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.     

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.     

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.     

L’avis du CCNE no 126 (15 juin 2017) sur les demandes sociétales de recours à l’assistance médicale à la procréation : un pas en avant et deux en arrière…

On June 15, 2017, the National Consultative Ethics Committee released an opinion in favour of the extension of medically assisted procreation (MAP) to lesbian couples and single women. This opinion recommends a reversal of the medical model, which serves as the starting point for the regulatory framework concerning MAP, and expresses its support to social and family evolutions. Nonetheless this liberal and progressive stand could be a mere smokescreen, if it does not result in any meaningful implementation due to practical hindrances; moreover, this seemingly progressive stand could be questioned in view of the conservative position expressed on the issues of surrogacy and oocyte self-preservation by the committee in the same opinion.     

Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood

Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.     

Empowering Muslim children’s spirituality in Malay Archipelago: integration between National Philosophical Foundations and Tawakkul (trust in God)

Multiple studies indicated that children raised to be spiritual were found to be happier, have more resilience and positive outlook towards life events. This paper attempts to explore and integrate the value of spirituality and religious practices. It is approached through the understanding and application of the tawakkul (trust in God) concept, as perceived from an Islamic viewpoint. This aspect is explored through the consolidation of the ‘believing in God’ component, as highlighted in the National Philosophical Foundations in Brunei, Indonesia and Malaysia to tawakkul. It will further seek to find the prospect of empowering Muslim children’s spirituality through such integration. This theoretical paper is based on the Islamic foundations and characteristics; its implementation and implications. The outcome illustrates indication of ‘divine involvement’ as the main essence of tawakkul; resulting sustainable religious, spiritual and moral enhancement. Moreover, an internalised and implicit form of tawakkul should be encouraged to promote self-understanding.