Stress reactions following acute situations involving moral challenges among health care professionals

Many health care professionals have to make morally difficult decisions during acute, stressful situations. The aim was to explore the applicability of an existing qualitatively developed model of individual reactions among professional first responders following such situations using a quantitative approach. According to the model, the interaction of antecedent individual and contextual characteristics affect the immediate emotional reactions to acute, stressful events involving a moral dilemma. Continuous coping efforts and the quality of social support will also affect the long‐term positive and negative reactions to the event. The participants (n = 204, about 50% response rate) represented three Swedish health care professions stationed at a university hospital and a regional hospital: Physicians (n = 50), nurses (n = 94) and “others” (n =60, mainly social welfare officers and assistant nurses). Except for the personality dimension emotional stability which was measured using an established instrument, all measurement scales were operationalizations of codes and categories from the qualitative study (ten scales altogether). Four multiple regression analyses were performed with long‐term positive and negative reactions in everyday acute and morally extremely taxing situations respectively as dependent variables. The outcome showed that long‐term positive reactions covaried with much use of the coping strategies Emotional distancing and Constructive emotional confrontation and a perception of a well‐functioning Formal social support. Regarding long‐term negative reactions, higher age and little use of Emotional distancing accounted for much of the variance. Immediate emotional reactions also contributed significantly. Conclusion: the results largely supported the model concepts and their assumed relationships.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

Generational Conversion? The Role of Religiosity in the Politics of Evangelicals

The political environment for evangelical Protestants has changed substantially since the Christian Right reached its apex, as a more issue and ideologically diffuse political environment has emerged. The present study tests two different theoretical perspectives on whether these contextual changes may have altered Millennial evangelicals’ political perspectives vis‐à‐vis those of previous generations of evangelicals. On the one hand, theoretical perspectives related to differential political socialization processes across generations would lead to expectations of generational change among evangelicals. On the other hand, theoretical perspectives related to social identity theory would suggest far less change across generations. Using Pew's 2007 U.S. Religious Landscape Survey, we test these expectations by comparing the relationships between religiosity and political attitudes across three generations of evangelicals. Ordered probit and logistic regression models estimate the impact of religiosity on various political attitudes. These models reveal that Millennial evangelical religiosity continues to be strongly related to Republican Party identification and opposition toward abortion, which is largely consistent with the social identity perspective. Generational change is most evident in a variety of nonsocial issues in which religiosity is associated with less conservatism among Millennials. Additional analysis using the 2012 Religion and Politics Survey with a smaller sample of Millennial evangelicals confirms these results.     

Comparative analysis of the risk-handling procedures for gene technology applications in medical and plant science

In this paper we analyse how the risks associated with research on transgenic plants are regulated in Sweden. The paper outlines the way in which pilot projects in the plant sciences are overseen in Sweden, and discusses the international and national background to the current regulatory system. The historical, and hitherto unexplored, reasons for the evolution of current administrative and legislative procedures in plant science are of particular interest. Specifically, we discuss similarities and differences in the regulation of medicine and plant science, and we examine the tendency towards dichotomizing risk — focusing on social/ethical risks in medicine and biological risks in plant science. The context of this article is the Synpraxia research project, an inter-disciplinary program combining expertise in sciences and the humanities.     

Homelessness in the United States: Assessing Changes in Prevalence and Public Opinion, 1993–2001

A national survey was administered in 1993-1994 (N = 360) and repeated in 2001 (N = 435) to assess the prevalence of homelessness as well as attitudes, opinions and knowledge regarding homelessness. No significant changes in prevalence were found, despite a strong US economy during most of the 7-8 year period. Respondents in 2001 had less stereotyped views of homeless people and were more supportive of services, but came to see homelessness as a less serious problem that was less often due to economic factors. This "mixed" set of findings may reflect both beliefs on the benefits of a good economy and an increased awareness of the complexity of homelessness. Across the surveys, younger, female, liberal, and less wealthy respondents demonstrated more sympathetic attitudes towards homeless people.     

Advocacy,Political Participation,and Citizenship: Lutheran Contributions to Public Theology1

Abstract : Martin Luther never developed a political theory, but his theology does inform the way Christians live in society, making it both public and political. Luther's “two kingdom theory” often has been misinterpreted to justify passivity and obedience toward civil authorities. Under closer examination, however, his theology applies to the everyday practices of politics, economics, and religious affairs. In the context of nation‐building, a Lutheran theology fosters citizenship not only as individual rights and responsibilities, but as active participation in civil society.     

Theme Articles: Mujerismo and The Two Kin‐doms: Distinction and Reconciliation

Abstract : The theological ethics underlining mujeristas' theological praxis and Luther's Two Kingdoms doctrine may seem to be contradictory to some. Mujerista theology calls for active engagement in the public sphere. Despite its utilization to the contrary, Luther's Two Kingdoms doctrine calls for that same active engagement of the Christian in civic matters. As a Lutheran Latina, I posit that the theological ethics of mujeristas and Luther's Two Kingdoms are distinct but reconcilable.     

The Historical Effect of Habermas in the Chinese Context: A Case Study of the Structural Transformation of the Public Sphere

The main purpose of this essay is not to give a full-scale and systematic exploration of the historical process concerning the acceptance of Habermas’ works in the Chinese-spoken world but to examine the historical effect of Habermas in the Chinese-spoken context and try to find a proper way to establish a good relationship between Habermas and the Chinese-spoken world by discussing the introduction, study, and application of Habermas’ most famous work, The Structural Transformation of the Public Sphere, by Chinese scholars in recent years. Translated from Xiandai zhexue, 2005:1     

A New Methodology for Reporting the Status of Community Health Improvement in the United States

Objective To assure that Healthy Communities are achieved, a tracking methodology is proposed using four health improvement categories. Methods Counties are classified as having met or not met nine HP2010 mortality targets and as improving or not improving, creating four categories of community health improvement – static, progressing, exemplary, and maintaining. Results Exemplary counties make up 1.7%32.7% of counties, counties have both improved and met the HP2010 target during the period. Across all indicators, a large proportion remains of counties that have neither met the HP2010 target nor improved (33.572.8%). Conclusions Understanding why, how, and in what ways communities move from static to maintaining categories is necessary to guiding every local public health system to community health improvement.     

The UK Hybrid Embryo Controversy: Delegitimising Counterpublics

The UK Human Fertilisation and Embryology Act of 1990 was revised in 2008 in response to legal challenges, societal changes and clinical advances since 1990. A provision permitting the creation of animal–human hybrid embryos was the subject of an extremely effective public relations (PR) campaign by embryo scientists and other supporters of such experimentation. In response, science correspondents of the ‘serious’ or ‘quality’ press commented favourably on these PR activities; this validation supplemented key messages in their press releases. The approval conferred on attempts to shape public opinion was explicitly contrasted with the public consultation exercise conducted by the UK Department of Health in 2005. Press coverage of the campaign demonstrated asymmetrical framings of the representativeness of public opinion and scientists' accounts of their proposed research. Scientists' views were represented as objective and therefore a legitimate basis for policymaking, in contrast with subjective views of putatively uninformed or opposed publics. Such opponents were cast as a counterpublic. The public interest was limited to evaluating the science on its own terms, thus pre-empting consideration of the possibility that public interests and scientists' interests may not coincide.