There’s No Place Like Home: Preparing Children for Geographical and Relational Attachment Disruptions Following Parental Death to Cancer

The death of a parent precipitates a number of profound losses and transitions for children, disrupting their sense of safety and security. Children who have lost both parents or who, due to divorce, are relocating across great distances following the death of their custodial parent incur a number of profound secondary losses, including place attachment disruptions. Work with this population should aim to create a holding environment for children to normalize and validate their experiences while keeping them on track academically, socially, and psychologically. The paper will present two case studies and will offer family-, developmental-, and attachment-based interventions to help prepare children for these inevitable transitions. The paper will suggest a unique role for clinicians when working with this population.     

The Quality of Male Fertility Data in Major U.S. Surveys

Researchers continue to question fathers’ willingness to report their biological children in surveys and the ability of surveys to adequately represent fathers. To address these concerns, this study evaluates the quality of men’s fertility data in the 1979 and 1997 cohorts of the National Longitudinal Survey of Youth (NLSY79 and NLSY97) and in the 2002 National Survey of Family Growth (NSFG). Comparing fertility rates in each survey with population rates based on data from Vital Statistics and the U.S. Census Bureau, we document how the incomplete reporting of births in different surveys varies according to men’s characteristics, including their age, race, marital status, and birth cohort. In addition, we use Monte Carlo simulations based on the NSFG data to demonstrate how birth underreporting biases associations between early parenthood and its antecedents. We find that in the NSFG, roughly four out of five early births were reported; but in the NLSY79 and NLSY97, almost nine-tenths of early births were reported. In all three surveys, incomplete reporting was especially pronounced for nonmarital births. Our results suggest that the quality of male fertility data is strongly linked to survey design and that it has implications for models of early male fertility.     

Revisiting Family of Origin in the Training of Family Therapists

Family of Origin exploration has had a controversial history in family therapy training. This article describes a process that aims to integrate family of origin work with skills development Co‐developed by a training group and their trainer, it builds on the existing approach at the Bouverie Centre in Melbourne. Family of origin work is clearly and practically linked with the enhancement of clinical skills, as argued for in the literature. Informed consent trust and safety are taken seriously, and negotiated within the training group. Trainee and trainer stories are included and the authors discuss the learning that resulted from asking trainees to present their family of origin to the group, including the unpredictable personal ramifications that inevitably occur in such processes.     

Mechanistic Insights Aid the Search for CFC Substitutes: Risk Assessment of HCFC-123 as an Example

An international consensus on the need to reduce the use of chlorofluorocarbons (CFCs) and other ozone-depleting gases such as the halons led to the adoptions of the 1987 Montreal Protocol and Title VI of the 1990 Clean Air Act Amendments, "Protecting Stratospheric Ozone." These agreements included major provisions for reducing and eventually phasing out production and use of CFCs and halons as well as advancing the development of replacement chemicals. Because of the ubiquitous use and benefits of CFCs and halons, an expeditious search for safe replacements to meet the legislative deadlines is of critical importance. Toxicity testing and health risk assessment programs were established to evaluate the health and environmental impact of these replacement chemicals. Development and implementation of these programs as well as the structural-activity relationships significant for the development of the replacement chemicals are described below. A dose-response evaluation for the health risk assessment of the replacement chemical HCFC-123 (2,2-dichloro-1,1,1-trifluoroethane) is also presented to show an innovative use of physiologically based pharmacokinetic (PBPK) modeling. This is based on a parallelogram approach using data on the anesthetic gas halothane, a structural analog to HCFC-123. Halothane and HCFC-123 both form the same metabolite, trifluoroacetic acid (TFA), indicative of the same metabolic oxidative pathway attributed to hepatotoxicity. The parallelogram approach demonstrates the application of template model structures and shows how PBPK modeling, together with judicious experimental design, can be used to improve the accuracy of health risk assessment and to decrease the need for extensive laboratory animal testing.     

Marital Disruption and Health Insurance

Despite the high levels of marital disruption in the United States and the fact that a significant portion of health insurance coverage for those less than age 65 is based on family membership, surprisingly little research is available on the consequences of marital disruption for the health insurance coverage of men, women, and children. We address this shortfall by examining patterns of coverage surrounding marital disruption for men, women, and children, further subset by educational level. Using the 1996, 2001, and 2004 panels of the Survey of Income and Program Participation (SIPP), we find large differences in health insurance coverage across marital status groups in the cross-section. In longitudinal analyses that focus on within-person change, we find small overall coverage changes but large changes in type of coverage following marital disruption. Both men and women show increases in private coverage in their own names, but offsetting decreases in dependent coverage tend to be larger. One surprising result is that dependent coverage for children also declines after marital dissolution, even though children are still likely to be eligible for that coverage. Children and (to a lesser extent) women show increases in public coverage around the time of divorce or separation. We also find that these patterns differ by education. The most vulnerable group appears to be lower-educated women with children because the increases in private, own-name, and public insurance are not large enough to offset the large decrease in dependent coverage. As the United States implements federal health reform, it is critical that we understand the ways in which life course events—specifically, marital disruption—shape the dynamic patterns of coverage.