Reducing Suicide Risk: Challenges and Opportunities in the Emergency Department.

Emergency departments (ED) are prime locations for identifying individuals at high risk of suicide and for making life-saving interventions. In an ideal scenario, all ED patients at risk of suicide could be identified and connected with effective, feasible interventions, and this would occur in a supportive system not overburdened by screening or assessment requirements. In this review, we focus on challenges to achieving this ideal--along with potential solutions--at the level of patients, providers, the ED environment, and the larger health care system.

What do I do? Developing a taxonomy of chaplaincy activities and interventions for spiritual care in intensive care unit palliative care.

BACKGROUND: Chaplains are increasingly seen as key members of interdisciplinary palliative care teams, yet the specific interventions and hoped for outcomes of their work are poorly understood. This project served to develop a standard terminology inventory for the chaplaincy field, to be called the chaplaincy taxonomy. METHODS: The research team used a mixed methods approach to generate, evaluate and validate items for the taxonomy. We conducted a literature review, retrospective chart review, focus groups, self-observation, experience sampling, concept mapping, and reliability testing. Chaplaincy activities focused primarily on palliative care in an intensive care unit setting in order to capture a broad cross section of chaplaincy activities. RESULTS: Literature and chart review resulted in 438 taxonomy items for testing. Chaplain focus groups generated an additional 100 items and removed 421 items as duplications. Self-Observation, Experience Sampling and Concept Mapping provided validity that the taxonomy items were actual activities that chaplains perform in their spiritual care. Inter-rater reliability for chaplains to identify taxonomy items from vignettes was 0.903. CONCLUSIONS: The 100 item chaplaincy taxonomy provides a strong foundation for a normative inventory of chaplaincy activities and outcomes. A deliberative process is proposed to further expand and refine the taxonomy to create a standard terminological inventory for the field of chaplaincy. A standard terminology could improve the ways inter-disciplinary palliative care teams communicate about chaplaincy activities and outcomes.

Knowing color terms enhances recognition: further evidence from English and Himba.

Two experiments attempted to reconcile discrepant recent findings relating to children's color naming and categorization. In a replication of Franklin and colleagues (Journal of Experimental Child Psychology, 90 (2005) 114-141), Experiment 1 tested English toddlers' naming and memory for blue-green and blue-purple colors. It also found advantages for between-category presentations that could be interpreted as support for universal color categories. However, a different definition of knowing color terms led to quite different conclusions in line with the Whorfian view of Roberson and colleagues (Journal of Experimental Psychology: General, 133 (2004) 554-571). Categorical perception in recognition memory was now found only for children with a fuller understanding of the relevant terms. It was concluded that color naming can both underestimate and overestimate toddlers' knowledge of color terms. Experiment 2 replicated the between-category recognition superiority found in Himba children by Franklin and colleagues for the blue-purple range. But Himba children, whose language does not have separate terms for green and blue, did not show a cross-category advantage for that set; rather, they behaved like English children who did not know their color terms.

Categorical perception of animal patterns.

As part of the more general issue of whether culture can affect perception, the present paper addresses the Whorfian question of whether the language available to describe perceptual experience can influence the experience itself. It investigated the effect of vocabulary on perceptual classification by the study of a remote culture (Himba) which possesses a poor colour vocabulary but a rich vocabulary of animal pattern terms. Thus, the present study examined Categorical Perception (CP) with a type of visual stimulus not previously used to assess the effect of labels on perceptual judgments. For the animal patterns, the Whorfian view predicted that it would only be the Himba who showed superiority for cross-category decisions as only they have the appropriate labels. The Whorfian view was upheld and confirmed previous findings that linked perceptual differences to labelling differences.

More accurate size contrast judgments in the Ebbinghaus Illusion by a remote culture.

The Ebbinghaus (Titchener) illusion was examined in a remote culture (Himba) with no words for geometric shapes. The illusion was experienced less strongly by Himba compared with English participants, leading to more accurate size contrast judgments in the Himba. The study included two conditions of inducing stimuli. The illusion was weaker when the inducing stimuli were dissimilar (diamonds) to the target (circle) compared with when they were similar (circles). However, the illusion was weakened to the same extent in both cultures. It is argued that the more accurate size judgments of the Himba derive from their tendency to prioritize the analysis of local details in visual processing of multiple objects, and not from their impoverished naming.

Cross-species differences in color categorization.

Berlin and Kay (1969) found systematic restrictions in the color terms of the world's languages and were inclined to look to the primate visual system for their origin. Because the visual system does not provide adequate neurophysiological discontinuities to supply natural color category boundaries, and because recent evidence points to a linguistic origin (Davidoff, Davies, & Roberson, 1999), a new approach was used to investigate the controversial issue of the origin of color categories. Baboons and humans were given the same task of matching-to-sample colors that crossed the blue/green boundary. The data and consequent modeling were remarkably clear-cut. All human subjects matched our generalization probe stimuli as if to a sharp boundary close to the midpoint between their training items. Despite good color discrimination, none of the baboons showed any inclination to match to a single boundary but rather responded with two boundaries close to the training stimuli. The data give no support to the claim that color categories are explicitly instantiated in the primate color vision system.

Funding a full continuum of mental health promotion and intervention programs in the schools.

PURPOSE: To assess the availability of public and private financing sources to support comprehensive school mental health programs. The paper focuses on "expanded school mental health" (ESMH) programs, which provide a full array of mental health promotion and intervention services to youth in general and special education through school-community partnerships. METHODS: A range of strategies to fund ESMH services are reviewed, including fee-for-service funding, as well as grants, contracts, and other mechanisms from federal, state, local, and private sources. RESULTS: An objective national study of the characteristics and financing of ESMH programs has yet to be conducted. Existing evidence suggests that funding for these programs is patchy and tenuous. Many programs are being funded through fee-for-service programs, which generally only support the provision of more intensive services (e.g., assessment, therapy) and are associated with significant bureaucracy and other concerns (e.g., the need to diagnose students). As programs move to enhance funding for preventive and mental health-promoting activities and services, there is an increasing need for grants, contracts, and other sources of support. CONCLUSION: Progress in the national movement toward ESMH will be promoted through an interconnected agenda of quality improvement, evaluation of program effectiveness, and the advancement of advocacy. These developments will facilitate policy improvements and increased funding for the full continuum of mental health promotion and intervention in the schools.