Design and evaluation of the parent education component of a comprehensive violence prevention project in middle schools

Low parental monitoring is related to youth risk behaviors such as delinquency and aggression. The purpose of this dissertation was to describe the development and evaluation of a parent education intervention to increase parental monitoring in Hispanic parents of middle school children.^ The first study described the process of intervention mapping as used to develop Padres Trabajando por la Paz, a newsletter intervention for parents. Using theory, empirical literature, and information from the target population, performance objectives and determinants for monitoring were defined. Learning objectives were specified and a staged social-cognitive approach was used to develop methods and strategies delivered through newsletters.^ The second study examined the outcomes of a randomized trial of the newsletter intervention. Outcome measures consisted of a general measure of monitoring, parent and child reports of monitoring behaviors targeted by the intervention, and psychosocial determinants of monitoring (self-efficacy, norms, outcome expectancies, knowledge, and beliefs). Seventy-seven parents completed the randomized trial, half of which received four newsletters over an eight-week period. Results revealed a significant interaction effect for baseline and treatment for parent's reports of norms for monitoring (p =.009). Parents in the experimental condition who scored low at baseline reported increased norms for monitoring at follow-up. A significant interaction effect for child reports of parental monitoring behaviors (p =.04) reflected an small increase across baseline levels in the experimental condition and decreases for the control condition at higher baseline scores. Both groups of parents reported increased levels of monitoring at follow-up. No other outcome measures varied significantly by condition.^ The third study examined the relationship between the psychosocial determinants of parental monitoring and parental monitoring behaviors in the study population. Weak evidence for a relationship between outcome expectancies and parental monitoring behaviors suggests further research in the area utilizing stronger empirical models such as longitudinal design and structural equation modeling.^ The low-cost, minimal newsletter intervention showed promise for changing norms among Hispanic parents for parental monitoring. In light of the importance of parental monitoring as a protective factor for youth health risk behaviors, more research needs to be done to develop and evaluate interventions to increase parental monitoring. ^

AIDS talk

The observations of Michel Foucault, noted Twentieth Century French philosopher, regarding modern power relations and orders of discourse, form the framework utilized to analyze and interpret the power struggles of AIDS activists and their opponents--the religious and radical right, and the administrative agencies of the 'Liberal' welfare State. Supported by the tools of sociolinguistic inquiry, the analysis highlights the success of a safer sex campaign in Houston, Texas to illustrate the dynamics of cultural and political change by means of discursive transformations initiated by the gay micro-culture. The KS/AIDS Foundation, allied with both the biomedical community and gay entertainment spheres, was successful in conveying biomedical cautions that resulted in altered personal behavior and modified public attitudes by using linguistic conventions consonant with the discourse of the Houston gay micro-culture. The transformation of discursive practices transgressed not only the Houston gay micro-culture's boundaries, but the city boundaries of Houston as well. In addition to cultural and political change, moderate and confrontational gay activists also sought to change the cognitive boundaries surrounding 'the gold standard' for clinical research trials.^ From a Foucauldian perspective, the same-sex community evolved from the subordinated Other to a position of power in a period of five years. Transformations in discursive practices and power relations are exemplified by the changing definitions employed by AIDS policy-makers, the public validation of community-based research and the establishment of parallel track drug studies. Finally, transformations in discursive practices surrounding the issues of HIV antibody testing are interpreted using Foucault's six points of power relations. The Montrose Clinic provides the case study for this investigation. The clinic turned the technical rationalities of the State against itself to achieve its own ends and those of the gay micro-culture--anonymous testing with pre and post test counseling. AIDS Talk portrays a dramatic transformation in discursive practices and power relations that transcends the historical moment to provide a model for future activists. Volume 2 contains copies of fugitive primary source materials largely unavailable elsewhere. Original documents are archived in the Harris County Medical Archives in the Houston Academy of Medicine located in the Texas Medical Center Library, Houston, Texas. ^

Nutrition knowledge and attitudes of physician assistants in Texas

Physician Assistants (PAs) are increasingly assuming more responsibilities as "front-line" health providers due to emphasis on primary care and cost-containment in the rapidly changing health care environment. Nutrition plays an important role in health promotion and disease prevention. Primary care providers, including PAs, have enormous potential as nutrition counselors and advocates. There have been no studies to date that address the PAs' adequacy of nutrition education or their attitudes toward the value of nutrition. Therefore, it was the purpose of the study to determine the nutrition knowledge and attitudes of PAs in Texas.^ All certified physician assistants in Texas were eligible for the study. A mailed survey was sent to 1,482 PAs in Texas with a response rate of 54.2%. The sample utilized for data analysis was 764 PAs.^ The study compared the nutrition knowledge mean scores for PAs who graduated from a PA program greater than 11 years ago with those who graduated less than 11 years ago. The study also examined Texas PAs' attitudes about their nutrition education training, the value of nutrition counseling, and their perceived ability to provide such nutrition counseling. Demographic and practice information was collected from the PAs. Demographically, PAs in Texas were found to be comparable to the national population of PAs surveyed in 1996.^ The overall mean level of nutrition knowledge was 70% correct. The mean level of nutrition knowledge was significantly related to the type of PA program that the PA graduated from (i.e., Certificate only or Master's degree level). No significant relationships were found between the mean nutrition knowledge score and age, year of graduation, length of practice, or the type of nutrition education provided in PA program.^ The majority of the PAs surveyed felt that diet and nutrition has an important role in disease prevention and felt that PA programs should place a greater emphasis on nutrition education. Many PAs surveyed were not satisfied with the amount of nutrition education they had received in their PA education programs and were not confident in their ability to provide nutrition counseling to patients.^ Suggestions are offered for improvement in PA nutrition education in the areas of both nutrition knowledge and patient counseling skills. In addition, this study recommends developing and strengthening partnerships between PAs and nutrition organizations. ^

Toward individualized cholesterol-lowering treatment in end-stage renal disease.

There is broad evidence that lowering low-density lipoprotein (LDL) cholesterol will reduce cardiovascular risk. However, in patients on maintenance hemodialysis treatment, lowering LDL cholesterol is not as effective in preventing cardiovascular complications as in the general population. Cholesterol is either endogenously synthesized or absorbed from the intestine. It has been suggested that the benefit of using statins to prevent atherosclerotic complications is less pronounced in people with high absorption of cholesterol. Recent data indicate that patients on hemodialysis have high absorption of cholesterol. Therefore, these patients may benefit from dietary counseling to reduce cholesterol intake, from functional foods containing plant sterols and stanols, and from drugs that interfere with intestinal absorption of sterols (i.e., ezetimibe, bile acid resins, and sevelamer). This review discusses cholesterol homeostasis and the perspective of personalized treatment of hypercholesterolemia in hemodialysis.

Practices of pediatric oncology and hematology providers regarding fertility issues: A European survey.

BACKGROUND Fertility is impaired in many survivors of childhood cancer following treatment. Preservation of fertility after cancer has become a central survivorship concern. Nevertheless, several doctors, patients, and families do not discuss fertility and recommendations for fertility preservation in pediatrics are still lacking. Recommendations based on scientific evidence are needed and before their development we wanted to assess the practice patterns of fertility preservation in Europe. PROCEDURES On behalf of the PanCare network, we sent a questionnaire to pediatric onco-hematology institutions across Europe. The survey consisted of 21 questions assessing their usual practices around fertility preservation. RESULTS One hundred ninety-eight institutional representatives across Europe received the survey and 68 (response rate 34.3%) responded. Pre-treatment fertility counseling was offered by 64 institutions. Counseling was done by a pediatric onco-hematologist in 52% (33/64) and in 32% (20/64) by a team. The majority of institutions (53%) lacked recommendations for fertility preservation. All 64 centers offered sperm banking; eight offered testicular tissue cryopreservation for pre-pubertal males. For females, the possibility of preserving ovarian tissue was offered by 40 institutions. CONCLUSIONS There is a high level of interest in fertility preservation among European centers responding to our survey. However, while most recommended sperm cryopreservation, many also recommended technologies whose efficacy has not been shown. There is an urgent need for evidence-based European recommendations for fertility preservation to help survivors deal with the stressful topic of fertility. Pediatr Blood Cancer 2014;9999:1-5. © 2014 Wiley Periodicals, Inc.

Assessing Difficulties in Career Decision Making Among Swiss Adolescents with the German My Vocational Situation Scale

Assessing problems in career decision making among adolescents is important for career guidance and research. The present study is the first to investigate among Swiss adolescents the factor structure and convergent validity in relation to personality of the German-language adaptation of the My Vocational Situation Scale. Two preliminary studies (N = 217) suggested that using a 5-point Likert scale response format would increase scale reliability. The confirmatory factor analyses in the main study with two cohorts (n = 341, eighth grade; n = 303, eleventh grade) confirmed that four main factors, which assess problems with identity, decision making, information, and perceived barriers, underlie the data. The barriers factor was differentiated into aspired vocation and personal situation. Construct validity was supported by significant relationships between favorable personality characteristics (emotional stability, extraversion, agreeableness, conscientiousness, generalized self-efficacy, and internal locus of control) and fewer problems. The results suggest that the vocational identity and barriers scales can be fruitfully applied to research on and the practice of career counseling with adolescents.

Callings and work engagement: Moderated mediation model of work meaningfulness, occupational identity, and occupational self-efficacy

Scholarly interest in callings is growing, but our understanding of how and when callings relate to career outcomes is incomplete. The present study investigated the possibility that the relationship of calling to work engagement is mediated by work meaningfulness, occupational identity, and occupational self-efficacy – and that this mediation depends on the degree of perceived person-job fit. I examined a highly educated sample of German employees (N=529) in diverse occupations and found support for two of the three hypothesized mediators – work meaningfulness and occupational identity – after controlling for the relation of core self-evaluations to work engagement. Contrary to expectations, the mediated relations of callings to work engagement were not conditional upon the degree of person-job fit. The findings are considered in terms of the pathways through which callings may relate to work engagement and other career development outcomes.

Préparation à la transition de l'école obligatoire à la formation professionelle

Cette contribution analyse les contraintes et opportunités issus de la transition entre l’école obligatoire et la formation professionnelle en Suisse. L’ambition est de montrer que des facteurs psychologiques et structuraux sont essentiels pour comprendre les inégalités observées lors de cette transition. Les résultats de différentes études empiriques montrent que des facteurs associés à la personnalité, au support social, et à l’engagement personnel dans la préparation au choix de carrière ont une incidence sur les différences interindividuelles en termes d’adaptabilité de carrière et de congruence du choix professionnel tel qu’observés avant la transition. Les implications pour la pratique dans le domaine du conseil en orientation seront présentées.

Stratification of high-risk prostate cancer into prognostic categories: a European multi-institutional study

BACKGROUND High-risk prostate cancer (PCa) is an extremely heterogeneous disease. A clear definition of prognostic subgroups is mandatory. OBJECTIVE To develop a pretreatment prognostic model for PCa-specific survival (PCSS) in high-risk PCa based on combinations of unfavorable risk factors. DESIGN, SETTING, AND PARTICIPANTS We conducted a retrospective multicenter cohort study including 1360 consecutive patients with high-risk PCa treated at eight European high-volume centers. INTERVENTION Retropubic radical prostatectomy with pelvic lymphadenectomy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Two Cox multivariable regression models were constructed to predict PCSS as a function of dichotomization of clinical stage (< cT3 vs cT3-4), Gleason score (GS) (2-7 vs 8-10), and prostate-specific antigen (PSA; ≤ 20 ng/ml vs > 20 ng/ml). The first "extended" model includes all seven possible combinations; the second "simplified" model includes three subgroups: a good prognosis subgroup (one single high-risk factor); an intermediate prognosis subgroup (PSA >20 ng/ml and stage cT3-4); and a poor prognosis subgroup (GS 8-10 in combination with at least one other high-risk factor). The predictive accuracy of the models was summarized and compared. Survival estimates and clinical and pathologic outcomes were compared between the three subgroups. RESULTS AND LIMITATIONS The simplified model yielded an R(2) of 33% with a 5-yr area under the curve (AUC) of 0.70 with no significant loss of predictive accuracy compared with the extended model (R(2): 34%; AUC: 0.71). The 5- and 10-yr PCSS rates were 98.7% and 95.4%, 96.5% and 88.3%, 88.8% and 79.7%, for the good, intermediate, and poor prognosis subgroups, respectively (p = 0.0003). Overall survival, clinical progression-free survival, and histopathologic outcomes significantly worsened in a stepwise fashion from the good to the poor prognosis subgroups. Limitations of the study are the retrospective design and the long study period. CONCLUSIONS This study presents an intuitive and easy-to-use stratification of high-risk PCa into three prognostic subgroups. The model is useful for counseling and decision making in the pretreatment setting.

Effects of orientations to happiness on vocational identity achievement

There is an increased interest in vocational psychology and career counseling regarding the link between career development and well-being, yet, little is known about how different ways to achieve well-being or happiness relate to career development. This study explored the relationship between 3 orientations to happiness (meaning, pleasure, and engagement) and vocational identity achievement among 2 groups of Swiss adolescents (n = 268, 8th grade; n = 208, 11th grade). The results indicated that more orientation to meaning and engagement but not to pleasure positively related to vocational identity achievement.

State of the art: Reproduction and pregnancy in rheumatic diseases

Throughout the last decade, increasing awareness has been raised on issues related to reproduction in rheumatic diseases including basic research to clarify the important role of estrogens in the etiology and pathophysiology of immune/inflammatory diseases. Sub- or infertility is a heterogeneous condition that can be related to immunological mechanisms, to pregnancy loss, to disease burden, to therapy, and to choices in regard to family size. Progress in reproductive medicine has made it possible for more patients with rheumatic disease to have children. Active disease in women with rheumatoid arthritis (RA) affects their children's birth weight and may have long-term effects on their future health status. Pregnancy complications as preeclampsia and intrauterine growth restriction are still increased in patients with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), however, biomarkers can monitor adverse events, and several new therapies may improve outcomes. Pregnancies in women with APS remain a challenge, and better therapies for the obstetric APS are needed. New prospective studies indicate improved outcomes for pregnancies in women with rare diseases like systemic sclerosis and vasculitis. TNF inhibitors hold promise for maintaining remission in rheumatological patients and may be continued at least in the first half of pregnancy. Pre-conceptional counseling and interdisciplinary management of pregnancies are essential for ensuring optimal pregnancy outcomes.

The role of chance events in the school-to-work transition: The influence of demographic, personality and career development variables

Chance events are considered important in career development, yet little empirical research is available on their predictors and consequences. The present study investigated socio-demographic (gender, nationality, school-type), personality (openness, locus of control) and career development variables (career decidedness, career planning) in relation to perceived chance events with a retrospective (N = 229, eleventh grade), and 1-year longitudinal prospective study (N = 245, eighth/ninth grade) among Swiss adolescents. The results showed that the majority of both groups reported a significant influence of chance events on their transition from compulsory school to vocational education or high school. Importance of chance events related to socio-demographics and personality but not career preparation. Career preparation and chance events predicted subjective career success in terms of wish correspondence and overall satisfaction with transition outcome among the younger cohort. Implications include the necessity to integrate both thorough career preparation and chance events in theory and counseling practice.

Using Accuracy of Self-Estimated Interest-Type as a Sign of Career Choice Readiness in Career Assessment of Secondary Students

A frequent applied method in career assessment to elicit clients’ self-concepts is asking them to predict their interest assessment results. Accuracy in estimating one’s interesttype is commonly taken as a sign of more self-awareness and career choice readiness. The study evaluated the empirical relation of accuracy of self-estimation to career choice readiness within a sample of 350 Swiss secondary students in seventh grade. Overall, accuracy showed only weak relations to career choice readiness. However, accurately estimating one’s first interest-type in a three-letter RIASEC interests-code emerged as a sign of more vocational identity and total career choice readiness. Accuracy also correlated positively with interest profile consistency, differentiation, and congruence to career aspirations. Implications of the results for career counseling and assessment practice are presented.

Fostering networking behavior, career planning and optimism, and subjective career success: An intervention study

The present study evaluated personal resource-oriented interventions supporting the career development of young academics, working at German universities within the STEM fields. The study sought to foster subjective career success by improving networking behavior, career planning, and career optimism. The study involved a quasi-experimental pre-post intervention with two intervention and two control groups (N = 81 research associates). Participants of the first intervention group received networking training; participants of the second intervention group received the same networking training plus individual career coaching. Participants of both intervention groups were female. Participants of the control groups (i.e., male vs. female group) did not participate in any intervention. As expected, path analyses, based on mean differences frompre-test to post-test, revealed an increase in career planning and career optimism within the networking plus career coaching intervention group, that was indirectly positively related to changes in subjective career success. Contrary to our expectations, the networking group training alone and in combination with the career coaching showed no effectiveness in fostering networking behavior. Results are discussed in the context of career counseling and intervention effectiveness studies.

More volunteers in football clubs. An evaluation of a method to increase the number of volunteers

An increasing number of clubs experience difficulties in recruiting and retaining sufficient numbers of volunteers to manage and staff their clubs (Lamprecht, Fischer, & Stamm, 2012). In order to facilitate volunteer recruitment, sport clubs need a specific strategy to recruit and retain volunteers for both formal positions and ad hoc tasks. Therefore, the intervention “More Volunteers in Football Clubs” was designed and its impact was evaluated in detail. The question this evaluation research wants to address is: Can football clubs recruit and retain volunteers successfully by implementing the intervention “More Volunteers in Football Clubs”? The designed intervention is based on the different expectations and needs of volunteers, as well as non-profit human resource management and organisational development management, with a strong emphasis on club-specific counseling and support. Task forces of the twelve participating football clubs attended four workshops in which they received tailor made counseling to reach the desired number of volunteers. The intervention has been implemented and its effectiveness tested in cooperation with the Swiss Football Federation with twelve Swiss football clubs following a pretest, intervention, posttest design Data have been gathered and analysed using a combination of qualitative and quantitative methods. Outcome measurements are: volunteer rate, number of recruited volunteers, number of filled volunteer positions and volunteer satisfaction. Four months after the intervention all clubs that completed the proposed intervention were successful in recruiting the desired number of volunteers. Further, all participating clubs found the intervention helpful and would recommend other clubs to participate as well. With the development of this practical intervention a solution for football clubs is provided to overcome the difficulties in recruiting and retaining sufficient numbers of volunteers. Lamprecht, M., Fischer, A., & Stamm, H.-P. (2012). Sportvereine in der Schweiz. Strukturen, Leistungen, Herausforderungen. Zürich, Switzerland: Seismo.