Women with Turner's Syndrome: helping them reach their full potential

The physical and psychological effects of Turner's Syndrome, a female sex chromosome abnormality, briefly are described. Principles for helping women master the special challenges posed by the disorder are discussed. The authors argue that women with TS must take control of defining their identities and potential in order to attain full status within society.     

Assessing the Concept of the ‘Insecure‐Other’ Category in the Cassidy–Marvin Scheme: Changes Between 4 and 6 Years in the English and Romanian Adoptee Study

We set out to explore the meaning of the attachment categories in the Cassidy/Marvin strange situation procedure, as employed in the home, using data from a longitudinal study of children adopted into UK families up to the age of 42 months from Romanian institutions, and of adopted children without the experience of institutional care––both groups being assessed at 4 and 6 years of age. Inter‐rater reliability was found to be good. Security (meaning the use of the parent as a secure base and no negative behavior on reunion) was the modal categorical rating in both the institution‐reared and comparison groups, but the category of anomalous non‐normative behavior (meaning a lack of any ordered attachment behavior as covered by the standard ratings), previously labeled ‘insecure‐other’, was more common in the institution‐reared children. Because this was unassociated with the usual manifestations of insecurity (such as avoidance or resistance) and because it was largely evident in interactions with the stranger, it is concluded that the adjective ‘insecure’ was not appropriate. Although this ‘insecure‐other’ category was associated with disinhibited attachment as reported by parents (meaning a lack of differentiation among adults, a willingness to go off with strangers and a lack of checking back with parents in anxiety‐provoking situations), it did not prove to be a good index of disinhibited attachment because changes over time in the ‘insecure‐other’ category were not associated with changes in the rate of disinhibited attachment. Also, whereas the rate of ‘insecure‐other’ fell markedly in the institution‐reared group between 4 and 6 years of age, it rose in the comparison group, raising queries over its meaning.     

Juggling Between Parental and School Expectations: The Development of Domain‐Specific Acculturation Orientations in Early Adolescence

We examined how perceived acculturation expectations from parents and school, and ethnic discrimination predicted early adolescents’ heritage and mainstream acculturation orientations at home (private domain) and in school (public domain) one year later. We surveyed 263 early adolescents of immigrant background in Germany (M_age = 10.44 years, 60% female). Multigroup path analyses revealed that perceived acculturation expectations and ethnic discrimination were more strongly related to adolescents’ private than public acculturation orientations. Parental heritage expectations were the strongest predictor of adolescents’ acculturation orientations. Boys were more susceptible than girls to ethnic discrimination and acculturation expectations in school, which affected their private and public acculturation orientations. Results highlight the importance of integrating domain‐specific and gendered experiences when analyzing adolescents’ acculturative development.     

中国现代思想中的知识论:朝向一种新的整体

在西方话语中占优势地位的自然主义知识论的主题乃是在很大程度上独立于理解主体的外部世界(或客观实在)。中国传统知识论可以被称作关系知识论,因为它们关涉的主题是关系。这不但适用于否定实体观念的整体主义知识论,而且还适用于许多倡导在理解主体与理解客体间作出严格区分的现代理论。在这一方面,对中西传统知识理论作一比较分析也许不失为一种解决关于人类理解的性质与对实在的认知的某些基本问题的有益方法。     

A Framework for Enabling Evidence-based Practice in Allied Health

Evidence-based practice (EBP) is upheld as best practice in health and human services but there is a need for more research on how this approach can be enabled in day-to-day practice. This qualitative study examined EBP with allied health managers and practitioners in a health service network (n = 17). The findings highlight the systemic nature of EBP and the extent to which it involves both individual and environmental attributes. Individual attributes include clear understanding of EBP, relevant knowledge and skills, and motivation and passion. Environmental attributes are the presence of an organisational culture that values and prioritises EBP and an integrated mix of research support services, professional development activities, supervision and mentorship, and university partnerships. Theoretical frameworks can be useful for making sense of complex processes, planning, and evaluating change. Therefore, the findings are presented as a framework incorporating reflective questions relating to the elements identified as enabling EBP.     

Estimation of parameters of inverse Weibull distribution and application to multi-component stress-strength model

The problem of estimation of the parameters of two-parameter inverse Weibull distributions has been considered. We establish existence and uniqueness of the maximum likelihood estimators of the scale and shape parameters. We derive Bayes estimators of the parameters under the entropy loss function. Hierarchical Bayes estimator, equivariant estimator and a class of minimax estimators are derived when shape parameter is known. Ordered Bayes estimators using information about second population are also derived. We investigate the reliability of multi-component stress-strength model using classical and Bayesian approaches. Risk comparison of the classical and Bayes estimators is done using Monte Carlo simulations. Applications of the proposed estimators are shown using real data sets.     

Einsatz von Simulationspatienten im Kommunikations- und Interaktionstraining für Medizinerinnen und Mediziner (Medi-KIT): Bedarfsanalyse — Training — Perspektiven

Communication skills are of central importance within daily medical life providing effective treatment. In the modern high-tech field of medicine, trustful conversations play a prominent role. In order to help students of the Heidelberg Medical Faculty to be ready for their highly responsible role as communication partner, training is carried out in the framework of HeiCuMed (short for Heidelberger Curriculum Medicinale) using specially trained simulation patients. The communication and interaction training program (referred to as Medi-KIT) enables to practice conducting conversations with challenging communication partners and grave conversational content in difficult situations. Feedback from the standardized patients, as well as from peers and tutors represents a central didactic element.In order to secure knowledge transfer into daily clinic life and as well to build a relation to cognitive knowledge transfer, all medical students are assigned, alongside Medi-KIT lessons, to a ward, and training units are coordinated in terms of content to correspond with symptom-oriented lectures and parallel POL-groups (problem-oriented learning groups). In addition, communication learning objectives are examined at the end of the semester in the form of a clinical practical exam (OSCE: Objective Structured Clinical Examination) and at patient’s bedside (Mini-CEX: Mini Clinical Examination). The goal in imparting communication skills within medical education is that the longitudinal communication curriculum be maintained and continued in subsequent medical specialization studies.     

Comparison of the characteristics of homes for older people in Slovenia with Goffman's concept of the total institution

The past concepts of life and work in homes for older people in Slovenia are no longer adequate to meet the needs, wishes and requirements of their current users. One of the basic premises, relying on Goffman's concept of the total institution, is that the first and foremost characteristic of homes for older people is that they are institutions. The theoretical starting point, namely that Goffman's concept of the total institution is ideal-typical, was corroborated by an investigation of the presence of elements of the total institution in Slovenian homes for older people, proving that not all features of the total institution can be found in any chosen empirical selection of institutions, with the data showing that those characteristics which are present do not exist in the ideal, that is in the most pronounced form. The homes’ users are given consideration, their personnel are adapting to their needs and requirements, even though this occurs within the functioning of an institution whose aims, i.e. to care for a large number of people living in one place, make life in such an institution subordinated to rules, along with the bureaucratisation and routinisation of services.     

Vocal Coordination During Early Parent–Infant Interactions Predicts Language Outcome in Infant Siblings of Children with Autism Spectrum Disorder

This study examined vocal coordination during mother–infant interactions in the infant siblings (high‐risk infants; HR) of children with autism spectrum disorder (ASD), a population at heightened risk for developing language delays (LDs). Vocal coordination between mothers and HR infants was compared to a group of low‐risk (LR; no first‐ or second‐degree relative with ASD) dyads and used to predict later language development. Nine‐month‐old infants were video‐taped at home playing with their mothers, and interactions were coded for the frequency and timing of vocalizations. Percent infant simultaneous speech was predictive of later LD, and dyads with LD infants were less coordinated with one another in average latency to respond than dyads with non‐delayed (ND) infants. The degree of coordination between mothers and infants on this variable predicted a continuous measure of language development in the third year. This research underscores the importance of understanding early development in the context of interaction.