Willingness of volunteers from Canadian Blood Service's Stem Cell Registry to donate blood, marrow, and other tissues for regenerative therapy.

BACKGROUND: As research surrounding cell-based regenerative therapy advances toward human trials, greater demand for cell products sourced from healthy donors will arise. The extent to which volunteers in Canadian Blood Services Stem Cell Registry would be willing to donate cells to support regenerative therapy is not known and warrants exploration. METHODS: We conducted a Web-based survey to assess factors that would influence donor willingness to donate various tissues (blood, skin, fat, and bone marrow) for regenerative therapy. The survey was provided to 15,000 randomly selected donors who registered between 2013 and 2018. Data from the 1118 respondents were analyzed. RESULTS: Despite a mixed degree of familiarity with regenerative medicine, potential donors were very supportive of donating for direct patient care and for research, and increasing their familiarity by reading a brief paragraph of information on regenerative medicine increased willingness to donate. Canadian Blood Services' stem cell registrants greatly preferred supporting nonprofit groups in research and development in comparison to entities that represent profit-seeking industry involvement. The most important factors influencing donor willingness to donate were having an impact on patients, safety of donation, advancing knowledge in regenerative medicine, a manageable time commitment, and tolerable pain that could be managed. Donors were most willing to donate blood and had mixed responses to donating other tissue types. CONCLUSIONS: Adult volunteers from a national stem cell registry are willing to support donation of biospecimens for regenerative therapy.

The theory of sibling trauma and the lateral dimension.

Juliet Mitchell has made an invaluable contribution to psychoanalytic developmental theory with her elucidation of sibling trauma. She suggests that this is a universal experience of the preoedipal child who becomes aware of the world of similar others through the birth of a sibling or the dawning recognition of the ubiquitous peer group. Suddenly no longer unique, the child is in dread of displacement and confronted with the loss of the special status of "the baby." Two examples from adolescent analyses are offered to illustrate the power of the lateral dimension.

Is Emerging Adulthood a New Developmental Phase?

In 2000, Jeffrey Arnett, a developmental research psychologist, proposed a new phase of development that he called "emerging adulthood." He delineated developmental challenges centered on identity, role exploration, and subjective experience and linked his observations to changes in the demographics and culture of contemporary society. This proposal elicited an extraordinary response in the research community, but the reaction among psychoanalysts has been tepid at best: developmental phases have not been amended for almost a century, and in some schools the very notion of such phases has been discredited. Adult development has historically attracted mostly lifespan psychoanalysts, and the concept of identity has never achieved full psychoanalytic status. But both adulthood and identity merit psychoanalytic legitimacy: adulthood because it looms in the mind as a meaningful endpoint that shapes earlier stages, and identity because it is a complex, organizing aspect of self-representation. The concept of emerging adulthood, too, has sufficient validity and heuristic value to be considered a developmental phase, provided we loosen our fixed ideas about what constitutes "developmental" and take a fresh look at the sweep of human development as it is shaping up in a transformed world.

Experiences in the Gulf of Mexico: Overcoming Obstacles for Commercial Fishing Occupational Safety and Health Research.

Researchers involved in community-based participatory research often face challenges due to numerous dynamic factors, including the physical location of the study population, willingness to participate, language barriers, cultural norms, social stigmas, and unpredictable weather and other disasters. Investigators who work with commercial fishermen are all too familiar with these potential obstacles and barriers to performing occupational safety and health research. Such has been the case along the Texas and Louisiana gulf coasts, where the burden of occupational fatalities in the shrimp fishery remains high. Moreover, the need for strategic community, regulatory agency, and research partnerships in order to explore solutions that can help to reduce this burden is ongoing. The IFISH 5 conference and the panel session described in this brief report offered a venue to acknowledge and create awareness of these barriers and opportunities for developing sustainable solutions that can have an impact on this loss of life. The approach taken was to explore the perspectives of a panel of regional collaborators including two researchers, an outreach community liaison, and a marine safety and health official from the U. S. Coast Guard. Key barriers emerging from the panel fell into four themes, each emphasized by one of the four panel members, allowing for discussion of potential solutions. The themes included: (1) language gap; (2) cultural influences and use of personal flotation devices; (3) relationships with the community; and (4) enforcement agency role as a trusted opinion leader. This panel session can readily serve as a model to promote similar exploration of barriers and solutions in commercial fishing across other regions of the US and internationally as well.

Psychoanalytic developmental theory: a contemporary reconsideration.

Psychoanalytic developmental theory has never enjoyed a broad consensus among psychoanalytic thinkers. In today's postmodern era, its relevance and basic premises are even more in question as a legitimate part of psychoanalytic theorizing. Part of the problem has been (1) the serious errors perpetrated historically in the name of psychoanalytic developmental theory and (2) its current state of disarray in the wake of piecemeal efforts to rectify these errors. Nonetheless, its presence is discernible in every psychoanalyst's theory and clinical work, whether or not it is acknowledged or brought into a cohesive theoretical frame. The point of view of "intersubjective ego psychology" (Chodorow 2004), embraced by a growing number of analysts interested in development, offers a more flexible and inclusive paradigm for psychoanalytic developmental thinking in order to preserve its rightful place in contemporary psychoanalysis.

Children's health in the rural environment.

The rural environment is not as wholesome as some might think. In fact, smoking, drinking, illicit drug use, and obesity are more prevalent in rural than in urban youngsters. Childhood mortality is higher in rural areas, with drowning, motor vehicle accidents, firearm injuries, and farm machinery accidents as the leading causes. Air and water quality are monitored less and actually may be worse in the country than in urban areas. This article describes children's health problems associated with the rural environment and provides a list of resources for addressing these problems.

Workplace Safety Interventions for Commercial Fishermen of the Gulf.

Commercial fishing continues to have one of the highest rates of occupational fatalities compared with other work sectors in the United States. Attitudes/beliefs among Vietnamese shrimp fishermen of the Gulf of Mexico may influence behaviors that are risk factors for fatal and nonfatal injuries. The study employs a community trial with quasi-experimental pretest/posttest intervention design. An advisory group made up of key stakeholders including representatives from the US Coast Guard was assembled. A survey was designed using the Theory of Planned Behavior as the theoretical framework. Three community groups at port sites along the Texas/Louisiana Gulf Coasts were identified. Focus groups were convened at each site to select priority areas for risk intervention using training and awareness measures. Initial and follow-up surveys were administered pre-/post-interventions for each of the three community groups (2008, n = 217 completed surveys; 2012, n = 206 completed surveys). The follow-up survey was condensed and "intent to act" questions were added for the priority concerns identified (noise-induced hearing loss, machinery/winches, and fatigue). Statistically significant changes (P ranging from .000 to .042) were observed in selective attitude/belief responses for hearing/noise and fatigue. Intent to action or to adopt the intervention was high among all three groups of shrimp fishermen (hearing conservation, 82.4%; machinery/winch safety, 94.6%; fatigue awareness, 95.3%). Simple, yet culturally appropriate training and awareness measures in the form of visual and written safety messages favorably influence attitudes, beliefs, and behavioral intent related to priority risk factors identified by Vietnamese commercial shrimp fishermen along the Texas and Louisiana Gulf Coasts.

Play in the psychoanalytic setting: Ego capacity, ego state, and vehicle for intersubjective exchange.

The psychoanalysis of an 8-year-old boy who does not play is presented to illustrate the centrality of the "state of playing" for meaning-making and communication in treatment. Developmental research links affect regulation, narcissistic balance, and the capacity for make-believe to the early inter subjective exchange between mother and infant. The intersubjective dialogue between patient and analyst in the "state of playing" is a crucial component of child analysis and its absence both reflects and compounds ego vulnerability in the child and presents a daunting technical challenge to the analyst.

Children's safety on American Indian farms: information and recommendations.

It is estimated that 1.2 million youth younger than age 20 live on farms; American Indian children constitute an important but understudied subset of this at-risk group. Despite documented risks of injuries and death among children who live and work on farms and a descending trend in the overall reported fatalities among youth who live and/or work on farms, very little is known about the agriculture-related injury and fatality experience of American Indian youth. Limited data indicate that drowning, motor vehicles, and poisonings are leading causes of unintentional mortality and morbidity for this group, although the attribution to agricultural exposure is not evident. The scant available data indicate a need to look more closely at agricultural work, bystander exposures, and other farm events that put American Indian youth at risk of illness, injury, or death compared to factors more fully reported for majority youth in the agriculture population, in order to guide intervention and prevention programs that are appropriate and acceptable to this vulnerable population.

Helping Gulf shrimpers adopt safety measures: importance of partnerships and research to practice.

Commercial fishing continues to be a dangerous line of work. There are many hazards and the work is complex, even on a small scale. Along the United States Gulf Coast, the make-up of the commercial fishing population is diverse, with many Vietnamese shrimpers. Cultural barriers can interfere with critical communication and with receptivity to necessary safety training. In the course of studying these factors, it became apparent that language was a significant barrier among Vietnamese shrimp fishermen learning sound signals and making Mayday calls, potentially contributing to adverse events. This article is a qualitative description of a pilot project in response to this observation and aimed at the development of a model simulating the bridge of a commercial fishing vessel (including horn blast and radio). The model is used to improve knowledge and skills of the fishermen by providing instruction in Vietnamese. As a Mayday call must be made in English, instructional aids are provided to assist fishermen in the exercise. This example of research to practice (r2p) demonstrates how research findings may enhance acquisition of safety knowledge and skills through development of these types of models as well sustainable instructional tools like the multi-lingual interactive CD described here. It further illustrates the importance of partnerships in the design and delivery of workplace safety training interventions. The model, instructional aids, and CD are timely as they coincide with new regulation which mandates certification of these competencies or skills.

Pretend play and development in early childhood (with implications for the oedipal phase).

Pretend play reflects both the unique mental organization and the developmental challenges of early to middle childhood, with a trajectory that parallels the monumental transformation of the toddler to the school-age child. Despite evidence for various forms of playing throughout the life cycle, the flowering of symbolic play in this phase is specific, essential, and typically transient in terms of its dominance in the life of the child. It reflects the simultaneous emergence, processing, and integration of the remarkable developmental advances occurring during this period, most especially the capacity to symbolize, in the service of the exponentially expanded psychosexual/social/emotional force field implied in the contemporary use of the term oedipus complex. Moreover, it constitutes a particular mental organization and ego state, with idiosyncratic mentation, affect regulation, and relationship to inner and outer experience, that accompanies the child's gradual orientation to consensual reality. Subsequent access to some form of this state varies widely among individuals but is rarely fully comparable.

"This strange disease": adolescent transference and the analyst's sexual orientation.

The treatment of adolescents by gay analysts is uncharted territory regarding the impact of the analyst's sexuality on the analytic process. Since a core challenge of adolescence involves the integration of the adult sexual body, gender role, and reproductive capacities into evolving identity, and since adolescents seek objects in their environment to facilitate both identity formation and the establishment of autonomy from primary objects, the analyst's sexual orientation is arguably a potent influence on the outcome of adolescent development. However, because sexual orientation is a less visible characteristic of the analyst than gender, race, or age, for example, the line between reality and fantasy is less clearly demarcated. This brings up special considerations regarding discovery and disclosure in the treatment. To explore these issues, the case of a late adolescent girl in treatment with a gay male analyst is presented. In this treatment, the question of the analyst's sexual orientation, and the demand by the patient for the analyst's self-disclosure, became a transference nucleus around which the patient's individual dynamics and adolescent dilemmas could be explored and clarified.

Evaluation of a school-based train-the-trainer intervention program to teach first aid and risk reduction among high school students.

BACKGROUND: Farming is a hazardous occupation posing health risks from agricultural exposures for the farm owner and family members. First Aid for Rural Medical Emergencies (F.A.R.M.E.) was developed to support a train-the-trainer (TTT) program to prepare high school students to teach first aid skills and risk reduction through peer interaction. This study was designed to evaluate the educational effectiveness for first aid skill development and awareness of safety issues and injury prevention impacting agricultural communities. METHODS: Forty-three agricultural science students from a rural high school participated in the study. A quasi-experimental design was used to evaluate knowledge acquisition and anticipatory action among groups: those participating in training and a comparison group with no training. The intervention group included 27 participants trained as first aid peer instructors using the F.A.R.M.E. manual, return demonstration, case scenario facilitation training, and teaching evaluation sessions. The effectiveness of the program was evaluated using triangulated data. Independent t test analyses were conducted on post-test scores to evaluate the knowledge acquisition and anticipatory action scores between groups. Focus group sessions assessed attitudes, experiences, and values held following the intervention of teaching peers. RESULTS: Results indicate that the intervention group scored significantly higher on anticipatory action (t = 2.23, p = .03) but not knowledge acquisition (t = 1.37, p = .18). Focus group data suggest that the TTT format bolstered confidence in teaching, confirmed that teens enjoy learning from teens, and fostered pride in team work. CONCLUSIONS: The F.A.R.M.E. TTT resulted in a theory and evidence-based intervention that can be implemented in a school setting to promote knowledge and skill acquisition of first aid and injury prevention among rural high school students.

Factors influencing safety among a group of commercial fishermen along the Texas Gulf Coast.

The commercial fishing trades are among the most dangerous jobs in the world. Little published information exists regarding some populations of commercial fishermen such as along the United States Gulf Coast. Studying these unique and often vulnerable groups is important to characterize potential influences on or barriers to safety in anticipation of designing interventions that can change safety behaviors. Working closely with the United States Coast Guard (USCG), a cross-sectional convenience sample of Gulf Coast shrimp fishermen in and near the Port of Galveston, Texas, was surveyed. The survey included demographic factors and broadly covered areas such as type of work and fishing activities, general or global perceptions and beliefs related to safety and accidents, self-report of ability to use safety equipment or apply procedures aboard vessel, and training considerations. Surveys were obtained following informed consent (n = 133). Of the participants, 96.7% were male with 60.9% ≥40 years old. A majority were of Asian descent (57.1% of all fishermen, 82.1% of shrimp fishermen). Over half claimed to speak little or no English and nearly 60% considered the job to be very safe to neutral. A third to half of respondents expressed doubt about their knowledge of using essential safety equipment in the event of emergency. A large portion of the participants preferred hands-on safety training (40.6%). Important findings about this group of commercial fishermen will help with future development of effective prevention practices through the delivery of culturally appropriate safety awareness training. One element that must be addressed in training programs is to increase the awareness among fishermen about the severe occupational risks inherent in this type of work. Community trust and collaborative partnerships are essential to the success of such initiatives.

Cultural influences on safety and health education among Vietnamese fishermen.

Every ethnic group has its own cultural background and history that influences how it views health behaviors. By virtue of their work history, many Vietnamese have pursued the fishing industry when migrating to the United States. Even though the fishing trades are among the most dangerous jobs in the world, there has been little attention in the literature to the significant role that culture plays in the expression and experience of occupational health practices among Vietnamese shrimp fishermen. Three focus group sessions were conducted to identify factors that hinder or facilitate receptivity to available training and to guide culturally appropriate content. Participants were recruited using purposive sampling among various Vietnamese shrimp fishermen communities in Texas. Utilizing a series of open-ended questions, sessions were conducted in their native language among owners/captains/deckhands; support infrastructure--adult family members and religious/community leaders; and industry management and insurance representatives. Translations of transcribed documents were compared with simultaneous translations to ensure thematic consistency. Conducting hands-on training among Vietnamese by experienced fishermen, specifically targeting captains, was considered key to safety culture on the vessels. Findings of the study support that training should occur in a variety of formats (hands-on), but should be periodic, current, practical, convenient, taught in the primary language of the audience by an experienced individual, culminate in a certificate of completion, and target captains first. These findings illustrate the importance of considering cultural factors in the design of workplace interventions that focus on changes in safety and occupational health behaviors.

Risk factors for musculoskeletal symptoms among crawfish farmers in Louisiana--a pilot study.

The prevalence of musculoskeletal symptoms (MSS) among crawfish farmers is unknown. The purpose of this study was to assess the prevalence of MSS in nine body regions among crawfish farmers, and to examine associations between MSS and crawfish farm work activities. Questionnaires were mailed to randomly selected crawfish farmers in the State of Louisiana, USA. Site-specific MSS, demographics, and crawfish farm work information was obtained from the previous six months. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with logistic regression adjusting for potential confounders. Among the participants (N = 184), shoulder MSS were reported most frequently (62%). Wrist/hand and low back MSS were significantly associated with tractor use (OR(adj) = 2.89; 95% CI = 1.28-6.56) and (OR(adj) = 2.41; 95% CI = 1.03-5.67), respectively. Also, upper back MSS were associated with the number of years working on a crawfish farm (OR(adj) = 3.07; 95% CI = 1.17-8.04). Shoulder and low back MSS were common. Tractor use may increase the risk of wrist/hand and low back MSS. Future studies need accurately assess exposures to physical risk factors for MSS so ergonomic interventions can be developed.