‘I'm beyond caring’, a response to the Francis Report: the failure of social systems in health care to adequately support nurses and nursing in the clinical care of their patients

Lord Francis was commissioned to look at why the serious problems (between January 2005 and March 2009) at Mid Staffs Foundation Trust were not identified sooner and the appropriate action taken. Lord Francis was also asked to outline what lessons could be learned to enhance patient care. The report was delivered on 5 February 2013 and contained 290 recommendations. The key message was that the National Health Service needed to put the patient first and everything else should flow from that principle. Poor standards of care should not be tolerated and staff would be expected to speak out when they felt patient care was being compromised. Lord Francis also recommended that there should be one regulatory body and that the role of the Care Quality Commission was to be reviewed.     

The Foundations of Capability Theory: Comparing Nussbaum and Gewirth

This paper is written from a perspective that is sympathetic to the basic idea of the capability approach. Our aim is to compare Martha Nussbaum’s capability theory of justice with Alan Gewirth’s moral theory, on two points: the selection and the justification of a list of central capabilities. On both counts, we contend that Nussbaum’s theory suffers from flaws that Gewirth’s theory may help to remedy. First, we argue that her notion of a (dignified) human life cannot fulfill the role of a normative criterion that Nussbaum wants it to play in selecting capabilities for her list. Second, we question whether Nussbaum’s method of justification is adequate, discussing both her earlier self-validating argumentative strategy and her more recent adherence to the device of an overlapping consensus. We conclude that both strategies fail to provide the capabilities theory with the firm foundation it requires. Next, we turn to Gewirth’s normative theory and discuss how it can repair these flaws. We show how his theory starts from a fundamental moral principle according to which all agents have rights to the protection of the necessary preconditions of their agency. Gewirth’s justification of this principle is then presented, using a version of a transcendental argument. Finally, we explicitly compare Nussbaum and Gewirth and briefly demonstrate what it would mean for Nussbaum to incorporate Gewirthian elements into her capabilities theory of justice.     

Reactive and Proactive Aggression: Attachment and Social Competence Predictors

In this study, 107 boys and girls aged 3 to 8 years were rated by their mothers on 6 factors: Reactive and Proactive Aggression, Secure and Insecure Attachment, and Prosocial Orientation and Social Initiative (i.e., social competence). Both secure attachment and prosocial orientation predicted proactive and reactive aggression, but prosocial orientation mediated the attachment–aggression relation in the case of reactive but not proactive aggression.     

Probabilistic models of expectation violation predict psychophysiological emotional responses to live concert music

We present the results of a study testing the often-theorized role of musical expectations in inducing listeners’ emotions in a live flute concert experiment with 50 participants. Using an audience response system developed for this purpose, we measured subjective experience and peripheral psychophysiological changes continuously. To confirm the existence of the link between expectation and emotion, we used a threefold approach. (1) On the basis of an information-theoretic cognitive model, melodic pitch expectations were predicted by analyzing the musical stimuli used (six pieces of solo flute music). (2) A continuous rating scale was used by half of the audience to measure their experience of unexpectedness toward the music heard. (3) Emotional reactions were measured using a multicomponent approach: subjective feeling (valence and arousal rated continuously by the other half of the audience members), expressive behavior (facial EMG), and peripheral arousal (the latter two being measured in all 50 participants). Results confirmed the predicted relationship between high-information-content musical events, the violation of musical expectations (in corresponding ratings), and emotional reactions (psychologically and physiologically). Musical structures leading to expectation reactions were manifested in emotional reactions at different emotion component levels (increases in subjective arousal and autonomic nervous system activations). These results emphasize the role of musical structure in emotion induction, leading to a further understanding of the frequently experienced emotional effects of music.     

A Cognitive-Behavioral-Based Workshop Intervention for Maladaptive Perfectionism

Maladaptive perfectionism (MP) can have adverse consequences for mental and physical health and can interfere with treatment success for various conditions. Theoretical conceptualizations of MP largely surround overly rigid and self-critical thinking as well as excessively high standards. Treatment for MP thus often focuses on these cognitive aspects and has been successful, albeit lengthy. The present study evaluated a brief cognitive-behavioral workshop for those with high, moderate, and low MP, which was defined as a composite of perfectionism subscales that included concern over mistakes, doubting of actions, parental criticism, parental expectations, and discrepancy. Workshop components focused on psychoeducation about MP, setting high standards, fearing mistakes and doubting oneself, and preventing distress and maintaining gains. Ratings of MP as well as anxiety, depression, and distress were significantly lower from pre-treatment across post-treatment and 3-week and 3-month follow-up assessments for those with high and moderate MP. Participants with low MP showed no significant change over time, as expected. The workshop thus provided a useful, brief, and cost-effective intervention for MP and related distress. Clinical implications are discussed, including routine assessment of MP in clinical practice, intervention for MP early in the clinical process, specific focus on self-criticism and setting high standards, and implementation in university counseling centers. Recommendations for future research are also discussed, including dismantling of workshop components, identifying treatment mechanisms, expanding to clinical populations, evaluating more diverse samples, and understanding the possible preventative aspects of a workshop approach.     

Less Religion,Better Society? On Religion,Secularity, and Prosperity in Scandinavia

Abstract : Phil Zuckerman argues in his book Society without God that Scandinavian secularity is strongly correlated to Scandinavian prosperity. In this article, we argue that such usage is premature. First, there are methodological issues that are not properly dealt with. Second, providing a causal narrative in addition to mere correlation is needed. Third, we argue that the causes of Scandinavian prosperity are found in close connection to Scandinavian Lutheranism.     

Forced to Leave: Forced Termination Experiences of Assemblies of God Clergy and Its Connection to Stress and Well-Being Outcomes

Although forced termination has been a subject of interest to clergy for some time, social scientists have generally studied job loss as if it was the same phenomenon regardless of occupation. Ministry work by itself has always been difficult and stressful, and termination from this occupation has been reported to be the result of a demeaning and systematic process of involuntary removal of paid and non-paid clergy-persons that includes psychological, socio-emotional, and spiritual abuse. This pilot project sampled 227 active ministers from the Assemblies of God denomination via an online survey and asked about their experiences with forced termination, as well as measures of their personal and family well-being. In general, ministers who had been forced from a ministry position had less family well-being and more health problems than those who had not been forced out.     

In Search of Balance: A Conceptual and Empirical Integration of Multiple Meanings of Work–Family Balance

This paper provides a framework that elaborates on four conceptualizations of work‐family balance: additive spillover (unique effects of bi‐directional conflict and enrichment), multiplicative spillover (interactive effects of lower conflict with higher enrichment), balance satisfaction (one's attitude toward resource allocation across work and family roles) and balance effectiveness (one's interdependent self‐evaluation of meeting shared expectations across work and family roles). We describe the conceptual differences among these approaches and hypothesize how they operate differently in predicting work and family attitudes and performance. Relative weights analyses showed that additive spillover was the most important predictor of work attitudes (organizational commitment, job satisfaction, and turnover intent), followed by balance satisfaction and effectiveness. However, balance satisfaction and effectiveness together were the most important predictors of family satisfaction and job and family performance. Mediation tests revealed that unique and interactive effects of bidirectional conflict and enrichment related to work and family attitudes and performance indirectly through balance satisfaction and effectiveness. We discuss implications of these findings and offer suggestions to guide future research and theory on work‐family balance.     

The Simulation of Smiles (SIMS) model: Embodied simulation and the meaning of facial expression

Recent application of theories of embodied or grounded cognition to the recognition and interpretation of facial expression of emotion has led to an explosion of research in psychology and the neurosciences. However, despite the accelerating number of reported findings, it remains unclear how the many component processes of emotion and their neural mechanisms actually support embodied simulation. Equally unclear is what triggers the use of embodied simulation versus perceptual or conceptual strategies in determining meaning. The present article integrates behavioral research from social psychology with recent research in neurosciences in order to provide coherence to the extant and future research on this topic. The roles of several of the brain's reward systems, and the amygdala, somatosensory cortices, and motor centers are examined. These are then linked to behavioral and brain research on facial mimicry and eye gaze. Articulation of the mediators and moderators of facial mimicry and gaze are particularly useful in guiding interpretation of relevant findings from neurosciences. Finally, a model of the processing of the smile, the most complex of the facial expressions, is presented as a means to illustrate how to advance the application of theories of embodied cognition in the study of facial expression of emotion.     

The development of gyrification in childhood and adolescence

Gyrification is the process by which the brain undergoes changes in surface morphology to create sulcal and gyral regions. The period of greatest development of brain gyrification is during the third trimester of pregnancy, a period of time in which the brain undergoes considerable growth. Little is known about changes in gyrification during childhood and adolescence, although considering the changes in gray matter volume and thickness during this time period, it is conceivable that alterations in the brain surface morphology could also occur during this period of development. The formation of gyri and sulci in the brain allows for compact wiring that promotes and enhances efficient neural processing. If cerebral function and form are linked through the organization of neural connectivity, then alterations in neural connectivity, i.e., synaptic pruning, may also alter the gyral and sulcal patterns of the brain. This paper reviews developmental theories of gyrification, computational techniques for measuring gyrification, and the potential interaction between gyrification and neuronal connectivity. We also present recent findings involving alterations in gyrification during childhood and adolescence.