Dissociation,Traumatic Attachments,and Self-Harm: Eating Disorders and Self-Mutilation

Self-harm, such as eating disorders and self-mutilation, represents dissociated compensatory attempts to serve self-regulatory functions. Self-harm develops when the child who has become attached to those who have inflicted pain and suffering maintains that attachment by inflicting pain on himself. Brain imaging studies have found that the communication pattern between parent and child shapes the way the child’s attachment system adapts to experiences with the attachment figure, literally hardwiring the child’s brain. The good news is that a safe and secure attachment is very good medicine and can rewire the brain. An attachment-based multi-phase approach to treatment is presented.

Protection Motivation and Risk Communication

The purpose of this study was to explore the utility of protection motivation theory (PMT) in the context of mass media reports about a hazard. Content elements of a hazard's severity, likelihood of occurring, and the effectiveness of preventive actions were systematically varied in a news story about a fabricated risk: exposure to fluorescent lighting lowering academic performance. Results of this experiment ( N = 206) suggest that providing information about the severity of a hazard's consequences produces greater information seeking. In addition, information about levels of risk, severity, and efficacy combined jointly to produce greater rates of willingness to take actions designed to avoid the hazard. Results are seen as providing general support for PMT and are discussed within the broader framework of information seeking and heuristic and systematic information processing.     

Decoupling thinking in service operations: a case in healthcare delivery system design

The notion of decoupling thinking has been well established in the manufacturing operations and supply chain management literature. This paper explores how this decoupling thinking can be applied in service operations and in particular in health care. It first reviews the relevant literature on decoupling fundamentals, the front- and back-office distinction, and new emerging decoupling thinking in service operations. Subsequently, a flow-based framework including content and process is developed for decoupling thinking in service operations. The framework provides an integrated perspective on customer contact, flow driver and flow differentiation (level of customisation). The framework hence, through flow differentiation, introduces the concept of standardisation versus customisation in a service context. This is followed by a health care case example to illustrate how the framework can be applied. The managerial implications are primarily in terms of a modularised approach to system design and management. The framework offers potential for benchmarking with other service systems as well as with manufacturing systems based on the shared foundation in decoupling thinking. Finally, suggestions are provided for further research opportunities derived from this research.     

Children Living With Uninsured Family Members: Differences by Family Structure

Despite increased access to insurance through the Patient Protection and Affordable Care Act of 2010, uninsurance rates are expected to remain relatively high. Having uninsured family members may expose children to financial hardships. Eligibility rules governing both private and public health insurance are based on outdated expectations about family structure. Using 2009–2011 data from the National Health Interview Survey (N = 65,038), the authors investigated family structure differences in family‐level insurance coverage of households with children. Children living with married biological parents were the least likely to have uninsured family members and most likely to have all family members covered by private insurance. Controlling for demographic characteristics and income, children in single‐mother families had the same risk of having an uninsured family member as children in married‐parent families. Children with cohabiting biological parents had higher rates of family uninsurance than children with married biological parents, even accounting for other characteristics.     

World Elder Abuse Awareness Day: The Concept,the Reality,and the Promise

This commentary traces the origins and evolution of the World Elder Abuse Awareness Day (WEAAD) initiative and provides recommendations for increasing WEAAD’s impact as a catalyst for a coordinated movement within the United States.     

Assessing Capacity to Change in High‐Risk Pregnant Women: A Pilot Study

Pre‐birth risk assessment is a process by which circumstances affecting an unborn child can be identified and support for mother and infant embedded. This mixed methods study describes a community‐based pre‐birth assessment and care pathway that utilised the Parents Under Pressure (PuP) programme to assess parenting capacity and provide support pre‐ and post‐birth for ‘at risk’ women. Sixty‐eight pregnant women referred to children's social care services were allocated to the pre‐birth assessment and care pathway (n = 35) or to routine care (n = 33). Standardised measures of psychological distress, social support and alcohol measured change for the women in the assessment and care pathway. Twenty women who provided pre‐ and post‐data reported significant improvements on all measures except alcohol use. Safeguarding outcomes at 12 months were obtained for both groups using administrative data. Forty‐two per cent of the infants whose mothers received the pre‐birth assessment and care pathway showed an improvement in child protection status compared to 14 per cent of the routine care infants. Safeguarding status deteriorated or stayed the same in 52 per cent of the routine cases compared to 26 per cent of those receiving the pathway. Qualitative data revealed that the pathway was acceptable and helpful to service users and service providers. Copyright © 2017 John Wiley & Sons, Ltd.

‘Describes a community‐based pre‐birth assessment and care pathway that utilised the Parents Under Pressure (PuP) programme’

Key Practitioner Messages

• The current project found that a community‐based pre‐birth assessment and care pathway with high‐risk pregnant women was feasible and acceptable for practitioners and service users.
• The pathway began mid‐pregnancy and support was provided following the birth of the infant for up to 12 months.
• Over 40 per cent of infants whose mothers were allocated to the pre‐birth risk assessment pathway showed improvements in child safeguarding status at 12 months.

     

Predictors of Sexual Minority Youth’s Reported Suicide Attempts and Mental Health

Lesbian, gay, and bisexual youth (LGBY) report higher rates of mental health concerns compared to heterosexual youth due to minority stressors. This study examined the interpersonal and intrapersonal variables that predict psychological distress and self-reported suicide attempts in a sample of 61 LGBY in the Mid-South, which is a highly overlooked regional area for LGBY research. Youth who lost friends when coming out were 29 times more likely to report suicide attempts, and those who experienced psychological maltreatment from caregivers were 9.5 times more likely to report a suicide attempt. Internalized heterosexism, feelings of guilt or shame, and psychological maltreatment from caregivers were significant predictors of depression and anxiety symptoms. This study highlights the importance of creating affirming spaces for LGBY, particularly in areas of the country that experience greater political oppression of sexual minorities, such as the Mid-South.     

Do You Prefer Having Much More or Slightly More than Others?

Several studies found that people have a positive utility when they have more than others do. These papers claim that individuals are willing to sacrifice part of their absolute income or products in order to have more than others. As far as we know, the current paper is the first to show that positionality is bounded, so that individuals enjoy having more than others only when the gap between them and the others is not too large. Using the results from a survey-based experiment conducted in Israel that included 924 participants, we show that when individuals were asked to forgive some of their income in order to have a higher income compared to others, most of them chose to forgive their absolute income in order to have more than others. However, when individuals were asked to forgive the same amount of income in order to a have a much higher income compared to others, the attractiveness of having more than others significantly decreased. These results may indicate that individuals suffer from a disutility when extreme gaps exist in society, even if they are the ones with the high income.     

A comparative gradient approach as a tool for understanding and managing urban ecosystems

To meet the grand challenges of the urban century??such as climate change, biodiversity loss, and persistent poverty??urban and ecological theory must contribute to integrated frameworks that treat social and ecological dynamics as interdependent. A socio-ecological framework that encapsulates theory from the social and ecological sciences will improve understanding of metropolitan dynamics and generate science for improved, sustainable management of urban ecosystems. To date, most urban ecological research has focused on single cities. A comparative approach that uses gradients within and between cities is a useful tool for building urban ecological theory. We offer five hypotheses that are testable using a comparative, gradient approach: (i) the current size, configuration, and function of larger metropolitan ecosystems predicts the potential trajectory of smaller urban areas; (ii) timing of growth explains the greatest variance in urban ecosystem structure and function; (iii) form and function of urban ecosystems are converging over time; (iv) urban ecosystems become more segregated and fragmented as populations increase; and (v) larger cities are more innovative than smaller cities in managing urban ecosystems.     

Privileging work not sex: flexibility and employment in the sexual services industry

We present findings from a study of sex workers recruited in indoor licensed premises in Victoria. While the study addressed regulation, enforcement and working conditions, we focus on the value of flexible well‐paid work for two particular groups of female workers (parents and students). We link this issue of flexibility to broader gendered employment conditions in Australia, arguing the lack of comparable employment is crucial to understanding worker decisions about sex work. Debates and regulation focus on gendered inequalities related to heterosexuality much more than they recognize gendered inequalities related to labour market conditions. The focus on criminalization, harm, exploitation and stigma obscures the centrality of work flexibility and conditions to women's decision‐making. A more direct focus on the broader employment context may produce better recognition of why women do sex work.