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This paper provides an overview of Jacques Lacan's views on psychology, paying particular attention to how such critiques support a distinctively Lacanian view of the subject. Lacan attacked various facets of psychology, including: psychology's objectifying (and objectivistic) tendencies; the discipline's historical attempt to model itself on the natural sciences; its conceptual and practical prioritizations of the ego and consciousness; its frequent prioritization of developmental, biological and physiological paradigms above a careful analysis of the structures and operations of language and speech. The aim of the paper is not to systematically work through Lacan's various criticisms, still less to refute them. Ultimately, Lacan's historical attacks against psychology-apposite as they are-have their greatest value in helping us to strike some distance from commonplace assumptions and psychological assumptions about the nature of the subject. [ABSTRACT FROM AUTHOR]

Objectives This paper reviews why and how theories of agency can be used as analytical lenses to help health professions education ( HPE) scholars address our community's wicked problems. Wicked problems are those that resist clear problem statements, defy traditional analysis approaches, and refuse definitive resolution (e.g. student remediation, assessments of professionalism, etc.). We illustrate how theories of agency can provide new insights into such challenges by examining the application of these theories to one particular wicked problem in HPE: interprofessional education ( IPE). Methods After searching the HPE literature and finding that theories of agency had received little attention, we borrowed techniques from narrative literature reviews to search databases indexing a broad scope of disciplines (i.e. ERIC, Web of Science, Scopus, MEDLINE and PubMed) for publications (1994-2014) that: (i) examined agency, or (ii) incorporated an agency-informed analytical perspective. The lead author identified the theories of agency used in these articles, and reviewed the texts on agency cited therein and the original sources of each theory. We identified 10 theories of agency that we considered to be applicable to HPE's wicked problems. To select a subset of theories for presentation in this paper, we discussed each theory in relation to some of HPE's wicked problems. Through debate and reflection, we unanimously agreed on the applicability of a subset of theories for illuminating HPE's wicked problems. This subset is described in this paper. Results We present four theories of agency: Butler's post-structural formulation; Giddens' sociological formulation; cultural historical activity theory's formulation, and Bandura's social cognitive psychology formulation. We introduce each theory and apply each to the challenges of engaging in IPE. Conclusions Theories of agency can inform HPE scholarship in novel and generative ways. Each theory offers new insights into the roots of wicked problems and means for contending with them. [ABSTRACT FROM AUTHOR]

The paper discusses how the condition of crossed-eyes affects a baby's eye contact with mother and potentially results in the loss of a vital emotional connection with her during the earliest days of life. This loss may contribute to a rupture that arrests emotional development at a deep psychic level. It is suggested that, in the same way as premature separation, the rupture can precipitate a 'fusional complex', a defence that develops to protect the infant against psychotic anxieties. The paper proposes that psychological development atrophies in this place and creates a blind spot. These ideas are explored through analytic theory and developmental literature. The dreams of a patient and his art are used to illustrate a 10-year 'alchemical' process of bringing repressed material into consciousness and transformation. Healing the psychological wounds of deficits in early eye contact may be found to bring sight to a blind spot that was created by the nature of the condition itself. [ABSTRACT FROM AUTHOR]

Research on the effects of rewards on creativity has resulted in hundreds of empirical studies and several reviews of the reward-creativity relationship (RCR). Most reviews are retrospective in nature. They have quantitatively summarised and integrated previous research findings, but have largely overlooked the need for a theoretical framework to guide future research. The current systematic review of this literature intends to bridge this gap, based on the findings of 329 papers and book chapters. Our review summarises the theoretical developments in reward-creativity (RC) research, and classifies the literature in three distinct phases, i.e. the emergence of the cognitive perspective; behavioural rebuttal, and convergence. The paper identifies three important gaps in the existing RC literature: (1) the moderating effects of individual, group, organisational, and national-level factors; (2) the mediating role of cognitive and affective states; and (3) the lack of consideration of creativity as a multidimensional construct. Based on these gaps, the paper presents a four-factor framework to guide future RC research. It identifies potential moderators and mediators of the RCR, and draws attention to creativity as a multidimensional construct. [ABSTRACT FROM AUTHOR]

Aim: Careful study and accurate description of behaviour are important to understand developmental challenges for individuals with Cornelia de Lange syndrome (CdLS). Here we present a systematic review of current understanding of behaviour in CdLS.Method: A systematic search was performed for articles published between January 1946 and December 2015 evaluating autism, self-injury, and/or cognition in CdLS. After study-selection, 43 papers were included. The Cochrane quality criteria were adjusted to assign quality scores to the included studies.Results: Participants were mostly categorized in the severe/profound developmental level. Methodology and quality were very heterogeneous, as well as reporting occurrence of autism. Self-injurious behaviour was reported in 15 papers. Physical conditions were reported in 21 studies, mostly related to hearing and vision. Only nine studies mentioned details about medication.Interpretation: Comparison of presented results was hindered by heterogeneous assessment methods. Improving our understanding of behavioural characteristics in CdLS requires more uniform methodology. We propose a criterion standard of instruments that can ideally be used in assessment of behaviour and development. This will improve understanding of behaviour in the context of developmental level and daily functioning. [ABSTRACT FROM AUTHOR]

Social workers working to protect children face the prospect of making very finely balanced judgements, often on the basis of incomplete information. Based on doctoral research into sense‐making by social workers, this paper explores aspects of the tipping point, i.e. where the categorization of a child's situation changes, potentially leading to a very different response to their needs. Those aspects include identifying the triggers for, and consequences of, the tipping point, and being aware that the tipping point being reached may have to do with changes in the internal world of the worker as well as changes in the circumstances of the family. This paper stresses the need for a more nuanced understanding of the tipping point, and emphasizes the need to take account of the processes of decision‐making, and of looking at both inter‐ and intra‐personal components of those processes. Further, it is argued that a cautious attitude requires to be taken towards technical–rational solutions and that there is a real need to place professional judgement and consideration of the tacit dimension at the heart of the child protection process. [ABSTRACT FROM AUTHOR]

Background and Aims Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus upon psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence. Methods We searched PubMed, Scopus, PsychINFO and CINAHL to December 2014, which yielded 852 papers. Using pre-established eligibility criteria, we identified papers focused on clinical issues and motivational mechanisms underlying smoking in established, adult smokers (i.e. maintenance, quit attempts and cessation/relapse) with elevated symptoms of depression. Two reviewers determined independently whether papers met review criteria. We included 297 papers in qualitative synthesis. Results Our review identified three primary mechanisms that underlie persistent smoking among depressed smokers: low positive affect, high negative affect and cognitive impairment. We propose a novel application of incentive learning theory which posits that depressed smokers experience greater increases in the expected value of smoking in the face of these three motivational states, which promotes goal-directed choice of smoking behavior over alternative actions. Conclusions The incentive learning theory accounts for current evidence on how depression primes smoking behavior and provides a unique framework for conceptualizing psychological mechanisms of smoking maintenance among depressed smokers. Treatment should focus upon correcting adverse internal states and beliefs about the high value of smoking in those states to improve cessation outcomes for depressed smokers. [ABSTRACT FROM AUTHOR]

Stigma is a problem for individuals with eating disorders (EDs), forming a barrier to disclosure and help-seeking. Interventions to reduce ED stigma may help remove these barriers; however, it is not known which strategies (e.g., explaining etiology to reduce blame, contact with a person with an ED, or educating about ED) are effective in reducing stigma and related outcomes. This review described effectiveness of intervention strategies, and identified gaps in the literature. A search of four databases was performed using the terms (eating disorder* OR bulimi* OR anorexi* OR binge-eating disorder) AND (stigma* OR stereotyp* OR beliefs OR negative attitudes) AND (program OR experiment OR intervention OR education), with additional texts sought through LISTSERVs. Two raters screened papers, extracted data, and assessed quality. Stigma reduction strategies and study characteristics were examined in critical narrative synthesis. Exploratory meta-analysis compared the effects of biological and sociocultural explanations of EDs on attitudinal stigma. Eighteen papers were eligible for narrative synthesis, with four also eligible for inclusion in a meta-analysis. Biological explanations reduced stigma relative to other explanations, including sociocultural explanations in meta-analysis ( g = .47, p < .001). Combined education and contact interventions improved stigma relative to control groups or over time. Most studies examined Anorexia Nervosa (AN) stigma and had mostly female, undergraduate participants. Despite apparent effectiveness, research should verify that biological explanations do not cause unintentional harm. Future research should evaluate in vivo contact, directly compare education and contact strategies, and aim to generalize findings across community populations. [ABSTRACT FROM AUTHOR]

This paper draws on a British Academy (BA) funded study exploring social workers' conceptions of family using a vignette and focus groups. The policy context is discussed and the data from the BA study are then compared and contrasted with families' accounts of their own situations using the data from a separate qualitative study about child protection social work. The paper discusses the themes emerging and argues for a renewed focus on theorizing family in children's social work and the implications for practice. [ABSTRACT FROM AUTHOR]

Although a widely accepted term in child welfare discourses, there remains a vagueness as to what Family Support as a named orientation in children and family services actually entails. This lack of clarity is, at times, used to detract from its usefulness within the policy and practice arena. Using the accumulated wisdom of a select group of accomplished managers, academics and policy makers in social work and social care, this paper retrospectively reviews the evolution of Family Support within the Irish context and distils the core characteristics of Family Support practice and service delivery. An unstructured narrative inducing interview was conducted with 14 veterans of Family Support and child welfare. Participants who are based in the USA, the UK and Ireland each had between 30 and 60 years' experience working in this field. Salient factors were identified by participants as having contributed to the growth of Family Support. Specific and distinct characteristics of Family Support practice and services were also categorized by these veterans, providing voice and meaning to Family Support as a specific approach. This paper addresses the debate on Family Support with its place as an accepted and valued orientation within the child welfare arena acknowledged. [ABSTRACT FROM AUTHOR]

This paper presents data from a qualitative case study of a family support service, support care. As a time‐limited service that aims to enable positive change within families and involves children and parents spending time apart, aspects of time feature prominently in understandings and experiences of the service. This paper uses the concept of time as a lens to explore some of the organizing principles and underlying assumptions of this service. Eighty‐two qualitative interviews and 22 participant observation sessions were undertaken with stakeholders engaged in support care. This paper examines the variety of ways in which time was understood and experienced over the course of the research. This includes a conceptualization of time as a resource, together with the hopes, expectations and concerns attached to the time provision. It is argued that the service‐specific questions regarding how much time to afford families, and the purpose of support have wider relevance within social work policy and practice. This includes debates about how best to respond to families with support needs, including those with enduring needs, how to manage tensions in respect of balancing need while seeking to avoid dependency and the sometimes competing nature of support and protection objectives. [ABSTRACT FROM AUTHOR]

This paper reports part of the findings from a 2014 audit of shelters for street children conducted in four provinces of South Africa. The paper focuses on the assessment of the types, structure and implementation of the programmes, as well as on the adequacy of resources necessary for implementing the programmes. The overall picture that emerged from the assessment was that all shelters draw on a comprehensive and enabling legislative and policy framework to offer some elements of developmental, therapeutic and recreational programmes at the early intervention level. Overall, however, the implementation of the programmes does not effectively take into consideration the varied and interconnected factors that, within and across multiple social systems, impel children to the streets. It was thus apparent that the programmes do not adequately address the risks and opportunities of street children in South Africa, specifically within the eco‐developmental framework. Recommendations are offered for social work policy and practice to further enhance the quality and impact of programmes offered in the shelters. [ABSTRACT FROM AUTHOR]

Listening analytically is not listening just to what is said but listening to what is just below the surface waiting to be said. This paper looks at Jung's insight into a 'third thing' being created intra-psychically and within the analytic encounter. Ogden's concept of an 'analytic third' is used to describe the clinical aspects of this thirdness. This paper explores: how the state of thirdness is created and accessed through use of reverie and associative dreaming; how the material emerging from it is used in a from or about manner; and the eventual fate of the third in a successful analysis by a reexamination of plates four and ten of the Rosarium. The focus is particularly on the awareness and possible meanings of mythological motifs appearing in the mind of the analyst while in session. Thirdness can be viewed as the interpersonal aspect of the anima media natura and functions in a way that informs us of permeability in and between individuals, while the operation of the anima mundi means that there is always an inseparability of the individual with the world. [ABSTRACT FROM AUTHOR]

Rural development refers to diverse attempts being made to address the problems of rural communities. In Finland, rural development leans heavily on entrepreneurship and small business development. Rural development processes have a strong social psychological component that entails that psychological knowledge is crucial for rural development agents. Nevertheless, psychological knowledge has also been criticised for simplifying highly complex development processes and overstating the role of internal psychological factors. In this paper, we argue that, regarding the relevance and utility of psychological knowledge, the question is not only how extensively different factors are taken into account but also how knowledge about psychological factors is read and interpreted. In this paper, we focus on Finnish rural business owners' values and demonstrate that value survey data can be read from two different social psychological perspectives: those of substantialism and relationalism. Although data and the conducted analyses are kept constant, the two readings produce differing types of knowledge of rural business owners' values; one reveals what business owners 'truly' are like and the other informs how to best communicate with business owners. Both readings are potentially useful for rural development work. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Culturally focused research has gained momentum in many disciplines, including psychology. However, much of this research fails to pay attention to the unconscious dynamics that underlie the study of culture and culturally influenced human beings. Such dynamics may be especially significant when issues of marginalization and oppression are present. Therefore, this paper seeks to contribute a framework for understanding cultural dynamics, especially unconscious cultural dynamics, within depth psychological qualitative research influenced by Jungian and post-Jungian scholarship. Inquiry that is approached with a commitment to making the unconscious conscious seeks to empower and liberate not only the subject/object studied but also the researchers themselves. Following a brief review of multiculturalism in the context of analytically informed psychology, this paper offers several case examples that focus on researchers' integration of awareness of the cultural unconscious in their study of cultural beings and topics. [ABSTRACT FROM AUTHOR]

Summary: Network science is an emerging area of complexity science that uses mathematical techniques to study complex systems and could represent a new way of quantifying and investigating the internal structure of domain‐specific knowledge as approximated by students' concept maps. Students enrolled in introductory psychology constructed concept maps to represent their understanding of a psychology chapter. Concept networks were constructed based on the concept maps generated by students. Network analysis revealed that the structure of concept networks differed across students (i.e., some networks were better connected than others), and network structure significantly predicted quiz scores, such that concept networks with larger average shortest path lengths (a network metric representing the average of the shortest paths between two nodes in a network) were associated with higher quiz scores, after controlling for network size. This paper illustrates how network science techniques can be used to quantify the conceptual structure of a learner's knowledge. [ABSTRACT FROM AUTHOR]

Addressing the emotional side of diabetes and its management has received considerable attention in recent years. At the centre of most of these efforts is the concept of 'diabetes distress', a generic term that captures the primary sources and intensity of emotional distress associated with diabetes and its management over time. As interest in diabetes distress has grown, however, it has been difficult to integrate and translate the various strands of clinical research in a manner that can guide diabetes distress intervention efforts in the real world of clinical care. The aim of this paper is to fill this gap by outlining practical strategies for intervention in clinical settings and to assist diabetes healthcare professionals in thinking through how diabetes distress might be addressed practically in their clinics. To address these goals, this review is divided into five sections: a definition of diabetes distress, ways diabetes distress can be assessed and monitored, information about diabetes distress for use in intervention planning, topics to be considered for inclusion in diabetes distress interventions, and alternatives for where in the care process a diabetes distress intervention might be considered. We focus on diabetes distress experienced by adults with both Type 1 and Type 2 diabetes. What's new?: As interest in diabetes distress has grown it has been difficult to integrate and translate the various strands of clinical research in a manner that can guide diabetes distress intervention efforts in the real world of clinical care.We outline practical strategies for intervention in clinical settings to assist diabetes healthcare professionals in thinking through how diabetes distress might be addressed practically in their clinics: programmes for highly distressed individuals; programmes centred around diabetes‐specific events, including information about distress to programmes of diabetes education; and incorporating distress content into all clinical contacts.We also provide a five‐step programme on distress content for use in clinical settings: assess distress regularly and systematically, focus on feelings and expectations, provide a new perspective, plan and follow‐up. [ABSTRACT FROM AUTHOR]

In 2015 Robert Veatch published the second edition of his Transplantation ethics, this time together with Lainie Ross. The chapters on postmortem organ procurement distinguish between 'giving' and 'taking' systems, and argue that 'taking' systems may promise a greater yield of organs for transplantation, but inevitably violate a requirement of respect for the deceased's autonomy. That argument has been very influential, and is also representative of a way of thinking that is widespread in the literature and in public debate. In this paper I contend that it is conceptually flawed in a number of important respects. These concern the understanding of both the concept of 'consent' and the requirement of respect for autonomy, the role of the relatives in any procurement system, and the factors that actually determine the extent to which a system respects autonomy, under any interpretation of that requirement. [ABSTRACT FROM AUTHOR]

Context: For centuries now, the operating room (OR) has been the environment in which surgical trainees come to master procedures. Restricted working hours and insufficient levels of autonomy at the end of their training necessitate a shift towards alternative effective learning strategies. Self‐regulated learning is a promising strategy by which surgical trainees can learn more with fewer exposures. However, the challenge is to understand how surgical trainees regulate their learning in the clinical context of the OR. Objectives: The purpose of this study is to identify and understand the strategies of surgical trainees in engaging their supervisors for learning purposes and how these strategies contribute to effective learning. Methods: Total hip replacement procedures performed by four surgical trainees and their supervisors were videotaped. Using the iterative inductive process of conversation analysis, each verbal initiative to engage the supervisor was identified, analysed ('why that now') and categorised. Results: Surgical trainees used a range of practices to engage supervisors and recruit expertise, ranging from explicit recruitment to implicit hints. We identified four major categories. Surgical trainees: (i) invite the supervisor to provide an evaluation of the ongoing task; (ii) express an evaluation of the ongoing task and then explicitly invite the supervisor to provide an evaluation; (iii) express an evaluation of the ongoing task and then invite the supervisor to provide confirmation, and (iv) express an evaluation of the ongoing task without engaging the supervisor. Conclusions: Surgical trainees recruit expertise from supervisors using practices of four different categories. Trainees' actions are provoked by the moment at which they experience insufficient expertise and are focused on the task at hand in the immediate present. Supervisors can and do elaborate on these requests to provide explicit teaching. Insight into these practices provides tools for reflection on OR learning, proficiency assessment and deliberation to adapt guidance in the real time of the procedure. Trainees' success at drawing upon the expertise of their supervisors plays a substantial role in determining the learning benefits derived from clinical encounters. This paper outlines four types of practice students use. [ABSTRACT FROM AUTHOR]

Airway management is a cornerstone of emergency care. Development of a robust evidence base to support the practice of pre‐hospital emergency anaesthesia is key to the safety and evolution of this common but high‐risk procedure. This paper discusses the benefits, risks, insights, learning and limitations of the use of an airway registry in pre‐hospital and retrieval medicine, for both research and quality improvement purposes. [ABSTRACT FROM AUTHOR]

Purpose: Humans evolved within the mammalian line as a highly social species. Indeed, sociality has been a major driver of human social intelligence. From birth, social relationships have emotional and self‐regulating properties and operate through different body systems. This paper will explore how heart rate variability (HRV), an index of the vagal regulation of the heart and a central element of the physiological underpinnings of sociality, is related to mental health problems, with important implications for psychotherapy. Methods: We conducted a narrative review of the literature on the bi‐directional links between prosocial motivations, HRV, and psychophysiological functioning. Results: HRV is associated not only with the ability to downregulate physiological arousal, but also with a variety of psychological and behavioural variables which are usually the target of psychotherapeutic interventions. A modern neurovisceral integration model can be employed to explain the complex intercorrelation between HRV and psychophysiological functioning. In particular, the link between HRV, the experience of inter‐ and intrapersonal safeness, and the inhibitory function of the prefrontal cortex will be explored in the context of prosocial motives, such as compassion, that alleviate and help prevent mental health difficulties. Conclusions: Our knowledge of the social brain and its physiological underpinnings might influence important elements of a therapeutic intervention, from the initial assessment of patient's difficulties to the evaluation of therapy outcomes. Practitioner points: Social relationships have emotional and self‐regulating properties.The experience of inter‐ and intrapersonal safeness is connected to prosocial motives, such as compassion, and the inhibitory function of the prefrontal cortex.Social relationships and compassion influence different body systems, such as the vagus nerve.Many forms of psychopathology represent the activation of evolved, defensive strategies especially in contexts where there are few stimuli indicating safeness and social support.Heart rate variability predicts psychotherapy outcome. [ABSTRACT FROM AUTHOR]

Fragmentation of processes and interventions plague the psychotherapies (Gilbert & Kirby,). Part of the problem is that we have not agreed on a framework that could be the basis for integrating knowledge and the scientific enquiry of processes and interventions. This paper outlines an approach that brings together a variety of different disciplines in the service of consilience (Wilson, , Consilience: The unity of knowledge, Vintage, New York, NY; Siegel,). It presents the importance of an evolutionary framework for understanding the proclivities and dispositions for mental suffering and antisocial behaviour, and how they are choreographed in different sociodevelopmental contexts. Building on earlier models (Gilbert, , Human nature and suffering, Routledge, London, UK; Gilbert, , Clin. Psychol. Psychother., 2, 135; Gilbert, , Br. J. Med. Psychol., 71, 353; Gilbert, , Case formulation in cognitive behaviour therapy: The treatment of challenging cases, Wiley, Chichester, UK, pp. 50–89) the call is for an integrative, evolutionary, contextual, biopsychosocial approach to psychology and psychotherapy. Practitioner points: Evolutionary functional analysis is part of an evolutionary, contextual, biopsychosocial approach to mental health that can serve as a scientific platform for the future developments of psychotherapy.Therapist skills and training will increasing need to focus on the multidimensional textures of mental states especially the context‐social‐body linkages.Therapies of the future will also focus more on the moral aspects of therapy and address the need to promote prosocial and ethical behaviour to self and others. [ABSTRACT FROM AUTHOR]

Objectives: There is considerable evidence that early parenting has profound effects on a range of physiological and psychological maturation processes. Furthermore, psychotherapy often addresses some of the distortions and developmental difficulties that have arisen from early childhood. While research has focused on obvious candidates such as abuse and neglect, this paper reviews some of the core themes related to a less investigated area, specifically parental shame on child development. Role shame sensitive parenting styles will be explored against an evolutionary background that contrasts early human and modern human rearing contexts. We also outline a study examining the role of shame in psychological controlling and dysfunctional parenting styles, its relationship to different dimensions of shame and fears of compassion. Design: An online survey was conducted containing self‐report measures of dysfunctional parenting styles, three dimensions of shame (external, internal, and reflected), fears of compassion, mental health indices, and a measure of psychological flexibility. Methods: An online survey was accessed by 333 parents (306 being female) with a child between the ages of 3–9 years. Results: Two hierarchical multiple regressions indicated support for our two primary hypotheses, with shame explaining significant variance in both psychological controlling and dysfunctional parenting styles over and above that explained by psychological inflexibility, parental mental health, and fears of compassion. Additionally, results from standard multiple regressions indicated that fears of compassion account for significant variance in external shame, as well as internal and reflected shame. Conclusions: Recommendations for future research include focusing on parental motivation in order to help support parents and children are provided. Practitioner points: Shame is a major factor for how parents engage in parenting practices and respond to their childrenPractitioners need to be sensitive to the shame parents can experience and asses for itAssessing shame‐threat in parenting and shifting to compassionate motivation can lead to more responsive and positive parenting [ABSTRACT FROM AUTHOR]

Background: Longitudinal cohort studies gather large amounts of data over time, often without direct benefit to participants. A positive experience may encourage retention in the study, and participants may benefit in unanticipated ways. Objective: To explore first‐time mothers' experiences of taking part in a longitudinal cohort study and completing self‐administered surveys during pregnancy and at 3, 6, 9 and 12 months' postpartum. Design: Content analysis of comments written by participants in the Maternal health And Maternal Morbidity in Ireland study's five self‐completion surveys, a multisite cohort study exploring women's health and health problems during and after pregnancy. This paper focuses on what women wrote about taking part in the research. Ethical approval was granted by the site hospitals and university. Setting and participants: A total of 2174 women were recruited from two maternity hospitals in Ireland between 2012 and 2015. Findings: A total of 1000 comments were made in the five surveys. Antenatally, barriers related to surveys being long and questions being intimate. Postpartum, barriers related to being busy with life as first‐time mothers. Benefits gained included gaining access to information, taking time to reflect, stopping to think and being prompted to seek help. Survey questions alone were described as valuable sources of information. Discussion and conclusions: Findings suggest that survey research can "give back" to women by being a source of information and a trigger to seek professional help, even while asking sensitive questions. Understanding this can help researchers construct surveys to maximize benefits, real and potential, for participants. [ABSTRACT FROM AUTHOR]

Elevated levels of suicide risk among transgender youth have alarmed both public health officials and researchers from various disciplines. Despite nursing's robust involvement in suicide research, literature reviews indicate a lack of nursing research focused on suicide among transgender youth. Most of the existing literature pertain to predictive factors in either the individual or environmental domain. There is limited research examining how interactions with the environment in of itself might be a predictive factor. This paper treats the subject of suicide risk among transgender youth with a heuristic inquiry into person–environment interaction. The Society to Cell Resiliency Framework and Social Self Preservation Model were used to inform exploration of how person–environment interactions might be associated with suicide risk. Implications of this framework will be discussed in terms of how it may affect advancements in nursing education, practice, and research with transgender youth. [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by hyperactivity, inattention and impulsivity. Up to two thirds of young people with ADHD may experience symptoms into adulthood, yet the limited literature available suggests that many young people with ongoing needs do not transfer from child to adult healthcare services. Although worldwide and NICE guidelines recognise the importance of supported transition, evidence suggests for ADHD that this is poorly managed and variable. Little is known about how transition is experienced by those involved. We aimed to synthesise existing peer‐reviewed literature to understand views and experiences of young people, carers and clinicians on transitioning between child and adult ADHD services. Method: Five databases were searched and all articles published between 2000 and up until January 2017 considered. Four key search areas were targeted; ADHD, Transition, Age and Qualitative Research. Quality appraisal was conducted using Wallace criteria. Findings from included studies were synthesised using thematic analysis. Results: Eight papers, six from the UK and one each from Hong Kong and Italy, were included. Emerging themes centred on difficulties transitioning; hurdles that had to be negotiated, limitations of adult mental health services, inadequate care and the impact of transition difficulties. Conclusions: Healthcare transition for this group is difficult in the United Kingdom because of multiple challenges in service provision. In addition to recommendations in NICE guidelines, respondents identified a need for better provision of information to young people about adult services and what to expect, greater flexibility around age boundaries and the value of support from specialist adult ADHD services. More research is needed into ADHD healthcare transition experiences, especially in countries outside the United Kingdom, including accounts from carers and clinicians. [ABSTRACT FROM AUTHOR]

A growing body of evidence indicates that the effects reported in many scientific fields may be overestimated or even false. This problem has gained a lot of attention in the field of psychology, where researchers have even started to speak of a 'replication crisis'. Fortunately, a number of measures to rectify this problem have already been proposed and implemented, some inspired by practices in other scientific fields. In this review, I briefly examine this issue in the field of psychology and suggest some practical tools and strategies that researchers can implement to increase replicability and the overall quality of their scientific research. WHAT THIS PAPER ADDS: Researchers can implement many practical tools and strategies to improve replicability of their findings. Strategies include improving statistical inference, pre-registration, multisite collaboration, and sharing data. Different scientific fields could benefit from looking at each other's best practices. [ABSTRACT FROM AUTHOR]

This article uses ethnographic methods to explore how transgender people engage the medicalisation of transgender experience in a U.S. context under the purview of the American Psychiatric Association. Building on sociological literature related to medicalisation, this paper argues that the lived experience of medicalisation is a non‐linear, complex process whereby individual engagement with medical authority is both empowering and constraining in the lives of trans people. Inductive qualitative analysis of 158 hours of participant observation and 33 in‐depth interviews with members of a transgender community organisation revealed that transgender individuals (i) reject a medical frame for gender dysphoria, (ii) embrace and stress the importance of gender‐affirming medical technologies for individual identity development and social interaction and (iii) strategically reintroduce medical logics and embrace medical authority in order to facilitate medical and social recognition, validation and acceptance. [ABSTRACT FROM AUTHOR]

This paper examines how gender dynamics shape human tissue donation for research and for human health. Drawing on research investigating the donation of different types of bodily tissues including blood, plasma, breastmilk, cord blood, foetal tissue and placentae we consider how and why women and men are viewed as different kinds of donors. We situate these donation practices within a broader understanding of gender difference to explain why any sociology of donation needs to take account of gender. In so doing we explore how tissue derived from the bodies of women acquires value in distinctive ways and for distinctive purposes and reasons. Within these gendered bioeconomies of donation, the supply and demand for tissue is structured by social understandings of maternity, parental responsibility, and risk, which in turn affect the experiences of donors. [ABSTRACT FROM AUTHOR]

Purpose: The theory of attachment has informed our understanding of survival and well‐being throughout the lifespan. There is a growing interest in the relationship between attachment and symptoms of post‐traumatic stress (PTS). Emerging evidence points to important links between attachment and PTS, yet current theoretical and clinical understandings of PTS symptoms and attachment remain relatively disparate. The current systematic review aimed to synthesize, describe, and critique evidence demonstrating the links between attachment and PTS in adults. It also aimed to explore whether the relationship between attachment and PTS differs according to the nature of the traumatic event. Methods: Searches were conducted using PsycINFO, the Cochrane Library, Medline, and Google Scholar to identify empirical studies focusing on PTS in adults. Results: Twenty‐one papers were identified. Attachment was shown to have moderating and mediating influences on the relationship between trauma and PTS. This varied according to the type of trauma, and how symptoms of PTS were reported across the different attachment styles. Methodological rigour varied across studies. Clinical and research implications are discussed, including the consideration of attachment security in assessment and formulation. Conclusions: Although findings were mixed, this review suggests that there is an important link between attachment and PTS. It supports the current emerging evidence demanding the development of a more unified theoretical framework for attachment, types of trauma, and symptoms of PTS. Practitioner points: The findings discussed in this review have important implications for the treatment of PTS symptoms.Consideration of attachment styles in formulations is likely to inform treatment plans.There is increasing evidence to suggest that assessing and accounting for attachment style in therapy may improve the chances of successful treatment. [ABSTRACT FROM AUTHOR]

Background: The benefits of social support for caregivers raising a child with a disability have been identified in the literature. These benefits include the improvement of the mental and physical well‐being of the caregivers, improvement in caregiving styles, and overall improvement of family quality of life. Whilst the benefits of social support are widely reported, the definitions and measures of social support in the literature are varied. Method: A scoping review was therefore undertaken to identify and describe the tools used to measure social support of primary caregivers (i.e., parents or grandparents) raising a child (0–18 years) with a congenital disability in international studies. Ten databases were systematically searched. Results: Sixteen studies were included in the review, from which nine social support measures were identified. Attributes of the measures were searched from their referenced papers and described in terms of their reported psychometric properties. Conclusions: Through the identification of the measures of social support and ensuring its accurate measurement, direction can be provided for intervention by allowing professionals to detect and address social support available. Future recommendations for research are made. [ABSTRACT FROM AUTHOR]

Low‐income Latinas/os are exposed to widespread mental health disparities in the United States. Most recently, a resurgence of anti‐immigration narratives has led vulnerable Latina/o immigrants to experience considerable contextual stressors with multiple deleterious consequences for their overall well‐being, including significant disruptions to their parenting practices. Within this context of adversity and despite the multiple benefits associated with parent training (PT) prevention interventions, the availability of contextually and culturally relevant PT interventions remains limited in underserved Latina/o communities. This paper constitutes a contribution to this gap in knowledge by presenting a model of intervention delivery utilized in the dissemination of culturally adapted versions of the evidence‐based intervention known as GenerationPMTO.© The proposed model also describes a process of change that we have documented in empirical research with low‐income Latina/o immigrant parents who have been exposed to the adapted interventions. The manuscript is organized in four sections. First, an overview of the model is discussed, along with a brief summary of major theories. Next, the core components of the model are described, complemented by the presentation of a case study. Finally, implications for prevention and clinical intervention are discussed. [ABSTRACT FROM AUTHOR]

In psychiatry, practitioners are encouraged to adopt a patient‐centred approach that emphasises shared decision‐making. In this article, we investigate how clients with severe mental illnesses (e.g. schizophrenia) advocate for their treatment preferences in psychiatric consultations. The study uses Conversation Analysis to examine audio‐recorded medication check appointments in a comprehensive treatment programme known as assertive community treatment (ACT). The analysis shows that clients solicit medication changes at activity boundaries and design them in one of the following ways: reporting a physical problem; reporting a medication problem; explicitly requesting a medication change; and demanding a change. These formats put pressure on the psychiatrist to respond by either offering a solution to the client's problem or by accepting or rejecting the client's request. Through a detailed analysis of clients' communicative behaviours, we show that, in soliciting a medication change, clients ordinarily respect boundaries of medical authority and present themselves as 'good' patients who are reliable witnesses of their own experiences. Overall, the paper advances our understanding of patient advocacy in psychiatry and mental health interactions more generally. [ABSTRACT FROM AUTHOR]

Young people experiencing first‐episode psychosis taking antipsychotic medications often develop comorbidities such as obesity and cardiometabolic abnormalities at an earlier age than young people in the general population. Therefore, it is important to explore the healthcare needs and experiences of this group of consumers. This paper reports research conducted to obtain an informed understanding of young people's health literacy, physical healthcare needs, and interest and knowledge about their physical health. Grounded theory methodology was used to guide the research. Semistructured interviews were conducted with 24 young consumers aged between 18 and 35 years who were case managed by one metropolitan community mental health service. The results describe the journey of young people from the time of diagnosis, to when they developed an awareness of the need to improve their physical health and the impact of physical health issues on their overall health and well‐being. Six categories emerged from the data: (i) initial responses when diagnosed with first‐episode psychosis; (ii) focus of care on treating first‐episode psychosis; (iii) lack of education on antipsychotic medications; (iv) adverse effects from taking antipsychotic medication; (v) increased awareness of the need for good physical health; and 6) importance of social support in the community. The findings highlight the importance for health professionals improving young people's health literacy and addressing physical health and well‐being as part of first‐episode psychosis programmes. Young people require improved health education on the importance of maintaining healthy lifestyle in relation to their overall health and well‐being. [ABSTRACT FROM AUTHOR]

Objective: To explore how caries was reported in studies that employed the International Caries Detection and Assessment System (ICDAS). Methods: A systematic database search up to August 2017 was carried out using PubMed, Ovid MEDLINE, Cochrane library and ISI Web of Science electronic databases. Only studies that used the ICDAS for dental caries examinations were included. Studies were excluded if the examination was done only for the validation or the calibration of the ICDAS and/or if the examination was not done for the whole dentition. Measures used to report caries were considered. Results: A total of 126 papers met the inclusion criteria. Forty‐four different synthesis measures were used to report caries. Most of the studies used a combination of multiple measures to report patient's caries level. These reporting measures cluster into four main groups: the number of individual ICDAS scores (ie, total counts of every score); the number of decayed surfaces/teeth (ie, total counts of combined caries scores for surfaces or teeth); measures of caries experience (ie, total counts of combined caries scores, filled and/or missing surfaces or teeth); and measures of central tendency and dispersion. The number of decayed surfaces and individual ICDAS scores were the most commonly used measures. Three studies used mean ICDAS score (ie, total ICDAS scores divided by the number of teeth), two used mean ICDAS score of carious teeth (ie, total ICDAS scores divided by the number of carious teeth) and two used the maximum ICDAS score (ie, highest ICDAS score recorded). The total ICDAS score was used only once. Many studies synthesized from the ICDAS the number of decayed, missing and filled teeth/surfaces (dmft/DMFT, dmfs/DMFS) as a measure of caries experience. Conclusions: There are variations among studies in the utilization of the system to summarize caries. Most studies presented caries data using the categorical characteristics of the ICDAS. [ABSTRACT FROM AUTHOR]

With growing concerns about the efficacy and costs of intrusive child protection interventions and increasing recognition of citizen rights to participation in governance, jurisdictions are looking to collaborative alternatives that divert families from the courts and out‐of‐home care. In Queensland (Australia), "intervention with parental agreement" (IPA) is one such response. Under IPA, the statutory child protection authority can work collaboratively with families, without a court order, to respond to children assessed as "in need of protection." In this paper, we use procedural justice theory as a lens to explore how IPA policy is enacted in practice. Procedural justice relates to the quality of treatment a person receives and the fairness of the process than an authority uses during decision‐making (Tyler,). It is associated with voluntary cooperation and compliance; key practice concerns when working to address child maltreatment via parental agreement rather than court ordered intervention. We report on a qualitative study that utilized semistructured, in‐depth interviews to capture the perceptions of 30 practitioners regarding the factors that shape the extent to which they enact IPA policy in a procedurally fair manner. Strategies for enhancing procedurally just enactment of IPA policy in practice are discussed. [ABSTRACT FROM AUTHOR]

Affinity propagation is a message‐passing‐based clustering procedure that has received widespread attention in domains such as biological science, physics, and computer science. However, its implementation in psychology and related areas of social science is comparatively scant. In this paper, we describe the basic principles of affinity propagation, its relationship to other clustering problems, and the types of data for which it can be used for cluster analysis. More importantly, we identify the strengths and weaknesses of affinity propagation as a clustering tool in general and highlight potential opportunities for its use in psychological research. Numerical examples are provided to illustrate the method. [ABSTRACT FROM AUTHOR]

Background: Cyberbullying is an international Public Health concern. Efforts to understand and address it can be enhanced by involving young people. This paper describes a rights‐based collaboration with young people in a qualitative exploration of cyberbullying. It describes the establishment, implementation and evaluation of a Young Person's Advisory Group as well as identifying the impact on the research process and the young people involved. Methods: Sixteen postprimary school students met with researchers on five occasions in a youth centre. Sessions focused on building the young people's capacity to engage with the research, designing the qualitative study, interpreting study findings and evaluating the collaboration process. Results: The Advisory Group highlighted a lack of understanding and appropriate action with regard to cyberbullying but believed that their involvement would ultimately help adults to understand their perspective. Evaluation findings indicate that members were supported to form as well as express their views on the design, conduct and interpretation of the research and that these views were acted upon by adult researchers. Their involvement helped to ensure that the research was relevant and reflective of the experiences, interests, values and norms of young people. Conclusion: Young people can contribute a unique perspective to the research process that is otherwise not accessible to adult researchers. The approach described in this study is a feasible and effective way of operationalizing young people's involvement in health research and could be adapted to explore other topics of relevance to young people. [ABSTRACT FROM AUTHOR]

Aim: To determine the long-term course of difficulty in participation of individuals with cerebral palsy (CP) without intellectual disability between 16 years and 34 years of age.Method: One hundred and fifty-one individuals with CP aged 16 to 20 years were included (63% male, 37% female; Gross Motor Function Classification System [GMFCS] levels I-IV; without intellectual disability). The Assessment of Life Habits questionnaire 3.0 general short form was used up to three times biennially and at 13-year follow-up (13-year follow-up: n=98). Scores (range 0-10) reflect difficulty and assistance in participation in housing, education and employment, interpersonal relationships, recreation, community life, and responsibilities. Multilevel models were used to determine the course of difficulty in participation by GMFCS level.Results: Despite high average participation levels, 41% to 95% of adolescents and young adults with CP experienced difficulty. Difficulty in participation in housing and interpersonal relationships increased from age 16 years onwards and in most other life areas in the mid- and late 20s. In adolescents in GMFCS levels III and IV, participation in recreation and community life improved up to age 23 years.Interpretation: Individuals with CP experience increasing difficulties in participation in their mid- and late 20s. Clinicians should systematically check for participation difficulties in young adults with CP and offer timely personalized treatment.What This Paper Adds: Many individuals with cerebral palsy (CP) aged 16 to 34 years experience difficulty in participation. Difficulty in participation increases in the mid- and late 20s for individuals with CP. Participation in recreation/community life improves before age 23 years for those in Gross Motor Function Classification System levels III and IV. [ABSTRACT FROM AUTHOR]

Aim: To describe 5-year motor and functional outcomes after paediatric arterial ischaemic stroke (AIS) and to explore factors associated with poorer long-term outcome.Method: Thirty-three children (21 males, 12 females) with AIS were recruited to a single-site, cross-sectional study, from a previously reported prospective longitudinal stroke outcome study. Children were stratified according to age at diagnosis: neonates (≤30d), preschool (>30d-5y), and school age (≥5y). Motor and functional outcomes were measured at 5 years after stroke. Neurological outcomes were evaluated using the Pediatric Stroke Outcome Measure (PSOM) at 1 month and more than 4 years after stroke.Results: At 5 years after stroke, motor function, quality of life, fatigue, adaptive behaviour, activities of daily living, and handwriting speed were significantly poorer than age expectations. The preschool group had the highest percentage of fine and gross motor impairment. Poorer fine motor skills were associated with subcortical-only lesions and large lesion size. Poorer gross motor outcomes correlated with preschool age, bilateral lesions, and PSOM impairment at 1 month.Interpretation: Children are at elevated risk for motor and functional impairments after AIS, with the preschool age group most vulnerable. Identifying early predictors of poorer outcomes facilitates targeted early intervention and long-term rehabilitation.What This Paper Adds: Following paediatric stroke, children are at elevated risk of motor and functional difficulties. Stroke occurring between 30 days and 5 years of age may result in poorer motor and functional outcomes. [ABSTRACT FROM AUTHOR]

Psychologists have typically defined obedience as a form of social influence elicited in response to direct orders from an authority figure. In the most influential set of studies of obedience, conducted by Stanley Milgram in the early 1960s, the orders at the disposal of the authority figure were a series of verbal prods. However, recent research has suggested that Milgram's experiments do not show people following orders. It has therefore been suggested that the experiments are not demonstrations of obedience. However, in the present paper, it is argued that rather than abandoning the idea that Milgram's work is a demonstration of obedience, it is in fact our conceptualization of obedience that is wrong. Obedience should not be understood as requiring direct orders from an authority figure. This argument is developed with reference to an extended case example from one of Milgram's experimental conditions in which a participant completed the experiment in the absence of direct orders. It is argued that such participants can still be understood as obedient if we consider the implicit demands of the system in which participants find themselves. The study concludes by presenting a new definition of obedience that omits the need for direct orders. [ABSTRACT FROM AUTHOR]

The notion of being a burden to others is mostly discussed in the context of care‐intensive diseases or end‐of‐life decisions. But the notion is also crucial in decision‐making at the beginning of life, namely regarding prenatal testing. Ever more sophisticated testing methods, especially non‐invasive prenatal testing (NIPT), allow the detection of genetic traits in the unborn child that may cause disabilities. A positive result often influences the decision of the pregnant women towards a termination of the pregnancy. Thus, critics claim that these testing methods send a negative message to people with disabilities. At the core of this is what we call the burden assumption. This assumption claims that children with disabilities are necessarily a burden to others, especially to their parents and other family members. In this paper, we discuss what being a burden to others means in this context and how such an attitude can be avoided without restraining reproductive autonomy. A closer examination shows that the burden assumption is mostly based on misinformation and a false model of disability. Empirical studies as well as narrative evidence from parents who raise a child with disabilities show that the burden assumption is wrong. Raising a child with disabilities does not necessarily mean a decrease in the quality of life. We show how the burden assumption can be challenged through an advanced genetic counselling that combines empirical evidence with narratives from a first‐person perspective. [ABSTRACT FROM AUTHOR]

Practitioners' preconceived ideas about service users can lead to prejudice and labelling, and ultimately may result in biased services. This paper reports on a UK‐based qualitative research study exploring the views and experiences of practitioners working with adult victims and perpetrators of domestic violence. It examines whether or not practitioners believe that childhood experiences of witnessing domestic violence indicate the likelihood of domestic violence in adulthood. It further explores practitioners' perceptions of factors contributing to the experiences of domestic violence amongst their service users. Twelve semi‐structured interviews were conducted with practitioners working in the domestic violence field, and thematic analysis was used to analyse their responses. The data did not indicate a general consensus on the matter of children becoming victims or perpetrators based on their childhood experiences of domestic violence. Participants' responses indicated that they thought the issue was more complex. Common themes that participants consider important to children's development of healthy/unhealthy relationships in this context were identified in the data. These included: an awareness of service users' individuality; the importance of meaningful support networks; and an understanding of the risk amongst their service users to normalise abusive behaviour. '[Explores] the views and experiences of practitioners working with adult victims and perpetrators of domestic violence' Key Practitioner Messages: Not all children witnessing domestic violence will inevitably become victims or perpetrators of abuse in adulthood.Perpetrating domestic violence in adulthood is often associated with a combination of various factors and circumstances, and can rarely be attributed to just one past experience.Assessments and holistic and judgement‐free services provided by practitioners are vital for children to develop positive and healthy future relationships. [ABSTRACT FROM AUTHOR]

The tension between expressing vulnerability and seeking credibility creates challenges for learning and teaching. This is particularly true in health care, in which practitioners are regarded as highly credible and making errors can often lead to dire consequences and blame. From a transformative learning perspective, expressing vulnerability may help individuals to access different ways of knowing. By contrast, from a sociological perspective, seeking to maintain credibility results in ritualised interactions and these ritualised encounters can reinforce credibility. One means of embracing this tension between expressing vulnerability and appearing credible is 'intellectual candour', an improvisational expression of doubts, thoughts and problems with the dual purpose of learning and promoting others' learning. Educators' revelations of inner struggles are proposed as a means of inviting reciprocal vulnerability. This builds trust and a platform for learning, particularly of the transformative nature. It also allows modelling of how to balance the vulnerability–credibility tension, which may provide a template for professional practice. This paper outlines the benefits and limitations of 'intellectual candour' (the public expression of thoughts, uncertainties and problems) for the dual purpose of learning and promoting learning. [ABSTRACT FROM AUTHOR]

Background: This paper explored the health beliefs and behaviours of families towards the health needs of children with intellectual and developmental disabilities (IDD) in Accra, Ghana. The aim was to inform health promotion strategies for the children and their families. Method: Twenty‐two parents of children with IDD participated in this study. Semi‐structured interviews were the primary means of data collection. The interviews were analysed using constant comparison. Results: The signs that alerted the parents that the children might be ill included high temperature, vomiting and excessive sleep. The parents explained that some children expressed feelings of ill‐health through verbal or non‐verbal communication. Most of the parents self‐prescribed medication for the children or waited for symptoms to persist for a while before accessing health care because they experienced difficulties managing the behavioural challenges associated with the IDD of the children in public and attitudinal barriers when accessing health care. The parents did not often patronise health facilities in their neighbourhoods due to private health insurance requirements for accessing care at designated facilities, poor confidence in neighbourhood facilities and long‐term established relationships with facilities elsewhere. Further, many parents did not patronise religious interventions for the children. However, some parents explained that in addition to seeking medical care to address the physical symptoms of the children's disabilities and/or illnesses, they sought religious interventions because they believed that there could be a spiritual dimension to the situation. Conclusion: The findings highlight key areas to address in health promotion for children with IDD and their families in Accra, Ghana. [ABSTRACT FROM AUTHOR]

Background: Informal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method – Intellectual Disability (FNM‐ID) offers a way to gather the perspective of people with mild intellectual disability on their family support. Method: The FNM is designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts. Results: By carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the original FNM. Data obtained by the FNM‐ID can be analysed using social network analysis. Thereby, the FNM‐ID provides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability. Conclusions: The FNM‐ID is a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability. [ABSTRACT FROM AUTHOR]

Background: For parents who experience stillbirth, knowing the cause of their baby's death is important. A post mortem examination is the gold standard investigation, but little is known about what may influence parents' decisions to accept or decline. Aim: We aimed to identify factors influencing maternal decision‐making about post mortem examination after late stillbirth. Methods: In the New Zealand Multicentre Stillbirth Study, 169 women with singleton pregnancies, no known abnormality at recruitment, and late stillbirth (≥28weeks gestation), from seven health regions were interviewed within six weeks of birth. The purpose of this paper was to explore factors related to post mortem examination decision‐making and the reasons for declining. We asked women if they would make the same decision again. Results: Maternal decision to decline a post mortem (70/169, 41.4%) was more common among women of Māori (adjusted odds ratio (aOR) 4.99 95% confidence interval (CI) 1.70–14.64) and Pacific (aOR 3.94 95% CI 1.47–10.54) ethnicity compared to European, and parity two or more (aOR 2.95 95% CI 1.14–7.62) compared to primiparous. The main reason for declining was that women 'did not want baby to be cut'. Ten percent (7/70) who declined said they would not make this decision again. No woman who consented regretted her decision. Conclusion: Ethnic differences observed in women's post mortem decision‐making should be further explored in future studies. Providing information of the effect of post mortem on the baby's body and the possible emotional benefits of a post mortem may assist women faced with this decision in the future. [ABSTRACT FROM AUTHOR]

Context: Competency‐based medical education has spurred the implementation of longitudinal workplace‐based assessment (WBA) programmes to track learners' development of competencies. These hinge on the appropriate use of assessment instruments by assessors. This study aimed to validate our assessment programme and specifically to explore whether assessors' beliefs and behaviours rendered the detection of progress possible. Methods: We implemented a longitudinal WBA programme in the third year of a primarily rotation‐based clerkship. The programme used the professionalism mini‐evaluation exercise (P‐MEX) to detect progress in generic competencies. We used mixed methods: a retrospective psychometric examination of student assessment data in one academic year, and a prospective focus group and interview study of assessors' beliefs and reported behaviours related to the assessment. Results: We analysed 1662 assessment forms for 186 students. We conducted interviews and focus groups with 21 assessors from different professions and disciplines. Scores were excellent from the outset (3.5–3.7/4), with no meaningful increase across blocks (average overall scores: 3.6 in block 1 versus 3.7 in blocks 2 and 3; F = 8.310, d.f. 2, p < 0.001). The main source of variance was the forms (47%) and only 1% of variance was attributable to students, which led to low generalisability across forms (Eρ2 = 0.18). Assessors reported using multiple observations to produce their assessments and were reluctant to harm students by consigning anything negative to writing. They justified the use of a consistent benchmark across time by citing the basic nature of the form or a belief that the 'competencies' assessed were in fact fixed attributes that were unlikely to change. Conclusions: Assessors may purposefully deviate from instructions in order to meet their ethical standards of good assessment. Furthermore, generic competencies may be viewed as intrinsic and fixed rather than as learnable. Implementing a longitudinal WBA programme is complex and requires careful consideration of assessors' beliefs and values. Are assessment practices ethical? This paper shows that longitudinal assessment of competencies may be complicated by assessors' beliefs [ABSTRACT FROM AUTHOR]

Humans segment naturalistic actions into meaningful units. These are hierarchically organized: multiple fine events are part of a coarse event. We investigated how repeated practice of a virtual sequential assembly task influences learning of coarse and fine assembly steps. In Experiment 1, participants (N = 10) parsed the task into coarse and fine events. This determined the task's hierarchical structure. In Experiment 2, domain experts (N = 18) and novices (N = 19) practiced the task in a virtual environment three times with intermittent memory testing. We found a hierarchical level effect: memory improved with repeated virtual training for coarse but not for fine steps. Further, experts' memory for fine assembly steps was higher compared with novices' memory. The hierarchical level effect could be explained by higher saliency (and lower similarity, respectively) of the coarse compared with the fine steps. We discuss implications for virtual training, which compose of hierarchical structure into task presentation. Lay Description: What is already known about this topic?: Virtual trainings offer a safe environment for repeated practice in which learners can handle challenging activities.Changes in the working life (e.g., "industry 4.0") require workers to learn new dynamic tasks quickly.Humans perceive dynamic tasks in terms of coarse and fine events, these are hierarchically structured. What this paper adds?: Repeated virtual training improves memory for coarse but not fine events.Domain experts recognize fine events more successfully than novices. Implications for practice and/or policy?: Virtual trainings considering the underlying event structure are useful for training dynamic assembly tasks.Knowledge tests of virtual trainings should be based on the event structure. [ABSTRACT FROM AUTHOR]

Aim: To analyse the health care usage of individuals with cerebral palsy (CP) as a function of age and ambulatory status.Method: In total, 970 self-administered questionnaires relating to health care usage were sent, via a clinical network of professionals and institutions, to children and adults with CP in Brittany, France. Frequency of use of different aspects of health care were analysed as a function of age and ambulatory status. Multivariate logistic regression evaluated differences in the frequency of each health care type with age; the transition from childhood to adulthood was specifically analysed.Results: The response rate was 53% (282 adults, 230 children). Use of medication (particularly psychotropic and analgesic) increased with age, while physical-types of health care (rehabilitation, physical medicine and rehabilitation follow-up, and equipment) decreased with age, independently of ambulatory status. Use of other treatments, such as botulinum toxin injections, was not influenced by age. The provision of rehabilitation was particularly affected by the period of transition.Interpretation: Although health care needs change naturally in adulthood, the large decrease in usage of specific types of rehabilitation after the transition to adulthood suggested individuals had difficulty accessing this type of health care after childhood. These results provide objectives for the development of patient-centred, transitional consultations, and longitudinal studies.What This Paper Adds: Use of medication, particularly psychotropic and analgesic drugs, increased with age in individuals with cerebral palsy. Use of orthoses, physical medicine and rehabilitation physician follow-up, and rehabilitation decreased with age. Transition from childhood to adulthood involved significant changes in health care usage. [ABSTRACT FROM AUTHOR]