Race,resource utilisation,and perceived need among urban community development workers from faith-based organisations

Organisations providing social services in communities of high crime and violence must address staff well-being. The current study surveyed 284 urban community development workers from faith-based organisations in five US cities. The study explored the effects of race and ethnicity on service utilisation and perceived need using binomial logistic regression. Race and ethnicity significantly predicted medical service utilisation, indicating that Caucasian participants were five times more likely and African-American participants were 3.8 times more likely than Latino/a participants to utilise medical services. Race and ethnicity did not predict differences in use of psychological or spiritual services, nor of perceived need for services. Furthermore, volunteer staffs were approximately four times more likely than paid staff to report self-addressing their psychological and spiritual needs rather than utilising services, despite a felt need for support. Barriers to resource utilisation and implications for policies and practices of urban community development organisations are discussed.     

Heidegger in America

Dismounting from the seesaw

Mind and World By John McDowell Harvard University Press, 1994. Pp. x + 191. £19.95.

Vagueness By Timothy Williamson Routledge, 1994. pp. xiii + 325 ISBN 0–415–03331–4. £35.00     

Applying a traumatic stress approach to understanding PCS following pediatric mild TBI

Pediatric traumatic brain injury is a significant public health concern affecting hundreds of thousands of children each year. The majority of children who sustain traumatic brain injuries are classified as having a mild traumatic brain injury, and a subset of these children go on to experience persistent physical, cognitive, and emotional symptoms. These symptoms, known as postconcussive symptoms, can endure for months and even years after injury. The outcomes of mild traumatic brain injury are variable and not well understood for a small percentage of children who experience persistent symptoms. The current article explores the potential influence of children’s posttraumatic stress symptoms on persistent postconcussive symptoms. Despite the high incidence of posttraumatic stress symptoms after pediatric accidental injury, they have not yet been identified as an important factor for consideration in the understanding of pediatric postconcussive outcomes. The article will review the literature on posttraumatic stress and postconcussive symptoms after pediatric injury and consider neurobiological and cognitive factors to propose a model explaining a pathway through which posttraumatic stress reactions may serve as the mechanism for the expression and maintenance of postconcussive symptoms after mild traumatic brain injury. The clinical implications for the proposed relationship between posttraumatic stress symptoms and postconcussive symptoms are considered prior to the conclusion of the article, which acknowledges limitations in the current literature and provides suggestions for future research.     

Correlates of household smoking bans in low-income families of children with and without asthma

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.     

Relationships between personality variables and bizarreness effects in free recall

Relationships between 6 personality variables and each of 3 different measures of recall for bizarre and common sentences were examined. The personality variables investigated included measures of sensation seeking, novelty experiencing, desire for novelty, arousal-seeking tendency, social potency, and conservatism. Recall was measured in terms of sentences accessed, target words recovered per accessed sentence, and misplaced target words. The results indicated the typical pattern of bizarreness effects on recall and significant relationships between personality variables and these effects. Arousal seeking and conservatism were positively related to a bizarreness advantage in sentences accessed. Additionally, high social potency was related to the recovery of more details from common than bizarre sentences, and high desire for novelty was related to a greater bizarre misplacement effect. The results are discussed in terms of orienting and defensive responses to bizarreness.     

Treating body dysmorphic disorder with medication: evidence, misconceptions, and a suggested approach

Body dysmorphic disorder (BDD) is a relatively common and often disabling disorder with high morbidity and mortality. Both psychotropic medication and cognitive behavioral therapy (CBT) are considered first-line treatments for BDD, and medication treatment is often essential for more severely ill and suicidal patients. In this practical overview of the pharmacotherapy of BDD, we briefly describe BDD's clinical features, associated morbidity, and how to recognize and diagnose BDD. We describe the importance of forming a therapeutic alliance with the patient, the need for psychoeducation, and other essential groundwork for successful treatment of BDD. We review available pharmacotherapy research, with a focus on serotonin-reuptake inhibitors (SSRIs, or SRIs), which are currently considered the medication of choice for BDD. Many patients have substantial improvement in core BDD symptoms, psychosocial functioning, quality of life, suicidality, and other aspects of BDD when treated with appropriate pharmacotherapy that targets BDD symptoms. We also discuss practical issues such as dosing, length of treatment, and potential side effects associated with the use of SRIs. In addition, we discuss pharmacotherapy approaches that can be tried if SRI treatment alone is not adequately helpful. Finally, some misconceptions about pharmacotherapy, gaps in knowledge about BDD's treatment, and the need for additional research are discussed.     

Connectedness: A Review of the Literature With Implications for Counseling,Assessment, and Research

In this article, the authors review the current conceptual and empirical literature from a variety of disciplines dealing with the construct of connectedness. A working definition of connectedness is provided along with a discussion of its multidimensional nature and major characteristics. Its relationship with a variety of other variables is also presented. Particular attention is given to gender and cultural considerations in the experience and operationalization of connectedness. Recommendations for counseling, assessment, and research related to connectedness are provided.     

The spit and image: a psychoanalytic dissection of a colloquial expression

"He is the spit of his father" or "he is the spit and image of his father" is a colloquial expression that has graced informal English for many centuries. When a "spitting image" made an entrance in the manifest content of an analysand's dream, it became possible to add a psychoanalytic point of view to an etymological and anthropological record. After discussing both this clinical case and an "anthropological case history," the author examines the subtle but complex genesis of this colloquial expression from a speculative applied psychoanalytic perspective.