A Narrative Approach to the Clinical Reasoning Process in Pediatric Intensive Care: The Story of Matthew

This paper offers a narrative approach to understanding the process of clinical reasoning in complex cases involving medical uncertainty, moral ambiguity, and futility. We describe a clinical encounter in which the pediatric health care team experienced a great deal of conflict and distrust as a result of an ineffective process of interpretation and communication. We propose a systematic method for analyzing the technical, ethical, behavioral, and existential dimensions of the clinical reasoning process, and introduce the Clinical Reasoning Discussion Tool—a dialogical and interpretive device aimed at improving communication, understanding, empathy, and moral deliberation in the clinical setting.     

The Five Factor Model (FFM) among four groups of male and female professionals

The present study examined the differences in personality traits among groups of seasoned professionals A Hebrew shortened version of Costa and McCrae’s [Costa, P. T., Jr., & McCrae, R. R. (1992). NEO-PI-R: Professional manual odessa. Florida: Psychological Assessment Resources] NEO-FFI questionnaire was administered to 236 Israeli male and female doctors, lawyers, clinical psychologists, and artists (mean age = 31.19). Artists were found to be significantly more neurotic than members of the other three professional groups and significantly more open to experience than doctors. Women were significantly more neurotic and extravert than men, regardless of their occupational affiliation.     

Overgeneral autobiographical memory and traumatic events: an evaluative review

Does trauma exposure impair retrieval of autobiographical memories? Many theorists have suggested that the reduced ability to access specific memories of life events, termed overgenerality, is a protective mechanism helping attenuate painful emotions associated with trauma. The authors addressed this question by reviewing 24 studies that assessed trauma exposure and overgenerality, examining samples with posttraumatic stress disorder, acute stress disorder, depression, traumatic event exposure, and other clinical disorders. Limitations are discussed, including variations in assessment of events, depression, and overgenerality and the need for additional comparison groups. Across studies, there was no consistent association between trauma exposure and overgenerality, suggesting that trauma exposure is unlikely to be the primary mechanism leading to overgenerality. Instead, psychopathology factors such as depression and posttraumatic stress appear to be more consistently associated with overgenerality. Alternative overgenerality theories may help identify key overgenerality mechanisms, improving current understanding of autobiographical memory processes underlying psychopathology.     

Why Do Students Keep Writing Me Sermons? Teaching Biblical Studies Cross‐Culturally in New Zealand

Abstract. Students from different cultural backgrounds respond in a variety of ways to my teaching of biblical studies. Some sermonize or plagiarize quite unselfconsciously in their written assignments, while others consistently hand in work late or are silent members of the class. As I struggled with what these behaviors were saying about my teaching, I came to realize that limited ability in spoken and written English was not the only barrier. Deeper issues were at stake here about the nature of cross‐cultural communication, teaching, and learning. In this note I analyze the issues of faith, authority, and styles of teaching and learning which underlie the “clash of educational cultures” ( Ballard and Clanchy 1997 , viii) occurring in the cross‐cultural classroom. Then I suggest a number of strategies that I have developed to build bridges of understanding between the various educational cultures, to encourage deeper participation and to develop critical thinking.     

Social-Evaluative Threat and Proinflammatory Cytokine Regulation: An Experimental Laboratory Investigation

ABSTRACT— This study experimentally tested whether a stressor characterized by social-evaluative threat (SET), a context in which the self can be judged negatively by others, would elicit increases in proinflammatory cytokine activity and alter the regulation of this response. This hypothesis was derived in part from research on immunological responses to social threat in nonhuman animals. Healthy female participants were assigned to perform a speech and a math task in the presence or absence of an evaluative audience (SET or non-SET, respectively). As hypothesized, stimulated production of the proinflammatory cytokine tumor necrosis factor-α (TNF-α) increased from baseline to poststressor in the SET condition, but was unchanged in the non-SET condition. Further, the increases in TNF-α production correlated with participants' cognitive appraisals of being evaluated. Additionally, the ability of glucocorticoids to shut down the inflammatory response was decreased in the SET condition. These findings underscore the importance of social evaluation as a threat capable of eliciting proinflammatory cytokine activity and altering its regulation.     

Gaze behavior and affect at 6 months: predicting clinical outcomes and language development in typically developing infants and infants at risk for autism

This paper presents follow‐up longitudinal data to research that previously suggested the possibility of abnormal gaze behavior marked by decreased eye contact in a subgroup of 6‐month‐old infants at risk for autism ( Merin, Young, Ozonoff & Rogers, 2007 ). Using eye‐tracking data and behavioral data recorded during a live mother–infant interaction involving the still‐face procedure, the predictive utility of gaze behavior and affective behaviors at 6 months was examined using diagnostic outcome data obtained longitudinally over the following 18 months. Results revealed that none of the infants previously identified as showing lower rates of eye contact had any signs of autism at outcome. In contrast, three infants who were diagnosed with autism demonstrated consistent gaze to the eye region and typical affective responses at 6 months. Individual differences in face scanning and affective responsivity during the live interaction were not related to any continuous measures of symptom frequency or symptom severity. In contrast, results of growth curve models for language development revealed significant relationships between face scanning and expressive language. Greater amounts of fixation to the mother's mouth during live interaction predicted higher levels of expressive language at outcome and greater rates of growth. These findings suggest that although gaze behavior at 6 months may not provide early markers for autism as initially conceived, gaze to the mouth in particular may be useful in predicting individual differences in language development.     

Upward and downward physical appearance comparisons: Development of scales and examination of predictive qualities

Despite good theoretical and empirical rationale for assessing tendencies to make upward and downward physical appearance comparisons no measure for these specific constructs exists. The present work developed and tested the psychometric properties of upward and downward physical appearance comparison scales. The scales were administered to participants (N = 224) along with measures of general appearance comparison tendencies, body image, disordered eating, Antifat and Antigay attitudes. The scales displayed good psychometric properties. Importantly, the upward but not downward physical appearance comparison scale predicted lower Appearance Evaluation and higher EAT-26 scores. Conversely, the downward but not upward physical appearance comparison scale predicted higher Appearance Evaluation and greater Antifat Attitudes (Dislike). The scales were unrelated to a nonappearance related construct. These new measures fill a gap in the literature and may be of benefit to researchers interested in body image, appearance concerns, eating disorders, social comparison, and obesity prejudice.     

Dietary patterns and intelligence in early and middle childhood

The association between intelligence and diet at 3.5 and 7 years was examined in 591 children of European descent. Approximately half of the children were born small-for-gestational age (birth weight ≤ 10th percentile). The relationship between IQ and diet (measured by food frequency) was investigated using multiple regression analyses. Eating margarine at least daily was associated with significantly lower IQ scores at 3.5 years in the total sample and at 7 years in SGA children. For all children, eating the recommended daily number of breads and cereals was associated with significantly higher IQ scores at 3.5 years, and those who ate fish at least weekly had significantly higher IQ scores at 7 years than those who did not. The consumption of fish, breads and cereals commeasurable with nutritional guidelines may be beneficial to children's cognitive development. In contrast, consuming margarine daily was associated with poorer cognitive functioning. Further research is needed to identify the nutrients that may underlie this association.     

Predicting romantic relationship satisfaction from life history strategy

Attachment style and communication style have been shown in previous research to predict relationship satisfaction. We hypothesized that the ultimate cause underlying the relationship among attachment style, communication style, and relationship satisfaction is Life History Strategy (LHS). Furthermore, we hypothesized that LHS would not only predict relationship satisfaction indirectly through a couple’s attachment style and communication style, but would also predict relationship satisfaction directly. Two structural equation models were constructed to model and test each of these hypotheses. The first showed that the indirect causal pathways from LHS to attachment style, attachment style to communication style, and communication style to relationship satisfaction predicted 16% of the variance in relationship satisfaction. The second added a causal pathway directly from LHS to relationship satisfaction which reduced the estimate for the influence of communication style on relationship satisfaction and increased the total variance predicted in relationship satisfaction to 60%. These results challenge the notion that it is primarily the communication between two romantic partners which influences their relationship outcome by proposing that their LHS may be influential: (1) indirectly through their attachment style and communication style; and (2) directly upon relationship satisfaction.