Religion, Spirituality, and Health Service Use by Older Hospitalized Patients

Background: Religious and spiritual beliefs and practices are common among medical inpatients, and may impact length of hospital stay (LOS) and other health services (HSU) during hospitalization. Methods: 812 consecutively admitted patients age 50 or over to Duke University Medical Center were assessed. Measures of religiousness and spirituality included religious TV/radio (RTV), self-rated religiousness (SRR), observer-rated spirituality (ORS), and daily spiritual experiences (DSE). The primary outcome was LOS. Results: RTV and SRR predicted longer LOS, whereas ORS and DSE predicted shorter LOS (p 0.05). Effects of RTV onLOS were stronger among women, but explained by worse health status. The effects of DSE on LOS were stronger among non-whites. Among those reporting high DSE, diagnostic tests and total procedures also tended to be less common. Conclusions: Religious activities, attitudes, and spiritual experiences are weak predictors of LOS and HSU during hospitalization. Whether the prediction is positive or negative depends on the religious or spiritual characteristic.     

Present mood states in Brazilian night nurses

Variations in the state of momentary emotions of Brazilian hospital nurses on day and night shifts were recorded. Ten graduate nurses working on day and night shifts in the clinical ward of hospitals completed the Present Mood States List of Engelmann at the beginning and end of the first and last days of each shift. Analysis indicated (a) nurses had a stable emotional profile, present at the working shift, and (b) variations in present mood states related to specific effects of shift work were observed when comparisons were made between the present mood states at the beginning and end of each shift duty.     

Estimation of the MIRID: A program and a SAS-based approach

The MIRID CML program is a program for the estimation of the parameter values of two different componential IRT models: the Rasch—MIRID and the OPLM—MIRID (Butter, 1994; Butter, De Boeck, & Verhelst, 1998). To estimate the parameters of both models, the program uses a CML approach. The model parameters can also be estimated with a MML approach that can be implemented in PROC NLMIXED of SAS Version 8. Both the MIRID CML program and the MML SAS approach are explained and compared in a simulation study. The results showed that they did about equally well in estimating the values of the item parameters but that there were some differences in the estimation of the person parameters, as could be expected from the differential assumptions regarding the distribution of the persons. The SAS MML approach is much slower than the MIRID CML program, but it is more flexible.     

Rolling away the stone: post-abortion women in the Christian community

This article seeks to bring to awareness and address the issues of a neglected group of people in need of pastoral care: women who have had an abortion. It offers some commentary regarding what many women experience following an abortion, focuses on the story of a specific woman, and goes on to offer a biblical perspective for a pastoral response to their needs. Responses to the article are offered by a healthcare chaplain and a seminary professor.     

Gay Identity and the Experience of Gay Social Stress1

The hypothesis that identity commitment affects the experience of identity-related stressors brings identity theory and social stress research together. Research findings are not yet conclusive regarding this hypothesis. Part of the contradictory research findings stem from inadequate knowledge about the causal direction of the relationship between depression and commitment. The authors analyze if identity commitment interacts with social stress in its impact on mental well-being. Only chronic stress has a moderate impact on the experience of depression. Commitment toward the gay identity did not buffer the experience of stress. The authors also use a nonrecursive model to establish the causal relationship between depression and commitment. They show that it is depression that lowers identity commitment. It is concluded that identity commitment cannot act as a buffer against identity-related stress because commitment is affected by the resulting distress.     

Corticosterone effects on BDNF mRNA expression in the rat hippocampus during morris water maze training

Corticosterone and Brain-Derived Neurotrophic Factor (BDNF) have both been shown to be involved in spatial memory formation in rats. In the present study we have investigated the effect of corticosterone on hippocampal BDNF mRNA expression after training in the Morris water maze in young adult Wistar rats. Therefore, we first studied BDNF mRNA levels in the hippocampus in relation to corticosterone levels at several time points after 4 training trials in the Morris water maze. Corticosterone levels were significantly increased after this procedure, and hippocampal BDNF mRNA levels only displayed a minor change: an increase in CA1 at 1 hr after training. However, in a previous study we observed dramatically decreased hippocampal BDNF mRNA levels in dentate gyrus and CA1 at 3 hr after injection of corticosterone. In order to analyze this discrepancy, we subsequently investigated if hippocampal BDNF mRNA expression is affected by corticosterone at 3 hr after water maze training. Therefore, we incorporated ADX animals and ADX animals which were injected with corticosterone in our study. ADX animals which were subjected to water maze training displayed similar hippocampal BDNF mRNA levels 3 hr after training compared to control ADX animals. Furthermore, ADX animals which were injected with corticosterone showed decreased BDNF mRNA levels in all hippocampal regions compared to control ADX animals. Water maze training did not alter this effect. Thus, the increased corticosterone levels during water maze training do not affect hippocampal BDNF mRNA expression, although exogenous corticosterone is effective under these conditions. Hence, our results suggest that in this situation BDNF is resistant to regulation by endogenous corticosterone, which may be important for learning and memory processes.     

Influences of Parental and Best Friends' Smoking and Drinking on Adolescent Use: A Longitudinal Study1

Many studies have dealt with the relative impact of parents and peers on adolescent substance use. However, only a few studies have explored the role of adolescents themselves in social relationships. Homogeneity in behavioral patterns within friendships can also be generated by selective association. Acknowledgment of selection processes might shed new light on the debate on the influences of parents and friends. This paper examines the impact of parental and best friends' smoking and drinking on adolescents' use, using data (N= 1,063) from a 3-wave, 5-year longitudinal study. The results show that friends' smoking did not affect adolescent smoking over time. Only in early adolescence did friends' drinking exert an influence on subjects' alcohol use. On the other hand, parental use had a small but significant impact on their offspring. Furthermore, support was found for processes of selective association.     

Simple mental addition in children with and without mild mental retardation.

The speeded performance on simple mental addition problems of 6- and 7-year-old children with and without mild mental retardation is modeled from a person perspective and an item perspective. On the person side, it was found that a single cognitive dimension spanned the performance differences between the two ability groups. However, a discontinuity, or "jump," was observed in the performance of the normal ability group on the easier items. On the item side, the addition problems were almost perfectly ordered in difficulty according to their problem size. Differences in difficulty were explained by factors related to the difficulty of executing nonretrieval strategies. All findings were interpreted within the framework of Siegler's (e.g., R. S. Siegler & C. Shipley, 1995) model of children's strategy choices in arithmetic. Models from item response theory were used to test the hypotheses.     

Collective self-esteem, personal self-esteem, and collective efficacy in in-group and outgroup evaluations

In assessing the relationship between self-esteem and in-group/outgroup evaluations, this study examined whether self-esteem is better measured at a collective (collective self-esteem [CSE]) than a personal level (personal self-esteem [PSE]). It was expected that subjects high in CSE would engage in more in-group favoritism (measured by in-group evaluations), whereas those low in CSE would engage in more outgroup derogation (measured by outgroup evaluations). No effect for PSE was predicted. Furthermore, the study explored whether perceptions of collective efficacy may underlie this relationship. Subjects played a public goods task. The in-group's outcome was compared to the outcome of other relevant outgroups, enhancing pressures towards intergroup differentiation. Consistent with the predictions, subjects high in CSE evaluated in-group members more positively than those in low CSE (i.e., in-group favoritism), whereas subjects low in CSE evaluated outgroup members more negatively than those high in CSE (i.e., outgroup derogation). Also in line with our predictions, no effect for PSE was found. Perceptions of collective efficacy appeared to be a mediator of the effect of CSE.     

The Props are Falling Down and We Want to Make Music: A Narrative Perspective on Organisations in Transition (Violins/Violence in Organisations)

While South African society finds itself in the throes of political changes, therapists working within organisations in transition find themselves challenged by the turbulence of transformation. The authors are a group of therapists attempting to understand, from a narrative perspective, the organisational context within which they work. This paper recounts the processes around the design, implementation, and outcomes of a workshop on this theme. The main body of the paper consists of a letter that was sent to participants after the workshop. The reader is invited to join collaboratively in our reflections so as to continue an open-ended, creative process.