Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory

We tested the hypothesis that a psychosocial dental intervention formulated in terms of self-determination theory would increase patients’ perceived competence and autonomous motivation for dental care and would decrease their plaque and gingivitis over a seven month period, compared to standard dental treatment. We also tested a process model in which the intervention was expected to increase perceived dental competence and autonomous motivation, that they would be positively associated with oral health behaviors (i.e., brushing and flossing), which was expected to decrease plaque and, in turn, decrease gingivitis. We also examined whether: changes in perceived competence and autonomous motivation would mediate the effect of the intervention on dental-health behaviors; dental-health behaviors would mediate the links from changes in perceived competence and autonomous motivation to change in plaque; and change in plaque would mediate the relation of dental health behaviors to change in gingivitis. Finally, we examined the fit of the overall model with structural equation modelling. Results supported all predictions.

Religious Involvement and Its Association to Risk Behaviors among Older Youth in Foster Care

This study examined religious involvement and its association to risk behaviors (sexual behavior, marijuana use, alcohol use, and cigarette use) among older youth in foster care (N=383). Three dimensions of religious involvement were assessed—church or religious service attendance, religious practices, and religious beliefs. Findings showed that gender, ethnic group membership, sexual abuse history, and placement type were significantly associated with older foster care youth’s religious involvement. Hierarchical logistic regression analyses showed that religious service attendance was associated with reduced odds of youth’s engagement in sexual behavior in the past 2 months and current use of cigarettes. In addition, greater religious beliefs were associated with a reduction in odds of youth’s use of alcohol in the past 6 months and current use of cigarettes. The consideration of religious involvement as a positive influence and resource that may reduce unhealthy risk behaviors among older youth in foster care is discussed.     

Preventing Depression Among Early Adolescents in the Primary Care Setting: A Randomized Controlled Study of the Penn Resiliency Program

This study evaluated the Penn Resiliency Program's effectiveness in preventing depression when delivered by therapists in a primary care setting. Two-hundred and seventy-one 11- and 12-year-olds, with elevated depressive symptoms, were randomized to PRP or usual care. Over the 2-year follow-up, PRP improved explanatory style for positive events. PRP's effects on depressive symptoms and explanatory style for negative events were moderated by sex, with girls benefiting more than boys. Stronger effects were seen in high-fidelity groups than low-fidelity groups. PRP did not significantly prevent depressive disorders but significantly prevented depression, anxiety, and adjustment disorders (when combined) among high-symptom participants. Findings are discussed in relation to previous PRP studies and research on the dissemination of psychological interventions. An erratum to this article is available at .     

A Recess Evaluation with the Players: Taking Steps Toward Participatory Action Research

This qualitative study, part of a Canadian national study of fathers’ involvement, opened up First Nations and Métis fathering as a new area of inquiry. Conversational interviews with 80 Indigenous fathers illuminated the socio-historical conditions that have shaped Indigenous men’s experiences of learning to be a father and becoming a man in the context of changing gender relationships and the regeneration of circles of care. Indigenous fathers’ experiences unfold in a socio-historical context fraught with difficulties. However, the study findings suggest cultural strengths and sources of resilience unseen in research and community programs driven by Euro-western perspectives. This research can inform efforts to reduce systemic barriers and reconstitute positive father involvement following disrupted intergenerational transmission of fathering in Canada and elsewhere.     

Moving from Principles to Practice: Recommended Policy Changes to Promote Family-Centered Care

This paper emphasizes the value of family-centered care. Discussion highlights family-centered philosophies (e.g., Systems of Care [SOCs]) and practice models (i.e., wraparound) and identifies discrepancies between conceptualizations and actual practice. Data from multiple sources detail issues in fidelity to family-centered values and needs and risks experienced by siblings of children with severe emotional disturbance and their caregivers. This discussion provides a springboard for policy recommendations to strengthen family support programming and enhance family-centered care, from modifying funding streams such that systems extend their reach beyond children with full-blown, diagnosable problems (those meeting standards of "medical necessity), to supporting prevention and early intervention initiatives that address families as targets for intervention. Recommendations include ensuring that communities with SOC funding address the needs of families; broadening Medicaid rules and definitions; expanding the range of reimbursable activities and services; and increasing funding for evaluating family-centered care models and family support programming.     

Autonomy,Reciprocity, and Responsibility: Darwall and Levinas on the Second Person

Abstract

Stephen Darwall’s The Second‐Person Standpoint converges with Emmanuel Levinas’s concern about the role of the second‐person relationship in ethics. This paper contrasts their methodologies (regressive analysis of presuppositions versus phenomenology) to explain Darwall’s narrower view of ethical experience in terms of expressed reactive attitudes. It delineates Darwall’s overall justificatory strategy and the centrality of autonomy and reciprocity within it, in contrast to Levinas’s emphasis on the experience of responsibility. Asymmetrical responsibility plays a more foundational role as a critical counterpoint to ‘mean‐spirited’ reciprocity than Darwall’s laudable distinction between accountability and revenge, and responsibility even founds this distinction. The experience of being summoned to asymmetrical responsibility amplifies the meaning of ‘authority’, which is a presupposition for Darwall. Finally, asymmetrical responsibility helps develop decentred reasoning, invites risk beyond the boundaries of reciprocity at moments when autonomy appears endangered, reconciles respect and care at the experiential level, and presses to extend the scope of moral obligation.     

Circles of Solicitude and Concern

Abstract

Heidegger distinguishes between concern for things and solicitude for other Dasein. As Dasein is already being‐in‐the‐world and being‐with from the start, there is no need to define what another Dasein is to recognize it. In this paper it is argued that Dasein is thrown into circles of care, where the distinction between solicitude and concern is given. Although this undermines any attempts to regard a comatose patient as non‐Dasein, it raises questions about Dasein’s relations with animals. It is suggested that Dasein’s relations with animals could be captured by inserting another circle, for which the German word versorgen might be suitable.     

新生儿重症监护病房患儿家属心理状况分析

探讨新生儿重症监护病房（NICU）住院患儿家属的心理状况及影响因素。采用焦虑自评量表（SAS）及自行设计的调查问卷对190名NICU住院患儿家属进行调查。结果显示患儿家属表现出不同程度的焦虑,与全国常模（29．78±0．46）相比,其焦虑情绪标准分49．54±1．07,高于常模组（P〈O．05）。影响因素主要包括文化水平、家庭人均收入及患儿病情严重程度等。患儿父母关注的主要问题包括：病情严重程度、预后、医护人员解释病情满意度及病房探视制度。笔者认为医护人员应加强与患儿家属的有效沟通,满足其心理需求,提高医疗护理质量,促进医患关系和谐。     

构建高质量的外科医学教育体系

医学教育是贯穿医疗职业生涯全过程的行为,是伴随医学进步和发展的重要工程.医学教育的质量直接影响医疗的质量和医学人才的素质,尤其是外科学领域,是以有创性的手段、方法治疗疾病.医生的职业素养、医疗水平均取决于医学教育的结果.医疗质量不能简单地用医生的学历衡量,学历教育是载体,其中应充实培养能力的教育项目、内容,以适应未来就职、就业的社会需求.医疗质量、医疗水平对医院而言是生命线,是生产力.同时,医生的教育及教育的质量是医疗质量的基础与保障.随着医学的飞速发展,医疗技术的日新月异,医学模式的改变,构建新的医疗环境下的医学教育体系,显得更为重要.