Anne E. Pidano

Program Ratings Do Not Predict Negative Content in Commercials on Children's Channels

Objective: The aim of this study was to determine the presence of negative content in commercials airing on 3 childrens channels (Disney Channel, Nickelodeon, and Cartoon Network). Method: The 1681 commercials were coded with a reliable coding system and content comparisons were made. Results: Although the majority of the commercials were coded as neutral, negative content was present in 13.5% of commercials. This rate was significantly more than the predicted value of zero and more similar to the rates cited in previous research examining content during sporting events. The rate of negative content was less than, but not significantly different from, the rate of positive content. Thus, our findings did not support our hypothesis that there would be more commercials with positive content than with negative content. Logistic regression analysis indicated that channel, and not rating, was a better predictor of the presence of overall negative content and the presence of violent behaviors. Commercials airing on the Cartoon Network had significantly more negative content, and those airing on Disney Channel had significantly less negative content than the other channels. Within the individual channels, program ratings did not relate to the presence of negative content. Conclusion: Parents cannot assume the content of commercials will be consistent with the program rating or label. Pediatricians and psychologists should educate parents about the potential for negative content in commercials and advocate for a commercials rating system to ensure that there is greater parity between childrens programs and the corresponding commercials.

An Italian-American view of grief: connection, transformation and resilience

Abstract Current theories regarding grief and mourning often acknowledge continued connection and reworking of the relationship to the lost person rather than relinquishing ties and bonds, and acknowledge the importance of culture in grief and mourning. Although there is little research regarding Italian-Americans and grieving, these ideas fit well with the description described by researchers as ‘Italians tend to keep their dead with them’. This paper explores Italian-American responses to the loss of a loved one. It comprises a brief summary of relevant literature around grieving, followed by an overview of themes from Italian traditions and culture that inform our thinking about Italian-Americans and grief. The authors, as participants in both the culture and the experience of grief, briefly situate themselves vis-à-vis these experiences. Three segments then illustrate our concepts of continued bonds and reworking relationships: a pilot study of Italian-Americans’ experiences of loss and grieving over time, a normative case study of one woman’s creative, ongoing response to major loss, and the importance of objects after loss from a research project of daughters who have lost their dads. Conclusions focus on the importance and complexity of mourning; the centrality of relationship; the use of symbol, ritual and meaning-making; and development of resiliency, for Italian-Americans and perhaps other groups.

Psychologists and Pediatricians in the Primary Care Sandbox: Communication is Key to Cooperative Play

Recent literature, public policy, and funding opportunities call attention to the need for better increased integration of health and mental health care services in primary care settings so as to best meet the needs of children and families. There are many benefits to such integration, but pediatric primary care providers (PCPs) face multiple barriers to identifying and managing patients with mental health difficulties. One way to address this problem is through the integration of psychologists into primary care settings who can collaborate with PCPs to provide integrated behavioral health care to youth and families. However, there are challenges to collaboration, which include differences in training, professional cultures, and expectations held by professionals from various disciplines. Effective communication is a key component in supporting interprofessional collaboration between primary care providers and psychologists working in primary care settings. This paper reviews aspects of pediatric medicine culture, critical components of communication, and strategies to improve communication. Three case examples are presented in which some of these challenges have been successfully addressed. Implications and future directions are discussed.

Pediatric primary care providers’ reported likelihood to refer to mental health specialists.

Introduction: Pediatric primary care providers (PPCPs) play an increasingly important role in addressing mental health concerns. Yet PPCPs are limited in the services they can provide because of constraints in training, time, and reimbursement. Whereas some patients may be appropriately treated in primary care, others require referrals to mental health specialists. The current study evaluated patient, clinician, and situational factors associated with PPCPS’ reported likelihood to refer hypothetical patients with mental health concerns to mental health specialists. Method: The sample included 106 PPCPs from Massachusetts and Indiana who read one of two vignettes of hypothetical patients (one with symptoms of attention-deficit hyperactivity disorder (ADHD) and one with symptoms of depression) and then completed surveys regarding patient diagnosis and treatment decisions. Results: Results indicated that PPCPs who read the depression vignette were significantly more likely to report intentions to refer the patient to a mental health specialist than those who read the ADHD vignette as were PPCPs with less confidence in treating mental health concerns. PPCPs who read the depression vignette were also more likely to report intentions to refer to psychologists and social workers as opposed to PPCPs who read the ADHD vignette, who reported intentions to refer to psychiatrists. Training in developmental and behavioral pediatrics was not related to reported likelihood of referring. Conclusion: These findings illuminate potential areas for future research on referral patterns from primary care to mental health specialists.

“Doctor, are you listening?” Communication about children’s mental health and psychosocial concerns.

Effective communication is critical, including in the pediatric primary care setting. Pediatric primary care providers (PPCPs) are in a unique position to address psychosocial and mental health concerns during office visits, and effective communication skills play a crucial role in providing an opportunity for parents and patients to disclose and discuss such concerns. In this article, the authors encourage two relatively simple strategies that have shown potential for enhancing effective communication in pediatric primary care regarding mental health and psychosocial issues: (a) ensure that pediatric residents and practicing providers have access to brief, targeted communications training and (b) strongly promote the use of screening tools both to encourage discussion and to assist in identifying children who may benefit from further assessment and/or treatment. (PsycINFO Database Record