Analytic practice: Convergences and divergences1

The author discusses current convergences and divergences concerning analytic practice. After presenting a clinical vignette that can be understood differently according to different theoretical approaches, he discusses Wallerstein’s proposal of a common ground in psychoanalysis and suggests that the present state of the art indicates that psychoanalysis is a pluralistic discipline, with different ways of training and practising it, and that the main challenge is to improve our ability to listen to and to learn from different approaches.     

国内外医学专业杂志发表医学人文相关文章情况分析

总结分析了201 2年1月～2013年5月国外4种医学专业杂志(BMJ、JAMA、LANCET和NEJM)医学人文相关文章的发表情况,并与国内4种知名医学专业杂志(《中华医学杂志》、《中国实用内科杂志》、《中华内科杂志》和《中华外科杂志》)发表的医学人文类文章的情况进行对比分析,结果发现,国外医学专业杂志医学人文类文章比重较大,而且涉及的领域较广,包括医疗卫生政策管理、医学社会学、对患者及医生的人文关怀、医疗风险告知和医疗差错告知的文章.而国内与国外杂志相比存在较大差距.     

Computer‐based training to teach observers to accurately score problem behavior using fast forwarding at 5x normal speed

The current study evaluated whether a computer‐based training program could improve observers' accuracy in scoring discrete instances of problem behavior at 5x normal speed using a multiple‐baseline design across subjects. During pretraining and posttraining, observers attempted to score multiple examples of problem behavior at 5.0x without feedback. During training, participants scored multiple examples of problem behavior at 5.0x with automated feedback. Researchers measured omission (missing problem behavior) and commission (scoring other behavior as problem behavior) errors and the total duration of scoring time to determine the observers' accuracy and efficiency, respectively. After training, all participants scored instances of problem behavior with less than 11% error using 5.0x. The time required to score the videos across 90‐min observations was reduced by 66%. Results extend previous evaluations of fast forwarding by demonstrating that the training program could be used to teach observers to accurately score problem behavior using a speed faster than 3.5x.     

Comparing computer‐based training and lecture formats to teach visual analysis of baseline‐treatment graphs

Accurate analysis of data is vital to the validation of interventions. As such, there has been a recent increase in studies evaluating visual analysis training procedures. However, past investigations have not evaluated direct and indirect visual analysis training methods with matched instructional content that was systematically designed. Furthermore, training has rarely included assessment of generalization and maintenance of visual analysis skills. The purpose of the current dissertation study was to compare the effectiveness and efficiency of (a) computer‐based training, (b) lecture formats with and (c) without the opportunity to pause, and (d) a no‐training group to teach visual analysis of AB graphs to university students. To make these formats directly comparable, the instructional content was equated by ensuring information and examples were identical across the three training procedures. Eighty‐three students were randomly assigned to one of the four groups. Results showed that all three training formats produced increases in accurate responding compared to the no‐training group. Visual analysis skills generalized to novel graphs and maintained approximately 2 weeks following all trainings. These results suggest that structured approaches that are carefully designed to train visual analysis are effective and lead to gains that generalize and maintain in the absence of training.     

Mindfulness-based programs,perceived stress and well-being at work: The preferential use of informal practices

IntroductionOrganizations which engage in the promotion of well-being are likely to prevent mental health issues in workers. Mindfulness-based interventions offer new perspectives to increase well-being at work. However, the issue of finding time and framework to practice at work is important. Recent studies suggested that informal mindfulness practices could be useful in reducing stress and increasing well-being.ObjectiveThe present study aimed to study how the duration and type of mindfulness practice may enhance employees’ well-being.MethodA multi-method (qualitative and quantitative), controlled pre/post design study (N = 72) was conducted to collect data about the type of preferred mindfulness practices used during an 8-week MBSR program, and to analyse the effects of the program on employees’ well-being. Number of sessions, number of days of practice, and practice time per day were used as moderators.ResultsParticipants reported a preferential use of brief, informal practices. Employees who followed the MBSR program reported higher levels of well-being compared to the wait-list control group (η² = .194). Those who preferentially used informal practices showed the same increase in well-being as those who reported preferentially using formal practices. The number of days of practice did not moderate the effect of the intervention on well-being.ConclusionBrief and informal mindfulness practices appear to be a promising means of increasing well-being in everyday life. Further research is needed to compare an 8-week mainly informal mindfulness-based program to a classical MBSR program to identify whether informal practices may be sufficient to increasing employees’ well-being.     

Fonctionnements et dysfonctionnements des psychothérapies : synthèse de la littérature et présentation de deux méthodologies associées aux meilleurs résultats

IntroductionPsychological difficulties are part of higher stakes health issues. What are the real effects and the difficulties to generate results of psychotherapies?Literature resultsPsychotherapy is efficient for multiple psychological disorders, as well in controlled as in naturalistic studies, and participate in reduction of health expenditure. However, all patients do not get real benefits from care, patients can deteriorate or drop-out treatment, and persistent side effects can occur; clinicians overestimate their efficiency and their performances decline during their career. Two promising methodologies seems to be associated with better outcomes: Routine Outcome Monitoring (ROM) and a specific form of training clinician expertise named “Deliberate Practice”.DiscussionUsing client feedback allows to implement ROM and “Deliberate Practice” in routine care.ConclusionImplementation of Routine Outcome Monitoring should be encouraged in French Speaking countries to produce evidence-informed practice for the delivering, the improvement and the payment for psychotherapy expenditure.     

Crafting Mosaics: Person-Centered Religious Influence and Selection in Adolescent Friendships

This research addresses the intersection of two key domains of adolescents’ lives: religion and peer networks. Religion scholars argue that religion is multi-faceted and better understood by focusing on combinations of indicators (i.e., mosaics), versus a variable-centered approach. We adopt this framework and investigate the interplay between religion and peer networks, both in how religious mosaics are shaped by friends and how religious profiles affect friend selection dynamics. With data from two schools in the National Longitudinal Study of Adolescent Health, we estimate religious mosaics using latent class analysis (LCA) to identify profiles consisting of combinations of commonly available survey-based measures of religious attitudes, behaviors, and identities. Finding evidence of theoretically expected profiles, we then use stochastic actor–based models (SABMs) to investigate network dynamics for these LCA-based religious profiles. We demonstrate how the profile data can be integrated within the SABM framework to evaluate processes of friend selection and influence. Results show evidence of adolescents influencing one another's religious mosaics, but not selecting friends on that basis.     

Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

Complementary teaching practices: Ignatian pedagogy and Buddhist‐inspired compassion meditation

While scholarly discussions on Jesuit education are plentiful, inquiries related to Ignatian pedagogy are rare. This article examines the applications of Ignatian pedagogy by juxtaposing it with the analysis of a Buddhist‐inspired and interdisciplinary contemplation program, Cognitively‐Based Compassion Training® (CBCT®). Drawing from the author's experience in teaching CBCT® at a Jesuit University, this article explores how CBCT® aligns with the Ignatian Pedagogical Paradigm's five elements: context, experience, reflection, action, and evaluation. This study uses psychometrical measurements, such as the Compassionate Love for Humanity Scale, to document how my interdisciplinary approach may enhance participants' emotional well‐being and widen their ethical concerns. As these outcomes are inherently cross‐disciplinary and include intellectual and affective dimensions, they cannot be achieved through a single field. Building a bridge between the Ignatian Pedagogical Paradigm and CBCT® provides a successful strategy for the educational objectives of developing the whole person and forming a compassionate character.