Integrating Attachment Theory into Family Therapy

Solution‐focused therapies have had only short‐term effectiveness for clients with serious problems stemming from abuse who come to our family counselling centre in Auckland, New Zealand. In seeking long‐lasting change, we have begun integrating attachment theory into the family systems therapy we have been practising. The Adult Attachment Interview (George, Kaplan, & Main, 1985) has been incorporated into a case in order to study the effectiveness of integrating attachment and family systems theories. This case illustrates how information gathered about the mother's attachment pattern can help the therapist comprehend the client's response to the present crisis, and clear a path through what can appear to be an overwhelming labyrinth of presenting issues.     

Attitudes and knowledge of social work students towards sexuality in later life

Background: Sexuality in later life may be compromised by restrictive attitudes, and lack of knowledge among professionals. This study examined social work students’ attitudes and knowledge towards sexuality and sexual expression in later life and investigated associated factors.

Method: Undergraduate social work students from Israel (n = 375) completed the Attitudes and Knowledge towards Older Adult’s Sexuality Scale and questionnaires regarding contacts and exposure to older adults, prior sexual education and sociodemographic.

Results: Attitudes and knowledge were correlated. First year students were the most conservative and demonstrated the least knowledge. No differences were found between men and women regarding attitude. However, men and married students had greater knowledge regarding older adults’ sexuality than women or non-married students did. Increased religious observance predicted more conservative attitudes. Age predicted more permissive attitudes and greater knowledge about sexuality in later life. A mediating process examined, suggested knowledge is a mediator variable between age and attitudes towards older adults’ sexuality.

Conclusion: As the population in Israel and in Western countries ages, it is important to examine the knowledge and attitudes of social work students regarding older adults’ sexuality and to develop educational and interventional programs aimed at increasing awareness, knowledge, and positive attitudes in this area.     

Upgrading local operations for global arbitrage

This study shows that upgrading sales operations in host countries towards production allows MNCs to perform global arbitrage in their networks of foreign subsidiaries and thereby contributes to a strategy of reaping the benefits of multinationality. We predict and find that operation upgrades follow opportunities of improving resource flows in the subsidiary network to exploit the advantages of host countries in tax rates, investment incentives, and technological knowledge across borders. Performance effects on the level of the MNC network give evidence of these benefits from global arbitrage.     

Editorial

Ohne Zusammenfassung     

Threshold-range scaling of excitable cellular automata

Each cell of a two-dimensional lattice is painted one of colors, arranged in a color wheel. The colors advance (k tok+1 mod ) either automatically or by contact with at least a threshold number of successor colors in a prescribed local neighborhood. Discrete-time parallel systems of this sort in which color 0 updates by contact and the rest update automatically are called Greenberg-Hastings (GH) rules. A system in which all colors update by contact is called a cyclic cellular automation (CCA). Started from appropriate initial conditions, these models generate periodic traveling waves. Started from random configurations the same rules exhibit complex self-organization, typically characterized by nucleation of locally periodic ram's horns or spirals. Corresponding random processes give rise to a variety of forest fire equilibria that display large-scale stochastic wave fronts. This paper describes a framework, theoretically based, but relying on extensive interactive computer graphics experimentation, for investigation of the complex dynamics shared by excitable media in a broad spectrum of scientific contexts. By focusing on simple mathematical prototypes we hope to obtain a better understanding of the basic organizational principles underlying spatially distributed oscillating systems.     

Internalization and internationalization under competing real options

The theories of internalization and internationalization provide general factors of international market entry but are not precise about its timing. The theory of real options may complement these approaches as it centers the impact of uncertainty on the timing and dimensioning of investment. A panel study of 5379 German entries to 22 countries suggests that, under the moderating influence of competition, the economic uncertainty in a host country has a U-shaped influence on the moment of entry. The results further reveal that uncertainty has a negative effect on the amount of capital at entry. Uncertainty shows no impact on the share in capital at entry, which challenges the view of international joint ventures as real options.     

Repetitive transcranial magnetic stimulation (rTMS) in depression

Transcranial magnetic stimulation (TMS) is a relatively non-invasive technique to interfere with the function of small cortical areas through currents induced by alternating magnetic fields emanating from a handheld coil placed directly above the targeted area. This technique has clear effects on a whole range of measures of brain function and has become an important research tool in neuropsychiatry. More recently, TMS has been studied in psychiatry mainly to assess its putative therapeutic effects in the treatment of refractory major depression. Most studies indicate that both low-frequency TMS and higher (20 Hz) frequency repetitive TMS may have some antidepressant properties. This is most interesting and opens a whole new avenue of low invasive techniques to stimulate the brain in major depression. However, definite therapeutic effects of clinical significance still remain to be demonstrated.

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Zusammenfassung Die transkranielle Magnetstimulation (TMS) ist eine wenig invasive Technik zur Beeinflussung der Funktion kleiner kortikaler Gebiete durch von alternierenden Magnetfeldern induzierte Ströme. Diese Magnetfelder werden mit Hilfe einer handgeführten Spule erzeugt, die unmittelbar über dem gewünschten Zielbereich positioniert wird. Diese Methode hat deutliche Auswirkungen auf ein ganzes Spektrum von Hirnfunktioen und ist stellt ein wichtiges Forschungsinstrument der Neuropsychiatrie dar. In jüngerer Zeit studiert man TMS in der Psychiatrie hauptsächlich, um ihre vermuteten Therapieeffekte in der Behandlung refraktärer majorer Depressionen zu klären. Die meisten Studien deuten darauf hin, dass sowohl niederfrequente TMS (1Hz) und höherfrequente (20 Hz) repetitive TMS (rTMS) antidepressive Eigenschaften zeigen. Dies ist höchst interessant und eröffnet eine vollkommen neue Perspektive für wenig invasive Techniken zur Stimulation des Gehirns in Fällen von majorer Depression. Überzeugende Effekte von klinischer Signifikanz gilt es jedoch noch nachzuweisen.

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Resumé La stimulation magnétique transcraniale (SMT) est une technique relativement non invasive visant à influer sur le fonctionnement de petites zones corticales au moyen de courants induits par des champs magnétiques alternatifs, provenant d’une bobine magnétique tenue à la main directement au-dessus de la zone visée. Cette technique a des effets manifestes sur toute une gamme de mesures des fonctions du cerveau et est devenue un important outil de recherche en neuropsychiatrie. Depuis quelques temps, la TMS est étudiée sur ses effets thérapeutiques supposés dans le traitement des dépressions majeures réfractaires. La plupart des études montrent que tant la TMS à basse fréquence que la TMS répétitive à fréquence plus élevée (20 Hz) (rTMS) pourraient avoir des propriétés antidépressives. Ceci est extrêmement intéressant et ouvre des perspectives entièrement nouvelles aux techniques faiblement invasives pour stimuler le cerveau dans les cas de dépressions majeures. Cependant, des effets thérapeutiques concrets avec pertinence clinique restent encore à démontrer.

     

Assessing switchability for biosimilar products: modelling approaches applied to children's growth

The present paper describes two statistical modelling approaches that have been developed to demonstrate switchability from the original recombinant human growth hormone (rhGH) formulation (Genotropin^®) to a biosimilar product (Omnitrope^®) in children suffering from growth hormone deficiency. Demonstrating switchability between rhGH products is challenging because the process of growth varies with the age of the child and across children. The first modelling approach aims at predicting individual height measured at several time‐points after switching to the biosimilar. The second modelling approach provides an estimate of the deviation from the overall growth rate after switching to the biosimilar, which can be regarded as an estimate of switchability. The results after applying these approaches to data from a randomized clinical trial are presented. The accuracy and precision of the predictions made using the first approach and the small deviation from switchability estimated with the second approach provide sufficient evidence to conclude that switching from Genotropin^® to Omnitrope^® has a very small effect on growth, which is neither statistically significant nor clinically relevant. Copyright © 2015 John Wiley & Sons, Ltd.