Group therapists' countertransference reactions to multiple deaths from aids

Group therapists for those with HIV Related Diseases are becoming the “professional” survivors of this world-wide epidemic. From their experiences we may learn a great deal more about the effects of multiple deaths on mental health care professionals. As therapists they are constantly eliciting and listening to the fears, hopes, agonies and terrors of those with this disease. They become the bereaved. Witnesses to the deaths of many of their group members, they struggle with a wide range of emotional responses while at the same time assisting surviving group members in their struggle to live with these deaths. Mourning reactions and countertransference phenomena are in abundance as these therapists grapple with these group processes. This article identifies and examines these therapists' responses by focusing on clinical illustrations drawn from their bi-weekly supervision sessions.     

Career Assessment and Counseling for STEM: A Critical Review

Career counselors must continually enhance their knowledge and skills to assist clients contemplating careers in science, technology, engineering, and mathematics (STEM). Therefore, the authors review STEM disciplines and theory‐driven strategies for assisting diverse individuals to explore, enter, and persist in STEM careers. Appropriate use of career assessments can contribute greatly to this effort. To identify available measures for STEM‐focused domains and constructs, the authors conducted a journal content analysis of stand‐alone STEM‐related career assessments from 1983 to 2016, identifying 39 articles with 153 measures. Notable results included the emergence of social cognitive theory and social cognitive career theory as prevailing frameworks for instrument development, a wide variety of disciplines and journals represented, an underrepresentation of minority samples, and untapped potential for cross‐discipline and researcher–practitioner collaboration. Useful strategies and resources for counselors and recommendations for enhancing career assessments and interventions are addressed.     

Examining the Impact of Demographic Factors on Air Pollution

This study adds to the emerging literature examining empirically the link between population size, other demographic factors and pollution. We contribute by using more reliable estimation techniques and examine two air pollutants. By considering sulfur dioxide, we become the first study to explicitly examine the impact of demographic factors on a pollutant other than carbon dioxide at the cross-national level. We also take into account the urbanization rate and the average household size neglected by many prior cross-national econometric studies. For carbon dioxide emissions we find evidence that population increases are matched by proportional increases in emissions while a higher urbanization rate and lower average household size increase emissions. For sulfur dioxide emissions, we find a U-shaped relationship, with the population-emissions elasticity rising at higher population levels. Urbanization and average household size are not found to be significant determinants of sulfur dioxide emissions. For both pollutants, our results suggest that an increasing share of global emissions will be accounted for by developing countries. Implications for the environmental Kuznets curve literature are described and directions for further work identified.     

An investigation of unmet intimacy needs in marital relationships

In this investigation we examined partners' responses to unmet intimacy needs in hopes of better understanding how these responses may affect intimacy satisfaction and overall relationship satisfaction. Eighty-four married couples, plus four additional husbands and 12 additional wives, were recruited from the community and completed measures of relationship satisfaction, intimacy need satisfaction, and attributional and communication responses to unmet intimacy needs. Consistent with the proposed mediational model, less negative attributional and communication responses to unmet intimacy needs were found to be beneficial for overall intimacy satisfaction and relationship satisfaction. In addition, more positive communication responses contributed to greater intimacy satisfaction. Limitations and clinical implications of the current study and directions for future work are discussed.     

The health care system should produce health

Reform of the U.S. health care system along the lines to be proposed by the Clinton Administration will not be an easy task, and it will not be accomplished quickly. A fundamental objective of the changes should be a health system whose purpose is improvement in the health of U.S. citizens, and not just the provision of services to all. This column is jointly edited by Kevin M. Fickenscher, MD, and David A. Kindig, MD, PhD, chair and member, respectively, of the College's Forum on National Health Policy. Dr. Fickenscher is participating in various advisory capacities on health care in the Clinton Administration, and Dr. Kindig is Senior Advisor to HHS Secretary Donna Shalala.     

A survey of physicians in a large group practice

Job satisfaction surveys among physicians, a recent phenomenon, are a very important managerial tool to determine the work motivation needs of physician-employees. The first MD Job Survey was done in 1984 by Lichtenstein on physicians employed by prisons. The largest survey of salaried physicians to date has been the 1987 Health Services Research Center of Chapel Hill survey of physicians employed in group practices. Currently, individual group practices are surveying their staffs with job satisfaction questions in order to enhance the work environment.     

Scheduling in a Management Context: Uncertain Processing Times and Non-Regular Performance Measures*

Decision makers often face scheduling problems in which processing times are not known with certainty. Non-regular performance measures, in which both earliness and tardiness are penalized, are also becoming more common in both manufacturing and service operations. We model a managerial environment with task processing times (which include sequenceindependent set-up times) prescribed by three-parameter lognormal distributions. Upon completion, each task derives a reward given by a particular piecewise-linear reward function. The objective is to select a sequence of tasks maximizing the expected total reward. The relative generality of the problem renders many enumerative methods inapplicable or computationally intractable. To overcome such difficulties we develop efficient priorityinduced construction (PIC) heuristics which build up a complete schedule by inserting tasks (singly from a list) into a partial sequence of tasks. In each partial and complete sequence a period of idle time is permitted prior to the first task. Performance on realistic-sized problems is very encouraging, with cost penalties averaging less than one percent.     

Cemetery locus as a mechanism of socio-cultural identity

In cultural studies of cemetery locus there is a very important aspect of understanding the cemetery as a tool for the formation of the socio-cultural identity of living people. I adhere to the point of view that the cemetery has always produced, and continues to produce, a variety of identities. While during the pre-Modern period the cemetery was a necessary element of individual self-understanding as a member of a certain community, in the Modern era the cemetery produces more particularistic identities. Modernity generates some universal and abstract schemes of identification, and by means of the repression of death from public consciousness, cemeteries lose their role as a focal point in social communication. I draw attention to the radical utopian ideas of the Russian philosopher Nikolai Fedorov, who not only considered the cemetery as a locus of memory, but also proclaimed the task of the transformation of cemeteries into a base for universal work on resurrection of dead ancestors and the restoration of brotherly relations in all mankind.     

Calculation of age-specific fertility schedules from tabulations of parity in two censuses

The mathematics of stable populations recently has been generalized to cover populations with time-varying fertility and mortality by a modification incorporating the sum of age-varying growth rates in place of the fixed growth rate of a stable population. Equations that characterize nonstable populations apply to any cohort-like phenomenon with a measurable property that cumulates gains or losses through time. In particular, the equations fit the relation between a population's average parity at a given age and age-specific fertility rates previously experienced at lower ages. Techniques devised to derive an intercensal life table from single-year age distributions in two censuses are adapted to estimate accurate intercensal fertility schedules from distributions of parity by age of woman in two censuses. Birth-order specific fertility schedules are also estimated.     

Factors predicting satisfaction judgments: A comparative examination

A number of psychological processes (e.g. social comparison, aspirations) may explain why people differ in their satisfaction with various life domains. This study compared the impact of a number of such processes on satisfaction judgments in a sample of 149 college students. Social comparison and positive affect were strong predictors of satisfaction across most domains. Objective conditions and aspirations were predictive of satisfaction in few domains. The relevance of Multiple Discrepancies Theory (Michalos, 1983) for the present findings is discussed. Limitations of the present study are noted and suggestions for future research are offered. Researchers need to focus on the reasons underlying the predictability of different domains from different processes.