Indigenizing CBPR: Evaluation of a Community-Based and Participatory Research Process Implementation of the Elluam Tungiinun (Towards Wellness) Program in Alaska

The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.     

Longitudinal study of striatal activation to reward and loss anticipation from mid-adolescence into late adolescence/early adulthood

Adolescent risk-taking behavior has been associated with age-related changes in striatal activation to incentives. Previous cross-sectional studies have shown both increased and decreased striatal activation to incentives for adolescents compared to adults. The monetary incentive delay (MID) task, designed to assess functional brain activation in anticipation of reward, has been used extensively to examine striatal activation in both adult and adolescent populations. The current study used this task with a longitudinal approach across mid-adolescence and late adolescence/early adulthood. Twenty-two participants (13 male) were studied using the MID task at two time-points, once in mid-adolescence (mean age = 16.11; SD = 1.44) and a second time in late adolescence/early adulthood (mean age = 20.14; SD = .67). Results revealed greater striatal activation with increased age in high- compared to low-incentive contexts (incentive magnitude), for gain as well as for loss trials (incentive valence). Results extend cross-sectional findings and show reduced striatal engagement in adolescence compared to adulthood during preparation for action in an incentive context.     

THE IMAGO DEI AS A WORK IN PROGRESS: A PERSPECTIVE FROM PALEOANTHROPOLOGY

This article considers the imago Dei from the perspective of paleoanthropology. We identify structural, functional, and relational elements of the imago Dei that emerged mosaically during human evolution. Humans are unique in their ability to relate to each other and to God, and in their membership of cultural communities where shared attention, the transmission of moral norms, and symbolic behavior are important elements. We discuss similarities between our approach and the concept of theosis adopted in the Eastern Orthodox Church.     

IMAGO DEI,DUALISM, AND EVOLUTION: A PHILOSOPHICAL DEFENSE OF THE STRUCTURAL IMAGE OF GOD

Most contemporary theologians have distanced themselves from views that identify the image of God with a capacity or a set of capacities that humans have. This article examines three arguments against the structural view and finds them wanting. The first argument is that the structural view entails mind/body dualism and dualism is no longer viable given neuroscience and contemporary philosophy. Against this, I argue that contemporary forms of dualism are able to circumvent such worries and are at least prima facie plausible. The second claim is that structural views end up disvaluing the human body and our relatedness. Here, I argue that neither the structural view nor dualism has such consequences. The third issue consists of various evolutionary worries that have to do with the lack of a clear‐cut boundary between human capacities and the capacities of nonhuman animals. As a response, the article argues that although there might not be a clear‐cut set of capacities that all humans share, we could still have a notion of human distinctiveness that is sufficient for the structural image of God.     

难治性丙型肝炎研究新进展

随着聚乙二醇化干扰素(IFN)的普及应用和慢性丙型肝炎规范化治疗的开展,其治愈率不断提高.但疗效不佳的慢性丙型肝炎患者不断积累,难治性慢性丙型肝炎患者成为临床医生必须面对的挑战.难治性丙型肝炎患者应当分为两类,第一类为“难治疗”性慢性丙型肝炎患者,该类患者由于宿主条件限制,不能耐受IFN联合利巴韦林(RBV)的标准治疗,如儿童和老年人、慢性肾功能衰竭患者等.第二类为“难治愈”性慢性丙型肝炎患者,该类患者可以耐受标准治疗方案,但按照应答指导的治疗原则(RGT)治疗后,效果仍然不佳或复发.本文就近年关于难治性丙型肝炎的研究进展,从难治性丙型肝炎的定义、机制、治疗诸方面作一综述.     

青少年的学校适应问题：家庭亲密度、家庭道德情绪和责任感的作用

随机选取某市三所普通中小学四、六、八、十年级的755名青少年为被试,使用自评和他评问卷探讨家庭亲密度、家庭道德情绪和责任感与青少年学校适应之间的关系。结果显示：（1）青少年家庭亲密度、责任感与学校适应问题存在性别差异,女生家庭亲密度和责任感高于男生,外化和学业问题少于男生;家庭亲密度、道德情绪和责任感随年龄增长呈下降趋势;（2）家庭亲密度正向预测道德情绪和责任感,直接和间接负向预测青少年学校适应问题。（3）责任感负向预测学校适应问题,并在家庭亲密度和学校适应问题之间起部分中介作用;结构方程模型各指标的拟合效果较好。家庭亲密度、责任感是学校适应问题的良好预测指标。     

Problematic,absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed.     

Blended courage: Moral and psychological courage elements in mental health treatment seeking by active duty military personnel

We propose that seeking mental health care in an environment with heightened stigma may combine elements of both psychological and moral courage. Interviews of 32 active duty US Army personnel about their process of seeking current mental health care were analyzed for themes of voluntary action, personal risk, and noble or worthwhile goals (benefits). Risks and benefits were divided into internal risks and benefits, characteristic of psychological courage; and external risks and benefits, characteristic of moral courage. Concerns about external risks were themes in all narratives, while concerns about internal risks were themes in only about half of narratives. Both internal and external benefits of treatment were themes in approximately three-quarters of the narratives, whereas doubts about internal (but not external) benefits were also expressed at a similar rate. Thus, participants described an act of blended courage, with social risks of moral courage taken for wellness goals of psychological courage.     

Toward a cosmopolitan ethos

There has been a rising trend in cosmopolitan moral theory to seriously take into consideration the human's rootedness in, and partiality toward, particular cultures, places, peoples and traditions. This essay suggests that reframing our theorizing on cosmopolitanism from one that primarily addresses an ethico-political set of questions to one that addresses questions related to moral psychology, personal and collective identity formation and the ways in which civilizations and cultural communities cultivate an ethos may assist in the task of generating a rooted form of cosmopolitanism. Conceptualizing cosmopolitanism as an ethos entails a shift from considering our moral obligations to distant others toward a focus on the types of dispositions and character traits necessary to forge a sense of intercultural solidarity. Through an analysis of the ideas of ‘diaspora’, ‘proximity’, ‘partiality' and the ‘foreign’, it will be suggested that through our rootedness in particularity, and our ability to be partial to particular persons and identify with particular cultures, we are capable of fostering a sense of world citizenship that can serve as a foundation upon which we can secure a tenable global ethic for our pluralistic society.