Hospital-sponsored networks. The rush to consolidate and the future of medical practice

As the medical delivery system undergoes fundamental change, there is a growing pressure on hospitals to form networks with physicians. The prime motivation for these entities is to preserve market share and fill beds. There is likewise intense pressure on physicians to join them, even if these networks do not serve their best interests, or the goal of fostering physician-centered practice. A transformation is under way, however, that may well place doctors again in the central role of guiding the new modes of medical practice in the United States.     

Promoting Justice in the Delivery of Services to Juvenile Delinquents: The Ecosystemic Natural Wrap-Around Model

Caught between their child and doing the right thing, families of chronic juvenile delinquents often experience a series of injustices in the name of justice. Attempts by the system to correct the delinquency problem often result in the imposition of values and beliefs that negate the family's values, experiences and meanings of their child's behavior. The Ecosystemic Natural Wrap-around (E.N.W.) model attempts to respectfully account for the many influences that maintain problematic interactions, both internal and external, in the nuclear family of chronic juvenile delinquents. The model focuses on a variety of interventions at different levels and contexts, building on the strengths of the family, using the extended family and fictive kin networks, and clarifying the meanings associated with problematic behavior for the multiple players. The model proposed is an integrative theoretical approach, emphasizing systems theory and constructivism.     

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Ohne Zusammenfassung     

Problem‐ and solution‐focused characteristics of parenting support, 3 years after implementation of the solution‐focused approach: A qualitative content analysis

In recent years, solution‐focused parenting support has been developed and implemented as a promising brief and strength‐based approach. Given the fundamental differences between solution‐focused and the historically more common problem‐focused parenting support and the complexity of transforming professional practice, an actual shift towards solution‐focused parenting support can be expected to be limited up to now. However, because research into the specific communication characteristics of professional parenting support is currently lacking, no conclusion can be drawn at present. Therefore, this study aims to explore the current problem‐ and solution‐focused characteristics of parenting support in the Dutch youth healthcare (YH). In total, 15 support sessions performed by 10 public health nurses were audio recorded and transcribed verbatim. A detailed qualitative content analysis of professional communication was conducted to identify problem‐ and solution‐focused factual, expressive, relational and appealing aspects of parenting support. Problem‐focused characteristics dominated all sessions of parenting support. This study is the first to thoroughly analyse the problem‐focused and solution‐focused communication characteristics of professional parenting support using a qualitative content analysis. Parenting support practice in the Dutch YH did not shift substantially to a solution‐focused approach. More effort is required to stimulate and facilitate this professional transformation.     

Explaining the Flight of Cupid’s Arrow: A Spatial Random Utility Model of Partner Choice

Spatial homogamy may be defined as follows: anyone may be attracted to anyone else, but near candidates are more attractive than distant candidates. In this article, we propose a model of partner choice, where homogamy is defined in terms of spatial, demographic, socioeconomic and cultural similarity. A spatial choice model using random utility theory is formulated, taking into account a relaxation of the independence from the irrelevant alternatives property, as spatial alternatives are not independent of one another. We model partner choice given the characteristics of the chosen partner and a choice set of alternatives, using unique micro data on all new cohabiters in the Netherlands, linked to other relevant data sets. The model takes the spatial locations of potential candidates within a choice set into account, including an indicator for the spatial similarity between alternatives. We find that spatial homogamy is a vital component of partner matching, aside from and adding to the spatial effects in demographic, socioeconomic and cultural homogamy. Given a choice set of partners, the highest likelihood of a match occurs with a person who is born and lives near by, who is close in age, is in the same life stage and has the same marital status, who has the same educational and income level and the same labour market status, who speaks the same dialect and lives in a culturally similar residential area. The distance effect is most pronounced for those individuals with lower levels of education and those living in rural areas.     

Attenuating Initial Beliefs: Increasing the Acceptance of Anthropogenic Climate Change Information by Reflecting on Values

Anthropogenic climate change information tends to be interpreted against the backdrop of initial environmental beliefs, which can lead to some people being resistant toward the information. In this article (N = 88), we examined whether self‐affirmation via reflection on personally important values could attenuate the impact of initial beliefs on the acceptance of anthropogenic climate change evidence. Our findings showed that initial beliefs about the human impact on ecological stability influenced the acceptance of information only among nonaffirmed participants. Self‐affirmed participants who were initially resistant toward the information showed stronger beliefs in the existence of climate change risks and greater acknowledgment that individual efficacy has a role to play in reducing climate change risks than did their nonaffirmed counterparts.     

How Moroccan‐Dutch parents learn in communities of practice: Evaluating a bottom‐up parenting programme

Research shows that top‐down‐designed parenting programmes do not always meet the needs of postmigration parents. Bottom‐up programmes by migrant organizations hold a promise to fill this gap; however, research about these programmes and appropriate evaluation methodologies is scarce. Drawing upon Wenger's ( 2010 ) “communities of practice,” this paper explores an alternative perspective on parenting programme evaluation. Findings are presented from a study looking into social learning processes of postmigration parents who participated in a bottom‐up programme about raising teenagers in urban areas. Using an ethnographically inspired method combined with a preprogramme and postprogramme design, 115 Moroccan‐Dutch mothers and fathers from 15 programme groups participated. Results show that the programme provided a social learning space in which parents used themselves as resources to learn collectively about parenting. Moreover, parents consciously engaged in learning interactions across learning spaces stretched into their social networks. These analyses showed how parents' development of “learning citizenship” (Wenger, 2009 ) provides us with insight in collective learning dimensions present in a bottom‐up parenting programme, which is often not included in evaluation studies. Implications for practitioners as facilitators of parents' collective learning are presented.     

The Relation Between Therapeutic Alliance and Treatment Motivation in Residential Youth Care: A Cross-Lagged Panel Analysis

This study investigated the longitudinal relation between therapeutic alliance and treatment motivation in a sample of 174 adolescents receiving residential treatment in the Netherlands. Structural equation modeling with a cross-lagged panel design was used to examine the relation between therapeutic alliance and treatment motivation up to 9 months of treatment. Results revealed that autoregressive associations between initial therapeutic alliance and alliance at subsequent time points were significant, whereas for treatment motivation a significant association was found after 6 months, but not after 9 months. Results also showed that a higher level of therapeutic alliance after 3 months was predictive of a higher level of treatment motivation after 6 months. Furthermore, a higher level of therapeutic alliance after 6 months was predictive of a higher level of treatment motivation after 9 months. Implications for research and clinical practice are discussed.