The arrogant physician--a Judaic perspective

Arrogance among physicians is all too common. This is in sharp contrast with medicine's sacred religious origins. The author presents a concise historical review of the Judaic perspective on the role of the physician, his position in the community, and the attitudes/values that should characterize his healing pursuit.     

Emotion and cognition: feeling and character identification in dreaming

This study investigated the relationship between dream emotion and dream character identification. Thirty-five subjects provided 320 dream reports and answers to questions on characters that appeared in their dreams. We found that emotions are almost always evoked by our dream characters and that they are often used as a basis for identifying them. We found that affection and joy were commonly associated with known characters and were used to identify them even when these emotional attributes were inconsistent with those of the waking state. These findings are consistent with the finding that the dorsolateral prefrontal cortex, associated with short-term memory, is less active in the dreaming compared to the wake brain, while the paleocortical and subcortical limbic areas are more active. The findings are also consistent with the suggestion that these limbic areas have minimal input from the dorsolateral prefrontal cortex in the dreaming brain.     

Elegiac Poetry: A Pastoral Resource with Complicated Grief

This essay argues that elegiac poetry, the poetry of mourning, may be a resource for pastoral care with complicated grief. It builds on Freuds distinction between mourning (normal grief) and melancholia (complicated grief), particularly as appropriated by French literary critic and psychoanalyst Julia Kristeva. It makes the case for elegy as a locus for externalizing a lost object which, in complicated grief, has been internalized as part of the bereaved persons self and which is not only grieved but also treated ambivalently if it is not hated. Drawing on the suffering God motif in Christian theologies of the cross, theological reflections supplement psychological arguments.     

Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects

Bright light therapy for seasonal affective disorder (SAD) has been investigated and applied for over 20 years. Physicians and clinicians are increasingly confident that bright light therapy is a potent, specifically active, nonpharmaceutical treatment modality. Indeed, the domain of light treatment is moving beyond SAD, to nonseasonal depression (unipolar and bipolar), seasonal flare-ups of bulimia nervosa, circadian sleep phase disorders, and more. Light therapy is simple to deliver to outpatients and inpatients alike, although the optimum dosing of light and treatment time of day requires individual adjustment. The side-effect profile is favorable in comparison with medications, although the clinician must remain vigilant about emergent hypomania and autonomic hyperactivation, especially during the first few days of treatment. Importantly, light therapy provides a compatible adjunct to antidepressant medication, which can result in accelerated improvement and fewer residual symptoms.     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Australian lawyers' views on competency issues in older adults

Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions.     

Dynamical concurrent schedules

Previous work on the matching law has predominantly focused on the molar effects of the contingency by examining only one reinforcer ratio for extended periods. Responses are distributed as a function of reinforcer ratios under these static conditions. But the outcome under a dynamic condition in which reinforcer ratios change continuously has not been determined. The present study implemented concurrent variable-interval schedules that changed continuously across a fixed 5-min trial. The schedules were reciprocally interlocked. The variable interval for one key changed continuously from a variable-interval 15-s to a variable-interval 480-s, while the schedule for the other key changed from a variable-interval 480-s to a variable-interval 15-s. This dynamical concurrent schedule shifted behavior in the direction of matching response ratios to reinforcer ratios. Sensitivities derived from the generalized matching law were approximately 0.62, the mean absolute bias was approximately 0.11, and r2s were approximately 0.86. It was concluded that choice behavior can come to adapt to reinforcer ratios that change continuously over a relatively short time and that this change does not require extensive experience with a fixed reinforcer ratio. The results were seen as supportive of the view that all behavior constitutes choice.     

Aesthetic Truth and Pastoral Theology: A Proposal for a New Method of Reflection and Practice

Pastoral theology needs to clarify its identity as an autonomous theological discipline by developing its own knowledge base, body of research, and practice methods. It needs to broaden its scope to include not only a concern for personal issues, but also larger sociocultural and anthropological ones as well. Additionally, there is a pressing need for moving beyond the confines of traditional methods of correlation. This essay offers a new method for pastoral theological reflection and practice that is grounded in Hans-Georg Gadamer's understanding of aesthetic truth and hermeneutics. It offers a new way of conceptualizing the relationship of pastoral theology to such conversation partners as the Bible and theological tradition, the social sciences, and practical wisdom, demonstrating how these can contribute to the pastoral theological task.     

Risk and Prisoner's Dilemma: A Reinterpretation of Coombs' Re‐parameterization

We propose a model to measure risk in a prisoner's dilemma based on Coombs' (1973) re‐parameterization of the game as an individual risk decision‐making task that chooses between a gamble of cooperation and another gamble of defection. Specifically, we propose an index, r, to represent the risk associated with cooperation relative to defection. In conjunction with Rapoport's (1967) index of cooperation (K), our formulation of risk allows us to construct games that vary in risk (as indexed by r) while controlling for cooperativeness (as indexed by K). Following utility analysis that models risk seeking as a convex utility function and risk averse as a concave function, we predict that risk‐seeking people cooperate more in games that the cooperation choice is more risky, whereas risk‐averse people cooperate more in games that the cooperation choice is less risky. In the three studies that we varied game parameters, used different measures of risk orientation and prosocial orientation and used different experimental procedures, we found robust results supporting our predictions. Theoretical analysis of our formulation further suggests that risk and cooperativeness of a prisoner's dilemma game is not entirely independent. Games that have a higher cooperativeness index are necessarily more risky. Copyright © 2011 John Wiley & Sons, Ltd.