more from classifying the coherent category structure because past work has shown that collaboration is more beneficial for tasks that build on shared prior knowledge and provide opportunities for explanation and abstraction. Results showed that dyads improved more than individuals during the classification task regardless of category coherence, but learning in a dyad improved inference-test performance only for participants who learned coherent categories. Although participants in the coherent categories performed better on a transfer test, there was no effect of collaboration.     

Three faces of context and their implications for career: A study of public sector careers cut short

This paper examines the impact of context on careers. It is based on a study of senior managers in an English local authority. It offers two important contributions: first, an empirical contribution examining how context matters to individuals in their career-making in the setting of the UK public sector. Our findings point to three aspects or faces of context: proximal events, ideology and enduring structural features. The first, context as ideology, attends to meaning-making that is collective in nature, and that incorporates concepts of power, domination, subordination and resistance. Our second refers to the enduring structural features. These are on-going trends and developments, predictable and traceable over the medium to long-term which offer rules and resources, thus structuring opportunity and constraint. Finally, the third face, context as proximal events, refers to (often unexpected) contingencies that arise at particular moments. Although bounded both spatially and temporally, they can significantly impact on career decision making. The second contribution of the paper builds upon this empirical base to develop theoretical and conceptual understanding of the link between career and context, illustrating the interconnectedness of the various faces of context and the dynamic ways in which these influence career-making over time.     

The Suicidal Narrative and Its Relationship to the Suicide Crisis Syndrome and Recent Suicidal Behavior

In this study, we introduce the construct of the suicidal narrative, a hypothetical personal narrative linked to imminent suicide, and explore its relationship to near‐term suicidal risk and the suicide crisis syndrome (SCS). Psychiatric outpatients (N = 289) were administered the Columbia Suicide‐Severity Rating Scale (C‐SSRS), Suicide Crisis Inventory (SCI), and Suicide Narrative Inventory (SNI), a novel instrument combining the documented risk factors of Thwarted Belongingness, Perceived Burdensomeness, Humiliation, Social Defeat, Goal Disengagement, and Goal Reengagement. Dimensional measures of past month, lifetime, and past suicidal phenomena, incorporating ideation and behavior, were calculated from the C‐SSRS. Structural equation modeling was used to explore the interaction among variables. Factor analysis of the SNI yielded two orthogonal factors, termed Interpersonal and Goal Orientation. The former factor was comprised of Perceived Burdensomeness, Social Defeat, Humiliation, and Thwarted Belongingness, the latter of Goal Disengagement and Goal Reengagement. The Interpersonal factor correlated with both SCS severity and suicidal phenomena in each time frame and the Goal Orientation factor with no other variable. As hypothesized, the proposed model was significant for the past month only. Our findings support the construct of the suicidal narrative and its function as a near‐term suicidal risk factor.