Iowa Cultural Leadership Partners 2013 Interview Highlights, September 2013

The Cultural Leadership Partners Program of the Iowa Arts Council and Iowa Department of Cultural Affairs (IAC/DCA) engages leaders in Iowa’s arts and cultural community that have demonstrated an exemplary record of programming and managerial excellence, as well as exceptional community service to the citizens of Iowa on a year-round basis. After a rigorous application process, organizations selected to become Cultural Leadership Partners (CLPs) receive annual operating support from IAC/DCA. This document will not only serve to communicate to CLPs what the IAC/DCA has learned from these conversations, but that it will act as a catalyst for further development of the program and inform how IAC/DCA can support, challenge, connect, and partner with Iowa’s leading arts and cultural institutions.

Diagnostic interview for genetic studies (DIGS): inter-rater and test-retest reliability of alcohol and drug diagnoses

The semi-structured diagnostic interview for genetic studies (DIGS) was developed to assess major mood and psychotic disorders and their spectrum manifestations in genetic studies. Our research group developed a French version of the DIGS and tested its inter-rater and test-retest reliability in psychiatric patients. In this article, we present estimates of the reliability of substance use and antisocial personality disorders. High kappa coefficients for inter-rater reliability were found for drug and alcohol as well as antisocial personality diagnoses and slightly lower kappas for test-retest reliability. Combined with evidence of the reliability of major mood and psychotic disorders, these findings support the suitability of the DIGS for studies of familial aggregation and comorbidity of psychiatric disorders including substance use and antisocial personality disorders.

The parties' voices in a therapeutic interview

Drawing on a dialogical approach inspired by Bakhtin, we start from the assumptionthat a concrete discussion is an intermingling between dialogue in praesentia and dialogue inabsentia, and we refer to the notion of 'enunciative positioning' to account for the variousrelations that a speaker may express towards the voices that he or she invokes. Our data arebased on a first therapeutic interview between a therapist, a mother and a child in a counselingcenter for children and adolescents. We identify the various voices invoked in this interviewand show that three levels of discursive process were involved: (a) the speakers invokedabsent speakers; (b) at the same time they developed their own discourse on the basis of theirinterlocutors' discourse which (c) itself drew on absent speakers or voices. We highlight thevarious discursive processes through which the speakers integrate their own voice into absentvoices, or integrate a distant voice so that it loses its property of being a distant (andborrowed) voice. As a theoretical and methodological contribution to dialogism, our resultsshow that absent voices and their specific intermingling with hic et nunc exchanges were amajor resource for therapeutic changes.

Prevalence of substance use in a Swiss psychiatric hospital: interview reports and urine screening.

BACKGROUND: Co-morbid substance misuse is common in psychiatric disorders, has potentially severe adverse consequences and may be frequently undetected. AIMS: To measure the prevalence of substance use among patients admitted to a Swiss psychiatric hospital and to examine the potential utility of routine urine drug screening in this setting. METHOD: 266 inpatients were included. 238 patients completed the interview and 240 underwent a urine drug screening. RESULTS: Lifetime prevalence of substance use among psychiatric patients was very high for alcohol (98%; 95% CI: 96-100), benzodiazepines (86%; 95% CI: 82-91) and cannabis (53%; 95% CI: 47-60), but also for "hard drugs" like cocaine (25% ; 95% CI: 19-30) or opiates (20%; 95% CI: 15-25). Regular current use of alcohol (32%; 95% CI: 26-38) or cannabis (17%; 95% CI: 12-22) was the most frequent. Substance use was associated with male sex, younger age, unmarried status and nicotine smoking. Urine screening confirms reports from patients on recent use, and remained positive for cannabis during hospitalisation, but not for cocaine nor for opiates. CONCLUSION: Substance use is frequent among psychiatric patients. Systematic interviewing of patients about their substance use remains essential, and is usually confirmed by urine screening. Urine screening can be useful to provide specific answers about recent use.

Smiling in a job interview: When less is more

Two studies examined the effect of applicants' smiling on hireability. In a pre-test study, participants were asked to rate the expected behavior for four types of applicants. Newspaper reporter applicants were expected to be more serious than applicants for other jobs. In Study 1, participants were randomly assigned to be an applicant or interviewer for a newspaper reporting job. Smiling was negatively related to hiring, and smiling mediated the relation between applicants' motivation to make a good impression and hiring. Hiring was maximized when applicants smiled less in the middle of the interview relative to the start and end. In Study 2, participants watched Study 1 clips and were randomly assigned to believe the applicants were applying to one of four jobs. Participants rated more suitability when applicants smiled less, especially for jobs associated with a serious demeanor. This research shows that job type is an important moderator of the impact of smiling on hiring.

Pediatric advance care planning from the perspective of health care professionals: a qualitative interview study.

BACKGROUND: Pediatric advance care planning differs from the adult setting in several aspects, including patients' diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals' perspective. AIM: We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. DESIGN: This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. SETTING/PARTICIPANTS: We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. RESULTS: Perceived problems with pediatric advance care planning relate to professionals' discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor's advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. CONCLUSION: Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers.

Safety Culture and Maritime Personnel’s Safety Attitudes: Interview Report

”METKU –projektissa” (Merenkulun turvallisuuskulttuurin kehittäminen) tutkitaan kansainvälisen turvallisuusjohtamiskoodin (ISM-koodin) vaikutuksia merenkulun turvallisuuteen ja etsitään kehittämiskohteita merenkulun turvallisuusjohtamisen parantamiseksi. Tämä haastatteluraportti on laadittu METKU –projektin yhteistyössä työpakettien 1 ja 2 kesken. Tähän raporttiin haastateltiin yhteensä 94 merenkulun ammattilaista. Suurimman osan haastateltavista muodostivat aktiiviset merenkulkijat: miehistön jäsenet, päällystö ja alusten päälliköt. Haastattelukohteena oli seitsemän suomalaista varustamoa. Haastatteluissa kerättiin merenkulkijoiden kokemuksia ja mielipiteitä ISM-koodin vaikutuksesta heidän käytännön työhönsä. Suomalaiset merenkulkijat uskovat, että tänä päivänä varustamoiden johtajat ovat hyvin sitoutuneita turvallisuuteen. Myös miehistön asenteet turvallisuuteen ovat ISM-koodin käytön myötä parantuneet. Haasteltavien yhteinen huoli kohdistui jatkuvan parantamisen toimivuuteen. Kaikki haastatellut ryhmät olivat samaa mieltä siitä, että poikkeamien raportointi ei ISMkoodin vaatimuksesta huolimatta toimi kunnolla. ISM-koodin käyttöön otosta on ollut merenkululle selkeää hyötyä. Haastateltavat esittivät hyötyinä parantuneen yhteistyön ja tiedonkulun alusten ja varustamon välillä sekä sen, että merenkulun toiminnan laatu on parantunut. Monet haastateltavat korostivat, että ISM-koodin selkeät turvallisuusvastuut yhtiölle on ollut merkittävä hyöty. Itse ISM-koodiin merenkulkijoilla ei ollut juurikaan huomauttamista. Sen sijaan turvallisuusjohtamisen käytännön toteutuksessa nähtiin parantamisen varaa. ISMkoodin aiheuttamina ongelmina mainittiin mm. lisääntynyt byrokratia ja liian monimutkaiset ja yksityiskohtaiset turvallisuuskäsikirjat. Monet haastateltavat toivovat, että ISM-koodin käytännön soveltamiseen laadittaisiin ohjeita.