Suggestions for psychologists working with Mexican American individuals and families in health care settings.

The number of Mexican Americans in the United States continues to grow at a rapid rate. As these numbers increase, so does the likelihood that Mexican Americans will eventually come into direct contact with the health care system. Mexican Americans with traditional Mexican attitudes, values, and behaviors encounter barriers as they attempt to access medical and rehabilitative care. Issues such as acculturation, language, family, interdependence, attitudes toward authority, and time orientation are some of the areas that may present challenges to rehabilitation staff. Psychologists working in health care facilities who have the cultural competence to intervene effectively with the Mexican American patient can play an important role in helping to remove some of these barriers. Specific suggestions for working with Mexican American patients are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social status and the health of families: a model

The aim of this study is to examine the association of family health and social status, taking the family as the unit of analysis. One particular dimension of social status, lifestyle incongruity, is examined as a predictor of family health, relative to other stressors and sociodemographic variables. Lifestyle incongruity refers to the degree to which style of life (measured by the accumulation of consumer goods and the adoption of specific leisure activities) exceeds economic status (as assessed by occupational class and educational credentials). Using the 1980 General Household Survey of the United Kingdom, it was found that lifestyle incongruity discriminated between households with and without chronically ill members, and was associated with a global rating of family health, controlling for a variety of factors. The logic of studying the health of families, and the implications of these results for future research are discussed.     

Earthquakes and children: The role of psychologists with families and communities.

The 2008 Sichuan Province earthquake and 2005 Pakistan earthquake are examples of natural disasters that took an unimaginable toll on children. In such disaster management contexts, family members as well as health care and school personnel are the first-line responders and are natural sources of continued social support as children recover. Although psychologists have increasingly sophisticated understandings of post-disaster reactions and strategies for helping children and adolescents cope with trauma, models for responding to mass catastrophes are limited, particularly in geographically remote communities and in regions in which mental health services are stigmatizing. With children’s well-being subsequent to earthquakes inextricably linked to family and community, psychologists can make important contributions in 3 spheres: (a) coordinating and activating collaborations within children’s existing social contexts to develop post-earthquake interventions; (b) designing prevention and preparedness programs focused on the emotional needs of children in earthquake-prone communities; and (c) conducting research on interventions and recovery with particular attention to developmental stage, sociocultural-economic contexts, and the similarities versus differences across various types of disasters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Allied health and physician assistants: a progressive partnership

Life expectancy of males in the Slovak Republic, a small postcommunist country in Central Europe, is among the lowest in Europe due to the extremely high mortality rate in middle-aged men. The relation between male life expectancy at age 20 and several variables (i.e. ethnic structure, educational status, religious belief and economic activity) was analysed by simple regressions and by multifactorial methods in all 38 districts of Slovakia. Significant negative associations were found between male life expectancy at age 20 and ethnic structure (i.e. percent of Hungarian population), economic activity (percent of men employed in agriculture) and educational status (percent of men having only a basic education). In multifactorial analysis educational status and ethnic structure entered the model. The most dramatic health decline occurred in agricultural southern districts with high percentage of Hungarian minority and with high percentage of men with the lowest educational status. Lifestyle probably presents the background of these relations, but there is a lack of reliable data from the individual districts for a more profound analysis. More sophisticated epidemiological research projects are important for the formulation of a public health strategy in Slovakia.     

Moving toward a broader model of health care.

This article looks at how we can move toward a broader model of health care. It discusses advances in U.S. health care, the issue of health care coverage for all Americans, the need for a biopsychosocial model of health care, and the impact that psychologists can make in improving health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral and biomedical research: a partnership for better health

In the last decade, global use of contraceptive methods has increased. About 50% of couples of childbearing age use a modern contraceptive method. This evolution and a positive change in attitude towards male contraception has encouraged research in fertility regulation to enlarge and to improve acceptance of the contraceptive mix. Current injectable contraceptives interfere with the menstrual cycle. Research is exploring ways to minimize such secondary effects by reducing the total hormone dose and by changing the way the active product is delivered (e.g., microspheres). An injectable prototype is an analogue of levonorgestrel (HRP 002). A new IUD is made of leather suspended by a nylon suture which has been inserted into the uterine muscle. RU-486, often used to interrupt early pregnancy, is being tested as an oral contraceptive (OC). It inhibits secretion of gonadotropins and ovulation. It holds promise as an OC with no estrogen component. Since it also inhibits endometrial development and thus prevents implantation, it may someday be used for emergency contraception (i.e., postcoital contraception). New contraceptive implants under study include Norplant RII (2 rods of levonorgestrel lasting for 3 years), Implanon (desogestrel), and Capranor (biodegradable implant lasting 2 years). The female condom consists of a flexible polyurethane sheath with a flexible ring at each end. It has the potential to protect against sexually transmitted diseases since it covers the labial lips and is impermeable to HIV. France and Switzerland have both approved its use. It will enter the UK market at the end of the year. Approval for marketing has been sought in the US.     

Educating families and caretakers of traumatically brain injured patients in the new health care environment: a three phase model and bibliography

Shorter inpatient stays for traumatically brain injured patients frequently allow less time for comprehensive education of families and caretakers. What is needed to compensate for the shortened duration of brain injury rehabilitation in many settings is a family educational programme that (1) satisfies the family's acute information needs as they arise, and (2) standardizes the delivery of information so that certain knowledge criteria are met. The following article proposes a three phase model of family and caretaker education with an accompanying bibliographical index.     

Helping families with homosexual children: a model for counseling

In the last decade large amounts of intravenous immunoglobulin (i.v.Ig) have been used worldwide. Doubts exist as to whether this increased use is paralleled by a comparable growth of reliable data on the therapeutic effectiveness of i.v.Ig. We performed a literature search using MEDLINE from January 1981 to January 1997 and analysed articles on the use of i.v.Ig in hematological disorders and searched for published guidelines. For most hematological disorders, evidence to use i.v.Ig as first line therapy is not very strong. For many disorders no controlled trials have been performed. In published guidelines, i.v.Ig is only recommended, with a few exceptions, when other treatments have failed or are contraindicated. Therefore the increase of consumption of i.v.Ig can not be explained by an increase in established indications in hematology.     

Knowledge and attitudes toward breast-feeding: differences among dietitians, nurses, and physicians working with WIC clients

We assessed the knowledge of and attitude toward breast-feeding of dietitians, nurses, and physicians who work with individuals in the Alabama Special Supplemental Food Program for Women, Infants, and Children. On a scale of 0 to 100, dietitians expressed stronger interest in lactation (78.6) and exhibited greater knowledge (79.6) of the questions asked than nurses (74.5 and 73.0, respectively). Attitude and knowledge scores of physicians (70.2 and 75.5, respectively) were not statistically different from those of dietitians or nurses. Respondents disagreed greatly about the relationship of breast-feeding to weight loss and the appropriateness of oral contraceptives during breast-feeding 6 weeks postpartum. Professionals were more knowledgeable about benefits to infants than about maternal concerns. Results of this study suggest that professional breast-feeding education programs should address maternal concerns such as weight loss, contraception, and mastitis as well as benefits to the infant.     

The underdevelopment of health of working America: causes, consequences and possible solutions

This article presents the health conditions of working America, and provides an analysis of the causes of that situation. It is postulated that the main health problems in the U.S. are due not to prevalent life styles-as the behavioralists indicate-but to the dramatic maldistribution of economic and political power in our society, with the absence of control by the majority of the U.S. population-the working and lower-middle classes-over the work process with which they are involved, the economic wealth that they produce, and the political institutions that they pay for. The production of goods and wealth as well as the political institutions of the United States are dominated and controlled by a minority of our population-the corporate and upper-middle classes. Empirical information is presented to support this postulate. In light of this explanation, it is asserted that a major public health task is to deliberately and actively contribute to the political mobilization of forces aimed at bringing about profound changes in the pattern of control of our working insitutions and of the distribution of wealth and political power, changes which seek to shift that control from the few to the many.     

A mediational model of quality of life for individuals with severe mental health problems

BACKGROUND: Despite the increasing importance of quality of life in the mental health field, the theoretical conceptualization of the construct remains poorly developed. A proposed mediational model of quality of life, which links subjective quality of life with self-related constructs, is examined with a group of long-term psychiatric hostel residents. The present study aims to develop a measure of quality of life based on the proposed model, to explore the data and their implications for service development and finally to conduct a preliminary analysis of the model's predictions. METHODS: A cross-sectional research design was employed. Quality of life interviews, using a modified version of Lehman's Quality of Life Interview, were carried out with 54 psychiatric residents in Greece. The model's predictions were examined by using a series of regression analyses. RESULTS: The results indicate that perceived improvements in lifestyle, greater autonomy and positive self-concept are significantly and directly associated with better quality of life. In contrast, a direct relationship between objective indicators and subjective quality of life was not found. CONCLUSIONS: The traditional two-part quality of life model that includes objective indicators of life circumstances and subjective indicators is extended to included the constructs of self-concept and perceived autonomy. The present extended mediational model of quality of life for individuals with long-term mental health problems appears to have important implications for the planning and delivery of mental health programmes.     

The primacy model: a new model of immediate serial recall

A new model of immediate serial recall is presented: the primacy model. The primacy model stores order information by means of the assumption that the strength of activation of successive list items decreases across list position to form a primacy gradient. Ordered recall is supported by a repeated cycle of operations involving a noisy choice of the most active item followed by suppression of the chosen item. Word-length and list-length effects are attributed to a decay process that occurs both during input, when effective rehearsal is prevented, and during output. The phonological similarity effect is attributed to a second stage of processing at which phonological confusions occur. The primacy model produces accurate simulations of the effects of word length, list length, and phonological similarity.     

The Fresno Asthma Project: a model intervention to control asthma in multiethnic, low-income, inner-city communities

The Fresno Asthma Project targeted the entire low-income, inner-city, multiethnic population of Fresno, California. For 36 months following a 6-month planning phase, continuing education was provided to a high proportion of physicians, pharmacists, nurses/respiratory therapists, emergency medical technicians, school personnel, and allied health professionals involved in asthma care in Fresno, including virtually all those providing care/services to the target population. Small group patient education was made available and provided in age- and culturally appropriate formats to patients/families in clinics, hospitals, and schools. General and ethnic media and a Speakers Bureau were used to raise public awareness of asthma as a serious but controllable health problem. This community intervention model is particularly appropriate to multiethnic communities. It is relatively low cost (total direct costs were $140,000 per year), uses existing educational resources, and appears to have minimized counterproductive competition. Although morbidity and mortality trend data are not yet available to monitor program impact, penetration into the target community has been substantial: community physicians refer patients to asthma classes, asthma educator training is ongoing through the local American Lung Association chapter, hospitals and managed care systems serving low- income/MediCal patients offer asthma classes, and public schools and HeadStart are institutionalizing asthma awareness and self-management classes.     

Parents, partnership and education officers: a study of attributions

Thirty-five parents of children with special educational needs were interviewed to ascertain their experiences of dealing with education officers involved in the assessment and placement of their children. They were found predominantly to make internal attributions for negative behaviours, and external attributions for positive behaviours. The implication of these results for new United Kingdom government initiatives to reduce conflict between parents and education authorities are examined.     

The new partnership of genomics and chemistry for accelerated drug development

The Grashey shoulder position is used to demonstrate damage to the glenohumeral joint caused by osteoarthritis, sclerosis, tumors, fractures, osteophytes and cystic changes. However, it can be difficult to assess loss of articular cartilage using the Grashey shoulder position because little axial load is applied to the glenohumeral joint. This article describes a method of creating a loading force across the glenohumeral joint by adding weighted arm abduction during the Grashey position to demonstrate loss of the articular cartilage. Case studies and radiographs are presented to discuss the advantages of using the Grashey position with weighted abduction.     

An inter district quality partnership: the experience of a large rural health service

The interleukin-2 receptor (IL-2R) gamma chain (gamma c chain) is shared by IL-4R, IL-7R, IL-9R, and IL-15R and plays an important role in regulation of the immune system. However, its regulation in monocytic cell lines has not been well clarified. We examined the expression and regulation of the IL-2R alpha, IL-2R beta, gamma c chain, IL-4R and IL-7R mRNA in a human monoblastic leukemia cell line, THP-1. Unstimulated THP-1 cells constitutively expressed a low level of gamma c chain and IL-4R mRNA. Phorbol myristate acetate (PMA) induced macrophage-like differentiation and up-regulated the gamma c chain mRNA expression in THP-1 cells. This effect of PMA was suppressed by the protein kinase inhibitors H-7 and staurosporine. PMA did not affect the expression of the other IL-R mRNAs examined. 1 alpha, 25(OH)2D3 and interferon-gamma also induced differentiation of THP-1 cells, but these reagents did not affect the expression of the IL-R mRNAs in THP-1 cells. These findings suggest that the expression of the gamma c chain mRNA is regulated by the PMA-dependent pathway and is not associated with that of the other IL-R mRNAs.     

Gender bias in short-term therapy: Toward a new model for working with women patients in managed care settings.

Examines a gender bias in short-term psychodynamic psychotherapy (PP) in a managed care setting, namely, the implicit relationship between separation and psychological development in treatment. The author proposes that brief PP is modeled after classic developmental theory where separation is the marker of development. While separation may be essential for male development, continuity of connection is critical for female development. Since brief therapy does not allow for continuity of connection, it does not integrate an important aspect of the female developmental and relational experience into the treatment. An extended model of psychotherapy, which uses a limited number of therapy sessions but provides more of an ongoing therapeutic relationship, is proposed as an alternative for women patients who need both time and continuity of connection for self-development. Cases of 5 women (aged 27–52 yrs) illustrate the model's stages. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The multiple partnership: Scientist, university, agency, and government.

In the US, a significant portion of scientific effort is carried out in universities and financed by government and private agencies. While partnerships among these bureaucratic and social systems are strung together institutionally, the connecting links are provided by individuals in these institutions whose ideas, proposals, and advocacies shape the programs that ultimately are established. These human and political realities, while contributing to the richness and diversity of US science, may also have negative implications for the progress of science, particularly in the face of limited resources. Despite this, science is likely to be enhanced overall by multiple sources of influence and multiple partnerships. The key element will be the careful selection of effective advocates linking foundations, universities, agencies, and government. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The health practices of homeless women: a causal model

A theoretical model was developed and tested to explain the effects of learned helplessness, self-esteem, and depression on the health practices of homeless women. Data were collected from a sample of 122 homeless women recruited from six shelters. Structural equation analysis was used to evaluate the model. Analysis revealed a goodness-of-fit index of 98, indicating a good fit of the model with the data. Overall, the variables in the model accounted for 14% to 21% of the variance in the health practices of homeless women.