Ricky T. Munoz

American Indian Grand-Families: Trauma and Services

ABSTRACT Since the United States Census Bureau began collecting data regarding grandparents raising their grandchildren, the American Indian and Alaska Native (AI/AN) population has had the highest proportion of families led by grandparents as the primary caregivers of their grandchildren. Despite this, research into AI/AN grand-families is limited. To begin to fill this gap, this qualitative study of 49 AI/AN grandparents raising grand-families (GFs) was conducted in an urban area with one of the highest AI/AN populations in the United States. Results indicated that loss and trauma within the middle generation is a central theme for GF formation. Such GFs also reported using a variety of services spanning state, tribal, and urban AI/AN programs, with educational support as a primary need articulated for their grandchildren. Surprisingly, enculturation was not mentioned as a primary driver of GF formulation. The study suggests a need for further exploration of the needs of urban-based AI/AN GFs, and that service providers must be aware of such issues when working with AI/AN GFs.

Electronic Fences Make Good Neighbors: The Importance of Medical Records Managers to Protecting Autonomy

not perfectly reliable; they contain random measurement error. For example, suppose it is known that the mean on some variable is 100 for the consenting population whereas it is 80 for the population that does not consent. The researcher wishes to avoid bias and chooses people from the consenting population in such a way that the sample mean is 80 to match the mean of those who do not consent. It might seem that the researcher has avoided bias by ensuring that the mean of the consenting sample matches the mean of people who do not consent. The fly in the ointment, however, is that the researcher has not matched on the variable of interest, but rather on the measure of that variable. This might seem to be a trivial distinction, but I shall show that it is not. Let us ask ourselves why a consenter might score below the mean for his or her population (e.g., scoring 80 when the mean consenter is 100). There are two reasons. First, the person really might be lower than the mean for his or her group on the variable of interest. Second, the person might have scored below the mean because of random measurement error. To the extent that the second reason is responsible for the person’s score, we would expect the person to score higher if tested a second time. Put more generally, we have a “regression to the mean” issue; the mean true score of the consenting sample is larger (closer to the mean of 100) than the sample’s mean observed score of 80. The exact number depends on the reliability of the test and can be determined by equations provided by Trafimow (2012). The important general point, however, is that matching on observed scores does not imply that there is a true score match. The simple fact of statistical regression guarantees that the mean true score of a sample of specially selected consenters will be closer to their population mean than will the sample observed score mean. In turn, this guarantees that matching on observed scores will cause a bias with respect to true scores. The reader might wonder why the same effect does not happen for a hypothetical sample of people who do not consent that could, in principle, be chosen to participate if researchers did not worry about obtaining consent. The reason is that in the example, the consenters were chosen to match those who did not consent rather than the other way around. So if those who did not consent were chosen to have a sample mean of 80, that sample mean equals their population mean of 80, and thus random measurement error would not have the systematic effect that I demonstrated in the earlier paragraph. Regression to the mean in this context merely indicates that the mean true score is similar to the mean observed score for that sample. In summary, I agree with Rothstein and Shoben that researchers should continue to obtain informed consent from their research participants. However, there are potential sources of bias that these authors did not cover and that researchers who are concerned with consent bias should consider addressing. Two of them result from the interaction of having two groups (those who consent and those do not) and the statistical fact of random measurement error.

Adverse childhood experiences and posttraumatic stress as an antecedent of anxiety and lower hope.

It is well established in literature that hope is an important psychological strength associated with resilience and overall psychological well-being. Early research also indicates that both posttraumatic stress disorder (PTSD) and anxiety have a negative relationship with hope. To better understand the potential mechanisms of the relationship between childhood trauma, PTSD, anxiety, and hope, we conducted a cross-sectional study of homeless individuals residing in the south central United States (N = 180). The study measured individual differences in the experience of childhood trauma, PTSD symptoms, anxiety, and hope. Based on the hope theory by C.R. Snyder, we hypothesized that PTSD has a negative relationship with hope because trauma memories can be “attention robbers” that take one’s focus off developing pathways toward future goals. The result is greater anxiety and lower hope. To test this theory, covariance-based structural equation modeling was used to evaluate a model of the variables in the sequential order as follows: (a) adverse childhood experiences, (b) PTSD symptoms, (c) increased anxiety, and (d) lower hope. The results indicated that the observed data produced a “good fit” to a model based on Snyder’s theory (&khgr;2 = 419.38; df = 247; p = < 001; root mean square error of approximation = .06 [90% confidence interval: .05, .07]; comparative fit index = .93; standardized root mean square residual = .06). Such a result suggests that future research is needed with survivors of childhood trauma to further explore mechanisms, such as “attention robbing,” that may link PTSD to greater anxiety and less hope.

The Effects of Mindfulness Meditation on Hope and Stress

Purpose: To evaluate mindfulness meditation as an antecedent of reductions in stress and increases in hope. Method: A quasi-experimental design (N = 46; meditation group, n = 23; comparison group, n = 23) using a community sample was used to evaluate the impact of mindfulness meditation on stress and hope. A path analysis was also used to model a directional relationship between meditation participation and increases in hope mediated by reductions in stress. Results: The data indicated that the meditation group exhibited significantly higher hope and lower stress than the comparison group. The path analysis indicated that reductions in stress fully mediated the relationship between mindfulness meditation and increases in hope. Discussion: The data support that meditation can increase hope via stress reduction. The results suggest a need for further research into mindfulness meditation and hope, especially since increasing hope is a fundamental aim of strengths-based practice.

Hope as a Coping Resource for Caregiver Resilience and Well-Being

In the context of caregiving, hope reflects a future orientated motivational process where the caregiver has an expectation toward attaining a desirable goal. More specifically, hope reflects the capacity for a caregiver to identify one or more cognitive strategies (pathways) toward a desirable goal. Along with pathways thinking, hopeful caregivers must direct and maintain mental energy (agency) toward the pursuit of a desirable goal. Indeed, both pathways and agency cognitions are required for hope. This chapter introduces the concept of hope using Snyder’s (2002) theoretical model and reviews the literature on the significance of hope as a coping resource contributing to the well-being and resilience among caregivers.

Absent in theory, invisible in practice: Queering HBSE for a more inclusive social work profession

ABSTRACT A sound theoretical foundation is a necessary element of social work education that prepares students to confront the challenges of practice with critical knowledge of the human experience. Queer theory is a strength-based framework for understanding sexual and gender identities that fall outside of the current social norms, and offers a highly relevant and useful pathway for the education of social work practitioners. Despite its utility for enhancing understanding and acceptance of gender and sexual minority (SGM) people, it is underutilized in social work compared with other disciplines. Additionally, this study reports on the gender and sexual identities of social work students and their endorsement of help-seeking behaviors related to issues of gender and sexual nonconformity. These empirical-based perspectives undergird the tenets of queer theory and support its application in research endeavors aimed at better understanding the human experience. A theoretical and empirical-based argument is made for the queering of HBSE to strengthen both explicit and implicit curricula in social work education. This study expands on the limited usage of queer theory within social work and directly challenges the normative and binary nature of sexual and gender identity evident within the professional literature and implications for education and research are offered.

Hazard Warning! The Perils of Extending Moral Hazard Analysis Only to Contrarian Parents

Hazard Warning! The Perils of Extending Moral Hazard Analysis Only to Contrarian Parents Michael R. Gomez, Rebecca Moran, Ricky T. Munoz & Mark D. Fox To cite this article: Michael R. Gomez, Rebecca Moran, Ricky T. Munoz & Mark D. Fox (2016) Hazard Warning! The Perils of Extending Moral Hazard Analysis Only to Contrarian Parents, The American Journal of Bioethics, 16:7, 50-52, DOI: 10.1080/15265161.2016.1180459 To link to this article: http://dx.doi.org/10.1080/15265161.2016.1180459

Ethical Issues in Organ Donation from Brain-Dead Donors

Organ donation and transplantation are value-laden enterprises. The relative scarcity of transplantable organs is commonly presumed to be the source of ethical dilemmas in transplantation. Accordingly, considerable emphasis has been placed on increasing the availability of organs for transplantation. The focus on supply and demand misses the fundamental human questions that necessarily shape our understanding of the donation and transplantation of organs, especially from deceased donors. The moral language of transplantation and the public policy framework for organ donation in the USA highlight some of the values underlying organ donation and transplantation practice and policies: gift, altruism, autonomy, and stewardship. Ultimately, donor organs are gifts unlike most other gifts, and they necessarily require an elaborate social context (including organ recovery and sharing infrastructure, as well as the expertise of transplant teams) to realize their value as gifts. The social context of transplantation points to the intersection of donor autonomy and the communal values informing transplant policies. This chapter examines ethical issues arising in the context of organ donation and transplantation generally, and specifically those associated with various proposals to increase the supply of transplantable organs, primarily through a critical analysis of the values shaping transplantation, as suggested by our moral language.