Adolescent and parent alliances with therapists in Brief Strategic Family Therapy with drug-using Hispanic adolescents

This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent, adolescent) and family level (within-family differences) for families that either dropped out or completed family therapy. Participants were 31 Hispanic adolescents and their family members who received brief strategic family therapy for the treatment of adolescent drug use. Videotapes of first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that Completer cases had significantly higher levels of alliance across all family members than Dropout cases, and Dropout cases had significantly higher unbalanced alliances than Completer cases. Clinical implications are discussed.     

Women's satisfaction with their breast prosthesis: what determines a quality prosthesis?

The aim of this study is to determine what factors constitute a quality prosthesis and ascertain which factors affect prosthesis satisfaction. Sixty-four women who received full funding for their prosthesis and 38 women who received their hospital's usual funding were recruited. Women rated the information provided about breast prostheses very highly, with 85% reporting that it was "very good" or "excellent." Satisfaction was significantly associated with how well the prosthesis fit (1 week, p = .001; 3 months, p = .01), level of comfort (3 months, p=.005), and appearance of the prosthesis when worn (6 months, p = .001). Quality was significantly associated with how well it fit (1 week, p = .001; 3 months, p = .001), how natural it felt (1 week, p = .001; 6 months, p = .01), the weight of the prosthesis (3 months, p = .003), and appearance when worn (6 months, p = .03). The results will be used to improve women's access to a quality prosthesis.     

Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood

Recent studies have found that chronic avoidance of unpleasant internal experiences (e.g., thoughts, emotions, memories) is a maladaptive means of affect regulation often adopted by women with a history of sexual victimization in childhood. The primary aim of this study was to replicate and extend previous findings suggesting that higher levels of experiential avoidance may account for the relationship between childhood sexual abuse (CSA) and psychological distress in adulthood. It was hypothesized that, in a sample of undergraduate females (n = 151), the relationship between severity of CSA (e.g., frequency, nature of victimization) and trauma-related psychological distress would be mediated by avoidance. Results supported this hypothesis. Findings are consistent with previous studies, and further suggest that the general tendency to avoid or escape from unpleasant internal experiences may be a specific factor that exacerbates psychological distress among women with a history of sexual victimization in childhood.     

Harnessing hormonal signaling for cardioprotection

Cardiovascular disease is the leading cause of death in women in the Western world and is predominant among the elderly. A large body of evidence suggests that hormonal signaling plays a critical role in the regulation of cardioprotective mechanisms, as premenopausal women are at significantly lower risk of heart disease compared with men, but the risk greatly increases with the onset of menopause. This association indicates that estrogen may protect the heart from cardiovascular disease. Whereas a number of analyses of the effects of hormone replacement therapy (HRT) on postmenopausal women supported the idea that estrogen is a cardioprotective factor, the findings of the more recent Women's Health Initiative (WHI) study suggested that HRT may actually increase the risk of cardiovascular events. These conflicting reports have left both patients and clinicians reluctant to continue using current HRT regimes. The WHI findings do not, however, negate the epidemiological link between menopause and increased cardiovascular risk. Hence, the identification of the specific actions of estrogen that promote cardioprotective pathways without enhancing deleterious vascular mechanisms may provide novel estrogen-based alternatives to current HRT strategies. In this Review, we outline the known actions of estrogen on the cardiovascular system, focusing on cardioprotective mechanisms that may be targeted for the development of new therapeutic approaches.     

The Availability of Supervision in Routine Mental Health Care

Clinical supervision is an embedded resource for practice quality in community mental health organizations. Supervision has been found to increase provider competence and decrease stress. In addition, supervision has been associated with service user outcomes including decreased depressive symptoms. However, little is known about the availability and nature of supervision in real world settings. The primary aims of this study were to identify available supervision and the extent to which contextual factors are related to that availability. The data source for this study was a multi-state and multi-site (N?=?14) NIMH-funded trial survey of providers (N?=?273). Supervision was measured by hours per week (quantity) and by utilization of best practice activities (content). Univariate, Chi square, independent samples t-tests, and ANOVA analyses were used to assess supervision content and quantity and to examine subgroup differences. Participants reported an average of 2.17 h of supervision per week and 28.6% of participants endorsed best practice content. Supervision quantity varied significantly across sites (p?<?0.05) and program type (p?<?0.05) while content did not. Individual role within the organization had a significant relationship with reported supervision content (p?<?0.001). In these settings, staff in organizations are exercising discretion in how to utilize supervision within the available time. Supervision time also varied by program type, increasing with the intensity of services. Findings demonstrate that reports of availability vary according to position within the organization and the intensity of services within a given program type. Implications for workforce development, access to quality services, and implementation of evidence-based practices are discussed.     

Strangers are friends I haven't met yet: a positive approach to young people's use of social media

This article reports on a recent research project undertaken in the UK that investigated young people's use of a range of prominent social media tools for socialising and relationship building. The research was conducted by a way of online survey. The findings suggest that this sample of British young people's socialising and relationship-building practices via the range of prominent social media tools reflect similar behavioural categories used offline. The use of these social media tools provides young people with an opportunity to manage, simultaneously, different categories of relationships in a multiplicity of ‘spaces’ created by these tools. The findings challenge the widely held belief that young people expose themselves to risk on social media as they indiscriminately befriend strangers. There is an absence of evidence of ‘unjustified’ intent to harm others. Indeed the findings indicate a strong desire to primarily support and protect those with whom relationships have been carefully established. The research suggests in fact that online engagement through social media can be positive and constructive for young people. It appears to provide them with a challenging ‘space’ to practice identity and relationship management strategies.     

Aids mortality and the mobility of children in Kwazulu Natal,South Africa

This paper examines the effect of parental death on the mobility of 39,163 children aged 0-17 in rural KwaZulu Natal, South Africa, in 2000 and 2001. Parental mortality from all causes prior to and during follow-up increased the risk of a child moving by nearly two times after we controlled for the age and gender of the child and household characteristics. However, in the follow-up period, child mobility following maternal deaths from AIDS was lower than child mobility following maternal deaths from other causes. Younger children, boys, and children whose mothers or fathers were resident members of the children's households were also less likely to move.     

Envisioning emerging nanotechnologies: a three-year panel study of South Carolina citizens

This article reports results from a three-year panel study of a nonrandom sample of 76 South Carolina citizens, recruited from a variety of walks of life, and their impressions of emerging nanotechnology. This discussion focuses on material from depth interviews conducted alongside a baseline opinion and awareness inventory at the beginning of the study, the most intensive data-gathering phase. These results are placed in the context of data from three additional surveys conducted at about equal intervals over the three years, plus exit interviews from 21 of the 34 individuals who completed the entire study. The results give insight into popular thinking about technology but little indication of strong emerging concerns, a trajectory of amplification of those concerns, or opinion polarization over time, despite some awareness of risks and potential ethical dimensions. Nanotechnology may stand out more as an example of risk attenuation than of risk amplification, consistent with most results from national surveys.