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\"The Contemporary Relational Supervisor is an empirically-based, academically-sophisticated, and learner-friendly book on the cutting edge of couple and family therapy supervision. Appropriate for master's and doctoral level students, as well as experienced clinicians who wish to learn about supervision, it emphasizes system and relational thinking and intervention, while privileging the diversity of training system members, their realities, experiences, and interpretations of life. The authors are attuned throughout the text to how and where clinical training and services are provided, and to whom, and provide detailed literature reviews for readers. These factors assist their discussion of the socio-historic development of the MFT supervision designation, and the fundamentals, contexts, philosophy, relationships, and pragmatics of MFT supervision. They also discuss major models and approaches, evaluation, ethical and legal issues, and therapist development. Perhaps most important is their presentation of methods that help tailor and extend supervision practices to meet the clinical, institutional, and economic realities that MFT therapists navigate. Readers are engaged by the discussions and exercises at the end of each chapter, which help them to feel more grounded in a topic, to have their own voices heard, and to be granted insight through experiencing multiple realities. This valuable reference prepares the next wave of cutting-edge CFT supervisors, those who are knowledgeable, skilled, and realistically confident\"-- Provided by publisher.

There are over 8 million central venous access devices inserted each year, many in patients with chronic conditions who rely on central access for life-preserving therapies. Central venous access device–related complications can be life-threatening and add tens of billions of dollars to health care costs, while their incidence is most likely grossly mis- or underreported by medical institutions. In this communication, we review the challenges that impair retention, exchange, and analysis of data necessary for a meaningful understanding of critical events and outcomes in this clinical domain. The difficulty is not only with data extraction and harmonization from electronic health records, national surveillance systems, or other health information repositories where data might be stored. The problem is that reliable and appropriate data are not recorded, or falsely recorded, at least in part because policy, payment, penalties, proprietary concerns, and workflow burdens discourage completeness and accuracy. We provide a roadmap for the development of health care information systems and infrastructure that address these challenges, framed within the context of research studies that build a framework of standardized terminology, decision support, data capture, and information exchange necessary for the task. This roadmap is embedded in a broader Coordinated Registry Network Learning Community, and facilitated by the Medical Device Epidemiology Network, a Public-Private Partnership sponsored by the US Food and Drug Administration, with the scope of advancing methods, national and international infrastructure, and partnerships needed for the evaluation of medical devices throughout their total life cycle.

Background Advanced liver disease is associated with increased risk for postoperative complications. It is not well known whether the presence of nonalcoholic steatohepatitis (NASH) in morbidly obese patients contributes to the rate of postoperative complications. The main objective was to study the association between NASH and postoperative complications in bariatric patients. Methods A total of 340 contemporary sequential patients who underwent laparoscopic bariatric operations and who had intraoperative liver biopsies were studied. The rates of severe postoperative complications were compared across three patient groups—those with (1) no liver disease or with simple steatosis, (2) mild nonalcoholic NASH [steatosis with necroinflammation and mild fibrosis (stage 0–1)], and (3) advanced NASH [steatosis, necroinflammation, and more advanced fibrosis (stage ≥ 2)]. Results Of 340 patients, 141 (42%) had no NASH, and 151 (44%) and 48 (14%) had mild and advanced NASH, respectively. Superobesity ( P  = 0.037), diabetes ( P  < 0.001), and cerebrovascular disease ( P  = 0.013) had highest frequencies in patients with advanced NASH. Hypertension was highly prevalent in cohort (57%) but similarly distributed across three groups. Forty-five patients experienced at least one complication (pulmonary 4, cardiovascular 8, surgical 16, and acute kidney injury 21). The complications rate did not differ significantly across NASH categories. Median hospital stay was 3 days (IQR 2, 3), and it was not associated with NASH severity. There were no 30-day postoperative deaths. Conclusions Despite the high prevalence of NASH among morbidly obese surgical patients, this condition was not associated with increased risk for postoperative complications. Postoperative acute kidney injury was the most frequent single complications.

This project qualitatively analyzed the stories that 23 preadolescent foster children told about their lives. An ecological framework in conjunction with the social constructionist understanding of stories guided the ethnographic semistructured interviews. These stories contained both common and unique features and provided insight into the lives of foster children whose environments involved poverty, drugs, crime, violence, and racism. Research domains included confusion, social ambivalence, anger, loss, and aids to resiliency. This study highlights the importance of these stories for the children who create them and those who will work with them.

This study explores the beliefs of middle class urban Hindus (MCUHs) about the meaning and purpose of the institution of heterosexual marriage. The intention was to develop a foundation for assessment tools valid for India’s population. Individual semistructured interviews were conducted in the homes of 32 MCUH in New Delhi who had been married for at least seven years. Qualitative methodology along with the constant comparison method was used to analyze the data. This sample conceived of marriage, both as a noun and a verb, differently than the theoretical models underlying Western assessment tools. To these MCUH, marriage is a sacred, inescapable, socially-sanctioned, developmental stage in which pragmatic collectivist rationales exclude romantic motives. Accordingly, the researchers found probes about marital “satisfaction” to be largely unfruitful. Some MCUH described minor changes driven by formal education, Western thinking, and technological development. Implications for family clinicians and future research are given.

This paper investigates four roles that local governments play in sustainability within the contemporary intergovernmental system—minimalist, implementing agent, entrepreneur, and regional champion. A conceptual framework is advanced to explain these roles based on the time horizons and capacities within which local governments operate. Interviews with local government managers offer insights into how these two dimensions shape the roles that local governments play in sustainability. Although the interviews offer support for the utility of the sustainability role framework, they also suggest additional factors influencing the roles that local governments play in sustainability.

Academic interest in local government collaboration is well documented. This article bridges that interest with practitioner preferences in a survey to a dozen experienced city and county managers in Florida on their experience in forging local government collaboration. The results showed that most formal collaboration agreements involved sharing facilities and most informal collaboration agreements involved sharing equipment. Moreover, none of these local managers felt that federal or state mandates had any impact on their agencies decision to enter into collaborative agreements and the managers did not evince a general agreement on either the process to follow to initiate or to evaluate interlocal agreements.

Research was conducted to determine the effects of boiling, refrigerating, and microwave heating on the cooked quality and stability of lipids in macaroni containing 15% (w/w) ground flaxseed. Boiling increased brightness but decreased redness and yellowness of macaroni containing ground flaxseed. Boiled macaroni and boiled‐refrigerated‐microwave heated (BRMH) macaroni had similar appearance. After boiling, cooking loss was lower and cooked firmness was greater for macaroni dried at ultra‐high temperature (90°C) than at low temperature (40°C). Macaroni fortified with ground flaxseed had lower cooking loss than did nonfortified macaroni. Firmness was greatest with boiled, intermediate with boiled‐refrigerated (BR), and least with BRMH macaroni. Cooking in boiling water reduced extractable lipid content of macaroni with flaxseed. Boiled‐refrigerated and BRMH macaroni with flaxseed had similar extractable lipid contents and were lower than that for boiled macaroni with flaxseed. Free fatty acid content was greatest with dried, intermediate with boiled, and least with BR and BRMH macaroni with flaxseed. Boiling, refrigerating, and microwave heating did not affect conjugated diene content in lipid extracted from macaroni with flaxseed, regardless of drying temperature.

Studies meant to allow \"cross-cultural\" comparisons may be fatally flawed by the concepts, instruments, and discoveries of one culture being applied uncritically to another (namely, \"etic\" errors; cf. current discussions and examples in Chand, 2008; Durrenberger and Erem, 2007). Moreover, studies of foster families often disregard the unique ecosystemic environments in which those families are embedded (Lee, 2008). Therefore, this paper describes an overarching family adaptation model meant to resolve the foregoing problems. Secondary analysis of data describing urban Egyptian foster families (Megahead, 2008; Megahead and Cesario, 2008) illustrates the application of this model and suggests its heuristic value: Use of this model and method will allow common understanding of commonalities and differences within and between cultures, while respecting the uniqueness of each. The Family Stress and Adaptation Model focuses on family adaptation as a function of family stressors interacting with family coping resources. Although the framework is thought to apply to all cultures involving families, the variables—adaptation, stressors, and resources—are defined and operationalized emically (that is, the cultural insider's perspective determines what is to be considered, its nature, and size). Les recherches sur les questions autour d'une famille de placement à l'intérieur et à travers des cultures sont souvent sans théorie et risquent d' avoir des problèmes à cause des concepts, des théories et des découvertes tirés d'une culture et appliqués à une autre. Cet article suggère l'application d' un modèle du concept de la famille transcendantalle — l'adaptation familiale comme fonction de l'interaction du stress dans la famille et les resources de la famillie — ce qui permet les variables dépendantes et indépendantes d'être définies et mise en action au niveau de la subcuture. L'imposition de cette méthode s'illustre par une étude récente des familles egyptiennes qui étaient les familles de placement pour les enfants abandonnés. Le modèle général s'est accordé avec l'aquisition de données et a indiqué que, dans cette subculture, le niveau du problème dans l'enfant était apparenté à la fin du soutien de la famille de placement. Le soutien de l'agence était plus important que la famille et le soutien social. L'auteur pense que le modèle marchera bien dans les cultures différentes, mais que la puissance des éléments qui sont influants et de leur interaction, varieront entre subcultures. La investigación cros-cultural enfocada en hogares sustitutos y sistemas carece frecuentemente de un sustento teórico y puede tener errores graves respecto a conceptos, instrumentos, y hallazgos de una cultura aplicados de manera superficial a otra. Este artículo recomienda el uso the un modelo conceptual transcendental—adaptación familiar como una función de la interacción de estresores familiares y recursos familiares- que permite a variables dependientes e independientes ser definidas y operacionalizadas subculturalmente. La aplicación de este método es ilustrada por medio de un estudio longitudinal de familias Egipcias con padres y madres sustitutos de infantes abandonados. El modelo mostró una adecuada adaptación a los datos e indico que en esta subcultura en particular, la resolución de la problemática del infante estaba fuertemente relacionada con la terminación de la experiencia de familia sustituta, y el apoyo de agencia era un moderador más fuerte que el apoyo familiar y social. El autor espera que el modelo mostrará una adecuada adaptación a los datos cros-culturalmente, pero la fuerza relativa de las variables moderadoras y de interacción diferirán respecto a las subculturas.