Primary Advisor Research Articles

How the doctor-patient relationship influences the perception of the diagnosis of pancreatic cancer

Background: The diagnosis of pancreatic cancer is usually associated with a poor prognosis. It is mostly diagnosed late and at an advanced stage. A cure is therefore not possible in most cases. Accordingly, the doctor-patient relationship (DPR) in pancreatic cancer is of particular importance: as the primary advisor, the treating physician is responsible not only for making the diagnosis but also for deciding whether pancreatic cancer should be treated curatively, neo-adjuvantly, or palliatively. At best, the decision is made following the patient's beliefs and wishes.

From the Coeditors

We are pleased to share important contributions to the scholarship of advising in this issue. The first two pieces focused on academic advising as a profession. The issue opens with an article that explored ethical practice in academic advising, while the second investigated motives for career persistence among females in the primary advisor role. The next three pieces, although vastly different, shared in revealing just how impactful advisor communication can be. We are excited to close this issue with an article that so clearly illustrated the continued lines of research and application of perspectives from personality and social psychology on academic advising.In the opening article, utilizing constructivist grounded theory, Puroway proposed a model of ethical practice, including ethical encounter and response, capturing how advisors deal with ethical dilemmas. Such scholarship on ethical practice is a crucial step in the professionalization of our field. In the second article, again through the lens of constructivist paradigm, Solon, McGill, and Jensen explored the motivations contributing to career persistence among females in the role of primary advisor. Interviews with female primary role advisors revealed that meaningful and rewarding relationships with students, supportive colleagues, and supervisors; opportunities for professional development and self-care; and the potential for work-life balance contributed to these advisors' persistence in advising positions that often have high turnover. NACADA (2016) membership demographics indicated that more than 70% of members identified as female. Thus, we believe this article may also be of great interest to our readers.The issue continues with a study by Payne, Vandecar-Burdin, and Cigularova who surveyed faculty and advisor attitudes about articulation agreements pertaining to transfer students. Survey results indicated overall favorable attitudes about these agreements. However, compared to faculty, professional advisors indicated more familiarity with how the agreements work and who to contact with questions about the transfer process. Payne et al. also noted the importance of two types of communication: with students and across institutions. In addition to illuminating the importance of communication, their study of attitudes about agreements between university and community colleges reminds us of the rich potential of another type of partnership—the research partnership. Research collaborations between community college and university scholars, advising practitioners and research scholars, emerging and experienced researchers, and global collaborations all hold enormous promise in advancing the scholarship of advising (Troxel, 2019).This issue includes two more studies in which the importance of advisor communication emerged. In a quantitative study replicating and expanding the work of Kyte et al. (2020) published in the Journal, Buchanan, Brown, Chirco, Klein, and Purgason advanced our understanding of advisor language choices and micromessaging. They found that small changes in language choice and micromessages positively influenced student outcomes, with a stronger effect noted for first-generation students and students of color. Their study and the previous work of Kyte et al. (2020) highlighted just how much an advisor's words matter. In a broader sense, the importance of advisor personalized communications with students also emerged in the next article by Talbott. In this qualitative study, Talbott interviewed academic advisors who were subject matter experts on career changers as well as surveyed graduate students engaged in career change. The interview and survey findings revealed that out of many available resources for academic and career advising, career changers most frequently relied on personal communication with advisors and new student orientation programming, once again illuminating the importance of advising communication.We conclude this issue with a quantitative study by Robinson and Shi who explored the relationship among the noncognitive factors of attribution perspective, shame resilience, and academic identity status in relation to outcomes for probationary students in academic recovery courses. Their findings pointed to the potential for positive attribution perspective and shame resiliency in relation to students' trying to recover academically and the role advisors might play in facilitating the development of these noncognitive factors. More than 10 years ago, previous Journal editors published a special issue on Perspectives from Personality and Social Psychology on Academic Advising (Robbins & Shaffer, 2011), and this study by Robinson and Shi demonstrated just how far this line of research has progressed and developed since. Thus, in so many ways, this issue advances the empirical and theoretical work captured in the rich history of this Journal while speaking to the future development of the profession, its practices, and the needs of student populations we serve.Karen Mottarella & Lisa M. Rubin

PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map.

PROTOCOL: The effects of cannabis liberalization laws on health, safety, and socioeconomic outcomes: An evidence and gap map.

Ethical foundations for graduate students in the psychological sciences.

Preparation to address ethical challenges is an essential component of graduate training, and no less so for the psychological sciences. However, in the absence of uniform guidelines, approaches to training vary in form and quality. Classroom lectures and online training seem to be the mechanisms of choice, but these fall short. First, such approaches conflict with the scholarship on teaching and learning that makes it clear that having a meaningful impact depends on having students actively engaged in constructing their own learning. Second, research is consistent with intuition that the impact of courses is likely to be far less than what happens in a graduate student's research environment. The conclusion is that promoting an ethical culture, and for the training of graduate students in particular, will be well served by enhancing the role of mentors. Examples of options to consider are: (1) recognizing that a primary advisor can be a mentor, but should certainly not be considered the only mentor; (2) emphasizing the importance of mentoring for individuals from underrepresented groups (e.g., because of gender or ethnicity); (3) strengthening the APA code of ethics to more fully articulate the full range and importance of mentoring; (4) developing and implementing mechanisms to evaluate and reward effective mentoring; and (5) providing targeted training for faculty advisors to empower them with tools and resources to be effective mentors for ethics generally and the responsible conduct of research specifically.

Emerging adults' financial capability: A financial socialization perspective

AbstractThis exploratory qualitative research uses the United Kingdom as a case study to understand how past and present financial socialization agents have either enhanced or inhibited emerging adults' financial capability in order to highlight potential opportunities for future policy and practice interventions. Three primary socialization agents were identified. The family as trusted primary advisor continues well into adulthood, even where family financial capability may be low. Beyond this, emerging adults only reluctantly engage with their bank, rely on just‐in‐time experiential learning or self‐socialize via diving, often with false confidence, into the internet. Although there are many quantitative studies on financial socialization, this paper fills a gap by taking a deeply qualitative approach showing, for the first time, empirically highlighting the limited number of financial socialization agents through the voices of emerging adults. The findings contradict previous socialization research that suggests parental socialization reduces into adulthood.

Pharmaceutical care – a chance or necessity in the context of Polish self-medication

Abstract Introduction. The modern pharmaceutical care is supposed to meet numerous demands resulting from the presence and broad availability of OTC medicines. In this case the pharmacist becomes the primary advisor as for the application of medicines which are not prescribed by a doctor. Aim. The aim of the study was to recognize the position of pharmacists employed in the pharmacy towards pharmaceutical care, possibilities to conduct it and barriers of its implementation. Material and method. The researchers conducted a survey with elements of a questionnaire interview. The number of 186 pharmacists who work in pharmacies in the province of Lublin took part in the research. Results. The surveyed perceive the benefits of performing pharmaceutical care: increased prestige of the profession, greater satisfaction with their job – 44.9% choices for each; increase of the effectiveness of pharmacotherapy (54.6%) and treatment (44.3%). The major barriers to introducing pharmaceutical care include insufficient education of pharmacists (33.7%) and lack of solid co-operation with the doctor (32.6%). Conclusions. Pharmacists are aware of the importance of pharmaceutical care, although they identify a number of barriers which hinder its effective introduction.

A Jugal in the Rough: The Evolutionary Importance of the Zygoma.

A Jugal in the Rough: The Evolutionary Importance of the Zygoma.

Updating the American Society of Clinical Oncology Value Framework: Revisions and Reflections in Response to Comments Received.

The mission of American Society of Clinical Oncology (ASCO) is to conquer cancer through research, education, and promotion of the highest quality patient care. Toward fulfillment of this goal and at the direction of its board of directors, the ASCOValue in Cancer Care Task Force set out to develop a framework that would enable a physician and patient to assess the value of a particular cancer treatment regimen given the patient’s individual preferences and circumstances. The rationale that served as the impetus for this initiative is many faceted. Substantial progress has been made in translating our knowledge of the biologic characteristics of cancer into novel therapies. Some of these therapies have led to major improvements in outcomes for specific diseases, and others have produced only modest advances. There is now a wide array of choices for treating many cancer types, and these treatment choices often differ by only small degrees in clinical effectiveness and toxicity. Yet, there is often a wide disparity in cost to patients and payers. Because patients are often confronted with enormous expenses when receiving cancer care, the goal of describing a relationship between the cost of an agent or regimen and the clinical benefits it delivers takes on great importance. As the primary advisor to the patient, the oncologist has an important role in providing a comparative assessment of the various treatment options available; in the spirit of shared decision making, the patient should have transparent information about the clinical impact that can be expected from the different options presented and their relative financial implications. The value framework has been constructed as a conceptual model that incorporates the elements of clinical benefit, toxicity, and symptom palliation as derived from a comparative clinical trial and combines these elements into a score termed the net health benefit (NHB). Ultimately, deployment of the framework as a software application is planned, enabling a patient to modify the weight attributed to any of the elements included in the NHB depending on his or her personal preferences and circumstances. The final NHB will therefore reflect the priorities that are most important to the patient and will be arrived at through guidance from the physician. Information on the cost of the regimens will also be presented so the patient can consider the relative financial impact of his or her treatment options. Two versions of the framework have been created: one for advanced disease and the other for potentially curable (adjuvant therapy) clinical presentations. The original framework versions are shown in Appendix Tables A1 and A2 (online only). The key elements included in the framework— namely, clinical benefit and toxicity—are also those that are regularly reported in the scientific literature when discussing the outcome of a clinical trial that compares two or more therapies. The importance of relying on high-quality, quantifiable evidence cannot be overstated, and this is most often provided by a well-designed, well-conducted prospective randomized trial. The task force recognizes that a limitation of this approach is that it does not readily permit cross-trial comparisons. Such analyses are important to patients and remain a goal for future versions of the value framework. The task force is well aware that there are many elements that might be important to individual patients in assessing the relative value of their treatment options that are not taken into account in our model. These include the convenience of receiving therapy, the avoidance of interrupting the flow of activities of daily living, and the impact of a treatment on quality of life

Gambling on second opinions: How seeking a second opinion can impact your primary advisor’s advice

Second opinions have been advocated as an antidote to bias in advice when primary advisors have conflicts of interest. However, in three experiments, we demonstrate that, unless advisors fear that ...

Professional referrals: The role of keeping-while-giving and other expectations

Entrepreneurial professionals are frequently presented by potential clients with opportunities that they cannot competently deal with or may be offered more work than they can handle. Due to finite resources, these entrepreneurs who are involved in the professions, such as law partners, solo-practitioner doctors, or architects who own their own firms, must give away paying clients, through a professional referral, to another entrepreneurial professional. Using a grounded theory approach, this project explores that dynamic process, focusing on the transfer, reciprocation, and return of client relationships. I find that entrepreneurs form a set of expectations regarding exchange and reliability; if these expectations are met, then a referral routine quickly emerges. The key finding is that entrepreneurial professionals engage in “keeping-while-giving.” Even though by referring a client away they are giving away a short term revenue stream, entrepreneurs attempt to keep their long-term revenue stream through maintaining the position of primary advisor to the client.

PCD Recognizes Outstanding Student Research: Kersten et al on Using a Standard Classification Scheme to Identify Small Food Stores That Offer Healthy Options

This week, Preventing Chronic Disease (PCD) publishes “Small Food Stores and Availability of Nutritious Foods: A Comparison of Database and In-Store Measures, Northern California, 2009,” (1) winner of the journal’s 2012 Student Research Contest. The winning article is authored by Ellen Kersten, a doctoral student in the Department of Environmental Science, Policy, and Management at the University of California, Berkeley. Her primary advisor is Rachel Morello-Frosch, PhD, MPH.

Fellowship in congressional health care policy

The Congressional Health Care Policy Fellow program was established in 2006 and is jointly sponsored by the Virginia Commonwealth University (VCU), American College of Clinical Pharmacy (ACCP), and American Society of Health-System Pharmacists (ASHP). As one of the first pharmacy-specific health policy fellowship programs in the United States, it is designed to immerse a practicing pharmacist in the congressional environment to experience federal health policy firsthand. I served as the second congressional health care policy fellow and describe my experiences herein. My fellowship program started on September 4, 2007, with a train ride from Washington, D.C., to VCU in Richmond. I met Dr. Gary Matzke, VCU’s associate dean for clinical research and public policy and the primary advisor for the fellowship program, to set goals and objectives for the year. The next day, I started a month-long rotation in the Government Affairs Division of ASHP. The 35,000 members of ASHP are well represented by the Government Affairs Division, which includes personnel with expertise on regulatory, legislative, and professional affairs. Each September, selected members of ASHP meet in Washington, D.C., to develop official professional policies for the continuum of pharmacy practice settings in integrated health systems.1 It was interesting to see the depth and breadth of knowledge that these members brought to each committee to develop or designate policy positions, statements, or guidelines. The ASHP annual policy week ends with a scheduled Legislative Day, when over 100 members go to Capitol Hill to serve as advocates and meet with their respective senators and representatives to discuss pharmacy-related issues.

Evaluating Academic Advising in a Multiversity Setting

The purpose of this study was to evaluate the advising system at a complex multiversity and provide answers to both summative and formative evaluation questions. The results suggest that most students (a) are advised, feel that their advising needs have been met, and are satisfied with the help they receive. Students, in general, are less satisfied with the help they receive with specific issues and concerns. However, the results also show that (a) relatively few students consider faculty to be their primary advisors, (b) many students seek advising help from multiple sources, and (c) a majority of students spend 15 minutes or less per semester with their primary advisor. Implications of these results for academic advising at multiversities are discussed.

Assistant Director, Science: Furthering CDC Goals

YOU GO OUT there and you get the job done, sums up Mary E. Guinan, MD, PhD, about her initial CDC experience as an Epidemic Intelligence Officer in 1975 working on smallpox eradication in India. Guinan is now the agency's Assistant Director for Science. In her role as overseer of the scientific effort at the CDC, she serves as the primary advisor to the director and program managers on scientific matters, which includes developing the agency's position on scientific issues that involve other agencies or that are complex or controversial. The assistant director for science serves as liaison with the National Institutes of Health and the Food and Drug Administration on all scientific issues. This may involve encouraging collaborative studies, like the ongoing tracking survey of children who received natural growth hormone and subsequently developed Creutzfeldt-Jakob disease. Guinan also oversees the CDC Office of Health and Safety. That's a demanding