Therapists under influence – Patient strategies and therapist reactions

Therapists having a positive influence on patients is a common view of psychotherapy. There is, however, an influence of patients on therapists too, which has received less attention. The more restricted and rigid patients are, the more limited the interpersonal behavior of others with which the get along well. In line with social psychological, interpersonal and clinical models they try to bring the therapist into an interpersonal position which suits them well. With 60 patients, common strategies have been rated: Good mood, Positive feedback, Negative feedback, Agenda setting, Provoking a response from the therapist, Negative reports about third persons, Fait accompli, Supplication, Self-promotion, Avoidance of contents, und Emotional avoidance. The rating procedure, frequencies, and therapist reactions upon these patient strategies will be reported

Influence of previous surgery on patient-rated outcome after surgery for degenerative disorders of the lumbar spine.

PURPOSE Few studies have used multivariate models to quantify the effect of multiple previous spine surgeries on patient-oriented outcome after spine surgery. This study sought to quantify the effect of prior spine surgery on 12-month postoperative outcomes in patients undergoing surgery for different degenerative disorders of the lumbar spine. METHODS The study included 4940 patients with lumbar degenerative disease documented in the Spine Tango Registry of EUROSPINE, the Spine Society of Europe, from 2004 to 2015. Preoperatively and 12 months postoperatively, patients completed the multidimensional Core Outcome Measures Index (COMI; 0-10 scale). Patients' medical history and surgical details were recorded using the Spine Tango Surgery 2006 and 2011 forms. Multiple linear regression models were used to investigate the relationship between the number of previous surgeries and the 12-month postoperative COMI score, controlling for the baseline COMI score and other potential confounders. RESULTS In the adjusted model including all cases, the 12-month COMI score showed a 0.37-point worse value [95 % confidence intervals (95 % CI) 0.29-0.45; p < 0.001] for each additional prior spine surgery. In the subgroup of patients with lumbar disc herniation, the corresponding effect was 0.52 points (95 % CI 0.27-0.77; p < 0.001) and in lumbar degenerative spondylolisthesis, 0.40 points (95 % CI 0.17-0.64; p = 0.001). CONCLUSIONS We were able to demonstrate a clear "dose-response" effect for previous surgery: the greater the number of prior spine surgeries, the systematically worse the outcome at 12 months' follow-up. The results of this study can be used when considering or consenting a patient for further surgery, to better inform the patient of the likely outcome and to set realistic expectations.

Noise peaks influence communication in the operating room. An observational study

Noise peaks are powerful distractors. This study focuses on the impact of noise peaks on surgical teams' communication during 109 long abdominal surgeries. We related measured noise peaks during 5-min intervals to the amount of observed communication during the same interval. Results show that noise peaks are associated with less case-relevant communication; this effect is moderated by the level of surgical experience; case-relevant communications decrease under high noise peak conditions among junior, but not among senior surgeons. However, case-irrelevant communication did not decrease under high noise level conditions, rather there was a trend to more case-irrelevant communication under high noise peaks. The results support the hypothesis that noise peaks impair communication because they draw on attentional resources rather than impairing understanding of communication. As case-relevant communication is important for surgical performance, exposure to high noise peaks in the OR should be minimised especially for less experienced surgeons. Practitioner Summary: This study investigated whether noise during surgeries influenced the communication within surgical teams. During abdominal surgeries, noise levels were measured and communication was observed. Results showed that high noise peaks reduced the frequency of patient-related communication, but did not reduce patient-irrelevant communication. Noise may negatively affect team coordination in surgeries.

The social perception of heroes and murders: Effects of gender-inclusive language in media reports

The way media depict women and men can reinforce or diminish gender stereotyping. Which part does language play in this context? Are roles perceived as more gender-balanced when feminine role nouns are used in addition to masculine ones? Research on gender-inclusive language shows that the use of feminine-masculine word pairs tends to increase the visibility of women in various social roles. For example, when speakers of German were asked to name their favorite "heroine or hero in a novel," they listed more female characters than when asked to name their favorite "hero in a novel." The research reported in this article examines how the use of gender-inclusive language in news reports affects readers' own usage of such forms as well as their mental representation of women and men in the respective roles. In the main experiment, German participants (N = 256) read short reports about heroes or murderers which contained either masculine generics or gender-inclusive forms (feminine-masculine word pairs). Gender-inclusive forms enhanced participants' own usage of gender-inclusive language and this resulted in more gender-balanced mental representations of these roles. Reading about "heroines and heroes" made participants assume a higher percentage of women among persons performing heroic acts than reading about "heroes" only, but there was no such effect for murderers. A post-test suggested that this might be due to a higher accessibility of female exemplars in the category heroes than in the category murderers. Importantly, the influence of gender-inclusive language on the perceived percentage of women in a role was mediated by speakers' own usage of inclusive forms. This suggests that people who encounter gender-inclusive forms and are given an opportunity to use them, use them more themselves and in turn have more gender-balanced mental representations of social roles.

A potential case of attitude change: The Spanish spoken in the city of Malaga and used on social network sites

The Spanish spoken in the city of Malaga, as Andalusian Spanish in general, was in the past often times considered an incorrect, low prestige variety of Spanish which was strongly associated with the poor, rural, backward South of Spain. This southern Spanish variety is easily recognised because of its innovative phonetic features that diverge from the national standard, even though in the past years in the case of some features a convergence to the standard could be observed. Despite its low prestige the local variety of Spanish is quite often used on social network sites, where it is considered as urban, fashion and cool. Thus, this paper aims at analysing whether the Spanish used in the city of Malaga is undergoing an attitude change. The study draws on naturally occurring speech, data extracted from Facebook and a series of questionnaires about the salience, attitude and perception of the local variety of Spanish. The influence of the social factors age and gender is analysed, since they are both known to play a crucial role in many instances of language change. The first is of special interest, as during the Franco dictatorship dialect use was not accepted in schools and in the media. Results show that, on the one hand, people from Malaga hold a more positive attitude towards non-standard features used on social network sites than in spoken language. On the other hand, young female users employ most non-standard features online and unsurprisingly have an extremely positive attitude towards this use. However, in spoken Spanish the use and attitude of some features is led by men and speakers educated during the Franco dictatorship, while other features, such as elision of intervocalic /d/, elision of final /ɾ/, /l/ and /d/ and ceceo, are predominantly employed by and younger speakers and women. These features are considered as salient in the local variety and work as local identity markers.

The influence of parent's body mass index on peer selection: An experimental approach using virtual reality

Relatively little is known about the influence of psychosocial factors, such as familial role modeling and social network on the development and maintenance of childhood obesity. We investigated peer se- lection using an immersive virtual reality environment. In a virtual schoolyard, children were confronted with normal weight and overweight avatars either eating or playing. Fifty-seven children aged 7–13 participated. Interpersonal distance to the avatars, child's BMI, self-perception, eating behavior and parental BMI were assessed. Parental BMI was the strongest predictor for the children's minimal distance to the avatars. Specifically, a higher mothers' BMI was associated with greater interpersonal distance and children approached closer to overweight eating avatars. A higher father's BMI was associated with a lower interpersonal distance to the avatars. These children approached normal weight playing and overweight eating avatar peers closest. The importance of parental BMI for the child's social approach/ avoidance behavior can be explained through social modeling mechanisms. Differential effects of pa- ternal and maternal BMI might be due to gender specific beauty ideals. Interventions to promote social interaction with peer groups could foster weight stabilization or weight loss in children.