Desire for euthanasia or physician-assisted suicide in palliative cancer care.

OBJECTIVE: To investigate the attitudes of terminally ill individuals toward the legalization of euthanasia or physician-assisted suicide (PAS) and to identify those who would personally desire such a death. DESIGN: In the Canadian National Palliative Care Survey, semistructured interviews were administered to 379 patients who were receiving palliative care for cancer. Patients who expressed a desire for physician-hastened death were followed prospectively. MAIN OUTCOME MEASURES: Attitudes toward the legalization of euthanasia or PAS were determined, as was the personal interest in receiving a hastened death. Demographic and clinical characteristics were also recorded, including a 22-item structured interview of symptoms and concerns. RESULTS: There were 238 participants (62.8%) who believed that euthanasia and/or PAS should be legalized, and 151 (39.8%) who would consider making a future request for a physician-hastened death. However, only 22 (5.8%) reported that, if legally permissible, they would initiate such a request right away, in their current situations. This desire for hastened death was associated with lower religiosity (p=.010), reduced functional status (p=.024), a diagnosis of major depression (p<.001), and greater distress on 12 of 22 individual symptoms and concerns (p<.025). In follow-up interviews with 17 participants, 2 (11.8%) showed instability in their expressed desire. CONCLUSION: Among patients receiving palliative care for cancer, the desire to receive euthanasia or PAS is associated with religious beliefs; functional status; and physical, social, and psychological symptoms and concerns. Although this desire is sometimes transitory, once firmly established, it can be enduring.     

Disparities in Current and Future Childhood and Newborn Carrier Identification

International carrier testing guidelines discourage testing in childhood to preserve autonomous decision making and prevent detrimental psychosocial consequences. Despite the discouragement of autosomal recessive carrier testing during childhood, some sickle cell disease (SCD) or cystic fibrosis (CF) carriers are incidentally identified through UK and international newborn screening (NBS). This creates a scenario where parents may have knowledge of their newborn’s, but not older child’s carrier status. In addition, there is wide variation in the identification of CF and SCD carriers due to the screening technologies implemented by different NBS programs. The current and future availability of childhood testing are determined to some extent by the impact of testing on children and parents (whether this is beneficial or detrimental to wellbeing). However empirical research informing carrier guidance and practice is conflicting. Echoing previous calls, this discussion highlights the need for further qualitative and longitudinal research with children to consider the psychosocial impact of carrier testing on children and role of disclosure from parents on adaptation to results. It is recommended that professionals aim to minimize harms resulting from carrier identification by providing support for parents and children following NBS. Support for non-genetics specialists from genetic counselors to enable discussion of carrier results with children is suggested.     

Yes,we can: physical activity and group identification among healthy adults

Drawing on social identity theory and social cognitive theory, this research was designed to investigate the role played by group identification, self‐efficacy and outcome expectations in physical activity behavior. Healthy adult participants (N = 130) who identified strongly with an exercise referent group reported higher levels of physical activity, and this relationship was mediated by self‐efficacy and outcome expectations. This study adds to the existing literature on the effects of social groups on health and is one of the first to examine the interplay of personal factors and group membership on physical activity.     

Involvement of the σ Receptor inPassive-Avoidance Learning in the Day-Old Chick during the Second Wave of Neuronal Activity

The specific σ-receptor agonist (+)-SKF 10047 and antagonist BD 1047 were used to investigate whether this receptor was involved in passive-avoidance training in the day-old chick. We found 300 μM (+)-SKF 10047 to be amnesic when injected into the lobus parolfactorius 5 h after training (p < .01). Higher or lower concentrations of (+)-SKF 10047 did not disrupt memory formation. The amnesia produced by the efficacious dose of (+)-SKF 10047 was reversed by the specific antagonist, BD 1047. It is suggested that the σ-receptor may exert its effect on passive-avoidance memory consolidation during the later stages of long-term memory formation by modulation of memory-related neurotransmission.     

Conditional same/different concept learning in the short‐beaked echidna (Tachyglossus aculeatus)

Echidnas have evolved separately from other mammalian groups for around 200 million years and incorporate a mixture of reptilian and mammalian features. Because of these attributes, they have historically been considered “primitive” animals. However, they have successfully adapted to a wide variety of ecological niches and their neurophysiology demonstrates a number of unusual and apparently sophisticated characteristics, including a relatively large brain and cerebral cortex and a comparatively massive frontal cortex. Studies of learning in the echidna have thus far been limited to only a handful of experiments which demonstrated relatively basic abilities such as forming a position habit in a T‐maze, successive habit‐reversal learning, and simple visual and instrumental discrimination. This study aimed to expand on these results and test the “primitive” echidna on what are generally considered more advanced cognitive tasks—same/different and conditional same/different concept learning. The results demonstrated that echidnas are able to discriminate on the basis of a relational same/different concept, using simultaneously presented multi‐element stimuli, and transfer that discrimination to novel stimuli. After further training, they were then able to repeat the performance when the correct choice was conditional on the background color of the stimulus panels.     

Nursing students’ reflections on an interprofessional placement in ambulatory care

Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.     

“Tell me more about this…”: An examination of the efficacy of follow-up open questions following an initial account

In information gathering interviews, follow-up questions are asked to clarify and extend initial witness accounts. Across two experiments, we examined the efficacy of open-ended questions following an account about a multi-perpetrator event. In Experiment 1, 50 mock-witnesses used the timeline technique or a free recall format to provide an initial account. Although follow-up questions elicited new information (18–22% of the total output) across conditions, the response accuracy (60%) was significantly lower than that of the initial account (83%). In Experiment 2 (N = 60), half of the participants received pre-questioning instructions to monitor accuracy when responding to follow-up questions. New information was reported (21–22% of the total output) across conditions, but despite using pre-questioning instructions, response accuracy (75%) was again lower than the spontaneously reported information (87.5%). Follow-up open-ended questions prompt additional reporting; however, practitioners should be cautious to corroborate the accuracy of new reported details.     

Improving specific autobiographical memory in older adults: impacts on mood,social problem solving,and functional limitations

Older adults have difficulty recalling specific autobiographical events. This over-general memory style is a vulnerability factor for depression. Two groups receiving interventions that have previously been successful at reducing over-general memory in depressed populations were compared to a control group. Participants were healthy older adults aged ≥70 years: memory specificity training (MEST; n = 22), life review (n = 22), and control group (n = 22). There were significant improvements in autobiographical memory specificity in the MEST and life review groups at post-training, relative to the control group, suggesting that over-general memory can be reduced in older adults. Change in social problem solving ability and functional limitations were related to change in autobiographical memory specificity, supporting the suggested role of specific retrieval in generating solutions to social problems and maintaining independence. Qualitative analysis of participants’ feedback revealed that life review may be more appropriate for older adults, possibly because it involves integrating specific memories into a positive narrative.