Encounter with Soul

For Americans in the new Millennium, there is a revival of interest in spiritual matters. Simultaneously, attention to spirituality in the social work profession is a cutting edge theme. Social work has a holistic focus on person-in-environment, acknowledging the psychological, emotional, physical and social aspects of the individual. The spiritual is also a defining aspect of each individual. Bidden or unbidden, therapists are confronted daily with the manifestations of the spiritual yearning of their clients while also being confronted with their own spiritual attitudes. The endeavor to understand the human dilemma must include the spiritual dimensions of both therapist and client. This article defines the author's therapeutic attitude as it is informed by social work training, personal life experience, and spiritual religious beliefs. Several case examples are included.     

Equal Opportunities Policies in English Schools: Towards Greater Gender Equality in the Teaching Workforce?

The under‐representation of women in promoted posts is one particular pattern of occupational segregation by gender across post‐industrial societies. This phenomenon also characterizes those professions which have been described as ‘women‐friendly’, such as teaching. The development of national and European legislation and recommendations on equal opportunities reflects this concern to address the gender imbalance among the workforce. But do schools identify women's under‐representation in promoted posts as an issue? To what extent do school's policies recognize and remedy the gender imbalance at managerial level? To answer these questions this article draws on a study of women teachers' careers in nursery, primary and secondary education in England. It shows that school equal opportunities policy statements widely ignore the under‐representation of women in school managerial positions. It suggests that the constructions of gender issues in schools by those in charge of designing and implementing school policies, that is, head‐teachers and governors, represent a key hindering factor for equal opportunities policies to contribute to greater gender equality. A major argument in the article is that because head‐teachers' and governors' discourses do not always fundamentally challenge the position of women in society, school policies and practices can offer only a limited contribution to gender equality.     

Perceptions of variation and change in German and Swedish address1

German and Swedish speakers diverge in contemporary address practice. The Swedish T form has become unmarked, with V limited to very specific situations. Apart from some specific T or V contexts, German now has coexistent systems, one with T, the other with V as the unmarked form, with different speakers or networks preferring one or the other. In an ongoing project, focus groups and participant observation in Austria, (eastern and western) Germany and Sweden and with Swedish speakers in Finland have identified factors and contexts determining degree of social distance and hence address choice. First name use is more marked than T use in Swedish but the two are closely linked in German. National variation is more substantial in Swedish than in German. In both languages there is some reversal of liberalization and distaste for imposition of the address form.     

Family Therapy Practitioners Researching the Reactions of Practitioners to an Outcome Measure

Family therapy is under increasing pressure to use ‘objective’ measures of effectiveness, but there are strong voices in the field objecting to such research. The primary objective of this project was to investigate the acceptability and perceived potential usefulness of a short self‐report questionnaire. A secondary objective was to explore the viability of conducting such research by a group of practitioners who would collaborate primarily through emails. Nine experienced family therapists were interviewed as they worked through the 16 items of a pilot version of the SCORE questionnaire. The recorded interviews were analysed using Template Analysis. The SCORE was found to be generally acceptable for use with clients but the exercise generated information on a variety of concerns about the content of the measure. Beyond its potential as an outcome measure there was considerable interest in how it could be used therapeutically. The operation of the Practitioner Research Network proved functional but indicated some of the difficulties that such networks might encounter.     

Predicting Change in Marital Satisfaction Throughout Emotionally Focused Couple Therapy

Emotionally focused couple therapy (EFT) is an empirically validated approach to couple therapy that uses attachment theory to understand the needs and emotions of romantic partners. EFT is recognized as one of the most effective approaches to couple therapy, but to guide therapists in their use of EFT, a theoretically based model to predict change is needed. This study tested such a model by recruiting 32 couples, and 14 therapists who provided approximately 21 sessions of EFT. Couples completed self‐report measures of marital satisfaction, attachment security, relationship trust, and emotional control at pre‐ and posttherapy and after each therapy session. Results of hierarchical linear modeling suggested that individuals higher on self‐report attachment anxiety and higher levels of emotional control had greater change in marital satisfaction across EFT sessions. Assessing attachment security at the start of therapy will inform therapists of the emotion regulating strategies used by couples and may help couples achieve positive outcomes from EFT.     

Are There Myths on Road Impact and Transport in Sub‐Saharan Africa?

Large investments in road infrastructure continue to be high on the agenda of many African countries, only a few of which have actually amended their investment strategy. In many cases, there seems to be a preference for a status quo that can easily be explained by political‐economy factors driving policies in the sector. After presenting data on the state of roads in sub‐Saharan Africa (length, density, condition), this article demonstrates how most countries’ transport strategies are based on certain misperceptions and recommends better prioritisation of investments, better procurement and contract management, better projects implementation and better monitoring to improve the developmental impact of recent road investments.     

Assessing the treatment effect in a randomized controlled trial with extensive non‐adherence: the EVOLVE trial

Intention‐to‐treat (ITT) analysis is widely used to establish efficacy in randomized clinical trials. However, in a long‐term outcomes study where non‐adherence to study drug is substantial, the on‐treatment effect of the study drug may be underestimated using the ITT analysis. The analyses presented herein are from the EVOLVE trial, a double‐blind, placebo‐controlled, event‐driven cardiovascular outcomes study conducted to assess whether a treatment regimen including cinacalcet compared with placebo in addition to other conventional therapies reduces the risk of mortality and major cardiovascular events in patients receiving hemodialysis with secondary hyperparathyroidism. Pre‐specified sensitivity analyses were performed to assess the impact of non‐adherence on the estimated effect of cinacalcet. These analyses included lag‐censoring, inverse probability of censoring weights (IPCW), rank preserving structural failure time model (RPSFTM) and iterative parameter estimation (IPE). The relative hazard (cinacalcet versus placebo) of mortality and major cardiovascular events was 0.93 (95% confidence interval 0.85, 1.02) using the ITT analysis; 0.85 (0.76, 0.95) using lag‐censoring analysis; 0.81 (0.70, 0.92) using IPCW; 0.85 (0.66, 1.04) using RPSFTM and 0.85 (0.75, 0.96) using IPE. These analyses, while not providing definitive evidence, suggest that the intervention may have an effect while subjects are receiving treatment. The ITT method remains the established method to evaluate efficacy of a new treatment; however, additional analyses should be considered to assess the on‐treatment effect when substantial non‐adherence to study drug is expected or observed. Copyright © 2015 John Wiley & Sons, Ltd.