Large-scale ensemble averaging of ambulatory impedance cardiograms

Impedance cardiography has been used increasingly to measure human physiological responses to emotional and mentally engaging stimuli. The validity of large-scale ensemble averaging of ambulatory impedance cardiograms was evaluated for preejection period (PEP), interbeat interval, and dZ/dt_(min) amplitude. We tested whether the average of “classical” 60-sec ensemble averages across periods with fixed activity, posture, physical load, social situation, and location could be accurately estimated from a single large-scale ensemble average spanning these entire periods. Impedance and electrocardiograms were recorded for about 24-h from 21 subjects. Recordings were scored by seven raters, using both methods for each subject. Good agreement (average intraclass correlation coefficient was .91) between both ensemble averaging methods was found for all three cardiac function measures. The results indicate that for unambiguous ambulatory impedance cardiograms, large-scale ensemble averaging is valid, which makes measuring prolonged changes in cardiac sympathetic activity by measuring ambulatory PEP feasible even in large epidemiological samples.     

A Question of Two Answers: Difference and Determination in Barth and von Balthasar

This essay uses the motif of 'the woman as answer' in Barth and von Balthasar to explore aspects of their accounts of sexual difference in relation to ontological and trinitarian difference. In both cases the motif is shown to be problematic for reasons which become apparent in christology. Barth's characterisation of woman as the 'sufficient answer' to the prior 'question' posed by man indicates a tendency towards the elision of difference in his anthropology, which is reflected in the nonsexuality of Christ - the 'true Man' Ð and in aspects of his trinitarian theology. Von Balthasar's 'double answer' of woman to man moves beyond viewing sexual difference as the locus of man's self-completion, but the overdetermination of 'woman' in his mariology undermines this. The pneumatology of von Balthasar's 'Spiritus Creator' suggests possibilities for the development of a christologically-focused anthropology which maintains difference.     

Quality of Life and Neurological Illness: A Review of the Literature

This article highlights some of the conceptual and methodological problems associated with quality of life (QoL) measurement in individuals with neurological illness. It is suggested that these problems have contributed to the underdeveloped status of QoL research in neurological settings. Many of the existing QoL measures that have been used, or show potential for use with individuals with neurological illness, are reviewed in terms of their theoretical basis, content, and practicality. A large proportion of these measures fail to meet adequate psychometric standards and/or have rarely been psychometrically tested. The confusion that surrounds adequate psychometric standards is discussed, and the dynamic nature of QoL is highlighted as a factor that requires further attention. Research addressing the discrepancies between proxy and patient ratings of patient QoL is also warranted. More focused research in these areas may contribute to a clearer understanding of how to assess QoL in individuals with neurological illness.     

Therapeutic work with refugees living in exile: Observations on clinical practice

Asylum seekers and refugees fleeing to Britain or other host countries face a range of dilemmas, which are qualitatively different from those facing any other client group. Refugees find themselves in an entirely different country, having often fled at short notice without making preparations. They may have suffered multiple practical and psychological losses. Significant numbers of refugees will have been subject to organised violence in their country of origin. Responding clinically to the needs of some of those becoming refugees has many implications and challenges for existing models of therapeutic intervention. This paper draws upon the author's clinical work in Britain and abroad, it details some observations on therapeutic practice and highlights the challenges and rewards of working with this client group.     

Callous-Unemotional Traits and Subtypes of Conduct Disorder

There has been growing consensus that children with conduct disorder (CD) constitute a very heterogeneous group containing children who vary substantially on the development, course, and causes of the disorder. While many have recognized the importance of this heterogeneity for developing better causal theories and for developing more effective treatments, there has been little consensus as to the best way to subtype children with CD. In this paper, we review a number of approaches to subtyping, each with some evidence for its validity for certain purposes. We focus on two recent approaches that have great potential for integrating past subtyping approaches and for advancing causal theory. The first approach is the division of children with CD into those with a childhood onset to their severe antisocial behavior and those with an adolescent onset to their behavior. The second approach is to designate children within the childhood-onset group who show callous and unemotional traits, which is analogous to adult conceptualizations of psychopathy. Both approaches help designate children who many show different causal processes underlying their severe aggressive and antisocial behavior, and who may warrant different approaches to treatment.     

Encouraging counsellor reflection

The evolution of an 'attributes checklist' tool for assisting counsellor development is described. The attributes relate to characteristics of case-notes that indicate evidence of counsellor reflection and consideration of the counselling process. The checklist was initially tested among a sample of 19 counsellors employed by an organisational EAP and was subsequently refined. The final checklist tool was found to be both usable and useful in differentiating 'process' from 'content' notes. The purpose of the checklist tool is not to enable quantitative assessment of counsellor notes, but rather to facilitate counsellor development within a professional supervisory relationship. The findings of the study are discussed, and suggestions for future research in this area are made.     

Alcohol Consumption and the Theory of Planned Behavior: An Examination of the Cognitive Mediation of Past Behaviorid

This study examined the predictive power of the theory of planned behavior (TPB) in explaining alcohol consumption in 3 prospective samples of students ( Ns = 178. 176. and 159). Generally, the TPB performed well. with attitudes, subjective norms and perceived behavioral control (PBC) explaining between 28% and 46% of the variability in intentions. Intentions and PBC explained between 12% and 50% of the variability in behavior. Measures of self-identity as a "drinker" and past behavior contributed to predictions of intentions over and above the contribution of attitudes. subjective norms. and PBC. Measures of past behavior but not self-identity consistently contributed to predictions of behavior over and above the contributions from intentions and PBC. The direct relationship between past behavior and intention and between past behavior and behavior (independent of the TPB variables or self-identity) could not be attributed to common method variance.     

The Main Argument for Value Incommensurability (and Why It Fails)

Arguments for value incommensurability ultimately depend on a certain diagnosis of human motivation. Incommensurablists hold that each person's basic ends are not only irreducible but also incompatible with one another. It isn't merely that some goals can't, in fact, be jointly realized; values actually compete for influence. This account makes a mistake about the nature of human motivation. Each value underwrites a ceteris paribus evaluation. Such assessments are mutually compatible because the observation that there is something to be said for an outcome from a particular perspective allows for any ultimate evaluation of that outcome; Values can be irreducible without thereby being incommensurable.