Six-Year Sustainability of Evidence-Based Intervention Implementation Quality by Community-University Partnerships: The PROSPER Study

There is a knowledge gap concerning how well community-based teams fare in implementing evidence-based interventions (EBIs) over many years, a gap that is important to fill because sustained high quality EBI implementation is essential to public health impact. The current study addresses this gap by evaluating data from PROSPER, a community-university intervention partnership model, in the context of a randomized-control trial of 28 communities. Specifically, it examines community teams' sustainability of implementation quality on a range of measures, for both family-focused and school-based EBIs. Average adherence ratings approached 90% for family-focused and school-based EBIs, across as many as 6 implementation cohorts. Additional indicators of implementation quality similarly showed consistently positive results. Correlations of the implementation quality outcomes with a number of characteristics of community teams and intervention leaders were calculated to explore their potential relevance to sustained implementation quality. Though several relationships attained statistical significance at particular points in time, none were stable across cohorts. The role of PROSPER's continuous, proactive technical assistance in producing the positive results is discussed.     

Evaluating the Evidence for the General Factor of Personality across Multiple Inventories

A general factor of personality (GFP) has been proposed as the apex of a personality trait hierarchy that explains covariance among the lower-order factors measured by various personality inventories. In this study we evaluated the GFP hypothesis across several personality inventories, unlike most previous research in which the GFP has been derived from individual instruments in isolation. Exploratory analyses did not produce substantial evidence for the existence of a single cross-instrument higher-order factor of factors and efforts to specify a range of GFP-inspired models in a confirmatory framework led to significant estimation difficulties and poor fit to the data. Overall these results fail to support a common GFP that is positioned at the top of a personality trait hierarchy.     

Dimensions of Religiousness and Spirituality as Predictors of Well-Being in Advanced Chronic Heart Failure Patients

We examined relationships between seven dimensions of religion/spirituality (RS) (forgiveness, daily spiritual experiences, belief in afterlife, religious identity, religious support, public practices, and positive RS coping) and three dimensions of well-being (physical, mental, and existential) in a sample of 111 patients with advanced chronic heart failure. Participants completed questionnaires at baseline and 3 months later. Results showed that fairly high levels of RS were reported on all seven dimensions. Furthermore, RS dimensions were differentially related to well-being. No aspect of RS was related to physical well-being, and only a few aspects were related to mental well-being. Forgiveness was related to less subsequent depression, while belief in afterlife was related to poorer mental health. All aspects of RS were related to at least one aspect of existential well-being. In particularly, daily spiritual experiences were linked with higher existential well-being and predicted less subsequent spiritual strain. These results are consistent with the view that in advanced disease, RS may not affect physical well-being but may have potent influences on other aspects of well-being, particularly existential aspects.     

‘The Extremely Difficult Realization That Something Other Than Oneself Is Real’: Iris Murdoch on Love and Moral Agency

Abstract: In the last few years, there has been a revival of interest in the philosophy of Iris Murdoch. Despite this revival, however, certain aspects of Murdoch's views remain poorly understood, including her account of a concept that she famously described as ‘central’ to moral philosophy—i.e., love. In this paper, I argue that the concept of love is essential to any adequate understanding of Murdoch's work but that recent attempts by Kieran Setiya and David Velleman to assimilate Murdoch's account of love to neo‐Aristotelian or neo‐Kantian theories of moral agency are misconceived. We will not understand what Murdoch is trying to do unless we understand her position as a radical alternative to such theories. Here, I present a reading of Murdoch's account of love as a form of Platonic eros directed toward two objects: the Good and the particular individual. It is in navigating the tension between these two objects that we find ourselves facing what Murdoch famously described as ‘the extremely difficult realization that something other than oneself is real’. When properly understood, Murdoch's account of love opens up conceptual space for an alternative approach to some of the central questions in contemporary moral theory.     

A Computational Model of the Self‐Teaching Hypothesis Based on the Dual‐Route Cascaded Model of Reading

The self‐teaching hypothesis describes how children progress toward skilled sight‐word reading. It proposes that children do this via phonological recoding with assistance from contextual cues, to identify the target pronunciation for a novel letter string, and in so doing create an opportunity to self‐teach new orthographic knowledge. We present a new computational implementation of self‐teaching within the dual‐route cascaded (DRC) model of reading aloud, and we explore how decoding and contextual cues can work together to enable accurate self‐teaching under a variety of circumstances. The new model (ST‐DRC) uses DRC’s sublexical route and the interactivity between the lexical and sublexical routes to simulate phonological recoding. Known spoken words are activated in response to novel printed words, triggering an opportunity for orthographic learning, which is the basis for skilled sight‐word reading. ST‐DRC also includes new computational mechanisms for simulating how contextual information aids word identification, and it demonstrates how partial decoding and ambiguous context interact to achieve irregular‐word learning. Beyond modeling orthographic learning and self‐teaching, ST‐DRC’s performance suggests new avenues for empirical research on how difficult word classes such as homographs and potentiophones are learned.     

Internetbasierte Gesundheitsinterventionen

Background

Internet-based health interventions can serve as a useful supplement to regular face-to-face therapy only if they are accepted by the clients.

Objective

This aim of the current study was to examine the attitudes and opinions of potential users on internet-based health interventions in Germany. This information could make a useful contribution to the development and promotion of measures which target their requirements.

Material and methods

To address this issue psychotherapy patients and persons on a waiting list for outpatient psychotherapy were interviewed about their attitudes towards internet-based interventions and compared with the results from a matched control group.

Results

Compared with the control group, waiting list candidates in particular declared a reduced interest in engaging in internet-based interventions and both patient groups perceived few advantages. All groups appreciated the enhanced flexibility associated with internet-based interventions, but both patient groups thought that the increased anonymity and reduced inhibition threshold for seeking treatment were less advantageous than the control group. Compared to the controls, both patient groups worried more about privacy issues and a possible misinterpretation of their written statements. Both patient groups considered internet-based psychotherapy as conceivable for the treatment of fewer kinds of psychopathological symptoms than the control group. Patients considered that internet-based treatment of panic disorder, posttraumatic stress disorder, depression and generalized anxiety disorder was least imaginable although, to date, relatively many internet-based options are available for these disorders. There appears to be interest in the treatment of sexual dysfunctions through the internet.

Conclusion

To address the reservations concerning privacy protection, paper and pencil registration procedures could be provided. In addition, by clearly emphasizing that there is the possibility of establishing personal contact to a therapist either face to face or by video conference, internet-based services could also be more useful in satisfying patient needs.

     

Avner Baz on the ‘Point’ of a Question

Abstract

Avner Baz claims that questions philosophers ask about hypothetical cases lack the kind of ‘point’ possessed by ‘everyday’ questions. He concludes from this that there is something wrong with the philosophical practice of asking questions about hypothetical cases. This paper defends the practice from Baz’s criticism.