Online professionalism: social media, social contracts, trust, and medicine

The AMA Council on Ethical and Judicial Affairs (CEJA) has initiated an important discussion on medical professionalism and the use of social media by issuing thoughtful and practical guidance for physicians and medical students. The implications of online activities for trust in the profession, as well as for trust between patient and doctor, however, will need further exploration as digital life expands and evolves.     

How much of a loss is the loss of self? Understanding Vygotsky from a social therapeutic perspective and vice versa

Using the example of Fred Newman’s social therapy, a methodology that works with the human capability of growing as social units, the contemporary self is explored as an impediment to human development and learning. Following Karl Marx in political philosophy and Lev Vygotsky in child psychology, it is the group/the collective/the mass that engages in developmental activity. In losing the self, we gain the opportunity to create collectivity and in that process come to sense the social-relational-collective quality of creativity and development. By getting rid of the self, we are more able to see the group, which is—developmentally speaking—the important unit of study. In this article I share the role that Marx, Vygotsky and Ludwig Wittgenstein played in the creation of this understanding and critical practice.     

Juvenile offenders' Miranda rights comprehension and self-reported likelihood of offering false confessions

This study examined whether age, IQ, and history of special education predicted Miranda rights comprehension and the self-reported tendency to falsely confess to a crime among 55 delinquent boys. The Miranda Rights Comprehension Instruments-II, a revised version of Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights, were developed for this study and are described in detail in this article. Results revealed that age, IQ, and special education were related to comprehension of Miranda rights. When Miranda comprehension, age, and IQ were simultaneously tested as predictor variables of the self-reported likelihood of false confessions, only age served as an independent predictor. Research and policy implications of this study are presented, and recommendations for use of the original and revised instruments are reviewed.     

Hostile/Helpless maternal representations in pregnancy and later child removal: A pilot study

This article presents the results of a small pilot study examining links between Hostile/Helpless (HH) representations of caregiving in pregnancy and later child removal by child protective services. The sample was drawn from a replication study of the Minding the Baby^® attachment‐based home‐visiting intervention conducted in the United Kingdom, serving young first‐time mothers in under resourced communities. The HH classification system (Lyons‐Ruth et al.) was adapted for use with the Pregnancy Interview (PI) (Slade); 26 PIs were assessed (coders blinded) in a sample that included 13 mothers whose infants were removed from custody due to anticipated or documented maltreatment within 2 years of childbirth, and 13 mothers who did not have their infants removed. Mothers whose infants were removed from their custody had significantly higher HH scores than mothers of infants who were not removed from their care (F(1, 24) = 14.500, p < .001), and the relation between overall HH classification and infant removal status was also significant (χ²(1, N = 26) = 12.462, p < .001). Results suggest that prenatal maternal caregiving representations may predict postnatal relationship disruptions, and indicate the need for larger studies further testing this prenatal approach to maltreatment risk assessment in at‐risk populations.     

Relationship between sleep disturbance,depression and anxiety in the 12 months following a cardiac event

We aimed to assess the prevalence of sleep disturbance in a cardiac patient population over a 12-month period and assess its relationship with treatment adherence, self-efficacy, anxiety and depression. A total of 134 patients consecutively admitted to two Australian hospitals after acute myocardial infarction (31%), or to undergo bypass surgery (29%) or percutaneous coronary intervention (40%) were interviewed at six weeks and four and 12 months. Sleep disturbance was measured using a recode of the Beck Depression Inventory (v.2) item 16. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Sleep disturbance was highly prevalent (69%) at 6 weeks but was not associated with 12-month psychological outcomes. Path analysis revealed that sleep disturbance at 4 months was, however, associated with reduced treatment adherence and self-efficacy, and higher anxiety and depression scores at 12 months. The high prevalence of sleep disturbance in this study and its association with psychological outcomes may have adverse prognostic implications and possibly impede cardiac rehabilitation efforts.     

Cognitive behavioral weight-loss program for individuals with psychotic mental diseases

Overweight derived from the intake of new antipsychotic medication in order to treat schizophrenia is a growing problem. The main purpose of this study is to launch a cognitive behavioural program in outpatients. It is focused on the weight control of patients with chronic mental diseases, especially those diagnosed as psychotic, and who are under treatment in a Psychosocial Rehabilitation Centre. In this study, the results of an experimental group and a control group were compared. The experimental group was made up of 7 individuals, 3 males and 4 females, and the control group comprised 4 males and 4 females. The program had a duration of twelve sessions administered over a period of three months. Three months after concluding the program, both groups were followed up. The data obtained indicate the efficiency of the cognitive-behavioural treatment in the patients. The achievements of this project were, on the one hand, to significantly reduce the patients' weight and, on the other, to modify their nutritional and physical exercise habits.