'Straight to the GP; that would be where I would go': an analysis of male frequent attenders' constructions of their decisions to use or not use health-care services in the UK

An important consideration that needs adding to discussions of patient choice and whether or not men are reluctant to use primary care services is that many frequent attenders are male. The aim of this article is to explore how male frequent attenders construct decisions to use or not use health-care services. This is achieved through secondary analysis of baseline interviews with male frequent attenders from the Self Care in Primary Care study. As this was a complex study, a three-step analytic process was employed to incorporate the involvement of multiple researchers working together over a number of years. First, the interviewer summarised each interview and second, the summaries were read as a group to find themes across them. Subsequently, we returned to the interviews to add detail that would further illustrate or challenge the analysis. Participants talked of 'engaging health and avoiding ill-health', constructing themselves as embodied, health conscious and rational in a similar vein to constructions of feminine interactions with health. While participants talked of 'choosing health services' as if they were drawing upon a range of choices, the dominance of the image of the GP was such that seeing a GP was the only legitimate health choice.     

The Influence of Family Dynamics on Ethnic Identity Among Adult Latinas

The literature on the development of ethnic identity within the young adult years and during childhood is plentiful. There is less research that examines how this development continues beyond young adult or college years. Research suggests that major life events experienced in adulthood could cause individuals to enter a period of identity reconstruction, yet little is known about this process. Because family and/or familism has been established as an important aspect of Latinos’ identities and lived experiences, this study seeks to examine the dimensions around family dynamics and their potential influences on ethnic identity development processes among adult Latinas. Findings indicate that Latinas often make sense of their ethnic identity when major life events associated with family dynamics occur; such as marriage, childbearing, and negotiating relationships with family members as culture is being transmitted across several generations. These findings have implications for understanding adult education students as well as considering the influence of education on the family dynamics of Latinas.     

Do the myths still exist? Revisiting people's negative beliefs about organ donation upon death

The prevalence of myths preventing people partial to donation in Australia from consenting is unknown. Respondents (N?=?468: 381 donors, 26 non-donors, 61 undecided) were surveyed about their (negative) donation beliefs. Approximately 30% of donors were neutral or supported negative beliefs about organ allocation, especially donation to undesirable organ recipients and a black market organ trade. Confusion about brain death, lack of family and religious support, and discomfort with donation were negative beliefs endorsed by some respondents irrespective of donor preference. Proportionally, donors had greater trust in hospitals/doctors than other groups. Some myths still exist but may vary with donation preference.     

Attachment insecurity and intimate partner violence

We argue that human attachment encompasses a broad spectrum of attachment insecurities including fearful and preoccupied attachment style, negative emotionality (NEM), and borderline personality organization (BPO). These, in turn, have a developing literature to link them as causative factors for intimate partner violence (IPV) in both adolescents and adults. These broad spectrum attachment disorders constitute the major psychological predictor of IPV. Direct assessments indicate that they increase the likelihood of aggression in adolescents and intimate partner violence in adults. Some of the proposed mechanisms increasing aggression in insecurely attached people include alterations in the appraisal of threat due to an inability to call on memories of parental support and diminished ability to implement affective controls and impulsivity.     

Attachment dismissal predicts frontal slow-wave ERPs during rejection by unfamiliar peers

Attachment representations are thought to provide a cognitive-affective template, guiding the way individuals interact with unfamiliar social partners. To examine the neural correlates of this process, we sampled event-related potentials (ERPs) during exclusion by unfamiliar peers to differentiate insecure-dismissing from securely attached youth, as indexed by the child attachment interview. Thirteen secure and 10 dismissing 11- to 15-year-olds were ostensibly connected with two peers via the Internet to play a computerized ball-toss game. Actually, peers were computer generated, first distributing the ball evenly, but eventually excluding participants. Afterward children rated their distress. As in previous studies, distress was related to a negative left frontal slow wave (500-900 ms) during rejection, a waveform implicated in negative appraisals and less approach motivation. Though attachment classifications were comparable in frontal ERPs and distress, an attachment-related dismissal dimension predicted a negative left frontal slow wave during rejection, suggesting that high dismissal potentially involves elevated anticipation of rejection. As expected, dismissal and self-reported distress were uncorrelated. Yet, a new approach to quantifying the dissociation between self-reports and rejection-related ERPs revealed that dismissal predicted underreporting of distress relative to ERPs. Our findings imply that evaluations and regulatory strategies linked to attachment generalize to distressing social contexts in early adolescence.     

Problems for Dogmatism

I argue that its appearing to you that P does not provide justification for believing that P unless you have independent justification for the denial of skeptical alternatives – hypotheses incompatible with P but such that if they were true, it would still appear to you that P. Thus I challenge the popular view of ‘dogmatism,’ according to which for some contents P, you need only lack reason to suspect that skeptical alternatives are true, in order for an experience as of P to justify belief that P. I pursue three lines of objection to dogmatism, having to do with probabilistic reasoning, considerations of future or hypothetically available justification, and epistemic circularity. I briefly sketch a fall-back position which avoids the problems raised.     

Desires in Practical Reasoning

Inferences from desired ends to intended necessary means seem to be among the most unproblematic elements of practical reasoning. A closer look dissolves this appearance, however, when we see that such inferences are defeasible. We can nevertheless understand such inferences as leading to the adoption of plans, by analogy with inferences leading to explanations. Plans should satisfy at least some important ends desired by the agent, be consistent with the satisfaction of other desired ends, and be inconsistent with as few desired ends as possible. A rational plan may rule out the satisfaction of some desires, however, and this feature explains the defeasibility of such inferences.     

Analysis of An Intervention to Reduce or Prevent Secondary Conditions for People with Spinal Cord Injuries

People with acute spinal cord injuries (SCI) are at risk for developing secondary conditions such as pressure sores, urinary tract infections, pain, weight gain and deconditioning, and depression. This study analyzed the effectiveness of an Internet assessment and feedback tool in determining secondary condition risk for this population based on individual responses to a knowledge and behavioral questionnaire. Seventy-one people with newly-diagnosed SCI who were treated at one of five Model Spinal Cord Injury Systems Centers were randomly assigned to either an experimental condition in which they received computerized feedback and one-on-one consultations based on their online questionnaire answers, or to a control condition in which they received no feedback until the study's completion. One year after the initial assessment, the online questionnaire was re-administered to all participants as a post-test. Three times between the pre- and post-test assessments researchers telephoned participants to administer phone surveys probing secondary condition development. Results indicate there were significant differences among race groups and between complete and incomplete injury status for pressure sore occurrence. This study represents a new era of interactive technology in health promotion that can serve as a basis for future research to decrease secondary condition risk for people with SCI.