The spiritual care of sick children: reflections from a pilot participation project

The authors are a multi-disciplinary team of chaplains, one with a counselling qualification, and an academic with a research background in spirituality and youth work. A pilot participation project undertaken at Birmingham Children’s Hospital (UK) focused on increasing the understanding of the spiritual needs of sick children and young people and involving children and young people in improving the service and provision of spiritual and religious care to them. Views from children, young people and parents were sought with the intention of developing resources and training that help facilitate the meeting of spiritual and religious needs of children and young people in hospital. Within the wider chaplaincy team are chaplains from the six major world faiths and this project considers spiritual needs of children and young people who perceive themselves as belonging to a faith group or not. Reflections from the pilot include identifying ten principles and practices to inform the spiritual care of sick children and proposing the concept of interpretive spiritual encounters as a tool for spiritual care. The pilot study indicated that being more proactive in offering spiritual care enhanced the quality of service offered by Chaplaincy.     

Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Movement in the ipsilesional hand is segmented following unilateral brain damage

Unilateral stroke results in hemiplegia or hemiparesis of the contralateral side of the body. The ipsilateral side of the body, the so-called "good" side, is often assumed to have no deficit. However, there is increasing evidence that the function of the unaffected limbs, especially the upper extremities, is different from that of normal age-matched controls. In the present study, we examined the motor control of both hands of chronic stroke subjects, 6 with left hemisphere brain damage (LHBD) and 5 with right hemisphere brain damage (RHBD). The control group consisted of 5 normal age-matched subjects. The task of the subject was to move a handle by flexing his/her fingers until the target position was reached. The target position was set as 33% of the range of each subject. No time constraints were imposed. The movements of the normal subjects were basically smooth, with few hesitations. In contrast to this, the movements of both hands in the two stroke groups were segmented and characterized by multiple starts and stops. As compared to normals, the time to reach the target, the number of pauses during the movement, and the percent of time spent in pauses, were significantly greater for both hands of the LHBD group. In the RHBD group, the percent of time spent in pauses was significantly greater than the control group for the ipsilesional hand. The increased segmentation seen in the movements of the ipsilesional, as well as the contralesional. hands of the hemiplegic subjects suggests that the motor deficits in stroke patients may be due to a global inability to correctly plan and carry out movements.     

Public Attitudes Toward the Use of Bioremediation to Clean Up Toxic Contamination

Bioremediation is an innovative approach to environmental management that uses microorganisms or plants to clean up toxic contamination in the environment. This research examines public attitudes toward the use of bioremediation at 2 sites in California: an urban site (Avila Beach) and a natural site (Guadalupe Dunes). At both sites, the study participants preferred excavation of the contaminated soil to bioremediation. The survey results help to explain the reasons why there is limited support for the use of bioremediation.     

A naturalistic longitudinal evaluation of counselling in primary care

This study evaluated the effectiveness of generic counselling in a primary healthcare setting during three months of counselling and followed up the patients' progress after counselling had finished for the next twenty-one months. Questionnaires were completed by patients within the Dorset Primary Care counselling service on referral to counselling and at set points afterwards. A naturally occurring waiting-list group was compared with patients receiving counselling at baseline and three months. Measurements were taken of patients' psychiatric symptomatology, quality of life (QOL) and self-esteem. Patients who received counselling made highly significant improvements compared with those on the waiting list. These improvements were maintained throughout the long-term follow-up. This would indicate that generic counselling has positive effects that can be maintained for a long period of time after counselling has been completed.     

Lorenz Curves: A New Model for the Distribution of Psychiatric Services

The growth of child and adolescent psychiatric services based on the wraparound philosophy raises new questions for medical directors, investigators, and clinicians interested in improving quality of care and outcomes. Typically, quality improvement studies have focused on standardizing care and decreasing variation while community based services following a wraparound model are by definition individualized. To date, little information on how to evaluate such services in a managed care environment has been available. We present one option for evaluating the distribution of medical services and the extent to which providers individualize services for children with severe emotional disorders. Specifically, we (a) review the philosophy and goals of wraparound services, (b) introduce the Lorenz curve as a tool for determining the degree of inequality in service distribution at a given institution, and (c) present a case study on the use of Lorenz curves by a Medicaid Behavioral Health Organization in profiling behavioral providers.     

Innocence Without Naivete,Uprightness Without Stupidity: The Pedagogical Kavannah of Emmanuel Levinas

While it is impossible to transfigurephilosophical and Judaic thought of EmmanuelLevinas into a moral agenda for education orthe programmatic regularities of a pedagogicalmethodology, this paper argues for theimportance of his work for re-openingeducational questions. These questions engagethe problem of what it could mean to livehistorically, to live within an uprightattentiveness to traces of those who haveinhabited times and places other than one'sown. In this sense, I address the problem ofremembrance as a question of and for history,as a force of inhabitation, as an inheritance weare obligated to live within, that intertwineswith our sense of limits and possibilities,hopes and fears, identities and distinctions.Substantively, this problem is manifest in howone attends to the experiences of others: howone reads, how one views, and how one listens,always historically specific normalizedpractices that in any given epoch are ingrainedin what it means to live in consort withothers, to live as though the lives of otherpeople mattered. The paper seeks to display thefecundity of the thought of Levinas forre-thinking such issues.     

Executive Heads and the Role of Intergovernmental Organizations: Expansionist Leadership in the United Nations and the European Union

Despite considerable advances in methods to examine leaders' personal characteristics using at–a–distance assessment, few studies have applied such techniques outside of the national level. This study reveals that such approaches can provide analytical leverage for examining executive heads of intergovernmental organizations (IGOs). The personal characteristics of six United Nations Secretaries–General and four European Union Commission Presidents were measured via content analysis of their responses to questions. Separately, their behavior in office was measured via historical accounts and analyses. In general, executive heads with higher expansionist leadership style scores displayed a greater willingness to try to enhance the status of their organizations.