Supervising family therapy trainees in primary care medical settings: context matters

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be attentive to the self-of-the-therapist. Recommendations are also made to help supervisors become better prepared for the questions medical family therapy trainees bring to supervision.     

The restructuring process and economic centrality in capitalist agriculture

The purpose of the paper is to examine contemporary relations in agricultural production. The discussion focuses upon the internal and external processes modifying production relations on the farm and, in particular, the changing significance of farm-based sources of income and capital (economic centrality) to the farm business in the restructuring of agricultural capital. There are a variety of reasons why farm businesses are finding it increasingly necessary to diversify their sources of income, and in some cases capital generation, which relate to their internal family relations and external contacts. While obtaining alternative sources of income for farmers may be advocated for the purpose of reducing their marginalisation and low income problems, this may only be realisable for a minority. The complexities of farm businesses and their external relations with other forms of capital suggest the need for a construction of a typology which focuses on the economic centrality of the business to the farm family. The discussion here is divided into four sections. First, the main characteristics of the restructuring process in British agriculture are identified, leading to a discussion focusing on the transformation of the family farm. The concept of economic centrality is then discussed as an important characteristic of the restructuring process affecting British farming, and a typology of farm businesses established, based upon empirical evidence collected from London's Metropolitan Green Belt. This evidence forms part of a wider study of the changing structure of farm businesses in three areas of lowland England (East Bedfordshire, West Dorset and London's Green Belt) which links farm business change to changes in the farm landscape.     

Improving Risk Communication in Government: Research Priorities

Despite the increased interest in risk communication among government agencies, there is evidence that agencies'risk communication practices lag. We conducted a study to explore which risk communication research would be most important to improve government agencies'risk communication practices. Qualitative interviews and a survey of 145 risk communication experts based in academic institutions and government agencies explored how important research on each of 48 topics would be to improving agencies'risk communication efforts. Respondents identified topics within three areas as priorities for further research: 1) involving communities in agency decisionmaking; 2) communicating with communities of different races, ethnic backgrounds, and incomes; and 3) evaluating risk communication. Both practitioners and researchers responded to additional statements about agencies'risk communication practices with reservations about staff and managers'commitment to effective communication about environmental issues. We discuss the implications of these findings.     

The experience of personal space: Perception of interpersonal distance

The experience of personal space was studied by comparing objective interpersonal distance with subjects' perception of interpersonal distance. Regardless of sex, several personality traits, and objective size of personal space, perceived personal space is larger than objective personal space. Yet in non-personal space situations, subjects did not overestimate distance. In personal space situations, individuals apparently believe they are farther from other people than they actually are.     

A winner determination problem of tendering transportation services

Summary  For the tendering of long-term transportation contracts in the bulk industry, shippers use bidbooks that specify for each lane the load location, the destination, the product and the volume that has to be transported over the next so many years. Bidbooks are sent out to a preselected group of carriers, who subsequently quote a price for each of the lanes. After the return of the bidbooks, the shipper determines the winning carriers. The winner determination problem is the problem of finding an allocation of the lanes to the carriers so as to minimize total transportation costs. The winner determination problem is NP-hard in the strong sense. We model the winner determination problem as an integer linear programming (ILP) problem and try and solve the model by use of CPLEX, a state-of-the-art ILP solver. It turns out, that the model can solve problems optimally with no more than 270 lanes. We also develop a fast randomized heuristic, and we show that it performs remarkably well, with a gap of no more than 0.8% from optimality.

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Zusammenfassung  Zum Abschluss langfristiger Transportvertr?ge in der Massengüterindustrie bedienen sich die Spediteure bestimmter Angebotsbücher, in denen für jede Tour die Ladestation, der Zielort, sowie die zu transportierende Produktart und deren Volumen für die n?chsten Jahre spezifiziert werden. Die Angebotsbücher werden an eine ausgew?hlte Gruppe von Transportunternehmen geschickt, die dann für jede Tour einen Preis angeben. Auf dieser Grundlage bestimmt der Spediteur dann die Transportunternehmen, die die Zuteilung der Touren erhalten. Dabei wird die Verteilung der Touren auf die Transportunternehmen in der Weise vorgenommen, dass die gesamten Transportkosten minimiert werden. Das Auswahlproblem ist NP-hard in strengem Sinne. Wir modellieren das Auswahlproblem als ganzzahliges lineares Programmierungsproblem (ILP) und testen bzw. l?sen es mit Hilfe mit CPLEX, einem Standardl?sungsansatz für ganzzahlige lineare Programmierung. Dabei zeigt sich, dass Modelle bis zu 270 Touren optimal gel?st werden k?nnen. Zugleich wird auch eine Heuristik entwickelt und vorgestellt, deren L?sung nur unwesentlich von der Optimall?sung entfernt liegt.

     

Healthcare providers' treatment of college smokers

About 28% of college students smoke tobacco, and many will continue smoking into adulthood. Although little is known about how to help college students quit smoking, 1 promising strategy is healthcare providers' advice. To estimate their life-time receipt of brief advice and to identify characteristics that predict who may receive that advice, 348 college students completed a survey about their smoking and related practices. Seventy-seven percent of the smokers (73% of the students) were asked about smoking. Of those smokers, 57% were advised to quit, 22% were given advice about quitting, 5% were helped with setting a quit date, and 4% were offered follow-up. Occasional smokers were less likely than daily smokers to be advised to quit. Although 36.2% of the smokers did not report their smoking accurately, smokers who were accurate were more likely to be advised to quit and to be given advice about quitting.     

Implementation and results of the statewide ONHRSS

In response to increased consumer demand, state governments are publishing more detailed information about the quality of nursing homes. In 2002, Ohio legislation mandated the publication of a Long-Term Care Consumer Guide that included information on nursing home resident and family satisfaction surveys. Using the 2002 Ohio Nursing Home Resident Satisfaction Survey as an example, this article addresses two research questions: (1) how can statewide resident face-to-face satisfaction interviews be implemented to maximize participation of residents and facilities and produce reliable and valid results, and (2) how satisfied are residents with their nursing home experiences, overall and by level of cognitive function.     

Non-estrogen-based treatments for menopausal symptoms

The British Menopause Society Council is committed to provide up-to-date authoritative reviews to aid health professionals to inform and advise women about key issues in postreproductive health. This guidance refers to non-estrogen-based treatments for menopausal symptoms, such as hot flushes, symptoms of urogenital atrophy and lack of sexual desire. Treatment of choice should be based on up to-date information and targeted to individual women's needs. Non-hormonal strategies may be useful for women with estrogen-dependent disease such as breast cancer.