The Relational Impact of Multiple Sclerosis: An Integrative Review of the Literature Using a Cognitive Analytic Framework

This integrative literature review uses cognitive analytic therapy (CAT) theory to examine the impact of a chronic illness, multiple sclerosis (MS), on relationships and mental health. Electronic searches were conducted in six medical and social science databases. Thirty-eight articles met inclusion criteria, and also satisfied quality criteria. Articles revealed that MS-related demands change care needs and alter relationships. Using a CAT framework, the MS literature was analysed, and five key patterns of relating to oneself and to others were identified. A diagrammatic formulation is proposed that interconnects these patterns with wellbeing and suggests potential “exits” to improve mental health, for example, assisting families to minimise overprotection. Application of CAT analysis to the literature clarifies relational processes that may affect mental health among individuals with MS, which hopefully will inform how services assist in reducing unhelpful patterns and improve coping. Further investigation of the identified patterns is needed.     

Partitioning default effects: why people choose not to choose

Default options exert an influence in areas as varied as retirement program design, organ donation policy, and consumer choice. Past research has offered potential reasons why no-action defaults matter: (a) effort, (b) implied endorsement, and (c) reference dependence. The first two of these explanations have been experimentally demonstrated, but the latter has received far less attention. In three experiments we produce default effects and demonstrate that reference dependence can play a major role in their effectiveness. We find that the queries formulated by defaults can produce differences in constructed preferences and further that manipulating queries can also mitigate default effects. The experimental context involves two environmentally consequential alternatives: cheap, inefficient incandescent light bulbs, and expensive, efficient compact fluorescent bulbs. Within this context we also measure the impact of each potential rationale for a default effect.     

Effects of the Positive Action programme on problem behaviours in elementary school students: a matched-pair randomised control trial in Chicago

This study examined the effects of the Positive Action (PA) programme in Chicago Public Schools on problem behaviours among a cohort of elementary school students from grade three through grade five. Using a matched-pair, randomised control design with 14 elementary schools, approximately 510 fifth-graders self-reported lifetime substance use, serious violence-related behaviour, and current bullying and disruptive behaviours. Three-level (i.e. students nested within schools within school pairs) overdispersed Poisson models were used to examine programme effects on the number of items endorsed for each of the four outcomes. Findings indicated that students in the intervention endorsed 31% fewer substance use behaviours (incidence rate ratio [IRR] = 0.69), 37% fewer violence-related behaviours (IRR = 0.63) and 41% fewer bullying behaviours (IRR = 0.59), respectively, compared to students in the control schools. Reduction in reported disruptive behaviours was of a similar magnitude (27%, IRR = 0.73), but was not statistically significant. These results replicate findings of an earlier randomised trial of the PA programme and extend evidence of its effectiveness to youth attending large urban school systems.     

自然分娩与剖宫产的比较研究

剖宫产不是一种分娩方式,而是解决难产的手段.日益增高的剖宫产率成为人们关注的热点话题,自然分娩和剖宫产对母婴的健康和卫生资源的影响,有很多的研究和争议,对于没有医学指征要求剖宫产目前倾向于在知情同意的情况下尊重患者的自主权和选择权,但控制剖宫产率在一个理性的范围之内,是一个系统工程,值得全社会的关注.     

自然分娩与剖宫产的比较研究

剖宫产不是一种分娩方式,而是解决难产的手段。日益增高的剖宫产率成为人们关注的热点话题,自然分娩和剖宫产对母婴的健康和卫生资源的影响,有很多的研究和争议,对于没有医学指征要求剖宫产目前倾向于在知情同意的情况下尊重患者的自主权和选择权,但控制剖宫产率在一个理性的范围之内,是一个系统工程,值得全社会的关注。     

Understanding,resisting, and overcoming oppression: toward psychopolitical validity

My first objective in this paper is to synthesize, synoptically, the literature on oppression and liberation with the contributions to this special issue. To fulfil this aim I introduce a framework for understanding, resisting, and overcoming oppression. The framework consists of psychopolitical well-being; experiences, consequences, and sources of oppression; and actions toward liberation. Each of these components is subdivided into 3 domains of oppression and well-being: collective, relational, and personal. Experiences of suffering as well as resistance and agency are part of the framework. My second objective is to offer ways of closing the gap between research and action on oppression and liberation. To do so I suggest 2 types of psychopolitical validity: epistemic and transformative.     

Gene therapy: ethical issues

To discern the ethical issues involved incurrent gene therapy research, to explore theproblems inherent in possible future genetherapies, and to encourage debate within thescientific community about ethical questionsrelevant to both, we surveyed American Societyof Human Genetics scientists who engage inhuman genetics research. This study of theopinions of U.S. scientific experts about theethical issues discussed in the literature ongene therapy contributes systematic data on theattitudes of those working in the field as wellas elaborative comments. Our survey finds thatrespondents are highly supportive of thepotential use of somatic cell gene therapy tocure serious diseases in adults and children aswell as prospective offspring. A clearmajority, however, believe that using suchgenetic techniques for enhancement purposes isunacceptable. Delineating the line betweendisease/disorder and improvement/enhancementposes a problem not easily resolved and oneconducive to the growth of slippery-slopeapprehensions. The majority of respondents alsoadvocate germ-line therapy, in theory at least,and under similar restrictions, but theyrecognize the roadblock that the existence ofunanticipated negative consequences currentlypresents. Another complex matter involvestrying to determine appropriate reasons forchoosing target diseases for research, forwhich the dichotomy between rare single-geneand common multifactorial diseases reveals anongoing dilemma.     

Adults returning to school: the impact on family and work

The authors examined the impact of attending a Weekend College (WEC) program on adult students' family, work, and social life. Student participants responded to a 26-item questionnaire and three open-ended questions. Regression analyses of the 566 completed surveys revealed that satisfaction with school and support from family and the work place were predictive of lower levels of stress. Content analyses of responses to open-ended questions showed that expected stress was the result of time constraints but also highlighted the positive aspects of continuing one's education. The study includes suggestions for designing programs to meet the needs of adult students.