Identification and Follow-Up by Primary Care Doctors of Children with PTSD After Terrorist Attacks

Abstract

Many children and adolescents were among the victims of the suicide bomb attacks in Israel since March, 2000. While the number with emotional and behavioral symptoms was expected to be high, very few children who developed terrorism-related posttraumatic stress disorder (PTSD) were actually referred to mental health professionals for assessment or treatment. Prolonged exposure to terrorism lowers even further the number of children who remain in treatment. This article discusses reasons and presents a training program for primary care providers (pediatricians, family doctors) in identifying PTSD in child victims, and for mobilizing them to carry out long-term follow-up of these children.     

The prevalence,risk factors and outcomes of workplace bullying among junior doctors: a systematic review

ABSTRACT

Junior doctors’ exposure to bullying may impact their training and compromise quality healthcare, yet little is known in relation to its predictors and effects. The aim of this paper is to assess the prevalence, factors and outcomes of workplace bullying among junior doctors. Literature search was performed to identify all primary studies examining workplace bullying among junior doctors using the following electronic databases: Medline, Scopus, Web of Science, PsycINFO and Cochrane Library. A total of 18 articles were included, reporting on a total of 9,597 junior doctors. The quality of evidence can be rated as moderate according to the Newcastle Ottawa Scale. From the review, a wide range (30–95%) of bullying prevalence, significant differences in bullying rates according to gender, age, height, ethnicity and subspecialty, and significant associations between bullying and mental strain, job dissatisfaction, burnout, and increased accidents at work were observed. Concurrently, heterogeneity in the terms and methodologies used to examine workplace bullying as well as definitional issues in relation to the persistency of negative interactions were noted. Evidence suggests that workplace bullying is a serious occupational hazard for junior doctors, and more research is warranted to better understand this phenomenon and address its definitional and methodological issues.     

Faith in welfare: the origins of the Open Home Foundation

This article analyses the origins of the Open Home Foundation (OHF), a Christian social service provider that commenced in New Zealand in 1977. It interprets the Foundation’s appeal, paying particular attention to the role of religious values and spirituality within the organisation. The article argues that OHF emerged and flourished from the late 1970s due to a confluence of personal, social, political and religious factors. Specifically, it reflected and benefited from post-war concerns about family life, renewed emphasis on policies of deinstitutionalisation, and a mobilisation of disparate conservative Christian interests. The latter factor concerning the religious context is particularly significant. On the one hand, it helps to explain the values and ethos of the organisation, and the social implications of a particular set of spiritual commitments. On the other, it complicates commonly held interpretations of conservative Christian engagement with social issues during this period.     

Service users’ perceptions of shared agency in mental health services

Objective: The concept of shared agency is used in examining the collaboration between the service user and the professionals. The study aims to find out what kind of experiences on shared agency mental health service users have.

Method: The study was based on interviews of 19 service users. The data set was formed of those parts of the interviews that dealt with shared aims, being heard, collaboration and joint planning and decision-making. Typical methods of inductive content analysis were applied.

Results: Three domains of shared agency were found: emotional, communicative and supportive ones. The emotional domain included elements of becoming heard and building confidence. In the communicative one, the main features were mutual information sharing, finding words to describe the chaos and reconstructing harmony. The supportive domain included encouragement and giving support. Experiences on non-shared agency were also found.

Conclusion: Many experiences on shared agency were found. Joint planning and working with life goals were, however, seldom reported. This result, together with experiences of non-shared agency, sets a challenge for mental health services.     

Forging partnerships for mental health: The case of a prefecture in crisis ravaged Greece

Public health and in particular mental health have been severely affected by the multitude of socioeconomic crises experienced by people in Greece. The severe austerity programmes, have reduced access to health services and increased demand for publically funded health care. This paper presents a case study focusing on the impact of these measures on the lives of mental health providers in one prefecture in Crete. Focus group methodology was applied and the data were analysed using thematic analysis. Analyses revealed three superordinate themes that converge at many levels and appear to be going counter to the circumstances: firstly, ‘forging partnerships for mental health’; secondly, ‘extending our reach’; and thirdly ‘transformations in professional identity through praxis’. These themes are discussed using the words of the participants and the relevant literature.     

Psychotherapy without the self–a Buddhist perspective,by Mark Epstein

This article seeks to explore how John Rolland's Family Systems Illness Model can be utilized by counselling psychologists working with individuals or families experiencing medical problems. Based on systemic theory the model provides a psychosocial typology of illness and examines how the demands of an illness over time can provide a number of hurdles to be overcome by the client and his/her family. Specific examples and techniques are described to illustrate how the application of the model can be used to guide the interventions employed in a counselling session. the model applies a biopsychosocial approach to health care, and the applicability of this within a British NHS healthcare setting is discussed with the conclusion that such an approach may be in its infancy in this country. Limitations and ideas for expansion of the model from chronic physical illness into spheres of mental health are discussed.     

Religious upbringing and current religiosity in Spanish nursing and medicine students

The influence of religious education in the family upon current spiritual and religious tendencies was assessed in a sample of 599 Spanish nurse and medicine students using a religiosity scale and answers to a series of belief/disbelief statements. Results showed that nursing and medicine students were equally low-religious, with no differences in religiosity total scores between participants coming from religious families; however, medical students coming from nonreligious families showed higher religiousness than the corresponding nursing trainees. This distinction appeared both across religiosity items and in a variety of responses to belief/disbelief of Christian/secular assertions. Regression analysis showed that religious family background was a consistent predictor of religious beliefs at young adulthood, and its influence was higher for medical students. In addition to establish religious upbringing as an important factor modulating enduring religiosity, these findings provide distinctions between nurse and medical trainees, and reproduce, in a Spanish mainly catholic sample, the structure of religiosity factors previously found on North American mainline protestants.     

You don't have to go to church to be a good Christian: the implicit religion of the cathedral carol service congregation

The notion that you don't have to go to church to be a good Christian is accepted as an indicator of the form of implicit religiosity espoused by those who (in Bailey's analysis) say that they “believe in Christianity.” The present paper builds on the findings of a recently published survey of rural Anglican churchgoers celebrating harvest which suggested that de-institutionalised implicit religion may be superseding commitment to conventional explicit religious attendance. The responses of 1081 people who attended Christmas carol services in two English cathedrals in 2009 and 2010 are analysed. The findings of the previous paper that implicit religiosity is more prevalent among younger people and among those who attend church less frequently are replicated. Evidence is also found that women are more inclined to this view than men and that those who have a loose historical connection through baptism are more likely to endorse it than those with either no historical connections or stronger ones. Suggestions are made for further research.     

综合性大学开设长学制高等医学教育的初步研究

我国现有的医学教育学制偏短,不利于培养高质量医学人才。综合性大学有着许多办学优势,有利于开设长学制医学教育,因此,要发挥综合性大学的优势,实行多通道办学模式,学分制和弹性学制,强化公共基础教育和人文素质教育,改善办学条件,提高管理水平,努力培养能参与国际竞争的高层次医学人才。     

2002年:中国医疗纠纷处理的重大转折

2002年4月1日开始实施的《最高人民法院关于民事诉讼证据的若干规定》,要求医院对医疗行为与损害的因果关系和不存在医疗过错承担举证责任,一时间,医院对此忿忿不平,百姓对此拍手叫好,4月15日,期待已久的《国务院医疗事故处理条例》缍正式颁布,与1987年颁布的《医疗事故处理办法》相比有了重大改变,中国医疗纠纷的处理在2002年发生了重大转折,对此进行了详细分析,与大多数人的观点不同,认为前者恰恰对医院有利,而后者对医院更为严格。