Competency-Based Training: Objective Structured Clinical Exercises (OSCE) in Marriage and Family Therapy

The field of marriage and family therapy (MFT) has recently engaged in the process of defining core competencies for the profession. Many MFT training programs are adapting their curriculum to develop more competency-based training strategies. The Objective Structured Clinical Examination (OSCE) is widely used in the medical profession to assess clinical competence. These examinations involve using simulated clinical situations as a tool in conducting summative evaluations of trainee competence. This article describes an adaptation of the OSCE procedures for competency-based training of MFT students. Instead of using the procedures as a summative examination as is typical in medical education, this article proposes how to use them as formative exercises in the development of student competence. The development of the OSCE is discussed, including “blueprinting,” focused competencies, procedures, and feedback protocols. The article concludes with suggestions of how to continue the development of the OSCE for evaluation in MFT education.     

Heterogeneity in treatment effects across diverse populations

Differences in patient characteristics, including age, sex, and race influence the safety and effectiveness of drugs, biologic products, and medical devices. Here we provide a summary of the topics discussed during the opening panel at the 2018 Johns Hopkins Center for Excellence in Regulatory Science and Innovation symposium on Assessing and Communicating Heterogeneity of Treatment Effects for Patient Subpopulations: Challenges and Opportunities. The goal of this session was to provide a brief overview of FDA-regulated therapeutics, including drugs, biologics and medical devices, and some of the major sources of heterogeneity of treatment effects (HTE) related to patient demographics, such as age, sex and race. The panel discussed the US Food and Drug Administration's role in reviewing and regulating drugs, devices, and biologic products and the challenges associated with ensuring that diverse patient populations benefit from these therapeutics. Ultimately, ensuring diverse demographic inclusion in clinical trials, and designing basic and clinical research studies to account for the intended patient population's age, sex, race, and genetic factors among other characteristics, will lead to better, safer therapies for diverse patient populations.     

The Inability of Self-affirmations to Decrease Defensive Bias Toward an Alcohol-Related Risk Message Among High-Risk College Students

Abstract

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies.     

Is deviance “Deadℍ? The decline of a sociological research specialization

Colin Sumner has declared that the sociology of deviance as a research specialty was “dead? by 1975; later influential studies on norm-violating behavior appeared only in the specific area of criminology. We subjected this argument to empirical test through an analysis of the most-cited scholars and works in 263 textbooks, articles, and research notes appearing in the sociology of deviance from 1993 to 1999. We found some support for Sumner's claims: The majority of the most-cited scholars in devi-ance today conduct research in other areas, primarily in criminology. Furthermore, among the 31 most-cited works in our analysis, only two of 15 studies classified in the sociology of deviance appeared after 1975. We conclude with some thoughts about the factors that contribute to the rise and fall of research specializations in sociology.     

Introduction: “There Is a Person Here”: An Interview with Judith Butler

In this interview, the coeditors, along with other contributors, ask Judith Butler a variety of questions regarding queer theory, gender identities, scientific and legal discourse, bodily abjection, race and class positioning, and political organizing. This range of subject matter suggests not only the breadth of Butler's work, but also its applicability to any number of people, whose relation to theory ranges from highly politicized to politically indifferent. The interview demonstrates the responsiveness of Butler's work to cultural translation and political action.     

Cash Transfers and Children's Education and Labour among Malawi's Poor

This article examines the impact on children's education and labour of monthly cash grants targeted on ultra‐poor households and designed to reduce poverty and enable families to invest in human development. It conducts a randomised community trial, with baseline and endline surveys of intervention and control households; verifies school enrolment; and completes key‐informant interviews and focus‐group discussions. Compared with non‐beneficiaries, intervention children experienced a 5 percentage point difference in enrolment, higher educational expenditures, fewer absences, and a 10 percentage point decrease in labour outside the home. Qualitative data confirm the quantitative findings. Transfers to poor households had a positive impact. However, the Malawian educational system needs to be improved for short‐term impacts to lead to long‐term development in human capital.     

Spatial distribution of structure infesting ant species inhabiting urban housing developments of different ages

The distribution of ant colonies within a community is often well defined, yet this distribution can change due to changing environmental conditions, resource availability, and colony growth. In this study, structure infesting ant communities were sampled for one year within three Puerto Rican housing developments of different ages. These developments represented environments in different stages of recovery after a disturbance (secondary succession). Spatial mapping was used to plot the distribution and abundance of ant communities within these developments. At the beginning of the study, the youngest housing development (1 year since construction), had the fewest number of species present (ave. 1.6 per house). The second housing development (4 years old) had a greater number of species (ave. 2.6 per house), and a greater sampling frequency (the same species collected at multiple houses) than Site 1. The oldest development (8 years old) had both the greatest number of species (ave. 2.7 per house), and sampling frequency of the three sites. In all developments, the number of species, sampling frequency, and ant biomass increased throughout the year as colonies grew and foraging ranges expanded. It was observed in all developments, that species coexistence also increased throughout the year. As colony populations increased, there was a greater occurrence of multiple species being collected at the same sample house. In the youngest development, the two most dominant species increased in numbers during the year and began to be collected from the same sample houses. Spatial diagrams documented that multiple species in the older housing developments (later stages of succession), also shared a common distribution. Even the most dominant species (S. invicta) in all three sites, did not exclude additional species from foraging within its established range.     

Evaluation of an analysis approach used to account for extra-variation in clustered categorical responses

This article presents the results of a simulation study investigating the performance of an approach developed by Miller and Landis (1991) for the analysis of clustered categorical responses. Evaluation of this “two-step” approach, which utilizes the method of moments to estimate the extra-variation pardmeters and subsequently incorporates these parameters into estimating equations for modelling the marginal expectations, is carried out in an experimental setting involving a comparison between two groups of observations. We assume that data for both groups are collected from each cluster and responses are measured on a three-point ordinal scale. The performance of the estimators used in both “steps” of the analysisis investigated and comparisons are made to an alternative analysismethod that ignores the clustering. The results indicate that in the chosen setting the test for a difference between groups generally operatbs at the nominal α=0.05 for 10 or more clusters and hasincreasing power with both an increasing number of clusters and an inrreasing treatment effect. These results provide a striking contrasc to those obtained from an improper analysis that ignores clustering.