Existential themes in the treatment of people at suicide risk. Understandings and practices of specialist healthcare professionals

ABSTRACT

This qualitative study focuses on the ways in which existential themes were understood and addressed in therapeutic relationships with patients who had attempted suicide. Health care professionals (HCP) from Norway specialist healthcare participated in focus groups. The interviews were transcribed and analysed by systematic text-condensation through a four-step procedure. We found that the HCPs emphasised the context-specific functions of their departments. They considered these conversations essential but demanding. They indicated existential themes of hope/hopelessness, loneliness, meaning, life/death, shame, religion and suicide. The HCPs’ understandings of themes deemed to be existential and how they should be addressed were primarily based on clinical experience. This appeared to exacerbate the pressure on their personal involvement, leading to the question of whether patients’ existential needs are tackled or instead disappear into a conversational vacuum. The study suggests that HCPs' professional competence of existential themes pertaining to patients at suicide risk needs to be strengthened.     

Self-reported Diabetes Prevalence and Risk factors in South Africa: Results from the World Health Survey

Using the data from the South African World Health Survey (WHS), the current study aims to assess the self-reported prevalence of diabetes and associated risk factors by socio-economic characteristics in South Africa. A population-based survey of 2314 participants (1116 men and 1236 women) was conducted in South Africa in 2003. Results indicate an overall self-reported diabetes prevalence of 9.1%, 7.1% for men and 10.8% for women. In terms of diabetes risk factors, high rates of overweight or obesity (58.4%), physical inactivity (55.2%), less than 5 servings of fruits and vegetables in a day (69.3%), and medium or high stress levels (63.3%) were found; 18.4% were smoking daily and 7.3% were risky drinkers. Univariate regression analyses found that from the six different risk factors none apart from having high stress were associated with the occurrence of diabetes. Greater age was associated with obesity and inversely associated with insufficient consumption of fruits and vegetables. Daily smoking and being physically inactive were inversely associated with risky drinking. Low socioeconomic background was associated with unhealthy diet, physical inactivity and stress.     

Mental health correlates of HIV risk behaviour and STIs/HIV infection among university students from 22 low,middle and high income countries

The aim of this study was to determine mental health correlates of HIV risk behaviour and self-reported STIs/HIV infection among university students in 22 low, middle and high income countries. Data on mental health and HIV risk were collected from 16 567 undergraduate university students (mean age 20.9, SD = 2.9) from 23 universities in 22 countries across Asia, Africa and the Americas. Results indicate that overall 16.8% of the students had two or more sexual partners in the past 12 months, and among the sexually active, 73.7% had inconsistently used a condom in the past three months with their primary sexual partner, 3.2% had ever been diagnosed with a sexually transmitted infection (STI) and 0.6% had been diagnosed with HIV. In multivariate logistic regression poorer mental health and child abuse (physical and sexual) were associated with HIV risk behaviour, and child abuse (physical and sexual) was associated with STI and HIV positive diagnoses.     

Still Photography Provides Data for Community-Based Initiatives

We use community psychology's accent on methodological pluralism and giving voice to the marginalised as a platform to critically examine the utility and outcome of photography as a data collection and community engagement method. Accordingly we focus on two community projects that used still photographs to identify environmental and household childhood injury risks respectively. The first project involved the visual documentation, examination and analysis of environmental threats in an informal settlement. The second project focused on the documentation and identification of selected childhood injury risks in and outside homes in an informal settlement. This study provided visual images that are detailed and complex and that allowed the researchers to acquire greater understandings than would have been possible from written texts alone. These photographs may be used to create injury risk awareness in the respective communities and among other relevant stakeholders.     

Variable- and person-centered approaches to examining temperament vulnerability and resilience to the effects of contextual risk

Using both variable- and person-centered approaches, this study examined the role of temperament in relation to children’s vulnerable or resilient responses to cumulative risk. Observed reactivity and regulation dimensions of temperament were tested as mediating and moderating the relation between family cumulative risk and teacher-reported adjustment problems in a sample of 259 preschool-age children. Further, latent profile analyses were used to examine whether profiles of temperament, accounting for multiple characteristics simultaneously, provided additional information about the role of temperament in children’s responses to risk. Results support a diathesis-stress model in which high frustration, low fear, and low delay ability confer particular vulnerability for children in high-risk contexts. Benefits of multiple approaches are highlighted.     

个体对不同社会阶层的内隐公平偏见及态度

考察个体对不同社会阶层的公平偏见及内隐态度,对社会治理和发展具有重要意义。采用内隐联想测验（IAT）对上述问题进行了探讨,结果发现,相对于低社会阶层,个体更易将公平性词汇与高社会阶层相联结（实验1）;也更易将积极性词汇与高社会阶层相联结（实验2）。上述结果表明,个体存在社会阶层偏好,对高社会阶层持有一种更加公平的、积极的内隐认知。     

干细胞生物材料来源及其伦理风险的系统性综述

对干细胞生物材料来源及其伦理风险进行系统性综述。干细胞生物材料来源主要有骨髓、脂肪、胚胎、脐带等组织。本次纳入的178篇有关不同来源的干细胞伦理风险文献中,近60%篇次是特指间充质干细胞、胚胎干细胞和造血干细胞的伦理风险,且对生物材料供者和干细胞受者以及社会伦理风险关注最多的是胚胎干细胞相关风险。此外,供者的伦理风险主要在招募、知情同意、公平性等方面。作者建议干细胞来源的生物材料供者应该得到充分的知情同意,干细胞生物材料的获取需要有严格的伦理管控,以使干细胞研究更符合伦理规范,保护供者的权益。

     

困惑与忧思:医学的边界在何处

现代医学将治未病的理想变成了现实。对疾病危险因素的控制, 癌症前期病变的基因检测, ECT等高清晰度的影像技术对人体微细病变的勾画, 以及生命的正常过程、个人和社交问题的医疗化, 疾病诊断标准不停歇的放宽, 使得健康与疾病的界线愈来愈模糊, 医学进步到没有健康人了。区分生命正常过程与疾病的不同, 明确医学的边界, 避免医学对人体过度的破坏性的干预, 杜绝对医疗资源的浪费, 是当今医学迫需努力解决的课题。