Connecting to the Heart: Teaching Value-Based Professional Ethics

Science and Engineering Ethics - Engineering programs in the United States have been experimenting with diverse pedagogical approaches to educate future professional engineers. However, a crucial...     

Going to the Heart of the Matter

Written as a conversational response to Rosa Luxemburg, this piece discusses the importance of going to the heart of the matter for education, seen here in terms of the actual flesh and blood subjects who are at the centre of a pedagogy of transformation.     

At the Heart of the Pregnancy: What Prenatal and Cardiovascular Genetic Counselors Need to Know about Maternal Heart Disease

In the last decade, an increasing number of cardiac conditions have been shown to have a genetic basis. Cardiovascular genetic counseling has emerged as a subspecialty aiming to identify unaffected at-risk individuals. An important sector of this at-risk population also includes expectant mothers, in whom unique clinical challenges may arise. Genetic counselors, especially those in cardiovascular and prenatal settings, have an opportunity to identify and assist women who may benefit from cardiovascular care during pregnancy. This paper provides basic management and genetic evaluation principles for affected women, as well as guidance on identifying those who are at risk. We provide considerations for cardiac surveillance in pregnancy and the post-partum period. Finally, key psychosocial issues that appraise how to best provide support to at risk women as they make informed decisions are discussed. We propose that a team approach including cardiology, maternal fetal medicine, and genetic counseling best serves this patient population. Ongoing questions addressing an evidence based approach to cardiovascular genetic conditions in pregnancy still remain. Thus, well-designed research protocols are essential to mark progress in this area.     

Responses to Ink-blot Configurations Resembling the Heart

A technique is described to measure an individual's awareness of the cardiac area. It utilizes three newly developed ink blots whose color-form configurations approximate the heart in various degrees. In the present exploratory study, projective responses were obtained from 68 nursing students. It was observed that their relative awareness of the anatomical connotations in the stimuli related to their past experience of psychophysiologic cardiac symptoms. The Moses Test of Extreme Reactions was used to analyze the data. This revealed upon calculation of the exact probability level a value of 0.0128 indicating that the symptomatic subjects fell more frequently at the extremes. It was hypothesized that these individuals respond to somatic anxiety by increasing or decreasing consciousness of their own heart.     

A new challenge to ethical codes: Heart transplants

Summary We have entered into a new era of medical achievement with the development of successful transplantation of human organs. The transplantation of the heart has aroused the greatest scientific interest and at the same time created serious new problems of an ethical and legal nature. It has been necessary to develop new criteria to determine the moment of death of the donor in order to ensure continued life for the recipient. The decision of the moment of death should be made by a small team of skilled physicians interested in furthering this important development, but not as emotionally involved as are the surgeons awaiting the chance to prolong their patient's life with a new heart. Available and suitable hearts will probably always be in very short supply, and the selection of recipients will therefore become critical if the procedure proves to be widely acceptable.New laws will be essential before this process can be adopted in many states and countries. The cost in terms of total resources is so large that careful evaluation of the long-term results must be undertaken after a reasonable number of patients have been operated on and observed, perhaps at the end of the second year following the first procedure. Since the cost of each operation of this type approximates that of the education of several young physicians who could care for thousands of patients during their life span, a good hard look at the potential benefits and ultimate values is in order. At this point in time it is extremely important that this type of surgery be encouraged but limited to those prepared to undertake it with maximum skill and minimal risk. At present it must be recognized as a great experiment rather than a therapeutic triumph for general application.     

Reason and the Heart: A Prolegomenon to a Critique of Passional Reason

International Journal for Philosophy of Religion -     

Religious Coping and Heart Transplantation: From Threat to Health

Previous research has established the existence of homogeneous religious coping profiles in cardiac-transplantation candidates labeled as the deferring/collaborators, self-directors, and the eclectic religious copers. However, their prospective impact on outcome has not yet been established. This paper examines potential differences between pre-cardiac transplantation religious coping cluster groups on post-cardiac transplantation quality of life (physical functioning, mental health, and general health). Results indicated that the religious coping profiles of deferring/collaborators and self-directors had significantly better scores on mental health and general health than did the eclectics. Implications for religious-coping research and clinical practice are discussed.     

The Biopsychosocial Model of Challenge and Threat: Using the Heart to Measure the Mind

The biopsychosocial model of challenge and threat (BPS) holds that during active goal pursuit, psychological processes reliably lead to specific patterns of cardiovascular responses. Because psychological experience during goal pursuit is not otherwise easily accessible, using cardiovascular responses to infer psychological states can provide valuable insight. In this context, challenge results from evaluating high resources and low demands, whereas threat results from evaluating low resources and high demands. Both challenge and threat lead the heart to beat faster and harder than during rest, but challenge results in dilation in arteries and more blood pumped, whereas threat results in constriction and less blood pumped. This article summarizes the BPS, presents recent research applications, and discusses remaining questions and future directions, including how research from other theoretical perspectives may clarify the nature of task engagement and how the BPS can inform the study of resilience to stressors.     

Sisters of the Heart: How Women's Friendships Heal

In this article we focus on the healing aspects of women's intimate friendships with other women. In particular, we discuss the role of female neurohromone oxytocin “the love hormone” in the promotion of health and wellbeing among women. We assert that the intimate women friendship construct can enhance psychotherapy's healing and empowering functions. In this context, we examine how women's friendships can inform feminist psychotherapy. Moreover, we discuss the feminist therapeutic relationship as an intimate bond, and compare it with women's friendships. We conclude with the introduction of the special issue on “Sisters of the Heart: Women Psychotherapist Reflections on Female Friendships.”     

Taking Racism to Heart: Race-Related Stressors and Cardiovascular Reactivity for Multiracial People

Multiracial people experience an accumulation of racial stress for both their minority and their multiracial identities, yet no research has examined the physiological impact of this stress. This within-groups experimental study examined whether two race-related stressors—identity invalidation and discrimination from family—affect cardiovascular reactivity for Black/White multiracial adults (N = 60). The authors found a Condition × Phase interaction effect indicating that discrimination from family affected blood pressure. Invalidation had no effect on blood pressure. Las personas multirraciales experimentan una acumulación de estrés racial tanto a causa de su identidad multirracial como de su identidad como minoría, pero no hay investigaciones que hayan examinado el impacto psicológico de este estrés. Este estudio experimental dentro de grupos examinó si dos factores causantes de estrés relacionados con la raza (la invalidación de la identidad y la discriminación por parte de la familia) afectan a la reactividad cardiovascular de personas adultas multirraciales blancas/negras (N = 60). Los autores hallaron un efecto de interacción Condición × Fase que indica que la discriminación por parte de la familia tuvo un efecto sobre la presión sanguínea. La invalidación no tuvo efecto sobre la presión sanguínea.     

Socioeconomic Differences in Psychosocial Factors Contributing to Coronary Heart Disease: A Review

Psychosocial factors have been shown to play an important role in the aetiology of coronary heart disease (CHD). A strong association between CHD and socioeconomic status (lower-level education, poor financial situation) has also been well established. Socioeconomic differences may thus also have an effect on psychosocial risk factors associated with CHD, and socioeconomic disadvantage may negatively affect the later prognosis and quality of life of cardiac patients. The aim of this study was to review the available evidence on socioeconomic differences in psychosocial factors which specifically contribute to CHD. A computer-aided search of the Medline and PsycINFO databases resulted in 301 articles in English published between 1994 and 2007. A comprehensive screening process identified 12 empirical studies which described the socioeconomic differences in CHD risk factors. A review of these studies showed that socioeconomic status (educational grade, occupation or income) was adversely associated with psychosocial factors linked to CHD. This association was evident in the case of hostility and depression. Available studies also showed a similar trend with respect to social support, perception of health and lack of optimism. Less consistent were the results related to anger and perceived stress levels. Socioeconomic disadvantage seems to be an important element influencing the psychosocial factors related to CHD, thus, a more comprehensive clarification of associations between these factors might be useful. More studies are needed, focused not only on well-known risk factors such as depression and hostility, but also on some lesser known psychosocial factors such as Type D and vital exhaustion and their role in CHD.