Book reviews

Religion and Globalisation. Peter Beyer, 1994 London: Sage Publications 250 pp., £12.95 pb, £37.50 hb ISBN 0–8039–8917–2

The Religious Culture of India: Power, Love and Wisdom. Friedhelm Hardy, 1994 Cambridge Studies in Religious Traditions 4, Cambridge University Press xiii + 613 pp. £55.00, US$74.95 ISBN 0–521–44181–1

Judaism and Other Faiths. Dan Cohn‐Sherbok, 1994 Basingstoke: Macmillan Press ix + 186 pp., £40.00 hb ISBN 0–312–10384–0.

Women in Religion Jean Holm with John Bowker, eds., 1994 London and New York: Pinter Publishers 181 pp., £29.50 hb, £9.99 pb ISBN 1–85567–108–5 hb, ISBN 1–85567–109–3 pb

Attitudes to Nature. Jean Holm (ed.) with John Bowker, 1994 London and New York: Pinter Publishers 172 pp., £23.50 hb, £9.99 pb ISBN 1–85567–092–5 hb, ISBN 1–85567–093–3 pb

Sacred Writings. Jean Holm (ed.) with John Bowker, 1994 London and New York: Pinter Publications 201 pp., £29.50 hb, £9.99 pb ISBN 1–85567–106–9 hb; 1–85567–107–7 pb

The Gospel of Buddha. Paul Carus, 1994 Oxford: Oneworld Publications 306 pp., £6.95 ISBN 1–85168–026–8

The New Religious Order: The Passionists and the Option for the Poor. James Sweeney CP, 1994 London: Bellew Publishing 240 pp., £35.00 ISBN 1–85725–105–9

Religions in the UK: A Multi‐Faith Directory. Paul Weller (ed), researched by Rachelle Castle and Paul Weller, 1993 Mickleover, Derby: University of Derby, in association with The Inter Faith Network for the United Kingdom 651 pp., £25.00 (incl. p&p) ISBN 0–901437–06–9     

Identifying and Addressing Barriers to Treatment Decision‐making in Bipolar II Disorder: Clinicians’ Perspective

Objective

Treatment decision‐making in bipolar II disorder is complex due to limited evidence on treatment efficacy and potentially burdensome side‐effects of options. Thus, involving patients and negotiating treatment options with them is necessary to ensure that final treatment decisions balance both clinician and patient preferences. This study qualitatively explored clinician views on (a) effective treatment decision‐making, unmet patient needs for (b) decision‐support and (c) information.

Method

Qualitative semi‐structured interviews with 20 practising clinicians (n = 10 clinical psychologists, n = 6 general practitioners, n = 4 psychiatrists) with experience treating adult outpatients with bipolar II disorder were conducted. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Self‐report professional experience, and clinician preferences for patient decision‐making involvement were also assessed.

Results

Qualitative analyses yielded two inter‐related themes: (a) challenges and barriers to decision‐making and (b) facilitators of clinician decision‐making. Symptom severity, negative family attitudes, system‐based factors, and information gaps were thought to pose challenges to decision‐making. By contrast, decision‐making was supported by patient information, family involvement and patient‐centredness, and a strong therapeutic relationship. Clinician views varied depending on their professional background (medical vs clinical psychologist), patient involvement preferences, and whether the clinician was a bipolar specialist.

Conclusions

Whilst clinicians uniformly recognise the importance of involving patients in informed treatment decision‐making, active patient participation is hampered by unmet informational and decision‐support needs. Current findings inform a number of bipolar II disorder‐specific, clinician‐endorsed strategies for facilitating patient decision‐making, which can inform the development of targeted patient decision‐support resources for use in this setting.     

Ordering and reordering in the auditory and visual modalities

This study investigates the hypothesis that the modality effect (i.e., the often-found recall advantage of the last few items presented in the auditory- rather than visual-input modality) is attributable to a directional auditory trace. Such a directional trace should help performance of forward item-to-item recall, but should hurt performance if mental reordering is required. However, it was found in our Experiment 1 that mental item-to-item reordering of the materials did not affect the modality effect. In Experiment 2, strict control was exercised over the order of recall of chunks of items, as well as over the order of recall within chunks. It was found that the item-to-item reordering of the materials had little effect on the modality effect. However, the larger scale order of recall of the chunks had a large effect on the modality effect. If recall was in a forward order (i.e., first chunk, second chunk, third chunk), there was a dramatic superiority of the auditory materials on the last chunk. If the recall order was backward (third chunk, second chunk, first chunk), the modality effect was inconsequential. These results suggest that the modality effect is related to access to large memorial units rather than to item-to-item associations.     

The politics, economics, and ethics of "appropriateness"

The terms "appropriate" and "necessary" are crucial determinants in decisions regarding the use and reimbursement of medical treatments. This paper encourages greater awareness of the political, economic, and normative assumptions that give meaning to these concepts.     

Contingent aftereffects: lateral interactions between color and motion

A randomly dotted yellow disk was rotated at a speed of 5 rpm, alternating in direction every 10 sec. Its change in direction of rotation was paired with a change in surround color, which was either red or green. After 15 min of exposure, observers reported vivid motion aftereffects contingent on the color of both the stationary disk and the surround, even though during adaptation only motion or color was associated with either alone. In further experiments, it was established that a change in color (or direction of motion) of the disk could be associated with a change in direction of motion (or color) of the surround. Such lateral effects were found even when a wide (5 degree) annulus was introduced between the disk and the surround during adaptation and testing. Furthermore, the aftereffects generalized to the annulus, which was not associated with either color or motion during adaptation. However, when the disk alone was adapted to color and motion, no generalization to the surround was found (and vice versa), suggesting that the effects are not produced by adaptation of large receptive fields or by scatter of light within the eye. The results appear to conflict with the ideas that contingent aftereffects are confined to the adapted area of the retina and that they are built up by links between single-duty neurones, and with an extreme view of the segregation of color and motion early in human vision.     

The Power of an Immediate Donor Registration Opportunity: Translating Organ Donation Attitudes Into Registration Behavior

In Australia, despite numerous campaigns encouraging the registration of organ donation intentions on a National Organ Donor Register, registration remains low. This disparity was investigated by examining the relationship between positive and negative donation attitudes, an immediate versus a delayed registration opportunity, and registration. In a community setting, 200 participants completed a short version of the Organ Donation Attitude Scale and were given either an immediate or delayed opportunity to register. In the immediate condition, 60% registered against 11.6% in the delayed condition despite participants in both conditions having similar attitude profiles, suggesting that attitudes were facilitated or obstructed by the registration opportunity.