Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Vignettes

  • case vignette
  • clinical vignette
  • hypothetical vignette

  • Selected Abstracts

    VIGNETTE IN CONTACT DERMATOLOGY Allergic contact dermatitis from ciclopirox olamine

    Caterina Foti
    SUMMARY A 50-year-old man with interdigital tinea pedis developed an allergic dermatitis spreading from the toes to the lower shins. Patch tests were strongly positive to ciclopirox olamine 1% pet. Sensitization to this topical antifungal agent has rarely been reported in the literature. [source]

    Hypercalcemia and Overexpression of CYP27B1 in a Patient With Nephrogenic Systemic Fibrosis: Clinical Vignette and Literature Review,,

    Vivian Y Pao
    Abstract Nephrogenic systemic fibrosis (NSF) is a disease of thickened, hard, hyperpigmented skin lesions with or without systemic fibrosis occurring in patients with renal insufficiency and associated with the administration of gadolinium-containing contrast. The pathogenesis of this disease is unclear, and there is no definitive treatment. We describe a 71-yr-old patient with stable chronic lymphocytic leukemia (CLL), end-stage renal disease (ESRD), and NSF who presented with hypercalcemia in 2006. Before onset of renal insufficiency in 2002, serum calcium, phosphorus, and PTH levels were normal. In 2004, the patient began hemodialysis, and he was diagnosed with NSF in 2005, shortly after undergoing an MRI with gadolinium contrast administration. Over the next 6 mo, albumin-corrected serum total calcium levels rose from 9.9 to 13.1 mg/dl (normal range, 8.5,10.5 mg/dl) with normal serum phosphorus levels. On admission in September 2006, 1,25-dihydroxyvitamin D [1,25(OH)2D] levels were elevated at 130.7 pg/ml (normal range, 25.1,66.1 pg/ml). Biopsy of an NSF lesion showed increased 25-hydroxyvitamin D3,1-, hydroxylase (CYP27B1) immunostaining compared with the biopsy from a normal control. This is the first reported association of NSF with hypercalcemia caused by elevated 1,25(OH)2D levels. This metabolic disturbance should be sought in future cases to determine a connection between NSF, 1,25(OH)2D metabolism, and CYP27B1 activation in the skin, which may shed light on the pathogenesis of this unusual local and systemic fibrosing disorder. [source]

    Clinical Vignette: Intraosseous Meningioma,A Mimicry of Paget's Disease?

    Kandaswamy Jayaraj
    No abstract is available for this article. [source]

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD Editor
    No abstract is available for this article. [source]

    Historical Vignettes in Heart Failure

    Hector O Ventura MD Editor
    No abstract is available for this article. [source]

    Historical Vignettes in Heart Failure

    Article first published online: 6 MAY 200
    No abstract is available for this article. [source]

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD Editor

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD Editor

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD Editor

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD Editor
    No abstract is available for this article. [source]

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD
    No abstract is available for this article. [source]

    Historical Vignettes in Heart Failure

    Hector O. Ventura MD
    No abstract is available for this article. [source]

    Vignettes in Osteoporosis: A Road Map to Successful Therapeutics,

    Clifford J Rosen
    Abstract The diagnosis and management of osteoporosis have become increasingly more complex as new drugs enter the marketplace and meta-analyses of randomized trials with "other" agents become more prolific. We describe five common clinical scenarios encountered in the practice of osteoporosis medicine and various road maps that could lead to successful therapy. Introduction: The diagnosis and treatment of osteoporosis have changed dramatically in the last decade. Advances in diagnostic technologies and a range of newer treatment options have provided the clinician with a wide array of choices for treating this chronic disease. Despite the issuance of several "guidelines" and practice recommendations, there still remains confusion among clinicians about basic approaches to the management of osteoporosis. This paper should be used as a case-based approach to define optimal therapeutic choices. Materials and Methods: Five representative cases were selected from two very large clinical practices (Bangor, ME; Pittsburgh, PA). Diagnostic modalities and treatment options used in these cases were selected on an evidence-based analysis of respective clinical trials. Subsequent to narrative choices by two metabolic bone disease specialists (SG and CR), calculation of future fracture risk and selection of potential alternative therapeutic regimens were reviewed and critiqued by an epidemiologist (DB). Results: A narrative about each case and possible management choices for each of the five cases are presented with references to justify selection of the various therapeutic options. Alternatives are considered and discussed based on literature and references through July 2003. The disposition of the individual patient is noted at the end of each case. Conclusions: A case-based approach to the management of osteoporosis provides a useful interface between guidelines, evidence-based meta-analyses, and clinical practice dilemmas. [source]

    Practitioner assessments of ,good enough' parenting: factorial survey

    Julie Taylor
    Aim., The aim of this study was to measure health visitors' professional judgements on ,good enough' parenting and identify what factors and combinations of these are important when making such judgements. Background., The relationship between parenting and child health is unclear. Whilst agreement exists that ,good enough' parenting requires boundary setting, consistency and putting the child's needs first, attempting to define ,good enough' parenting in precise terms is complex. When faced with a complex situation, practitioners rely on relatively few factors to form judgements. Design., Factorial survey methods were employed using vignette techniques. Methods., Vignettes were constructed using previous research on those variables, which may influence nurses' judgements, for example, accommodation and child dentition. The level of factors was randomly varied. Two thousand vignettes were administered to a sample of 200 health visitors in two Health Boards who then made a judgement about this scenario. Analysis., Data were analysed through multiple regression with dummy variables and one-way analysis of variance. Regression equations for both good enough mothering and good enough parenting are reported. Results., The models used are significant predictors of parenting and mothering. Significant predictors on health visitor judgements' were boundary setting in sleep behaviours, type of housing inhabited and health behaviours. Although parenting and mothering are often conflated, health visitors appear to separate these aspects when making judgements based on type of housing. Conclusions., Most professionals can articulate what makes a ,good' parent, equally they may have strong views regarding what constitutes ,poor' parenting. The difficulty is in determining when parenting is ,good enough' to provide a child with a nurturing environment. Relevance to clinical practice., This study suggests that practitioners move their thresholds of what is ,good enough' depending on a narrow range of factors. Awareness of the factors, which influence individuals' judgements is important in safeguarding children. [source]

    A psychodynamic perspective on resistance in psychotherapy: Vive la résistance

    Stanley B. Messer
    The term resistance has an overly negative connotation, indicating a recalcitrant, oppositional tendency on the part of psychotherapy clients. This article emphasizes the inevitability and ubiquity of resistance and argues that it should be greeted as a therapist's friend, not as an enemy. It is the way in which clients present themselves to the world in general and to the therapist in particular. Five forms of resistance are presented, including: resistance to the recognition of feelings, fantasies, and motives; resistance to revealing feelings toward the therapist; resistance as a way of demonstrating self-sufficiency; resistance as clients' reluctance to change their behavior outside the therapy room; and resistance as a function of failure of empathy on the part of the therapist. Vignettes from the author's practice and from the cases presented in this issue are discussed in terms of these five modes of resistance and their treatment. © 2002 John Wiley & Sons, Inc. J Clin Psychol/In Session 58: 157,163, 2002. [source]

    Measuring physiotherapists' guideline adherence by means of clinical vignettes: a validation study

    Geert M.J. Rutten MPH
    Abstract Rationale, aims and objectives, To assess the criterion validity of paper-and-pencil vignettes to assess guideline adherence by physiotherapists in the Netherlands. The evidence-based physiotherapy practice guideline for low back pain was used as an example. Methods, Four vignettes were constructed and pre-tested. Three vignettes were found to represent an adequate case-mix. They described one patient with specific low back pain, one with non-specific low back pain and a normal recovery process and one with non-specific low back pain and a delay in the recovery process. Invited to participate were 113 primary care physiotherapists who had joined an randomized controlled trial study 8 months before, in which guideline adherence had been measured by means of semi-structured treatment recording forms. The criterion validity was determined with Spearman's rs, using Cohen's classification for the behavioural sciences to categorize its effect size. Results, Of the 72 physiotherapists who agreed to participate, 39 completed the questions on the vignettes. In the end, both adherence measures were available for 34 participants, providing 102 vignettes and 268 recording forms. Mean guideline adherence scores were 57% (SD = 17) when measured by vignettes and 74% (SD = 15) when measured by recording forms. Spearman's rs was 0.31 (P = 0.036), which, according to Cohen's classification, is a medium effect size. Conclusion, Vignettes are of acceptable validity, and are an inexpensive and manageable instrument to measure guideline adherence among large groups of physiotherapists. Further validation studies could benefit from the use of standardized patients as a gold standard, a more diverse case mix to better reflect real physiotherapy practice, and the inclusion of longitudinal vignettes that cover the patients' course of treatment. [source]

    Emergency Management of Pediatric Skin and Soft Tissue Infections in the Community-associated Methicillin-resistant Staphylococcus aureus Era

    Rakesh D. Mistry MD
    Abstract Objectives:, Skin and soft tissue infections (SSTIs) are increasing in incidence, yet there is no consensus regarding management of these infections in the era of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). This study sought to describe current pediatric emergency physician (PEP) management of commonly presenting skin infections. Methods:, This was a cross-sectional survey of subscribers to the American Academy of Pediatrics Section on Emergency Medicine (AAP SoEM) list-serv. Enrollment occurred via the list-serv over a 3-month period. Vignettes of equivocal SSTI, cellulitis, and skin abscess were presented to participants, and knowledge, diagnostic, and therapeutic approaches were assessed. Results:, In total, 366 of 606 (60.3%) list-serv members responded. The mean (± standard deviation [SD]) duration of practice was 13.6 (±7.9) years, and 88.6% practiced in a pediatric emergency department. Most respondents (72.7%) preferred clinical diagnosis alone for equivocal SSTI, as opposed to invasive or imaging modalities. For outpatient cellulitis, PEPs selected clindamycin (30.6%), trimethoprim-sulfa (27.0%), and first-generation cephalosporins (22.7%); methicillin-sensitive S. aureus (MSSA) was routinely covered, but many regimens failed to cover CA-MRSA (32.5%) or group A streptococcus (27.0%). For skin abscesses, spontaneous discharge (67.5%) was rated the most important factor in electing to perform a drainage procedure; fever (19.9%) and patient age (13.1%) were the lowest. PEPs elected to prescribe trimethoprim-sulfamethoxazole (TMP-Sx; 50.0%) or clindamycin (32.7%) after drainage; only 5% selected CA-MRSA,inactive agents. All PEPs suspected CA-MRSA as the etiology of skin abscesses, and many attributed sepsis (22.1%) and invasive pneumonia (20.5%) to CA-MRSA, as opposed to MSSA. However, 23.9% remained unaware of local CA-MRSA prevalence for even common infections. Conclusions:, Practice variation exists among PEPs for management of SSTI. These results can be used to measure changes in SSTI practices as standardized approaches are delineated. ACADEMIC EMERGENCY MEDICINE 2010; 17:187,193 © 2010 by the Society for Academic Emergency Medicine [source]

    Medical Error Identification, Disclosure, and Reporting: Do Emergency Medicine Provider Groups Differ?

    Cherri Hobgood MD
    Abstract Objectives: To determine if the three types of emergency medicine providers,physicians, nurses, and out-of-hospital providers (emergency medical technicians [EMTs]),differ in their identification, disclosure, and reporting of medical error. Methods: A convenience sample of providers in an academic emergency department evaluated ten case vignettes that represented two error types (medication and cognitive) and three severity levels. For each vignette, providers were asked the following: 1) Is this an error? 2) Would you tell the patient? 3) Would you report this to a hospital committee? To assess differences in identification, disclosure, and reporting by provider type, error type, and error severity, the authors constructed three-way tables with the nonparametric Somers' D clustered on participant. To assess the contribution of disclosure instruction and environmental variables, fixed-effects regression stratified by provider type was used. Results: Of the 116 providers who were eligible, 103 (40 physicians, 26 nurses, and 35 EMTs) had complete data. Physicians were more likely to classify an event as an error (78%) than nurses (71%; p = 0.04) or EMTs (68%; p < 0.01). Nurses were less likely to disclose an error to the patient (59%) than physicians (71%; p = 0.04). Physicians were the least likely to report the error (54%) compared with nurses (68%; p = 0.02) or EMTs (78%; p < 0.01). For all provider and error types, identification, disclosure, and reporting increased with increasing severity. Conclusions: Improving patient safety hinges on the ability of health care providers to accurately identify, disclose, and report medical errors. Interventions must account for differences in error identification, disclosure, and reporting by provider type. [source]

    The Politics of Revision in Samuel Daniel's The Civil Wars

    Gillian Wright
    Samuel Daniel's historical poem The Civil Wars has traditionally been regarded as a conservative text, committed in presentation and in practice to upholding the principle of hereditary right in monarchy. Such a view overlooks Daniel's many complex revisions to the poem between its first appearance in print in 1595 and the final,though still unfinished,version published in 1609. Comparative analysis of the different printed editions of the poem shows that between 1595 and 1609 Daniel's political priorities changed significantly, especially on the question of the role and legitimacy of kingship. Whereas the 1595 Civil Wars does indeed adopt a broadly conservative attitude to the rights of hereditary monarchs, the 1609 text of the poem no longer automatically endorses kingly authority but instead consistently privileges the monarch's commitment to the "publique good" and the just execution of the laws. This subtle but radical pattern of change culminates in Daniel's vignette of Elizabeth Grey and Edward IV (1609, Book VIII), which departs from the poet's sources in representing Grey's resistance to Edward's attempted seduction in explicitly politicized terms. This observable shift in Daniel's political values also foreshadows later aspects of his historiography in the prose Collection of the Historie of England (1618). (G.W.) [source]

    Size really doesn't matter

    Bethan Lawrence
    Abstract Objective: The judgement of what constitutes a large amount of food is one part of determining a binge and is therefore crucial for the diagnosis of BN. This study aimed to determine whether eating disorder professionals agree on what constitutes a large amount of food and the criterion they use to make the decision. Method: 147 eating disorder professionals completed a short questionnaire, that involved rating five food vignettes according to whether they believed them to consist of a large amount of food. Results: There was general consensus among eating disorder professionals as to what constituted a large amount of food. The results also suggested that many participants based their judgement on how dissimilar the vignette was to a normal meal. Discussion: The finding that the judgement of whether an amount of food is large can be made with high reliability but low validity should be the subject of further research due to its importance in the diagnosis of bulimia nervosa. Copyright © 2003 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Dementia and the Over-75 Check: the role of the primary care nurse

    Heather Trickey BSc MSc (Med)
    Abstract Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers. [source]

    A judicial,mental health partnership to heal young children in juvenile court

    Judge Cindy Lederman
    In this article, we describe the background and issues to be addressed related to dependent children in juvenile court. In an important effort to systematically examine developmental functioning and treatment needs in maltreated and violence-exposed young children, the Prevention and Evaluation of Early Neglect and Trauma (PREVENT) initiative of the Dependency Court Intervention Program for Family Violence, a national demonstration project in the Miami-Dade Juvenile Court, developed a program to evaluate all infants, toddlers, and preschoolers who are adjudicated dependent by the court. The goal of the intervention is to raise awareness of the needs of infants and toddlers in juvenile court and to work toward healing the child. The PREVENT program involved the evolution of a judicial,mental health partnership designed to assist the court in making more informed decisions about the best interest of the child by adding scientific knowledge about development, prevention, intervention, evaluation, and treatment. The outcome of the partnership and multidisciplinary approach is illustrated through presenting a case vignette of a mother and baby showing the challenges and strengths of intervention. Finally, we consider overall outcomes of the intervention and directions for the future. [source]

    From generative fit to generative capacity: exploring an emerging dimension of information systems design and task performance

    Michel Avital
    Abstract Information systems (IS) research has been long concerned with improving task-related performance. The concept of fit is often used to explain how system design can improve performance and overall value. So far, the literature has focused mainly on performance evaluation criteria that are based on measures of task efficiency, accuracy, or productivity. However, nowadays, productivity gain is no longer the single evaluation criterion. In many instances, computer systems are expected to enhance our creativity, reveal opportunities and open new vistas of uncharted frontiers. To address this void, we introduce the concept of generativity in the context of IS design and develop two corresponding design considerations ,,generative capacity' that refers to one's ability to produce something ingenious or at least new in a particular context, and ,generative fit' that refers to the extent to which an IT artefact is conducive to evoking and enhancing that generative capacity. We offer an extended view of the concept of fit and realign the prevailing approaches to human,computer interaction design with current leading-edge applications and users' expectations. Our findings guide systems designers who aim to enhance creative work, unstructured syntheses, serendipitous discoveries, and any other form of computer-aided tasks that involve unexplored outcomes or aim to enhance our ability to go boldly where no one has gone before. In this paper, we explore the underpinnings of ,generative capacity' and argue that it should be included in the evaluation of task-related performance. Then, we briefly explore the role of fit in IS research, position ,generative fit' in that context, explain its role and impact on performance, and provide key design considerations that enhance generative fit. Finally, we demonstrate our thesis with an illustrative vignette of good generative fit, and conclude with ideas for further research. [source]

    Expanding the usefulness of Interpersonal Psychotherapy (IPT) for depressed elders with co-morbid cognitive impairment

    Mark D. Miller
    Abstract Background The utility of Interpersonal Psychotherapy (IPT) has been documented as a maintenance treatment for late life depression as mono-therapy or in combination with antidepressant medication. Late life depression, however, is frequently co-morbid with declining memory or other cognitive abilities such that the usefulness of one-to-one psychotherapies is called into question for this subgroup. Additionally, concerned caregivers often accompany these patients to request help and their role in the presenting symptoms and in their potential resolution must also be addressed by any successful psychotherapy in this population. Objectives To explore ways in which IPT could be modified to better serve the particular presentation and needs of depressed elders with cognitive decline along with their caregivers. Methods Various modifications of traditional IPT techniques were experimented with and refined in our collaborative late life research center using regular group supervision and feedback from patients and their caregivers. Results A key component of these modifications involves the integration of the caregiver into the treatment process in flexible ways that recognize their own role transition that is taking place simultaneously with that of the patient's role transition from a greater to a lesser functional state. Other techniques for resolving role conflicts, particularly those directly involving care issues for the patient, are also delineated. These modifications are collectively referred to as IPT-CI for cognitive impairment. A brief case vignette is presented. Conclusion The modifications outlined in this communication reflect an evolving work-in-progress and serve as a framework for the future development of a manual of guidelines to assist healthcare personnel to optimally treat this population and their caregivers. Copyright © 2006 John Wiley & Sons, Ltd. [source]

    The Impact of Service User Cognitive Level on Carer Attributions for Aggressive Behaviour

    Hannah Tynan
    Background This study was designed to test the hypothesis that carer attributions for aggressive behaviour vary according to a service user's severity of intellectual disability. Methods Forty-two residential care staff participated in an investigation examining the effects of the level of a service user's intellectual disability on causal attributions for their aggressive behaviour. Equal numbers of participants were assigned to either a ,mild disability' or a ,severe disability' condition and required to read a vignette depicting a service user with aggressive challenging behaviour. The service user's cognitive abilities were experimentally manipulated across conditions, whilst the behaviour described remained unchanged. Participants were required to make attributions along Weiner's (1980) dimensions of locus, stability and controllability, and in accordance with five prominent models of challenging behaviour (Hastings 1997b). Results The service user depicted in the mild disabilities condition was perceived to have significantly greater control over factors causing the aggressive behaviour than the service user in the severe disabilities condition. Participants in the severe disabilities condition considered the aggression to be significantly more challenging. Learned behaviour and emotional causal models of aggressive behaviour were favoured, whilst the physical environment account was seen as least appropriate. Additionally, the biomedical model was rated as significantly more applicable in the severe disability condition than in the mild disability condition. Conclusions Implications for staff and service users are discussed. In particular, the relationship between staff causal attributions for challenging behaviour, their emotional responses and willingness to engage in helping behaviour is explored. [source]

    The effectiveness of an educational programme for nursing students on developing competence in the provision of spiritual care

    René Van Leeuwen
    Aim., To determine the effects of a course for nursing students on developing competence in spiritual care and the factors that might influence the effects. Background., Studies suggest that role preparation in nursing for spiritual care is poor. For the assessment of competence, few or no explicit competency framework or assessment tools seemed to be used. Design., Quasi-experimental crossover design (pre,post-test). Method., The subjects were students from Christian nursing schools in the Netherlands (n = 97). The intervention consisted of a course in spiritual care. Competencies were measured with an assessment tool, the Spiritual Care Competence Scale. Data were analysed by t -test procedures (paired-samples t -test). At T1 vignettes were added to assess the quality of the students' own analyses. These data were analysed by a Mann,Whitney test. Regression analyses were performed on the influence of student characteristics on the subscales of the assessment tool. Results., Ninety-seven students participated in this study. Analysis showed statistically significant changes in scores on three subscales of the Spiritual Care Competence Scale between groups (T1) and over time for the whole cohort of students on all subscales (T2). Clinical placement showed as a negative predictor for three subscales of the Spiritual Care Competence Scale. Experience in spiritual care and a holistic vision of nursing both showed as positive predictors on certain competencies. A statistically significant difference was observed between groups in the student analysis of a vignette with explicit spiritual content. Conclusions., The outcomes raise questions about the content of education in spiritual care, the measurement of competencies and the factors that influence competency development. Relevance to clinical practice., The results provide nurse educators with insight into the effects of education in spiritual care on students' competencies and help them consider a systematic place for spiritual care within the nursing curriculum. [source]

    Diffusion of treatment research: does open access matter?

    David J. Hardisty
    Abstract Advocates of the Open Access movement claim that removing access barriers will substantially increase the diffusion of academic research. If successful, this movement could play a role in efforts to increase utilization of psychotherapy research by mental health practitioners. In a pair of studies, mental health professionals were given either no citation, a normal citation, a linked citation, or a free access citation and were asked to find and read the cited article. After 1 week, participants read a vignette on the same topic as the article and gave recommendations for an intervention. In both studies, those given the free access citation were more likely to read the article, yet only in one study did free access increase the likelihood of making intervention recommendations consistent with the article. © 2008 Wiley Periodicals, Inc. J Clin Psychol/In Session 64: 1,19, 2008. [source]

    Making sense of male rape: constructions of gender, sexuality and experience of rape victims

    Kathy Doherty
    Abstract This study reports a preliminary investigation into accounting practices for male rape in conversation. Thirty men and women, in dyads, were asked to discuss an incident of male rape presented to them in a vignette. The findings showed that two main issues were discussed: the experience of the rape act and societal responses to male victims. In addition, participants established a ,hierarchy of suffering', where rape was judged to be worse for ,heterosexual' men than it is for ,women' or ,gay' men. Hegemonic, phallocentric representations of heterosexuality were mobilized to argue that acts of rape and consensual intercourse are the same for ,gay' men and ,women' and therefore less traumatic than for ,heterosexual' men. This obscures the violence of rape for gay men and women and exonerates perpetrators by minimizing injury sustained. Participants also argued that heterosexual victims are likely to experience ridicule for having departed from hegemonic masculinity. Arguments were constructed to avoid charges of being dismissive towards women and gay men and of victim blaming in relation to heterosexual men. Copyright © 2004 John Wiley & Sons, Ltd. [source]

    Cultural factors in help-seeking for child behavior problems: Value orientation, affective responding, and severity appraisals among Chinese-American parents

    Anna Lau
    This study explored the relationships between cultural values, appraisal of child behavior problems, and associated help-seeking intentions among Chinese-American parents. Questionnaires were administered to 120 Chinese-American parents of elementary-school-aged children. Parents were asked how they might respond if their child displayed the behavioral problems depicted in a hypothetical vignette. Influences of Chinese value orientation, severity appraisal, and affective reactions on help-seeking intentions were examined using regression analyses and structural equation modeling. The study examined three hypotheses regarding the nature of the influence of cultural value orientation on help-seeking intentions: (a) a direct effect model, (b) an indirect effect through cultural differences in severity appraisal, and (c) an indirect effect through cultural differences in affective responding. Results supported the hypothesis that cultural value orientation exerted an indirect effect on help-seeking intentions through its influence on affective responding. Those parents who had more traditional Chinese values responded with more feelings of shame to child behavior problems and, in turn, reported lower intentions to seek help. Findings are discussed with reference to the literature on help-seeking among Asian Americans. © 2001 John Wiley & Sons, Inc. [source]