降低医疗的二次伤害是医学人性化发展方向

医学是一种人性化的表达,然而,医学手段的伤害性特征也是现代医学本身无法回避的一个缺陷,忽视对医学技术本身的伤害性因素的认识,是当下医学人文衰退的一个重要原因,也是构建人性化医疗的一道障碍,面对越来越多的对医学伤害性的质疑,医学应该进行自我剖析,撕开医学手段的非人性化面纱,务必直面问题和解决问题,用医学的人性化关怀弥补医学手段的伤害性缺陷,并以医学技术本身的发展,促进医学向无伤害的人性化方向发展,这是现代医学发展的终极目标。     

The Ethics of Mandatory Personal Psychotherapy for Trainee Psychotherapists

Although the psychotherapist's personal psychotherapy has received considerable research attention in recent years, little systematic investigation of the ethical issues involved has been published. This article provides a rigorous interrogation of mandatory personal psychotherapy (MPP) as a training requirement for mental health professionals, a topic that remains ethically contentious. The article begins with a discussion of why MPP is an explicitly ethical issue, before debating the ethics of MPP under six questions, each worded to capture a salient ethical issue relevant to the appropriateness of making personal treatment a mandatory training requirement. Using principle, virtue, and care ethics perspectives, the arguments for and against MPP are critically investigated. The article concludes with an ethical position statement.     

“Do More,Feel Better”: Pilot RCT of Lay-Delivered Behavioral Activation for Depressed Senior Center Clients

This pilot randomized control trial (RCT) tested “Do More, Feel Better” (DMFB), a lay-delivered Behavioral Activation intervention for depressed senior center clients. The study examined: (1) the feasibility of training older lay volunteers to fidelity; and (2) the acceptability, safety, and impact of the intervention. Twenty-one lay volunteers at four senior centers were trained in DMFB. Fifty-six depressed clients were randomized to receive 9 sessions of DMFB or Behavioral Activation delivered by social workers (MSW BA). Research assessments of overall client activity level (BADS) and depression severity (HAM-D) were conducted at baseline and Weeks 3, 6, and 9. Eighty-one percent of lay volunteers who underwent training were formally certified in DMFB. Depressed clients receiving each intervention reported high levels of satisfaction and showed large and clinically significant changes in 9-week activity level (d ≥ 1.35) and depression severity (d ≥ 3.34). Differences between treatment groups were very small for both activity level (d_MSW = 0.16; 95% CI, -0.70 to 1.02) and depression (d_MSW = 0.14; 95% CI, -0.63 to 0.91). Increases in activity level were associated with decreases in depression (β = -0.42; 95% CI, -0.55 to -0.30). Both interventions appeared to work as intended by increasing activity level and reducing depression severity. “Do More, Feel Better” shows the potential of evidence-based behavioral interventions delivered by supervised lay volunteers, and can help address the insufficient workforce available to meet the mental health needs of community-dwelling older adults.     

家庭认知环境与0~3岁婴幼儿发展的关系:有调节的中介效应

本研究以5914名0~3岁婴幼儿家长为问卷调查对象,考察了家庭认知环境、入托经历、努力控制对0~3岁婴幼儿发展的影响机制。研究发现：（1）婴幼儿努力控制在家庭认知环境与婴幼儿发展中具有中介效应,即家庭认知环境通过作用于努力控制而对婴幼儿发展产生影响;（2）婴幼儿是否入托在“家庭认知环境→努力控制→婴幼儿发展”这一中介路径的前半段中具有调节作用,当婴幼儿有入托经历时,家庭认知环境对婴幼儿努力控制的影响更大。     

Brexit et protection sociale : quel accès aux soins ?

Brexit, by its magnitude, has many legal consequences, including the issue of access to healthcare. Although an exit agreement has been reached between the European Union and the United Kingdom, problems still arise regarding the social protection of European and British residents.     

What are the benefits of having a village? Effects of allomaternal care on communicative skills in early infancy

This study investigates whether exposure to allomaternal care (AMC—care for infants from individuals other than the mother) improves rates of communicative behaviors during late infancy by providing more opportunities to practice communicating with varied caregivers. Data were collected from 102 typically-developing infants aged 13–18 months and their mothers. AMC variables were collected using a current care questionnaire, structured 14-day diary, and longitudinal interview. Communicative behaviors were assessed through post hoc microcoding of in-lab administrations of the Early Social Communication Scales (ESCS), as well as additional microcoding of the Bayley III Screening Cognitive Subtest. Demographic covariates were also included. For each communicative behavior, backward model selection was used to determine the best fitting linear regression model. Results suggested that rates of turn-taking decreased with Household AMC (p < 0.008), but increased with two or more siblings present at home (p < 0.01). Conversely, rates of spontaneous giving increased with Household AMC (p < 0.003) regardless of the presence of siblings. Notably, exposure to more AMC was neither helpful nor harmful for many of the tested communicative behaviors, although the number of siblings present was significantly related to rates of following commands, as well as pointing and reaching. Ultimately, this study suggests that household level experiences with AMC, rather than formalized care, impact the development of some communicative behaviors during late infancy.     

Evidence for an Evolutionary Cheater Strategy—Relationships Between Primary and Secondary Psychopathy,Parenting, and Shame and Guilt

In the present study, shame and guilt proneness were investigated in relation to primary and secondary psychopathy, looking at parental care as a possible mediator. A sample of 388 volunteers participated in an on-line study, completing several self-report measurements. Primary psychopathy, robust to parental care and sex of the participant, was associated with lower guilt proneness after a private transgression and lower negative self-evaluations after a public transgression. Secondary psychopathy was not associated with guilt or shame proneness. Paternal care played a mediating role between primary psychopathy and guilt, but only in male participants. High paternal care was associated with lower guilt repair in high psychopathy males, suggesting that a positive father-son relationship might be essential for development of exploitive strategies in primary psychopathy. The results highlight the fundamental differences between primary and secondary psychopathy, and provide support for the idea that primary psychopathy is an evolutionary cheater-strategy.     

The role of the regular teacher in a whole school approach to guidance counselling in Ireland

A whole school approach to guidance counselling has been promulgated by Irish policy-makers as a model of good practice in the delivery of guidance counselling in the post-primary sector since the 1998 Education Act (DES, 2005a, 2009, 2012). This approach to guidance counselling provision is viewed as a whole school responsibility where schools are expected to collaboratively develop a school guidance plan to support the needs of their students. The role of the regular teacher in a whole school approach to guidance counselling has received very little attention either in the Irish education system or in empirical research. This article will address this deficit through its discussion of a case study carried out in one school in 2012. It will position the findings from the study in the context of the re-allocation of post-primary guidance counselling provision in the national Budget 2012 that has witnessed the substantive erosion of the guidance counselling service in the last two years.     

Does personality moderate the link between women’s testosterone and relationship status? The role of extraversion and sensation seeking

Research shows that testosterone (T) is lower among partnered women, but not for women with a more unrestricted sociosexuality. There are fundamental personality traits, which are indices of mating effort and might moderate the association between T and relationship status. Two such traits are extraversion (E) and sensation seeking (SS). The present study tests if E and SS moderate the association of women’s T with relationship status and parental care. Seventy-three Portuguese women completed a short form of the NEO-FFI and the Sensation Seeking Scale (SSS-V). Salivary T was assayed using luminescence immunoassays. Being involved in a committed relationship was related to lower T for the total sample, and for the subgroups low in E and SS, but not for the subgroups high in E and SS. Parental care was related to lower T in the subgroup low in E, and marginally in the subgroup low in SS. In multivariate analyses, only relationship status predicted T in the total sample and in the subgroups low in E and SS. The results were not confounded by age and oral contraception. These results provide support for lower T being important for monogamous pair bonding rather than for being partnered per se.     

The mediating role of self-esteem in the relationship between big five personality traits and depressive symptoms among Chinese undergraduate medical students

The objectives of this study were to examine the correlations between big five personality traits and depressive symptoms among Chinese undergraduate medical students, and to explore the mediating role of self-esteem on the correlations. Self-reported questionnaires, including Big Five Inventory, the Center for Epidemiologic Studies Depression Scale, Rosenberg’s Self-Esteem scale, and socio-demographic section were distributed to 2000 undergraduate medical students at four medical colleges and universities in Liaoning province, China, in June 2014. 1738 students became the final subjects. After adjustment for age and gender, agreeableness (β = −0.329) and openness (β = −0.096) were negatively related to depressive symptoms, while neuroticism (β = 0.245) was positively related to the symptoms. Self-esteem functioned as a mediator in the relationship between agreeableness (a * b = −0.154, 95% CI: −0.182, −0.127)/openness (a * b = −0.097, 95% CI: −0.124, −0.069)/neuroticism (a * b = 0.031, 95% CI: 0.007, 0.058) and depressive symptoms. Therefore, identifying at-risk students and undertaking appropriate intervention strategies that focus on both personality traits and self-esteem may be effective in preventing and reducing depressive symptoms among Chinese medical students.