The relationships between self-compassion, attachment and interpersonal problems in clinical patients with mixed anxiety and depression and emotional distress

Self-compassion has been consistently linked to psychological well-being. The ability to be self-compassionate may be shaped by early attachment experiences and associated with interpersonal difficulties. However, evidence has yet to be extended to clinical populations. This study examined the role of self-compassion and its relationship with attachment and interpersonal problems in clinical patients with anxiety and depression. Participants (N = 74; 60% female, mean age 40 years) were recruited from a primary care psychological therapies service in Scotland, UK. Participants completed four self-report questionnaires assessing self-compassion, attachment, interpersonal problems and emotional distress (including depression and anxiety). Low self-compassion, attachment-related avoidance (but not attachment-related anxiety) and high interpersonal problems were all associated with higher levels of emotional distress and anxiety. Low self-compassion and high interpersonal problems were predicted by attachment-related avoidance. Self-compassion mediated the relationship between attachment-related avoidance and emotional distress and anxiety. This was a cross-sectional design and therefore a definitive conclusion cannot be drawn regarding causal relationships between these variables. Self-reported questionnaires were subject to response bias. This study has extended the evidence base regarding the role of self-compassion in patients with clinical levels of depression and anxiety. Notably, our findings indicated that self-compassion may be a particularly important construct, both theoretically and clinically, in understanding psychological distress amongst those with higher levels of attachment avoidance. This study supports the development and practice of psychotherapeutic approaches, such as compassion-focused therapy for which there is a growing evidence base

Surveillance in ubiquitous network societies: Normative conflicts related to the consumer in-store supermarket experience in the context of the Internet of Things

Peer-reviewed journal articleThe Internet of Things (IoT) is an emerging global infrastructure that employs wireless sensors to collect, store, and exchange data. Increasingly, applications for marketing and advertising have been articulated as a means to enhance the consumer shopping experience, in addition to improving efficiency. However, privacy advocates have challenged the mass aggregation of personally identifiable information in databases and geotracking, the use of location-based services to identify one’s precise location over time. This paper employs the framework of contextual integrity related to privacy developed by Nissenbaum (Privacy in context: technology, policy, and the integrity of social life. Stanford University Press, Stanford, 2010) as a tool to understand citizen response to implementation IoT-related technology in the supermarket. The purpose of the study was to identify and understand specific changes in information practices brought about by the IoT that may be perceived as privacy violations. Citizens were interviewed, read a scenario of near-term IoT implementation, and were asked to reflect on changes in the key actors involved, information attributes, and principles of transmission. Areas where new practices may occur with the IoT were then highlighted as potential problems (privacy violations). Issues identified included the mining of medical data, invasive targeted advertising, and loss of autonomy through marketing profiles or personal affect monitoring. While there were numerous aspects deemed desirable by the participants, some developments appeared to tip the balance between consumer benefit and corporate gain. This surveillance power creates an imbalance between the consumer and the corporation that may also impact individual autonomy. The ethical dimensions of this problem are discussed

What are the roles involved in establishing and maintaining informational continuity of care within family practice? A systematic review

<p>Abstract</p> <p>Background</p> <p>Central to establishing continuity of care is the development of a relationship between doctor and patient/caregiver. Transfer of information between these parties facilitates the development of continuity in general; and specifically informational continuity of care. We conducted a systematic review of published literature to gain a better understanding of the roles that different parties – specifically doctors, patients, family caregivers, and technology – play in establishing and maintaining informational continuity of care within family practice.</p> <p>Methods</p> <p>Relevant published articles were sought from five databases. Accepted articles were reviewed and appraised in a consistent way. Fifty-six articles were retained following title and abstract reviews. Of these, 28 were accepted for this review.</p> <p>Results</p> <p>No articles focused explicitly on the roles involved in establishing or maintaining informational continuity of care within family practice. Most informational continuity of care literature focused on the transfer of information between settings and not at the first point of contact. Numerous roles were, however, were interpreted using the data extracted from reviewed articles. Doctors are responsible for record keeping, knowing patients' histories, recalling accumulated knowledge, and maintaining confidentiality. Patients are responsible for disclosing personal and health details, transferring information to other practitioners (including new family doctors), and establishing trust. Both are responsible for developing a relationship of trust. Technology is an important tool of informational continuity of care through holding important information, providing search functions, and providing a space for recorded information. There is a significant gap in our knowledge about the roles that family caregivers play.</p> <p>Conclusion</p> <p>The number of roles identified and the interrelationships between them indicates that establishing and maintaining informational continuity of care within family practice is a complex and multifaceted process. This synthesis of roles provided serves as an important resource for continuity of care researchers in general, for the development of continuity of care quality indicators, and for the practice of family medicine.</p

Policy as a Crime Scene

This paper explores how policy constructs the objects it seeks to regulate, taking as its case the setting of penal policy in contemporary Scotland. It employs two distinctive theoretical frames to develop the analysis: Science and Technology Studies (STS) and ‘scene theory’ a body of work in cultural studies. These offer distinctive lenses that bring into focus how the technologies of policy – statistical reports, independent Commissions, research advice – help produce populations that require intervention. The penal policy setting in question, we argue, can be understood in the same way as a crime scene, where investigators must re-construct forensically a narrative that will be legally validated. In line with the theme of this book, it offers a reflexive account of how researchers themselves are drawn into and participate as key witnesses in the scene, testifying to ‘facts’ about a crime that may have never taken place. The article aims to make the case for the potential of STS and scene theory in producing insights about our understanding of policy, particularly criminal justice policy. In doing this, it also offers a critique of the formation of the criminological discipline in a way that has side-lined policy as an ‘administrative’ rather than critical intellectual issue

One stop or full stop? The continuing challenges for researchers despite the new streamlined NHS research governance process

<p>Abstract</p> <p>Background</p> <p>Obtaining the necessary approvals and permission for clinical research requires successful negotiation of the ethical and R&D layers of the NHS. Differences in structure and governance frameworks feature between the constituent nations of the UK (England, Scotland, Wales and Northern Ireland), which adds complexity to cross-national studies. Difficulties in carrying out research in the NHS in the UK due to bureaucratic and time-consuming governance processes have led to the development of a new system of application and co-ordination from 2009. This paper illustrates how this new system fails to be consistent and streamlined and is unlikely to become so unless changes are made to the implementation and management of the governance processes.</p> <p>Methods</p> <p>We present a case study of the research governance process at the survey stage of an investigation into the use, preferences and need for information by people making choices or decisions about health care. The method involved home-based, face-to-face interviewing in a questionnaire survey in relation to decisions about lymphoma treatment, Down's syndrome screening in pregnancy, and caring for people with dementia.</p> <p>Results</p> <p>Our experience of the ethics stage was very positive, noting an efficient process of application and a speedy decision, both in relation to the initial application and to subsequent substantial amendments. By contrast, the R&D stages were very slow, most with unexplained delays, but some offering contradictory advice and exhibiting a lack of clear guidance and training for NHS staff. The R&D arrangements in Scotland were far quicker and more likely to be successful than in England. Overall, the delays were so severe that substantial parts of the research could not be delivered as planned within the funding timescale.</p> <p>Conclusions</p> <p>If high-quality research in the NHS, particularly in England, is to be delivered in a timely and cost-effective way, R&D processes for gaining research governance approval need improvement. Attention is needed in process implementation and management, particularly in relation to staff training, as well as clarity in guidance and communication within and between organisations.</p

Extending the remit of evidence-based policing

Evidence-based policing (EBP) is an important strand of the UK’s College of Policing’s Police Education Qualifications Framework (PEQF), itself a component of a professionalisation agenda. This article argues that the two dominant approaches to EBP, experimental criminology and crime science, offer limited scope for the development of a comprehensive knowledge base for policing. Although both approaches share a common commitment to the values of science, each recognizes their limited coverage of policing topics. The fundamental difference between them is what each considers ‘best’ evidence. This article critically examines the generation of evidence by these two approaches and proposes an extension to the range of issues EBP should cover by utilizing a greater plurality of methods to exploit relevant research. Widening the scope of EBP would provide a broader foundational framework for inclusion in the PEQF and offers the potential for identifying gaps in the research, constructing blocks for knowledge building, and syllabus development in higher level police education

A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

<p>Abstract</p> <p>Background</p> <p>Shared decision making (SDM) is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP) teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care.</p> <p>Methods/Design</p> <p>We will use a qualitative case study and a quantitative survey to capture the macro, meso and micro levels of stakeholders in home care. The case study will follow the knowledge-to-action process framework to evaluate the work of an IP home care team at a Quebec City health center. Sources of data will include one-on-one interviews with patients, family caregivers or surrogates and significant others, and administrators; a focus group of home care health professionals; organizational documents; and government policies and standards. The interview guide for the interviews and the focus group will explore current practices and clinical problems addressed in home care; factors that could influence the implementation of the proposed IP approach to SDM; the face and content validity of the approach; and interventions to facilitate the implementation and evaluation of the approach. The survey will ask 300 health professionals working in home care at the health center to complete a questionnaire based on the Theory of Planned Behaviour that measures their intentions to engage in an IP approach to SDM. We will use our analysis of the individual interviews, the focus group and the survey to elaborate a toolkit for implementing an IP approach to SDM in home care. Finally, we will conduct a pilot study in Alberta to assess the transferability of our findings.</p> <p>Discussion</p> <p>We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering patient-centered care. This study will contribute to the evaluation of IP SDM delivery models in home care. It will also generate practical, policy-oriented knowledge regarding the barriers and facilitators likely to influence the practice of IP SDM in home care.</p