Adapting enactments to couple reactivity: five developmental stages

Interest in change interventions that are common to different models of relationship therapy has spurred investigation of enactments as one such candidate. In change-focused enactments, therapists structure and coach couple/family interaction, as opposed to channeling interaction through the therapist. Still, varying levels of couple/family distress, volatility, and reactivity mean that readiness for enactment intervention varies along a broad continuum and changes over the course of therapy. This suggests the need for differentiated enactments. Currently, however, no model exists for adapting enactments to changing relationship conditions. We propose a five-stage developmental model of clinical operations in couple therapy that adapts the process and structure of enactments to changing levels of relationship distress, interactional volatility, and emotional reactivity. The model increases the possibility for therapists to use enactments successfully over the entire course of couple therapy. Issues to be considered in using the couple enactments model as a template for the development of enactment models for other relationship systems are noted.     

More harm than good? Diagnostic codes for child and adult abuse

This study sought to understand the reasons for the lack of use of ICD diagnostic codes for child and adult abuse. New Jersey professionals were recruited to participate in three focus groups on child abuse, adult or primarily woman abuse, and elder abuse. Participants included health care providers, advocates from the community, and representatives of state agencies and the insurance industry. Concerns about coding abuse included further jeopardizing victims/patients, diagnostic uncertainty, and lack of resources. Members of the child abuse group were somewhat more receptive to coding abuse. Reasons to code, such as for documentation and reimbursement were discussed and rebutted. Most participants concluded that use of the abuse codes should be judicious because they have the potential to do more harm than good. More research is needed on the implications of coding for victims/patients along with medical education in the identification of abuse in general and coding abuse in particular.     

Definition and Measurement of Chasing in Off-Course Betting and Gaming Machine Play

The attempt to recover gambling losses by continuing to gamble (chasing) has featured prominently in accounts of excessive gambling. This research represents the first attempt to operationalize and measure chasing in terms of its cognitive (behavioral intention), emotive (urges) and behavioral components, and to investigate the role of chasing in relation to impaired control over gambling. Two survey samples of 84 male off-course (betting shop) race gamblers (mean age 41, SD = 15) and 137 gaming machine players (73 females, mean age 48, SD = 15 and 64 males, mean age 43, SD = 16) were recruited at gambling venues. Respondents completed a structured questionnaire that investigated retrospective report of chasing and an impaired control scale (The Scale of Gambling Choices). It was found that the various components of chasing formed a composite measure with high internal reliability that was strongly related to indicators of excessive gambling (e.g. time spent gambling, expenditure as a proportion of income) and to impaired control scores. Reacting to large wins by further betting was almost as strongly related to impaired control as was persistence after losing. Those who returned later to chase had significantly higher impaired control scores than those who only chased within a session. Alcohol-related chasing was associated with impaired control over gambling. Chasing of losses and impaired control appear to be generic processes in evidence across both forms of gambling and gender (most format and sex differences were of minor significance).     

Vitamin B1 blocks damage caused by hyperglycemia

Diabetes accelerates the aging process and leads to complications that include blindness, renal failure, nerve damage, stroke, and cardiovascular disease. It has been hypothesized that high plasma glucose concentrations are responsible for increased mitochondrial free radical production and subsequent inactivation of glyceraldehyde phosphate dehydrogenase (GAPDH) in vascular endothelial cells and other cells implicated in these complications. As a result of the decreased ability of GAPDH to process upstream metabolites, three pathways of metabolic damage are activated, which include the advanced glycation end-product formation pathway, the protein kinase C pathway, and the hexosamine pathway. All three pathways have been implicated in abnormal cell signaling in diabetes. A group of German and U.S. scientists has now found that treating diabetic rats with high doses of benfotiamine, a lipid-soluble form of vitamin B1, can prevent diabetic retinopathy and all three forms of metabolic damage by stimulating transketolase activity and thus diverting excess metabolites toward the pentose pathway. Although vitamin B1 is available over the counter, the researchers at this time do not advocate self-treatment without further clinical data.     

Huntington's disease

In this case study, we describe the symptoms, neurological exam, neuropsychological test results, and brain pathology of a man who died with Huntington's disease (HD). HD is a rare neurodegenerative disease. Like other movement disorders involving the basal ganglia, HD affects motor, cognitive, and psychiatric functioning. The disease follows an autosomal dominant pattern of inheritance, with onset of symptoms most commonly occurring in the late 30s or early 40s, as in this patient. HD is caused by an unstable expansion of the trinucleotide CAG, coding for glutamine, on chromosome 4. Despite knowledge of the gene mutation responsible for HD, no definitive treatment is currently available to slow or halt progression of the disease. However, symptomatic treatment can significantly improve the quality of life for patients with HD.     

The impact of an industry-based rehabilitation programme

An industry specific rehabilitation programme was developed to cater for the special requirements of the New Zealand logging industry. The aims of the rehabilitation programme were to: reduce the amount of time lost due to injury, reduce the number of lost time injuries, and overall, to reduce the direct costs associated with logging injuries. The programme was field-tested on a logging company. The rehabilitation programme was effective for reducing the average amount of time lost due to injury and also for reducing the cost of the injuries. Although there were a number of factors that may have had an impact upon these results, this research provides evidence that this rehabilitation programme was effective for reducing the severity and cost of injury to the New Zealand logging industry.     

Human and organizational factors in offshore safety

The role of human and organizational factors in predicting accidents and incidents has become of major interest to the UK offshore oil and gas industry. Some of these factors had been measured in an earlier study focusing on the role of risk perception in determining accident involvement. The current study sought to extend the methodology by focusing on perceptions of organizational factors that could have an impact on safety. A self-report questionnaire was developed and distributed to 11 installations operating on the UK Continental Shelf. A total of 722 were returned (33% response rate) from a representative sample of the offshore workforce on these installations. The study investigated the underlying structure and content of offshore employees' attitudes to safety, feelings of safety and satisfaction with safety measures. Correlations and step-wise regression analysis were used to test the relationships between measures. The results suggest that 'unsafe' behaviour is the 'best' predictor of accidents/near misses as measured by self-report data and that unsafe behaviour is, in turn, driven by perceptions of pressure for production.     

Use of a conceptual model of societal drivers of ecological change in South Florida: Implications of an ecosystem management scenario

Human-dominated ecosystems such as in South Florida's Everglades region are greatly affected by societal actions and choices, and efforts to restore degraded ecosystems must take into account the societal drivers of ecosystem change. A conceptual model of societal-ecological interactions within the region illustrates connections between major societal drivers, such as water management and land use, and ecological stressors, such as loss of habitat and nutrient loading. Using the conceptual model as an initial guide for discussion, examination of a restoration scenario for the region shows that social and economic effects from activities proposed in a restoration scenario will likely affect most sectors of South Florida. Political effects from changing land and water management practices likely will be significant, as will the physical effects of changing water structures and management practices. Conceptual models such as this can aid in the initial stages of ecosystem restoration discussions and can assist in planning for subsequent social science evaluations of specific societal impacts of actual proposed governmental restoration alternatives. In crafting restoration scenarios, local, regional, and national decision makers can use conceptual models such as this to help broaden the early considerations of how possible future changes in societal drivers, including management choices, will change ecological stressors that affect ecosystem health.     

Does It Cost Less to Live in Rural Areas? Evidence from New Data on Food Security and Hunger*

Abstract Rural‐urban differences in the association of food insecurity and hunger with income suggest that the cost of living is substantially lower in rural than in urban areas. This implies that the official poverty rate overstates rural economic hardship compared with that in urban areas. Geographic differences in cost of living implied by the association between food insecurity and income provide some validation of the cost of housing adjustment proposed by the National Academy of Sciences (NAS) panel on improving the measurement of poverty, but suggest that the NAS adjustment generally overcorrects for cost of living and would be seriously problematic in some regions.