The effects of patient's frequency of attendance and etiology of symptoms,on the General Practitioners wellbeing

IntroductionThe presence of Medically Unexplained Symptoms and a high Frequency of Attendance negatively affects the General Practitioners’ (GP) wellbeing. Although, overlapping between both phenomena is partial, with a number of frequent attenders reporting medically unexplained symptoms during consultation, there is no evidence on how GP's well-being it is affected by the specific main effects of these factors and their interaction. Evidence is also scant on the psychological processes explaining the negative impact of attendance and the etiology of symptoms on GP's wellbeing.ObjectiveDrawing on the Job Demand-Control and the Conservation of Resource stress models, this paper tests the moderating effects of the GP’ perception of patient's attendance and etiology of symptoms on the relationship between patient's demands and feedback on the GP's wellbeing.MethodA total of 105 volunteer GPs self-reported on the study variables through an experience sampling methodology after 898 patients’ consultation. Patients attendance and etiology of symptoms were categorized according to the physician self-perception and an external criterion (organizational records).ResultsPerception of Patients Frequent Attendance and Medically Unexplained Symptoms were positively related to physician's Emotional Exhaustion. Contrary to expected the test of the moderation effects of patients characteristics on the relation between patient's demands and feedback and the GP's emotional exhaustion were stronger for normal attenders compared with frequent attenders. An ad hoc study shows this unexplained result is related to the GP's expectations on Frequent vs. normal attenders’ behaviors. No significant results were found when the external criterion of classification was used.ConclusionCombined analysis of Frequency of Attendance and Etiology of Symptoms lead to a better understanding of the GP's decreased wellbeing. Also, the perception of the strain level (demands/positive feedback levels) associated to the consultation with different types of patients contribute to explain the consequences for the GP's wellbeing, especially when GP's expectations on patient's behaviors are violated.     

Truly Inclusive or Uniformly Liberal? An Analysis of the Politics of the Emerging Church

The emergent church movement has fashioned itself as an alternative for Christians who do not want to walk away from their faith, but feel uncomfortable with the dogmatic conservatism found in mainstream evangelicalism. The emerging church movement has portrayed itself as diverse and inclusive, which is a direct result of evading ingroup‐outgroup boundaries. However, despite the desire for a plurality of opinions, the movement's leaders have been known to take political positions that are largely left‐leaning. We use the first dataset known to gather this identity from a sample of Protestant clergy, and assess whether denominationally connected emergent church clergy do, in fact, present a distinctive political profile. Emergent clergy are what they say they are—diverse and inclusive—while they are, on average, more liberal than nonemergent clergy in the sample.     

Predictors of treatment attendance and adherence to treatment recommendations among individuals receiving Cognitive Behavioral Therapy for Insomnia

ABSTRACT

Insomnia disorders affect up to 10% of adults and are associated with other health problems and poor quality of life. Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment; however, its effectiveness is hindered by poor attendance and adherence to treatment recommendations. The present study sought to identify predictors of attendance and adherence in CBT-I. Participants were 108 adults with insomnia disorder. Participants were primarily female (71.3%), middle aged (mean age = 50.5), and Caucasian (92.6%). Demographic variables, physical health problems, Beck Anxiety Inventory, Center for Epidemiologic Studies Depression-Revised scale, and Insomnia Severity Index were used to predict attending three or more sessions and adherence to consistent bedtime and waketime. Higher age was associated with better attendance and less deviation in bed and wake times. Anxiety and depression symptoms were associated with less attendance, and depression was also associated with more deviation in waketimes. To promote better attendance and adherence in treatment, depression or anxiety symptoms should be addressed before or during CBT-I. Identifying and tailoring CBT-I treatments toward the needs of different age groups may also improve attendance and adherence.     

The Search for a Current Mission Model in Cambodia

This paper is a contribution to the debate on the current mission model of the church in Southeast Asia. Scholars from St Elizabeth University in Bratislava, Slovakia, have performed qualitative research to examine the present mission model in Cambodia. Research was conducted on a sample of Catholic missionaries who have worked in Cambodia for a longer period of time. On the basis of this qualitative study, we have outlined and proposed some characteristics for today’s mission model in that country. Features included and emphasized dialogue with Buddhism, formation of spiritually mature people, social promotion and social inclusion, community development, the shift in inculturation regarding value systems, working in small groups, and reconciliation between ethnic communities.     

Charles F. Mackenzie and Early Colonial Racism

Archdeacon Charles F. Mackenzie ministered in the diocese of Natal in South Africa from 1855 to 1859. The early days of the diocese and the colony of Natal were characterized by conflict both inside and outside the church. The church conflict of Bishop John Colenso is perhaps most infamous. Mackenzie attempted to navigate this space and minister to settlers, soldiers, and Africans alike. This article draws on primary sources to explore the life and times of Mackenzie and argues that despite Mackenzie's remarkable story, the inseparability of coloniality from the missionary endeavour, racism, and the civilizing narrative was inescapable. Racism has evolved and is still a challenge for many churches.