Childhood emotional abuse and neglect as predictors of psychological and physical symptoms in women presenting to a primary care practice

Objective: There were two aims to this study: first to examine whether emotional abuse and neglect are significant predictors of psychological and somatic symptoms, and lifetime trauma exposure in women presenting to a primary care practice, and second to examine the strength of these relationships after controlling for the effects of other types of childhood abuse and trauma. Method: Two-hundred and five women completed the Childhood Trauma Questionnaire (Bernstein et al., 1994), Trauma History Questionnaire (Green, 1996), the Symptom Checklist-revised (Derogatis, 1997), and the Revised Civilian Mississippi Scale for posttraumatic stress disorder (Norris & Perilla, 1996) when presenting to their primary care physician for a visit. Hierarchical multiple regression analyses were conducted to examine unique contributions of emotional abuse and neglect variables on symptom measures while controlling for childhood sexual and physical abuse and lifetime trauma exposure. Results: A history of emotional abuse and neglect was associated with increased anxiety, depression, posttraumatic stress and physical symptoms, as well as lifetime trauma exposure. Physical and sexual abuse and lifetime trauma were also significant predictors of physical and psychological symptoms. Hierarchical multiple regressions demonstrated that emotional abuse and neglect predicted symptomatology in these women even when controlling for other types of abuse and lifetime trauma exposure. Conclusions: Long-standing behavioral consequences may arise as a result of childhood emotional abuse and neglect, specifically, poorer emotional and physical functioning, and vulnerability to further trauma exposure. (C) 2003 Elsevier Ltd. All rights reserved.

Adapting to new challenges: extension theory and practice for the 21st century

Twenty first century challenges facing agriculture include climate change, threats to food security for a growing population and downward economic pressures on rural livelihoods. Addressing these challenges will require innovation in extension theory, policy and education, at a time when the dominance of the state in the provision of knowledge and information services to farmers and rural entrepreneurs continues to decline. This paper suggests that extension theory is catching up with and helping us to understand innovative extension practice, and therefore provides a platform for improving rural development policies and strategies. Innovation is now less likely to be spoken of as something to be passed on to farmers, than as a continuing process of creativity and adaptation that can be nurtured and sustained. Innovation systems and innovation platforms are concepts that recognise the multiple factors that lead to farmers’ developing, adapting and applying new ideas and the importance of linking all actors in the value chain to ensure producers can access appropriate information and advice for decision making at all stages in the production process. Concepts of social learning, group development and solidarity, social capital, collective action and empowerment all help to explain and therefore to apply more effectively group extension approaches in building confidence and sustaining innovation. A challenge facing educators is to ensure the curricula for aspiring extension professionals in our higher education institutions are regularly reviewed and keep up with current and future developments in theory, policy and practice.

Narrativising the facts: acting in screen and stage docudrama

This article presents findings and seeks to establish the theoretical markers that indicate the growing importance of fact-based drama in screen and theatre performance to the wider Anglophone culture. During the final decade of the twentieth century and the opening one of the twenty-first, television docudrama and documentary theatre have grown in visibility and importance in the UK, providing key responses to social, cultural and political change over the millennial period. Actors were the prime focus for the enquiry principally because so little research has been done into the special demands that fact-based performance makes on them. The main emphasis in actor training (in the UK at any rate) is, as it always has been, on preparation for fictional drama. Preparation in acting schools is also heavily geared towards stage performance. Our thesis was that performers called upon to play the roles of real people, in whatever medium, have added responsibilities both towards history and towards real individuals and their families. Actors must engage with ethical questions whether they like it or not, and we found them keenly aware of this. In the course of the research, we conducted 30 interviews with a selection of actors ranging from the experienced to the recently-trained. We also interviewed a few industry professionals and actor trainers. Once the interviews started it was clear that actors themselves made little or no distinction between how they set about their work for television and film. The essential disciplines for work in front of the camera, they told us, are the same whether the camera is electronic or photographic. Some adjustments become necessary, of course in the multi-camera TV studio. But much serious drama for the screen is made on film anyway. We found it was also the case that young actors now tend to get their first paid employment before a camera rather than on a stage. The screen-before-stage tendency, along with the fundamental re-shaping that has gone on in the British theatre since at least the early 1980s, had implications for actor training. We have also found that theatre work still tends to be most valued by actors. For all the actors we interviewed, theatre was what they liked doing best because it was there they could practice and develop their skills, there they could work most collectively towards performance, and there they could more directly experience audience feedback in the real time of the stage play. The current world of television has been especially constrained in regard to rehearsal time in comparison to theatre (and, to a lesser extent, film). This has also affected actors’ valuation of their work. Theatre is, and is not, the most important medium in which they find work. Theatre is most important spiritually and intellectually, because in theatre is collaborative, intensive, and involving; theatre is not as important in financial and career terms, because it is not as lucrative and not as visible to a large public as acting for the screen. Many actors took the view that, for all the industrial differences that do affect them and inevitably interest the academic, acting for the visible media of theatre, film and television involved fundamentally the same process with slightly different emphases.

Reflective practice among MATESOL graduates in the UAE: theoretical construct or ongoing benefit?

Many teacher training programs, including the MATESOL program at the American University of Sharjah (AUS) in United Arab Emirates, encourage their trainees to reflect on their practice. However, whether or not reflection becomes a part of the trainees’ practice once they leave these programs is a thought-provoking question, which formed the core of the current study. The study was qualitative in nature, using interviewing as its method of data collection. The researcher conducted semi-structured interviews with four AUS MATESOL program graduates, and investigated their perceptions of and engagement with reflective practice. The findings of the study indicate that the participants have generally developed an understanding of and appreciation for reflection and reflective practice, are aware of its values, and use different forms of reflection in order to reflect on their practice. However, some of them hold some uncertainties and misconceptions about reflective practice and its different aspects.

Communities of practice in UK large contracting firms: contrasting application and non-utilized merits

The idea of a community of practice (CoP) has been offered as the engine to unlock the potential of organizational resources, mainly knowledge and people, to achieve the strategic goal of sustained competitiveness. The relevance and application of CoPs in large UK contracting companies was investigated using two case studies. Contrasting variations in the understanding of the concept between the two contracting companies were observed. While a CoP was applied in one company with strategic intent, the concept was not fully understood in the other. In one company, only a third of CoP members surveyed agreed that CoPs were a vehicle for driving best practice and innovation throughout the business; this compared with more than 60% in agreement in the other contracting firm. The higher agreement and satisfaction of CoP members in the latter case study was the result of the management's understanding and commitment. CoPs require time and organizational support to mature. The strategic inception and management support of CoP application is vital for their maturation and progress. Although the construction industry change discourses portray CoPs as fostering an environment of trust, and hence serving as innovation and competiveness enablers, their potential contribution to contracting firms does not provide a compelling case and hence merits further research studies.

Entertainment education theory and practice in HIV/AIDS communication: a South Africa / United Kingdom comparison

Within development communication, gaps remain in theory and practice: communication innovations are taking place which either do not incorporate theory or fail to challenge the assumptions of development communication and HIV/AIDS theory. This can lead to the implementation of unsuccessful interventions that lack theoretical frameworks or to uninformed practice, making it difficult to replicate. Further, research has demonstrated that Entertainment Education (EE) interventions have a measurable impact on behaviour in areas such as HIV/AIDS prevention. Given the transitions in EE practice and evidence of its impact, EE theory and practice can contribute insight into these challenges. A pilot study investigated these dilemmas within the context of the monitoring and evaluation of development communication. Framing this discussion is the concept of South-North dialogue, using comparative analysis of EE interventions to distil lessons through contrasting experiences in two diverse settings. It holds as a principle that lessons from the experience of EE in the Southern context can inform lessons for the North. Further, comparison of the case studies can generate insights for the broader development communication field. We present four case studies, informed by key informant interviews, of EE interventions in the UK and South Africa. We address how communication is defined in planning, implementation and evaluation, highlighting how it often misses the importance of 'listening'. The case studies show that HIV/AIDS communication, and development communication more broadly, has not internalised ideas of evaluation and listening in communication. Successes in the case studies can be partially attributed to responsiveness and context-specificity rather than following rigid planning templates, such as those found in some development communication literature. This indicates the importance of flexibility and responsiveness to context for both development communication and HIV/AIDS communication.

Best practice in the training, appointment and remuneration of members of dispute boards for large infrastructure projects

This paper reports part of a qualitative study into evolving practice in the implementation of the Dispute Adjudication Board (DAB) construction dispute resolution technique, a variant of the Dispute Review Board (DRB) concept used in the US and Canada. Data was collected through a focus group interview of 20 highly experienced dispute resolution practitioners from engineering and the law. The group was assembled from members of FIDIC-NET with direct experience of project DABs. The part reported here concerns practice and procedure for establishing DABs. The main findings are that: constitution of the DABs is often delayed because of either project owners' ignorance of the DAB process or deterrence by the cost of the DABs; such owners also tend to insist on appointing DAB members from local engineers and lawyers without sufficient understanding of the DAB process; rates of remuneration of DAB members vary widely; the training provision for DAB membership and advocacy skills is inadequate; the process of selecting candidates for DAB membership and negotiating the tripartite agreement between each member and the contractual parties needs to be navigated with great care to avoid raising ethical problems. The research contribution is threefold. First, it highlights the importance of realistic fees for DAB members within a standard framework in achieving timely establishment of a board that works well as a team. Second, it illustrates the use of qualitative focus group interview to study the impact of new contract terms from multiple stakeholder perspectives. Finally, it identifies areas where further research is needed.

State practice, customary humanitarian law and civilian casualties of armed conflict

The article examines the customary international law credentials of the humanitarian law rules proposed by the International Committee of the Red Cross (ICR) in 2005. It relies on the BIICL/Chatham House analysis as a ‘constructive comment’ on the methodology of the ICRC study and the rules formed as a result of that methodology with respect to the dead and missing as an aid to determination of their customary law status. It shows that most of the rules studied have a customary international lawpedigree which conforms to the conclusions formed on the rules generally in the Wilmshurst and Breau study. However, the rules with respect to return of personal effects, recording location of graves and notification of relatives of access to gravesites do not seem to have even on a majoritarian/deductive approach enough volume of state practice to establish them as customary with respect to civilians.

Connecting research and practice in TESOL: a community of practice perspective

In line with a growing interest in teacher research engagement in second language education, this article is an attempt to shed light on teachers’ views on the relationship between teaching and practice. The data comprise semi-structured interviews with 20 teachers in England, examining their views about the divide between research and practice in their field, the reasons for the persistence of the divide between the two and their suggestions on how to bridge it. Wenger’s (1998) Community of Practice (CoP) is used as a conceptual framework to analyse and interpret the data. The analysis indicates that teacher experience, learning and ownership of knowledge emerging from participation in their CoP are key players in teachers’ professional practice and in the development of teacher identity. The participants construe the divide in the light of the differences they perceive between teaching and research as two different CoPs, and attribute the divide to the limited mutual engagement, absence of a joint enterprise and lack of a shared repertoire between them. Boundary encounters, institutionalised brokering and a more research-oriented teacher education provision are some of the suggestions for bringing the two communities together.

Patient and public involvement in healthcare quality improvement: how organizations can help patients and professionals to collaborate

Citizens across the world are increasingly called upon to participate in healthcare improvement. It is often unclear how this can be made to work in practice. This 4- year ethnography of a UK healthcare improvement initiative showed that patients used elements of organizational culture as resources to help them collaborate with healthcare professionals. The four elements were: (1) organizational emphasis on nonhierarchical, multidisciplinary collaboration; (2) organizational staff ability to model desired behaviours of recognition and respect; (3) commitment to rapid action, including quick translation of research into practice; and (4) the constant data collection and reflection process facilitated by improvement methods.

Adding a treatment arm to an ongoing clinical trial: a review of methodology and practice

Incorporating an emerging therapy as a new randomisation arm in a clinical trial that is open to recruitment would be desirable to researchers, regulators and patients to ensure that the trial remains current, new treatments are evaluated as quickly as possible, and the time and cost for determining optimal therapies is minimised. It may take many years to run a clinical trial from concept to reporting within a rapidly changing drug development environment; hence, in order for trials to be most useful to inform policy and practice, it is advantageous for them to be able to adapt to emerging therapeutic developments. This paper reports a comprehensive literature review on methodologies for, and practical examples of, amending an ongoing clinical trial by adding a new treatment arm. Relevant methodological literature describing statistical considerations required when making this specific type of amendment is identified, and the key statistical concepts when planning the addition of a new treatment arm are extracted, assessed and summarised. For completeness, this includes an assessment of statistical recommendations within general adaptive design guidance documents. Examples of confirmatory ongoing trials designed within the frequentist framework that have added an arm in practice are reported; and the details of the amendment are reviewed. An assessment is made as to how well the relevant statistical considerations were addressed in practice, and the related implications. The literature review confirmed that there is currently no clear methodological guidance on this topic, but that guidance would be advantageous to help this efficient design amendment to be used more frequently and appropriately in practice. Eight confirmatory trials were identified to have added a treatment arm, suggesting that trials can benefit from this amendment and that it can be practically feasible; however, the trials were not always able to address the key statistical considerations, often leading to uninterpretable or invalid outcomes. If the statistical concepts identified within this review are considered and addressed during the design of a trial amendment, it is possible to effectively assess a new treatment arm within an ongoing trial without compromising the original trial outcomes.

Holism and understanding sustainability

In work undertaken in both Malta and Lebanon we have been reflecting on the current means by which the international community apply concepts intended to achieve what is called "sustainable development." In an attempt to make means and ends conform to each other we have developed a holistic approach to what is essentially a timeless need for understanding, systemic planning, and compassionate stewardship. This essay indicates that we may be closer to holistic means with which to realize these goals than we know. It describes how some planning and analysis methods have their origins in ancient traditions. However, the milieu in which sustainability occurs is often unsympathetic to and sometimes incompatible with the ideals of holism. The essay assesses the current understanding of sustainability and points to the need for a wider and more inclusive base to contemporary sustainability as practiced in the community.

Bridging the two cultures. Commercial archaeology and the study of prehistoric Britain

This paper was given at a meeting of the Society held on 12 January 2006 and it discusses the relationship between academic research and developer-funded archaeology in Britain today, highlighting the strengths and weaknesses of each. It considers the relationship between archaeological theory and practice and discusses the changing roles of academics, fieldworkers and managers. It argues that important issues need to be resolved, including the dissemination of information from recent archaeological fieldwork and the use of ‘grey literature’ in informing more ambitious interpretations of the past.

Glacier shrinkage and climatic change in the Russian Altai from the mid-20th century: An assessment using remote sensing and PRECIS regional climate model

This paper examines changes in the surface area of glaciers in the North and South Chuya Ridges, Altai Mountains in 1952-2004 and their links with regional climatic variations. The glacier surface areas for 2004 were derived from the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) imagery. Data from the World Glacier Inventory (WGI)dating to 1952 and aerial photographs from 1952 were used to estimate the changes. 256 glaciers with a combined area of 253±5.1 km2 have been identified in the region in 2004. Estimation of changes in extent of 126 glaciers with the individual areas not less than 0.5 km2 in 1952 revealed a 19.7±5.8% reduction. The observed glacier retreat is primarily driven by an increase in summer temperatures since the 1980s when air temperatures were increasing at a rate of 0.10 - 0.13oC a-1 at the glacier tongue elevation. The regional climate projections for A2 and B2 CO2 emission scenarios developed using PRECIS regional climate model indicate that summer temperatures will increase in the Altai in 2071-2100 by 6-7oC and 3-5oC respectively in comparison with 1961-1990 while annual precipitation will increase by 15% and 5%. The length of the ablation season will extend from June-August to the late April – early October. The projected increases in precipitation will not compensate for the projected warming and glaciers will continue to retreat in the 21st century under both B2 and A2 scenarios.

Student projects: plagiarism and assessment

Within the Information Technology degree programme of the University of Reading, the students undertake a major project in their final year. The module is both a hurdle to an honours degree and significant in terms of assessment weighting. The two year history so far has shown that bad citation and plagiarism are issues, and in one case called for the due referral of a project report. In the light of experience to date, we are focusing firstly on plagiarism prevention, giving generic advice on report writing and citation practice, and secondly on detection. In the longer term, I believe we need to reflect on what capabilities we should be creating in our undergraduates and therefore what and how we should be assessing them.