Spiritual Need Five: Providing Quality Pastoral Care as a Congregation

SUMMARY

Critical to the needs of older adults is the care and nurturing of the feelings and emotions that often offer context for the human spirit. Grounded in the history of pastoral care, this chapter explores an approach to pastoral care that is reflective of the author's study and experience in the parish.     

The Primary Care Health System as a Core Resource in Response to Terrorism

Abstract

Living through a terrorist event or under threat of attack affects both mental and physical health. A nation's primary care system plays a critical role under such circumstances. This article reviews the American experience after September 11, 2001 and advocates for integration of mental and physical health services in primary care settings as a key counter-terrorism strategy. Americans put their trust in primary care providers. The nation's healthcare system must develop and implement a strategy that informs and supports primary care providers in meeting the mental health needs of a nation confronted by terrorism.     

The Family Peace Project

Summary

Intimate partner violence-assault by a spouse, ex-spouse, intimate friend or ex-friend-is the most common cause of injury for women and a serious public health problem. As a result, the American Medical Association has recognized physicians' ethical obligation to diagnose and treat partner violence, and called for new models of training. In this article, we review literature on the health care system's response to domestic violence. We then describe the Family Peace Project, a community oriented model for training health care professionals to identify, treat and prevent partner violence in primary health care settings. This training program provides knowledge, clinical skills and a sense of professional empowerment. Unique features of this program include: involvement of community mentors (survivors of family violence) as program faculty; training in specific clinical skills and protocols for screening, assessment and intervention; a hands-on assessment of community resources; coinmunity service; and, creation of an award winning web site to promote dissemination of the training program.     

Pertinence clinique en population dépressive d’un médiateur thérapeutique axé sur les ressources personnelles : évaluation par protocole individuel de type arrêt—reprise sur une patiente hospitalisée pour dépression

IntroductionThe low to moderate benefit of current care on optimal functioning in depressed patient encourages the development and evaluation of new interventions in this area.ObjectiveThis study aims at the clinical evaluation by single case of a serious game focused on personal resources in depressed population.MethodThe recommendations of the Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) Statement were respected to design and report the results of this single-case research (Tate et al., 2016). A Withdrawal/Reversal ABA design has been applied to a young patient hospitalized for depression. Each phase contained 3 measurement opportunities spaced 7 to 10 days apart. In intervention phase B, a serious game was introduced in positive psychotherapy workshops without replacing the patient's usual care.ResultsIn the patient, serious game had a clinically significant benefit on depression, psychological well-being and affects. On the other hand, an increase in stress and anxiety levels, as well as a progressive decrease in the feeling of autonomy were also observed.ConclusionSerious game as a therapeutic mediator seems to have demonstrated its effectiveness for the patient. The reduction in depression coupled with the increase in stress and anxiety points out a favourable progression of the patient's problem. Elements specific to the patient's intra-individual problem were highlighted and could shed light on her clinical management.     

A critical commentary on follow-up studies and “desistance” theories about transgender and gender-nonconforming children

ABSTRACT

Background: It has been widely suggested that over 80% of transgender children will come to identify as cisgender (i.e., desist) as they mature, with the assumption that for this 80%, the trans identity was a temporary “phase.” This statistic is used as the scientific rationale for discouraging social transition for pre-pubertal children. This article is a critical commentary on the limitations of this research and a caution against using these studies to develop care recommendations for gender-nonconforming children.

Methods: A critical review methodology is employed to systematically interpret four frequently-cited studies that sought to document identity outcomes for gender-nonconforming children (often referred to as “desistance” research).

Results: Methodological, theoretical, ethical, and interpretive concerns regarding four “desistance” studies are presented. The authors clarify the historical and clinical contexts within which these studies were conducted to deconstruct assumptions in interpretations of the results. The discussion makes distinctions between the specific evidence provided by these studies versus the assumptions that have shaped recommendations for care. The affirmative model is presented as a way to move away from the question of, “How should children's gender identities develop over time?” toward a more useful question: “How should children best be supported as their gender identity develops?”

Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children's gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health, we call for a more inclusive conceptual framework that takes children's voices seriously. Listening to children's experiences will enable a more comprehensive understanding of the needs of gender-nonconforming children and provide guidance to scientific and lay communities.     

Digging beneath the surface: Results from stage one of a qualitative analysis of factors influencing the well-being of trans youth in Quebec

ABSTRACT

Background: The literature on trans youth has been dominated by etiological studies interested in trans experience as a medical phenomenon. An emerging body of literature has begun to document that trans youth are a diverse, vulnerable, yet resilient population, and to investigate the role of various sites of support such as the family, peer groups, institutions, and community spaces in contributing to or impeding trans youth's well-being.

Method: This article presents the results of Stage One of interviews (n = 24) conducted for a Community-Based Participatory Action Research (CBPAR) qualitative research project based in Quebec. It studies the factors that enhance trans youth's well-being as well as the factors of oppression that negatively affect it. This paper offers a brief overview of the anti-oppressive methodology used for this project, emphasizing how CBPAR was combined with Grounded Theory (GT) methods to encourage the direct involvement of communities and the translation of knowledge into action.

Results: We present preliminary categories emerging through the ongoing axial coding process. These categories address trans youth's experiences in and perceptions of various “sites”: 1) healthcare services both for gender-related and general care, 2) other institutional spaces, 3) the family and other social circles, and 4) community spaces.

Conclusion: While much of this study's results support existing evidence on trans youth's experiences, they also provide a more nuanced portrayal of the complex ways in which recognition, as well as non-, mis-, or mal-recognition, influence trans youth's well-being at different sites. We also argue that recognition itself must be considered through the lens of intersectionality.     

Contributing to System Change in Kentucky

SUMMARY

Currently a change that requires monitoring and action is the state public payers' movement toward managed behavioral health care and the re-structuring of Medicaid to reflect this movement. In this article the response of one state, Kentucky, to managing Medicaid costs, quality and access is reported. The author's participation in a multi-disciplinary effort to identify outcomes and outcome measures for the state's managed behavioral healthcare system is described. The proposed Medicaid waiver for mental health and substance abuse and the resulting implications for occupational therapy are discussed.     

The men's movement: Substance and significance for mainstream men

Abstract

The men's movement has a breadth and significance for mainstream men, too little evidenced. This paper provides a historical review of the men's movement and presents implications for mainstream men. Four themes in the men's movement are identified: 1) men adopting a feminist philosophy, 2) fathers with equal rights interest in divorce, 3) men supportive of gay rights, and 4) mythopoetic men. Implications for mainstream men and emotional health are considered for each theme within the Men's Movement. Finally, it is argued that each time a man struggles to balance his work with his family, his anger with his pain and his power with his care, he is an active participant in the men's movement.     

Worship in the Early Reformed Tradition

Abstract

Joseph's House, a ministry of the Church of the Saviour in Washington, D.C., provides residential care for homeless men with the HIV virus/AIDS. The following article is excerpted from letters written to prospective donors by the director.     

The Call of the Wild Woman

Abstract

Women have a longstanding and unique connection to healing and health care. The feminine perspective, however, has been discounted and decimated through the last 600 years. Now general social and political changes, as well as increasing numbers of women practitioners in health and mental health, are leading to a re-emergence of the feminine perspective in addressing women's needs and in providing health care. This paper traces some of the elements in the history of women and their influences on present day models of health care. It emphasizes women's roles as healers, as patients and as crafters of a new synthesis of health care delivery in the 21st century.     

Women in Prison

Abstract

The issues and needs of addicted women are for the most part invisible in the criminal justice system. Historically, treatment, research and recovery have been based on men's lives, often neglecting women's experience. While statistics indicate that for women there is a high correlation between drug abuse and incarceration and parole/probation violations, a comprehensive continuum of care is missing. This article presents a relational model of treatment which incorporates the multiple issues in women's recovery and is based on the integration of three theoretical perspectives–addiction, trauma and women's psychological development. The strengths and limitations of Twelve Step programs for women are also discussed.     

On the Representation of N4-Lattices

N4-lattices provide algebraic semantics for the logic N4, the paraconsistent variant of Nelson's logic with strong negation. We obtain the representation of N4-lattices showing that the structure of an arbitrary N4-lattice is completely determined by a suitable implicative lattice with distinguished filter and ideal. We introduce also special filters on N4-lattices and prove that special filters are exactly kernels of homomorphisms. Criteria of embeddability and to be a homomorphic image are obtained for N4-lattices in terms of the above mentioned representation. Finally, subdirectly irreducible N4-lattices are described.     

Divine Compositionalism: A Form of Occasionalism or a Preferable Alternative View of Divine Action?

Abstract

This paper recommends divine compositionalism, a distinct view of divine creative action, as God's compositional, existence-conferring efficient causation according to his will or plan. It addresses the question of whether divine compositionalism is a species of occasionalism, treating occasional causation as a manifesting disposition which is analyzed in terms of God's creative action. We describe how divine compositionalism accounts for fundamental concepts in science including dispositions, causation, event, law of nature, and mechanism. We conclude that divine compositionalism is a more comprehensive view of divine creative action than concurrentism, and is distinct from extant views of occasionalism.     

RECENT TRENDS IN RESPONSE TO CHILD VICTIMIZATION

Abstract

This chapter serves as an introduction to the many roles of health care professionalsin the assessment, care, and treatment of child victimization. It concentrates on those professionals caring for the physical health of victims of child abuse and neglect, although there are many similarities between child maltreatment and other family violence victims. In reviewing the health impact of maltreatment and the historical contributions of health care professionals, it discusses the roles that health care disciplines play in clinical care, training, research, and advocacy and their interaction with the community's child welfare, legal, and criminal justice systems.     

Proof theory and mathematical meaning of paraconsistent C-systems

A proof-theoretic analysis and new arithmetical semantics are proposed for some paraconsistent C-systems, which are a relevant sub-class of Logics of Formal Inconsistency (LFIs) introduced by W.A. Carnielli et al. (2002, 2005) [8] and [9]. The sequent versions BC, CI, CIL of the systems bC, Ci, Cil presented in Carnielli et al. (2002, 2005) [8] and [9] are introduced and examined. BC, CI, CIL admit the cut-elimination property and, in general, a weakened sub-formula property. Moreover, a formal notion of constructive paraconsistent system is given, and the constructivity of CI is proven. Further possible developments of proof theory and provability logic of CI-based arithmetical systems are sketched, and a possible weakened Hilbert?s program is discussed. As to the semantical aspects, arithmetical semantics interprets C-system formulas into Provability Logic sentences of classical Arithmetic PA (Artemov and Beklemishev (2004) [2], Japaridze and de Jongh (1998) [19], Gentilini (1999) [15], Smorynski (1991) [22]): thus, it links the notion of truth to the notion of provability inside a classical environment. It makes true infinitely many contradictions B∧¬B and falsifies many arbitrarily complex instances of non-contradiction principle ¬(A∧¬A). Moreover, arithmetical models falsify both classical logic LK and intuitionistic logic LJ, so that a kind of metalogical completeness property of LFI-paraconsistent logic w.r.t. arithmetical semantics is proven. As a work in progress, the possibility to interpret CI-based paraconsistent Arithmetic PACI into Provability Logic of classical Arithmetic PA is discussed, showing the role that PACIarithmetical models could have in establishing new meta-mathematical properties, e.g. in breaking classical equivalences between consistency statements and reflection principles.     

Media reviews

Abstract

Dr. H. James Lurie, reviewer of the videotape “Sybil's Plight” is Clinical Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, in Seattle. His expertise in the development of training and educational audio-visual materials, as well as his long teaching experience with both primary care physicians and family therapists, makes his assessment especially valuable. The importance of family concepts in the treatment and management of patients and families who must cope with chronically disabling medical illnesses has reached a new level of concern, and has resulted in renewed interest in the fields of consultation-liaison and family medicine.

—I.A.

Sibyl's Plight, black and white videotape, Library, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213.     

An Israeli Sex Therapist Considers a New View of Women's Sexual Problems

Abstract

By focusing on the inequalities that exist between men and women as a result of culture, ethnicity, religion, legislation, etc., the New View of Women's Sexual Problems brings to the forefront the social inequalities that may produce sexual dysfunction in women in Israel. In addition, the rights to sexual information, comprehensive sexual education and appropriate sexual health care have not been recognized in Israel. The field of sexology in Israel is also relatively young and underdeveloped. Therefore, the New View of Women's Sexual Problems' focus is extremely relevant for sexologists and sex therapists working in Israel.     

Supporting Transgender and Sex Reassignment Issues

SUMMARY

For the care provider unfamiliar with supporting transsexual and transgender persons, as well as their partners, it becomes an imperative to be able to identify this population's unique needs, transition concerns and relationship dynamics. New challenges arise as transgender clients become more prevalent within the GLBT community and contact community clinical resources. These include distinguishing between sexual orientation and the complexities of gender identity; differentiating actual transgender issues and ordinary relationship concerns; and recognizing characteristics of strong relationships versus those doomed to fail when one or both partner's needs can no longer get met.

This article reviews an abundance of stereotypes adversely affecting transgender individuals, relationships and which can taint the treatment environment. At a core level, there exists the need for care providers to recognize when having a transgender identity stops being a disorder, such as when the client is no longer gender dysphoric, and where the care provider needs to advocate the individual's right of self-determination. This includes recognizing when situational depression or anxiety and social discrimination are the actual root of ongoing individual and relationship concerns. With basic transgender knowledge, effectively supporting transgender persons and their relationships is possible for cross-specialty providers, and is recommended.     

The Care-Based Ethic of Nazi Medicine and the Moral Importance of What We Care About

This article reports on an inquiry into ideas used to justify the shift of medical ethos in Germany prior to and during the Nazi era, specifically the principles of care advocated by Erwin Liek and Karl Kötschau, the era's most influential medical theorists, who argued that commitments to care of individual sick persons (Fürsorge) had to give way to a preventive care that respects emerging needs of the entire society (Vorsorge). The article examines both the socio-cultural factors that shaped, and the far-reaching effects of, this manipulation of care. It argues that we should be attentive to the meaning and requirements of the care revealed in this debate, the ancient Greek idea of care as a concerned moral option.     

Kripke Incomplete Logics Containing KTB

It is shown that there is a Kripke incomplete logic in NExt(KTB ⊕ □² p → □³ p). Furthermore, it is also shown that there exists a continuum of Kripke incomplete logics in NExt(KTB ⊕ □⁵ p → □⁶ p). Presented by Michael Zakharyaschev