Methodological issues in the measurement of birth preparedness in support of safe motherhood

Behavior change interventions focusing on birth preparedness for pregnant women, their husbands, and adults in the community are common components of community-oriented Safe Motherhood programs in developing countries. Few studies have examined the effectiveness of these interventions, and existing studies are flawed due to study and sample design. This article highlights methodological issues that are often overlooked when measuring indicators of birth preparedness among multiple audiences for program evaluation purposes in household-based surveys. Solutions are proposed to address each of these problems in an effort to improve future research.     

Some Clinical Applications of Attachment Theory in Adult Psychotherapy

This paper discusses the usefulness of attachment theory in working with adults in psychotherapy. There are four classifications of attachment status in adults: secure attachment, and three types of insecure attachment: dismissing, preoccupied, and disorganized. These categories do not conform to standard diagnostic entities. I discuss examples of the three insecure attachment categories and the likely transference and countertransference configurations that may occur in each category. These categories provide an additional way for therapists to understand and to respond to the needs of their clients.     

Rapid response to a conjunctivitis outbreak: the use of technology to leverage information

When an outbreak of conjunctivitis was identified at a rural New England college early in 2002, the college health center medical staff used various information management and communication systems to alert the community to the situation. They called upon the state Department of Human Services and the Centers for Disease Control and Prevention to help them understand and manage the outbreak. Technological systems already in place at the college allowed for rapid collection of data by means of a survey delivered over the Internet and a carriage study facilitated by a Web-based appointment and communication system. Within days, the data were collected and analyzed and an immediate response to contain the outbreak was launched.     

The latex allergic psychiatric patient

Latex allergy is an immune system illness affecting an increasing number of individuals. People with latex allergy often experience anxiety and fear about real and potential exposure to products containing natural rubber latex. Nurses working in acute care and general medical-surgical areas are more likely to be aware of this emerging illness than nurses working on a psychiatric unit. The nature of latex allergy and the immune system response are described in this article. People with latex allergy may react when they are exposed to latex allergens or specific foods. This article identifies nursing interventions and describes those appropriate for people with anxiety or fear responses. Patients with latex allergy can be managed when nursing staff understand both the medical and psychiatric aspects of care.     

Pediatrics: The emerging psychosocial challenges of the AIDS epidemic

HIV has a pervasive and profound effect on the psychological, social and neuropsychological functioning of infected infants, children and their families. This article discusses direct and indirect psychological manifestations of HIV in children. Direct effects are the outcome of the virus acting on the central nervous system and can result in compromised cognitive, language, motor, socio-emotional and motivational functioning. Indirect effects involve psychological responses to the stress of living with a life threatening illness, the social ostracism, disruption in life goals and undergoing frequent invasive and protracted medical procedures. A major focus of this article is to outline and describe a model comprehensive psychosocial support system developed within the Pediatric Branch of the National Cancer Institute. This includes early intervention issues and strategies for working with families during the introductory phase of the treatment program that also provides the framework for a care management approach, salient mental health problems that frequently occur in this group, and appropriate interventions for individuals and families. Attention is also given to dealing with anticipatory loss and bereavement, implementing traditional innovative intervention techniques, and for providing advocacy services concerning possible legal, financial, housing, and educational issues.     

The Social Construction of Abducted Children as a Social Problem

Using the theoretical framework developed by Spector and Kitsuse (1973; 1977), this paper describes the development of the issue of abducted children as a social problem. Analysis of this particular case suggests theoretical refinements for the social constructionist perspective. It is argued that the concept of a "valence issue" could be used to differentiate between the natural histories of substantively different kinds of social problems.     

Theoretical biases in judging eye movements

The effects of theoretical expectations upon judgments of direction of eye movement were examined. The results indicated that theoretically trained judges were less accurate than untrained judges when their theoretical expectations were violated. Theoretically induced observer bias does not appear to require highly inferential judgments as a condition for occurrence.     

Cotrainers as Models of Relationships: Effects of the Outcome of Couples Therapy

This study investigated the generally neglected effects of the cotrainer relationship in studies of the outcome of couples communication training. Male-female cotrainer pairs modeled verbal dominance patterns similar or dissimilar to those of client couples. As hypothesized, changes in couples' speaking patterns after a two-hour workshop mirrored their trainers' models. Female-dominated couples exhibited greater modeling of dominance patterns, and male-dominated couples exposed to a dominant female trainer reported relatively negative impressions of both trainers. The need for cotrainers to be aware of the relationship models they present and clients' responses to these models is discussed.