What Can Feminist Epistemology Do for Surgery?

Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence‐based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surgery relating to this lack of fit, and investigate how resources from feminist epistemology can help to characterize them. We point to ways in which these epistemic challenges may be addressed by gathering and disseminating evidence about what works in surgery using methods that are contextual, pluralistic, and sensitive to hierarchies.     

Diagnostic Work through Evidence-Based Guidelines: Avoiding Gaps Between Development and Implementation of a Guideline for Problem Behaviour in Elderly Care

Diagnostic work is the reflexive work of figuring out what issues are at stake and determining the scope for action. This work is not generally accommodated by evidence-based guidelines, which generally promote a uniform, predefined approach to solving healthcare problems that risk narrowing the opportunities for diagnostic work in healthcare practice. Consequently, guidelines are often criticised as too general to solve situated, individual healthcare problems and gaps between guidelines and their implementation are often reported. The Netherlands has developed a guideline for problem behaviour in elderly care, explicitly designed for diagnostic work, thus stimulating a situated approach. Relational problem behaviour is highly embedded in its context. The guideline stimulates diagnostic work, which helps to unravel problem behaviour and is opening alternatives in elderly care. Diagnostic work does not transfer guideline development problems to healthcare practice, but simply structures the decision-making process without giving a predefined answer. Diagnostic work is thus important to consider in order to avoid a gap between guideline development and implementation.     

Threatening scenes but not threatening faces shorten time-to-contact estimates

We previously reported that time-to-contact (TTC) judgments of threatening scene pictures (e.g., frontal attacks) resulted in shortened estimations and were mediated by cognitive processes, and that judgments of threatening (e.g., angry) face pictures resulted in a smaller effect and did not seem cognitively mediated. In the present study, the effects of threatening scenes and faces were compared in two different tasks. An effect of threatening scene pictures occurred in a prediction-motion task, which putatively requires cognitive motion extrapolation, but not in a relative TTC judgment task, which was designed to be less reliant on cognitive processes. An effect of threatening face pictures did not occur in either task. We propose that an object’s explicit potential of threat per se, and not only emotional valence, underlies the effect of threatening scenes on TTC judgments and that such an effect occurs only when the task allows sufficient cognitive processing. Results are consistent with distinctions between predator and social fear systems and different underlying physiological mechanisms. Not all threatening information elicits the same responses, and whether an effect occurs at all may depend on the task and the degree to which the task involves cognitive processes.     

Antecedents of mothers' emotional and cognitive responses to infant distress: The role of family,mother, and infant characteristics

The antecedents of mothers' emotional and cognitive responses to infant distress were examined. Participants were 67 mothers and their infants. Mothers completed questionnaires assessing their experiences in the family of origin and current marital relationships both pre‐ and postnatally and their coping strategies prenatally. Infant temperament was observed at 6 months, and mothers were interviewed about their emotional and cognitive responses to infant distress 2 years later to assess their emotional competencies (i.e., accurate identification of negative emotions, emotion efficacy, emotional responses to infant distress, and emotion goals). A childhood history of emotional rejection was negatively associated with empathy and efficacy and positively associated with negative emotions. The association between childhood history and some emotional competencies was moderated by current marital dysfunction, engaged coping, and positive intervening relationships. Maternal marital styles and coping strategies and infant temperament correlated with emotional competencies. Theoretical and clinical implications are discussed from an attachment theory perspective.     

International Organisations in Psychology: The International Council of Psychologists

Cet article décrit le développement de ľassociation International Council of Psychologists. II donne des détails sur sa contribution à Finternationalisation de la psychologic
This paper looks at the International Council of Psychologists in an international perspective. Its history is briefly traced and its contributions to the internationalisation of psychology are discussed. The point is made that today our interest in international organisations -is guided by the extent to which this aim is reached.     

Evaluating the effectiveness of employee assistance programmes: a systematic review

The rapid growth of employee assistance Programmes (EAPs) has not been matched by the accompanying research base of their efficacy. Given the inconsistent information relating to the effectiveness of EAPs in enhancing employee and organizational outcomes, the present review systematically appraised available evidence from organizational psychology and business databases and grey literature sources. A total of 17 studies examining the impact of EAPs, met the inclusion criteria. These were mostly from North America and utilized quantitative methodology and pre- and post-intervention designs. The majority of studies focused on EAPs offered by external providers and the counselling service, with the most common limitations being discrepancies in variable definitions and an absent comparable control group. Overall, this review found that utilizing EAPs enhanced employee outcomes, specifically improving levels of presenteeism and functioning. Absenteeism was most commonly investigated but produced mixed results. Presenteeism demonstrated a stronger effect size and greater improvement than absenteeism, suggesting presenteeism as a better variable for assessing EAP effectiveness. This review clarified parameters of existing evidence and highlighted the narrow range of measures used to date, omitting important constructs such as health and well-being and productivity. A broader evaluation capturing a wider range of variables is urgently needed.     

‘Hope givers’? A scoping review of new media and mental health in 27 Australian Christian organisations

This article explains a range of conceptual and methodological innovations in the use of new media for the clinical practice and public communication of mental health. Building on two current contexts – the emerging research area of new media and mental health, and major reform of the mental health system in Australia – this article presents a scoping review of the online communication of Christian organisations that offer mental health care in Australia. This article compares the websites of 27 Australian Christian mental health organisations, analysing these organisations’ configurations of mainstream and religious modalities of mental health care, their discursive and visual communication strategies, as well as their use of social media platforms.     

Supervision in Community Mental Health: Understanding Intensity of EBT Focus

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.