The treatment of forgiveness in counselling and therapy.

Situations involving perceived hurts, slights, and other interpersonal maltreatment are at the core of counselling and therapy. Resolution of these situations frequently involves forgiveness of the transgressor. Despite this the concept of forgiveness has received relatively little attention within the counselling and therapy literature. The reasons for this are explored beginning with the association between forgiveness and the Judaeo-Christian tradition. Freud avoided the term forgiveness and psychoanalysts until very recently have followed suit. Ways in which forgiveness are conceptualised are explored. Difficulties related to forgiving associated with our conceptualisations of natural justice are identified. A cautionary note is struck about the dangers of pathologising non forgiveness given the enthusiasm for forgiveness in the current research literature and in Positive Psychology. Distinctions between processes of forgiveness are made which are particularly potent for counselling. A summary of the literature with regard to the health benefits of forgiveness is presented and some client dilemmas in relation to forgiveness are outlined. Most of the emergent research on forgiveness is being undertaken by academic psychologists and the argument is made that counselling psychologists are uniquely equipped to contribute to the growing research literature on forgiveness.</p

Postdisaster Reconstruction of Horizontal Infrastructure Systems: A Review of the Christchurch Rebuild

This paper investigates the decision-making processes guiding postdisaster infrastructure reconstruction— concentrating on wastewater, water supply, stormwater and road networks (“horizontal infrastructure”). It draws on empirical analysis of the postearthquake reconstruction currently underway in Christchurch, New Zealand. Restoring infrastructure services to provide at least a basic level of essential services after a disaster helps wider economic recovery. Subsequently, there is pressure to restore infrastructure services to predisaster levels as quickly as possible. Reconstruction programmes thus commence in highly uncertain decision-making environments and are reactive to perceived, immediate needs. The extent and nature of the work is later clarified and re-evaluated as projects progress. This context of postdisaster response presents unique challenges in terms of design and delivery processes. The focus of this paper is to address the impact of such institutional and organizational arrangements on postdisaster reconstruction decisions. It also discusses changes in decision making that occur over time as needs change. It does this through examining changes in the overall design philosophy and approaches to prioritization and deferment in the Christchurch case study

Development and evaluation of an early detection intervention for mouth cancer using a mass media approach

Scotland has a high incidence of mouth cancer, but public awareness and knowledge are low compared with other cancers. The West of Scotland Cancer Awareness Project sought to increase public awareness and knowledge of mouth cancer and to encourage early detection of symptoms among an at-risk population of people aged over 40 years from lower socio-economic groups using a mass media approach. The media campaign aimed to increase people’s feelings of personal risk, while also enhancing feelings of efficacy and control. To achieve this, a testimonial approach (using real people to tell their own stories) was adopted

Effects of self-management program on healthy lifestyle behaviors among elderly with hypertension

© 2018, Behavioral Science Research Institute. This research aimed to evaluate whether a self-management program promoted healthy lifestyle behaviors (HLBs) and improved health outcomes among Thai elderly with hypertension. Participants were randomly allocated to either an intervention group (n=20), that received an 8-week self-management program that included home visits, or a control group (n = 20). The data were analyzed by a chi-square analysis, a mixed-model repeated measure MANOVA, and MANCOVAs. There were significant differences in the mean scores of healthy lifestyle behaviors at posttest and follow-up between the two groups (p < 0.01). Moreover, the experimental participants showed statistically significant decrease in BMI as compared to the control group participants in posttest and follow-up (p < 0.001). There was a statistically significant reduction in blood pressure in the experimental participants, compared with the control participants at follow-up (p < 0.001). Furthermore, healthy lifestyle behaviors increased significantly in the experimental participants compared with the control participants and baseline (p < 0.001). In addition, BMI and blood pressure decreased in the experimental participants compared with the control participants and baseline (p < 0.001). The self-management program resulted in improved healthy lifestyle behaviors, and health outcomes among the elderly with hypertension, and has implications for health promotion

Positron Emission Tomography Techniques to Measure Active Inflammation, Fibrosis and Angiogenesis in Hypertensive Heart Failure

Heart failure, which is responsible for a high number of deaths worldwide, can develop due to chronic hypertension. Heart failure can involve and progress through several different pathways, including: fibrosis, inflammation, and angiogenesis. Early and specific detection of changes in the myocardium during the transition to heart failure can be made via the use of molecular imaging techniques, including positron emission tomography (PET). Traditional cardiovascular PET techniques, such as myocardial perfusion imaging and sympathetic innervation imaging, have been established at the clinical level but are often lacking in pathway and target specificity that is important for assessment of heart failure. Therefore, there is a need to identify new PET imaging markers of inflammation, fibrosis and angiogenesis that could aid diagnosis, staging and treatment of hypertensive heart failure. This review will provide an overview of key mechanisms underlying hypertensive heart failure and will present the latest developments in PET probes for detection of cardiovascular inflammation, fibrosis and angiogenesis. Currently, selective PET probes for detection of angiogenesis remain elusive but promising PET probes for specific targeting of inflammation and fibrosis are rapidly progressing into clinical use

The cessation in pregnancy incentives trial (CPIT): study protocol for a randomized controlled trial

Background: Seventy percent of women in Scotland have at least one baby, making pregnancy an opportunity to help most young women quit smoking before their own health is irreparably compromised. By quitting during pregnancy their infants will be protected from miscarriage and still birth as well as low birth weight, asthma, attention deficit disorder and adult cardiovascular disease. In the UK, the NICE guidelines: 'How to stop smoking in pregnancy and following childbirth' (June 2010) highlighted that little evidence exists in the literature to confirm the efficacy of financial incentives to help pregnant smokers to quit. Its first research recommendation was to determine: Within a UK context, are incentives an acceptable, effective and cost-effective way to help pregnant women who smoke to quit? &lt;p/&gt;Design and Methods: This study is a phase II exploratory individually randomised controlled trial comparing standard care for pregnant smokers with standard care plus the additional offer of financial voucher incentives to engage with specialist cessation services and/or to quit smoking during pregnancy. Participants (n=600) will be pregnant smokers identified at maternity booking who when contacted by specialist cessation services agree to having their details passed to the NHS Smokefree Pregnancy Study Helpline to discuss the trial. The NHS Smokefree Pregnancy Study Helpline will be responsible for telephone consent and follow-up in late pregnancy. The primary outcome will be self reported smoking in late pregnancy verified by cotinine measurement. An economic evaluation will refine cost data collection and assess potential cost-effectiveness while qualitative research interviews with clients and health professionals will assess the level of acceptance of this form of incentive payment. Research questions What is the likely therapeutic efficacy? Are incentives potentially cost-effective? Is individual randomisation an efficient trial design without introducing outcome bias? Can incentives be introduced in a way that is feasible and acceptable? &lt;p/&gt;Discussion: This phase II trial will establish a workable design to reduce the risks associated with a future definitive phase III multicentre randomised controlled trial and establish a framework to assess the costs and benefits of financial incentives to help pregnant smokers to quit

A conceptual framework for understanding adaptation planning of urban road infrastructure

In the field of adaptation of road infrastructure, several frameworks for decision-making are available, but these have focused mainly on the adaptation of national or regional road network systems. Although the protection of these systems from the possible impacts of climate change is important, protecting road infrastructure in urban contexts is equally important for the efficient functioning of society. Consequently, it is imperative to understand the particularities of adapting road infrastructure in cities, however, existing frameworks may not be appropriate for this purpose. With this in mind, this paper presents a conceptual framework called the “Expanded Adaptation Action Cycles” (EAAC). This framework conceptualizes adaptation planning as an iterative action-learning cycle. In each iteration of the planning cycle, decision-makers implement adaptation actions based on their best current knowledge while at the same time learn how to better adapt their systems in the next iteration. Adaptation can be implemented at different scales (i.e. resistance, incremental adaptation or transformational adaptation) depending on the level of risks expected and the amount of change desired in the system. Decision-makers, therefore, can decide for adaptation that increases and concentrates investment on existing pathways and practices (resistance), creates marginal changes in the system (incremental adaptation), or generates fundamental change to the functioning of the system (transformational adaptation). A case study of the decision-making processes for the development and maintenance of the road network of Bogotá, Colombia was conducted to demonstrate the utility of this framework in an urban setting. Transport planners in Bogotá are currently trying to increase their understanding of the possible impacts of climate change over its principal road infrastructure through a study called “Red Vial Vital”. Additionally, the main adaptation actions expected for the city are the use of “green infrastructure” and sustainable urban drainage systems. Analysing the information using the EAAC framework indicates that the city is currently at the early stages of its adaptation planning and that the adaptation measures being considered suggest that, at most, the city is aiming for implementing incremental adaptation. Moreover, the analysis identified the presence of barriers to effective adaptation planning specific to cities such as a high degree of decentralization of urban authority. This shows how the EAAC framework provides the ability to understand the relative position of a city’s approach to adaptation planning within a wider spectrum of possibilities, providing insight into the potential impact of possible planning interventions

A comparison of treadmill versus outdoor running economy in recreational runners

There has been a large uptake in recreational running in recent years, as people see it as an easy way to improve fitness, and 5 km is considered an accessible entry level distance. This is due in part to the widespread use of apps such as Couch to 5k, free from the NHS, and the growth of parkrun, including GPs prescribing parkrun. Given this large cohort of recreational runners, there is a dearth of research examining this population and their physiological makeup. It is widely accepted that running economy (RE), the metabolic cost of steady-state running, is a reliable indicator of running performance at 5 km distances (Saunders et al., 2004, Sports Medicine, 34(7), 465-485). However, research has predominantly examined elite and well-trained runners, on a laboratory treadmill. Hence little is known about the outdoor RE of recreational runners. The aim of this study was to examine the differences in RE over the two conditions, to determine whether measuring RE only in an external environment can be considered a useful measure. Eight recreationally active participants (5 female) (mean ± SD: age 33.25 ± 10.39 years; stature 1.72 ± 0.93 m; body mass 66.19 ± 13.66 kg) provided written informed consent before taking part in the study which had institutional ethical approval. Participants wore a portable COSMED K5 metabolic analyser and ran, in a randomised order, at a self-selected comfortable 5k running pace for 5 minutes on a treadmill (TD), and at the same speed for 5 minutes outside (OG), using an accompanying bike to pace the runner. Rating for perceived exertion (RPE) was recorded post-test, and the RE for each condition determined during the final minute of the test. A t-test showed there was a statistical difference in RE between the two conditions (P = 0.03; TD mean ± SD: 221.58 ± 56.25 ml.kg-1 .km-1 ; OG mean ± SD: 187.48 ± 33.98 ml.kg-1 .km-1 ), although there was a strong correlation between them (R = 0.784, P = 0.021), the effect size (Hedges’ g = 0.68) suggested there is a moderate difference. Participants reported a statistically significantly lower RPE (P < 0.01) when running outside (TD mean ± SD: 14 ± 1.84; OG mean ± SD: 10 ± 3.23). The results suggest that further studies should examine possible reasons for the differences between RE in the two conditions as there may be limitations in assessing one condition and applying results to the other