Books on the topic 'Psychological availability'

Chapter 4 describes the Improving Access to Psychological Therapies Program in the United Kingdom, a sweeping national effort to ensure availability of evidence-based treatments by providing intensive training and utilizing a stepped-care model consistent with best-practice recommendations for the treatment of anxiety and depression.

Sleep patterns of quantity and quality are affected by a variety of cultural, social, psychological, behavioural, pathophysiological, and environmental influences. Changes in modern society—such as longer working hours, more shift work, 24/7 availability of commodities, and 24-hour global connectivity—have been associated with a gradual reduction in sleep duration and sleeping patterns across westernized populations. In the present chapter we review the evidence to suggest that prolonged curtailment of sleep duration and worsening of sleep quality are both powerful risk factors for the development of common diseases such as obesity, diabetes, hypertension, heart disease, and stroke, and may even be responsible, in the long term, for premature death.

The increasing availability of genetic tests is transforming health care. Patients can benefit from earlier, more precise diagnosis and sometimes tailor-made treatment; their relatives can be offered pre-symptomatic, predictive tests and carrier tests. Physicians must balance confidentiality with duty to other individuals, and are responsible for using genetic tests for the benefit of patients in an ethical way. An offer of testing must balance potential additional benefit from potential downsides of testing including psychological effects, risk of error, continuing uncertainty, and cost. The ability to do multiple tests on many genes, even to sequence the whole genome, is rapidly approaching, and mainstreaming of tests means that geneticists are not necessarily involved. Further work and thinking needs to inform medical ethics in this area.

This book compiles a series of educational and thought-provoking chapters from the world's leading cognitive and clinical scientists to describe the latest research on cognitive impairments in a host of pathological conditions that affect CNS functioning, the available treatments for these impairments, and how new treatments are being tested. This volume advances the field toward the availability of cognitive enhancing drugs and devices that will benefit those who need them most and others who may believe that these techniques can help them to thrive. Psychological science and cognitive neuroscience have become the most popular endeavor of students worldwide, are the focus of attention of our greatest scientific accomplishments, and are the emphasis of many publications in the mainstream media. Because humans depend on cognitive abilities for survival, quality of life, and productivity, improving them has never been more important. Those with impairments in key aspects of cognition suffer dearly because they are unable to obtain and retain information, unable to make sound decisions based on the information at hand, and unable to plan future activities. The availability of pharmacological and behavioral interventions that can improve cognitive abilities and provide impaired individuals with the social, occupational, and functional quality of life that the rest of us enjoy has potential far-reaching implications. Such interventions can also benefit those who want to boost current cognitive abilities to higher levels, perhaps as a means to hone skills in providing products for others or to gain an edge on competition.

In recent years, there has been a movement away from traditional disorder-specific manuals for the treatment of psychological disorders and toward treatment approaches that focus on addressing psychological processes that appear to cut across disorders. These “transdiagnostic” evidence-based treatments may prove to be more cost-efficient and have the potential to increase availability of evidence-based treatments to meet a significant public-health need. Among clinicians, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), developed by Dr. David Barlow and colleagues, is the most recognizable and widely used transdiagnostic treatment protocol with empirical support for its use. This book provides clinicians with a “how to” guide for using the UP to treat a broad range of commonly encountered psychological disorders in adults. Each chapter covers a specific emotional disorder but important transdiagnostic processes are highlighted and discussed in relation to treatment. Case studies are employed throughout to illustrate the real-world application of this unique cognitive behavioral protocol and to instruct clinicians in the nuts and bolts of assessment, case formulation, and treatment in accordance with a transdiagnostic perspective. Most of the chapters are authored by current or former unified protocol team members who are all thoroughly familiar with the UP and will be writing about cases they themselves have treated.

Surgery and radiotherapy for cancers can disrupt mental health through direct biological mechanisms in addition to the well-described psychological distress associated with the physical consequences of treatment. Upper bowel surgery and bilateral oophorectomy both frequently provoke psychopathology. Total gastrectomy, or ileal resection, causes an inevitable vitamin B12 deficiency. The molecular mechanisms by which these surgical treatments provoke depressive symptoms, or even a dementia, are considered. Raised homocysteine levels and reduced SAM availability are involved. Chronic gonadal oestrogen deprivation increases the risk of anxiety, depression, and dementia in later life. The likely molecular basis for this is discussed. Hypothyroidism, with its associated psychopathology, complicates radiotherapy for head & neck cancers in 40 per cent of patients. The chapter closes with a review of the effects of whole-brain radiotherapy on cognitive function, and the psychopathology arising from radiation-induced hypopituitarism.

Suicide among service members is associated with several demographic and social risk factors, especially precipitating intimate partner relationship issues, but the cause and nature of these failed relationships in the military have not been well explored. Service members have histories leading up to a suicide analogous to those among civilians. However, separations from families, deployments, combat or other trauma, command climate, and medical and psychological injuries are also stressors and may be linked to additional risks related to substance abuse, sexual dysfunction, domestic violence, lifestyle disagreements, or secretive thoughts and behaviors, which distance couples and add to disintegration of the supportive dyad the relationship could provide. Loss of vital social supports impacts resilience and facilitates a mindset enabling suicidal or other harmful thoughts and actions. Therefore, prevention programs that build, maintain, and sustain resilience are critical, as is availability of mental health clinicians trained to address relationship issues.

Cardiac genetic counselling is an emerging but important subspecialty. The qualifications of cardiac genetic counsellors depend on the country of practice, but at a minimum they are Master’s-level trained health professionals with expertise in genetics, and are integral members of the multidisciplinary inherited cardiovascular disease clinic. Though the framework is diverse in different countries, key roles include investigation and confirmation of family history details, discussion of inheritance risks and facilitation of cardiac genetic testing, communication with at-risk relatives, and increasingly, curation of genetic test results. The use of next-generation sequencing technologies has seen a recent shift in the uptake of genetic testing, due to greater availability and lowered costs. As these gene tests become more comprehensive, including large panels of genes and even whole exome or whole genome sequencing, the need for cardiac genetic counsellors to provide informed consent, appropriate pre- and post-test genetic counselling, and ongoing curation of the variants identified is evident. Finally, given the improved understanding of the psychological implications of living with a cardiovascular genetic disease, cardiac genetic counsellors are integral in delivering psychosocial care and identifying patients requiring intervention with a clinical psychologist.

Research has highlighted a puzzling discrepancy in our selective attention performance: whereas in some circumstances we are able to be highly selective, at other times we can exhibit high levels of distraction. The load theory of attention and cognitive control provides an explanation for these contrasting observations, proposing that the extent to which people can focus their attention in the face of irrelevant distractions depends on the level and type of information load involved in their current task. According to the theory, the extent to which unattended visual information is perceived depends on the perceptual load of the attended task, such that increasing the level of perceptual load in the task decreases processing of task-irrelevant stimuli. Effective prioritization of task-relevant stimuli in the face of competition from irrelevant distractors is proposed to depend on the availability of executive control functions. Thus, loading executive control results in increased processing of irrelevant stimuli. This chapter presents converging research from a wide range of approaches in support of these proposals, as well as highlighting some of load theory’s wider influences in areas as diverse as emotion processing, developmental psychology, and the understanding of psychological disorders.

Cervical and lumbar spine pain are major causes of disability and distress. Careful assessment is needed of the nature and extent of the problem, for diagnosis and exclusion of important (treatable) differential diagnoses, and for the formulation and engagement of the patient in an appropriate treatment plan. Acute spinal pain frequently does not indicate underlying joint pathology. Chronic spinal pain is often associated with intervertebral disc disease or which is often classified together with facet joint osteoarthritis as spondylosis. Sciatica, brachalgia, or spinal claudication may each be a consequence of either spondylosis or intervertebral disc prolapse. Simple mechanical low back and neck pain may respond well to conservative management with analgesics and physiotherapy. Specific spinal problems, such as neuronal compromise, may require additional treatments. The roles of injections and surgery in the management of spinal pain continue to evolve. Although ongoing management is largely determined by the individual's clinical response, comprehensive health economic analyses inform healthcare policies which may limit treatment availability. Many people with spinal problems suffer long-term or recurrent pain and disability, with significant psychological and social impact. Multidisciplinary approaches are needed to facilitate pain management and enable people with spinal pain to lead fulfilling lives when the underlying condition cannot be cured.

Research on media gatekeeping is focused on the factors leading to a distribution of information in media content that is systematically different from the “real world.” Early gatekeeping work examined editorial decisions, and emphasized the effect that a single editor’s preferences and beliefs could have on the content new consumers receive. The literature has gradually shifted to focus on more generalizable factors, however. These include organization-level assessments of newsworthiness and commercial/economic considerations; broader system-level factors including the impact of dominant ideologies and political and social norms; and common individual-level factors, including a range of cognitive and psychological biases.The tendency for humans to prioritize negative over positive information is one such cognitive bias—and the growing literature on the negativity bias is discussed here as one example of a set of organization-, system-, and individual-level “gates” that have a systematic impact on news content. Negativity is just one example, however. Sensationalism, violence, geographic proximity, availability of visuals, prominence of celebrities—all of these tendencies in media content can and have been examined effectively using the gatekeeping metaphor. Some of this work is reviewed here, alongside some recent trends in gatekeeping work, including the “distributional” approach to gatekeeping, and the shift in gatekeeping brought on by the “new media” environment.

Must causal models distinguish default from deviant events? Yes, say Menzies (2004, 2007), Hitchcock (2007), Hall (2007), and Halpern (2008), inter alia. No, argues this chapter. It argues that adding defaults into causal models (1) generates complicating and under-constrained unclarities, (2) fails to solve the problems it has been claimed to solve, and (3) fails to fit the most psychologically plausible accounts of how norms influence cognition generally. Instead of adding defaults into causal models, it recommends clarifying the background constraints on what counts as an apt causal model, and attending to background cognitive biases about the availability of alternatives.

The term ‘polytrauma’ refers to blunt (or crush) trauma that involves multiple body regions or cavities, and compromises physiology to potentially cause dysfunction of uninjured organs. Polytrauma frequently affects muscles resulting in rhabdomyolysis. In daily life, it mostly occurs after motor vehicle accidents, influencing a limited number of patients; after mass disasters, however, thousands of polytrauma victims may present at once with only surgical features or with additional medical complications (crush syndrome). Among the medical complications, acute kidney injury (AKI) deserves special mention, since it is frequent and has a substantial impact on the ultimate outcome.Several factors play a role in the pathogenesis of polytrauma (or crush)-induced AKI: (1) hypoperfusion of the kidneys, (2) myoglobin-induced direct nephrotoxicity, and intratubular obstruction, and also (3) several other mechanisms (i.e. iron and free radical-induced damage, disseminated intravascular coagulation, and ischaemia reperfusion injury). Crush-related AKI is prerenal at the beginning; however, acute tubular necrosis may develop eventually. In patients with crush syndrome, apart from findings of trauma, clinical features may include (but are not limited to) hypotension, oliguria, brownish discoloration of urine, and other symptoms and findings, such as sepsis, acute respiratory distress syndrome, disseminated intravascular coagulation, bleeding, cardiac failure, arrhythmias, electrolyte disturbances, and also psychological trauma.In the biochemical evaluation, life-threatening hyperkalaemia, retention of uraemic toxins, high anion gap metabolic acidosis, elevated serum levels of myoglobin, and muscle enzymes are noted; creatine phosphokinase is very useful for diagnosing rhabdomyolysis.Early fluid administration is vital to prevent crush-related AKI; the rate of initial fluid volume should be 1000 mL/hour. Overall, 3–6 L are administered within a 6-hour period considering environmental, demographic and clinical features, and urinary response to fluids. In disaster circumstances, the preferred fluid formulation is isotonic saline because of its ready availability. Alkaline (bicarbonate-added) hypotonic saline may be more useful, especially in isolated cases not related to disaster, as it may prevent intratubular myoglobin, and uric acid plugs, metabolic acidosis, and also life-threatening hyperkalaemia.In the case of established acute tubular necrosis, dialysis support is life-saving. Although all types of dialysis techniques may be used, intermittent haemodialysis is the preferred modality because of medical and logistic advantages. Close follow-up and appropriate treatment improve mortality rates, which may be as low as 15–20% even in disaster circumstances. Polytrauma victims after mass disasters deserve special mention, because crush syndrome is the second most frequent cause of death after trauma. Chaos, overwhelming number of patients, and logistical drawbacks often result in delayed, and sometimes incorrect treatment. Medical and logistical disaster preparedness is useful to improve the ultimate outcome of disaster victims.