Development and validation of the relational behavior interactions scale for couples.

In this research, we developed and validated a measure of couple-based reported behavior interactions (RBI). Specifically, Study 1 was designed to describe the development of the scale and to examine its reliability; Study 2 (N = 222), was designed to examine factors that could differentiate men and women. Additionally, we tested if women's behaviors could predict their partner's behavior. Results from the exploratory factor analysis (EFA) revealed a three-factor structure for couples' RBI which were labelled: Social Companionship and Affective Behavior Interactions (SAI) (Factor 1), Fulfilling Obligations and Duties of the Partner (FOD) (Factor 2) and Openness in the Relationship (OR) (Factor 3). In linear regression analyses, there was a significant difference between men and women in the second factor, which represents behaviors associated with fulfilling the responsibilities of a partner. On the other hand, neither the SAI factor nor the OR factor showed any distinct gender differences. The SPSS PROCESS analysis revealed that women's Social Companionship and Affective Behavior Interactions (Factor 1), and Openness in the Relationship (Factor 3) significantly predicted their male partner's behaviors. The relationship duration significantly moderated the association between women's and men's behaviors for both factors. Results are discussed in light of the need for a broader understanding of romantic behavioral interactions.

Psychiatric Hospital Ethics Committee Discussions Over a Span of Nearly Three Decades.

Various types of health settings use clinical ethics committees (CEC) to deal with the ethical issues that confront both healthcare providers and their patients. Although these committees are now more common than ever, changes in the content of ethical dilemmas through the years is still a relatively unexplored area of research. The current study examines the major topics brought to the CEC of a psychiatric hospital in Israel and explores whether there were changes in their frequency across nearly three decades. The present paper reports on a thematic analysis of the written verbatim transcripts from 466 ethical topics brought to the CEC between the years 1991 and 2016. The following major topics related to ethical dilemmas were identified: confidentiality (30%), patient autonomy (23%), health records (14%), dual relationship (12%), allocation of resources (11%), inappropriate professional and personal conduct (9%), and multicultural sensitivity (1%). Topics related to confidentiality increased significantly over the years, as did inappropriate professional and personal conduct. In addition, the analysis showed that the content of the ethical cases and the resolutions suggested by the CEC also varied over the years. In conclusion, although most ethical topics have remained relatively stable over time, the discourse around them has evolved, requiring a dynamic assessment and reflection by the mental health practitioners serving as members of a CEC.

Relationship Expectations, Behavior Interactions and Commitment: A Dyadic Study Among Dual-Earner Couples.

Previous researchers have analyzed the links between relationship expectations and commitment in cohabiting and married couples. The present study examines a dyadic model where couple's reported behavior interactions (RBI) are suggested as potential mediators and Work-Family Conflict (WFC) as a moderator. The association among these variables was tested by recruiting 111 (N = 222) dual-earner couples to complete questionnaires. To examine the dyadic model, we used the Actor-Partner Interdependence Model on the hypothesized model. The results showed that actor's RBI was seen as a significant mediator of the associations between relationship expectations and both partner's commitment. The partner's affective behavior interactions emerged as a significant mediator between the actor's expectations-actor's commitment link but not with the partner's commitment. In addition, actor's WFC significantly moderated the effect of partner's RBI on their commitment. These findings extended our knowledge of possible factors that play a role in promoting relationship commitment among dual-earners couples in long-term relationships. Through the integration of the Investment Model this study illuminates the pathways by which relationship expectations affect commitment via RBI of married and cohabiting couples. Furthermore, the study elucidates the behavioral component of cohabiting couples in long-term relationships from a dyadic perspective. From a practical perspective, clinicians and counselors working with couples experiencing relational difficulties, may want to inquire as to their clients' relationship expectations and behavior interactions for better understanding commitment among couples.

Anxiety and pain perception using a speculum-free eyelid retraction technique for intravitreal injection.

PURPOSE: This study compared pain and anxiety levels in individuals receiving intravitreal injections (IVIs) using a speculum-free injection technique, the lid splinting eyelid retraction technique, or using a speculum. METHODS: This was a prospective study of individuals receiving IVI at a single tertiary care medical center who responded to a questionnaire and visual analog scale (VAS) between December 2019 and January 2020. In one group, a speculum was used prior to injection, whereas in the other group, a speculum-free injection technique was used. RESULTS: A total of 108 individuals were included in this study: 54 received IVI with the speculum-free lid splinting eyelid retraction technique and 54 received IVI with a speculum. A correlation between pain and anxiety was demonstrated in the control group (p-value < 0.01); however, in the speculum-free group, this correlation was lower and not significant. When comparing pain and anxiety between the study groups, lower median pain (Mood's: Z = 5.378, p-value < 0.001) and lower anxiety (Mood's: Z = 2.108, p-value = 0.035) scores were demonstrated in the speculum-free group than in the control group. The distribution of pain scores was significantly different between the study groups (Kolmogorov-Smirnov: D = 0.518, p-value < 0.001), and trending differences in anxiety between the groups were observed (Kolmogorov-Smirnov: D = 0.259, p-value = 0.053). CONCLUSION: The lid splinting eyelid retraction technique, a speculum-free technique, was associated with less anxiety and pain in patients than the use of a speculum. As IVI often involves repeated treatment, identifying modifiable factors that may relieve anxiety and pain is of utmost importance.

Life under the COVID-19 lockdown: On the relationship between intolerance of uncertainty and psychological distress.

OBJECTIVE: One of the significant features of the recent lockdown caused by the coronavirus 2019 coronavirus pandemic was the lengthy period of uncertainty that accompanied it. The present study examined a moderated model that links conditions of uncertainty with psychological distress during the coronavirus 2019 lockdown. METHOD: Married parents in Israel (N = 186), all of whom were working at home during the lockdown, completed several measures, including those assessing intolerance of uncertainty (IU), psychological distress, dispositional optimism, and work arrangements at home. RESULTS: Data analysis supported the association between IU and psychological distress. Two additional measures, optimism and work schedule, were found to act as moderators. Whereas optimism buffered IU's negative ramifications, the inability to schedule proper work arrangements at home during the lockdown comprised a risk factor for IU and psychological distress. CONCLUSIONS: Findings suggest that IU is associated with psychological distress. Theoretical and practical ramifications of the study findings are presented. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Impact of COVID-19 on Intravitreal Injection Compliance.

Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) agents have become the most prevalent intraocular procedure as they represent the major therapeutic modality for prevalent retinal conditions such as age-related macular degeneration (AMD) and diabetic retinopathy. Effective therapy requires adherence to a schedule of iterative IVI as well as routine clinic appointments. The ongoing coronavirus disease 2019 (COVID-19) pandemic has resulted in the reduction of attendance at scheduled clinic visits and IVI. In this study, we attempted to analyze the effect of COVID-19 on compliance with anti-VEGF therapy. A total of 636 eyes received injections during a 4-week period of the COVID-19 outbreak in the Retina Clinic. The number of clinic visits for IVI during 1 month from March 15 to April 14 of 2020 was compared to a similar time period in each of the last 4 years. The study demonstrates a decrease in clinic visits for IVI when compared with the same 4-week interval in the four previous years. Based on the trend of the previous 4 years, 10.2% of the year's total was expected for this time period. Using this model, the 636 reported number of injections for the March-April 2020 period was ~ 5%. This represents a decrease of ~ 50% of the expected IVI for this time period. The COVID-19 outbreak in Israel severely impacted compliance with anti-VEGF treatments.

Living in fear: The relationship between fear of COVID-19, distress, health, and marital satisfaction among Israeli women.

After the COVID-19 virus was officially declared a pandemic on March 11, 2020, the Israeli government adopted lockdown restrictions to limit its spread. The purpose of the present article is to examine the impact of this disturbing environment on Israeli women. Specifically, we examined whether fear of the virus would impact the women's distress symptoms, self-rated health (SRH), and marital satisfaction. A total of 130 Israeli married women with children completed the survey during the lockdown restrictions period. All participants reported that their children were living with them during the lockdown, and that no one had been infected by the virus. The results indicated that fear of COVID-19 was negatively associated with SRH as well as marital satisfaction, and positively associated with psychological distress. In addition, psychological distress mediated the link between fear of COVID-19 and both SRH and marital satisfaction. To mitigate similar negative consequences in the future, it is suggested that interventions should focus on the way the crisis is presented in the public domain. In addition, further research is recommended to identify the various indirect consequences of the COVID-19 pandemic on psychological, physical, and relational aspects among women.

OCB-Work-Family Facilitation: Is It Positive for All Attachment Orientations?

The present study seeks to expand on research concerning the benefits of organizational citizenship behaviors (OCBs) to work-family facilitation (WFF) by integrating the theoretical framework of the attachment personality perspective (Bowlby, 1982). We hypothesized that OCB would enhance WFF for employees having lower levels of avoidance and anxious orientations but reduce WFF for employees with higher levels of avoidance and anxiety orientations. Two studies were conducted to test these hypotheses. Study 1 adopted a cross-sectional design, and Study 2 implemented a diary procedure. In Study 1, employees from a pharmaceutical company completed attachment orientations and WFF questionnaires, whereas their direct supervisors assessed the participants' OCB. In Study 2, attachment orientations of 108 participants were assessed, with OCB and WFF measures collected over 10 days. Findings from both studies supported our hypotheses relating to avoidance orientations. Performing OCB can enhance WFF, with the effect stronger for employees having lower avoidance orientations. However, findings regarding anxiety orientations were non-significant. A better understanding of the role that attachment orientations play in the OCB - WFF association may facilitate implementing possible interventions that could benefit both the organization and the family.

Emergence of an Israel faith-based community organization facilitating live donor kidney transplantation.

BACKGROUND: The 2014 Consensus Conference on Best Practices in Living Kidney Donations recognized live donor kidney transplantation as the best treatment for late-stage kidney disease, yielding superior graft and patient survival, improved quality of life, fewer requirements for dialysis and increased cost-effectiveness compared to deceased donor kidney transplantation. Yet in spite of the excellent results of living kidney donation, the annual number of living kidney donors is declining in many countries, including the United States. In Israel, a non-profit organization, Matnat Chaim ("Gift of Life" in Hebrew), a faith-based initiative, has emerged as a major force for arranging living donor kidney transplantation mainly by facilitating altruistic living unrelated donor transplantation. METHODS: A retrospective review of the records of live kidney donations facilitated by the Matnat Chaim organization and referred to Israel transplant centers, since the organization's inception in 2009, was performed and compared to published data from the Israel Ministry of Health. RESULTS: Matnat Chaim has facilitated 494 live kidney donations since its founding in February 2009 until the end of 2017. Of the 124 live kidney transplants performed in 2016, 111 (90%) were shown to be altruistic and unrelated. This large number of donations was associated with a doubling of the total number of kidney transplantations, performed in Israel (data published by the Israel Ministry of Health). CONCLUSIONS: The success of an Israel community organization in the promotion of kidney transplantation may serve as a model for other religious and non-religious communities worldwide.

Ethical behaviour of physicians and psychologists: similarities and differences.

OBJECTIVE: To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas. POPULATION: 88 clinical psychologists and 149 family physicians in Israel. METHOD: Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical. The vignettes were presented to both family physicians and clinical psychologists. RESULTS: Psychologists' aggregated mean ethical intention score, as compared with the physicians, was found to be significantly higher (F(6, 232)=22.44, p<0.001, η2=0.37). Psychologists showed higher ethical intent for two dilemmas: issues of payment (they would continue treating a non-paying patient while physicians would not) and dual relationships (they would avoid treating the son of a colleague). In the other four vignettes, psychologists and physicians responded in much the same way. The highest ethical intent scores for both psychologists and physicians were for confidentiality and a colleague's inappropriate practice due to personal problems. CONCLUSIONS: Responses to the dilemmas by physicians and psychologists can be categorised into two groups: (1) similar behaviours on the part of both professions when confronting dilemmas concerning confidentiality, inappropriate practice due to personal problems, improper professional conduct and academic issues and (2) different behaviours when confronting either payment issues or dual relationships.

What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel.

BACKGROUND: Simulation-based training improves residents' skills for end-of-life (EOL) care. In the field, staff providers play a significant role in handling those situations and in shaping practice by role modeling. We initiated an educational intervention to train healthcare providers for improved communication skills at EOL using simulation of sensitive encounters with patients and families. METHODS: Hospital physicians and nurses (n = 1324) attended simulation-based workshops (n = 100) in a national project to improve EOL care. We analyzed perceptions emerging from group discussions following simulations, from questionnaires before and after each workshop, and from video-recorded simulations using a validated coding system. We used the simulation setting as a novel tool for action research. We used a participatory inquiry paradigm, with repetitive cycles of exploring barriers and challenges with participants in an iterative pattern of observation, discussion and reflection - including a description of our own responses and evolution of thought as well as system effects. RESULTS: The themes transpiring included lack of training, knowledge and time, technology overuse, uncertainty in decision-making, poor skills for communication and teamwork. Specific scenarios demonstrated lack of experience at eliciting preferences for EOL care and at handling conflicts or dilemmas. Content analysis of simulations showed predominance of cognitive utterances - by an order of magnitude more prevalent than emotional expressions. Providers talked more than actors did and episodes of silence were rare. Workshop participants acknowledged needs to improve listening skills, attention to affect and teamwork. They felt that the simulation-based workshop is likely to ameliorate future handling of EOL situations. We observed unanticipated consequences from our project manifested as a field study of preparedness to EOL in nursing homes, followed by a national survey on quality of care, leading to expansion of palliative care services and demand for EOL care education in various frameworks and professional areas. CONCLUSIONS: Reflective simulation exercises show barriers and paths to improvement among staff providers. When facing EOL situations, physicians and nurses use cognitive language far more often than emotions related expressions, active listening, or presence in silence. Training a critical mass of staff providers may be valuable to induce a cultural shift in EOL care.

Modeling Psychologists' Ethical Intention: Application of an Expanded Theory of Planned Behavior.

At the core of all therapeutic and medical practice lies ethics. By applying an expanded Ajzen's Theory of Planned Behavior formulation, the present investigation tested a model for explaining psychologists' intention to behave ethically. In the pretest, dual relationships and money conflicts were seen as the most prevalent dilemmas. A total of 395 clinical psychologists filled out questionnaires containing either a dual relationship dilemma describing a scenario where a psychologist was asked to treat a son of a colleague or a money-focused dilemma where he or she was asked to treat a patient unable to pay for the service. Results obtained from applying the expanded Ajzen's model to each dilemma, generally, supported the study hypotheses. In particular, attitudes were seen as the most important predictor in both dilemmas followed by a morality component, defined here as the commitment of the psychologist to the patient included here as an additional predictor in the model. The expanded model provided a better understanding of ethical intention. Practical implications were also discussed.

tDCS polarity effects in motor and cognitive domains: a meta-analytical review.

In vivo effects of transcranial direct current stimulation (tDCS) have attracted much attention nowadays as this area of research spreads to both the motor and cognitive domains. The common assumption is that the anode electrode causes an enhancement of cortical excitability during stimulation, which then lasts for a few minutes thereafter, while the cathode electrode generates the opposite effect, i.e., anodal-excitation and cathodal-inhibition effects (AeCi). Yet, this dual-polarity effect has not been observed in all tDCS studies. Here, we conducted a meta-analytical review aimed to investigate the homogeneity/heterogeneity of the effect sizes of the AeCi dichotomy in both motor and cognitive functions. The AeCi effect was found to occur quite commonly with motor investigations and rarely in cognitive studies. When the anode electrode is applied over a non-motor area, in most cases, it will cause an excitation as measured by a relevant cognitive or perceptual task; however, the cathode electrode rarely causes an inhibition. We found homogeneity in motor studies and heterogeneity in cognitive studies with the electrode's polarity serving as a moderator that can explain the source of heterogeneity in cognitive studies. The lack of inhibitory cathodal effects might reflect compensation processes as cognitive functions are typically supported by rich brain networks. Further insights as to the polarity and domain interaction are offered, including subdivision to different classes of cognitive functions according to their likelihood of being affected by stimulation.

Factors related to perceived power usage in schools.

Based on Raven's (1992) power interaction model, situational and personal variables were examined as determinants of power choice in educational settings. The impact of educational sector (secular, religious), class level, gender and content of conflict on perceived power usage in teacher-pupil conflicts was analysed. A total of 370 elementary and junior high school pupils and 62 teachers from the same schools responded to a series of scenarios where they were asked how often specific power bases are used by teachers in trying to gain compliance. Results indicated that harsh power bases were perceived as more prevalent in the secular educational sector rather than in the religious one, in junior high school rather than elementary school, for boys as compared with girls, and for conflicts stemming from students rather than teachers. Findings were interpreted in terms of conformity level and frequency of conflicts. The discussion also addresses the lack of correspondence between teacher and pupil responses.

Determinants of employee punctuality.

Although researchers have studied employee lateness empirically (e.g., S. Adler & J. Golan, 1981; C. W. Clegg, 1983), few have attempted to describe the punctual employee. In the present study, results of a discriminant analysis on employees in Israel indicated that a personality characteristic, time urgency, a subcomponent of Type A behavioral pattern, distinguished between punctual and late employees. Organizational commitment and age of employee's youngest child also distinguished between the groups.

Effect of Participation in Strategic and Tactical Decisions on Acceptance of Planned Change.

Participation of workers or clients in decision-making has been suggested as a critical method for achieving acceptance and effectiveness of planned change (Blumberg, 1976). The literature does not provide full support for this suggestion (Locke & Schweiger, 1979; Wagner & Gooding, 1987). The present study investigated the type of change decision and change certainty, which may moderate the effect of participation on change acceptance. A battery of psychological ability tests was administered to 222 Israeli subjects participating in a laboratory experiment. Subjects in three experimental groups were offered an opportunity to participate in strategic and/or tactical decisions regarding a change in type of test. The fourth group was not given any chance for participation. The effect of participation upon acceptance of change was consistent with the proposed hypotheses.