Cardiovascular medicine at face value: a qualitative pilot study on clinical axiology

Introduction

Cardiology is characterized by its state-of-the-art biomedical technology and the predominance of Evidence-Based Medicine. This predominance makes it difficult for healthcare professionals to deal with the ethical dilemmas that emerge in this subspecialty. This paper is a first endeavor to empirically investigate the axiological foundations of the healthcare professionals in a cardiology hospital. Our pilot study selected, as the target population, cardiology personnel not only because of their difficult ethical deliberations but also because of the stringent conditions in which they have to make them. Therefore, there is an urgent need to reconsider clinical ethics and Value-Based Medicine. This study proposes a qualitative analysis of the values and the virtues of healthcare professionals in a cardiology hospital in order to establish how the former impact upon the medical and ethical decisions made by the latter.

Results

We point out the need for strengthening the roles of healthcare personnel as educators and guidance counselors in order to meet the ends of medicine, as well as the need for an ethical discernment that is compatible with our results, namely, that the ethical values developed by healthcare professionals stem from their life history as well as their professional education.

Conclusion

We establish the kind of actions, communication skills and empathy that are required to build a stronger patient-healthcare professional relationship, which at the same time improves prognosis, treatment efficiency and therapeutic adhesion.

     

Socio-demographic and psychopathological risk factors in obsessive-compulsive disorder: Epidemiologic study of school population

We assessed the presence of emotional disorders (obsessive-compulsive, anxiety and depressive) in 1,514 Spanish non-referred children (8–12 years old) to investigate the predictive ability of psychopathological and socio-demographic characteristics, and identify which of these were possible correlates for clinical obsessive-compulsive disorder (OCD) and subclinical OCD. At one year later, 562 subjects (risk group and without risk group) were re-assessed and we established the OCD diagnoses or the subclinical OCD diagnoses. We found that 20 participants presented clinical OCD and 46 participants presented subclinical OCD. Somatic and separation anxiety symptomatology were good predictors for clinical OCD, and obsessive concern was a predictor for subclinical OCD. Clinical OCD was associated with order/checking/pollution symptoms and with a lower socioeconomic status (SES). Subclinical OCD was associated with hyperactive and impulsive manifestations, obsessive concern, and superstition/mental compulsion. An early detection and the follow-up of anxiety or obsessive symptoms in children may be important for preventing the course of OCD.     

Gender differences in applying social cognitive career theory in engineering students

This study tested Social Cognitive Career Theory (SCCT) in predicting engineering interest and major choice goals among male and female college students. Participants were 579 sophomore engineering students who completed measures of self-efficacy beliefs, outcome expectations, interests, goals and social supports and barriers. Findings confirmed that the SCCT model produced a good fit to the data across gender. The findings also corroborated that women have less self-efficacy beliefs and interest than men. However, there are no statistically significant differences in measures relating to outcome expectations and goals. Moreover, women are more likely to perceive support, especially from peers and family, while men are more likely to perceive family barriers than women. For other supports and barriers there are no gender differences. Implications for future research and practice are discussed.     

Characteristics of Individuals Seeking Treatment for Obsessive-Compulsive Disorder

Despite severe functional impairment, only 35% to 40% of individuals with obsessive-compulsive disorder (OCD) seek treatment, and fewer than 10% receive evidence-based treatment. The current study examined the characteristics of 525 individuals who contacted the clinic of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania to inquire about OCD treatment and completed a phone screen. Callers who were deemed appropriate for the clinic (n = 396, 75%) were invited to participate in an in-person intake evaluation. Only 137 (35%) of the eligible individuals completed the intake evaluation (“treatment intake group”) whereas the majority (n = 259, 65%) did not (“phone screen–only group”). Compared to individuals in the phone screen–only group, those in the treatment intake group were younger, less likely to endorse depressed mood, and more likely to have received a diagnosis of OCD, to have previously sought psychological services, and to have taken psychotropic medication. The findings suggest that familiarity with their diagnosis and past contact with mental health professionals enhance openness to explore yet another treatment. In contrast, lack of awareness about the problem and depressed mood may reduce openness to seek treatment.     

Feasibility,Acceptability, and Preliminary Outcomes of the Fortalezas Familiares Intervention for Latino Families Facing Maternal Depression

This pilot study examined the feasibility, acceptability, and preliminary outcomes of a linguistically and culturally adapted intervention for immigrant Latina mothers with depression and their families. Fortalezas Familiares (Family Strengths) is a community‐based, 12‐week, multifamily group intervention that aims to increase communication about family processes leading up to and affected by the mother's depression, build child coping and efficacy, enhance parenting competence and skills, and promote cultural and social assets within the family. In terms of feasibility, of 16 families who enrolled and participated in the intervention, 13 families attended more than 90% of meetings and completed the intervention. Posttests reported positive changes following the intervention, including improved psychological functioning, increased family and marital support, and enhanced family functioning, as reported by mothers and other caregivers. Mothers also reported decreased conduct and hyperactivity problems among their children. Children reported positive changes in their psychological functioning and coping, parenting warmth and acceptance, and overall family functioning. Postintervention focus groups and surveys measuring acceptability revealed families' satisfaction with the intervention and suggested areas of improvement. We discuss similarities and differences in outcomes between the adapted intervention, Fortalezas Familiares, and the original intervention, Keeping Families Strong, and propose future areas of intervention adaptation and development.     

Does Feeling Empathy Lead to Compassion Fatigue or Compassion Satisfaction? The Role of Time Perspective

Research has shown that feeling empathy sometimes leads to compassion fatigue and sometimes to compassion satisfaction. In three studies, participants recalled an instance when they felt empathy in order to assess the role time perspective plays in how empathizers perceive the consequences of empathy. Study 1 revealed that college students perceive empathy as having more negative consequences in the short term, but more positive consequences in the long term. Study 2 showed that service industry professionals perceive the consequences of feeling empathy for customers who felt bad as less negative, and the consequences of feeling empathy for people who felt good as less positive, in the long as opposed to the short term. Because Studies 1 and 2 confounded time perspective with event specificity a third study was conducted in which event specificity was held constant across time perspectives. The same pattern of results emerged. The results of these studies indicate that perceptions of the effects of feeling empathy, whether positive or negative, become less extreme over time. These findings shed light on the relation between empathy and compassion fatigue and satisfaction by suggesting that situations that initially are experienced as stressful can over time make the empathizer stronger.     

Tests of dual process theory: Word priming and recognition

Dual process theory postulates two representational processes: Activation of a representation makes the mental event more easily and automatically accessible. Elaboration of a mental event produces access to the representation through search and retrieval processes. We explored word priming in recognition and in a stem completion task where the primed word was one of several possible completions for a 3-letter stem. The main hypothesis was that priming has similar and parallel effects in the two tasks. The initial presentation (priming) of items was under conditions of either semantic or non-semantic processing. Priming was either direct, by the presentation of the target word, or indirect, by the presentation of phonologically related (rhyming) or semantically related (categorical) items. When priming occurred, RTs increased from direct to phonologically primed and to semantically primed items for both completion and recognition tests. One additional experiment confirmed the absence of semantic processing in the non-semantic condition, and another experiment showed that when response requirements for recognition and completion responses are equated, RTs to the two tests are comparable.     

The effects of age and emotional valence on recognition memory: An ex‐Gaussian components analysis

The aim of this work was to study the effects of valence and age on visual image recognition memory. The International Affective Picture System (IAPS) battery was used, and response time data were analyzed using analysis of variance, as well as an ex‐Gaussian fit method. Older participants were slower and more variable in their reaction times. Response times were longer for negative valence pictures, however this was statistically significant only for young participants. This suggests that negative emotional valence has a strong effect on recognition memory in young but not in old participants. The τ parameter, often related to attention in the literature, was smaller for young than old participants in an ex‐Gaussian fit. Differences on the τ parameter might suggest poorer attentional performance in old participants.     

Are integrative or distributive outcomes more satisfactory? The effects of interest‐based versus value‐based issues on negotiator satisfaction

Negotiation research usually distinguishes between integrative and distributive outcomes. Integrative outcomes satisfy the negotiation parties' most important interests (by trading off less important for more important issues). In contrast, distributive outcomes require negotiators to give up their most important interests (as they make concessions on both less and more important issues). Integrative outcomes are more beneficial, but do they offer greater satisfaction? In this research, we hypothesized that satisfaction with integrative versus distributive outcomes depends on whether people negotiate interest‐based or value‐based issues. Three experiments consistently revealed that people in interest‐based negotiations were more satisfied with integrative outcomes, whereas those in value‐based negotiations tended to be more satisfied with distributive outcomes. Copyright © 2014 John Wiley & Sons, Ltd.     

Working memory effects in speeded RSVP tasks

The present paper examines the effects of memory contents and memory load in rapid serial visual presentation (RSVP) speeded tasks, trying to explain previous inconsistent results. We used a one target (Experiment 1) and a two-target (Experiment 2) RSVP task with a concurrent memory load of one or four items, in a dual-task paradigm. A relation between material in working memory and the target in the RSVP impaired the identification of the target. In Experiments 3 and 4, the single task was to determine whether any information in memory matched the target in the RSVP, while varying the memory load. A match was detected faster than a non-match, although only when there was some distance between targets in the RSVP (Experiment 4). The results suggest that memory contents automatically capture attention, slowing processing when the memory contents are irrelevant to the task, and speeding processing when they are relevant.