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Study: Discuss Religion, Spirituality When Treating Young Adults with Severe Mental Illness

Baylor researcher and expert says it’s “critical” that mental health providers be equipped to assess clients’ religion/spirituality A majority of young adults with severe mental illness – bipolar disorder, schizophrenia or major depression – consider religion and spirituality relevant to their mental health, according to a new study from Baylor University’s Diana R. Garland School of Social Work. Holly Oxhandler, Ph.D., associate dean for research and faculty development in the Garland School of Social Work, served as lead author on the study, which was published in the journal Spirituality in Clinical Practice. Researchers examined data from 55 young adults (ages 18-25) with serious mental illness who had used crisis emergency services. Of the 55 young adults interviewed, 34 “mentioned religion or spirituality in the context of talking about their mental health symptoms and service use with little-to-no prompting,” researchers wrote. The sample for the study was racially diverse and gender-balanced. Not all of those interviewed considered themselves religious, as 41 percent answered “other,” “I don’t know” or “none” when asked their religious preference. However, researchers found that religion and spirituality emerged as a unique way in which this sample was able to make sense of their difficult life situations and mental health struggles. “Not only did these young adults struggle with serious mental illness, but they had also experienced extreme adversity – including abuse, poverty, homelessness, addiction, near-death experiences, loss and an overwhelming lack of access to medical and mental health services,” researchers wrote. “Yet, many attempted to explain, make sense of or organize their circumstances through their religious/spiritual perspective and talked about God as a source of comfort and support.” The young adults expressed both positive and negative views of God, prayer and support from religious and spiritual communities. Regardless of their views, the important thing to note, Oxhandler explained, is that they’re talking about these topics – something social workers and counselors traditionally are not often equipped or trained to assess or discuss. “It’s the elephant in the room,” Oxhandler said of discussions of religion and spirituality. “If we continue to ignore it, we’re ignoring a huge component of peoples’ lives that may be tied to the clinical issue.” Oxhandler, who has researched this area extensively, said such discussions can help drive subsequent treatment options. “As mental health care providers discern what mental health services to provide or coping strategies to recommend, it’s especially important they understand the role of religion/spirituality in the lives of the vulnerable young adults they serve,” she said. Researchers also found that those surveyed described using positive religious coping, negative religious coping or experiences, discussed their relationship with God/Higher Power and unpacked the role of their support systems and faith. Positive religious coping included prayer, reading religious texts, support from their religious and spiritual communities and identifying religious and spiritual meaning in difficult situations. Negative religious coping or experiences included having a negative experience with a religious organization not being supportive or receiving hurtful messages from the religious community. “Those who discussed their relationship with God or a higher power discussed God providing a sense of comfort or protection, accepting them for who they are or positively intervening in their lives,” Oxhandler said. “Among those who unpacked the role of their support systems and faith, they often described family and friends referencing religion or God for support, and some even offered recommendations for others struggling with mental illness that involve religion and spirituality.” Some of those interviewed shared that they found the mention of God or religion by family and friends less than helpful. For example, a 22-year-old white female with no religious identification mentioned in her interview that a family member “tries to tell me that going to church will be better for me because it will help me find peace, and it really does quite the opposite.” Interestingly, researchers noted that nearly all participants who reported negative experiences with religion and spirituality also reported utilizing positive religious and spiritual coping or having a positive relationship with God. Oxhandler said such complexity highlights the importance of including religion and spirituality during the initial assessment with a client. “It’s critical that mental health care providers be well equipped and trained to assess for the complex role of religion and spirituality in the lives of young adults with serious mental illness, recognizing that it could appear to be a tremendous source of support and resilience and/or a source of pain and discomfort, if even a part of their lives at all,” she said. ABOUT THE STUDY “Religion and Spirituality Among Young Adults With Severe Mental Illness,” published in the journal Spirituality in Clinical Practice, is authored by Holly K. Oxhandler, Ph.D., L.M.S.W., assistant professor and associate dean for research and faculty development, Diana R. Garland School of Social Work, Baylor University; Sarah C. Narendorf, Ph.D., L.C.S.W., assistant professor, Graduate College of Social Work, University of Houston; and Kelsey M. Moffatt, M.S.W., Diana R. Garland School of Social Work, Baylor University. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT DIANA R. GARLAND SCHOOL OF SOCIAL WORK Baylor University’s Diana R. Garland School of Social Work is home to one of the leading graduate social work programs in the nation with a research agenda focused on the integration of faith and practice. Upholding its mission of preparing social workers in a Christian context for worldwide service and leadership, the School offers a baccalaureate degree (B.S.W.), a Master of Social Work (M.S.W.) degree and three joint-degree options, M.S.W./M.B.A., M.S.W./M.Div. and M.S.W./M.T.S., through a partnership with Baylor’s Hankamer School of Business and George W. Truett Theological Seminary, and a Ph.D. program. Visit www.baylor.edu/social_work to learn more.

Grip Strength of Children Gives Clues about Their Future Health, Study Finds

Measuring hand grip can help identify youths who could benefit from lifestyle changes to improve health, Baylor researcher says Adolescents with a strong hand grip — an indicator of overall muscle strength — have better odds of being healthy over time, according to a two-year study of 368 elementary school children. While other studies have shown that muscle weakness as measured by grip strength is a predictor of unhealthy outcomes — including cardiovascular and metabolic diseases, disability and even early mortality — this is the first to do so for adolescent health over time, a Baylor University researcher said. “What we know about today’s kids is that because of the prevalence of obesity, they are more at risk for developing pre-diabetes and cardiovascular disease than previous generations,” said senior author Paul M. Gordon, Ph.D., professor and chair of health, human performance and recreation in Baylor’s Robbins College of Health and Human Sciences. “This study gives multiple snapshots over time that provide more insight about grip strength and future risks for developing diabetes and cardiovascular disease,” he said. “Low grip strength could be used to predict cardiometabolic risk and to identify adolescents who would benefit from lifestyle changes to improve muscular fitness.” The study — "Grip Strength is Associated with Longitudinal Health Maintenance and Improvement in Adolescents" — is published in The Journal of Pediatrics. It was conducted by researchers at Baylor University, the University of Michigan and the University of New England. Students tracked in the study were assessed in the fall of their fourth-grade year and at the end of the fifth grade. Using the norms for grip strengths in boys and girls, researchers measured the students’ grips in their dominant and non-dominant hands with an instrument called a handgrip dynamometer. Researchers found that initially, 27.9 percent of the boys and 20.1 percent of the girls were classified as weak. Over the course of the study, boys and girls with weak grips were more than three times as likely to decline in health or maintain poor health as those who were strong. Researchers also screened for and analyzed other metabolic risk factor indicators, including physical activity, cardiorespiratory fitness, body composition (the proportion of fat and fat-free mass), blood pressure, family history, fasting blood lipids and glucose levels. “Even after taking into account other factors like cardiorespiratory fitness, physical activity and lean body mass, we continue to see an independent association between grip strength and both cardiometabolic health maintenance and health improvements,” Gordon said. While much emphasis has been placed on the benefits of a nutritious diet and aerobic activity, this study suggests that greater emphasis needs to be placed on improving and maintaining muscular strength during adolescence. If someone with a strong grip develops an even stronger grip, “we don’t necessarily see a drastic improvement in that individual’s health,” Gordon noted. “It’s the low strength that puts you at risk. “Given that grip strength is a simple indicator for all-cause death, cardiovascular death and cardiovascular disease in adults, future research is certainly warranted to better understand how weakness during childhood tracks into and throughout adulthood,” he said. “Testing grip strength is simple, non-invasive and can easily be done in a health care professional’s office. It has value for adults and children.” *An estimated 17.2 percent of U.S. children and adolescents aged 2 to 19 years are obese and another 16.2 percent are overweight, according to the National Center for Health Statistics. Excess weight carries a greater lifetime risk of diabetes and premature heart disease. While the World Health Organization and the U.S. Department of Health and Human Services recommend that youths perform at least 60 minutes of moderate to vigorous physical activity daily — including vigorous activity at least three days a week — fewer than a quarter of U.S. children do so, according to a report by the nonprofit National Physical Activity Plan Alliance. ABOUT THE STUDY The data source was the Cardiovascular Health Intervention Program (CHIP), supported by a subcontract from the Children’s National Medical Center in Washington, D.C., which was funded from The Clark Charitable Foundation. Co-researchers were lead author Mark D. Peterson, Ph.D., assistant professor, University of Michigan Department of Physical Medicine and Rehabilitation in Ann Arbor, Michigan; Baylor graduate Sonja Smeding, B.S. (Biology), ’18; and Paul Visich, Ph.D., professor and chair, University of New England’s Department of Exercise and Sport Performance in Biddeford, Maine. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT THE ROBBINS COLLEGE OF HEALTH AND HUMAN SCIENCES The Robbins College of Health and Human Sciences at Baylor University was established in 2014, a result of identified priorities for strengthening the health sciences through Baylor’s strategic vision, Pro Futuris, which serves as a compass for the University’s future. The anchor academic units that form the new College – Communication Sciences and Disorders, Family and Consumer Sciences and Health, Human Performance and Recreation – share a common purpose: improving health and the quality of life. The College is working to create curricula that promote a team-based approach to patient care and establish interdisciplinary research collaborations to advance solutions for improving the quality of life for individuals, families, and communities. For more information visit Robbins College of Health and Human Sciences.

Children with Brain Tumors Who Undergo Radiation Therapy Are Less Likely to Recall Recent Personal Events than to Remember Pre-Treatment Happenings

‘The surprise, and the up side, is that episodic memories from before the children’s treatment were spared,’ Baylor researcher says Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of events they experienced after radiation than to remember pre-treatment happenings, according to a Baylor University study comparing them to children with healthy brains. The finding is significant because children after treatment had less volume in the hippocampus — a part of the brain that plays an important role in memory. But while such a decrease usually is associated Alzheimer’s disease, dementia, brain injury, epileptic amnesia, encephalitis and aging, with those conditions both remote and recent memories are impaired, said lead author Melanie Sekeres, Ph.D., director of Sekeres Memory Laboratory at Baylor University. “The surprise, and the up side, is that episodic memories from before the children’s treatment were spared,” Sekeres said. For the study, published in The Journal of Neuroscience, researchers focused on “autobiographical memory,” which is linked to unique personal events and involves the recollection of emotional and perceptual details that allow a person to mentally re-experience the event, said Sekeres, assistant professor of psychology and neuroscience in Baylor’s College of Arts & Sciences. Radiotherapy and chemotherapy are used to treat the most common malignant brain tumor in children — a medulloblastoma. The reduced volume of the hippocampus is likely associated with radiation’s impact on the development of new cells in the nervous system, including the growth of new neurons in the hippocampus, or neurogenesis. “We know that these new cells play crucial roles in regulating memory and spatial learning, which is required to navigate. These treatments limit the brain’s ability to produce these new cells, which, in turn, limits the ability to form new memories,” Sekeres said. Research participants were 13 child survivors of brain tumors who had previously received radiotherapy and chemotherapy treatment at least one year before the study. Twenty-eight healthy youths of similar ages (ranging from 7 to 18) also were recruited for the study, conducted with The Hospital for Sick Children in Toronto, Ontario, Canada. All the youths completed the Children’s Autobiographical Interview — a standardized memory test — and underwent magnetic resonance imaging (MRI) of the brain. In individual interviews, children in both groups also were asked to recall memories from personal events that occurred at a specific time and place. Children were asked to recall a very old memory from an event before their radiation treatment (or an equally old memory for the healthy children) and a recent memory from within the past month. They were offered a list of events such as a birthday party, family trip, graduation and getting a pet but were told that they could choose another happening. The interview allowed children to freely recall without prompting before being asked general and specific questions about the event. “They have a hard time forming new, detailed memories,” Sekeres said. For example, when talking about a recent birthday party for a friend, they might tell how they met the friend and what that individual likes to do, but few specifics such as what they wore, the type of cake, what friends were there and what activities they did at the party, she said. “Such specific details might seem trivial, but these are precisely the kinds of details that allow us to vividly replay important events in our lives,” Sekeres said. “For most events, though, even healthy people forget a lot of specific details over time because we typically don’t need to retain all that incidental information. Some forgetting is normal and adaptive, and what we remember is the gist of an older event.” The patients were just as capable as healthy children of recalling these older memories, she said. But for children with brain tumors who have undergone radiation, the study suggested “deficits in their ability to either encode and/or retrieve highly detailed memories for personal events,” Sekeres said. “And those are the kind of memories that allow us to understand who we are and give us rich personal lives. “The study identifies an area of cognition that is inadvertently impacted by standard treatment, which has real consequences for the quality of life of the survivors. The physicians’ ultimate goal is to allow their patients to survive and to live as well as possible,” Sekeres said. “Although these treatments are often crucial in the effective management of the cancer, if the physicians and the family know there are these unintended side effects, that may be an additional factor to consider when exploring the treatment options.” ABOUT THE STUDY The study — “Impaired recent, but preserved remote, autobiographical memory in pediatric brain tumor patients” — was conducted with the Brain Tumor Program and the Program in Neurosciences and Mental Health at The Hospital for Sick Children in Toronto, Ontario, Canada. Funding was provided through the Canadian Institutes of Health Research. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT BAYLOR COLLEGE OF ARTS & SCIENCES The College of Arts & Sciences is Baylor University’s oldest and largest academic division, consisting of 25 academic departments and seven academic centers and institutes. The more than 5,000 courses taught in the College span topics from art and theatre to religion, philosophy, sociology and the natural sciences. Faculty conduct research around the world, and research on the undergraduate and graduate level is prevalent throughout all disciplines. Visit College of Arts & Sciences.

When Religiosity Competes with Materialism, Charitable Giving Takes a Hit, Baylor Study Shows

Baylor researchers suggest fundraisers can use study results to boost giving Religious people tend to be more charitable than their nonreligious counterparts, but they’ll think twice about opening their wallets if it prolongs their next big purchase, according to new research from Baylor University’s Hankamer School of Business. Baylor researchers James A. Roberts, Ph.D., professor of marketing, and Meredith David, Ph.D., assistant professor of marketing, partnered on a study that examined the relationship between religiosity and charitable giving, and what drives the latter. They found that religiosity – the way people live out their lives based on their faith – can drive donors to give. But when materialism – that self-serving want for more money or material possessions – enters the equation, giving decreases. “At once, we want to help others, but at the same time, we desire the money and possessions that we all cherish to a greater or lesser degree,” the researchers wrote. “It is the result of such give-and-take between opposing values that drives our behavior as donors to charitable causes.” A total of 180 adults participated in the study, which is published in  International Journal of Nonprofit and Voluntary Sector Marketing. Roberts and David looked specifically at religiosity’s effect on peoples’ attitudes toward helping others (AHO) and attitudes toward charitable organizations (ACO). Religiosity, they explained, is different from religious affiliation; it “is something that individuals experience outside of their place of worship and constitutes a way of viewing and experiencing the world that is different from their less religious (or nonreligious) counterparts.” They said they approached the study with the idea that helping others is a common rule among major religions. In general, the research showed that those expressing higher levels of religiosity were found to possess more favorable attitudes toward helping others and to charitable organizations. And those with stronger attitudes toward helping others also expressed a greater breadth in their giving. But higher levels of religiosity do not guarantee open wallets, David said. “We can’t always assume that religiosity ensures charitable giving,” she said. “Our study results suggest that increasing materialism lessened the positive effect of AHO on the breadth of giving.” Roberts, a nationally recognized expert on consumerism, said he and David, a nationally recognized expert on consumer behavior and well-being, weren’t too surprised by the study’s findings, given a basic understanding of human nature and the self-centeredness that accompanies materialism. However, they believe that understanding these dynamics can benefit charitable organizations as they identify potential donors and prepare for “the ask.” “Although materialism was found to reduce the breadth and likelihood of charitable giving in the present study, it could spur charitable giving if it is driven by self-serving motivations,” they wrote in the “managerial implications” section of the study. In other words, appeal to the donors’ inclination to give and their desire for public acknowledgment. “Large donations that come with naming rights, spur news coverage or exceed the donations of other prominent individuals are all examples of how materialism can be used to drive charitable donations,” they wrote. ABOUT THE STUDY “Holier than thou: Investigating the relationship between religiosity and charitable giving,” published in the June 2018 issue of International Journal of Nonprofit and Voluntary Sector Marketing, is authored by James A. Roberts, Ph.D., The Ben H. Williams Professor of Marketing, Hankamer School of Business, Baylor University, and Meredith David, Ph.D., assistant professor of marketing, Hankamer School of Business, Baylor University. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT HANKAMER SCHOOL OF BUSINESS Baylor University’s Hankamer School of Business provides a rigorous academic experience, consisting of classroom and hands-on learning, guided by Christian commitment and a global perspective. Recognized nationally for several programs, including Entrepreneurship and Accounting, the school offers 24 undergraduate and 13 graduate areas of study. Visit www.baylor.edu/businessand follow on Twitter at twitter.com/Baylor_Business.

Baylor Researchers Awarded Grant to Develop Diabetes Mobile Health App for Use in India

An interdisciplinary team of Baylor University researchers – from nursing and business information systems to art and video game design – and physicians from Bangalore Baptist Hospital in Bengaluru, India, were awarded a 21st Century Knowledge Initiative Grant from the U.S. India Education Foundation (USIEF) to develop a diabetes mobile health app to boost awareness and educate those in India who are most at risk for diabetes. The team is led by Shelby Garner, Ph.D., R.N., assistant professor in Baylor’s Louise Herrington School of Nursing, who has worked in India over the past six years to develop technological health resources. She cited statistics from the World Health Organization that show life expectancy in India is among the lowest in the South East Asian Region and is largely attributed to growing rates of non-communicable diseases, such as diabetes. Contextualized health education is one key to help raise awareness in the country, she said. “There is a need for culturally appropriate health education materials in India,” Garner said. “Our early research showed that technology, such as smartphones and internet accessibility, are widely available in India among health providers, but most technological educational resources were developed in the West and do not effectively translate to the Indian context.” Physicians from Bangalore Baptist Hospital will provide cultural context and help identify important medical content to be included in the app. “Our diabetes app will feature an interactive 3D animated video with gaming features to help educate patients at risk for diabetes,” Garner said. “Answers to questions addressed in the app include: What is diabetes? What happens if I have diabetes? How do I prevent and treat diabetes? What do I do now?” The app also serves as a data collection tool to help researchers determine if the video is improving participants’ knowledge on diabetes. Community health workers employed by Bangalore Baptist Hospital will use the app as they visit with people in rural villages and urban slums during door-to-door health education visits, Garner said. The research team will compare the app’s effectiveness with standard health educational resources previously used. Garner said the USIEF grant was awarded, in large part, due to the success of an earlier project that led to the development of a hypertension app. “Earlier this year, we tested the hypertension app among 346 people in one of the largest slums in Bengaluru, India, and in several rural villages surrounding Bengaluru,” she said. “The app was significantly effective in improving knowledge among participants. We used these results to justify the need to design more resources and applied for funding from the U.S. India Education Foundation.” From previous experience developing and employing the hypertension app, Garner said she knew this new project would require input from a variety of perspectives. “I’ve realized some of the ‘big picture’ challenges in health education, and it will take a team of experts to make this happen,” she said. Team members are: • Shelby Garner, Ph.D., R.N., assistant professor in Baylor’s Louise Herrington School of Nursing • Dr. Carol Elizabeth George, community health physician, Bangalore Baptist Hospital • Dr. Gift Norman, community health physician, Bangalore Baptist Hospital • Dr. Kingsly Victor, internal medicine physician, Bangalore Baptist Hospital • Hope Koch, Ph.D., associate professor of business information systems, Baylor’s Hankamer School of Business • Phil Young, Ph.D., assistant clinical professor of business information systems, Baylor’s Hankamer School of Business • Julia Hitchcock, M.F.A., associate professor of art, Baylor’s College of Arts & Sciences • Matthew Fendt, Ph.D., lecturer in computer science, Baylor’s School of Engineering and Computer Science The grant also will fund exchange teams of researchers and faculty from India to come to the U.S. and for Baylor team members to go to India to collaborate on the research for the next two years. The first team from India is due in late October. “We are really excited about the work we will do together with our Indian partners over the next two years,” Garner said. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT LOUISE HERRINGTON SCHOOL OF NURSING The Baylor University Louise Herrington School of Nursing (LHSON) located in Dallas was established in 1909 as a diploma program within Baylor Hospital in Dallas, which is now Baylor University Medical Center, and in 1950 became one of the six degree-granting schools of Baylor University. The first Baccalaureate degrees were granted in 1950 establishing the school among the earliest baccalaureate nursing programs in the United States. In 1999, the School was renamed the Baylor University Louise Herrington School of Nursing after Louise Herrington Ornelas, a 1992 Baylor Alumna Honoris Causa, who made an endowment gift to the school. Accredited by the Commission on Collegiate Nursing, LHSON offers Bachelor of Science in Nursing (B.S.N.) degrees through a traditional program and FastBacc (one-year accelerated program). LHSON also offers an online Master of Science in Nursing (M.S.N.) Leadership and Innovation program, as well as Doctor of Nursing Practice (D.N.P.) programs to include Family Nurse Practitioner (F.N.P.), Nurse-Midwife (C.N.M.) and Neonatal Nurse Practitioner (N.N.P.). LHSON was featured in U.S. News & World Reportfor the 2018Best Graduate Schools ranking the D.N.P.program in the top 50 U.S.nursing schools at No. 46. The Baylor M.S.N.program is ranked at No. 56and the Nurse Midwifery Program ranked No. 10. Baylor’s M.S.N. in Nursing Leadership andInnovation Online Program ranked No. 39 in the 2018U.S. News Best Online Graduate Programs. For more information, www.baylor.edu/nursing.

Out of Office: New Baylor Management Study Examines Relationship Between Stress and Remote Work

Researchers say people with high emotional stability and autonomy are best suited for remote-work opportunities Many U.S. employees believe working from home – or at least away from the office – can bring freedom and stress-free job satisfaction. A new Baylor University study says, “Not so fast.” The study, published recently in the European Journal of Work and Organizational Psychology, examines the impact of remote work on employee well-being and offers several strategies to help managers provide remote-work opportunities that are valuable to the employee and the company. “Any organization, regardless of the extent to which people work remotely, needs to consider well-being of their employees as they implement more flexible working practices,” the researchers wrote. A total of 403 working adults were surveyed for the two studies that made up the research, said lead author Sara Perry, Ph.D., assistant professor of management in Baylor University’s Hankamer School of Business. The research team measured each employee’s autonomy (the level of a worker’s independence), strain (defined in this study as exhaustion, disengagement and dissatisfaction) and emotional stability. Emotional stability, Perry explained, “captures how even keeled someone is or, on the opposite end, how malleable their emotions are. An example would be if something stressful happens at work, a person who is high on emotional stability would take it in stride, remain positive and figure out how to address it. A person low on emotional stability might get frustrated and discouraged, expending energy with those emotions instead of on the issue at hand.” The research found that: • Autonomy is critical to protecting remote employees’ well-being and helping them avoid strain. • Employees reporting high levels of autonomy and emotional stability appear to be the most able to thrive in remote-work positions. • Employees reporting high levels of job autonomy with lower levels of emotional stability appear to be more susceptible to strain. Perry said the study contradicts past research that says autonomy is a universal need that everyone possesses. Per this research, those who are lower in emotional stability may not need or want as much autonomy in their work. “This lower need for autonomy may explain why less emotionally stable employees don’t do as well when working remotely, even when they have autonomy,” researchers wrote. In addition to their findings, the researchers offered several recommendations for managers who design or oversee remote-work arrangements. The research team advised managers to consider their employees’ behavior when deciding who will work remotely. “I would suggest managers look at employee behaviors, rather than for personality traits, per se,” Perry said. “For example, if someone does not handle stress well in the office, they are not likely to handle it well at home either. If someone gets overwhelmed easily, or reacts in big ways to requests or issues in the office, they are likely less well positioned to work remotely and handle that responsibility and stress.” Based on this study, individuals with high emotional stability and high levels of autonomy are better suited for remote work, but such candidates might not always be available. “If less emotionally stable individuals must work remotely, managers should take care to provide more resources, other than autonomy, including support to help foster strong relationships with coworkers and avoid strain,” they wrote. Managers might also consider providing proper training and equipment for remote work, including proper separation of work and family spaces, clear procedural and performance expectations and regular contact (virtual or face-to-face) with coworkers and managers. ABOUT THE STUDY “Stress in Remote Work: Two Studies Testing The Demand-Control-Person Model,” published in the European Journal of Work and Organizational Psychology, is authored by Sara Perry, Ph.D., assistant professor of management, Hankamer School of Business, Baylor University, Emily Hunter, Ph.D., associate professor of management, Hankamer School of Business, Baylor Univeersity, and Cristina Rubino, professor of management, David Nazarian College of Business and Economics, California State University Northridge. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT HANKAMER SCHOOL OF BUSINESS Baylor University’s Hankamer School of Business provides a rigorous academic experience, consisting of classroom and hands-on learning, guided by Christian commitment and a global perspective. Recognized nationally for several programs, including Entrepreneurship and Accounting, the school offers 24 undergraduate and 13 graduate areas of study. Visit www.baylor.edu/business and follow on Twitter at www.twitter.com/Baylor_Business.

Ethics Quandary? Women in PR More Apt to Seek Allies Before Giving Execs Advice

Women in public relations are more likely than men to seek allies and form coalitions before they give ethics counsel to senior leaders, while men are more likely to rely on presenting research, according to a Baylor University study. The study also showed that while senior public relations executives in the study overall tend to use “rational approaches,” such as research, case studies and appeals about what is right and lawful, success depends on building relationships with colleagues in other departments so that they have backup when ethical issues arise. “A PR person can be the conscience, but are they listened to? Are they respected? Are they at the table?” one woman said. “You can be doing everything right, but if nobody is listening to you, it really doesn’t matter a whole lot. Except that you can sleep at night.” The study — “The Use of Influence Tactics by Senior Public Relations Executives to Provide Ethics Counsel” — is published in the Journal of Media Ethics. The article highlights the need for younger PR practitioners to seek out senior PR executives as mentors before and during confrontation of ethics issues, said lead author Marlene Neill, Ph.D., assistant professor of journalism, public relations and new media in Baylor’s College of Arts & Sciences and author of the book “Public Relations Ethics: PR Pros Tell Us How to Speak Up and Keep Your Job.” “What inspired us to conduct this research were findings from a study I conducted in 2016 with Millennials working in public relations,” Neill said. “Survey results indicated that Millennials did not feel prepared to provide ethics counsel, were unlikely to speak up and did not even expect to face ethical dilemmas. We decided to conduct this study to instruct them how to do this effectively based on the experiences of senior executives working in our industry.” Researchers conducted through in-depth interviews with an elite selection of 55 public relations executives, many of them with Fortune 500 companies. They included members of the *Public Relations Society of America (PRSA) College of Fellows and The Arthur W. Page Society, with the combined sample averaging 33 years in PR. They represented 19 states and industries including government, healthcare, telecommunications, financial services and energy. Interviewees discussed ways to exert influence, ethics training and whether they are of value as an ethics counselor. “Some see it as being of little use; some recommend the PR practitioner take a modest role in encouraging consideration of ethics among multiple leaders,” Neill said. But others felt strongly that they should be an “organizational conscience” when they think company actions might pose an ethical dilemma with troubling consequences. One reason to do so is that without “boat-rocking” with straightforward tactics   an organization, some may turn outside the company by whistleblowing or leaking information to stakeholders, media or government officials. “Our study found that building relationships was critical for practitioners to ensure that other executives would listen to and respect their counsel,” Neill said. “That doesn’t mean they always won the debate, but relationship building has to do with building respect and trust.” While the interviewees’ most common approach to influencing was rational, followed by coalition-building, “some said they relied on persistence and assertiveness if they felt an issue was so objectionable they could not stay silent,” Neill said. “A few people turn to ingratiation, such as flattery.” When it comes to differences in how genders approach the role of ethics counselor, one reason women may recruit allies is that they tend to be outnumbered by men in the boardroom, Neill said. One woman said that “Going in force can help your case. But sometimes it can backfire . . . you know, if somebody wants to kill the messenger. But if several people come to you with the same messaging, I think you take notice.” Another woman said that she was “reprimanded for being so forthright. So, I didn’t do it that way anymore.” Some women were wary of using emotional appeals. Because of stereotypes about women being emotional in the workplace, “I probably erred in the other direction,” one woman said. Men, meanwhile, were more likely to prefer informational sources of power such as research and case studies, Neill said. But both genders said they ask questions, discuss, listen, share alternatives or solutions and recommend. A few men and women used more confrontational descriptions, such as saying, “We absolutely put our foot down” and “Tell them it’s wrong.” But in the case of women, “some of these more confrontational accounts were used in connection with allies or coalitions,” Neill said. In a few cases, men and women gave examples of resigning accounts or refusing to accept new clients if they decided the client’s business was not worth the ethical cost. Many interviewees said they had received ethics training through PRSA. A few said they had received training through their employer, college courses, personal study and mentors. A few pointed to their religious upbringing. Some of the more common ethics issues centered around communication, such as open disclosure of information, inaccurate information or sending fake letters to an editor. But others were business challenges, such as abusive behavior toward subordinates, misuse of public funds, smear campaigns and conflicts of interest. Neill said that because the study was limited to 55 individuals, a larger study and surveys of senior PR executives in other nations would be valuable. She and a colleague next plan to study to women’s leadership experiences. *PRSA College of Fellows is an exclusive group of approximately 350 senior professionals, each with a minimum of 20 years of experience in PR, Accreditation in Public Relations and recognition for distinguished careers. The Arthur W. Page Society is open by invitation to chief communications officers of Fortune 500 corporations and leading nonprofit organizations, chief executive officers of PR agencies and senior professors from business and communications schools. The study was funded by The Arthur W. Page Center for Integrity in Public Communication and supported by the PRSA Board of Ethics and Professional Standards and PRSA College of Fellows. Co-author is Amy Barnes, associate professor in the School of Mass Communications at the University of Arkansas at Little Rock and co-author of “Public Relations Ethics: PR Pros Tell Us How to Speak Up and Keep Your Job.” ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT BAYLOR COLLEGE OF ARTS & SCIENCES The College of Arts & Sciences is Baylor University’s oldest and largest academic division, with 25 academic departments and seven academic centers and institutes. The more than 5,000 courses taught in the College span topics from art and theatre to religion, philosophy, sociology and the natural sciences. Faculty conduct research around the world, and research on the undergraduate and graduate level is prevalent throughout all disciplines.

Ethical Leadership Can Have Negative Consequences, Baylor University Researchers Say

Coupled with stress, ethical leadership can lead to employee deviance and turnover Ethical leadership is a good thing, right? Certainly, management experts say. But ethical leadership can have negative consequences, too, according to new research from management faculty in Baylor University’s Hankamer School of Business. A 2018 Baylor study published in the Journal of Business Ethics reveals that ethical leadership compounded by job-hindrance stress and supervisor-induced stress can lead to employee deviance and turnover. The research reflects the thoughts of 609 employees who were surveyed across two studies. “If someone is an ethical leader but induces stress, our research shows that his or her employees will feel less support,” said lead author Matthew Quade, Ph.D., assistant professor of management. “Thus, employees who do not feel supported are more likely to consider leaving their jobs or engage in workplace deviance – things like coming in late to work, daydreaming, not following instructions or failing to be as productive as they could be.” Quade said that ethical leadership is a good thing and often beneficial in terms of employee resources. An example would be a trusted supervisor who listens to her employees and has her employees’ best interests in mind. The trouble comes, he said, when supervisor-induced stress or job-hindrance stress enters the picture. “When those stressors are added, there is a depletion of resources,” Quade explained. “Many of the gains or benefits from ethical leadership are negated.” What does stress-inducing ethical leadership look like? Quade said it could be as simple as supervisors setting expectations too high or, in the interest of “following all the rules,” not allowing for any deviation from a process, even if a shortcut, still within the bounds of behaving ethically, would deliver a desired result. The researchers wrote: “Ethical leadership can be an exacting process of sustaining high ethical standards, ensuring careful practice and enforcement of all rules and meeting leaders’ lofty expectations, all of which can consume time and energy and be perceived by employees as overly demanding or an obstacle to job performance.” As part of the study, those surveyed were asked to what extent they agreed or disagreed with the following statements: My supervisor makes it so that I have to go through a lot of red tape to get my job done. Working with my supervisor makes it hard to understand what is expected of me. I receive conflicting requests from my supervisor. My supervisor creates many hassles to go through to get projects/assignments done. Working with him/her thwarts my personal growth and well-being. In general, I feel that my supervisor hinders my personal accomplishment. I feel that my supervisor constrains my achievement of personal goals and development. Quade said his team in no way wants to discourage ethical leadership. Research consistently shows such leadership is very beneficial, he said. But this new research shows that there are boundaries to those benefits. “This places quite an onus on appropriately managing the stress that comes from the leader and the job, in efforts to most fully realize the potential of ethical leadership,” the researchers wrote. The study listed some tips and takeaways for organizations and leaders. They include: Strike a balance between promoting ethical behavior and providing resources to help employees meet those standards. Encourage employees in word and deed by reducing ambiguity in ethical dilemmas that might otherwise drain resources. Model fair and ethical behavior. Communicate efficient methods to meet standards and reduce unnecessary steps or procedures. Equip and train leaders to balance the demands of leading ethically while not overburdening their employees. ABOUT THE STUDY “Boundary Conditions of Ethical Leadership: Exploring Supervisor-Induced and Job Hindrance Stress as Potential Inhibitors” is published in the Journal of Business Ethics. Study authors are Baylor University Hankamer School of Business faculty members Matthew Quade, Ph.D., assistant professor of management; Sara Perry, Ph.D., assistant professor of management; and Emily Hunter, Ph.D., associate professor of management. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT HANKAMER SCHOOL OF BUSINESS Baylor University’s Hankamer School of Business provides a rigorous academic experience, consisting of classroom and hands-on learning, guided by Christian commitment and a global perspective. Recognized nationally for several programs, including Entrepreneurship and Accounting, the school offers 24 undergraduate and 13 graduate areas of study. Visit www.baylor.edu/businessand follow on Twitter at twitter.com/Baylor_Business.

The Storm After the Storm: Scam Contractors Who Prey on Those Suffering After a Natural Disaster

‘The key is to get a lawyer to look at the contract before you sign it,’ Baylor legal expert says WACO, Texas (Oct. 11, 2018) – Following a natural disaster or strong storm like Hurricane Michael, there is usually a second wave of potential destruction – scam artists looking to line their pockets. “After any major weather-related incident, insurance adjusters and contractors swarm the affected area and, unfortunately, some are looking to take advantage of those in distress,” said Stephen Rispoli, L.L.M, J.D., assistant dean of student affairs and pro bono programs at Baylor Law School. As an attorney, he works with victims of insurance scams. Rispoli said most contractors are legitimate businesspeople helping neighbors rebuild. But there are the unscrupulous ones whose practices inflict financial and emotional pain on people already suffering from storm damage. “The primary result of these scams is financial loss,” Rispoli said. “The homeowners may pay much, much more than they should have to fix the damage, sometimes having to pay multiple contractors for the same work. Sadly, in some cases, homeowners could even lose their homes.” In this Q&A, Rispoli shares some tips to help those reeling from storm damage identify and avoid scammers. Q: Who are the most common victims? A: The most common targets are those in distress following a major storm, the elderly and the disabled. Q: How will scam artists approach a potential victim? A: Usually, contractors will approach homeowners they know have been affected. This happens as simply as the contractor driving through neighborhoods looking for damaged homes. Let’s say, for example, they see a damaged roof with a homeowner standing outside looking at it. They’ll quickly pull over and offer to tarp the roof to prevent damage. The homeowner, already distressed by the storm and the damage to the house, agrees. Once the tarp is on, the contractor then starts asking questions about insurance coverage, which insurance company has insured the house, and helpfully offering his or her opinion on how much it will cost to fix the damage. Unscrupulous contractors will try to take advantage of this situation by pressing the homeowner to sign a contract with them. I have even seen cases where the contractor left all the blanks in the form contract unfilled, including the work to be done and the price, saying things like, “Don’t worry about that, we’ll talk to your insurance company and get it all taken care of, just sign it.” Once the unscrupulous contractor has a signed contract, they can fill in the blanks at their leisure. At this point, they are in total control – they know how much the insurance company will pay, and they can try to squeeze the homeowner for more money by charging too much or with add-ons that may or may not be necessary. Q: What are some of the potential losses victims can suffer? A: Financially, victims could lose money by paying more – sometimes much more – than they should for repairs. Or, in extreme cases, they could even lose their homes. That could happen if the homeowner signs a contract with the contractor that contains a mechanic’s or materialman’s lien provision. Under these provisions, contractors can file a lien with the county for work done on the house to ensure payment. If the homeowner does not pay the contractor the amount owed under the contract, the contractor can seek to foreclose on the house to recover the amount owed. Q: What about dealing with the insurance company? A: It’s important that you cooperate with your insurance company and your adjustor. Call your insurance company as soon as you can. Waiting to file a claim may make the process take longer or complicate matters. You should be responsive to their requests, but don’t be afraid to ask questions if you have them. Be sure to take photographs of any damage or evidence of the storm if it’s safe to do so. After your initial conversation with your insurance company, the company will send an adjustor out and will give you a quote. However, after you’ve had two or three contractors come out and give you estimates, if the adjustor’s quote looks too low, don’t be afraid to ask for another adjustor to come out and give you a quote. You should feel comfortable with the process as you move forward. Q: Is it illegal or unethical for contractors to file liens? A: It is not necessarily unscrupulous for contractors to include a mechanic’s or materialman’s lien provision in the contract. Generally, creditors cannot foreclose on a person’s homestead in Texas. The purpose of a mechanic’s or materialman’s lien provision is to protect the contractor should the homeowner wrongfully refuse to pay for work done on a homestead. On large jobs where several thousands of dollars are at stake, the contractor may rightfully want to make sure that they can be paid for the job. Whether they are appropriate can only be decided on a case-by-case basis. Q: Are there red flags people should look for when presented with a contract? A: Do not sign a contract you are not comfortable with. There are several red flags to look for: pressure to sign a contract, giving you little time to think about it, refusing to let you take the contract to a lawyer, and asking to collect the money directly from the insurance company or pressuring you to give them the check from the insurance company. Q: How do people know if the repair costs presented to them are too high? A: Be sure to get written estimates from several (at least three) contractors. By getting three estimates, you’ll have a better idea of how much the repair should cost. Any estimates that are way lower or way higher than the others are good indications that something is off. If that happens, get another estimate from a different contractor. Do not be afraid to ask contractors to come give you an estimate. It is a normal part of their job, and good contractors will not mind taking the time to do it. Q: How do you know if a contractor is legitimate? A: Do your homework on the contractors. Ask for references and call them, and check with the Better Business Bureau. Be cautious when dealing with contractors who are not from your area, and extra cautious if they are not from Texas or will not provide local references. Q: Contractors often ask for upfront money, don’t they? A: Once the contract is signed and the work begins, be sure to control the money. The contractor will likely ask you to pay some of the contract up front so that they can begin to purchase materials and hire the crew to work on your repair. Try to pay as little as possible. You do not want to give them the bulk of the money up front, because then the incentive to get the job done quickly is diminished. After the job starts, ask the contractor to give you, in writing, progress reports when they ask for more money. Do not pay more than the progress report. Do not give the contractor the final payment until all the work is done. Q: If someone feels they’ve been taken advantage of, are there legal steps they can take? A: The key here is to get a lawyer to look at the contract before you sign it. Once the contract is signed, it will be difficult for a lawyer to undo the damage. If the contractor is trying to foreclose on the home using a mechanic’s or materialman’s lien, a lawyer may be able to save your home. There are several Texas Constitutional and statutory protections for homeowners. If the contractor did not strictly follow the steps necessary to properly attach a lien, a lawyer may be able to keep the foreclosure from happening. ABOUT BAYLOR UNIVERSITY Baylor University is a private Christian University and a nationally ranked research institution. The University provides a vibrant campus community for more than 17,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 12 nationally recognized academic divisions. ABOUT BAYLOR LAW SCHOOL Established in 1857, Baylor Law was one of the first law schools in Texas and one of the first west of the Mississippi River. Today, the school has more than 7,400 living alumni. It is accredited by the American Bar Association and is a member of the Association of American Law Schools. Baylor Law has a record of producing outstanding lawyers, many of whom decide upon a career in public service. Baylor Law boasts two governors, members or former members of the U.S. House of Representatives and the U.S. Senate, two former directors of the FBI, U.S. ambassadors, federal judges, justices of the Texas Supreme Court and members of the Texas Legislature among its notable alumni. In its law specialties rankings, U.S. News & World Report ranked Baylor Law’s trial advocacy program as one of the top 5 in the nation. Baylor Law School also is ranked No. 50 in the magazine’s 2019 edition of “America’s Best Graduate Schools.” The National Jurist ranks Baylor Law as one of the “Best School for Practical Training” and No. 4 in the nation in its most recent “Best Law School Facilities” listing. The Business Insider places Baylor Law among the top 50 law schools in the nation. Baylor Law School received the 2015 American Bar Association Pro Bono Publico Award, making it only the third law school in the nation to be honored with the award since the award’s inception in 1984. Learn more at baylor.edu/law.

Electronic health records and the impact on workflow and costs

Healthcare practitioners and hospitals were initially slow to implement electronic health records (EHR) due to the perceived cost. The financial incentives from Medicare/Medicaid to adopt EHRs helped alleviate some of that concern, but the actual impact on workflow and profits, irrespective of those incentives, are still under investigation. In a research study, Steven D. Culler, adjunct associate professor of finance, along with David J. Ballard (Baylor Health Care System); Edmund R. Becker (Emory University); Dunlei Cheng (U of Texas); Briget da Graca (Baylor Health Care System); Neil S. Fleming (Baylor Health Care System); and Russell McCorkle (HealthTexas Provider Network) analyzed administrative, payroll, and billing data from 26 primary care practices in a Dallas-Fort Worth, Texas-based fee-for-service network that implemented EHRs from June 2006 through December 2008. In the 12-month period following implementation, staffing expenses increased 3 percent and practice costs increased 6 percent. The data revealed that “productivity, volume, and net income decreased initially, but recovered to/close to preimplementation levels after 12 months.” Given the recent rollout of EHRs across the country, the researchers noted the need for a longer-term investigation of the impact on productivity and costs. Source: