Personal responsibility,empowerment and medical utilization: a theoretical framework for considering counselling and offset costs

The problem of effectively managing patients with functional somatic symptoms remains huge in both primary and hospital care, although the potential benefits of mental health interventions such as counselling or psychotherapy are still not widely accepted. Unfortunately, the cost-effective evaluation of counselling has been beset by methodological problems, which stem from attempting to make comparisons between counsellors with different types of training, therapeutic approach and case mix. Since these real-world variations in counselling practice are likely to remain, it is proposed that a different approach to the evaluation of cost-effectiveness should be adopted in the hope of accelerating acceptance of the value of psychological interventions for the army of patients who are currently labelled as ‘difficult’ or ‘heartsink’ and who do not receive the treatment they deserve from the health-care services. It is proposed that, since the common aim of almost all mental health interventions is to engender or enhance a sense of ‘personal responsibility’ in patients/clients, this core objective should form an agreed ‘yardstick’ against which to evaluate the impact of various mental health interventions. Furthermore, since personal responsibility and future health-care utilization (and associated costs) can be assumed to be directly causally related, it is proposed that offset costs should form the basis for future cost-effectiveness evaluations.     

The role of personal resources in explaining well-being and performance: A study among young veterinary professionals

This study examines the role of three personal resources (i.e., proactive behaviour, reflective behaviour, and self-efficacy) in the Job Demands–Resources (JD-R) model in order to predict self and other ratings of performance. The sample consisted of 860 Dutch veterinary professionals and 170 colleagues. We hypothesized and found that work engagement mediates the relationship between job as well as personal resources and extrarole performance and the relationship between job resources and work engagement. Although hypothesized, we found no support for the mediating role of exhaustion in the relationship between job demands as well as personal resources and inrole performance. Moreover personal resources were directly related to in- and extrarole performance. In conclusion, the study expands the JD-R model by integrating personal resources at a behavioural level and performance measures in the model, and shows that personal resources have a mediating and initiating role in explaining work engagement and performance in young veterinary professionals.     

Resilience is associated with better recovery in Chinese people diagnosed with coronary heart disease

This study investigated the impact of personal resilience (a composite measure of optimism, perceived control and self-esteem) on outcome measures in 67 Chinese coronary heart disease patients in response to an 8-week rehabilitation programme. The effect of personal resilience on posttraumatic growth attributed to the onset of heart disease was also examined. Results indicated that coronary heart disease patients high in personal resilience achieved better outcomes than those low in personal resilience, as indicated by higher physical and mental summary measures in SF-36, lower cholesterol levels and better performance on the 6?min walk test. Moreover, personal resilience was demonstrated to be a significant predictor of the level of posttraumatic growth although the rehabilitation programme exerted a weak mediating effect on the link between personal resilience and posttraumatic growth. Findings were discussed in relation to clinical implications of the construct of personal resilience and the intervention programme.     

The effect of message framing and the nature of the targeted illness on individuals’ intention to participate in clinical trials

IntroductionClinical trials are considered as the most useful methods to evaluate the efficacy of new medical treatments, but the participation of healthy individuals is often too small, which limits the statistical power of the trial and hence its effectiveness.ObjectiveThe goal of the present research is to assess, for the first time, the effects of message framing (gain versus loss) and of the nature of the illness targeted by a clinical trial (highly- versus mildly-contagious) on individuals’ intention to enter it.MethodsThe experimental manipulation is carried out within a scenario promoting a clinical trial, in a 2 (framing: gain vs loss) × 2 (nature of the illness: highly- vs mildly-contagious) between-participants design. After reading the scenario, participants were asked to rate their intention to enter the trial and their perception of its utility.ResultsStatistical analyses validated a causal model explaining that a gain-framed message describing a highly-contagious illness increases the perception of the utility of the clinical trial, which in turn enhances the intention to participate.ConclusionThe discussion mainly focuses on the contributions of these findings at a theoretical level, considering the limits and potential of their possible application.     

Organizational climate in Spanish Public Health Services: Administration and Services Staff

The main goal of this research is to explore the organizational climate perceived by administrative and healthcare personnel working in Spanish healthcare services, analyzing the differences according to their health specialization, sex, age and professional status. The sample was made up of 3,787 individuals working in the administrative and healthcare services of the Public Health System of the Principality of Asturias, 88.7 % were working in specialist care and 11.3 % in primary care. Mean age was 51.88 (standard deviation of 6.28); 79.9 % were women and 20.1 % men. The organizational climate was assessed with the CLIOR scale. The organizational climate perceived is moderately positive, with a global mean of 3.03 on a scale of 1 to 5 points. The differences are statistically significant (p < .01) according to specialty, age and profession. A better working climate is perceived in primary care than in specialist care, and among older as compared to younger workers. The results indicate that the working climate perceived by administration and services staff employees in the Spanish healthcare context is moderately positive, with a better perceived climate in primary care than in specialist care.     

Luck and Free Will

This essay sketches a problem about luck for typical incompatibilist views of free will posed in Alfred Mele, Free Will and Luck (2006), and examines recent reactions to that problem. Reactions featuring appeals to agent causation receive special attention. Because the problem is focused on decision making, the control that agents have over what they decide is a central topic. Other topics discussed include the nature of lucky action and differences between directly and indirectly free actions.     

Les préjudices professionnels des jeunes victimes de dommages corporels. Partie 3 : Les difficultés liées à l’évaluation de l’incidence professionnelle

Though professional damages in respect of young personal injury victims are recognized in principle by the Dintilhac group, and confirmed by the Court of Cassation in terms of full compensation for damages suffered, the assessment of such professional damages remains difficult, and the source of myriad legal disputes. The recognition and assessment of professional incidence raises the question of the risk of double compensation: The cumulative award of lifetime compensation for lost future earnings and of compensation for professional incidence not recognized at first by the 2nd chamber of the Court of Cassation is a source of debate in terms of both doctrine and jurisprudence. Though a source of discussion, the cumulative award of compensation for professional incidence and for educational, academic or training damages (PSUF) is more consensual.     

Le rôle modérateur du harcèlement environnemental au travail dans la relation entre l’attachement au lieu de travail et le soutien organisationnel perçu. Étude auprès d’un échantillon féminin

This article examines the effect of environmental harassment at work in the relationship between attachment to the workplace and perceived organizational support. A survey was conducted via a questionnaire with 304 employees in different professional sectors (commerce, healthcare, teaching, administration) in the public or private sector. Analyses show that (a) attachment to the workplace and environmental harassment at work are strongly associated with perceived organizational support, the former positively and the latter negatively, and (b) two dimensions of environmental harassment at work, namely manipulation of the work environment and manipulation of the personal space, moderate the relationship between attachment to place and perceived organizational support, reducing the effect of this relationship. The practical implications of the research are discussed.     

A re-examination of the 2x2 model of perfectionism,burnout, and engagement in sports

Studies examining perfectionism, engagement and burnout in sport have produced different levels of support for the hypotheses of the 2 × 2 model of perfectionism. One explanation for why this is so is that researchers have used different measures of perfectionism when testing the hypotheses. To determine whether this is the case, in the current study we retested the hypotheses of the 2 × 2 model for engagement and burnout using different measures of perfectionism. A sample of 401 adult athletes from various sports and levels completed measures of athlete engagement and burnout, along with two measures of perfectionism. Moderated regression analyses revealed that support for the hypotheses of the 2 × 2 model did indeed differ depending on the measure of perfectionism. This was evident for both burnout (emotional and physical exhaustion and reduced sense of accomplishment) and engagement (dedication and vigor). The findings are aligned with similar work that has found differences in support for the hypotheses of the 2 × 2 model when using other measures of perfectionism for engagement and, importantly, provide the first evidence that this extends to athlete burnout. Researchers will need to consider the influence of the measures of perfectionism used when interpreting, comparing, and summarising future research on the 2 × 2 model for these and other outcomes.     

正念与大学生智慧推理的关系：个人成长主动性的部分中介作用

为了考察正念、个人成长主动性(PGI)与智慧推理之间的关系,采用五因素正念量表、个人成长主动性量表与智慧推理量表对242名18-27岁成年早期的大学生进行调查,探讨正念对智慧推理的影响,并检验个人成长主动性的中介效应模型。结果发现：（1）正念对智慧推理水平具有显著的正向影响;（2）个人成长主动性在正念对智慧推理的影响中发挥部分中介作用。