Family systems psychiatry in an acute in‐patient setting: the implementation and sustainability 5 years after its introduction

From 2003 to 2008 a multicentre research project, systems therapy methods in acute psychiatry (SYMPA), attempted to establish structured in‐patient treatment based on systemic interventions in German non‐university psychiatric hospitals. Utilising multi‐professional family systems training for team members in six in‐patient wards, its main goal was to improve the involvement of familial and non‐familial important others. This follow‐up study explores the sustainability of family systems psychiatry by evaluating the frequency of the utilisation of four core systemic interventions; elements of a systemic organizational culture in psychiatry; and institutional barriers to this new approach. The degree of implementation was high to moderate, depending on the intervention. More intense communication developed among staff of different professions and the status of nursing staff improved. Organizational barriers to implementation included the ambiguous role of junior doctors in teams, continuously understaffed wards and frequent over‐occupancy.     

Perceived Group Identity Alters Task-Unrelated Thought and Attentional Divergence During Conversations

Task-unrelated thought (TUT) occurs frequently in our daily lives and across a range of tasks, but we know little about how this phenomenon arises during and influences the way we communicate. Conversations also provide a novel opportunity to assess the alignment (or divergence) in TUT during dyadic interactions. We conducted a study to determine: (a) the frequency of TUT during conversation as well as how partners align/diverge in their rates of TUT, (b) the subjective and behavioral correlates of TUT and TUT divergence during conversation, and (c) if perceived social group identity impacts TUT and TUT divergence during conversation. We used a minimal groups induction procedure to assign participants (N = 126) to either an ingroup, outgroup, or control condition. We then asked them to converse with one another via a computer-mediated text chat application for 10 min while self-reporting TUTs. On average, participants reported TUT about once every 2 min; however, this rate was lower for participants in the ingroup condition, compared to the control condition. Conversational pairs in the ingroup condition were also aligned more in their rates of TUT compared to the outgroup condition. Finally, we discuss subjective and behavioral correlates of TUT and TUT divergence in conversations, such as valence, turn-taking ratios, and topic shifts.     

Social relations and presence of others predict bystander intervention: Evidence from violent incidents captured on CCTV

Are individuals willing to intervene in public violence? Half a century of research on the “bystander effect” suggests that the more bystanders present at an emergency, the less likely each of them is to provide help. However, recent meta-analytical evidence questions whether this effect generalizes to violent emergencies. Besides the number of bystanders present, an alternative line of research suggests that pre-existing social relations between bystanders and conflict participants are important for explaining whether bystanders provide help. The current paper offers a rare comparison of both factors—social relations and the number of bystanders present—as predictors of bystander intervention in real-life violent emergencies. We systematically observed the behavior of 764 bystanders across 81 violent incidents recorded by surveillance cameras in Copenhagen, Denmark. Bystanders were sampled with a case–control design, their behavior was observed and coded, and the probability of intervention was estimated with multilevel regression analyses. The results confirm our predicted association between social relations and intervention. However, rather than the expected reversed bystander effect, we found a classical bystander effect, as bystanders were less likely to intervene with increasing bystander presence. The effect of social relations on intervention was larger in magnitude than the effect of the number of bystanders. We assess these findings in light of recent discussions about the influence of group size and social relations in human helping. Further, we discuss the utility of video data for the assessment of real-life bystander behavior.     

重症胰腺炎外科治疗观之辩

分析了当前外科治疗重症胰腺炎（ＳＡＰ）原则仍然不能提高手术后生存率的原因，用辩证法的观点，剖析当代手术治疗ＳＡＰ的误区，提出判断ＳＡＰ手术时机的简易方法和ＳＡＰ开腹手术的基本原则，应该按照辩证法的观点来正确看待ＳＡＰ的手术时机，应该用发展的眼光来分析传统治疗ＳＡＰ的手术方法，不能用一成不变的观点对待传统的手术方式，不能照搬书本教条，不能违背外科手术的基本原则。只有这样才有助于提高外科治疗ＳＡＰ的成功率。