General mood of professional caregivers in child care centers and the quality of caregiver–child interactions

The present study is the first to relate professional caregivers’ general mood to the observed quality of their interactions with the children in their care. A total of 238 female caregivers from 133 child care groups in 64 centers completed the General mood scale of Bar-On’s Emotional Quotient Inventory (1997) and was observed while playing with small groups of children. Factor analysis on the General mood scale yielded five general mood factors, one negative and four positive. Two positive mood factors in particular, i.e., positivity and optimism, were found to contribute positively to the quality of professional caregivers’ behavior toward the children and, through their caregiving behavior, to the children’s well-being.     

AN ISLAMIC APPRAISAL OF MINDING THE GAP

The neglect of psycho‐spiritual needs of patients as they traverse the modern healthcare system has been a featured theme in medical literature over the past decade. This literature, which often highlights in‐patient palliative care, as well as acute and critical care settings, influences practice guidelines and protocols of doctors and nurses. In this essay, I review some of the pertinent issues raised in the literature and examine the validity of placing an ethical perspective on this issue. I also compare Islamic theocentric perspectives with secular, non‐theistic perspectives on restoring psycho‐spiritual care for patients. I then develop a framework for pastoral intervention based on aspects of the Islamic tradition and elaborate this framework by addressing clinical contexts and cases. The essay is an exposition based upon a review of the modern medical literature, an analysis of some of the traditional Islamic written sources, and the observations of the investigator, a practicing physician and an American Muslim.     

THE SPIRIT IN CREATION: A UNIFIED THEOLOGY OF GRACE AND CREATION CARE

This essay identifies one of the deeper theological sources of the tendency toward environmental neglect in evangelical and Pentecostal theology and proposes a theological vision that facilitates a vision of creation care as a dimension of Christian formation. The first section identifies, describes, and evaluates the traditional distinction between common and special grace or the natural and the supernatural orders as a theological foundation for environmental neglect in Pentecostal theology. The second and third sections propose that a pneumatological vision of grace based on a fundamental trinitarianism provides Pentecostals and other Christians with a way to overcome these stark dualisms and to attain a more unified and comprehensive vision of God's grace that is more conducive to creation care. The fourth section presents a case for seeing creation care as a pneumatological and proleptic participation in the eschaton and, as such, as a dimension of Christian formation and sanctification.     

Interpersonal Psychotherapy for Late Life Depression: Current Status and New Applications

Interpersonal Psychotherapy (IPT) is an empirically-supported treatment for depression and other mental disorders. This article discusses the structure of IPT, its use with older adults, and research that supports its efficacy with depressed older people. Depressed older persons with significant health problems or cognitive impairment present special challenges for those conducting IPT and other psychotherapies. Promising new psychotherapies developed for depressed older adults with cognitive impairment and those living in nursing homes are reviewed. Recommendations are made for use of IPT with older adults in nursing homes.     

Protection of Life and Human Dignity: The German Debate between Christian Norms and Secular Expectations

The German debate on bioethics and medical ethics turns on achange in the meaning of human dignity. Such dignity is increasinglyrendered contingent upon a person's empirically assessable qualityof life. In contrast to such dignity-endowed human life, a merelybiological human life is taken to disqualify its bearer fromsuch dignity, depriving his life of the protection "respectfor human dignity" would otherwise guarantee. The idea of a"life not worth living" or "undignified life" evokes categories,which were developed at the beginning of the 20th century, andlater informed the crimes of National Socialist medicine inGermany. Against this secular development, this article analysesthe theological and church-based discussion of basic bioethicalquestions in Germany, especially the controversy among Protestants:once Protestant ethicists abandon an explicitly theologicalbasis for their arguments, their conclusions come to closelyresemble those of the secular participants in the debate. Asa result, such Protestants relativize fundamental ethical norms.They subordinate, along with their secular environment, theprotection of life to respect for autonomy. They thus preparethe ground for a revival of the risky concepts of the past.     

The Lost Voice: How Libertarianism and Consumerism Obliterate the Need for a Relational Ethics in the National Health Care Service

This article analyzes the contribution Christian ethics mightbe able to make to the ethical debate on policy and caregivingin health and social care in the United Kingdom. The articledeals particularly with the concepts of solidarity and subsidiaritywhich are essential in Christian social ethics and health careethics, and which may be relevant for the ethical debate onhealth and social caregiving in the United Kingdom. An importantargument in the article is that utilitarian and market-drivenpolicies in the National Health Service (NHS) and the socialcare system have marginalized the position of the elderly andhave seriously impoverished the quality of care for the elderly.The neglect of the elderly and other vulnerable groups is alsothe result of widespread consumerist attitudes among patientsand of libertarian models of noninterference which are affirmedby a public ethos of self-sufficiency and counter-dependency.Those who need care dare not make their need known to othersand ask for help, while simultaneously those who could helpare so intimidated by the public affirmation of privacy andnegative rights that they do not dare to offer help except ifthis is explicitly demanded. This distant and standoffish attitudeis in an important way responsible for the fact that the voiceof those in need is altogether lost to the public forum. Christianethics puts much emphasis on responsibility and solidarity withthe needy other but is not able to have much impact on the deliveryof care in a secularized society and health care system likethe NHS. Nonetheless, Christianity still has a powerful andrespected voice, by speaking up for those who cannot speak forthemselves, such as the elderly and the handicapped. Christianscan find allies in the ethics of care and other relational approachesin health care ethics in order to combat libertarianism, consumerism,and utilitarianism.     

The quality of caregiving in child care: relations to teacher complexity of thinking and perceived supportiveness of the work environment

This study examined the relationship between the complexity of thinking about children by child care teachers and observed teachers' caregiving for infants and toddlers. It was hypothesized that the perceived supportiveness of the work environment would affect this relationship. Fifty‐six child care teachers completed a survey assessing complexity of thinking about children's behaviour as well as a measure of the perceived opportunities for professional development. Teachers' quality of caregiving was assessed using the Caregiver Interaction Scale. Planned contrasts revealed that when professional development opportunities were perceived unfavourably, teachers who were complex in thinking about children's behaviour provided significantly more sensitive care than did teachers who were less complex in their thinking. Findings indicate that the complexity of teachers' thinking about children may be very important in understanding teacher's sensitivity when the quality of the work environment is poor. High‐quality work environments may buffer teachers with less complexity of thinking from being less sensitive with children. Efforts to improve quality of care could focus on individual teachers to improve their complexity of thinking as well as on the work environment to make it more supportive of teachers' professional development. Copyright © 2008 John Wiley & Sons, Ltd.     

医疗保健领域的功利主义理论

在医疗保健领域功利主义具有重要作用。功利主义主张根据行为的结果进行道德判断,功利主义认为医疗保健政策应该满足大多数人的利益,应该根据治疗效果决定享有权和相应的治疗措施。这一思想在医疗保健领域体现为成本效益分析,通过收益的大小确定医疗资源分配的限度和范围。     

姑息治疗及其在肿瘤学中的地位

本文对姑息治疗的历史及概念作了详细的介绍,解释了其不同阶段的内涵,作为医学学科之一,姑息治疗的内容主要包括了疾病伴随或治疗所致症状的诊断评估、预防和治疗,心理和非癌性躯体疾病的预防和治疗,姑息治疗的科研、教学和教育以及终末期病人的治疗和护理等,特别纠正了对“安乐死”的看法。在肿瘤学中,经过40多年,它已从治疗中的辅助角色迅速成为肿瘤综合治疗中的主角,且贯穿于始终。它倡导多学科协作,与抗癌治疗完整结合,对无法治愈的晚期癌症患者以缓解症状、改善生活质量为主要目标,在全球范围内,很大一部分晚期肿瘤病人已从姑息治疗中明显获益。它的有力实施,也是我们创建和谐社会的重要反映。     

The efficacy of a pilot pediatric cognitive remediation summer program to prepare for transition of care

This study assessed the efficacy of a time-sensitive cognitive remediation summer program (CRSP) that provided patients and their families with tools to help mitigate neurocognitive deficits and promote independence to foster precursor transition of medical care skills. A total of 38 participants (aged 9–15) were included in one of the CRSPs offered yearly from 2013 to 2016. A longitudinal design was employed and at each evaluation time point, one week before start of the CRSP (pre-testing) and within three weeks after the end of the program (post-testing)), participants were administered measures of executive functioning in addition to parent ratings of behavior, executive functioning, and adaptive skills (Year 1–Year 4). In Year 4, additional measures were collected, including parenting style and parent engagement and involvement in the program. Results from Year 1 to Year 4 (n = 35) demonstrated that participants in the CRSP showed significant improvement on neuropsychological testing in sustained and selective attention, planning, and cognitive flexibility. Robust changes in parent ratings of adaptive functioning from pre- to post-treatment were also found. Specific to Year 4 (n = 13), results revealed that participants showed improvement in levels of independence with at least one of the individualized goals focused on during the program. This study provided a systematic method to gauge the levels of instruction necessary to reach goals, a crucial tool in skill-teaching. Overall, our study provides evidence for the efficacy of the CRSP and validates a feasible intervention that can be integrated into standard of care for pediatric medical populations.