Hospitality Towards People with Mental Illness in the Church: a Cross-cultural Qualitative Study.

Mental illness is a prevalent concern that affects Christian churches in North America in significant ways. Previous studies on the relationship between mental illness and the church have found that beliefs and practices within the church can contribute to stigma towards people with mental illness. Yet, the typical experience of people with mental illness who attend church has been found to be positive, suggesting that there are considerable resources within the church for supporting those who experience mental health problems. One such resource is the concept of hospitality, which promotes a sense of belonging for those with mental illness in the church. This qualitative study advances the construct of hospitality as a helpful paradigm for addressing mental health needs within the church, capturing perspectives and practices that are currently in place or seen as necessary by church attendees. The study methodology also emphasized the need to incorporate cultural considerations that are appropriate for the racial and ethnic make-up of particular churches. Semistructured focus group interviews were conducted with participants from eight churches that were either predominantly African American, Asian American, Latinx, or multi-ethnic. Findings resulting from content analysis of transcripts indicated that hospitality was a broadly helpful construct for addressing mental health concerns in the church, though some cultural differences existed in the understanding and application of hospitality. Both the interface of the findings with the existing scholarly literature and the relevance of findings for church leaders are discussed.

Threshold score for the self-report Pediatric Distress Thermometer Rating Scale in childhood cancer patients.

OBJECTIVE: Although there is enthusiasm for identifying and treating psychosocial problems in childhood cancer patients, there are few validated instruments to help providers identify at-risk children for further assessment. The study objective was to evaluate the sensitivity and specificity of the self-report pediatric Distress Thermometer Rating Scale (Peds DTRS) in childhood cancer survivors and identify a threshold score to help providers classify pediatric patients. METHODS: We evaluated 54 children 7-17 years old using 178 Peds DTRS longitudinal data points from the cohort that was used for the original pediatric adaptation of the DTRS. We compared Peds DTRS scores against two established standardized measures using a generalized linear mixed model to deal with the dependency in the longitudinal data to estimate ROC curves and related statistics. RESULTS: Results indicate that a score of 3 is a reasonable cutoff to identify distress with children 7-17 years old. This cutoff yielded high sensitivity (87.0%) and specificity (79.7%) using the PedsQL Emotional Domain score as the standard. Similar results were obtained using the CDI as the standard, but we are cautious as very few CDI scores reached the cutoff criterion. Exploratory analysis highlighted clinical factors that correlate with increased distress measured using the Peds DTRS. CONCLUSIONS: The Peds DTRS is a very brief, convenient, and rapid screening tool for global distress in children. Further investigation of the Peds DTRS and other tools can improve the ability of providers to prevent and treat the negative emotional consequences of cancer and improve the quality of survivorship.

Bidirectional Associations across Time between Entitativity, Positive Affect, Generosity, and Religiousness in Adolescents Training with a Religiously Affiliated Charity Marathon Team.

Numerous studies have established that participation in regular physical activity provides physical, cognitive, and affective benefits to adolescents, but fewer studies have examined how athletic involvement might affect character, social, or religious developmental markers of psychosocial functioning. The purpose of this study is to examine the bidirectional associations between entitativity (group closeness), positive affect, generosity, and religiousness across time among adolescents and emerging adults involved in charitable marathon training. We collected data from 396 adolescents and emerging adults who trained for half/full marathons with a religiously affiliated charity team. Participants completed measures at three occasions over 18 weeks (pre-training, mid-training, post-race). We conducted cross-lagged path analysis of latent factors to study concurrent and longitudinal effects of intrinsic religiousness, positive affectivity, and entitativity on interpersonal generosity and fundraising. Participants who reported higher levels of pre-training generosity were more likely to experience positive affect during training, which predicted higher levels of post-race generosity. Likewise, the internalization of religious ideas, reflected in increased intrinsic religiousness during training, was associated with higher post-race generosity. Overall, results support the potential of charitable sporting events to promote positive psychosocial developmental outcomes.

Transcendent motivations and virtue development in adolescent marathon runners.

OBJECTIVE: To understand how health, prosocial, and spiritual motivations correspond to changes in the virtues of self-control, patience, and interpersonal generosity among adolescents and emerging adults. METHOD: Participants included adolescent and emerging adult athletes (N = 396; 12-22 years, M = 18.42, SD = 2.03) on marathon training teams fundraising for a faith-based charity. Participants completed self-report questionnaires four times over six months. Participants were 63% female and identified as 61% Caucasian, 17% Latino/a, 10% African American, 6% Asian American, and 6% other. RESULTS: Bivariate latent growth curve models showed positive relations between baseline levels of transcendent motivations (spiritual, prosocial) and all three virtues (self-control, patience, interpersonal generosity) as well as baseline health motivation and self-control. Linear slopes in all three motivations were positively correlated with change in patience, and greater decreases in these motivations from wave 1 to wave 2 before recovering motivation in subsequent waves correlated with less change in patience. Only the linear slope in prosocial motivation positively correlated with change in generosity. None of the motivation slopes correlated with change in self-control. CONCLUSIONS: More than just sport participation is required to cultivate virtue in adolescents; instead, transcendent and non-transcendent motivations are concurrently developing for athletes who increase in prosocial virtues.

Wartime Vascular Injury.

Wartime vascular injury can be particularly challenging due to the complexity of the case, concomitant injuries, resource limitations, and often lack of expertise of the operating surgeon. The proliferation of vascular shunting has been of particular importance as a damage control surgery technique to restore perfusion and temporize the immediate need for definitive repair necessary for limb salvage, particularly in austere locations. Diagnosis of vascular injury can be made using a variety of techniques, from physical examination to ankle-brachial indices to the use of CT angiography or invasive angiographic techniques. Operative planning and judgment are therefore critical in deciding both how and whether to operate. Surgeons likely to deploy should take every opportunity to practice vascular exposures and techniques through clinical practice and laboratory courses.

Convergent and criterion validity of the CogState computerized brief battery cognitive assessment in women with and without breast cancer.

OBJECTIVE: Computerized tests have increasingly garnered interest for assessing cognitive functioning due to their potential logistical and financial advantages over traditional 'pencil and-paper' neuropsychological tests. However, psychometric information is necessary to guide decisions about their clinical and research utility with varied populations. We explored the convergent construct validity and criterion validity of the CogState computerized tests in breast cancer survivors, a group known to present with mostly mild, subtle cognitive dysfunction. METHOD: Fifty-three post-menopausal women (26 breast cancer survivors, 27 healthy controls) completed the CogState Brief Battery tests with passed performance checks, conceptually matched traditional neuropsychological tests, and a self-report measure of daily functioning, the Functional Activities Questionnaire. RESULTS: Significant positive correlations were found between the CogState Brief Battery tests and traditional neuropsychological tests, although the traditional tests specifically hypothesized to correlate with CogState tests did not reach statistical significance. Analysis of Covariance results showed preliminary support for criterion validity, as the patient and control groups differed on the traditional test of working memory (Digits Backwards, p = .01), with a trend towards significance for the CogState test of working memory (One Back, p = .02), controlled for age, race, and mood. CONCLUSIONS: The results provide preliminary support for further research to determine if the CogState tests are viable as screening tools to detect subtle cognitive differences between breast cancer survivors and healthy women. Our study was limited by the low base rate of cognitive impairment and small sample size. We recommend further research employing sufficiently powered sample sizes and a longitudinal, repeated measures study design.