Auditory perception of speech and speech sounds in recent and recovered cases of aphasia

Auditory perception of speech and speech sounds was examined in three groups of patients with cerebral damage in the dominant hemisphere. Two groups consisted of brain-injured war veterans, one group of patients with high-frequency hearing loss and the other, a group of patients with a flat hearing loss. The third group consisted of patients with recent cerebral infarcts due to vascular occlusion of the middle cerebral and internal carotid artery. Word and phoneme discrimination as well as phoneme confusions in incorrect responses were analyzed from conventional speech audiometry tests with bisyllabic Finnish words fed close to the speech reception threshold of the patient. The results were compared with those of a control group with no cerebral disorders and normal hearing. The speech discrimination scores of veterans with high-frequency hearing loss and patients with recent cerebral infarcts were some 15–20% lower than those of controls or veterans with flat hearing loss. Speech sound feature discrimination, analyzed in terms of place of articulation and distinctive features, was distorted especially in cases of recent cerebral infarcts, whereas general information transmission of phonemes was more impaired in patients with high-frequency hearing loss.     

The interaction of locus of control expectancies and providing purpose on children's motivation

Children differing in locus of control orientation (internals, mediums, and externals' were administered an extended coding task following either a fictional rationale for the study (purpose incentive statement) or no purpose. As predicted, externals' performance under no purpose was significantly poorer and their rated interest in the task was significantly less favorable than those of internals. Also as predicted, these differences were nullified under the purpose incentive condition. The findings extend Lefcourt's (1967) suggestion that cue explication is important for externals to include external children, and support the position (Mischel, 1973; Rotter, 1975) that personality variables are increasingly important as a function of greater situational ambiguity. Implications of these findings for education and child-rearing are discussed.     

Les pratiques professionnelles au cœur de la crise dans la gestion de l’urgent : l’exemple de la crise du COVID-19

Our organisations have been severely shaken by the COVID-19 pandemic and the world of work has not been spared. Only essential activities continued in order to maintain a minimum level of functioning, just like in hospitals or in local authorities. During the first five months of the crisis in 2020 (from March to July), 34 interviews were conducted in these two public service entities in order to examine the management of urgent matters in the light of “activity” and at the heart of the crisis. The results show that while the emergency is mainly managed by an improvisation activity based on the intuition of the actors in the field, the crisis is managed by governance in a rational manner leading to the drafting of procedures after the event. This crisis situation pushed organisations to reconfigure themselves in an emergency, allowing the development of new professional practices. The strategies of damage control and proceduralization will be discussed. Perspectives are opened on the questions of training for these crisis situations against a background of developing presumption of ignorance.     

Effectiveness of Cognitive Behavioral Therapy for Anxiety and Depression Among Orthodox Jews

Several clinical papers have provided clinical recommendations for how to provide cognitive behavioral therapy (CBT) for obsessive-compulsive symptoms among Orthodox Jewish individuals. However, no published studies have described culturally adapted CBT for anxiety or depression in this population or quantified the effectiveness of such approaches. We evaluated the effectiveness of CBT for symptoms of generalized anxiety and depression in a sample of Orthodox Jews (n = 65) and a comparison sample (n = 42) presenting to the Center for Anxiety, a private outpatient clinic with three offices in the New York area (www.centerforanxiety.org). A chart review revealed that all patients received CBT-based interventions with appropriate religious-cultural adaptations of treatment, which we present in two case studies. We observed statistically and clinically significant treatment gains from pretreatment to midtreatment (anxiety: t = 8.56, p < .001; depression: t = 8.01, p < .001), and again from midtreatment through termination (anxiety: t = 3.68, p < .001; depression: t = 3.62, p < .001). No significant differences in anxiety or depression were observed between Orthodox Jewish patients and controls at any time point or for treatment effects (anxiety: Wilks’ Lambda = .950, F = 2.65, p = .076, η_p² = .050; depression: Wilks’ Lambda = .99, F = 2.00,p = .49, η_p² = .014). This paper offers clinical insight into delivery of CBT to Orthodox Jewish patients, as well as preliminary support for the effectiveness of CBT in treating symptoms of generalized anxiety and depression within this population.     

Never Turn Your Back on a Wave

This article reviews the intersections of personal and professional life development for the author. She offers perspective on three important life lessons that have guided her in this rewarding life path. First, be responsible in fulfilling and seeking professional opportunities. Second, be nice—respectful, warm, collegial, collaborative; treat others with the respect you want to receive yourself. Finally, “Never turn your back on a wave”—face the challenges that life presents, forthrightly, with energy and enthusiasm, and enjoy a full and fulfilling career and personal life.     

守护受试者的权益——对“药物研究与应用的伦理监督”

如何保障和守护临床试验研究中受试者的权益?这既是医生、患者(受试者)、工业界与公众注目的问题,也是医院伦理委员会工作面临并要解决的基本而至关重要的问题。从华西医院伦理委员会工作角度出发,分析了临床试验研究中的权益冲突和对受试者权益的科学、伦理与政策守护的要素,论述了如何保障受试者权益问题。     

医院数字化管理在临床决策中的作用

医院数字化建设是管理行为中的重要手段,借助这一工具,医疗决策的制定和执行将更加科学和规范,但同时医院数字化管理在法律和具体操作上对临床决策的管理还有一定的影响。讨论医院数字化在医疗决策中的合法性、安全性及对临床决策基本原则的作用。     

The Hospital Room as Uncanny: Psychoanalytic Observations and Recommendations for Pastors and Chaplains

This essay in applied psychoanalysis is written for the field of pastoral psychology, and it also has obvious affinities with the medical humanities. The author uses Freud’s (The uncanny. In J. Strachey (Ed. and Trans.), The standard edition of the complete psychological works of Sigmund Freud (Vol. 17, pp. 217–256). Vintage, London, 1919/2001) “The Uncanny” to question the concept of homelike hospital rooms. Instead of making patients feel more comfortable, the authors believes that these rooms could, in some cases, actually increase the anxiety of patients. The author uses Helena Michie’s personal story of her experience of touring a birthing suite to support this argument, as well as some poetry by Billy Collins. The author, however, does not stop with identifying a problem, as he also suggests that pastors and chaplains, when they provide care for their patients, should help them identify and use their own transitional and transformational objects. These objects, of course, will be highly idiosyncratic, and it is precisely this kind of attention—attention to the idiosyncrasies of individuals—that pastors and chaplains should be giving to those in their care. While there is a growing literature on D. W. Winnicott, who coined the term “transitional object,” and Christopher Bollas, who gave us the term “transformational object,” in medical and pastoral circles, the author suggests that attention to and the endorsement of the use of transitional and transformational objects should become a part of hospital policy, if only in chaplaincy handbooks, so as to recognize what many individuals are already doing.