bluuebunny/crossref_metadata_2025 huggingface dataset:
Spousal Education and Cognitive Functioning in Later Life
Authors: Xu Minle
Published: January 2019

Objectives

Numerous studies have documented the relationship between education and cognitive functioning at the individual level. Yet few studies have examined whether a spouse’s education spills over to influence the other spouse’s cognitive functioning. This study, therefore, investigates the association between spousal education and cognitive functioning, the pathways that may account for this association, and gender differences in this association.

Method

Growth curve models were analyzed by using longitudinal couple data from the Health and Retirement Study (N = 5,846 individuals).

Results

More years of spousal education are associated with higher level of cognitive functioning at age 65 (γ000 = 0.0532, 95% confidence interval [CI] = 0.0163−0.0901) and slower decline in cognitive functioning in later adulthood (γ100 = 0.0054, 95% CI = 0.0026−0.0082). The positive association between spousal education and the level of cognitive functioning at age 65 is fully explained by economic resources. The association of spousal education with the rate of change in cognitive functioning decreases but remains significant after controlling for economic resources and health behaviors (γ100 = 0.0043, 95% CI = 0.0014−0.0072). The association between spousal education and cognitive functioning is similar for men and women.

Discussion

Findings suggest that more years of spousal education may slow decline in cognitive functioning for men and women in later life.
Neighborhood Environments and Cognitive Decline Among Middle-Aged and Older People in China
Authors: Luo Ye , Zhang Lingling , Pan Xi
Published: January 2019

Objectives

Despite the growing interest in the effects of neighborhood environments on cognitive function, most studies on older people are based on cross-sectional survey data from developed countries. This study examines the relationship between neighborhood environments and decline in cognitive function over time among middle-aged and older people in China and whether this relationship varies between rural and urban residents.

Methods

The three waves of China Health and Retirement Longitudinal Study (CHARLS 2011–2015) were used. The sample included 12,131 respondents living in 298 rural villages and 4,059 respondents living in 150 urban communities. Three-level linear growth curve models were estimated to track trajectories of cognitive change over a 4-year period.

Results

Chinese older people who lived in neighborhoods with more handicap access, more bus lines, employment service, and higher socioeconomic status (SES) had slower cognitive decline. Neighborhood basic infrastructures, number of days that roads were unpassable, outdoor exercise facilities, and average social activity participation were associated with baseline cognitive function in both rural and urban areas, but neighborhood environments had more impact on cognitive decline among rural older adults than urban older adults.

Discussions

Findings from this study call for increased infrastructure development and community building programs in rural China.
Provider and LGBT Individuals’ Perspectives on LGBT Issues in Long-Term Care: A Systematic Review
Authors: Caceres Billy A , Travers Jasmine , Primiano Jillian E , Luscombe Rachel E , Dorsen Caroline
Published: January 2019

Background and Objectives

Discrimination toward the lesbian, gay, bisexual and transgender (LGBT) population has raised concerns about the type of long-term services and supports (LTSS) that will be available to them as they age. To understand the unique needs of aging LGBT populations, we sought to synthesize and critique the evidence related to LTSS providers and LGBT individuals’ perspectives of LGBT issues in LTSS in the United States.

Research Design and Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review of the literature was conducted. The Crowe Critical Appraisal Tool was used to appraise the quality of the included studies.

Results

Nineteen studies met inclusion criteria. Seven studies that examined the perspectives of LTSS providers identified two themes, including that they lack knowledge and training on LGBT health issues and generally report negative attitudes toward same-sex relations among older adults. In addition, 12 studies that examined the perspectives of LGBT individuals found that they (i) are concerned about LTSS planning, (ii) fear discrimination from providers in LTSS, and (iii) identify several strategies for improving care of LGBT older adults receiving LTSS.

Discussion and Implications

This systematic review highlights the importance for LTSS providers to receive training in LGBT health and be reflective of potential biases toward the LGBT population. LGBT individuals identified concerns related to LTSS planning and fear of discrimination from LTSS providers. LGBT individuals also identified a need for increased training of providers to improve the care of LGBT older adults in LTSS.
Genome sequence of Malania oleifera, a tree with great value for nervonic acid production
Authors: Xu Chao-Qun , Liu Hui , Zhou Shan-Shan , Zhang Dong-Xu , Zhao Wei , Wang Sihai , Chen Fu , Sun Yan-Qiang , Nie Shuai , Jia Kai-Hua , Jiao Si-Qian , Zhang Ren-Gang , Yun Quan-Zheng , Guan Wenbin , Wang Xuewen , Gao Qiong , Bennetzen Jeffrey L , Maghuly Fatemeh , Porth Ilga , Van de Peer Yves , Wang Xiao-Ru , Ma Yongpeng , Mao Jian-Feng
Published: January 2019

Background

Malania oleifera, a member of the Olacaceae family, is an IUCN red listed tree, endemic and restricted to the Karst region of southwest China. This tree's seed is valued for its high content of precious fatty acids (especially nervonic acid). However, studies on its genetic makeup and fatty acid biogenesis are severely hampered by a lack of molecular and genetic tools.

Findings

We generated 51 Gb and 135 Gb of raw DNA sequences, using Pacific Biosciences (PacBio) single-molecule real-time and 10× Genomics sequencing, respectively. A final genome assembly, with a scaffold N50 size of 4.65 Mb and a total length of 1.51 Gb, was obtained by primary assembly based on PacBio long reads plus scaffolding with 10× Genomics reads. Identified repeats constituted ~82% of the genome, and 24,064 protein-coding genes were predicted with high support. The genome has low heterozygosity and shows no evidence for recent whole genome duplication. Metabolic pathway genes relating to the accumulation of long-chain fatty acid were identified and studied in detail.

Conclusions

Here, we provide the first genome assembly and gene annotation for M. oleifera. The availability of these resources will be of great importance for conservation biology and for the functional genomics of nervonic acid biosynthesis.
Comparative analyses identify genomic features potentially involved in the evolution of birds-of-paradise
Authors: Prost Stefan , Armstrong Ellie E , Nylander Johan , Thomas Gregg W C , Suh Alexander , Petersen Bent , Dalen Love , Benz Brett W , Blom Mozes P K , Palkopoulou Eleftheria , Ericson Per G P , Irestedt Martin
Published: January 2019

The diverse array of phenotypes and courtship displays exhibited by birds-of-paradise have long fascinated scientists and nonscientists alike. Remarkably, almost nothing is known about the genomics of this iconic radiation. There are 41 species in 16 genera currently recognized within the birds-of-paradise family (Paradisaeidae), most of which are endemic to the island of New Guinea. In this study, we sequenced genomes of representatives from all five major clades within this family to characterize genomic changes that may have played a role in the evolution of the group's extensive phenotypic diversity. We found genes important for coloration, morphology, and feather and eye development to be under positive selection. In birds-of-paradise with complex lekking systems and strong sexual dimorphism, the core birds-of-paradise, we found Gene Ontology categories for “startle response” and “olfactory receptor activity” to be enriched among the gene families expanding significantly faster compared to the other birds in our study. Furthermore, we found novel families of retrovirus-like retrotransposons active in all three de novo genomes since the early diversification of the birds-of-paradise group, which might have played a role in the evolution of this fascinating group of birds.
Localization of the W-1,q norm for local a posteriori efficiency
Authors: Blechta Jan , Málek Josef , Vohralík Martin
Published: January 2019

This paper gives a direct proof of localization of dual norms of bounded linear functionals on the Sobolev space ${W^{1,p}_0(\varOmega )}$, $1 \leq p \leq \infty $. The basic condition is that the functional in question vanishes over locally supported test functions from ${W^{1,p}_0(\varOmega )}$ which form a partition of unity in $\varOmega $, apart from close to the boundary $\partial \varOmega $. We also study how to weaken this condition. The results allow in particular to establish local efficiency and robustness with respect to the exponent $p$ of a posteriori estimates for nonlinear partial differential equations in divergence form, including the case of inexact solvers. Numerical illustrations support the theory.
Effect of Hepatitis C Virus Coinfection on the Progression of Vertically Acquired Human Immunodeficiency Virus Infection During Childhood and Adolescence
Authors: Fernández-McPhee Carolina , Sainz Talía , Mellado María José , Noguera-Julian Antoni , Otero Carmen , Fortuny Claudia , Soler-Palacín Pere , Falcón María Dolores , Ramos Amador José Tomás , Gavilán César , González-Tomé María Isabel , Navarro María Luisa
Published: January 2019

Data for a total of 57 patients vertically coinfected with human immunodeficiency virus (HIV)/hepatitis C virus (HCV) and 365 HIV-monoinfected patients were compared until their transition to adult care. No differences regarding the dynamics of CD4 and/or CD8 T-cell counts during childhood were found. The coexistence of HCV does not increase the risk of disease progression in vertically HIV-infected patients.
Effect of Armed Conflict and Displacement on Women’s Social, Cultural and Economic Roles and Responsibilities in Northern Uganda
Authors: Corbin Joanne N
Published: January 2019

This qualitative study explored the resettlement experiences of women who were internally displaced by northern Uganda's 21 year armed conflict with the Lord's Resistance Army (LRA). Exploration of the ways that women's social, cultural and economic roles and responsibilities were affected by the experiences of armed conflict and internal displacement and women's adaptations reveal profound changes in women's relationships with men, their connection with other women, and challenges with cultural norms. Program developers will gain examples of how conflict and displacement related changes affect women’s socio-economic relationships, land rights, and families' health and well-being.
Testimony That Sticks
Authors: Postal Karen
Published: January 2019

How do we create access to complex, highly technical neuropsychological and psychological information for jurors in a way that is engaging, understandable, and (to quote Faulkner) sets the truth on fire? Testimony that Sticks shares the fruits of 4-years of in-depth interviews with over 70 seasoned forensic neuropsychologists and psychologists, as well as attorneys and judges, presenting compelling analogies, metaphors, and succinct explanations of assessment processes and findings, as well as principals of productive expert testimony for direct and cross examination. This book allows readers to be a fly on the wall as seasoned forensic neuropsychologists and psychologists share what they actually say on the stand: their best strategies and techniques for creating access to our science for juries and other triers of fact. Readers also have access to the thought bubbles of attorneys and judges as they watch expert testimony and weigh in on what they need from our profession to create more productive testimony. At its heart, the book is about disrupting the academic communication style learned in our years of scientific training that results in a net loss of our ability to communicate clearly and simply about the neuroscience we love. It is about shedding jargon, giving ourselves permission to allow emotion to creep back into our language, freeing up our body language, and using vivid, clear, language to create moments of genuine, productive communication with jurors and other triers of fact.
Setting the Truth on Fire
Authors: Postal Karen
Published: January 2019

This chapter addresses general principles of expert testimony that apply whether one is testifying on direct or cross examination and explores the existential questions of our roles as expert witnesses: What is our purpose in the courtroom? What are the boundaries of our role? How can we be most helpful to juries and triers of fact as they engage in their difficult job of deciding a case? What are we doing when we are testifying well? The chapter also addresses the critical issue of engaging jurors as active participants in our testimony. Are we reciting our opinions, or are we actively creating access for the jurors to a set of tools that they can use to develop their own opinions? Use of storytelling, stepping past the comfortable language of our scores and tests (not being test-bound or diagnosis-bound), and using vivid metaphors and analogies are among the strategies discussed.
Social Pragmatics of Testifying
Authors: Postal Karen
Published: January 2019

Social pragmatics is the language behind the words we speak. This language is visual and auditory. It involves how we dress, our posture, hand gestures, and facial expressions; the pitch, rate, and volume of our voice; our vocal patterns; and how we move when we approach the witness box. Even seasoned clinicians often appear stiff and rigid when they testify. Being awkward in a courtroom can be a barrier to building credibility and connecting with jurors. This chapter challenges expert witnesses to identify the social pragmatics they are using to communicate the message behind their words. Are we using social pragmatics that reflect who we are, or are we unwittingly sending a message we don’t want to send? The purpose of looking closely at the language behind our words is not to create a false or misleading persona for a jury but to identify and eliminate nonverbal barriers that are distracting from our message and distancing us from our true selves and from others.
Jargon
Authors: Postal Karen
Published: January 2019

As experts, we are so used to speaking and thinking in the language of our profession that our jargon often becomes invisible to us. We assume everyone understands what we mean. But when we use jargon during testimony, jurors cannot access our messages, no matter how important or compelling our message. A good attorney will recognize when the expert has veered off into language that others in the court have no access to and will try to rehabilitate the testimony by asking for clarification. However, even if the expert then uses language that is clearer, the relationship between the expert and the jury has been damaged. Experts who use impenetrable words often seem arrogant to listeners. This chapter first makes the case for actively searching for and eliminating jargon and then offers replacement phrases for many of these terms.
Direct Examination
Authors: Postal Karen
Published: January 2019

Following credentialing, the retaining attorney asks open-ended questions designed to draw the expert out about the nature of his or her opinions. Rather than cross examination’s restrictive “isn’t it true . . .” questions, which are designed to be answered with a yes or no, the questions on direct examination invite the expert to expand, “How did you conduct your evaluation?” The questions the attorney asks on direct and the answers the expert gives form the heart of this chapter. While some attorneys have a clear vision for how they would like to draw the expert’s opinions out, most rely on the expert to collaborate with them to structure the series of questions they will ask on direct. This prearranged strategy includes the sequence and goals of the overall narrative and where to insert breaks to move the narrative forward in the form of questions. The goal is not just to present the information in an organized fashion; an important component of strong direct testimony is organizing the information into a narrative that is compelling and engaging and holds jurors’ attention so they can access information critical to performing their role of deciding the case.
Concussion
Authors: Postal Karen
Published: January 2019

Concussion has become a driving force behind forensic neuropsychology practice. This chapter offers vivid, concise, accessible strategies that seasoned forensic experts use in explaining concussion to jurors. Specific topics include explaining the pathophysiology of concussion, how a concussion is diagnosed, posttraumatic amnesia, Glasgow Coma Scale scores, the difference between head injury and brain injury, the typical symptoms of concussion and expected recovery course, the sports as a laboratory research model, problems with the concept of “postconcussion syndrome,” differentiating the literature on chronic traumatic encephalopathy and concussion, and discussing the persistent idea of a “15% miserable minority.” The chapter also provides strategies for explaining alternative narratives as to why a person might feel they have persistent symptoms months or years following a concussion, including diagnosis threat, misattribution, iatrogenesis, “the grass is greener” phenomenon, litigation effects, medication effects, and emotional factors.
Specific Psychiatric and Neurological Disorders
Authors: Postal Karen
Published: January 2019

When experts discuss psychological or neurological syndromes, jurors will bring to the courtroom their own background knowledge and understanding of those disorders. The challenge for the expert is that the jurors’ information may or may not be accurate. This chapter shares vivid, succinct strategies to explain psychiatric illness, intellectual disability, cognitive effects of illness, neurological disorders, and chronic pain to jurors and other triers of fact. Seasoned forensic psychologists and neuropsychologists were asked to share what they actually say in court to describe the most common clinical phenomena that are the subject of criminal and civil cases, including PTSD and depression.
Cross Examination
Authors: Postal Karen
Published: January 2019

While cross examinations are anxiety-provoking, many forensic neuropsychologists enjoy the challenge. This chapter addresses how we can remain productive as experts in communicating our opinions during cross examination by discussing common techniques and strategies that cross-examining attorneys use, including questioning your credibility, trying to damage your carefully built rapport with the jury, attempting to rattle you so that you’ll appear arrogant or biased, and trying to draw you off sides. Experts should remember that this is simply the attorney’s job; it’s nothing personal. Throughout the chapter attorneys, judges, and experts present best practices that they’ve developed for maintaining credibility and clarity through the sometimes trying and difficult process.
Relationship with Other Experts
Authors: Postal Karen
Published: January 2019

It is the nature of our adversarial court system that two experts will testify that they have come to different conclusions about the same person. How that fundamental disagreement is handled by the expert determines whether jurors must witness a “pissing contest” or are thoughtfully educated about the nature of the disagreement. Depending on the litigation strategy, one or both attorneys may want to incite such a contest. This chapter provides rationale and strategies from seasoned forensic psychologists and neuropsychologists as well as attorneys and judges for avoiding unproductive conflicts while accurately and productively explaining differences in opinions. Experts, attorneys, and judges all agreed that tearing down another expert’s credibility damages your own on the stand.
Depositions
Authors: Postal Karen
Published: January 2019

What are the differences between testifying in court and testifying in the context of a deposition? Attorneys, judges, and seasoned forensic psychologists and neuropsychologists share their perspectives in this chapter about all phases of deposition testimony. Topics include setting the boundaries of the deposition, goals of deposition testimony, typical differences in tone by cross-examining attorneys during depositions as opposed to court testimony, videotaped depositions versus videotaped testimony, and strategies for experts to maintain their credibility and clarity through the deposition process.
Training
Authors: Postal Karen
Published: January 2019

This chapter addresses methods, strategies, and resources for training students and mid-career forensic psychology and forensic neuropsychology practitioners to become outstanding communicators on the witness stand.
Introduction
Authors: Romero Adam P. , Goldberg Abbie E.
Published: January 2019

This chapter provides an overview of the edited volume. It provides historical context for the current volume, highlighting how despite shifts in political discourse, changes in the legal landscape surrounding same-sex relationship dissolution, and a slowly growing research base on LGBTQ marriage equality, attention to LGBTQ relationship dissolution and divorce has lagged. In turn, the chapter briefly addresses the range of research, legal, and practice questions that the current volume addresses—including issues related to child custody and mediation—which are significant inasmuch as with marriage equality (may) come relationship dissolution and divorce. The chapter also names the unique aspects of the volume, including the interdisciplinary nature of the authors, the inclusion of personal narratives in the volume, and the integration of discussion questions and practical resources in each chapter. It also provides an outline of each major section of the book and the chapters within each section.
Stress in the Lives of Same-Sex Couples
Authors: Frost David M. , LeBlanc Allen J.
Published: January 2019

Due to the stigmatization of their relationships, people in same-sex couples are at risk for exposure to forms of social stress that those in different-sex couples are not. This chapter discusses how these “couple-level minority stressors,” which may be individually experienced as well as jointly experienced with a partner, may have deleterious effects and lead to relationship dissolution and divorce among same-sex couples. Moreover, it describes potential stress processes emanating from discrepancies in minority stress experiences and stress contagion between partners in same-sex relationships, which may contribute to relationship dissolution in previously unexamined ways. The chapter discusses the role resilience resources may play in same-sex couples’ experiences of minority stress, potentially mediating or moderating its effects on relationship quality, and concludes by considering how better understandings of minority stress in relational contexts can deepen emerging understandings of relationship dissolution in same-sex couples and inform psychological interventions for those seeking help.
Same-Sex Binational Families
Authors: Domínguez Daniela G. , Coppock Jacqueline , polanco marcela
Published: January 2019

This chapter addresses challenges that can surface for some same-sex binational couples in the United States. Vulnerable to both immigration enforcement and social institutions seeking to deny the validity of their relationship, same-sex binational couples may be at increased risk for emotional hardship, relationship instability, conflict, and dissolution. The ramifications of divorce in binational relationships may include jeopardizing the residency status or lengthening the naturalization timeline; separation from children if removed from the United States; and potential removal to a country where one or both members in the partnership may be exposed to sexual prejudice. The chapter discusses the unique challenges that increase the risk of binational same-sex relationships ending in dissolution or divorce, highlighting the limited research on LGBTQ dissolution or divorce and the need for further research on clinical and legal interventions that could enhance the well-being of same-sex binational couples during and after relationship dissolution or divorce.
Consensual Dispute Resolution with Same-Sex Couples
Authors: Goodman Diane M. , Geldenhuys Mariette
Published: January 2019

This chapter discusses the role of consensual dispute resolution (CDR), which allows parties to resolve their disputes outside of the judicial system, in same-sex relationship dissolutions. Two forms of CDR are mediation and collaborative law. In mediation, the parties meet with a neutral professional who helps the parties identify and resolve their disputes. In collaborative law, each party is represented by a collaborative attorney. The chapter, outlines characteristics of mediation and collaborative law, including their similarities and differences, and the tenets of a collaborative divorce. It then describes how the history of discrimination in the courts has affected LGBTQ families and made the use of CDR a more satisfactory and safe way to uncouple. It examines the unique issues that arise for some LGBTQ clients. Lastly, it reviews the skills a CDR professional needs to work with LGBTQ clients.
Same-Sex Relationship Dissolution and Divorce
Authors: Farr Rachel H. , Goldberg Abbie E.
Published: January 2019

As of June 2015, same-sex marriage is a right nationwide in the United States, which means legal same-sex divorce is also a reality across the nation. As many same-sex couples have children, it is likely that at least some children will experience the dissolution of their parents’ relationship. Little research has examined outcomes for children who experience their same-sex parents’ relationship dissolution. In considering these children’s outcomes, this chapter draws parallels to the literature on heterosexual parent divorce and child outcomes. It reviews data on same-sex relationship dissolution and divorce, particularly among same-sex couples who are parents. It also highlights issues unique to same-sex parents and their children who experience divorce. It discusses qualitative and quantitative research, including reflections on relevant longitudinal studies conducted by each author. It acknowledges challenges of conducting research on same-sex relationship dissolution and divorce. Finally, it discusses implications for policy, practice, and research.
Social Science Research on Heterosexual Relationship Dissolution and Divorce Where One Parent Comes Out as LGB
Authors: Tasker Fiona , Rensten Katy
Published: January 2019

Lesbian, gay, and bisexual (LGB) parenthood post-heterosexual relationship (PHR) dissolution was the focus of much of the early social science research on sexual minority parenting from the 1980s onward, and remains relevant today. The initial legal cases contesting LGB parenting involved mainly lesbian mothers seeking custody of their children PHR. Yet the focus of most research on LGB parenting and legislation in the twenty-first century has been on children brought up in planned LGB-parent families. This chapter highlights the key issues of sexual identity disclosure and identity intersection for LGB parents PHR. It considers family transition through single parenthood, nonresidential parenting, and stepfamily formation that might particularly marginalize LGB parents and their children PHR. The review focuses on studies of LGB parents, new same-gender partners, and children in these families. When relevant, it considers how family law relates to sexual minority identity empowerment and disempowerment PHR.
Tying Tight or Splitting Up
Authors: Sachs Aaron Dickinson
Published: January 2019

In this reflexive autoethnography, the author uses performative writing and evocative personal narrative to recount the dissolution of his parents’ relationship and explore the implications of such dissolutions for children of same-sex relationships. The lack of legal and social support structures available to LGBTQ families in the 1980s, and the prevalence of anti-LGBTQ rhetoric focused on the effects of LGBTQ parents on children, both increased the already traumatic impact of family dissolution on the author. As a child, like members of many groups under “political threat,” the author feared that discussing the difficulty of his parents’ separation would validate anti-LGBTQ rhetoric. For the author, labeling the dissolution of his parents’ relationship as “divorce,” and finding friendship with other young people from divorced families, was insufficient; only peer support from other people with LGBTQ parents helped the author to find a safe space to share the trauma of parental relationship dissolution.
Trans Partnership and Marriage
Authors: Pfeffer Carla A. , Castañeda Natalie N.
Published: January 2019

This chapter offers a broad survey of existing research on trans individuals and partnerships conducted across the disciplines and professions of counseling, family studies, medicine, psychology, social work, sociology, and women’s and gender studies, with the goal of assessing and distilling factors associated with the stability and instability of relationships in which at least one of the members is trans. This chapter also provides an assessment of key sources of support and strain for trans partnerships as identified by researchers or that deserve further research exploration. Finally, the authors identify a number of researcher assumptions and biases that may cloud the interpretation of some research findings and outcomes in trans people’s partnerships, suggesting avenues for further focus in clinical practice and research.
Legal Issues in Divorce for Transgender Individuals
Authors: Minter Shannon Price
Published: January 2019

This chapter examines the legal issues faced by transgender people in divorce and child custody cases. Despite trans people’s increased visibility, and gains in legal rights and protections, many people—including judges—continue to harbor misconceptions about transgender people. Attorneys representing transgender clients must anticipate the possibility of judicial bias and take proactive steps to address it. Attorneys must be prepared for the unique legal issues that arise when a spouse transitions during an existing marriage. Even under modern “no-fault” divorce regimes, attorneys must be prepared to rebut the claim that coming out as transgender constitutes misconduct or justifies awarding the other spouse more marital property or spousal support. In custody cases, attorneys must anticipate and rebut misinformation and negative judicial attitudes toward transgender parents. Finally, even after Obergefell v. Hodges (2015), attorneys representing transgender clients who married before Obergefell must be prepared to explain why that decision is retroactive.
A Daughter of a Transgender Parent’s Perspective on Relationship Dissolution
Authors: Veldorale-Griffin Amanda
Published: January 2019

In this chapter, the author presents her experience as the daughter of a transgender woman who transitioned when the author was a child. The author explores her experience coming to terms with her father’s gender identity, managing her own fears of stigma and harassment from others, and navigating her parents’ divorce. She also discusses her journey to becoming a family therapist and family science researcher whose work focuses on transgender individuals and family dynamics. This chapter also includes a brief overview of the author’s research with transgender parents and their children and a discussion of best practices for therapists working with these families.
The Role of Gender and Gender Dynamics in Same-Sex Divorce and Dissolution
Authors: Kim Suzanne A. , Stein Edward
Published: January 2019

This chapter identifies ways researchers, policymakers, therapists, lawyers, and couples should attend to the role of gender and gender dynamics facing same-sex couples upon divorce or relationship dissolution. When same-sex couples marry, gender roles associated with a particular vision of different-sex couples—in reference to which the legal institution of marriage developed historically—may be projected onto same-sex couples both socially and by judges adjudicating their relationship dissolutions, often in a manner conflicting with couples’ intentions and practices. Thus, couples consisting of two men and couples consisting of two women may be differentially affected. Gender and gender dynamics are likely to affect the bases for dissolution (e.g., whether one of the spouses committed adultery or whether there is a basis for annulment); the financial aspects of dissolution; and determination of child custody. The chapter suggests directions for future research regarding the impact of gender on the dissolution of same-sex relationships.
Dissolution of Polyamorous Relationships, Multiple Parent Families, and Other Complex Arrangements
Authors: Argentino Jodi A. , Fiore Celeste
Published: January 2019

This chapter explores the challenges facing multipartner and multiparent families in family law during dissolution. It first explores society’s idealization of the traditional husband-wife-child family, which persists despite the fact that a diversity of family forms have long existed in the United States and are becoming increasingly common today. It explains how this idealized construct underlies family law in the United States and disadvantages multipartner and multiparent families in a variety of ways. Courts and legislatures have been slow to recognize and provide for legal rights among multipartner and multiparent families, and even where courts have recognized more than two parents, the results have been unsatisfactory. Statutes in California and Maine, by contrast, are more progressive toward multipartner and multiparent families. Preparation and education are vitally important to multipartner and multiparent families. The chapter discusses how the trust, honesty, and communication that define many polyamorous families can impact dissolution.
Conclusion
Authors: Gartrell Nanette K. , Rothblum Esther D.
Published: January 2019

This chapter presents seven scenarios that illustrate how stressors can place long-term LGBTQ relationships at risk for dissolution, and discusses the strategies couples implemented to navigate through these challenges. We engaged in conversations with at least one person in a series of LGBTQ couples (diverse in race, ethnicity, gender, gender identity, geography, SES/income, education, and health/ability) that have been together for over 15 years. We focused on issues that frequently arise in the LGBTQ community, including (1) differences in outness, (2) gender identity, (3) polyamory, (4) rearing children, (5) money and status, (6) health, and (7) the role of ex-lovers. We then discuss effective strategies for maintaining relationships, including (1) acknowledging demographic and culture differences, (2) giving relationships time, (3) using community supports, (4) understanding gender differences in sexual activity and monogamy, (5) perceiving differences in money and power, (6) seeking therapy and legal advice, and (7) compromising versus issuing an ultimatum.
Ethical Issues in the Neonatal SUPPORT Trial
Authors: Lantos John D.
Published: January 2019

The controversy over the neonatal Surfactant, Positive Pressure, and Oximetry Randomized Trial (SUPPORT) study of oxygen saturation targets in extremely premature babies was intense and polarizing. The fundamental issue turned on whether or not there were reasonably foreseeable risks to the babies who were enrolled in the study and, if so, whether that should have either (a) been disclosed in the consent form or (b) led institutional review boards to never approve the study in the first place. The federal Office for Human Research Protections (OHRP) took the first view. The advocacy group Public Citizen (PC) took the second. This chapter suggests that both views were wrong. Being in the study was, in fact, safer than not being in the study. The mistakes made by both OHRP and PC have dangerous implications for research ethics and regulation. They could lead to mandates for consent forms that are inaccurate and misleading.
Invasive Placebos, Patient Burdens, and Community Advocacy
Authors: Snyder Donna L. , Lee Catherine S. , Nelson Robert M.
Published: January 2019

The “Additional Safeguards for Children in FDA-Regulated Clinical Investigations,” 21 CFR 50 subpart D, places limits on the risk to which a child can be exposed in a study. Absent a prospect of direct clinical benefit, institutional review boards (IRBs) cannot approve an intervention or procedure that exceeds “a minor increase over minimal risk.” If there is an ethical justification for the study to proceed, the IRB may refer the protocol for review by a federal panel under 21 CFR 50.54. A study allowing use of a totally implantable central venous access device (TICVAD) to provide placebo was referred for federal panel review; the committee voted unanimously in favor of a TICVAD. A determination by the Food and Drug Administration commissioner was issued within 10 weeks of the initial referral, an unprecedented time line. The Duchenne Muscular Dystrophy community was instrumental in initiating the referral and informing the panel’s decision.
When, If Ever, Is It Ethical to Do Research in Developing Countries That Could Not Be Done Ethically in Developed Countries?
Authors: Ross Lainie Friedman
Published: January 2019

In this chapter, three studies performed in the 1990s in three developing countries focused on three neonatal infectious diseases are discussed. The studies were (a) a randomized, double-blind, placebo-controlled trial to reduce perinatal transmission of HIV in Thailand; (b) a randomized, double-blind, placebo-controlled trial to prevent Haemophilus influenzae type b pneumonia in infants in The Gambia; and (c) a nonrandomized cluster trial to reduce neonatal mortality rate from sepsis in infants born at home in India. The chapter examines the ethical controversies raised by these studies and concludes that location and intention matter. Although these studies could not have been performed in the United States or United Kingdom, they were designed to answer a question relevant to the community in which the research was being conducted. Finally, the chapter explores the different ethical scrutiny these studies received and what lessons can be learned.
The Welfare of Children, Research Ethics, and the Bucharest Early Intervention Project
Authors: Master Maria G. , Fins Joseph J.
Published: January 2019

Ethical principals demand that science foster human goodness and flourishing—serving as a tool to help, not harm, humanity. This chapter considers as a case study the Bucharest Early Intervention Project (BEIP), a randomized controlled trial comparing the effects of foster care as an alternative to institutional care for young children in Bucharest, Romania. The study results suggested that early institutionalization leads to profound deficits in many domains. The ethical issues triggered by these experiments span the domains of randomization to harm, clinical equipoise, standard of care, researcher ambivalence, duty to rescue, political cooptation and conflicts of interest, and logicality. The alleged methodological rigor of the randomized controlled BEIP has a seductive internal consistency, but careful analysis reveals that gloss distracted the scientific community from our fundamental ethical obligation to provide authentic witness to, and compassionate care for, the most vulnerable among us.
Communication and Decision-Making with Parents and Seriously Ill Children about Phase 1 Research Trials
Authors: Cousino Melissa K. , Morrison Wynne E. , Miller Victoria A.
Published: January 2019

This chapter uses a case study to explore communication and decision-making with parents and seriously ill children about phase 1 research trials. The chapter begins with a case scenario about 13 year-old “Gabby,” who has relapsed high-risk acute myeloid leukemia, which brings to the forefront ethical issues specific to communication and decision-making with parents and seriously ill children about phase 1 research trials. A brief history on phase 1 research trials in pediatric oncology is provided, followed by a review of the scientific literature regarding challenges to informed consent and child assent in this context. The chapter ends with evidence-based strategies for improving informed consent for pediatric phase 1 trials and questions for discussion.
Social Media and Pediatric Research Recruitment
Authors: Gelinas Luke , Kesselheim Jennifer C.
Published: January 2019

Social media use has increased exponentially across all demographics. With social media’s widespread popularity comes an increased potential for research sponsors and investigators to use it as an effective tool for recruiting individuals into clinical research. Despite this, there has been relatively little attention paid to the general ethical issues implicated in social media recruitment and even less attention paid to the distinct ethical issues raised by using social media to recruit pediatric populations more specifically. This chapter examines these issues, providing an overview of the use of social media in clinical practice, an assessment of the general ethical issues associated with social media recruitment, and analysis of the potential risks and benefits of using social media to target adolescents for recruitment into clinical research.
Payments for Participation of Children in Research
Authors: Diekema Douglas S.
Published: January 2019

Providing payment to those who participate is common practice for research studies involving both children and adults. While there may be good reasons for providing payment for research participation, there are also reasons to be concerned about the practice, especially when the subjects are children and the payment has the potential to distort parental decision-making by tempting parents to consider issues other than the welfare of their child. This chapter examines the ethical implications of providing payment to children and their parents for participation in research. After a brief survey of current practices regarding payments to research participants, the chapter will examine the distinct kinds of payments offered to research participants and their parents (Those intended to reimburse expenses and those intended to induce participation), evaluate the ethical considerations relevant to each kind of payment, and make some final recommendations concerning the provision of payments for research involving children.
Ethics and Research with Children
Authors: Nelson Robert M. , Kodish Eric
Published: January 2019

This chapter explores the ethical tension between protecting vulnerable children from research risks and protecting children through access to appropriate research in support of safe and effective pediatric products. The history of the debate over pediatric research is reviewed briefly, along with central ethical themes within that debate. Each of the chapters in this volume are set within this context. Themes examined include the role of the clinician-investigator, the concept of the best interests of the child, appropriate risk assessment, the importance of component analysis to the assessment of pediatric research protocols, the choice of an appropriate control group, parental permission and child assent, compensating children for research participation, and the fetus as research subject.
In Graduate School, I Learned What I Need to Know About Running a Successful Practice
Authors: Barnett Jeffrey E. , Zimmerman Jeffrey
Published: January 2019

Although most mental health professionals receive excellent education and training that helps them to become competent and highly effective clinicians, graduate school tends not to provide training in the business side of practice that is needed for success in private practice. Many trainees and early-career clinicians may think they learned in graduate school all they need to know to be successful in the business of practice. Unfortunately, this is generally not true and many of those who enter private practice are poorly prepared for planning, establishing, and running a successful private practice. This chapter addresses the key issues every mental health clinician should know about when contemplating opening a private practice. Business and financial issues are addressed, including developing a business plan and utilizing various consultants. This chapter addresses the myth that excellent clinical skills are sufficient for success in the business of private mental health practice.
Becoming Licensed Means That I Am Now Competent
Authors: Barnett Jeffrey E. , Zimmerman Jeffrey
Published: January 2019

Mental health clinicians invest in many years of hard work to develop their clinical competence through graduate coursework and through supervised clinical experiences. All this is done with the ultimate goal of becoming independently licensed to practice in one’s profession. Because licensure is such an important event, signifying the culmination of so much education and training, it may be natural to believe that becoming licensed means that one is now clinically competent. This chapter addresses how clinical competence and licensure should be viewed and understood. Licensure assesses one’s competence to enter the profession, but it cannot guarantee competence in all areas of clinical practice at the time of licensure or in the future. How to maintain, update, and expand one’s competence over time is addressed. Risks and threats to competence are discussed, and recommendations are provided for ensuring one’s ongoing competence over time.
If I “Sell Out” to the Business of Practice, I Give Up My Core Value of Altruism
Authors: Barnett Jeffrey E. , Zimmerman Jeffrey
Published: January 2019

Mental health clinicians in private practice are business persons who have the goal of running a successful business. It is easy to believe that those who are highly successful in the business of private practice care primarily about making money and that they have lost their focus on caring for others and addressing their mental health treatment needs. This chapter examines how running an ethically responsible successful practice is essential for assisting and caring for others. It highlights how clinicians may run a financially successful private practice and remain true to the values that led them to pursue a career as a mental health professional. Specific recommendations are provided for being financially successful while remaining true to one’s values.
Managed Care Is Evil and Should Be Avoided Like the Plague; Experienced and Competent Clinicians Don’t Participate in Managed Care
Authors: Barnett Jeffrey E. , Zimmerman Jeffrey
Published: January 2019

It is easy to believe that managed care is evil and that it should be avoided at all possible costs. Yet, as this chapter explains, not all managed care companies are equivalent. How to determine which managed care companies are worth working with is explained. Factors to consider include contractual issues, fees, documentation requirements, ethical and legal issues, and utilization-review processes. Further, in some communities, many residents may only be able to afford mental health treatment by utilizing their managed care insurance benefits. Consistent with the values of the mental health professions, selective participation with some managed care companies may help achieve the greatest good for those one serves. This chapter explains how with careful forethought, one may ethically participate in managed care, meet clients’ best interests, and be fairly compensated for the clinical services provided.