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.     

Leaving an Institution in Flanders (Belgium): A Road to Homelessness?

People living in an institution will leave this residential context one day and have to proceed to a stable independent way of living. This transition is not without difficulties as it turns out this socially vulnerable group runs an increased risk of becoming homeless. Research in Flanders (Belgium) has shown that a considerable share of the homeless population has previously stayed in an institutional setting, mostly in youth care (48.7%), psychiatric (34.4%) and penitentiary (33.1%) institutions. Moreover, the share of homeless people with a history in one of these institutions has increased in the past decades. Institution leavers, face at least three obstacles to a stable housing situation in Flanders: a lack of affordable housing, a lack of access to (non-residential) social assistance and personal difficulties in coping with living independently. Yet, there are several programs that support institution leavers and prepare them for the transition to an independent living situation and legal developments that strengthen their position in society and on the housing market. In this paper, we explore these initiatives and developments in three case studies (Antwerp, Ghent and Leuven). Based on in-depth interviews with “street-level bureaucrats” who work in these institutions (youth care, psychiatric and penitentiary settings), social support services and social housing organizations, we reconstruct the pathways of institution leavers to the housing market, the support they receive and the experienced difficulties.     

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.