What Do Grandmothers Think about Self‐esteem? American and Taiwanese Folk Theories Revisited

The study investigates European American and Taiwanese grandmothers’ folk theories of childrearing and self‐esteem, building on an earlier comparison of mothers from the same families. Adopting methods that privilege local meanings, we bring grandmothers’ voices into the conversation about childrearing, thereby contributing to a deeper understanding of intergenerational nuances in folk theories. In each cultural case, 16 grandmothers of 3‐year‐olds participated in in‐depth interviews that were customized according to local communicative norms. Although self‐esteem emerged as a central organizing concept in the folk theories of European American mothers, grandmothers spoke in two voices, either echoing their daughters or invoking a counter‐discourse of wariness towards self‐esteem. By contrast, Taiwanese mothers and grandmothers resembled one another—but differed from their American counterparts—in treating self‐esteem as peripheral in childrearing. Results contribute to the growing consensus that self‐esteem is a culture‐specific childrearing goal and suggest that the European American tendency to valorize self‐esteem varies by generation.     

Assessing accuracy of a continuous screening test in the presence of verification bias

Summary.  In studies to assess the accuracy of a screening test, often definitive disease assessment is too invasive or expensive to be ascertained on all the study subjects. Although it may be more ethical or cost effective to ascertain the true disease status with a higher rate in study subjects where the screening test or additional information is suggestive of disease, estimates of accuracy can be biased in a study with such a design. This bias is known as verification bias. Verification bias correction methods that accommodate screening tests with binary or ordinal responses have been developed; however, no verification bias correction methods exist for tests with continuous results. We propose and compare imputation and reweighting bias-corrected estimators of true and false positive rates, receiver operating characteristic curves and area under the receiver operating characteristic curve for continuous tests. Distribution theory and simulation studies are used to compare the proposed estimators with respect to bias, relative efficiency and robustness to model misspecification. The bias correction estimators proposed are applied to data from a study of screening tests for neonatal hearing loss.     

Struggles with Time: the careers of parents with adult sons and daughters with learning disabilities

The experiences of parents with adult offspring with learning disability and the meanings their parental careers have for them, has been the subject of very little empirical research. In this paper we describe and examine some of the features that gave shape and meaning to the day to day lives of parents of 33 co-resident adults with learning disabilities. Their accounts of their situations revealed that 'time' was a factor of some importance. Participants suggested that socialisation into the parental role was one that continued over the life course. In addition, they also felt that the services they received were based upon an inadequate and too narrow an understanding of how they experienced 'time'. The data reveal that both 'over time' and 'in time', parents struggled to maintain a set of aspirations for a typical life. The data show that for many parents there was a slow accommodation to the constraints of service provision and, as a result, their needs for service support became less extensive.     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.     

Conceptualizations of Heterosexual Anal Sex and HIV Risk in Five East African Communities

Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered “sex” and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.     

Is Valuing Equality Enough? Equality Values, Allophilia, and Social Policy Support for Multiracial Individuals

We conducted a field study to investigate positive intergroup attitudes (i.e., allophilia) and equality values as potential antecedents of social policy support for multiracial individuals. Participants (N = 97) reported their social policy support for multiracial individuals in two ways—support for the recognition of "multiracial" as a distinct racial category (recognition) and support for multiracial individuals' access to programs and policies (assistance). Results revealed that allophilia motivated those who held equality beliefs to support social policies for multiracial individuals. Implications of these findings for theories of positive intergroup relations, as well as the processes that may underlie progress for multiracial individuals, are discussed.     

在公共服务递送中运营共同生产：服务蓝图的贡献

本文认为,公共服务应从以产品为主导的逻辑转向服务途径。通过采取服务导向,公共服务递送的经验性、组织间和系统性,以及作为共同生产者的服务使用者角色,将一同被考虑。论文将通过服务蓝图的应用,解释共同生产如何操作。并介绍了高等教育中的一个案例。在这一案例中,蓝图的创建将师生汇聚在一起,专注于学生入学的设计,从而改善学生体验,并支持共同生产。      

Cultural Contributors to Ego‐Resiliency and Associations with Depressive Problems in Midwestern Latino Youth

Ego‐resiliency is an enduring psychological construct reflecting how individuals‐adapt to environmental stressors, conflict, and change which is linked to positive adjustment. Ego‐resiliency has not been examined in Latino youth, despite their high risk for mental health problems; nor have cultural precursors to ego‐resiliency been examined. Given these gaps, we examined whether familism values (supportive, obligation, and referent) were associated with ego‐resiliency and, in turn, depressive problems in Latino adolescents across two time points (N = 123, mean age = 11.53). Results indicated that supportive familism was associated positively with ego‐resiliency and negatively with depressive problems. Ego‐resiliency negatively predicted depressive problems across time, controlling for prior levels, suggesting that ego‐resiliency may have long‐term effects on depressive problems in Latino youth.     

Pointing to Visible and Invisible Targets

We investigated how the visibility of targets influenced the type of point used to provide directions. In Study 1, we asked 605 passersby in three localities for directions to well-known local landmarks. When that landmark was in plain view behind the requester, most respondents pointed with their index fingers, and few respondents pointed more than once. In contrast, when the landmark was not in view, respondents pointed initially with their index fingers, but often elaborated with a whole-hand point. In Study 2, we covertly filmed the responses from 157 passersby we approached for directions, capturing both verbal and gestural responses. As in Study 1, few respondents produced more than one gesture when the target was in plain view and initial points were most likely to be index finger points. Thus, in a Western geographical context in which pointing with the index finger is the dominant form of pointing, a slight change in circumstances elicited a preference for pointing with the whole hand when it was the second or third manual gesture in a sequence.