In this essay, I take up the question of the time of medicine in relation to two events in the U.S. from 2005—the Terri Schiavo case and Hurricane Katrina and its aftermath. I consider both cases as “mediatized medical events,” that is, as events in which the practices of medicine received considerable media attention at a particular historical moment; or, we might say, as events that brought a convergence between media and medical practices. (...) I juxtapose these two events because, placed side by side, they help make visible two stories of catastrophe, as well as the many difficulties of telling stories of catastrophe. Bringing together these seemingly divergent events allows me to draw connections that I hope will expand our bioethical imaginary beyond the reductive approaches that tend to dominate the practice of bioethics today. I also juxtapose them to signal a bioethical tension at the heart of the neoliberal state’s response to catastrophe in general, what Foucault might have diagnosed as the difference between making live and letting die. In these two events, we glimpsed—if only fleetingly—the state’s operation of making live and letting die, and medicine’s central role in that operation, as well as the re-assertion of medical sovereignty in crisis events. (shrink)

ABSTRACTOn 28 October 2012, Savita Halappanavar, an Indian woman living in Ireland, died in hospital while under medical care for a miscarrying pregnancy. According to her husband, her repeated requests for an abortion were ignored because of the presence of a foetal heartbeat. Ms Halappanavar’s death was a critical event in the process leading to a referendum on 25 May 2018, when the Irish electorate voted to repeal the Eighth Amendment of the Constitution, removing the constitutional ban on abortion. (...) The name Savita has become indelibly linked to the changing course of abortion politics, so it is timely to reassess the role of the media in shaping the parameters of the debate about the impact of her death on the issue. This study presents a frame analysis of Irish newspapers in the weeks following her death, mapping the political, medical, legal and socio-ethical discourses, as well as the related contemporaneous events that set the agenda for the type of debate that was to follow. It identifies four media frames: Public Tragedy, Political Opportunity, Abortion Legacy and Maternal Health. Our central argument is that the overall effect of media framing provided much face-saving for politicians in the way that the legislative issue was viewed through a conservative party-political lens, despite public outrage. (shrink)

In the event that a patient has lost their decision-making capacity due to illness or injury, a surrogate is often appointed to do so on their behalf. Research has shown that people take less risk when making treatment decisions for other people than they do for themselves. This has been discussed as surrogates employing greater caution for others given the accountability they are faced with. We tested the prediction that making accountability salient reduces risk- taking for others relative to the (...) self by manipulating the information shown to participants while they made treatment choices. One group was asked to focus on the consequences for the recipient’s family, another on the legal implications of their decisions, and another was not given additional information. Participants reduced their risk-taking for others compared to themselves, irrespective of the condition they were in. Although participants in each condition reported thinking about these factors to different extents, there were no clear differences in risk-taking between groups. However, we did find that, across all participants, thinking about legal consequences reduces risk-taking. We suggest that future research investigates how the effect of thinking about accountability on surrogate choices is mediated by feelings of accountability, in order to further examine the explanations suggested in the literature. (shrink)

Rivers et al. raise two ethical issues in relation to the use of medication event monitoring systems (MEMS). The first issue, identified as an 'economic' concern, centres on the waste of health resources caused by patient failure to adhere to medication programmes. The second is the danger that MEMS may pose to 'the trust that should exist between patient and prescriber'. In what follows I offer an analysis of these issues, and their relationship to each other.

The Medication Event Monitoring System (MEMS) is a relatively new device designed to overcome some of the disadvantages of traditional adherence-measuring techniques. MEMS has also been found useful in tracking adherence behaviour without the need to visit patients frequently. In this study each patient was given a pre-filled, labelled MEMS bottle and cap. Patients were monitored for 24 weeks. For patients specifically studied, there were periods when drug levels may have been low and some exhibited erratic medication-taking behaviour. It is (...) concluded that MEMS can measure adherence behaviour objectively, and so might be used to improve prescribing decisions, identify drug wastage and improve carer support. Further research is needed before the routine use of electronic medication monitoring can be recommended. (shrink)

The interior of the body is an alien landscape, the frontiers of which we are continually expanding. Technological developments have allowed us to see more and more of what lies beneath the skin. Starting with the violently erotic public spectacle of dissection in amphitheatres, through X-ray and endoscopy, to other current and future technologies that work towards the yet to be realized ideal (or myth) of a truly non-invasive but microscopically detailed depiction of the human body. This opening up of (...) the human interior to our gaze is not exclusively a medical phenomenon. It is an exploration that has been shared by scientists, artists and entertainers, variously reappropriating imagery and technologies of seeing. Each new invasive technology brings with it the somewhat naïve belief that it can excavate the essence of the subject, their passions, motivations and faults, their ‘souls’ for lack of a better word. Yet while an X-ray can certainly not tell us anything of the subject’s personality, as we delve deeper we discover more about our chemical and electrical natures, encouraging the perception that our consciousness is the ‘sum of our parts’. However, as technologies have become more sophisticated, there has been an increasing tendency to present the body in segments, detached from their surrounding structures. A certain objectification and distancing that occurs when we view the flesh laid open. How do we engage with these views culturally, and how do they influence how we view others and ourselves? In this article I grapple with notions of a mutating body that we are actively in the process of changing in the context of my own and others’ visual practice, with particular emphasis on making the mediated nature of these images visible. I will engage in a celebratory but critical discussion of others’ and mine. (shrink)

While previous studies highlight the dynamic nature of identity co-construction, how and especially why speakers construct and shift their own multiple identities still remains understudied. The present study argues that identity is part of speaker communicative resources as evidenced by radio program hosts’ strategic employment and shift among their different identities to facilitate their interactional purposes. Based on data drawn from radio medical consultations, this article attempts to reveal the dynamic adaptability of hosts’ identity construction. It is found that (...) in general, hosts of medical consultation programs construct three identities for themselves, namely an authoritative expert identity, a caring friend identity and a sales representative identity; the three identities constructed are respectively adaptable to power relationships, solidarity and role relationships between hosts and callers in conversation; the three identities shift in conversations to facilitate callers’ purchasing acts. (shrink)

Medical ethics committees are increasingly called on to assist doctors, patients, and families in resolving difficult ethics issues. Although committees are becoming more sophisticated in the substance of medical ethics, little attention has been given to the processes these committees use to facilitate decision-making. In 1990, the National Institute for Dispute Resolution in Washington, D.C., provided a planning grant from its Innovation Fund to the Institute of Public Law of the University of New Mexico School of Law to (...) look at what ethics committees can learn from facilitation and mediation techniques. The study's thesis was that, if adapted for use by medical ethics committees, facilitation and mediation techniques can be helpful to those bodies in case review consultations and in other internal committee processes. This article reports on that project. (shrink)

Neutrality is held to be the touchstone of good mediation. True neutrality is elusive, however, and probably not even desirable, at least when applied to patient‐provider disputes over medical care. In this context, mediators should not posture as “neutrals”; they should strive instead to protect their clients’ autonomy.

This case study provides a multi-perspective view on the power of political events as a strategy to influence public opinion-building regarding the European Union and the European Idea. To achieve this purpose, it examines one prominent political issue of 2007, namely the German Presidency of the Council of the EU. Looking at three different groups of actors, the German Government, the media, and the audience, the public perception of events is analyzed according to their varying degree of mediatization. (...) The case study compares the three main objectives of the German Presidency on the actors' agendas and describes how issues were framed during three different time periods. The findings suggest that the media agenda was heavily influenced by the government's scheduled events. Regarding the frames identified in the public sphere, the media offered different interpretations, somewhat varying from the political leaders' intentions and from the citizens' perceptions. (shrink)

The present article attempts to investigate the 'philosophical foundations' of psychology and thereby of the social sciences in general with regard to a central problem, viz. the question of the 'inner'. It does this with special critical reference to an authoritative psychological theory, viz. the so-called 'mediation theory', and tries to show the necessity of interdisciplinary clarification. In the first part mediation theory was introduced as a variant of psychological behaviorism which attempts to substitute for the untenable total neglect of (...) 'inner' events a way of talking about them which is secured methodologically and retains a behavioral foundation. Of the three crucial questions raised by the project the second, viz. question, which concerns the theoretical status of the assumed inner mediators could be answered to the effect that they must be "hypothetical constructs" having the nature of real, phenomenally verifiable events, if, indeed, they are to figure as links in S-R-chains. Conceiving of them as "intervening variables", such a conception would exclude this function. The discussion of 'internalization' of behavior sequences as assumed by mediation theory has led to the conclusion that the relevant phenomena cannot, in this case, justify the necessity of a non-dispositional explanation which goes beyond 'external' performances ). Likewise the subject matter of question remained undecided; that is, the possibilities of phenomenally verifying the assumed 'inner' mediation processes which are only asserted to exist by the theory but are unspecified in content. Therefore, the observable performances in the case of sequential behaviour do not support the mediation theoretic solution of the problem of the 'inner'. (shrink)

Mental health problems are frequent obstacles in medical students’ careers as doctors. Given that previous studies overlook the mediation of stress perception, the current study expanded previous goal orientation researches by addressing an unexplored mechanism. This study aims to examine the mediational roles of stress perception on the relationship between achievement goal orientation and depression in medical students. A total of 1,015 Chinese 2-year medical students completed a multi-section questionnaire. Hypotheses were examined by structural equation modeling. The (...) findings suggest that performance-avoidance goal orientation and perceived stressors both demonstrated direct facilitative effects on depression, whereas stress-related cognition demonstrated direct obstructive effects on depression. Both perceived stressors and stress-related cognition mediated the relationship between achievement goal orientation and depression. The findings spark a new perspective on motivational intervention that assist students in adopting mastery-approaching strategy as well as ways of coping with stressful academic situations. Identifying students with achievement goal orientation and providing them with the appropriate supportive services may help them to manage stress and mitigate or prevent depression. (shrink)

The process of medicalization has been analyzed in the medical humanities with disapprobation, with much emphasis placed on its ability to reinforce existing social power structures to ill effect. While true, this is an incomplete picture of medicalization. I argue that medicalization can both reinforce and disrupt existing social hierarchies within the clinic and outside of it, to ill or good effect. We must attend to how this takes place locally and globally lest we misunderstand how medicalization mediates power (...) and justice. I provide concrete examples of how this occurs by considering dysesthesia ethiopsis, autism, chronic fatigue syndrome, depression, and HIV/AIDS. (shrink)

BackgroundThe pandemic of Coronavirus Disease 2019 has burdened an unprecedented psychological stress on the front-line medical staff, who are at high risk of depression. While existing studies and theories suggest that factors such as gratitude, social support, and hope play a role in the risk of depression, few studies have combined these factors to explore the relationship between them.ObjectiveThis study examined the mediating roles of social support and hope in the relationship between gratitude and depression among front-line medical (...) staff during the pandemic of COVID-19.MethodsThis study used the Gratitude Questionnaire, the Perceived Social Support Scale, the State Hope Scale, and the Center for Epidemiologic Studies Depression Scale to examine the gratitude, social support, hope, and depression among 344 front-line medical workers in Wuhan, which was the hardest-hit area of COVID-19 in China.ResultsThe results showed that the prevalence of mild depressive disorder was 40.12% and the prevalence of major depressive disorder was 9.59% among front-line medical staff during the pandemic of COVID-19; gratitude has a direct and negative effect on depression. Gratitude was negative predictors of depression through the mediating variables of social support and hope [βgratitude–social support–depression = −0.096, 95%CI; βgratitude–hope–depression = −0.034, 95%CI], as well as via an indirect path from social support to hope [βgratitude–social support–hope–depression = −0.089, 95%CI ].ConclusionThe study findings indicate that gratitude as a positive emotion can reduce depression in medical staff by promoting social support and hope, respectively. Gratitude also reduced depression in health care workers through a chain mediating effect of social support and hope. Overall, gratitude can directly foster social support and hope, and protect people from stress and depression, which has implications for clinical interventions among front-line medical staff during the pandemic of COVID-19. (shrink)

We examined the role of work-related emotions and personal resources operationalised as psychological capital (PsyCap) in the relationship between events occurring at work and employees’ work engagement. Using affective events theory and broaden-and-build theory as theoretical frameworks, we theorise that the perceived frequency of positive and negative events at work and work engagement is mediated by positive and negative work-related emotions and moderated by PsyCap. The results of path analysis on a sample of US and Polish employees (...) showed that PsyCap moderated the relationship between the perceived frequency of negative work events and negative work-related emotions, however, we also found culture-specific effects of PsyCap. Our study contributes to the human resource development (HRD) literature by providing evidence of the role of personal resources in the event–emotion–engagement process in the workplace. Also, our findings deepen the understanding of HR developers in multinational organisations and provide suggestions on how they can implement PsyCap trainings based on culture-specific work environment. (shrink)

A review of medical ethics literature relating to the importance of the participation of patients in decision-making introduces the role of rights-based mediation as a voluntary process now being developed innovatively in America. This is discussed in relation to the theory of communicative ethics and moral personhood. References are then made to the work of medical ethics committees and the role of mediation within these. Finally it is suggested that mediation is part of an eirenic ethic already being (...) used informally in good patient care, and that there is a case for developing it further. (shrink)

Stressful life events and subjective well-being are negatively related, but there is little research in the current literature exploring the mediating and moderating mechanisms underlying this association, especially for female adolescents in vocational schools who are subjected to undesirable life events. In the present study, we examined the mediating role of depression in the association between stressful life events and female adolescents’ subjective well-being, as well as the moderating role of perceived social support in the direct and (...) indirect relations involved. The participants were 1,096 vocational school female adolescents, who completed the questionnaires regarding stressful life events, subjective well-being, depression, and perceived social support. The results showed that depression partially mediated the relation between stressful life events and subjective well-being. Importantly, perceived social support moderated the direct link between stressful life events and subjective well-being, and the indirect link between stressful life events and depression, but not the indirect link between depression and subjective well-being. Especially, female adolescents high in perceived social support displayed higher levels of subjective well-being and lower levels of depression in facing with stressful life events than those low in perceived social support. These findings highlight the mechanisms underlying the relationship between stressful life events and subjective well-being in vocational school female adolescents. (shrink)

BackgroundProphylactic Bilateral Salpingo-Oophorectomy reduces the risk of developing ovarian cancer. However, the psychological mechanisms that may affect post-surgery Quality of Life among patients who underwent PBSO are still largely unknown. Thus, this study aimed at exploring the direct and indirect associations of satisfaction with medical communication and cancer anxiety on post-surgery QoL among women at high risk of developing ovarian cancer.MethodFifty-nine women who underwent PBSO took part in this cross-sectional study, filling out a sociodemographic and clinical questionnaire, a battery (...) of validated psychological measures and an ad hoc developed scale for the assessment of cancer anxiety. We first examined the correlations among all variables of interest, and then tested if cancer anxiety mediated the association between satisfaction with medical communication and post-surgery psychological QoL, controlling both for time from surgery and education.ResultsPost-surgery psychological QoL was unrelated from any sociodemographic or clinical variable. Cancer anxiety had a significant direct negative effect on psychological QoL, while satisfaction with medical communication had a significant positive direct effect on it. Finally, cancer anxiety significantly mediated the association between satisfaction with medical communication and post-surgery psychological QoL.DiscussionResults suggest that post-surgery psychological QoL of patients who underwent PBSO may be increased with interventions, delivered in a genetic counselling setting, targeting quality of medical communication and cancer anxiety. (shrink)

Learning burnout is a pressing issue among Chinese medical undergraduates and Postgraduates and has drawn continuous attention worldwide. Studies have found that problematic smartphone use could affect learning burnout, but more research is needed in this direction. Furthermore, few studies focused on the mediating effect of psychological capital on the relationship between problematic smartphone use and learning burnout. The present study was a cross-sectional survey that recruited 1,800 participants from a medical university in Chongqing, China. A questionnaire based (...) on the Mobile Phone Addiction Tendency Scale, Psychological Capital Questionnaire, Learning Burnout Scale, and demographic variables were administered to these students, and 1,475 provided valid responses. 771 were undergraduates and 704 were postgraduates. Hierarchical regression and the bootstrap method were used to examine the mediating effect of psychological capital. After controlling for demographic variables, problematic smartphone use positively predicted learning burnout in undergraduates and in postgraduates. The partial mediating effect of psychological capital was 0.068 in undergraduates and 0.074 in postgraduates, accounting for 20.67 and 21.64%, respectively, of the total effect of problematic smartphone use on learning burnout. All the 95% confidence intervals did not contain 0. Problematic smartphone use can directly predict learning burnout and their relationship was mediated by psychological capital in Chinese medical undergraduates and postgraduates. Strategies to alleviating problematic smartphone use and enhance psychological capital in medical undergraduates and postgraduates may provide useful suggestions for future interventions on dealing with learning burnout in Chinese medical undergraduates and postgraduates. (shrink)

After experiencing the COVID-19 pandemic, the status and mechanisms of leadership, and the challenges for medical workers in terms of family–work conflicts, have caused widespread concern. In the post-pandemic era, based on role theory and the stressor-detachment model, this paper seeks to break the “black box” of negative effects that can be caused by leadership, research the mechanism and boundary conditions of those negative effects, and explore factors to reduce those negative effects. We recruited 1,010 Chinese medical workers (...) fighting COVID-19 on the frontline. Our study results showed that there was a significant negative correlation between empowering leadership and work–family conflict, and this relationship was completely mediated by role stress, while psychological detachment moderated the relationship between role stress and work–family conflict. Moreover, psychological detachment moderated the mediating effect of empowering leadership on work–family conflict through role stress. Therefore, higher levels of psychological detachment were less conducive to medical workers' family–work conflict. This study has important theoretical significance and practical value for revealing the negative effects and mechanisms of empowering leadership and for medical workers to better deal with work–family relations. (shrink)

A mass casualty (MASCAL) event is different to a major incident. The crux of this difference is that in a major incident, by the adoption of special measures, normal or near-normal standards of care can be maintained. In a MASCAL, irrespective of what special measures are instituted, standards of care inevitably drop. This is a, currently unmet, challenge for medical planning and planning policy. Twenty-First century weaponry is capable of producing thousands of causalities a day over a period of (...) several days in peer-on-peer conflict. In this chapter, we propose that medical planning for military events on this scale should include the following: explicit acceptance that ‘gold standard’ care cannot be given to patients who are triaged for treatment, a better understanding how to identify those patients who will not be triaged for treatment, a focus on ensuring patient flow (which includes diversion, self-care and remote monitoring), and implementation of the principle that care should be given by the lowest capable provider. We attempt to begin to develop some principles for planners to consider drawing on historical precedents and explore some of the ethical implications of our proposals. (shrink)

Patient safety has assumed a prominent role on the policy agenda since the Institute of Medicine report To Err Is Human was released in November 1999. The report maintained that medical error is the predominant mechanism by which patients in the United States and around the world are injured. This finding, along with the report’s recommendation for a “systems” approach to reducing medical error, provided an extremely important insight into the operation of our medical delivery system. Clearly, (...) while advances in medical technology, diagnostic techniques, and knowledge provide the foundation for saving lives, medical error has resulted in their loss. However, recognition that medical error is a primary cause of these avoidable patient injuries and deaths is a key one and may result in improvements within our system of health-care delivery as well as minimization of the emotional and financial toll that iatrogenic injury causes. (shrink)

Patient safety has assumed a prominent role on the policy agenda since the Institute of Medicine report To Err Is Human was released in November 1999. The report maintained that medical error is the predominant mechanism by which patients in the United States and around the world are injured. This finding, along with the report’s recommendation for a “systems” approach to reducing medical error, provided an extremely important insight into the operation of our medical delivery system. Clearly, (...) while advances in medical technology, diagnostic techniques, and knowledge provide the foundation for saving lives, medical error has resulted in their loss. However, recognition that medical error is a primary cause of these avoidable patient injuries and deaths is a key one and may result in improvements within our system of health-care delivery as well as minimization of the emotional and financial toll that iatrogenic injury causes. (shrink)

In this article, we explore alternative conflict resolution strategies to assist families and clinicians in cases of intractable dissent in paediatric health care decision-making. We focus on the ethical and legal landscape using cases from the Australian jurisdiction in New South Wales, while referencing some global sentinel cases. We highlight a range of alternative means of addressing conflict, including clinical ethics support, and contrast and contextualise facilitative or interest-based mediation, concluding that legal intervention via the courts can be protracted and (...) distressing and should be a ‘last resort’. We acknowledge many might view this as the current status quo, but we go further to recommend strategies optimal for all parties to recognise early signs of conflict and prevent its harmful escalation. While more empirical research is needed, we contend that interest-based mediation may be a valuable adjunctive method of conflict resolution. If judiciously distinguished from and utilised with clinical ethical support, it can be an effective tool to address dissent and its negative sequelae in paediatric healthcare decision-making. (shrink)

Why mediation? -- What makes bioethics mediation unique? -- Before you begin a bioethics mediation program -- The stages of bioethics mediation -- Techniques for mediating bioethics disputes -- How to write a bioethics mediation chart note -- Mediation with a competent patient : Mr. Samuels's case -- Mediation with a dysfunctional family : Mrs. Bates's case -- A complex mediation with a large and involved family : Mrs. Leonari's case -- Discharge planning for a dying patient : a role-play (...) -- An at-risk pregnancy : a role-play -- HIV and postsurgical complications in the ICU : a role-play -- Treating the dying adolescent : a role-play -- She didn't mean it : a role-play -- Don't tell mama : a role-play -- An at-risk pregnancy : a role-play transcript -- HIV and postsurgical complications in the ICU : a role-play transcript -- She didn't mean it: a role-play transcript -- Don't tell mama : a role-play transcript. (shrink)

Perceived trust is a key factor affecting the behavior to donate online. In order to further explore the factors and influencing mechanisms that affect the success of medical crowdfunding projects, this paper, combined with the Stimulus-Organism-Response theory, introduces the mediating variable of social presence and perceived differences in trust, and constructs a model of online users’ donation behavior to medical crowdfunding projects. We collected 437 valid samples through a questionnaire survey, and processed the data with SPSS and Amos (...) software to test and analyze the theoretical model. The research results showed that project description and user participation have a significant positive effect on social presence; project transparency and patient identity have a significant negative effect on perceived differences in trust; social presence has a positive effect on donation behavior, while the perceived difference in trust has a negative effect; social presence and perceived differences in trust play a mediating role respectively; there is no significant effect of patient status on social presence. This study further expands the application of social presence and perceived differences in trust in medical crowdfunding, and provides a theoretical basis for the success of medical crowdfunding projects. (shrink)

The cognitive model for social anxiety disorder highlights the role of safety behaviors and post-event processing. We identify the serial mediating effect of state and trait PEP between three types of safety behaviors and social anxiety. Given that the associations between the three subtypes of safety behaviors and two perspectives of PEP have not yet been examined, we aimed to investigate these relationships according to the level of social anxiety. A total of 487 participants participated in an online survey. Participants (...) were classified into two groups, high and low, based on their social anxiety scores. We used Social Behavior Questionnaire to distinguish three types of safety behaviors and the State and Trait versions of the Post-Event Processing Inventory to identify two perspectives of PEP. We used descriptive statistics and an independent t-test to compare the high and low social anxiety groups. Mediation effects were examined using mediation analysis and bootstrapping with 5,000 replications. The results showed that the three safety behaviors had different effects on social anxiety via PEP. In the high social anxiety group, avoidance behavior and anxiety-symptom control predicted social anxiety positively, whereas impression management did not. However, with state PEP and trait PEP as mediators, impression management and avoidance behavior positively predicted social anxiety but not anxiety-symptom control. In the low social anxiety group, only avoidance behavior was significantly related to social anxiety, but when the state and trait PEP were mediated, the effect disappeared. These results indicated that impression management could affect social anxiety only when mediated by PEP in people with high social anxiety. A better understanding of the content and processes underpinning safety behavior and PEPs might have important implications for the prevention and treatment of social anxiety disorder. (shrink)

Learning burnout is an important indicator that reflects an individual’s learning state. Understanding the influencing factors and mechanism of learning burnout of medical students has practical significance for improving their mental health. This study aimed to explore the mediating roles of school identity and collective self-esteem between school psychological environment and learning burnout in medical students. A total of 2,031 medical students were surveyed using the School Psychological Environment Questionnaire, School Identity Questionnaire, Collective Self-esteem Scale, and Learning (...) Burnout Scale. The results showed the following: school psychological environment had a negative effect on learning burnout among medical students, and school identity and collective self-esteem played significant mediating roles between school psychological environment and learning burnout [95% CI = ]. Specifically, there were three paths that school psychological environment and learning burnout: first, through the independent mediating role of school identity; second, through the independent mediating role of collective self-esteem; and third, through the chain mediating roles of school identity and collective self-esteem. The findings reveal that school psychological environment not only directly influences the learning burnout of medical students but also indirectly influences it through school identity and collective self-esteem. Thus, this study has some important implications for prevention and intervention of learning burnout among medical students. (shrink)

Empirical research has shown that maladaptive perfectionism may lead to lower life satisfaction. However, the relationship between maladaptive perfectionism and life satisfaction among medical students and the mechanism underlying this relationship still need to be further explored. The present study used a large sample of undergraduate medical students to examine the associations between maladaptive perfectionism and life satisfaction and to explore the mechanism underlying the associations. Specifically, the present study tried to probe the mediating role of academic burnout (...) and the moderating role of self-esteem in the relationship between maladaptive perfectionism and life satisfaction in medical students. We invited 1628 undergraduate medical students from two medical universities in Northeastern China to participate in the survey. Among the students recruited, 1377 medical students completed questionnaires including the Frost Multidimensional Perfectionism Scale maladaptive perfectionism subscales, the Chinese College Student Academic Burnout Inventory, the Satisfaction With Life Scale, the Rosenberg Self-Esteem Scale and demographic information. Results show that maladaptive perfectionism was significantly negatively related to life satisfaction among medical students and academic burnout played a significant mediating role in this relationship. Moderated mediation analyses reveal that the mediating effect of maladaptive perfectionism on life satisfaction via academic burnout was moderated by self-esteem. Maladaptive perfectionism exerted a stronger effect on life satisfaction via the mediating role of academic burnout for medical students with high self-esteem [β = −0.026, SE = 0.009, 95%CI = ] than for medical students with low self-esteem [β = −0.019, SE = 0.009, 95%CI = ]. Medical institutions can implement effective interventions to decrease medical students’ maladaptive perfectionism levels and academic burnout levels, and increase their self-esteem levels in order to enhance their life satisfaction. (shrink)

ABSTRACTThe pragmatist reform and opening-up in 1978 has revolutionised the way China communicates internally and engages with the outside world. Firmly embedded within this broader historical context, the interpreter-mediated and televised Premier-Meets-the-Press conferences are a high-profile institutional event in China. At this discursive event, the Chinese premier – ranked second in China’s political hierarchy – is put in the international media limelight, answering journalists’ questions on a range of topics. The section involving the interpreters’ rendering of journalists’ questions is triadic (...) and dynamic and represents a particularly interesting site of ideological contestation, which can be conceptualised profitably using Bakhtin’s concept dialogised heteroglossia. Drawing on a corpus containing 20 years’ press conference data between 1998 and 2017, this CDA study interrogates the interpreters’ agency, particularly in constructing the Chinese government’s image when rendering journalists’ questions. Despite the commonplace assumptions of interpreters being impartial with little agency, the government-affiliated interpreters are found to actively engage in facework and image construction. This leads to a discursive pattern described in Van Dijk’s ideological square, which involves further emphasising and foregrounding the positive elements yet de-emphasising and mitigating the negative elements about Beijing. (shrink)