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.     

The future of refugee flows and policies

"The number of forced migrants...is estimated today to exceed 40 million [worldwide]. The changed international climate of the 1990s...has shifted the focus from the asylum and resettlement countries to the countries of origin: there is today a greater willingness to intervene in other countries' affairs either to avert the creation of new flows of focused migrants or to assist internally displaced populations, and there is the expectation of large-scale voluntary returns of refugees in asylum. This article discusses these and other policy issues concerning forced migration in this new international environment."     

Assessing right to die attitudes: a conceptually guided measurement model

This article discusses the current status of research regarding the assessment of attitudes toward euthanasia and other right to die constructs with a focus on conceptual and methodological issues hindering advancement in this area. Two models are presented: a conceptual model for differentiating the various right to die constructs, and a measurement model to guide scale development and refinement. The conceptual model defines the right to die constructs as a function of locus of decision and locus of action. Health status and age are hypothesized as important factors that in some instances are defining attributes in right to die constructs and in other instances are factors influencing people's attitudes toward the right to die. The measurement model considers the importance of construct specificity, individual characteristics, and conviction in the assessment of right to die attributes. An extant euthanasia attitude scale is presented and evaluated in terms of the models to demonstrate how they may be useful for advancing attitude research in this important area.     

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.     

Evaluating a private foundation's health program

Public policy decisions in health are increasingly difficult and expensive. Although there will never be enough information available, private foundations can help to bridge the most important gaps in knowledge. Larger foundations may also wish to respond to those who doubt the value of foundation activities. This article reviews the experiences over the past eight years of The Robert Wood Johnson Foundation in employing evaluation and related social research procedures in the planning and implementation of a major philanthropic effort to improve the health and medical care of Americans. Discussed are the still evolving Foundation evaluation framework, the unanticipated problems in undertaking specific evaluations, and the substantive findings of some of the studies.     

Internalized Other Interviewing in Relational Therapy: Three Discursive Approaches to Understanding its Use and Outcomes

For over 20 years, family therapist Karl Tomm has been engaging families and couples with a therapeutic intervention he calls Internalized Other Interviewing (IOI). The IOI (cf. Emmerson‐Whyte, 2010; Hurley, 2006) entails interviewing clients, from the personal experiences of partners and family members as an internalized other. The IOI is based on the idea that through dialogues over time, one can internalize a sense of one's conversational partner responsiveness in reliably anticipated ways. Anyone who has thought in a conversation with a family member or partner, “Oh there s/he goes again,” or anticipates next words before they leave the other's mouth, has a sense of what we are calling an internalized other. For Tomm, the internalized anticipations partners and family members may have offers entry points into new dialogues with therapeutic potential—particularly, when their actual dialogues get stuck in dispreferred patterns.     

Mothers' interoceptive knowledge predicts children's emotion regulation and social skills in middle childhood

Interoception, often defined as the perception of internal physiological changes, is implicated in many adult social affective processes, but its effects remain understudied in the context of parental socialization of children's emotions. We hypothesized that what parents know about the interoceptive concomitants of emotions, or interoceptive knowledge (e.g., “my heart races when excited”), may be especially relevant in emotion socialization and in supporting children's working models of emotions and the social world. We developed a measure of mothers' interoceptive knowledge about their own emotions and examined its relation to children's social affective outcomes relative to other socialization factors, including self‐reported parental behaviors, emotion beliefs, and knowledge of emotion‐relevant situations and non‐verbal expressions. To assess these, mothers (N = 201) completed structured interviews and questionnaires. A few months later, third‐grade teachers rated children's social skills and emotion regulation observed in the classroom. Results indicated that mothers' interoceptive knowledge about their own emotions was associated with children's social affective skills (emotion regulation, social initiative, cooperation, self‐control), even after controlling for child gender and ethnicity, family income, maternal stress, and the above maternal socialization factors. Overall, findings suggest that mothers' interoceptive knowledge may provide an additional, unique pathway by which children acquire social affective competence.