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The current study evaluated formal training around spiritual care for healthcare providers and the relationships between that training, perceived barriers to spiritual care, and frequency of inquiry around spiritual topics. A mixed methods explanatory sequential design was used. Quantitative methods included an online survey administered to providers at The Ohio State University Comprehensive Cancer Center. Main and interactive effects of formal training and barriers to spiritual care on frequency of inquiry around spiritual topics were assessed with two-way ANOVA. Qualitative follow-up explored provider strategies to engage spiritual topics. Among 340 quantitative participants, most were female (82.1%) or White (82.6%) with over one-half identifying as religious (57.5%). The majority were nurses (64.7%) and less than 10% of all providers (n = 26) indicated formal training around spiritual care. There were main effects on frequency of inquiry around spiritual topics for providers who indicated "personal discomfort" as a barrier (p < 0.001), but not formal training (p = 0.526). Providers who indicated "personal discomfort" as a barrier inquired about spirituality less frequently, regardless of receiving formal training (M = 8.0, SD = 1.41) or not (M = 8.76, SD = 2.96). There were no interactive effects between training and "may offend patients" or "personal discomfort" (p = 0.258 and 0.125, respectively). Qualitative analysis revealed four strategies with direct and indirect approaches: (1) permission-giving, (2) self-awareness/use-of-self, (3) formal assessment, and (4) informal assessment. Training for providers should emphasize self-awareness to address intrapersonal barriers to improve the frequency and quality of spiritual care for cancer patients.

PurposeThe purpose of this study was to examine the organizational context that may support learning and change readiness climates that previous research has found to be conducive to implementing evidence-based interventions.Design/methodology/approachAn exploratory, mixed method evaluation that included 15 rheumatology clinics throughout the United States was performed. Quantitative data were collected using a web-based survey completed by 135 clinic members. Qualitative data were collected via semi-structured interviews with 88 clinic members.FindingsIn general, clinics reported strong, positive learning and change readiness climates. More complex organizations (e.g. multispecialty, academic medical centers) with rational/hierarchical cultures and members with longer tenure were associated with less supportive learning and change readiness climates. The authors’ findings highlight opportunities for organizational leaders and evidence-based intervention sponsors to focus their attention and allocate resources to settings that may be most susceptible to implementation challenges.Originality/valueFirst, the authors address a deficit in previous research by describing both the level and strength of the learning and change readiness climates for implementing an evidence-based shared decision-making aid (SDMA) and examine how these vary as a function of the organizational context. Second, the study examines a broader set of factors to assess the organizational context (e.g. organizational culture, organizational structure, ownership) than previous research, which may be especially salient for shaping the climate in smaller specialty clinics like those we study. Third, the authors utilize a mixed methods analysis to provide greater insights into questions of how and why organizational factors such as size and structure may influence the learning and change readiness climate.

Cannibalism of females by males before, during or immediately following sex has been attributed to misidentification of females, rejection of females as mates and prioritisation of feeding over reproduction. In the gammarid amphipod Gammarus zaddachi, males demonstrate that they have identified a female and accepted her as a suitable mate by engaging in precopula pairing behaviour. However, a male may later decide to eat the female after pairing with her. Laboratory experiments were performed in which survival of females in precopula pairs of G. zaddachi was monitored after their male partners had been subjected to starvation, herbivorous diets or diets containing animal matter. These indicate that the female is less likely to survive when she is abnormally small relative to the male, when the male is at risk of death by starvation or when the male’s diet has lacked animal content. Decisions by males to forgo reproductive opportunities in favour of cannibalism, even after engaging in costly mate-guarding behaviour, emphasise the importance of carnivory in the trophic ecology of Gammarus species.

The essay examines the Catholic Church's theology of work, as revealed specifically by two influential encyclicals on human work, Rerum Novarum (1891) and Laborem Exercens (1981). Both documents attracted approval for their espousal of the dignity of the worker, and Laborem Exercens in particular is said to have expounded the establishment of a dynamic new form of economic personalism in which John Paul II attempts to analyse the moral ramifications of economic activity in light of a theological vision of the human person. For all their good intentions of rationalising human materiality, both encyclicals served primarily to redress the imbalances of the employer/employee relationship, rather than to fundamentally question the philosophical and biblical anthropology of the increasingly dysfunctional nature of human work. The Catholic Land Movement (1929 – 1939), an English agrarian community initiative that embraced the principles of Rerum Novarum, attempted in to create an entirely new theology of human work, around the principles of Distributism, Dominicanism and the arts-and-crafts movement. The ideological progress of the land colonies, and their increasing antipathy to industrialism, led them to challenge fundamentally the presumption of the need for mass employment - a position that significantly undermined the primacy of Rerum Novarum, and consequently compromised hierarchy support for their initiative, leading to the organisation's rapid decline. Despite its failure, the Catholic Land Movement nonetheless gave voice to the theologically significant possibility that the message of Genesis might not be that Man is destined for a lifetime's arduous toil.

ometime in 1932, Warner Brothers wanted to translate James Joyce's epic Ulysses onto the silver screen. That fact is known, if not well known, by Joyceans. Paul Leon, Joyce, Giorgio Joyce, and Ralph Pinker, Joyce's agent in London, discussed the matter in a few published letters. Leon told Pinker that "Mr. Joyce has been approached by Warner Bros. in view of obtaining his consent to the filming of Ulysses" (LettersIll 262). Leon "went to see the ... manager of their Paris Office," who was "very eager to have the film done as quickly as possible" (LetterslIll262). Joyce told L on "to give a dilatory answer" (Letterslll 263). Though Bennett Cerf, Joyce's American publisher, thought a film would be great publicity, Leon insisted that publicity was hardly a consideration for Joyce, who took what Leon called "the literary" rather than the "material point of view" (LetterslII 263). It was not entirely clear that Joyce owned the film rights to his own novel, but should they belong to him, Ldon explained unequivocally to Pinker on 26 October 1932, "he would absolutely refuse" to allow a film to be made (LettersllI 263). A few days later, Loon equivocated: if Joyce owned the American film rights, then Leon would authorize "negotiations[,] and if they run satisfactorily," he wrote, "I can promise you that I will do my very best to prevail upon Mr Joyce to alter his present attitude" (LettersI 326). Such is the general impression left to us, and Richard Ellmann confirms what Leon implied: Joyce "discountenanced the idea" of making a film "on the ground that the book could not be made into a film with artistic propriety" (JJII 654). At best, he "allowed" Leon to let the matter percolate and "did not discourage" Stuart Gilbert from writing scenarios (JJII 654). More recently, critics have taken Joyce's interest in film more seriously, persuading us that Joyce thought film was a sister to the new kind of literature he was inventing.1 Critics today take it for granted that film techniques and Joyce's techniques in Ulysses are connected, and most will admit the resemblance between Joyce's method of narration and the montage of Sergei Eisenstein. I am interested here not in questions of narrative methodology but in the less subtle issue of biography. In particular, I want to dispute

Rats maintained at either 75% or 90% of their ad lib weight were trained to run in a straight alley for either a 10- or 1-pellet reward. Following 15 days (30 trials) of acquisition training, the 10-pellet groups were shifted to 1 pellet. A significant negative contrast was obtained only with the 75% rats and only in the goal region of the alley. The effects of deprivation on contrast found in this study were consistent with those found in earlier studies and consistent with the effects of deprivation on a number of other extinction-related phenomena.

The importance of the aged community has been realized recently, and has caused a re-examination of the methods of assessing mental deterioration. A review of the literature shows that, while the purely quantitative approach is now known to be inadequate, little attempt has been made to deal with the problem. qualitatively, apart from descriptive treatment of results. This paper presents a method which combines quantitative and qualitative data, and attempts to relate emotional reaction of the patient to his deterioration. The method has been applied to a series of forty senile-arterio-sclerotic patients. treated in a mental hospital. It is shown that, while the loss of ability to abstract determines the level of problem difficulty which the patient can master, his total efficiency depends not only upon this lose but also upon the emotional reaction to it. The results of the senile group were compared with those of children. We are indebted to Dr. P. K. McCowan, Physician Superintendent, for his kind permission to publish the material contained in this paper, and we wish to express our gratitude to Mr. J. C. Raven, Director of Psychological Research, and to Dr. W. Mayer-Gross, Director of Clinical Research, for the unfailing interest they have shown and for their much appreciated counsel.

1. The Rorschach test was carried out onfour adult subjects, three of whom were without mental abnormality. 2. A number of changes in the Rorschach records were noted which seem to be common and which may therefore be put down as specific to the drug. 3. An attempt was made to relate other changes to the type of personality and to the stability of the defence mechanisms operating under normal conditions. 4. The effect of memory on the responses given in the second test was mentioned but is not considered in this paper. A detailed comparison of responses repeated, responses omitted or modified, and responses added is required with more subjects. 5. It is suggested that the discussion as to whether the “true” personality is revealed under normal conditions or under drug intoxication is irrelevant. Within its limits, the Rorschach test reflects the personality; but the nature of the changes in personality revealed under the influence of drugs requires further study.