Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self-management for African Americans with hypertension

African Americans are at significantly greater risk of hypertension and worse cardiovascular outcomes than other racialized groups, yet hypertension intervention effects remain limited. Thus, it is necessary to understand the potential mechanisms whereby interventions may be more effectively targeted to improve health. Supported by prior research evidence and guided by the Biobehavioral Family Model, this study examined associations between family relationship quality, psychological wellbeing, and self-management behaviors for African Americans with hypertension. Data were pooled from three Midlife Development in the U.S. projects, resulting in a sample of 317 African Americans (63.4% female, M_age = 53.32) with self-reported high blood pressure in the past 12 months. We tested four cross-sectional multiple mediator models, with depressed mood and environmental mastery mediating associations between family strain and exercise, smoking, problematic alcohol use, and stress-eating. Environmental mastery mediated the association between greater family strain and decreased odds of achieving recommended exercise levels; greater odds of reporting problematic alcohol use; and greater stress-eating. Though family strain was associated with depressed mood in each model, this variable did not serve as an indirect pathway to self-management behaviors. Family strain, and the potential pathway identified via environmental mastery, may be a meaningful predictor of disease self-management for African Americans with hypertension. Longitudinal studies are needed to examine directionality and to support intervention trials for improving self-management and hypertension outcomes.     

The myth of science education

It is argued that the manner in which we teach science in the high schools represents an outdated positivistic conception of science. The standard presentation of a year of each of chemistry, biology and physics should be replaced by an integrated science plus history, philosophy, and sociology of science which would take a total of three years to complete. A proper appreciation for the true nature of science is essential to the continued health of the scientific enterprise.     

Screw Those Guys: Polarization,Empathy, and Attitudes About Out-Partisans

Empathic ability is the ability to interpret the emotional state of others. In today's highly partisan and polarized environment, empathic ability may play a key role in determining how partisans respond emotionally to changes in public policy and those helped or harmed by the policy. Utilizing Baron-Cohen et al.'s (Journal of Child Psychology and Psychiatry, 42, 241–251, 2001) “Reading the Mind in the Eyes” test to measure empathic ability, we conduct a survey experiment where we asked participants to read about a partisan individual who may lose their health insurance if the Affordable Care Act were to be repealed. We show that empathic ability shapes attitudes about people and policies, but that the effects are contingent upon the respondent's partisanship, the target's partisanship, and an interaction of the two. Empathic ability produces more positive affect and policy support among Democrats but reduces positive affect among Republicans. The divergent effects of empathic ability on Democrats and Republicans are further exacerbated when the target is an out-partisan.     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Identity and moral responsibility of healthcare organizations

In this paper the moral responsibility of a Healthcare Organization (HCO) is conceived as an inextricable aspect of the identity of the HCO. We attempt to show that by exploring this relation a more profound insight in moral responsibility can be gained. Referring to Charles Taylor we explore the meaning of the concept of identity. It consists of three interdependent dimensions: a moral, a dialogical, and a narrative one. In section two we develop some additional arguments to apply his concept of personal identity to organizations. The final section works out the relationship of three dimensions of identity to some actual issues in contemporary HCOs: the tension between care and justice, the importance of dialogues about the diversity of goods, and the relevance of becoming familiar with the life-story of the HCO. Identity of an HCO is established and developed in commitments to and identification with certain goods that are central for a HCO. However, many of these goods are interwoven with everyday practices and policies. Therefore, moral responsibility asks for articulation of goods that often stay implicit and should not be reduced to a merely procedural approach. However difficult this articulation may be, if it is not tried at all HCOs run the risk of drifting away from their very identity as healthcare institutions: to offer care to patients and to do this in accordance with demands of social justice.     

Self‐Stigma,Mental Health Literacy,and Health Outcomes in Integrated Care

The authors describe research on the self‐stigma of mental illness and help seeking, mental health literacy, and health outcomes in an integrated care medical center. Results revealed that self‐stigma of mental illness and self‐stigma of seeking help had an inverse relationship with mental health literacy. No statistically significant relationships were found between health outcomes, either type of self‐stigma, and mental health literacy. The authors discuss these and other findings and offer research and counseling implications.     

Do students feel authentic in integrated RE? A quantitative analysis

Abstract

The purpose of this article is to present quantitative results concerning students’ sense of authenticity during a teaching experiment conducted in Finnish ninth grade religious education classes in 2014. In this experiment, students (N = 24) from three different faith traditions (Lutheran, Orthodox, secular humanist) studied ethical contents together on four subsequent lessons. The analysis showed some differences in students’ experiences of common trait authenticity and lesson-specific experiences of state authenticity but in general, the students felt welcome in the integrated RE lessons. There was not a lot of difference between girls and boys but Orthodox students seemed to be more complacent than the other students. This article adheres to the view that the ability to be authentic is one of the prerequisites of successful spiritual education and it seems that meeting this prerequisite is possible, even among students who have previously studied in segregated religious education.     

To Brexit or not to Brexit: The roles of Islamophobia,conspiracist beliefs,and integrated threat in voting intentions for the United Kingdom European Union membership referendum

We used an identities approach to examine voting intentions in the June 2016 UK referendum on membership of the European Union (EU). In April 2016, 303 British adults (58.7% women, age M = 34.73) indicated their voting intentions for the referendum and completed measures of identification with the national in-group, perceived threat from Muslim immigrants, belief in Islamophobic conspiracy narratives, Islamophobia, general conspiracist beliefs, ambiguity tolerance, and belief in a clash of civilizations. Path and mediation analyses indicated that greater belief in Islamophobic conspiracy theories mediated the link between Islamophobia and intention to vote to leave. Islamophobia and Islamophobic conspiracist beliefs also mediated the effects of perceived threat from Muslims on voting intentions. Other variables acted as antecedents of perceived threat or Islamophobic conspiracy narratives. These findings highlight the role that identity-based cognitions may have played in shaping voting intentions for the UK EU referendum.     

Blameless Guilt: The Case of Carer Guilt and Chronic and Terminal Illness

My ambition in this paper is to provide an account of an unacknowledged example of blameless guilt that, I argue, merits further examination. The example is what I call carer guilt: guilt felt by nurses and family members caring for patients with palliative-care needs. Nurses and carers involved in palliative care often feel guilty about what they perceive as their failure to provide sufficient care for a patient. However, in some cases the guilty carer does not think that he has the capacity to provide sufficient care; he has, in his view, done all he can. These carers cannot legitimately be blamed for failing to meet their own expectations. Yet despite acknowledging their blamelessness, they nonetheless feel guilty. My aims are threefold: first, to explicate the puzzling nature of the carer guilt phenomenon; second, to motivate the need to solve that puzzle; third, to give my own account of blameless guilt that can explain why carers feel guilty despite their blamelessness. In doing so I argue that the guilt experienced by carers is a legitimate case of guilt, and that with the right caveats it can be considered an appropriate response to the progressive deterioration of someone for whom we care.