Warren Zevon’s <Emphasis Type="Italic">The Wind</Emphasis> and Ecclesiastes: Searching for Meaning at the Threshold of Death

Telling one's story itself brings purpose to ones life, and it is an essential part of coming to grips with death. The book of Ecclesiastes and Warren Zevon’s album The Wind express the hope for social immortality rather than an actual afterlife. Both of them are suffused with a sense of death-awareness, although their location in time and place and the genre of their expressions are quite different. By looking closely at these texts, one is able to ascertain certain aspects of life review which are necessary for wholeness and completion. Hospice Chaplain CHRISTUS VNA Hospice and Palliative Care, 4415 Centerview, San Antonio, TX 78228, USA. Reverend Philip Browning Helsel is a hospice chaplain at CHRISTUS Hospice in San Antontio. He received his Master of Divinity from Princeton Theological Seminary and Clinical Pastoral Education units from Yuma Regional Medical Center in Yuma, AZ, and is an ordained minister in the Church of God (Anderson, IN). He has been a chaplain in psychiatric and general hospital settings. Past publications include articles in Pastoral Psychology and Presence, the Journal of Spiritual Directors International. He is working on a book about the life review process in literature and music, and applying for membership in the Association of Professional Chaplains.     

Extensions and Mechanisms of Mindfulness‐based Cognitive Therapy: A Review of the Evidence

Mindfulness‐based cognitive therapy (MBCT) was originally developed to prevent depressive relapse and recurrence and has also been widely extended to new patient populations and target problems over the last 14 years. We provide a comprehensive review of this literature, examining the strength of the evidence base for specific populations and target problems and identifying questions for future research to address. Specifically, we review studies addressing the use of MBCT for depressive disorders (prevention of depressive relapse and treatment of residual and current depressive symptoms), the use of MBCT in the treatment or management of other mental disorders (bipolar disorder, anxiety disorders, mixed anxiety and depression symptoms, disordered eating, personality disorders, and psychosis), and the use of MBCT in behavioural medicine contexts. Additionally, we discuss the extension of MBCT during specific developmental periods, like childhood, pregnancy and post‐partum, and adult caregiving, and, finally, we address the use of MBCT among clinical health‐care providers. In the second section, we review hypothesised mechanisms of change in MBCT and reflect on implications for theories of how MBCT works in the application to various patient populations and target problems. We also consider research addressing active ingredients and what is known about the “dosage” of meditation practice. We conclude with a summary of recommendations for future research.     

医学伦理审查如何适应转化医学的要求

随着转化医学的兴起,医学伦理审查面临前所未有的机遇与挑战.如何使医学伦理审查工作更好地适应转化医学发展的需要,提高审查质量,成为亟需解决的问题.在分析当前我国医学伦理审查工作现状和主要问题的基础上,进一步探讨了可行的解决方法,如进一步明确和强化管理部门服务功能、保证伦理委员会成员多样性和重视伦理审查多视角、强化伦理委员会后续跟踪审查、规范伦理审查委员的培训与继续教育等,为我国医学伦理审查工作的规范化发展和医学伦理审查质量的进一步提高提供参考.     

山东省医疗机构医学伦理委员会运行现状调查

为了解山东省医疗机构医学伦理委员会的运行现状、人员构成和任免情况、伦理审核状况和运行情况,课题组对山东省17地市58家医疗机构进行了问卷调查.结果显示,成立医学伦理委员会的有27家,占46.55％,其中12家成立了多种类别的伦理委员会,且大部分成立时间较短.医院伦理委员会成员的总人数平均为19.89人,本单位成员占94.77％,96.30％的主任委员由行政领导兼任.调查发现,目前仍存在成员结构需完善、培训交流较欠缺、相关政策支持力度不够、伦理审核能力有待加强等问题.     

A systematic review of the literature on counselling and psychotherapy for the prevention of suicide: 2. Qualitative studies

Scope of review: The paper reports a meta‐synthesis of 13 qualitative studies of counselling and psychotherapy with people at risk of suicide. Publication time span: The studies considered were reported between 1997 and 2006. Publication origin: Seven studies were conducted in the UK, four in the USA, one in Canada, and one in Sweden. Findings: Themes in clients' and therapists' accounts of the process of counselling or psychotherapy were therapist qualities; therapy components; theoretical framework; and therapy techniques. Themes in their accounts of the effectiveness of counselling and psychotherapy were decrease in self‐destructive behaviour, and quality of life. Themes in clients' views of barriers to effective counselling or psychotherapy were therapist characteristics; therapy components; secrecy; and transferring to the real‐life situation. Secrecy was also identified as a barrier by therapists, as were responsibilities of the profession; training; and the nature of suicide and self‐harm. Facilitators of successful counselling and psychotherapy as identified by clients were responsibility; support; and teaching therapy skills to family members, the latter also being identified by therapists.     

Treatment-resistant depression: A systematic review of systematic reviews

The objective of this research study was to assess pharmacological, somatic and/or psychological treatments in adults with a diagnosis of major depressive disorder who have not responded to at least one course of antidepressant medication. We conducted a systematic review to identify systematic scientific reviews and meta-analyses on treatment-resistant depression (TRD) published until February 2012. Of the sixty studies selected, sixteen met the inclusion criteria and were therefore included in the review. We considered eight main themes, including the definition of TRD, long-term results, and different treatment strategies, including so-called somatic therapies. Based on the review, the definition of TRD should be standardized in order to achieve a shared conceptualization of this disorder. This would allow a better understanding among clinicians and researchers in the field, promoting a homogeneous research methodology and thus leading to more reliable and comparable results. This essential conceptual clarification would also have a positive impact on patients with TRD, their families, and social and health systems.     

Can Culture Influence Body‐Specific Associations Between Space and Valence?

People implicitly associate positive ideas with their dominant side of space and negative ideas with their non‐dominant side. Right‐handers tend to associate “good” with “right” and “bad” with “left,” but left‐handers associate “bad” with “right” and “good” with “left.” Whereas right‐handers' implicit associations align with idioms in language and culture that link “good” with “right,” left‐handers' implicit associations go against them. Can cultural conventions modulate the body‐specific association between valence and left‐right space? Here, we compared people from Spanish and Moroccan cultures, which differ in the strength of taboos against the use of the left hand, and therefore in their preference for the right. Results showed stronger explicit associations between space and valence in Moroccan participants than in Spaniards, but they did not show any increased tendency for right‐handed Moroccans to associate “good” with “right” implicitly. Despite differences in cultural conventions between Spaniards and Moroccans, we find no evidence for a cross‐cultural difference in the implicit association between space and valence, which appears to depend on patterns of bodily experience.     

Conscious and unconscious processing of facial expressions: Evidence from two split‐brain patients

We investigated how the brain's hemispheres process explicit and implicit facial expressions in two ‘split‐brain’ patients (one with a complete and one with a partial anterior resection). Photographs of faces expressing positive, negative or neutral emotions were shown either centrally or bilaterally. The task consisted in judging the friendliness of each person in the photographs. Half of the photograph stimuli were ‘hybrid faces’, that is an amalgamation of filtered images which contained emotional information only in the low range of spatial frequency, blended to a neutral expression of the same individual in the rest of the spatial frequencies. The other half of the images contained unfiltered faces. With the hybrid faces the patients and a matched control group were more influenced in their social judgements by the emotional expression of the face shown in the left visual field (LVF). When the expressions were shown explicitly, that is without filtering, the control group and the partially callosotomized patient based their judgement on the face shown in the LVF, whereas the complete split‐brain patient based his ratings mainly on the face presented in the right visual field. We conclude that the processing of implicit emotions does not require the integrity of callosal fibres and can take place within subcortical routes lateralized in the right hemisphere.     

A Systematic Review and Psychometric Evaluation of Adaptive Behavior Scales and Recommendations for Practice

Adaptive behavior scales are vital in assessing children and adolescents who experience a range of disabling conditions in school settings. This article presents the results of an evaluation of the design characteristics, norming, scale characteristics, reliability and validity evidence, and bias identification studies supporting 14 norm-referenced, informant-based interviews and rating scales designed to measure adaptive behaviors. To derive these results, the manuals for each of these scales were reviewed using a standardized coding procedure, and information about each scale was double-coded by reviewers. Findings reveal that several evidence-based adaptive behavior scales are available to school psychologists. Concluding recommendations address selection and use of adaptive behavior scales as part of a comprehensive assessment, using the optimal methods of administration of adaptive behavior scales, and interpreting resultant scores that have demonstrated the highest levels of reliability and the largest body of validity evidence.     

临床医学教学研究课题伦理审查常见问题分析

临床医学教学研究课题常见的伦理问题包括混淆常规教学与课题研究、混淆理论教学与临床教学、自行做出“豁免知情同意”判断、混淆临床试验与教学研究、忽视“间接受试者”选择的公正性等。分析其深层次原因,发现主要包括对风险的防范意识与“爱伤”观念未有机结合、在课题设计阶段并未考虑风险控制的问题、对伦理学原则特别是知情同意原则理解不深。因此,研究项目主持者应该增强风险意识、提高伦理修养、自觉树立保护受试者利益的意识、认真履行知情同意程序。