Exposure to violence reduces empathetic responses to other’s pain

Past researches showed that empathy for pain not only triggers a resonance mechanism between other and self, but also is modulated by contextual factors. Using functional magnetic resonance imaging, the present study demonstrated that short-term media violence exposure reduced both pain ratings and also the activation of anterior insula and anterior mid-cingulate cortex to other’s pain. Thus, violence exposure modulated empathic responses to other’s pain based on a physiological desensitization.     

Psychology,health and health care

This article traces the development of the World Health Organization's emphasis on psychological and behavioural factors in health and notes its encouragement of recognition of these factors by member states. The article further outlines the reasons for this increasing recognition and stresses the important role of psychological and behavioural factors in the maintenance of health and prevention of illness.     

Quality-of-life assessment in HIV-infected psychiatric outpatients: Perceived health,functional status,symptoms, and preferences for cardiopulmonary resuscitation

Abstract

The current study had two purposes: (1) to describe the reliability and validity of a measure of quality of life (QOL) in HIV-infected psychiatric outpatients, and (2) to predict cardiopulmonary resuscitation (CPR) preferences from disease stage, depression, and other QOL factors. We studied 63 patients, who were seen in one year at an HIV/AIDS psychiatry clinic. The results provide evidence for the validity of our instrument as a measure of health status in an HIV-infected psychiatric population. Overall symptoms were the strongest associates of functional limitations. disability, and perceived health, but depression was also significantly associated with all measures of QOL. Twenty-two patients (35.5%) would not have wanted to be revived if their heart stopped beating the day of the study. Disease stage and poor mental health were independent predictors of this preference, but severity of depression, social support, fatigue, perceived health, functional limitations, and life satisfaction were not.     

A comparison of two online cognitive‐behavioural interventions for symptoms of depression in a student population: The role of therapist responsiveness

Objectives: The study aimed to compare the efficacy of eight weekly sessions of a self‐administered online CBT treatment (cCBT; n=51) to a therapist‐assisted email CBT treatment (eCBT; n=50) in University students. Design: The design was a randomised parallel group trial. The study randomised participants with symptoms of depression to one of two available treatments. Method: Participants were offered eight weekly sessions of either cCBT or eCBT. Participants completed the Beck Depression Inventory‐II (BDI‐II) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE‐OM) at pre‐and post‐treatment, at weeks 16 and 32 follow‐up. The Working Alliance Inventory‐Short Form (WAI‐SR) was completed at weeks 2, 4, and 6. Results: For both groups, pre‐post within group effect sizes reported were large for the BDI‐II and the CORE‐OM and these were maintained at follow‐up. Perceptions of working alliance were similar in each group, but Bond was significantly stronger for the eCBT condition. WAI scores correlated more positively with the outcome on BDI‐II for those in the eCBT condition than the cCBT condition, but not significantly. Conclusion: There were no significant differences between the two online treatments, both reduced depressive symptoms and improved general functioning. Similarly, at post‐treatment and follow‐up, clinical improvement and recovery was demonstrated for both groups equally. The study demonstrates the possibility for cCBT in a university setting that may contribute to addressing the shortcomings in meeting increasing demands that mental health services presently face.     

The Twofold Assumption: A Response to Cole-Turner,Moritz, Peters and Peterson

Abstract

The article discusses points and perspectives offered by the four respondents to the R.J. Russell Fellow Lectures for 2013/14. Joshua M. Moritz and Ron Cole-Turner bring in new material from biblical and patristic traditions relevant for the proposal of deep incarnation. How does the concept of deep incarnation fare in relation to tradition and science? Ted Peters and Daniel J. Peterson raise questions about the compatibility between a compatibilist view of divine action and creaturely freedom on the one hand, and ideas of kenosis on the other. Which models of kenosis models are workable, and which forms of compatibilism?     

Health Literacy,Health Inequality and a Just Healthcare System

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy.     

Toward a Reconstruction of Medical Morality

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary.     

Inconsistent child-rearing: A reply to rosenthal

Abstract

In a reply to our paper (Kohlmann, Schumacher, & Streit, 1988), Rosenthal (in a Letter to the Editors, this issue) primarily gives some comments on findings regarding the association of inconsistent child-rearing behavior and anxiety in the child. Results of our study were compared to results from a study by Rosenthal, Finkelstein, Ni, and Robertson (1959).     

History and Analysis of Delayed Discovery Statutes of Limitations in Adult Survivor Litigation

Summary

In this chapter, attorney Mary R. Williams examines how while Childhood Sexual Abuse (CSA) cases share many of the types of facts for which delayed discovery, mental incapacity, equitable estoppel and other legal statutes of limitations doctrines were created, the combination of factors of CSA cases, including unusual social dynamics and long-term psychological effects, does not fit exactly with any of these legal doctrines. She explores the historical development of delayed discovery statutes of limitations, evaluates the different types of statutes and case law, and analyzes the problematic use of the concept of repression in legislation. This chapter interprets her ground-breaking state-by-state tabulations of delayed discovery statutes of limitations and reported appellate decisions on limitations in CSA actions, published in this volume as appendices A, B, and C.     

Substitutes for leadership in anaesthesia teams and their impact on leadership effectiveness

In this study we aim to increase our understanding of leadership in anaesthesia teams by investigating the relationship between substitutes for leadership, leadership behaviour, and team performance in situations with varying levels of routine and standardization. The present study relied on video recordings of 12 anaesthesia teams in a simulated setting with the occurrence of a nonroutine event. Clinical team performance was measured by the speed of adequate team reaction to this event. The leadership behaviours observed were coded either as content oriented (e.g., information transmission) or structuring (e.g., assigning tasks). Results showed that leadership behaviour changed depending upon the level of routine of a situation, the degree of standardization, and, to some extent, on the experience of team members. Leadership tends to be positively related to team performance during nonroutine and low standardized situations but negatively related to team performance in routine and highly standardized situations. Furthermore, leadership is only slightly related to team member experience. This study improves our understanding of influences of substitutes for leadership on successful leadership behaviour in anaesthesia teams. The findings also lead to suggestions for both further research and the enhancement of team leadership in critical care.