Maximal care considerations when treating patients with end-stage heart failure: ethical and procedural quandaries in management of the very sick

Deciding who should receive maximal technological treatment options and who should not represents an ethical, moral, psychological and medico-legal challenge for health care providers. Especially in patients with chronic heart failure, the ethical and medico-legal issues associated with providing maximal possible care or withholding the same are coming to the forefront. Procedures, such as cardiac transplantation, have strict criteria for adequate candidacy. These criteria for subsequent listing are based on clinical outcome data but also reflect the reality of organ shortage. Lack of compliance and non-adherence to lifestyle changes represent relative contraindications to heart transplant candidacy. Mechanical circulatory support therapy using ventricular assist devices is becoming a more prominent therapeutic option for patients with end-stage heart failure who are not candidates for transplantation, which also requires strict criteria to enable beneficial outcome for the patient. Physicians need to critically reflect that in many cases, the patient’s best interest might not always mean pursuing maximal technological options available. This article reflects on the multitude of critical issues that health care providers have to face while caring for patients with end-stage heart failure.     

Development and validation of a scale to assess positive youth development values

This paper describes the development of a self-report scale for adolescents to assess positive youth development values. It presents a substantial number of psychometric results performed on a sample of 2,400 adolescents (1,068 boys and 1,332 girls) from 12 to 17 years ( M = 14.73, SD = 1.25), who were studying secondary education in Western Andalusia. The results provide evidence of the psychometric quality of items, cross-validity of a structure of eight first-order factors and three second-order factors, obtained through exploratory and confirmatory factor analysis, and adequate reliability. This study concludes that the scale presents adequate evidence of validity and reliability that allows assessment, especially in school contexts, of a broad set of values of particular relevance to positive youth development.     

Positive Experiences at Work and Daily Recovery: Effects on Couple’s Well-Being

The present diary study investigates, at the within-person level, how job satisfaction mediates the relationship between self-rated job performance and recovery experiences (i.e., psychological detachment from work and relaxation) during off-job time. Furthermore, we explore the effects of these two recovery experiences on couple´s well-being. Data were collected from 145 dual-earner couples (N = 290 participants; N = 1450 occasions) with a daily diary design (five consecutive working days). Multilevel analyses showed that daily job performance positively predicted psychological detachment and relaxation, and that daily job satisfaction partially mediated this relationship. In addition, we found that psychological detachment and relaxation have positive effects on own and partner´s indicators of well-being (i.e., relationship satisfaction and positive emotions). The benefits of recovery go beyond the individual and affect their partner´s level of well-being.     

Personality factors in relation to violent crimes

The personalities of a group of 54 persons (51 men and 3 women), imprisoned for the perpetration of violent crimes, were evaluated. The results were then compared to a normative group. This study considers personality factors and dimensions on three levels: (a) Basic factors: the "Big Five", (b) Personality disorders and clinical syndromes, (c) Personality dimensions related to personal wellbeing and social adaptation said to define a psychologically healthy individual. The results of the study show that it is not possible to define a basic personality profile for this group of violent delinquents based on the "Big Five" factors. It is, however, possible to find two habitual patterns of behaviour if the Millon Model (1990) is applied. These two behaviour patterns and attitudes towards life situations will be named "Dependent with compulsive traits" and "Psychopath tendencies". Both relate to indicators of mental health.     

Conscientiousness,Its Facets,and the Prediction of Job Performance Ratings: Evidence against the narrow measures

This study empirically tested the predictions of the three basic perspectives on the bandwidth debate about the relationship between personality and job performance, regarding the validity of conscientiousness and its facets. The sample consisted of 226 police officers. Conscientiousness and three facets (order, industriousness, and self‐control) were correlated with three performance criteria (overall job performance, task performance, and orderliness). A Schmid–Leiman transformation made it possible to residualize the variance of the facets and to isolate their unique contribution to the prediction of performance measures. The results showed that conscientiousness predicted the three criteria (true validities of.25,.28 and.37, respectively) and that the facets neither predicted job performance nor showed incremental validity over conscientiousness. Finally, the implications of the findings for theory and practice are commented on, and future research is suggested.     

Limitations of the Mnemonic-Keyword Method

The effectiveness of the mnemonic-keyword method was investigated in 4 experiments in which participants were required to learn the lst-language (L₁, Spanish) equivalents of a list of 30 2nd-language words (L₂, Latin). Experiments 1 (adolescents) and 2 (adults) were designed to assess whether the keyword method was more effective than the rote method; the researcher supplied the keyword, and the participants were allowed to pace themselves through the list. Experiments 3 (adolescents) and 4 (adults) were similar to Experiments 1 and 2 except that the participants were also supplied with a drawing that illustrated the relationship between the keyword and the L₁ target word. All the experiments were performed with groups of participants in their classrooms (i.e., not in a laboratory context). In all experiments, the rote method was significantly more effective than was the keyword method.     

Fluctuaciones en la autoestima tras un informe psicológico

RESUMEN

El autor comienza repasando el estudio que los procesos del “self' o “sí mismo” han tenido en psicología y observa que recientemente se han levantado serias dudas acerca de la presunta firmeza y consistencia de los autoconceptos. En esta línea plantea su hipótesis: un informe psicológico que comunique al sujeto el hallazgo en él de cualidades deseables, como elevada inteligencia o buen equilibrio afectivo, elevará su puntaje en autoestima y un informe que exprese lo contrario, lo rebajará. Realiza tres estudios en los que queda comprobada esta hipótesis -con diferente grado de confianza- y con el tercero examina también un fenómeno inicialmente no esperado: la ampliación de la variabilidad de los puntajes en el grupo con informe desfavorable y la reducción de la misma en el grupo que recibió información propicia. El autor concluye que los efectos no pueden atribuirse en exclusiva al tratamiento o condición experimental ya que las características de la personalidad de los sujetos parecen influir. Sugiere que la autoestima extraexperimental -que integra aspectos más estables, subrayados por las teorías tradicionales- puede haber mediatizado los efectos experimentales y finaliza subrayando las posibles implicaciones de los juicios clínicos en la modificación de la autoestima de los sujetos.     

Positive Correlation Between Serum Interleukin‐1β and State Anger in Rugby Athletes

Recently, several studies reported a relationship between immune system activation and anger expression. Consequently, the aim of this study was to explore immunitary molecular mechanisms that potentially underlie anger expression. To this end, we applied the Frustration—Aggression Theory in a contact sport model, utilizing the nearing of sporting events to trigger anger feelings. In parallel, we evaluated the activation of immune system at mRNA levels. We enrolled 20 amateur rugby players (age ± SD, 27.2 ± 4.5) who underwent psychological assessment to evaluate anger, with the State‐Trait Anger Expression Inventory‐2 (STAXI‐2), before rugby matches; at the same time blood samples were taken to analyze the variations of gene expression by microarray. During the 2 hr before each game, a significant increase was verified in the Rage State (RS) score compared to the score ascertained 72 hr before. At the same time, we found modulation in expression profile, in particular increased expression of gene that encodes interleukin l‐β (IL‐1β). In a regression analysis, RS score was related to IL‐1β, and the potential risk factors age, body mass index, smoking, and drinking. The levels of cytokine were positively and independently related to RS score. Our results suggest that the nearing of sporting event can trigger anger state feelings and activate immune system in rugby players. We propose the IL‐1β as a potential biological marker of anger. However, further research is necessary to clarify the correlation between cytokine and anger. Aggr. Behav. 39 :141‐148, 2013. © 2012 Wiley Periodicals, Inc.