Action sets and decisions in the medial frontal cortex

Activations in human dorsomedial frontal and cingulate cortices are often present in neuroimaging studies of decision making and action selection. Interpretations have emphasized executive control, movement sequencing, error detection and conflict monitoring. Recently, however, experimental approaches, using lesions, inactivation, and cell recording, have suggested that these are just components of the areas' functions. Here we review these results and integrate them with those from neuroimaging. A medial superior frontal gyrus (SFG) region centred on the pre-supplementary motor area (pre-SMA) is involved in the selection of action sets whereas the anterior cingulate cortex (ACC) has a fundamental role in relating actions to their consequences, both positive reinforcement outcomes and errors, and in guiding decisions about which actions are worth making.     

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.     

Childhood awaits every person

This article briefly describes the activity we call Magic Spots (others use the name Sit-spots), silent solitude in the natural world with children; explores the notion of metaxic space, the space between one and another, and with the help of children’s voices introduces the important of the context in which of facilitating times of solitude in the natural world (which I call ‘stretching this in-between space enough for children to experience spirit’) takes place. The second half of the article shares examples of children’s own agency of their spirituality and finally, reflects on the characteristics needed for adults who are privileged to accompany them.     

Practical Reasoning Arguments: A Modular Approach

This paper compares current ways of modeling the inferential structure of practical (goal-based) reasoning arguments, and proposes a new approach in which it is regarded in a modular way. Practical reasoning is not simply seen as reasoning from a goal and a means to an action using the basic argumentation scheme. Instead, it is conceived as a complex structure of classificatory, evaluative, and practical inferences, which is formalized as a cluster of three types of distinct and interlocked argumentation schemes. Using two real examples, we show how applying the three types of schemes to a cluster of practical argumentation allows an argument analyst to reconstruct the tacit premises presupposed and evaluate the argumentative reasoning steps involved. This approach will be shown to overcome the limitations of the existing models of practical reasoning arguments within the BDI and commitment theoretical frameworks, providing a useful tool for discourse analysis and other disciplines. In particular, applying this method brings to light the crucial role of classification in practical argumentation, showing how the ordering of values and preferences is only one of the possible areas of deep disagreement.     

Mechanisms of health: Education and health-related behaviours partially mediate the relationship between conscientiousness and self-reported physical health

The personality trait of conscientiousness is an important predictor of health and longevity. The present research examined how conscientiousness, in combination with educational attainment and health-related behaviours, predicted self-reported physical health across adulthood. These relations were investigated in two studies, one using a large, representative sample of Illinois residents (N = 617) and the other using a community sample with a multi-method assessment of conscientiousness (N = 274). Across both studies, structural path analyses provided evidence for a model wherein conscientiousness predicted health, in part, through its relationship to both educational attainment and health-related behaviours. The findings suggest conscientiousness predicts health through a diverse set of mechanisms including, but not limited to, educational attainment and health-related behaviours.     

Contextualizing Acculturation: Gender, Family, and Community Reception Influences on Asian Immigrant Mental Health

This article investigates differences in the mental health among male and female immigrants from an ecological perspective, testing the influences of both individual acculturation domains and social contexts. Data from the first nationally representative psychiatric survey of immigrant Asians in the US is used (N = 1,583). These data demonstrate the importance of understanding acculturation domains (e.g., individual differences in English proficiency, ethnic identity, and time in the US), within the social contexts of family, community, and neighborhood. Results demonstrate that among immigrant Asian women, the association between family conflict and mental health problems is stronger for those with higher ethnic identity; among immigrant Asian men, community reception (e.g., everyday discrimination) was more highly associated with increases in mental health symptoms among those with poor English fluency. Findings suggest that both individual domains of acculturation and social context measures contribute to immigrant mental health, and that it is important to consider these relationships within the context of gender.