Medical students' involvement in patient care

In a recent issue of The Journal of Clinical Ethics, Peter A. Ubel and Ari Silver-Isenstadt reported on patients' willingness to participate in medical education. Their findings and other data they refer to suggest that patients are generally willing to interact with medical students, but that this willingness may vary depending upon the clinical setting. The authors concluded that patients hold a right to information regarding students' participation in their care and that openness in this regard is valuable. The Council on Ethical and Judicial Affairs (CEJA) of the American Medical Association (AMA) recently developed a policy that addresses the issues that were investigated by Ubel and Silver-Isenstadt.     

Child,parent, and peer predictors of early-onset substance use: a multisite longitudinal study

The purpose of this study was to identify kindergarten-age predictors of early-onset substance use from demographic, environmental, parenting, child psychological, behavioral, and social functioning domains. Data from a longitudinal study of 295 children were gathered using multiple-assessment methods and multiple informants in kindergarten and 1st grade. Annual assessments at ages 10, 11, and 12 reflected that 21% of children reported having initiated substance use by age 12. Results from longitudinal logistic regression models indicated that risk factors at kindergarten include being male, having a parent who abused substances, lower levels of parental verbal reasoning, higher levels of overactivity, more thought problems, and more social problem solving skills deficits. Children with no risk factors had less than a 10% chance of initiating substance use by age 12, whereas children with 2 or more risk factors had greater than a 50% chance of initiating substance use. Implications for typology, etiology, and prevention are discussed.     

Infant mental health home visiting therapists’ fidelity to the Michigan IMH-HV model in community practice settings

Implementation research suggests that fidelity to a therapeutic model is important for enhancing outcomes, yet can be difficult to achieve in community practice settings. Furthermore, few published studies have reported on characteristics of treatment fidelity. The present study examined fidelity to the Infant Mental Health Home Visiting (IMH-HV) model among 51 therapists with a range of experience practicing in community settings across the state of Michigan. IMH therapists completed fidelity checklists after every session with participating families to track use of 15 treatment strategies central to the IMH-HV model across the 12-month study period. Results indicated that the most commonly endorsed components utilized in home visits were developmental guidance and infant–parent psychotherapy, followed by the provision of emotional support. Use of IMH-HV components did not vary over time for the entire sample; however, patterns of strategies used showed somewhat more variability among more experienced therapists and when serving higher risk families. Findings demonstrate that IMH-HV therapists report a range of adherence to the model in community settings, with greatest fidelity to several model core components. Ongoing training in the flexible use of all core strategies may further enhance fidelity and contribute to positive outcomes for caregivers and their children receiving IMH-HV services.     

Don't judge a living book by its cover: effectiveness of the living library intervention in reducing prejudice toward Roma and LGBT people

In Hungary, prejudices toward Roma and the LGBT community are highly salient and explicit in public opinion, the media, and in the political discourse. The present study examined the effectiveness of the Living Library prejudice reduction intervention—in which participants as “Readers” have engaging contact with living “Books” who are trained volunteers from the Roma and LGBT communities. In a pre‐post intervention study with high school students (N = 105), results suggest that the Living Library intervention reduced participants’ scores on multiple measures of prejudice. The Living Library intervention appeared to be effective among both those participants whose friends endorsed prejudice or more tolerant attitudes toward Roma and LGBT people. In sum, Living Library appears to be a useful method for reducing prejudice in contexts which are characterized by strong negative attitudes toward these different groups.     

The neural underpinnings of facial emotion recognition in ischemic stroke patients

Deficits in facial emotion recognition occur frequently after stroke, with adverse social and behavioural consequences. The aim of this study was to investigate the neural underpinnings of the recognition of emotional expressions, in particular of the distinct basic emotions (anger, disgust, fear, happiness, sadness and surprise). A group of 110 ischaemic stroke patients with lesions in (sub)cortical areas of the cerebrum was included. Emotion recognition was assessed with the Ekman 60 Faces Test of the FEEST. Patient data were compared to data of 162 matched healthy controls (HC’s). For the patients, whole brain voxel-based lesion–symptom mapping (VLSM) on 3-Tesla MRI images was performed. Results showed that patients performed significantly worse than HC’s on both overall recognition of emotions, and specifically of disgust, fear, sadness and surprise. VLSM showed significant lesion–symptom associations for FEEST total in the right fronto-temporal region. Additionally, VLSM for the distinct emotions showed, apart from overlapping brain regions (insula, putamen and Rolandic operculum), also regions related to specific emotions. These were: middle and superior temporal gyrus (anger); caudate nucleus (disgust); superior corona radiate white matter tract, superior longitudinal fasciculus and middle frontal gyrus (happiness) and inferior frontal gyrus (sadness). Our findings help in understanding how lesions in specific brain regions can selectively affect the recognition of the basic emotions.     

通过演绎方式得概称句推理的逻辑

基于[4]中的逻辑系统G,本文通过删减和增加公理及规则给出3个逻辑G0,GD和Gs,同时,我们通过对正常主项选择函数添加不同的条件给出与三个逻辑相应的不同的模型定义。其中,G0是GD和Gs的基础。这些逻辑的给出是为了刻画通过演绎方式得概称句的推理的局部推理。