Training in firearm safety counseling in family practice residency programs

We have studied the function of partial orthotopic liver transplantation in the rat by evaluating prothrombin time (PT), liver blood flow, basal and glucose-stimulated insulin secretion and glucose tolerance, and the reticuloendothelial function (RES) in hepatectomized rats subjected to partial liver transplantation. A graft corresponding to 68% of a normal liver was transplanted to totally hepatectomized rats. Comparison was made between control rats and rats subjected to 32% liver resection. PT was not significantly different in the transplanted group compared with liver-resected and control rats. Laser Doppler flowmetry showed that at 28 days after surgery, blood flow had increased in the transplanted livers. Furthermore, on the third day after transplantation, basal plasma insulin was increased and the plasma insulin response to glucose was exaggerated, suggesting reduced insulin action and impaired insulin degradation. Finally, uptake of radioactive-labeled E. coli bacteria, as a measure of RES function, was not compromised in transplanted animals. Based on these results, we conclude that reduced-size liver transplant in out-bred rats results in fast normalization of liver function after surgery although, immediately after surgery, glucose intolerance is seen.     

Ethics of practice: The beliefs and behaviors of psychologists as therapists.

There is an absence of comprehensive, systematically gathered data concerning psychologists' beliefs about and compliance with ethical principles. Furthermore, we know little about which resources are valued as effective in guiding appropriate behavior. Survey data were collected from 456 APA Division 29 members regarding the degree to which they engaged in each of 83 behaviors and the degree to which they considered each behavior to be ethical. These data were categorized and examined in terms of five principles derived from the Hippocratic oath (avoiding harm, competence, avoiding exploitation, respect, and confidentiality) as well as two additional principles (informed consent; social equity and justice). Twelve of the behaviors were very difficult for participants to evaluate on the basis of ethics. Seven of the 83 behaviors were practiced by over 90% of the participants; 16 by fewer than 10%. Colleagues, the APA Ethical Principles, and internship training were rated as the most helpful resources in guiding behavior; state and federal laws, published research, and local ethics committees were rated least helpful. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spiritual issues in counseling: Clients' beliefs and preferences.

The current study assessed psychotherapy clients' beliefs about the appropriateness of discussing religious and spiritual concerns in counseling, clients' preferences for such discussion, and identified explanatory variables for these beliefs and preferences. These variables were assessed using the Client Attitudes toward Spirituality in Therapy survey; the Index of Spiritual Experiences (J. D. Kass, R. Friedman, J. Leserman, P. C. Zuttermeister, & H. Benson, 1991); the Expectations About Counseling-Brief Form (H. E. A. Tinsley, 1982); the Religious scale of the Counseling Appropriateness Check List (R. Warman, 1960); the Socially Desirable Response Set-5 Scale (R. D. Hays, T. Hayashi, & A. L. Stewart, 1989); and the Religion Section of the Mooney Problem Check List-Adult Form (L. V. Gordon & R. L. Mooney, 1950). Clients believed religious concerns were appropriate for discussion in counseling and had a preference for discussing spiritual and religious issues in counseling. Spiritual experience was the most potent variable for explaining preferences for discussing spiritual issues. Implications and limitations of the study are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family practice residents and future obstetrics practice

Retinoids and interferon-alpha (IFN-alpha) have been shown to have a synergetic antiproliferative and differentiative effect on many cell lines, and in combination they have already been tested with some success in the treatment of some tumors. We investigated the tolerance and efficacy of high dose 13-cis-retinoic acid (2 mg/kg/day) and IFN-alpha in the treatment of advanced squamous cell carcinoma of the lung and of the head and neck. No partial or complete response was observed in the 10 patients treated. The toxicity was unusual and mild to moderate considering the dose of retinoid given. This observation leads us to suspect that IFN-alpha may alleviate some of the side effects of the retinoid, and is of interest in the design of future clinical trials.     

The punitive beliefs and behaviors of adolescent delinquent boys.

In a study with 22 institutionalized male delinquent and 22 matched high school students, delinquents were found to have very punitive beliefs relative to previously tested populations. The delinquents tended to have more punitive beliefs and did have more punitive behavior than the controls. Responses to Piagetian interview stories that represented 3 relationships between thief and victim (adolescent to mother, teacher, or peer) were significantly different with the mother story eliciting the most number of punitive responses. In a subsequent rat-training procedure the delinquent boys used punishment as their predominant response to the "misbehaving" rat showing cooccurrence of punitive belief and behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating traditional beliefs with western practice

176 patients with myocardial infarction were subjected to a sequence of tests: an original gravimetric test on the disease day 7-10, bicycle ergometry on day 12-20, repeated bicycle ergometry on days 30-35 and 100-120. The results of the investigations performed in different times were interrelated. This helped to make accurate prognosis of recovering ability in 85% of patients. This system of dynamic control demonstrated that the greatest positive effects on exercise tolerance are reached in combined use of intravenous blood radiation with He-Ne laser and combined chemotherapy. Nitroglycerin+heparin combination is the least effective. Nitroglycerin+heparin in combination with metabolism correctors is of moderate efficacy.     

Firearm injury prevention counseling by pediatricians and family physicians. Practices and beliefs

OBJECTIVES: To ascertain and compare beliefs, attitudes, and counseling practices of primary care physicians of children and adolescents regarding firearm injury prevention counseling. DESIGN: Cross-sectional survey. SETTING: State of Washington. SUBJECTS: All active members of the state chapters of the American Academy of Pediatrics and American Academy of Family Physicians. A total of 979 pediatricians and family physicians (53%) responded to the survey after two mailings. MAIN OUTCOME MEASURES: Attitudes, beliefs, and current practices with regard to firearm safety counseling among families of child and adolescent patients. RESULTS: Only 25% of pediatricians and 12% of family physicians currently counsel more than 5% of their patients. Pediatricians were more likely than family physicians (70% vs 46%, P < .001, chi 2 test) to believe that physicians have a responsibility to counsel families about firearm safety. Pediatricians recommended removing guns from the home more frequently than family physicians (32% vs 19%, P < .001, chi 2 test), but most physicians of both specialties perceived that parents are rarely receptive to this advice. However, 97% of physicians from both specialties agreed that firearms should be stored locked separately from ammunition, and a substantial majority believed that parents would be receptive to this advice. Compared with physicians who owned guns (32%), non-owners were 15 times more likely (odds ratio, 15; 95% confidence interval, 10 to 23) to agree that families with children should not keep firearms in the home. CONCLUSIONS: Few primary care physicians who see children and adolescents currently counsel families about firearm safety, although many agree that they have such a responsibility. At least half of these physicians would potentially benefit from an intervention to improve their knowledge of and counseling skills on this topic.     

Self-esteem and irrational beliefs: An exploratory investigation with implications for counseling.

In a group-testing situation, 251 university students completed the Irrational Beliefs Test and the Janis-Field Feelings of Inadequacy Scale. Pearson product-moment correlation coefficients were calculated for all variables, and a common multiple regression procedure was used to calculate the standardized parameter estimates for the prediction models. A significant negative correlation was found between self-esteem and irrational beliefs. Four specific beliefs were useful predictors of low self-esteem: demand for approval, high self-expectations, anxious overconcern, and problem avoidance. These beliefs may prove to be important targets for counselors working with clients experiencing low self-esteem. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Non-random associations between fears, beliefs and behaviors among panic patients

Self-report questionnaires have been used to compare panic patients' fears, anxious thoughts and behaviors with those of a group of controls. Individual items revealed significant differences between groups in all three areas: factor analysis revealed group differences in the pattern of intraquestionnaire associations between items. Correlational analysis of factor scores revealed significant group differences in the pattern of interquestionnaire associations. These findings only partly support a formulation of panic based upon "catastrophic interpretations." On the other hand, they do provide evidence of cognitive rigidity among panic patients which can be interpreted as evidence of impaired effortful processing when anxious.     

General practice patients' beliefs about their symptoms

BACKGROUND: Patients' beliefs about symptoms are major influences on consultation and its consequences. However, little information is available about the beliefs of patients when they consult their general practitioner (GP). AIM: To describe and quantify the range of beliefs of patients about their symptoms before consultation, and to test the hypothesis that patients who attribute symptoms to stress or lifestyle would expect less benefit than others from physical medicine but more from lifestyle change and emotional support. METHOD: Interviews with 100 patients attending one of two general practices were used to form a questionnaire, which was completed by 406 patients attending one of three general practices in contrasting areas of Greater London. This measured the frequency of specific beliefs about the causes of their symptoms and about effective forms of help. Patients were seen before their consultation. RESULTS: The most common aetiological beliefs concerned stress and lifestyle. In general, the mechanisms underlying symptoms were thought to be disturbances in bodily functioning rather than pathological processes. The most valued form of help was explanation and discussion of symptoms. Nevertheless, about half the patients expected benefit from medication and only slightly fewer from hospital investigation or treatment. Patients who attributed symptoms to stress or lifestyle were no less likely to expect help from medication or specialist referral, but they were more likely to see benefit in explanation and counselling or lifestyle change. CONCLUSIONS: These findings suggest hypotheses for future research into the effects that patients' attributions of their symptoms to stress and lifestyle have on their health care demands, emphasize the importance of routinely assessing patients' beliefs on consulting the GP, and provide information that can help to direct this assessment in the individual case.     

Kentucky physicians' perspectives and preparedness for computing in medical education and practice

PURPOSE: To examine the University of Kentucky College of Medicine's community-based faculty's (CBF) perspective on computing skills that students should acquire for future medical practice, and if the CBF currently use these skills in their daily practice. METHODS: A survey was mailed to 281 of the institution's CBF in the spring of 1997. The survey listed eight basic computing skills derived from our computing curricular objectives for students and asked respondents (a) if they use the skill, and (b) if students should learn the skill. RESULTS: 200 respondents returned a completed survey. 14 CBF (7.2%) indicated that they have all eight computer skills while 91 CBF (46.4%) indicated that students should learn all eight computer skills. 25 CBF (13%) indicated that they have none of the computer skills, while none of the CBF indicated students need none of the skills. A significant difference between primary care CBF and other specialist CBF was found with respect to self-report of computer use, but not regarding their opinions about students' need to learn computer skills. CONCLUSION: The majority of our CBF report using at least one computer skill in their practices. Regardless of specialty, CBF report that students should possess more computer skills than they themselves have. Medical educators should incorporate computing applications into the curriculum to provide appropriate computer training for future physicians.     

Ethical beliefs about burnout and continued professional practice.

Investigated psychologists' ethical beliefs about continued professional practice in psychology when the practitioner is experiencing burnout or impairment. 94 psychologists completed a demographic questionnaire, an attitude survey, and the Maslach Burnout Inventory. Relationships among Ss' ethical beliefs, professional practices, and measured levels of burnout were examined, and these elements were found to correlate significantly. Results also suggest that psychologists perceive burnout to be a form of impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Home treatment in a private counseling practice.

Attempts to stimulate interest in home treatment by demonstrating its potential for producing novel and promising psychotherapeutic experience and reflections. The author maintains that while home treatment forces the practitioner to abandon many of the controls he/she can use in an office or laboratory, it also creates a gain that the laboratory cannot simulate—the presentation of the most direct materials of daily living. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Microskills practice versus mental practice training for competence in decision-making counseling.

Undergraduates enrolled in an introductory counseling course who lacked training and experience as counselors were randomly assigned to 1 of 2 decision-making counseling training groups or to a wait-control (WC) group. Microskills practice (MS) and mental practice (MP) were each separately combined with instructions, modeling, feedback, and review in the 2 treatment groups. Data from independent ratings of the videotapes indicate that MS and MP were superior to WC on 3 of 5 qualitative dimensions and a proficiency measure. Implications for teaching higher-order counseling skills are discussed. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious beliefs and political ideologies as predictors of psychotherapeutic orientations of clinical and counseling psychologists.

Examined the relations among religious beliefs, political ideologies, and psychotherapeutic orientations in 233 34-98 yr old clinical and counseling psychologists. A majority of the respondents affirmed having religious or spiritual beliefs and claimed that their religious beliefs influenced their practice of therapy. Most respondents labeled themselves as politically liberal, and almost half claimed that their political ideologies influenced their practice. The humanistic therapeutic orientation was positively related to Eastern and mystical beliefs, atheistic and agnostic beliefs, and political liberalism; the cognitive-behavioral orientation was positively related to conservative Christian beliefs; and the psychodynamic orientation was negatively related to Eastern and mystical beliefs and positively related to political liberalism. These findings are discussed in the contexts of the scientist practitioner model and postmodern, constructivist thought. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family psychology specialty practice.

The specialty of family psychology prepares practitioners to work systemically with individuals, couples, families, and larger social organizations. The specialty is defined, and a rationale is provided for its relevance to professional practice. Key concepts, competencies, and practice dimensions (e.g., assessment, case conceptualization, and intervention) are detailed, as are training and board certification in the specialty. Applications to specific problems and specialty niches are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)