St Christopher's and the future

The founding vision of St Christopher's Hospice was based on a recognition that permeating mainstream health care services would be essential and an emphasis on an adaptable philosophy rather than a building. Today, demographic and disease related changes mean that need and demand for end-of-life care will inevitably outstrip professional and financial resource. Hospices must engage with the development of cost-effective models of service delivery and rational planning. Only partnership working with the National Health Service, care homes, and others will ensure that appropriate care is available to everyone wherever the bed in which they die, regardless of diagnosis. Only collaboration and active engagement will ensure that future strategy in end-of-life care retains the original insight that its focus rightly includes not only patients but also the social context that will be affected by their death. Cost and patient choice dictate an emphasis on care at home. Health-promoting, public education and family-focused strategies will be essential. At a pivotal moment for the delivery of health care generally, hospices can play a vital part by marrying the role of "insistent conscience" of the health care service with continued cost-effective clinical innovation.     

Predicting behaviour: comparing the performance of factual versus attitudinal approaches

Despite years of refinement and improvement to questionnaire design, the need remains to identify effective, but ‘user-friendly’ questioning procedures to predict behaviour, without compromising predictive performance. Questionnaires developed to predict behaviour typically use an attitudinal approach. However, those types of questionnaires are associated with increased respondent fatigue, decreased question comprehension, opposition to question tone and demand effects. An alternative approach involves use of factual questions. This study compares ease of application in the field as well as predictive performance of the two approaches to questionnaire design in the context of predicting willingness to donate blood. Results indicate that factual questions are quicker and easier to apply in the field than attitudinal questions, while predictive performance of the approaches is equivalent.     

Bird and mammal use of vernal pools along an urban development gradient

Vernal pools in the northeastern US are of conservation concern primarily because of their role as habitat for specialized pool-breeding amphibians, but their use by birds and mammals may also be of interest, especially from the perspective of the impact of urbanization. We describe camera-trapped wildlife (CTW) at 38 vernal pools along an urban development gradient in greater Bangor, Maine, USA. We detected 20 mammal and 39 bird taxa (29 contacted pool water; 39 detected at >1 site). Land cover type within 1000 m (%), within-pool vegetation (%), and amphibian egg mass numbers explained a substantial portion of the variance (40.8%) in CTW assemblage composition. Submerged vegetation within pools and cover by water and impervious surfaces within 1000 m of pools were key site characteristics defining assemblages. We scored the urban-affiliation of taxa and modeled the relationship between weighted assemblage scores for each site and impervious cover. Impervious cover within 1000 m of pools was positively (p?<?0.01) related to site urban-affiliation scores. Use probability for red fox increased and snowshoe hare decreased with impervious cover at 1000 m. These results indicate that within-pool vegetation and land cover types at 1000 m influenced bird and mammal assemblages that used study pools and greater impervious cover at 100 and 1000 m was correlated with a shift in assemblages from being dominated by urban-avoider to urban-adapted species. We encourage land use planners and managers to consider the influence of land use practices within 1000 m of vernal pools on birds and mammals, especially near amphibian breeding pools.     

Social Monogamy in Nonhuman Primates: Phylogeny,Phenotype, and Physiology

Monogamy as a social system has been both a scientific puzzle and a sociocultural issue for decades. In this review, we examine social monogamy from a comparative perspective with a focus on primates, our closest genetic relatives. We break down monogamy into component elements, including pair-bonding and partner preference, mate guarding or jealousy, social attachment, and biparental care. Our survey of primates shows that not all features are present in species classified as socially monogamous, in the same way that human monogamous relationships may not include all elements—a perspective we refer to as “monogamy à la carte.” Our review includes a survey of the neurobiological correlates of social monogamy in primates, exploring unique or common pathways for the elemental components of monogamy. This compilation reveals that the components of monogamy are modulated by a suite of androgenic steroids, glucocorticoid hormones, the nonapeptide hormones oxytocin and vasopressin, and other neurotransmitter systems (e.g., dopamine and opioids). We propose that efforts to understand the biological underpinnings of complex human and animal sociosexual relationships will be well served by exploring individual phenotypic traits, as opposed to pursuing these questions with the assumption that monogamy is a unitary trait or a species-specific characteristic.     

THE SOCIAL CONSTRUCTION OF AMERICAN INDIAN DRINKING: Perceptions of American Indian and White Officials

Research has shown that alcohol abuse is a significant problem among American Indians. It has been suggested, however, that American Indians and whites interpret the behavioral pattern differently, which may reflect the distinct symbolic-moral universes of the two groups. Whites are said to stereotypically blame Indians for the alcohol problem, and they favor assimilation to ameliorate it. American Indians purportedly blame the historical incursions of whites for the problem and advocate cultural revitalization to solve it. However, systematic empirical documentation of the competing viewpoints is lacking. Here we compare the perceptions of twelve American Indian and twelve white officials responsible for controlling alcohol abuse and related problems on the Wind River Indian Reservation, Wyoming. Data were collected using in-depth, semistructured interviews. The findings show that the two groups tend to converge in their assessments of the extent of the alcohol abuse problem but clearly diverge in their attributions concerning both its causes and appropriate approaches to controlling it. The discourse of whites and American Indians thus reflects the existence of separate symbolic-moral universes. This investigation redirects attention from the traditional focus on the incidence and etiology of alcohol abuse among American Indians to the politics surrounding the definition and interpretation of the deviant behavior. It also highlights the significance of cultural competition to race relations theories grounded in political economy, which are commonly used to analyze Indian-white contact.     

Self-Perceived Distress and Impairment in Problem Gamblers: A Study of Pre- to Post-treatment Measurement Invariance

Gambling help services typically evaluate treatment outcomes using self-reported responses and measurements. However, gamblers’ conceptualisations and prioritisations with respect to these measurements may shift over time. Thus, changes in the self-reported responses may not always reflect true change in the individuals. This study investigated for response shift in self-report measures of psychological distress and impairment in 293 help-seeking problem gamblers. We used confirmatory factor analysis to model data structures from pre-treatment to post-treatment. The findings indicated that a response shift had occurred. Two items became less important and one item became more important in measuring psychological distress. Measurement invariance was achieved for the complete set of items for impairment. These findings provide a more in-depth understanding of the nature of self-report outcomes in otherwise routinely collected data.     

Gender, technology and jobs

Men have traditionally gained more than women from access to technologies at work which bring prestige, job security, more satisfying work and higher pay. Typically female jobs have centred on technologies, if they have at all, which tend towards routine and possibly deskilled work. Typing is a prime example. It is possible that this is changing through computerization, which is extensive but also equally distributed by gender. Does the wage premium, which use of a computer has been found to confer on users, benefit women sufficiently to suggest some sort of equalization through technology, or possibly even a female advantage? This is tested using data from four European countries. There is no across‐the‐board benefit from the use of computers. For both men and women it depends on the nature of their occupation. Some, more routine usages of computers are associated with a negative outcome. However, this occupational balance itself varies by gender.